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Journal of Pediatrics
Journal Prestige (SJR): 1.522
Citation Impact (citeScore): 2
Number of Followers: 177  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0022-3476
Published by Elsevier Homepage  [3184 journals]
  • The Effect of Extended Continuous Positive Airway Pressure on Changes in
           Lung Volumes in Stable Premature Infants: A Randomized Controlled Trial
    • Abstract: Publication date: Available online 10 September 2019Source: The Journal of PediatricsAuthor(s): Ryan Lam, Diane Schilling, Brian Scottoline, Astrid Platteau, Meike Niederhausen, Kelli C. Lund, Robert L. Schelonka, Kelvin D. MacDonald, Cindy T. McEvoyObjectiveTo compare changes in lung volumes, as measured by functional residual capacity (FRC), through to discharge in stable infants randomized to 2 weeks of extended continuous positive airway pressure CPAP (eCPAP) vs CPAP discontinuation (dCPAP).Study designInfants born at ≤32 weeks of gestation requiring ≥24 hours of CPAP were randomized to 2 weeks of eCPAP vs dCPAP when meeting CPAP stability criteria. FRC was measured with the nitrogen washout technique. Infants were stratified by gestational age (
       
  • The Impact of Severe Maternal Morbidity on Very Preterm Infant Outcomes
    • Abstract: Publication date: Available online 10 September 2019Source: The Journal of PediatricsAuthor(s): Jennifer Zeitlin, Natalia N. Egorova, Teresa Janevic, Paul L. Hebert, Elodie Lebreton, Amy Balbierz, Elizabeth A. HowellObjectiveTo estimate the prevalence of severe maternal morbidity among very preterm births and determine its association with very preterm infant mortality and morbidity.Study designThis study used New York City Vital Statistics birth and death records linked with maternal and newborn discharge abstract data for live births between 2010 and 2014. We included 6901 infants without congenital anomalies born between 240/7 and 326/7 weeks of gestation. Severe maternal morbidity was identified as life-threatening conditions or life-saving procedures. Outcomes were first-year infant mortality, severe neonatal morbidity (bronchopulmonary dysplasia, severe necrotizing enterocolitis, stage 3-5 retinopathy of prematurity, and intraventricular hemorrhage grades 3-4), and a combined outcome of death or morbidity.ResultsTwelve percent of very preterm live-born infants had a mother with severe maternal morbidity. Maternal and pregnancy characteristics associated with occurrence of severe maternal morbidity were multiparity, being non-Hispanic black, and preexisting health conditions, but gestational age and the percentage small for gestational age did not differ. Infants whose mothers experienced severe maternal morbidity had higher first-year mortality, 11.2% vs 7.7% without severe maternal morbidity, yielding a relative risk of 1.39 (95% CI: 1.14-1.70) after adjustment for maternal characteristics, preexisting comorbidities, pregnancy complications, and hospital factors. Severe neonatal morbidity was not associated with severe maternal morbidity.ConclusionsSevere maternal morbidity is an independent risk factor for mortality in the first year of life among very preterm infants after consideration of other maternal and pregnancy risk factors.
       
  • Bone Health in Children and Youth with Cystic Fibrosis: A Systematic
           Review and Meta-Analysis of Matched Cohort Studies
    • Abstract: Publication date: Available online 10 September 2019Source: The Journal of PediatricsAuthor(s): Esther Ubago-Guisado, Iván Cavero-Redondo, Celia Alvarez-Bueno, Dimitris Vlachopoulos, Vicente Martínez-Vizcaíno, Luis Gracia-MarcoObjectiveTo assess the evidence regarding the differences in areal bone mineral density (aBMD) between children and adolescents with cystic fibrosis (CF) compared with their healthy peers, based on data from longitudinal studies.Study designWe searched MEDLINE, SPORTDiscus, the Cochrane Library, PEDro (Physiotherapy Evidence Database), and Embase databases. Observational studies addressing the change of aBMD in children with CF and healthy children and adolescents were eligible. The DerSimonian and Laird method was used to compute pooled estimates of effect sizes (ES) and 95% CIs for the change of whole body (WB), lumbar spine (LS), and femoral neck (FN) aBMD.ResultsSix studies with participants with CF and 26 studies with healthy participants were included in the systematic review and meta-analysis. For the analysis in children with CF, the pooled ES for the change of WB aBMD was 0.29 (95% CI –0.15 to 0.74), for the change of LS aBMD was 0.13 (95% CI –0.16 to 0.41), and for the change of FN aBMD was 0.09 (95% CI –0.39 to 0.57). For the analysis in healthy children, the pooled ES for the change of WB aBMD was 0.37 (95% CI 0.26-0.49), for the change of LS aBMD was 0.13 (95% CI –0.16 to 0.41), and for the change of FN aBMD was 0.52 (95% CI 0.19-0.85).ConclusionsaBMD development might not differ between children and adolescents with CF receiving medical care compared with their healthy peers. Further longitudinal studies in a CF population during growth and development are required to confirm our findings.
       
