SARS-CoV-2 Antibodies in Breast Milk After Vaccination
CONCLUSIONSWe found a clear association between COVID-19 vaccination and specific immunoglobulin concentrations in HM. This effect was more pronounced when lactation periods exceeded 23 months. The influence of the lactation period on immunoglobulins was specific and independent of other variables. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Deaths in Children and Adolescents Associated With COVID-19 and MIS-C in the United States
CONCLUSIONSSARS-CoV-2-associated deaths among persons<21 years of age occurred predominantly among Black (non-Hispanic) and Hispanic persons, male patients, and older adolescents. The most commonly reported underlying conditions were obesity, asthma, and developmental disorders. Decedents with coronavirus disease 2019 were more likely than those with MIS-C to have underlying medical conditions. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Pediatric Poisoning Fatalities: Beyond Cough and Cold Medications
For more than 10 years, there have been Food and Drug Administration recommendations and manufacturer labeling changes in place advising against the use of cough and cold medications (CCMs) in young children.1,2 In this issue ofPediatrics, Halmo et al3 present concerning findings characterizing fatalities associated with CCMs in recent years. Identifying cases through the Pediatric Cough and Cold Safety Surveillance System and then using an expert panel for review, the authors report 40 CCM-related fatalities in children under 12 years old that occurred from 2008 to 2016. Although overall fatalities associated with CCMs ...
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Parents as Advocates for Pediatric Palliative Care
Caring for a child with a serious or life-limiting illness presents many challenges for families and health care providers. Through that experience (and, many times, as it ends), parents are compelled to find and make meaning from their ultimate loss and the many losses along the way. In this Advocacy Case Study, we describe the experiences that led a bereaved mother to seek to harness the insights from her own family ’s loss to help support other families facing the challenges and complexities of a child’s serious illness. Her family initially established a family foundation to advocate for palliative care. She later ...
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Advances in Neonatal Acute Kidney Injury
In this state-of-the-art review, we highlight the major advances over the last 5 years in neonatal acute kidney injury (AKI). Large multicenter studies reveal that neonatal AKI is common and independently associated with increased morbidity and mortality. The natural course of neonatal AKI, along with the risk factors, mitigation strategies, and the role of AKI on short- and long-term outcomes, is becoming clearer. Specific progress has been made in identifying potential preventive strategies for AKI, such as the use of caffeine in premature neonates, theophylline in neonates with hypoxic-ischemic encephalopathy, and nephr...
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Update on Phototherapy and Childhood Cancer in a Northern California Cohort
CONCLUSIONSWe did not confirm previous, concerning associations between phototherapy and adjusted risk of any cancer, nonlymphocytic leukemia, or brain and/or central nervous systems tumors in later childhood. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Corticosteroids for Acute Orbital Cellulitis
CONCLUSIONSIn this database query, we were not able to detect a reduction in LOS associated with corticosteroid exposure during hospitalization for orbital cellulitis. Corticosteroid prescription was associated with PICU admission and operative episodes after 2 days of hospitalization. Before the adoption of routine corticosteroid use, prospective, randomized control trials are needed. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Multisystem Autoimmune Inflammatory Disease, Including Colitis, Due to Inborn Error of Immunity
In conclusion, a clinical history of recurrent infections, atypical histologic features of inflammatory bowel disease, additional autoimmune manifestations, and an inadequate response to conventional therapy should prompt the physician to refer to an immunologist with the query of inborn error of immunity. We report how extensive immune evaluation and genetic diagnosis can individualize care and facilitate a multidisciplinary team approach. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Sexuality Among Adolescents With Intellectual Disability: Balancing Autonomy and Protection
We present a case of a young adult with moderate ID who is engaging in a sexual relationship with her boyfriend without parental knowledge. The pediatrician must decide the most appropriate course of action to support the patient ’s autonomy but also ensure that the patient is a willing participant and understands the risks of engaging in sexual activity. This case highlights 4 main themes: (1) practical concerns when approaching sexual health in the adolescent with ID, (2) advocating for the rights of those with ID to liv e life to the fullest, (3) the critical inclusion of individuals with ID in decisions directly affe...
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Variation of Patent Ductus Arteriosus Treatment in Very Low Birth Weight Infants
CONCLUSIONSPDA diagnosis and treatment rates are trending downward. Wide variation exists in PDA treatment despite a largely uniform VLBW infant population. This variation correlates with differences in hospital treatment capabilities and geography. Further understanding of the effects of treatment disparity could aid in guiding clinical management. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Explanatory Diagnoses Following Hospitalization for a Brief Resolved Unexplained Event
CONCLUSIONSMost infants hospitalized with a BRUE did not receive an explanation during the hospitalization, and a majority of diagnoses were benign or self-limited conditions. More research is needed to identify which infants with a BRUE are most likely to benefit from hospitalization for determining the etiology of the event. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
State Spending on Public Benefit Programs and Child Maltreatment
CONCLUSIONSState spending on benefit programs was associated with reductions in child maltreatment, which might offset some benefit program costs. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Constraint-Induced Movement Therapy for Cerebral Palsy: A Randomized Trial
CONCLUSIONSCHAMP provides novel albeit complex findings: although most individual blinded outcomes fell below statistical significance for group differences, high-dose CIMT consistently produced the largest improvements at both time points. An unexpected finding concerns shifts in UCT toward higher dosages, with improved outcomes compared with previous reports. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Surfactant Nebulization to Prevent Intubation in Preterm Infants: A Systematic Review and Meta-analysis
CONCLUSIONSSN reduced the intubation rate in preterm infants with a higher efficacy for specific subgroups. There was no difference in relevant neonatal morbidities or mortality. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
Racial/Ethnic Differences in ED Opioid Prescriptions for Long Bone Fractures: Trends Over Time
Pain caused by long bone fractures is a common reason for opioid prescribing in the emergency department (ED) setting.1 Approximately 40% of opioid overdose deaths involve a prescription,2 and in response, opioid prescribing has declined in the last decade.3 We previously demonstrated racial and/or ethnic disparities in the ED management of pain among children with long bone fractures.4 We now perform this study to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have attenuated over time. (Source: PEDIATRICS)
Source: PEDIATRICS - November 1, 2021 Category: Pediatrics Source Type: research
