Journal of Pediatrics最新文献

{"title":"Characteristics of Fentanyl Toxicity in Very Young Children","authors":"Courtney Temple MD,&nbsp;Emma Cassidy MD,&nbsp;Robert G. Hendrickson MD","doi":"10.1016/j.jpeds.2024.114409","DOIUrl":"10.1016/j.jpeds.2024.114409","url":null,"abstract":"<div><div>Children exposed to illicit fentanyl often experience severe toxicity and receive repeated naloxone doses and prolonged airway support. This retrospective study presents the clinical course and management of 4 cases, emphasizing the urgent need for prompt recognition and intervention to address the severe, extended effects of illicit fentanyl exposure in very young children.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114409"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649545","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":"Step Up After Concussion","authors":"Paul G. Fisher MD","doi":"10.1016/j.jpeds.2025.114467","DOIUrl":"10.1016/j.jpeds.2025.114467","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114467"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147602","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)00554-7","DOIUrl":"10.1016/S0022-3476(24)00554-7","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114451"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147599","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":"One of the Most Common Diseases You May Never Have Heard About","authors":"Thomas R. Welch MD","doi":"10.1016/j.jpeds.2025.114468","DOIUrl":"10.1016/j.jpeds.2025.114468","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114468"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147603","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":"Assessing Early Severity of Hypoxic-Ischemic Encephalopathy: The Role of Electroencephalogram Background in Addition to Sarnat Exam","authors":"Marie-Coralie Cornet MD, PhD ,&nbsp;Adam L. Numis MD ,&nbsp;Sarah E. Monsell MS ,&nbsp;Natalie H. Chan MD, MPH ,&nbsp;Fernando F. Gonzalez MD ,&nbsp;Bryan A. Comstock MS ,&nbsp;Sandra E. Juul MD, PhD ,&nbsp;Courtney J. Wusthoff MD, MS ,&nbsp;Yvonne W. Wu MD, MPH ,&nbsp;Hannah C. Glass MDCM, MAS","doi":"10.1016/j.jpeds.2024.114411","DOIUrl":"10.1016/j.jpeds.2024.114411","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the relationship between the Sarnat exam, early electroencephalogram (EEG) background, and death or neurodevelopmental impairment (NDI) at age 2 years among neonates with moderate to severe hypoxic-ischemic encephalopathy treated with therapeutic hypothermia.</div></div><div><h3>Study design</h3><div>Neonates enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy trial with EEG (n = 463) or amplitude-integrated electroencephalogram (n = 15) reports available on the first day after birth were included in this cohort study. A Sarnat exam was performed between 1 and 6 hours after birth, and neonates were classified into 3 groups of increasing severity based on the number of severe features (none, 1-2, or 3+). EEG background continuity was extracted from reports and categorized as normal, excessively discontinuous, or severely abnormal. The primary outcome was severe NDI or death at age 2.</div></div><div><h3>Results</h3><div>Among 478 neonates with hypoxic-ischemic encephalopathy, EEG background continuity was normal in 186 (39%), excessively discontinuous in 171 (36%), and severely abnormal in 121 (25%). For each additional severe feature on the Sarnat exam, the risk of abnormal EEG background increased by 16% (relative risk 1.16 [95% CI 1.09-1.23]). Both the Sarnat exam and EEG background severity were associated with an increased risk of severe NDI or death. After adjusting for Sarnat exam severity, severe EEG background remained associated with severe NDI and death (relative risk 5.7 [95% CI 3.7-8.9]).</div></div><div><h3>Conclusions</h3><div>The early EEG background provides additional information beyond the Sarnat exam and could be an additional early marker when assessing the severity of HIE.