  • Chronology and Determinants of Respiratory Function Changes Following
           Administration of Systemic Postnatal Corticosteroids in Extremely Preterm
           Infants
    • Abstract: Publication date: Available online 6 September 2019Source: The Journal of PediatricsAuthor(s): Theodore Dassios, Ourania Kaltsogianni, Ann Hickey, Ravindra Bhat, Anne GreenoughObjectiveTo describe the effect of systemic corticosteroids administered to treat evolving bronchopulmonary dysplasia on oxygen diffusion and ventilation efficiency.Study designThis was a retrospective cohort study of ventilated infants who received a 9-day course of dexamethasone in a tertiary neonatal unit. We calculated the transcutaneous oxygen saturation–to–fraction of inspired oxygen (FiO2) ratio (SFR), the ventilation perfusion ratio (VA/Q), and the ventilation efficiency index (VEI) before, during, and after the course of corticosteroids. The response to corticosteroids was calculated as the difference between the FiO2 percentage before starting steroids and the lowest FiO2 value during the course of steroid treatment.ResultsSeventy infants (38 males) with a median gestational age (GA) of 25.0 weeks (IQR, 24.3-26.0 weeks) and a median birth weight of 0.70 kg (IQR, 0.63-0.82 kg) were studied at a median postnatal age of 39 days (IQR, 29-48 days). The median SFR before treatment was 1.42 (IQR, 1.19-1.72), and the highest SFR was 2.35 (IQR, 1.87-2.83) after 9 days of treatment. The median VA/Q before treatment was 0.14 (IQR, 0.11-0.18) and was significantly higher at 72 hours after the start of treatment (0.22; IQR, 0.15-0.29; P 
       
  • Developmental Outcomes of Extremely Preterm Infants with a Need for Child
           Protective Services Supervision
    • Abstract: Publication date: Available online 6 September 2019Source: The Journal of PediatricsAuthor(s): Elisabeth C. McGowan, Abbot. R. Laptook, Jean Lowe, Myriam Peralta-Carcelen, Dhuly Chowdhury, Rosemary D. Higgins, Susan R. Hintz, Betty R. Vohr, Richard A. Polin, Abbott R. Laptook, Martin Keszler, Angelita M. Hensman, Barbara Alksninis, Kristin M. Basso, Robert Burke, Melinda Caskey, Katharine Johnson, Mary Lenore Keszler, Andrea M. Knoll, Theresa M. LeachObjectiveTo evaluate neurodevelopmental outcomes of preterm infants with need for Child Protective Services (CPS) supervision at hospital discharge compared with those discharged without CPS supervision.Study designFor infants born at
       
  • Longitudinal Changes in Weight Status from Childhood and Adolescence to
           Adulthood
    • Abstract: Publication date: Available online 5 September 2019Source: The Journal of PediatricsAuthor(s): Justin R. Ryder, David R. Jacobs, Alan R. Sinaiko, Annabel P. Kornblum, Julia SteinbergerObjectivesTo study the change in body mass index (BMI) from childhood and adolescence and development of obesity into adulthood.Study designWe performed a longitudinal study of 480 individuals (49% male; 67% white) with height and weight measures in childhood (mean age 7 years), repeated in adolescence (mean age 16 years) and adulthood (mean age 39 years). Weight status in childhood was defined as low normal weight (0-
       
  • Predicting Long-Term Survival Without Major Disability for Infants Born
           Preterm
    • Abstract: Publication date: Available online 4 September 2019Source: The Journal of PediatricsAuthor(s): Jenny Bourke, Kingsley Wong, Ravisha Srinivasjois, Gavin Pereira, Carrington C.J. Shepherd, Scott W. White, Fiona Stanley, Helen LeonardObjectiveTo describe the long-term neurodevelopmental and cognitive outcomes for children born preterm.Study designIn this retrospective cohort study, information on children born in Western Australia between 1983 and 2010 was obtained through linkage to population databases on births, deaths, and disabilities. For the purpose of this study, disability was defined as a diagnosis of intellectual disability, autism, or cerebral palsy. The Kaplan–Meier method was used to estimate the probability of disability-free survival up to age 25 years by gestational age. The effect of covariates and predicted survival was examined using parametric survival models.ResultsOf the 720 901 recorded live births, 12 083 children were diagnosed with disability, and 5662 died without any disability diagnosis. The estimated probability of disability-free survival to 25 years was 4.1% for those born at gestational age 22 weeks, 19.7% for those born at 23 weeks, 42.4% for those born at 24 weeks, 53.0% for those born at 25 weeks, 78.3% for those born at 28 weeks, and 97.2% for those born full term (39-41 weeks). There was substantial disparity in the predicted probability of disability-free survival for children born at all gestational ages by birth profile, with 5-year estimates of 4.9% and 10.4% among Aboriginal and Caucasian populations, respectively, born at 24-27 weeks and considered at high risk (based on low Apgar score, male sex, low sociodemographic status, and remote region of residence) and 91.2% and 93.3%, respectively, for those at low risk (ie, high Apgar score, female sex, high sociodemographic status, residence in a major city).ConclusionsApgar score, birth weight, sex, socioeconomic status, and maternal ethnicity, in addition to gestational age, have pronounced impacts on disability-free survival.
       
  • Children with Attention-Deficit/Hyperactivity Disorder Perform Differently
           on Pediatric Concussion Assessment
    • Abstract: Publication date: Available online 30 August 2019Source: The Journal of PediatricsAuthor(s): Nathan E. Cook, Patricia M. Kelshaw, Shane V. Caswell, Grant L. IversonObjectiveTo compare Child Sport Concussion Assessment Tool Fifth Edition (Child SCAT5) performance between uninjured children with attention-deficit/hyperactivity disorder (ADHD) and precisely matched controls without ADHD.Study designA nested case-control study was conducted within a cohort of middle school athletes (age 11-12 years) who completed preseason testing. Students with ADHD were individually matched to students without ADHD based on age, sex, language spoken at home, number of prior concussions, sport, and school they attended. The final sample included 54 students (27 with ADHD and 27 controls), 38 (70.4%) boys and 16 (29.6%) girls (average age: 11.7 years, SD = 0.5).ResultsChildren with ADHD reported more symptoms (M = 13.33, SD = 5.69, P 
       
  • The Anxiety-Asthma Relationship: Risk or Resilience'
    • Abstract: Publication date: Available online 30 August 2019Source: The Journal of PediatricsAuthor(s): Andrea A. Pappalardo, Sally Weinstein
       
  • One Key to Timely Diagnosis and Services' A Coordinated System of Care
    • Abstract: Publication date: Available online 30 August 2019Source: The Journal of PediatricsAuthor(s): Bergen B. Nelson
       
