Journal of Pediatrics最新文献

{"title":"The Cross-Sectional Relation of Body Mass Index to Adiposity among 8- to 19-Year-Olds within Several Races and Ethnicities","authors":"David S. Freedman PhD ,&nbsp;Babette S. Zemel PhD ,&nbsp;David R. Weber MD ,&nbsp;William H. Dietz MD, PhD","doi":"10.1016/j.jpeds.2024.114375","DOIUrl":"10.1016/j.jpeds.2024.114375","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the screening ability of a high body mass index (BMI) for high adiposity among 8- to 19-year-olds.</div></div><div><h3>Study design</h3><div>This cross-sectional study included 6454 National Health and Nutrition Survey participants from 2011 through 2018. Fat and lean mass were measured with dual-energy X-ray absorptiometry. We expressed adiposity as fat mass index (FMI, kg ÷ m²) and %fat.</div></div><div><h3>Results</h3><div>Based on the Centers for Disease Control and Prevention 95th percentile, a high BMI correctly classified a high FMI for about 95% of participants in each racial and ethnic group. About 81% (Blacks) to 90% (Hispanics) of participants with a high BMI also had a high FMI. Further, children with a high BMI were 17 (Hispanics) to 46 (Blacks) times more likely to have a high FMI than those with a “normal” BMI. The screening ability of high BMI for high %fat was weaker because levels of %fat are influenced by both fat mass (numerator) and lean mass (denominator).</div></div><div><h3>Conclusions</h3><div>Despite differences in body composition, a high BMI is a very good screening tool for identifying high FMI not only among White 8- to 19-year-olds but also among Asians, Blacks, and Hispanics. Compared with %fat, FMI is likely a better adiposity metric among children and adolescents.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114375"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0022-3476(24)00415-3","DOIUrl":"10.1016/S0022-3476(24)00415-3","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"274 ","pages":"Article 114312"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substantiating the Need for Need for NICU “Follow Through”","authors":"Raye-Ann deRegnier MD","doi":"10.1016/j.jpeds.2024.114297","DOIUrl":"10.1016/j.jpeds.2024.114297","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"274 ","pages":"Article 114297"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Go Where the Money is in Antibiotic Stewardship – The Outpatient Clinics","authors":"Sarah S. Long MD","doi":"10.1016/j.jpeds.2024.114296","DOIUrl":"10.1016/j.jpeds.2024.114296","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"274 ","pages":"Article 114296"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Childhood Experiences and Socioemotional Outcomes of Children Born Very Preterm","authors":"Callie L. Bishop MD ,&nbsp;Rachel E. Lean PhD ,&nbsp;Tara A. Smyser MSE ,&nbsp;Christopher D. Smyser MD ,&nbsp;Cynthia E. Rogers MD","doi":"10.1016/j.jpeds.2024.114377","DOIUrl":"10.1016/j.jpeds.2024.114377","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether adverse childhood experiences (ACEs) confer risk for socioemotional problems in children born very preterm (VPT).</div></div><div><h3>Study design</h3><div>As part of a longitudinal study, 96 infants born VPT at 23-30 weeks of gestation were recruited from a level III neonatal intensive care unit and underwent follow-up at ages 2 and 5 years. Eighty-three full-term (FT) (37-41 weeks gestation) children were recruited from an adjoining obstetric service and the local community. ACEs were assessed with the Child Life Events Scale at age 2 and Preschool Age Psychiatric Assessment at age 5. At age 5, internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms were assessed with the Child Behavior Checklist and Conner's Rating Scale-Revised, respectively. Covariates including socioeconomic disadvantage, maternal distress, and parent ADHD symptoms were assessed at the 2- and/or 5-year follow-up. Mediation and moderation analysis, accounting for family clustering, examined associations between birth group, ACEs, and socioemotional outcomes.</div></div><div><h3>Results</h3><div>After covariate adjustment, children born VPT experienced more ACEs (<em>P</em> &lt; .001), particularly medical ACEs (<em>P</em> &lt; .01), and had worse ADHD and internalizing outcomes (<em>P</em> &lt; .05) than full-term children. ACEs mediated the association between birth group and ADHD outcomes (95% CI, 0.11-4.08). There was no evidence of mediation for internalizing outcomes. Higher parent ADHD symptoms (<em>P</em> &lt; .001) and maternal distress (<em>P</em> &lt; .05) were associated with poorer internalizing outcomes.</div></div><div><h3>Conclusions</h3><div>Screening for childhood ACEs should be embedded in the follow-up care of children born VPT and their families. Strategies to screen for and address parent psychosocial functioning may be important to support children's socioemotional development.