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114411"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669438","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":"Longitudinal Analysis of Amplitude-Integrated Electroencephalography for Outcome Prediction in Infants with Hypoxic-Ischemic Encephalopathy: A Validation Study","authors":"Mathies Rondagh MD ,&nbsp;Linda S. de Vries MD, PhD ,&nbsp;Andrea van Steenis MD ,&nbsp;Unoke Meder MD ,&nbsp;Laszlo Szakacs MSc ,&nbsp;Agnes Jermendy MD, PhD, MPI ,&nbsp;Sylke J. Steggerda MD, PhD","doi":"10.1016/j.jpeds.2024.114407","DOIUrl":"10.1016/j.jpeds.2024.114407","url":null,"abstract":"<div><h3>Objectives</h3><div>To validate the prognostic accuracy of a previously published tool (HOPE calculator) using longitudinal analysis of amplitude-integrated electroencephalography (aEEG) background activity and sleep-wake cycling to predict favorable or adverse 2-year neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH), and to evaluate the predictive value for outcome at 5-8 years of age.</div></div><div><h3>Study design</h3><div>Single-center retrospective cohort study in 117 infants who underwent TH for HIE between 2008 and 2022. We scored 2-channel aEEG BGPs, sleep-wake cycling, and seizure activity at 6-hour intervals for 84 hours. Neurodevelopmental outcome at 2 years was evaluated using the Bayley Scales of Infant Development-III, defining adverse outcome as death, cerebral palsy, and/or cognitive/motor scores of &lt;85. Adverse outcome at 5-8 years was defined as a total IQ score of &lt;85, a Movement-ABC-2 score of less than p15, cerebral palsy, severe sensory impairment, or death.</div></div><div><h3>Results</h3><div>The prediction model showed an area under the curve of 0.90 (95% CI, 0.83-0.95) at 2 years and 0.83 (95% CI, 0.73-0.92) at 5-8 years. Mean predicted probability of favorable outcome was 74.5% (95% CI, 69.4-79.6) in the favorable outcome group compared with 32.8% (95% CI, 23.5-42.2) in the adverse outcome group (<em>P</em> &lt; .001) at 2 years (n = 115) and 76.85% (95% CI, 70.0-83.4) compared with 40.7% (95% CI, 30.0-51.4) at 5-8 years (n = 68).</div></div><div><h3>Conclusions</h3><div>Our study provided external validation of the HOPE calculator, assessing longitudinal aEEG background activity during TH in infants with HIE. The results suggest that this method can predict favorable or adverse outcomes accurately not only at 2 but also at 5-8 years of age.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114407"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649547","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":"Early Young Adult Death Underscores the Need for Adolescent and Young Adult Transition Programs in Neurofibromatosis Type 1","authors":"Tina Tarnawsky MD ,&nbsp;Inez Y. Oh PhD ,&nbsp;Ethan Hillis MS ,&nbsp;Aditi Gupta PhD ,&nbsp;David H. Gutmann MD, PhD","doi":"10.1016/j.jpeds.2024.114413","DOIUrl":"10.1016/j.jpeds.2024.114413","url":null,"abstract":"<div><div>There are few centers with combined pediatric and adult neurofibromatosis 1 practices and transition of care programming. Using an electronic health records-based approach, we found an early death peak in the fourth decade of life largely owing to malignancy, underscoring the need for integrated neurological training and practice across the lifespan.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114413"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669398","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":"Reply to Why the Negative? A Reflective Analysis on the Impact of Weekly Vitamin D Supplementation on Acute Respiratory Infections in Young Children","authors":"María Loreto Reyes MD,&nbsp;Cecilia Vizcaya MD,&nbsp;Catalina Le Roy MD,&nbsp;Carlos A. Camargo Jr MD, DrPH,&nbsp;Arturo Borzutzky MD","doi":"10.1016/j.jpeds.2024.114418","DOIUrl":"10.1016/j.jpeds.2024.114418","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114418"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695317","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":"Outcomes of Patent Ductus Arteriosus Closure by Availability of Cardiac Surgeons for Infants Born Preterm","authors":"Tomohiro Takeda MD ,&nbsp;Tetsuya Isayama MD, MSc, PhD ,&nbsp;Tohru Kobayashi MD, PhD ,&nbsp;Shoichiro Amari MD ,&nbsp;Atsushi Nakao MD ,&nbsp;Katsuaki Toyoshima MD ,&nbsp;Satoshi Masutani MD ,&nbsp;PLASE (Patent Ductus Arteriosus and Left Atrial Size Evaluation in Preterm Infants) Study Group Investigators","doi":"10.1016/j.jpeds.2025.114492","DOIUrl":"10.1016/j.jpeds.2025.114492","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the treatment strategies for closure of patent ductus arteriosus (PDA) and clinical outcomes among very preterm infants based upon the availability of cardiac surgeons in neonatal intensive care units (NICUs).