  • Neonate with Congenital Intrahepatic Portosystemic Shunt
    • Abstract: Publication date: Available online 30 August 2019Source: The Journal of PediatricsAuthor(s): Tim Flerlage, Eugene Sheffield, Nadeem I. Shafi
       
  • Population-Based Newborn Screening for Mucopolysaccharidosis Type II in
           Illinois: The First Year Experience
    • Abstract: Publication date: Available online 30 August 2019Source: The Journal of PediatricsAuthor(s): Barbara K. Burton, George E. Hoganson, Julie Fleischer, Dorothy K. Grange, Stephen R. Braddock, Rachel Hickey, Lauren Hitchins, Daniel Groepper, Katherine M. Christensen, Amelia Kirby, Conny Moody, Heather Shryock, Laura Ashbaugh, Rong Shao, Khaja BasheeruddinObjectivesTo assess the outcome of population-based newborn screening for mucopolysaccharidosis type II (MPS II) during the first year of screening in Illinois.Study designTandem mass spectrometry was used to measure iduronate-2-sulfatase (I2S) activity in dried blood spot specimens obtained from 162 000 infant samples sent to the Newborn Screening Laboratory of the Illinois Department of Public Health in Chicago.ResultsOne case of MPS II and 14 infants with pseudodeficiency for I2S were identified.ConclusionsNewborn screening for MPS II by measurement of I2S enzyme activity was successfully integrated into the statewide newborn screening program in Illinois.
       
  • Advancing a More Health-Literate Approach to Patient Safety
    • Abstract: Publication date: Available online 29 August 2019Source: The Journal of PediatricsAuthor(s): Lee M. Sanders
       
  • Median Raphe Cyst of the Perineum
    • Abstract: Publication date: Available online 29 August 2019Source: The Journal of PediatricsAuthor(s): Christopher E. Bayne, Romano T. DeMarco, Mark A. Wehry
       
  • Sex-Dependent Gene Expression in Infants with Neonatal Opioid Withdrawal
           Syndrome
    • Abstract: Publication date: Available online 29 August 2019Source: The Journal of PediatricsAuthor(s): Elizabeth Yen, Tomoko Kaneko-Tarui, Robin Ruthazer, Karen Harvey-Wilkes, Mona Hassaneen, Jill L. MaronObjectivesTo evaluate salivary biomarkers that elucidate the molecular mechanisms by which in utero opioid exposure exerts sex-specific effects on select hypothalamic and reward genes driving hyperphagia, a hallmark symptom of infants suffering from neonatal opioid withdrawal syndrome (NOWS).Study designWe prospectively collected saliva from 50 newborns born at ≥34 weeks of gestational age with prenatal opioid exposure and 50 sex- and gestational age-matched infants without exposure. Saliva underwent transcriptomic analysis for 4 select genes involved in homeostatic and hedonic feeding regulation (neuropeptide Y2 receptor [NPY2R], proopiomelanocortin [POMC], leptin receptor [LEPR], dopamine type 2 receptor [DRD2]). Normalized gene expression data were stratified based on sex and correlated with feeding volume on day of life 7 and length of stay in infants with NOWS requiring pharmacotherapy.ResultsExpression of DRD2, a hedonistic/reward regulator, was significantly higher in male newborns compared with female newborns with NOWS (Δ threshold cycle 10.8 ± 3.8 vs 13.9 ± 3.7, P = .01). In NOWS requiring pharmacotherapy expression of leptin receptor, an appetite suppressor, was higher in male subjects than female subjects (Δ threshold cycle 8.4 ± 2.5 vs 12.4 ± 5.1, P = .05), DRD2 expression significantly correlated with intake volume on day of life 7 (r = 0.58, P = .02), and expression of NPY2R, an appetite regulator, negatively correlated with length of stay (r = −0.24, P = .05).ConclusionsPrenatal opioid exposure exerts sex-dependent effects on hypothalamic feeding regulatory genes with clinical correlations. Neonatal salivary gene expression analyses may predict hyperphagia, severity of withdrawal state, and length of stay in infants with NOWS.
       
  • Bone Quality Measured Using Calcaneal Quantitative Ultrasonography Is
           Reduced Among Children with HIV in Johannesburg, South Africa
    • Abstract: Publication date: Available online 29 August 2019Source: The Journal of PediatricsAuthor(s): Stephen M. Arpadi, Cara B. Thurman, Faeezah Patel, Jonathan J. Kaufman, Renate Strehlau, Megan Burke, Stephanie Shiau, Ashraf Coovadia, Michael T. YinWe evaluated bone quality among South African children with HIV over a 2-year period by quantitative ultrasound (QUS). Children with HIV have persistently lower bone quality compared with controls reflecting increased porosity, reduced strength, and possibly an increased short- and long-term risk of fracture.
       
  • Periorbital Exercise-Induced Purpura
    • Abstract: Publication date: Available online 28 August 2019Source: The Journal of PediatricsAuthor(s): Kazuki Iio, Akiko Kinumaki
       
  • Stem Cell Composition of Umbilical Cord Blood Following Milking Compared
           with Delayed Clamping of the Cord Appears Better Suited for Promoting
           Hematopoiesis
    • Abstract: Publication date: Available online 27 August 2019Source: The Journal of PediatricsAuthor(s): Anup C. Katheria, Ramina Amino, Jason M. Konop, Anthony J. Orona, Elizabeth Kim, Yang Liu, Donlaong Wu, Evan Y. SnyderIn comparing placental transfusion strategies, blood obtained from an umbilical cord that has been “milked” vs one in which clamping was simply delayed contains mesenchymal stromal cells in addition to solely hematopoietic stem cells, a composition more favorable for hematopoiesis, as suggested by its superior rescue of lethally irradiated bone marrow–depleted mice.
       
