A 14-Year-Old Boy With Neck Pain, Fevers, and Diffuse Erythematous Rash
A previously healthy 14-year-old boy developed right-sided neck pain, tachycardia, a diffuse erythematous rash, and subjective fevers over 2 days. He sought medical attention in a local urgent care clinic, where he had a negative Sars-CoV-2 antigen test and was referred to the local emergency department (ED) for persistent tachycardia and further workup. After fluid resuscitation, his tachycardia was not improved, so he was admitted to the Pediatric Hospital Medicine Service. Physical examination showed large areas of erythema and erythroderma of multiple body sites, perioral sparing, increased erythema in flexor skin fold...
Source: PEDIATRICS - September 23, 2022 Category: Pediatrics Source Type: research
Farm to Families: Clinic-based Produce Provision to Address Food Insecurity During the Pandemic
10.1542/6308709247112Video AbstractPEDS-VA_2022-0571186308709247112With rising rates of food insecurity (FI) during the pandemic, we implemented a clinic-based, community-supported agriculture program at 2 outpatient centers in low-income areas associated with an urban children ’s hospital and evaluated (1) the program’s ability to reach FI families without preceding eligibility criteria, and (2) caregiver experiences and preferences for programming. Free boxes of produce were distributed weekly to caregivers of pediatric patients during a 12 week pilot period. Ability to reach the target population was measured by num...
Source: PEDIATRICS - September 22, 2022 Category: Pediatrics Source Type: research
Preterm Infant Outcomes at 24 Months After Clinician-Supported Web-Based Intervention
CONCLUSIONSThis study provides preliminary evidence that a clinician-supported, web-based early intervention program for preterm infants had a positive effect on the parent –child relationship and maternal mental health immediately after the intervention but potentially little effect on child development. (Source: PEDIATRICS)
Source: PEDIATRICS - September 22, 2022 Category: Pediatrics Source Type: research
Maternal Depressive Symptoms and Adolescents ’ Unhealthy Behavior: A 15-year Longitudinal Study
CONCLUSIONSMaternal depressive symptoms are associated with the number of adolescent unhealthy behaviors, both directly and indirectly. Promoting mothers ’ mental health can be crucial for promoting children’s health behaviors and health. (Source: PEDIATRICS)
Source: PEDIATRICS - September 21, 2022 Category: Pediatrics Source Type: research
Improving HPV Vaccination Rates in a Racially and Ethnically Diverse Pediatric Population
CONCLUSIONSA multilevel intervention was associated with sustained HPV vaccine series completion by age 13 years. Hispanic children were more likely to be vaccinated. Qualitative family input was critical to intervention design. Provider communication training addressed vaccine hesitancy. Initiation of the vaccine at age 9 and clinicwide vaccine protocols were key to sustaining improvements. (Source: PEDIATRICS)
Source: PEDIATRICS - September 21, 2022 Category: Pediatrics Source Type: research
Health Care Use Prior to Diabetes Diagnosis in Children Before and During COVID
During COVID-19, health care systems reorganized with less ambulatory care and a shift to virtual care.1 There was an increase in diabetic ketoacidosis (DKA), a preventable, life-threatening condition, at diabetes onset in children during COVID-19.2 DKA at diabetes onset has been attributed to delays in seeking care, missed diagnosis, or delays in referral after a primary health care contact.3 Reasons for the recent increase in DKA may relate to hesitancy to seek care, providers failing to recognize diabetes symptoms because of cognitive bias focusing on COVID-19, or limitations of virtual care. To explore these potential ...
Source: PEDIATRICS - September 20, 2022 Category: Pediatrics Source Type: research
The Weight of Restraints
The following is the winning submission from the sixth annual Section on Pediatric Trainees essay competition. This year ’s competition was informed by the 2021–2022 Section on Pediatric Trainees Advocacy Campaign: “Rx Against Racism,” which encouraged trainees to focus on racism as a public health crisis, with the goal of improving health equity for their patients, training programs, neighborhoods, and broade r communities. In titling the essay competition “Beyond Bearing Witness,” we asked writers to reflect not only on the effects of systemic racism on children, but also on how pediatricians can address thes...