</div></div><div><h3>Study design</h3><div>This study retrospectively assessed infants born at 23-29 weeks of gestation who participated in a prior prospective cohort study in Japan. The primary outcome was PDA surgery. The secondary outcomes included mortality and various morbidities, such as intraventricular hemorrhage and chronic lung disease (CLD). Outcomes were compared between with-surgeon and no-surgeon NICUs using generalized linear mixed effect models, adjusted for gestational age, antenatal corticosteroid, small-for-gestational age, and unit patient volume.</div></div><div><h3>Results</h3><div>This study included 613 infants from 27 NICUs, including 245 from 9 no-surgeon NICUs and 368 from 18 with-surgeon NICUs. Infants received significantly more prophylactic indomethacin in the no-surgeon NICUs than those in the with-surgeon NICUs. The frequency of PDA surgery showed no significant difference between the groups (9.0% vs 12%, adjusted odds ratio [aOR]: 0.56 [95% confidence interval: 0.21-1.51]). CLD was significantly more frequent in no-surgeon NICUs than in with-surgeon NICUs (55% vs 40%, aOR: 3.24 [95% CI 1.45-7.29]).</div></div><div><h3>Conclusions</h3><div>The frequency of PDA surgery did not differ significantly according to the availability of surgeons. The incidence of CLD was higher in no-surgeon NICUs; however, the risk of unmeasured confounding cannot be excluded due to the observational study design.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"280 ","pages":"Article 114492"},"PeriodicalIF":3.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076515","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":"Weight Trajectories among Children with Down Syndrome: A Retrospective Study","authors":"Haley J. Killian PhD ,&nbsp;Bethany Forseth PhD ,&nbsp;Dana M. Bakula PhD ,&nbsp;Lauren Ptomey PhD ,&nbsp;Earl Glynn MS ,&nbsp;Hung-Wen Yeh PhD, MS ,&nbsp;Ann M. Davis PhD, MPH ,&nbsp;Meredith Dreyer Gillette PhD","doi":"10.1016/j.jpeds.2025.114491","DOIUrl":"10.1016/j.jpeds.2025.114491","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate body mass index trajectories over time and to evaluate common comorbidities across a large, nationally representative sample of youth with Down syndrome (DS).</div></div><div><h3>Study design</h3><div>This retrospective study included children ages 2-18 years within the Cerner Health Facts database with a diagnosis of DS and a medical visit between 2010 and 2017. Comorbid conditions were mapped into PheCodes (ie, ≥1 <em>International Classification of Diseases</em> codes that combine into specific diseases or traits) and were included if they occurred in ≥1% (145 PheCodes) of the sample.</div></div><div><h3>Results</h3><div>Outcomes trajectories were analyzed through generalized additive mixed models. Estimated modified body mass index <em>z</em>-scores showed a general trend of nonlinear increasing weight by age, specifically an increase from age 2 through 5 years, then stabilization until age 10, thereafter increasing again. When comorbidities were included, some were associated with lower rates of weight gain, whereas others were associated with higher rates of weight gain.</div></div><div><h3>Conclusions</h3><div>This study showed rapid weight gain in early years and early adolescence for youth with DS. This pattern of weight gain is consistent with same-age peers; however, youth with DS have difficulty recovering after these periods owing to several factors, such as not having the same height gain. Given these patterns, intervention and prevention should target periods of time when recovery is difficult.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"280 ","pages":"Article 114491"},"PeriodicalIF":3.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069278","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}