  • Coordinating Care Across the Perinatal Continuum in Hemolytic Disease
           of the Fetus and Newborn: The Timely Handoff of a Positive Maternal
           Anti-Erythrocyte Antibody Screen
    • Abstract: Publication date: Available online 23 August 2019Source: The Journal of PediatricsAuthor(s): Kalyani Vats, Jon F. Watchko
       
  • Vascular Health of Children Conceived via In Vitro Fertilization
    • Abstract: Publication date: Available online 20 August 2019Source: The Journal of PediatricsAuthor(s): Wendy Y. Zhang, Elif Seda Selamet Tierney, Angela C. Chen, Albee Y. Ling, Raquel R. Fleischmann, Valerie L. BakerObjectiveTo evaluate whether in vitro fertilization (IVF) has an effect on the cardiovascular health of offspring.Study designThis was a cross-sectional pilot study. We performed vascular health assessment for 17 children aged 10-14 years who were conceived via IVF with autologous oocytes at Stanford University. Carotid artery ultrasound evaluated intima-media thickness and stiffness, carotid-femoral pulse wave velocity determined segmental arterial stiffness, and endothelial pulse amplitude testing assessed endothelial function. We compared IVF offspring with control adolescents assessed in the same laboratory, with all comparisons adjusted for age, sex, and race/ethnicity.ResultsAll participants had normal body mass index and blood pressure. Compared with controls, IVF children had thicker common carotid artery intima-media thickness (0.44 ± 0.03 mm vs 0.38 ± 0.03 mm; P 
       
  • Langerhans Cell Histiocytosis of the Gastrointestinal Tract: Evidence for
           Risk Organ Status
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Hoi Soo Yoon, Jae Hee Lee, Jennifer Michlitsch, Manuel Garcia-Carega, Michael JengObjectiveTo investigate the “risk status” of Langerhans cell histiocytosis (LCH) of the gastrointestinal tract.Study designOutcomes from 43 published cases of patients with LCH and gastrointestinal tract involvement were matched to 43 patients with LCH without gastrointestinal tract involvement cared for at our institution. Comparisons were made of the 5-year overall survival rates determined from Kaplan−Meier survival curves for the entire cohort of patients, as well as subgroups defined by lack of risk organ involvement and later era of treatment (to control for temporal changes in LCH treatment regimens). In addition, an association between LCH−gastrointestinal tract and risk organ involvement was investigated.ResultsThe 5-year overall survival for children with LCH−gastrointestinal tract (45.3%) was significantly worse than for those without gastrointestinal tract involvement (94.6%; P = .001). This difference remained significant after we excluded risk organ involvement (53.6%% vs 100%; P = .001), and analyzing subjects diagnosed after 2000 (75% vs 100%; P = .012). A 4-fold increase in risk organ involvement with LCH−gastrointestinal tract was observed (OR 4.359; 95% CI 1.75-10.82, P = .001).ConclusionsThis limited retrospective study suggests that patients with LCH−gastrointestinal tract involvement may have decreased survival, independent of risk organ involvement, and provides evidence to support a prospective study to evaluate risk organ status of LCH−gastrointestinal tract. LCH−gastrointestinal tract may be associated with a 4-fold risk for risk organ involvement. Attention to gastrointestinal symptoms and LCH−gastrointestinal tract in young children diagnosed with LCH is warranted.
       
  • The Clinician Scientist, a Distinct and Disappearing Entity
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Ido Somekh, Eli Somekh, Massimo Pettoello-Mantovani, Raz Somech
       
  • Neuropsychiatric side effects of montelukast
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Thomas Kovesi
       
  • Reply
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Tracy N. Zembles, Glenn Bushee, Rodney E. Willoughby
       
  • More on the impact of American Academy of Pediatrics palivizumab guidance
           for infants with respiratory syncytial virus infection
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Michela Silvestri, Oliviero Sacco, Giovanni A. Rossi
       
  • Reply
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Steven B. Powell, Jean M. Silvestri
       
  • Stem cells for bronchopulmonary dysplasia: A promising yet challenging
           journey lies ahead
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Tanushree Sahoo, Krishna Mohan Gulla
       
  • A significant portion of Sudden Unexpected Infant Death appears
           attributable to suffocation
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Christopher E. Gaw
       
  • A low cost, skin-color-matching tool to detect hyperbilirubinemia
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Vinod K. Bhutani
       
  • Lead screening update from the US Preventive Services Task Force
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): David E. Jacobs
       
  • SCFE diagnosis delayed among patients with referred pain
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Michael B. Millis
       
  • New, less-expensive inactivated polio vaccine non-inferior to conventional
           inactivated vaccine
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Andrew Kreppel
       
  • A Neonate with Unexplained Hair Loss
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Bin Zhang, Li Wei, Lin Ma
       
  • Prolonged PR Interval and Erythema Marginatum in a Child with Acute
           Rheumatic Fever
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Toshihiro Matsui, Kenichi Yamaguchi, Tadayoshi Ikebe, Saori Aiga, Isao Kusakawa
       
  • Nicolau Syndrome: A Rare Complication following Intramuscular Injection
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Elizabeth Quincer, Preeti Jaggi
       
  • Chronic Herpes Simplex Virus Infection in an Immunosuppressed Girl
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Yue-Tong Qian, Jin-Yuan Ma, Jia-Wei Liu, Wei Liu, Dong-Lai Ma
       
  • Gaze Palsy: An Important Diagnostic Clue
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Priyanka Madaan, Chaitanya Reddy, Lokesh Saini
       
  • Asymmetric Crying Facies Syndrome
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Kai-Yu Ho, Jing Nong Liang
       
  • Incidence of Thyroid Disease in Adolescent Females Presenting with Heavy
           Menstrual Bleeding
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Angela C. Weyand, Elisabeth H. Quint, Gary L. FreedThe incidence of thyroid disease in adolescents with heavy menstrual bleeding is unknown. A retrospective cross-sectional study of 427 adolescents presenting with heavy menstrual bleeding found 0.23% (95% CI 0%-0.7%) had thyroid disease, lower than that expected in the general population. Thyroid testing should only be considered when other symptomatology is present.
       