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"276 ","pages":"Article 114377"},"PeriodicalIF":3.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Acute Lymphangitis Manifesting as Skip Skin Lesions","authors":"Daisuke Matsubara MD,&nbsp;Megumi Akutsu MD,&nbsp;Tomoyuki Ota MD","doi":"10.1016/j.jpeds.2024.114373","DOIUrl":"10.1016/j.jpeds.2024.114373","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"276 ","pages":"Article 114373"},"PeriodicalIF":3.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 Pandemic Interventions on Sudden Unexpected Death in Infancy Incidence in France","authors":"Pauline Scherdel PhD ,&nbsp;Adeline Ricard MD ,&nbsp;Christèle Gras-le Guen MD, PhD ,&nbsp;Bérengère Jarry RN ,&nbsp;Léa Ferrand MSc ,&nbsp;Karine Levieux MD ,&nbsp;Naïm Ouldali MD ,&nbsp;Sophie de Visme MSc ,&nbsp;Camille Aupiais MD, PhD","doi":"10.1016/j.jpeds.2024.114369","DOIUrl":"10.1016/j.jpeds.2024.114369","url":null,"abstract":"<div><h3>Objective</h3><div>To study the impact of nonpharmaceutical interventions implemented during the COVID-19 pandemic on the monthly incidence of sudden unexpected death in infancy (SUDI) cases overall and those with a viral or bacterial identification.</div></div><div><h3>Study design</h3><div>We conducted an interrupted time-series analysis using seasonally adjusted Poisson regression models from the French national prospective and multicenter SUDI registry, that included all SUDI cases below the age of 1 year who died from 2016 to 2021 in mainland France.</div></div><div><h3>Results</h3><div>Of 998 SUDI cases analyzed, 750 were recorded during the prepandemic period (January 2016 through March 2020) and 248 during the NPI period (April 2020 through December 2021). We found a significant seasonal pattern of overall monthly SUDI incidence, with a peak observed periodically from November to February. The monthly SUDI incidence decreased significantly from the prepandemic to NPI periods (adjusted incidence rate ratio 0.83 [95% CI 0.72-0.96]). In particular, the monthly incidence of SUDI cases with a viral or bacterial identification decreased significantly, while no significant difference was found for SUDI cases without a viral or bacterial identification.</div></div><div><h3>Conclusions</h3><div>Nonpharmaceutical interventions were associated with a significant change in the incidence of SUDI cases with a viral or bacterial identification. Further investigations are needed to analyze the pathophysiologic role of viruses and bacteria in the SUDI.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114369"},"PeriodicalIF":3.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Values and Preferences Related to Surgical Decision-Making for Children with Medical Complexity","authors":"Jody L. Lin MD, MS ,&nbsp;Tsivya Devereaux MD ,&nbsp;Tamara D. Simon MD, MSPH ,&nbsp;Kimberly A. Kaphingst ScD ,&nbsp;Angela Zhu BA ,&nbsp;Unni Narayanan MBBS ,&nbsp;Andrew B.L. Berry PhD ,&nbsp;Kaleb G. Eppich MS ,&nbsp;Greg Stoddard PhD ,&nbsp;John T. Smith MD ,&nbsp;Lindsay Andras MD ,&nbsp;John Heflin MD ,&nbsp;Heather T. Keenan MDCM, PhD ,&nbsp;Steven M. Asch MD ,&nbsp;Angela Fagerlin PhD","doi":"10.1016/j.jpeds.2024.114366","DOIUrl":"10.1016/j.jpeds.2024.114366","url":null,"abstract":"<div><h3>Objective</h3><div>To uncover the values and preferences of the caregivers for children with medical complexity using the test case of surgical treatment decision-making for pediatric neuromuscular scoliosis that will inform the future development of a decision support tool in this population.</div></div><div><h3>Study design</h3><div>We conducted a qualitative study of semistructured interviews of English- and Spanish-speaking caregivers of children with neuromuscular scoliosis from 2 geographically distinct children's hospitals. We used purposive sampling of language and treatment options selected to capture diverse experiences. Analysis was on the basis of grounded theory with synthesized caregiver values and preferences themes.</div></div><div><h3>Results</h3><div>From 47 participants, we completed 41 interviews (9 in Spanish). Caregivers had a mean age of 43.2 years, were mostly White (66%), and had children with a mean age of 15.6. In total, 64% chose surgery. The following values and preferences were important to many caregivers: reducing scoliosis-related pain, minimizing mobility limitations to optimize socioemotional quality of life, limiting the impact of comorbidities on overall quality of life, information provided by peer support, the uncertainty of outcomes due to underlying comorbidities, and the uncertainty related to the anticipated progression of their child's scoliosis curve. Caregivers experienced immense uncertainty related to treatment outcomes due to their child's comorbidities.