Source: PEDIATRICS - September 20, 2022 Category: Pediatrics Source Type: research
Immunization Information Systems
Immunization (IZ) information systems (IISs) are confidential, computerized, population-based systems that collect and consolidate IZ data from vaccination providers. The American Academy of Pediatrics continues to support the development and implementation of IISs as a beneficial tool to provide quality health care for children. Since the last revision of the American Academy of Pediatrics policy statement on IISs in 2006, numerous public health events and new data demonstrate the importance and value of these systems in society and expand the functionality and benefits of IISs beyond the basic IZ database intended to imp...
Source: PEDIATRICS - September 19, 2022 Category: Pediatrics Source Type: research
Evaluating for Suspected Child Abuse: Conditions That Predispose to Bleeding
Child abuse might be suspected when children present with cutaneous bruising, intracranial hemorrhage, or other manifestations of bleeding. In these cases, it is necessary to consider medical conditions that predispose to easy bleeding or bruising. When evaluating for the possibility of bleeding disorders and other conditions that predispose to hemorrhage, it is important for pediatricians to consider the child ’s presenting history, medical history, and physical examination findings before initiating a laboratory investigation. Many medical conditions can predispose to easy bleeding. Before ordering laboratory tests for...
Source: PEDIATRICS - September 19, 2022 Category: Pediatrics Source Type: research
Eviction and Household Health and Hardships in Families With Very Young Children
CONCLUSIONSDemonstrated associations between eviction and health and hardships support broad initiatives, such as housing-specific policies, income-focused benefits, and social determinants of health screening and community connections in health care settings. Such multifaceted efforts may decrease formal and informal eviction incidence and mitigate potential harmful associations for very young children and their families. (Source: PEDIATRICS)
Source: PEDIATRICS - September 19, 2022 Category: Pediatrics Source Type: research
Evaluation for Bleeding Disorders in Suspected Child Abuse
Bruising or bleeding in a child can raise the concern for child abuse. Assessing whether the findings are the result of trauma and/or whether the child has a bleeding disorder is critical. Many bleeding disorders are rare, and not every child with bruising/bleeding that may raise a concern for abuse requires an evaluation for bleeding disorders. However, in some instances, bleeding disorders can present in a manner similar to child abuse. Bleeding disorders cannot be ruled out solely on the basis of patient and family history, no matter how extensive. The history and clinical evaluation can be used to determine the necessi...
Source: PEDIATRICS - September 19, 2022 Category: Pediatrics Source Type: research
Global Perspectives on the Health and Social Impacts of Child Trafficking
CONCLUSIONSThe HSDF is a highly applicable framework within which to evaluate stigmatization of CST survivors. This study suggests the utility of stigma-based public health interventions for CST and provides a global understanding of the influence and dynamics of stigmatization unique to CST survivors. (Source: PEDIATRICS)
Source: PEDIATRICS - September 19, 2022 Category: Pediatrics Source Type: research
From Survival to Survivorship in Pediatric Liver Transplantation
In this issue ofPediatrics, Baumann et al1 demonstrate the considerable gains in survival after pediatric liver transplantation in Europe over the past 30 years. This retrospective study of pediatric liver transplant recipients (N = 14 515) in the European Liver Transplant Registry between 1968 and 2017 compared outcomes across 3 consecutive time periods: 1968 to 1999 (historical era,n = 4482), 2000 to 2009 (surgical innovation era,n = 4972), and 2010 to 2017 (current practice era,n = 5061). The authors found that, despite increasingly complex and younger recipients, patient survival improved over the time periods, ac...
Source: PEDIATRICS - September 16, 2022 Category: Pediatrics Source Type: research
Prognosis of Children Undergoing Liver Transplantation: A 30-Year European Study
CONCLUSIONSPLT has become a highly successful medical treatment that should be considered for all children with end-stage liver disease. The main challenge for further improving the prognosis remains the early postoperative period. (Source: PEDIATRICS)
Source: PEDIATRICS - September 16, 2022 Category: Pediatrics Source Type: research
Epidemiology of Neonatal COVID-19 in the United States
CONCLUSIONSMost neonates infected with SARS-CoV-2 were asymptomatic or developed mild illness without need for respiratory support. Some had severe illness requiring treatment of COVID-19 with remdesivir and COVID-19 convalescent plasma. SARS-CoV-2 infection in neonates, though rare, may result in severe disease. (Source: PEDIATRICS)
Source: PEDIATRICS - September 15, 2022 Category: Pediatrics Source Type: research