  • Gastroenteritis, Hepatitis, Encephalopathy, and Human Herpesvirus 6
           Detection in an Immunocompetent Child: Benefits and Risks of Syndromic
           Multiplex Molecular Panel Testing
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Christina A. Olson, Samuel R. Dominguez, Steve Miller, Charles Y. Chiu, Kevin MessacarAn immunocompetent toddler came to medication attention with gastroenteritis, complicated by encephalopathy and hepatitis. Multiplexed testing using a polymerase chain reaction meningitis panel was positive for human herpesvirus 6 (HHV-6). Clinical correlation, quantitative HHV-6 polymerase chain reaction, and metagenomic next-generation sequencing supported a likely diagnosis of primary HHV-6B infection.
       
  • Comparing the Risk of Sudden Unexpected Infant Death to Common Causes of
           Childhood Injury Death
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Douglas R. Roehler, Erich K. Batra, Kyran P. QuinlanIn a secondary analysis of publicly available data, the rate of sudden unexplained infant death in the first year exceeded the peak rates of the leading causes of injury death for youth (≤19 years of age). The absolute risk of sudden unexplained infant death exceeded age-specific risks of the major causes of child injury mortality regardless of race or ethnicity.
       
  • The Low Risks and High Rewards of Penicillin Allergy Delabeling: An
           Algorithm to Expedite the Evaluation
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Cathleen Collins
       
  • Necrotizing Enterocolitis: Using Regulatory Science and Drug Development
           to Improve Outcomes
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Michael S. Caplan, Mark A. Underwood, Neena Modi, Ravi Patel, Phillip V. Gordon, Karl G. Sylvester, Steven McElroy, Paolo Manzoni, Sheila Gephart, Walter J. Chwals, Mark A. Turner, Jonathan M. Davis, Marilee Allen, Gerri Baer, Gail Besner, Jennifer Canvasser, Hala Chaaban, Robert Clay, Eamonn Connolly, Jonathan M. Davis
       
  • he +J ournal+of +P ediatrics :+Heparin+Therapy+in+Fulminant+Meningococcemia&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in T he J ournal of P ediatrics : Heparin Therapy in
           Fulminant Meningococcemia
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Elizabeth Dorn, Philip Toltzis
       
  • Cost-Savings of Fluoride Varnish Application in Primary Care for
           Medicaid-Enrolled Children in Virginia
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Christina R. Scherrer, Shillpa NaavaalObjectivesTo determine the cost-benefit of fluoride varnish application during pediatric well-visits for the Medicaid/Children's Health Insurance Program population in Virginia (VA) from a Medicaid payer perspective. To provide initial cost estimates from the primary care provider (PCP) perspective.Study designA systematic search of recent literature was completed to obtain input data for a Monte Carlo cost-benefit simulation and for the fluoride varnish application time, labor, and materials costs for PCPs. The analysis was conducted from a Medicaid perspective; costs and savings related to fluoride varnish application in primary dentition through 7.5 years were calculated for all Medicaid-eligible children up to 3 years of age in VA. Sensitivity analysis was performed to mitigate the effects of parameter uncertainty.ResultsDelivering fluoride varnish to all children
       
  • Development of the Serum α-Fetoprotein Reference Range in Patients with
           Beckwith-Wiedemann Spectrum
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Kelly A. Duffy, Jennifer L. Cohen, Okan U. Elci, Jennifer M. KalishObjectiveTo establish reference ranges for serum α-fetoprotein (AFP) at various ages in patients with Beckwith-Wiedemann spectrum (BWSp), to better predict the risk for hepatoblastoma in this population.Study designA retrospective analysis of AFP measurements collected from patients with BWSp was performed. Factors including sex, prematurity, molecular diagnosis of patients, and performing laboratory were evaluated for significant differences. In total, 1372 AFP values were collected from 147 patients and the predictive AFP values at various ages were calculated to establish reference ranges. Mixed-effects polynomial regression models were used to study various potential factors affecting log(AFP) values.ResultsOverall, predicted AFP values declined to normal range for age (
       
  • The Association between First Fractures Sustained during Childhood and
           Adulthood and Bone Measures in Young Adulthood
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Yi Yang, Feitong Wu, Benny Antony, Feng Pan, Tania Winzenberg, Graeme JonesObjectiveTo describe the association between fractures sustained at different stages of growth and bone measures in early adulthood.Study designParticipants (n = 201) in southern Tasmania were at birth at a higher risk of sudden infant death syndrome; they were followed to age 25. Outcomes were areal bone mineral density at the spine, hip, and total body (by dual-energy x-ray absorptiometry) and trabecular and cortical bone measures at the radius and tibia (by high-resolution peripheral quantitative computed tomography). Fractures were self-reported and confirmed by radiographs at 8, 16, and 25 years of age. Multivariable linear regression was used to analyze the association of the occurrence of prepubertal (
       
  • Who's Watching the Children' Caregiver Features Associated with
           Physical Child Abuse versus Accidental Injury
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Amanda K. Fingarson, Mary Clyde Pierce, Douglas J. Lorenz, Kim Kaczor, Berkeley Bennett, Rachel Berger, Melissa Currie, Sandy Herr, Sheila Hickey, Julia Magana, Kathi Makoroff, Marcia Williams, Audrey Young, Noel ZuckerbraunObjectiveTo compare caregiver features and caregiving arrangements of children with physical abuse vs accidental injuries.Study designData came from a prospective, observational, multicenter study investigating bruising and psychosocial characteristics of children younger than 4 years of age. Using logistic regression, we examined how abuse vs accidental injury and severity of injury were associated with caregiver sex, relation to the child, whether caregiving arrangements were different than usual at the time of injury, and length of the main caregiver's relationship with his/her partner.ResultsOf 1615 patients, 24% were determined to have been physically abused. Abuse was more likely when a male caregiver was present (OR 3.31, 95% CI 2.38-4.62). When the male was the boyfriend of the mother (or another female caregiver), the odds of abuse were very high (OR 169.2, 95% CI 61.3-614.0). Severe or fatal injuries also were more likely when a male caregiver was present. In contrast, abuse was substantially less likely when a female caregiver was present (OR 0.25, 95% CI 0.17-0.37) with the exception of a female babysitter (OR 3.87, 95% CI 2.15-7.01). Caregiving arrangements that were different than usual and caregiver relationships
       