</div></div><div><h3>Conclusions</h3><div>Caregivers of children with medical complexity may benefit from decision support that includes both values clarification exercises to help caregivers identify what of the many possible values and preferences are important to them and novel methods to communicate uncertainty in the care of CMC.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"276 ","pages":"Article 114366"},"PeriodicalIF":3.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Allergy Specialty Care and Asthma Outcomes for Medicaid-Enrolled Children","authors":"Melanie Boyd MS ,&nbsp;Arina Eyimina MA ,&nbsp;Clare C. Brown PhD, MPH ,&nbsp;Anthony Goudie PhD ,&nbsp;Erhan Ararat MD ,&nbsp;Mandana Rezaeiahari PhD ,&nbsp;Tamara T. Perry MD ,&nbsp;J. Mick Tilford PhD ,&nbsp;Akilah A. Jefferson MD, MSc","doi":"10.1016/j.jpeds.2024.114361","DOIUrl":"10.1016/j.jpeds.2024.114361","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the comparative effectiveness of allergy specialist care for children with asthma enrolled in the Arkansas Medicaid program.</div></div><div><h3>Study design</h3><div>We used the Arkansas All-Payers Claims Database to identify Medicaid-enrolled children with asthma who had an allergy specialist visit in 2018. These children were propensity score matched to children without an allergy specialist visit to evaluate differences in asthma-related adverse events (AAEs), specifically emergency department visits and/or hospitalizations in 2019. Multivariable logistic regression was used to assess the association between allergy specialist care in 2018 and AAEs in 2019.</div></div><div><h3>Results</h3><div>Prior to matching, a higher percentage of children with an allergy specialist visit had persistent asthma, were atopic, and received influenza vaccination. In the matched sample, 10.1% of identified patients experienced an AAE in 2019. Adjusted analysis showed 21.0% lower odds of AAEs (aOR: 0.79; 95% CI: 0.63, 0.98) in 2019 for children with an allergy specialist visit (n = 2964) in 2018 compared with those without an allergy specialist visit (ME: 9.1% vs 11.0%; <em>P</em> = .04).</div></div><div><h3>Conclusions</h3><div>Children with asthma enrolled in Arkansas Medicaid who saw an allergy specialist were less likely to have an AAE. Asthma quality metrics developed using guideline-based recommendations for allergy specialist care should be considered for asthma health management programs.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114361"},"PeriodicalIF":3.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient Infant Botulism in the United States, 1976-2021","authors":"Jessica M. Khouri MD,&nbsp;Haydee A. Dabritz PhD,&nbsp;Jessica R. Payne MPH ,&nbsp;Jennifer S. Read MD,&nbsp;Connie H. Chung MPH","doi":"10.1016/j.jpeds.2024.114365","DOIUrl":"10.1016/j.jpeds.2024.114365","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize cases of outpatients with infant botulism (IB) in the US identified by the Infant Botulism Treatment and Prevention Program at the California Department of Public Health from 1976 through 2021.</div></div><div><h3>Study design</h3><div>Outpatient IB cases were defined as patients presenting with an illness consistent with the known paralyzing action of botulinum neurotoxin and with laboratory confirmation. Outpatient cases were distinguished from the majority of patients with IB by the atypical fact that they did not require hospitalization throughout the course of their illness.</div></div><div><h3>Results</h3><div>Of the 4372 cases of IB identified by the Infant Botulism Treatment and Prevention Program over a 45-year period (1976-2021), 17 (0.4%) were outpatient cases. Most (11/17; 65%) cases occurred in California. The median age at disease onset was 20 weeks (range = 6 to 55 weeks). The most common symptom among cases was constipation (16/17; 94%). Most patients (16/17; 94%) had at least one cranial nerve palsy, manifested as decreased head control, ptosis, weak cry, or poor suck.</div></div><div><h3>Conclusions</h3><div>Outpatient IB occurs nationwide, although clinical diagnosis may be difficult because the severity of symptoms do not necessitate hospitalization or more comprehensive clinical intervention. Identification of outpatient cases requires an astute clinician and a capable, willing diagnostic testing laboratory. It is likely that more outpatient cases of IB are occurring than are presently recognized in infants mildly affected by this disease. Healthcare providers should consider the possibility of IB when presented with a previously well infant with failure to thrive, poor feeding, constipation, mild hypotonia, or cranial nerve palsy.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"276 ","pages":"Article 114365"},"PeriodicalIF":3.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}