Care of Congenital Melanocytic Nevi in Newborns and Infants: Review and Management Recommendations
A pediatric dermatology expert working group performed a narrative review to describe care related to congenital melanocytic nevi (CMN) in neonates and infants. There are no published guidelines for most aspects of care, including routine skin care and visit intervals. Few guidelines exist for surgical management; newer recommendations favor conservative practice. Emerging evidence contributes to recommendations for screening MRI to evaluate for neural melanosis and related central nervous system complications, however, more research is needed. Risk for melanoma is generally low, but those with large, giant, or multiple CM...
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Perinatal Mental Health Task Force: Integrating Care Across a Pediatric Hospital Setting
Perinatal mood and anxiety disorders (PMADs) are the most common complication of childbirth, with suicide a leading cause of postpartum deaths. PMADs are associated with poor maternal, infant, and family outcomes. Identification and early intervention are imperative for successful treatment. This case study describes the implementation and outcomes of a multidisciplinary Perinatal Mental Health Task Force ( “Task Force”) at one urban academic children’s hospital that was created to promote systems change and health care policy solutions for improved identification and treatment of PMADs. Using the social ecological m...
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Antibiotic Use in Term and Near-Term Newborns
CONCLUSIONSDuring the study period, a substantial decrease in the proportion of newborns treated with antibiotics was observed together with a decline in treatment duration for newborns without culture-positive sepsis. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Mumps in Vaccinated Children and Adolescents: 2007 –2019
CONCLUSIONSSince 2007, one-third of US reported mumps cases occurred in children and adolescents, the majority of whom were vaccinated. Clinicians should suspect mumps in patients with parotitis or mumps complications, regardless of age, travel history, and vaccination status. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Rotavirus Vaccine Safety and Effectiveness in Infants With High-Risk Medical Conditions
CONCLUSIONSIn contrast to previous findings among healthy term infants, in routine use, HRV offered limited protection to vulnerable medical risk infants. HRV is generally well tolerated in this group in single administration, but when coadministered with routine vaccines, it is associated with higher risk of (mostly gastrointestinal) AE. Our study highlights the importance of studying vaccine performance in subgroups of medically vulnerable infants. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Gestational Age and Neonatal Electrocardiograms
CONCLUSIONSGA was associated with significant differences in multiple neonatal ECG parameters. The association generally persisted after multifactorial adjustment, indicating a direct effect of GA on the developing neonatal cardiac conduction system. For HR, the QRS axis, and R-V1, the use of GA-specific reference values may optimize clinical handling of neonates. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Promoting the Participation of Children and Adolescents With Disabilities in Sports, Recreation, and Physical Activity
The benefits of physical activity are likely universal for all children, including children and adolescents with disabilities (CWD). The participation of CWD in physical activity, including adaptive or therapeutic sports and recreation, promotes inclusion, minimizes deconditioning, optimizes physical functioning, improves mental health as well as academic achievement, and enhances overall well-being. Despite these benefits, CWD face barriers to participation and have lower levels of fitness, reduced rates of participation, and a higher prevalence of overweight and obesity compared with typically developing peers. Pediatric...
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Tuberculosis Infection in Children and Adolescents: Testing and Treatment
Tuberculosis (TB) remains an important problem among children in the United States and throughout the world. There is no diagnostic reference standard for latent tuberculosis infection (also referred to as tuberculosis infection [TBI]). The tuberculin skin test (TST) has many limitations, including difficulty in administration and interpretation, the need for a return visit by the patient, and false-positive results caused by cross-reaction with Mycobacterium bovis –bacille Calmette-Guerin vaccines and many nontuberculous mycobacteria. Interferon-gamma release assays (IGRAs) are blood tests that use antigens specific for...
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
COVID-19 –Associated Orphanhood and Caregiver Death in the United States
CONCLUSIONSWe found substantial disparities in distributions of COVID-19 –associated death of parents and caregivers across racial and ethnic groups. Children losing caregivers to COVID-19 need care and safe, stable, and nurturing families with economic support, quality child care, and evidence-based parenting support programs. There is an urgent need to mount an evide nce-based comprehensive response focused on those children at greatest risk in the states most affected. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Parenthood, Parental Benefits, and Career Goals Among Pediatric Residents: 2008 and 2019
CONCLUSIONSResidents are less likely to report availability of parental benefits during residency training in 2019. Most residents, both those with children and those without, consider parent friendly characteristics important in post-training positions. Parenthood does not correlate with subspecialty career goals independent from gender. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Maximizing Benefits and Minimizing Harms: Diagnostic Uncertainty Arising From Newborn Screening
Screening newborns for rare diseases for which effective treatments are available is a crucial public health practice. Indeed, the expansion of population-wide newborn screening (NBS) programs was named by the Centers for Disease Control and Prevention as 1 of the 10 great public health achievements in the first 10 years of the 21st century.1 Pivotal randomized controlled trials of NBS for cystic fibrosis (CF) revealed potential benefits,2,3 with evidence from the Wisconsin trial revealing that early ascertainment through screening could prevent severe malnutrition and improve long-term growth.2 NBS for CF is now widely im...
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Child Care Center Hand Hygiene Programs ’ Cost-Effectiveness in Preventing Respiratory Infections
CONCLUSIONSHand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents are more effective and cost less than a program with soap and water and initial observation in children attending DCCs. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
IVIG Compared With IVIG Plus Infliximab in Multisystem Inflammatory Syndrome in Children
CONCLUSIONSPatients with MIS-C initially treated with IVIG plus infliximab compared with those treated with IVIG alone were less likely to require additional therapy and had decreased ICU length of stay, decreased development of left ventricular dysfunction, and more rapid decline in C-reactive protein levels. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Adverse Childhood Experiences and Foster Care Placement Stability
CONCLUSIONSFindings from this study, in conjunction with previous research on ACEs and foster care, highlight the need to proactively address ACEs and trauma exposure at foster care entry. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
Nonmedical Opioid Use After Short-term Therapeutic Exposure in Children: A Systematic Review
CONCLUSIONSSome studies suggest an association between lifetime therapeutic opioid use and nonmedical opioid use. Given the lack of clear evidence regarding short-term therapeutic exposure, health care providers should carefully evaluate pain management options and educate patients and caregivers about safe, judicious, and appropriate use of opioids and potential signs of misuse. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2021 Category: Pediatrics Source Type: research