  • Near Adult Height in Girls with Turner Syndrome Treated with Growth
           Hormone Following Either Induced or Spontaneous Puberty
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Roberto Lanes, Anders Lindberg, Martin Carlsson, Dionisios Chrysis, Ferah Aydin, Cecilia Camacho-Hübner, Donna King, Marsha DavenportObjectiveTo understand whether spontaneous vs induced puberty and the type and route of estrogen influence the height of girls with Turner syndrome on growth hormone (GH).Study designSearch of an international database of children treated with GH revealed 772 girls with Turner syndrome followed from GH initiation to near adult height. Data from girls with sustained spontaneous puberty (n = 145) were compared with those requiring estrogens for induction or maintenance of puberty (n = 627).ResultsAt GH start, mean age (7.5 vs 7.9 years), weight (−1.7 vs −1.7 SDS), and body mass index (0.2 SDS vs 0.1 SDS) were similar for girls with spontaneous puberty and with induced puberty. Although those girls with spontaneous puberty were shorter than those with induced puberty, when midparental height was taken into consideration, starting heights in both groups averaged −2.8 SDS. Both groups received approximately 0.3 mg/kg/week of GH. Girls with spontaneous puberty initiated puberty and reached near adult height earlier than girls with induced puberty (12.6 ± 1.8 years vs 13.4 ± 1.4 years and 16.0 ± 1.3 years vs 16.9 ± 1.4 years, respectively). Although girls with spontaneous puberty grew more in the first year of GH therapy and between the onset of puberty and near adult height (11.0 cm vs 9.3 cm), height SDS at near adult height and the length of time in puberty before reaching near adult height were comparable. A 45,X karyotype was detected in 22.1% of girls with spontaneous puberty and in 58.4% of girls with induced puberty. Patients receiving transdermal estrogens did not grow better than those on oral estrogens. Adverse event reporting was comparable between groups.ConclusionsGirls with Turner syndrome with spontaneous puberty tended to grow better in response to GH than girls with induced puberty, but not enough to produce a difference in height SDS at near adult height.
       
  • Attributable Delay of Discharge for Children with Long-Term Mechanical
           Ventilation
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Sarah A. Sobotka, Carolyn Foster, Emma Lynch, Lindsey Hird-McCorry, Denise M. GoodmanObjectiveTo assess the reasons for discharge delays for children with long-term mechanical ventilation.Study designCharts of children (0-18 years of age) with a new tracheostomy in the Pulmonary Habilitation Program at the Ann and Robert H. Lurie Children's Hospital of Chicago were retrospectively reviewed for demographic information, medical diagnoses, medical stability, discharge to home, reasons for discharge delay, and hours of staffed home nursing. All patients were discharged on mechanical ventilation. Discharge delay was defined as>10 days after medical stability. Hospital charges were analyzed and excess charges quantified beginning with the date of delay. Descriptive statistics and Pearson χ2 tests were used to compare nursing hours and demographics.ResultsOf 72 patients, 55% were male with mean age 1.8 years (SD 3.8) at tracheostomy placement. The most common long-term mechanical ventilation indication was chronic lung disease (n = 47, 65%); 54% had discharge delays, the majority were primarily due to lack of home nursing (62%), followed by delay of caregiver training (18%), caregiver health and social issues (8%), and delay in a transitional care facility bed (8%). Of the 39 delayed patients, 10% ($13 217 889) of hospital charges occurred during excess days with a median of $186 061 (IQR $117 661-$386 905) per patient.ConclusionsOver one-half of children discharged to the community from a large inpatient pediatric long-term mechanical ventilation program had a nonmedical delay of discharge home, most commonly because of home nurse staffing. This case series provides further evidence that limited availability of home nursing impedes efficient discharge and prolongs hospitalizations.
       
  • Small-for-Gestational Age Birth Confers Similar Educational Performance
           through Middle School
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Karna Murthy, Krzysztof Karbownik, Craig F. Garfield, Gustave H. Falciglia, Jeffrey Roth, David N. FiglioObjectiveTo estimate the association between small for gestational age (SGA) at birth and educational performance on standardized testing and disability prevalence in elementary and middle school.Study designThrough linked birth certificates and school records, surviving infants born at 23-41 weeks of gestation who entered Florida's public schools 1998-2009 were identified. Twenty-three SGA definitions (3rd-25th percentile) were derived. Outcomes were scores on Florida Comprehensive Assessment Test (FCAT) and students' disability classification in grades 3 through 8. A “sibling cohort” subsample included families with at least 2 siblings from the same mother in the study period. Multivariable models estimated independent relationships between SGA and outcomes.ResultsBirth certificates for 80.2% of singleton infants were matched to Florida public school records (N = 1 254 390). Unadjusted mean FCAT scores were 0.236 SD lower among
       
  • he +J ournal+of +P ediatrics :+Field+Anthropometry+Independent+of+Precise+Age&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in T he J ournal of P ediatrics : Field Anthropometry
           Independent of Precise Age
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Dheeraj Shah, Piyush Gupta
       
  • Echography-Guided Surfactant Therapy to Improve Timeliness of Surfactant
           Replacement: A Quality Improvement Project
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Roberto Raschetti, Nadya Yousef, Giulia Vigo, Gianluigi Marseglia, Roberta Centorrino, Rafik Ben-Ammar, Shivani Shankar-Aguilera, Daniele De LucaObjectiveTo improve time of surfactant administration with a surfactant replacement protocol based on semiquantitative lung ultrasound score (LUS) thresholds.Study designQuality improvement (QI), prospective, before-after, pilot study. In a 6-month period surfactant replacement was based only on inspired oxygen fraction (FiO2) thresholds. In the second 6-month period, surfactant was given when either the FiO2 or LUS exceeded the limits. The main QI measures were the proportion of neonates receiving surfactant within the first 3 hours of life and maximal FiO2 reached before surfactant replacement. Secondary QI measures were the duration of respiratory support and ventilator-free days. Data were also collected for 1 year after the study to verify sustainability.ResultsEchography-guided Surfactant THERapy (ESTHER) increased the proportion of neonates receiving surfactant within the first 3 hours of life (71.4%-90%; P 
       
  • Association of Neonatologist Continuity of Care and Short-Term Patient
           Outcomes
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Kerri Z. Machut, Ankur Datta, Jason Z. Stoller, Rakesh Rao, Amit Mathur, Theresa R. Grover, Zeenia Billimoria, Karna MurthyObjectivesTo describe neonatologist continuity of care and estimate the association between these transitions and selected patient outcomes.Study designWe linked Children's Hospitals Neonatal Database records with masked neonatologist daily schedules at 4 centers, which use 2- and 3-week and 1-month “on service” blocks to provide care. After describing the neonatologist transitions, we estimated associations between these transitions and selected short-term patient outcomes using multivariable Poisson, logistic, and linear regression analyses, independent of length of stay (LOS) and case-mix. We also completed analyses after stratifying the cohort by LOS, birthweight, age at admission categories, and selected diagnoses.ResultsStratified by LOS, patient transitions varied between centers in both unadjusted (P 
       
  • Randomized Controlled Trial of Iron-Fortified versus Low-Iron Infant
           Formula: Developmental Outcomes at 16 Years
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Sheila Gahagan, Erin Delker, Estela Blanco, Raquel Burrows, Betsy LozoffObjectivesTo test differences in cognitive outcomes among adolescents randomly assigned previously as infants to iron-fortified formula or low-iron formula as part of an iron deficiency anemia prevention trial.Study designInfants were recruited from community clinics in low- to middle-income neighborhoods in Santiago, Chile. Entrance criteria included term, singleton infants; birth weight of ≥3.0 kg; and no major congenital anomalies, perinatal complications, phototherapy, hospitalization>5 days, chronic illness, or iron deficiency anemia at 6 months. Six-month-old infants were randomized to iron-fortified (12 mg/L) or low-iron (2.3 mg/L) formula for 6 months. At 16 years of age, cognitive ability, visual perceptual ability, visual memory, and achievement in math, vocabulary, and comprehension were assessed, using standardized measures. We compared differences in developmental test scores according to randomization group.ResultsAt the follow-up assessment, the 405 participants averaged 16.2 years of age and 46% were male. Those randomized to iron-fortified formula had lower scores than those randomized to low-iron formula for visual memory, arithmetic achievement, and reading comprehension achievement. For visual motor integration, there was an interaction with baseline infancy hemoglobin, such that the iron-fortified group outperformed the low-iron group when 6-month hemoglobin was low and underperformed when 6-month hemoglobin was high.ConclusionsAdolescents who received iron-fortified formula as infants from 6 to 12 months of age at levels recommended in the US had poorer cognitive outcomes compared with those who received a low-iron formula. The prevention of iron deficiency anemia in infancy is important for brain development. However, the optimal level of iron supplementation in infancy is unclear.Trial registrationClinicaltrials.gov: NCT01166451.
       
  • Late-Onset Circulatory Collapse and Risk of Cerebral Palsy in Extremely
           Preterm Infants
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Kazuaki Yasuoka, Hirosuke Inoue, Naoki Egami, Masayuki Ochiai, Koichi Tanaka, Toru Sawano, Hiroaki Kurata, Masako Ichiyama, Junko Fujiyoshi, Yuki Matsushita, Yasunari Sakai, Shouichi Ohga, Neonatal Research Network of JapanObjectiveTo investigate whether the development of postnatal, late-onset refractory hypotension, referred to as late-onset circulatory collapse, was associated with an increased risk of developing cerebral palsy (CP) at 3 years of age in extremely preterm infants.MethodsIn this historical cohort study, infants who were born at 22-27 weeks of gestation from 2008 to 2012 in the Neonatal Research Network of Japan were eligible. The study sample consisted of 3474 infants (45.6% of 7613 potentially eligible infants) who were evaluated at 36-42 months of age. Late-onset circulatory collapse was defined as a clinical diagnosis of late-onset circulatory collapse requiring treatment with corticosteroids. We compared the neurodevelopmental outcomes between infants with and without late-onset circulatory collapse.ResultsLate-onset circulatory collapse was diagnosed in 666 of the infants studied. Infants with late-onset circulatory collapse had a higher incidence of CP than those without late-onset circulatory collapse (18.0% vs 9.8%; P 
       
  • Seizure Rescue Medication Use among US Pediatric Epilepsy Providers: A
           Survey of the Pediatric Epilepsy Research Consortium
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Adam Wallace, Elaine Wirrell, Eric PayneObjectiveTo assess how pediatric neurologists prescribe home seizure rescue medications to treat acute prolonged seizures and clusters of seizures in children.Study designA brief, email survey was sent to the members of the Pediatric Epilepsy Research Consortium assessing seizure rescue medication prescribing practices for patients of different age groups, cognitive abilities, and seizure type. Survey responses were anonymous.ResultsThirty-six respondents (of 76 surveyed; 47% response rate) completed the survey. Rectal diazepam was the most commonly chosen rescue medication for a prolonged convulsive seizure in a severely developmentally delayed 16-year-old (44%) and typical and delayed 7-year-old (44% and 61%, respectively), 3-year-old (78% and 86%, respectively), and 9-month-old (83%) patients. Most responders (69%) indicated that developmentally typical 16-year-olds would be prescribed intranasal midazolam. For clusters of seizures, clonazepam orally disintegrating tablets were the most frequent first-line option in all age groups, except developmentally delayed 3-year-old and 9-month-old children, for whom rectal diazepam was chosen more commonly. Medication dosing generally followed standard dosing guidelines with very few exceptions.ConclusionsRectal diazepam remains the most frequently used rescue medication for prolonged seizures for nearly all age groups, except in developmentally typical teenagers, for whom intranasal midazolam is used more often. Clonazepam orally disintegrating tablets are the most frequently used medication for treatment of clusters of seizures, except in younger patients. Further work is necessary to establish best practices for type and administration route of seizure rescue medications.
       
  • Risk of Meningitis in Infants Aged 29 to 90 Days with Urinary Tract
           Infection: A Systematic Review and Meta-Analysis
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): James Nugent, Molly Childers, Nicholas Singh-Miller, Robin Howard, Rhonda Allard, Matthew EberlyObjectiveTo determine the risk of bacterial meningitis in infants aged 29-90 days with evidence of urinary tract infection (UTI).MethodsPubMed (MEDLINE), Embase, and the Cochrane Library were systematically searched for studies reporting rates of meningitis in infants aged 29-90 days with abnormal urinalysis or urine culture. Observational studies in infants with evidence of UTI who underwent lumbar puncture (LP) reporting age-specific event rates of bacterial meningitis and sterile cerebrospinal fluid pleocytosis were included. Prevalence estimates for bacterial meningitis in infants with UTI were pooled in a random effects meta-analysis.ResultsThree prospective and 17 retrospective cohort studies were included in the meta-analysis. The pooled prevalence of concomitant bacterial meningitis in infants with UTI was 0.25% (95% CI, 0.09%-0.70%). Rates of sterile pleocytosis ranged from 0% to 29%. Variation in study methods precluded calculation of a pooled estimate for sterile pleocytosis. In most studies, the decision to perform a LP was up to the provider, introducing selection bias into the prevalence estimate.ConclusionsThe risk of bacterial meningitis in infants aged 29-90 days with evidence of UTI is low. A selective approach to LP in infants identified as low risk for meningitis by other clinical criteria may be indicated.
       
  • Associations of Neonatal Noncardiac Surgery with Brain Structure and
           Neurodevelopment: A Prospective Case-Control Study
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Margaret M. Moran, Julia K. Gunn-Charlton, Jennifer M. Walsh, Jeanie L.Y. Cheong, Peter J. Anderson, Lex W. Doyle, Susan Greaves, Rod W. HuntObjectiveTo examine the associations of neonatal noncardiac surgery with newborn brain structure and neurodevelopment at 2 years of age.Study designInfants requiring neonatal noncardiac surgery for congenital diaphragmatic hernia, esophageal atresia, or anterior abdominal wall defect were compared with infants who did not require surgery, matched for sex, gestation at birth, and postmenstrual age at magnetic resonance imaging. Cerebral magnetic resonance imaging was performed at a mean (SD) postmenstrual age of 41.6 (1.7) weeks. Images were assessed qualitatively for brain maturation and injury and quantitatively for measures of brain size, cerebrospinal fluid spaces, and global abnormality. Neurodevelopment was then assessed at 2 years using the Bayley Scales of Infant and Toddler Development, 3rd edition.ResultsInfants requiring surgery (n = 39) were 5.9 times (95% CI, 1.9-19.5; P 
       
  • Cross-Sectional Study of Arterial Stiffness in Adolescents with Down
           Syndrome
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Andrea Kelly, Sheela N. Magge, Rachel Walega, Claire Cochrane, Mary E. Pipan, Babette S. Zemel, Meryl S. Cohen, Samuel S. Gidding, Ray TownsendObjectivesTo test whether youth with Down syndrome have aortic stiffness indices, as measured by pulse wave velocity (PWV), that differ from youth without Down syndrome and to compare reference-based age-adjusted (age-PWV-Z) and height-adjusted (Ht-PWV-Z) in youth with and without Down syndrome.Study designCross-sectional study of PWV in 129 adolescents with Down syndrome and 97 youth of comparable age, sex, race/ethnicity, and body mass index (BMI). PWV, age-PWV-Z, and Ht-PWV-Z were compared. Regression models were developed to test for associations with PWV.ResultsYouth with Down syndrome and controls were comparable in BMI-Z (1.4 [−1.5 to 2.8] vs 1.2 [−2.0 to 2.8], P = .57) but not Ht-Z (−2.3 [−4.7 to 0.8] vs 0.4 [−2.0 to 2.6], P 
       
  • Transition Readiness in Adolescents and Young Adults with Heart Disease:
           Can We Improve Quality of Life'
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Karen Uzark, Katherine Afton, Sunkyung Yu, Ray Lowery, Cynthia Smith, Mark D. NorrisObjectivesWe previously reported common knowledge deficits and lack of transition readiness in 13- 25-year-olds with congenital or acquired heart disease. The aims of this study were to re-evaluate transition readiness in this cohort at follow-up and to examine the relationship between changes in transition readiness and quality of life (QOL).Study designIn this prospective cohort study, patients completed the Transition Readiness Assessment and the Pediatric Quality of Life Inventory using an e-tablet, web-based format at a routine follow-up visit. Changes from initial to follow-up scores were evaluated.ResultsSixty-five percent of patients (106 of 164) completed follow-up assessments at a median age of 18.7 years (IQR, 16.5-21.2 years) at a median follow-up of 1 year. The average perceived knowledge deficit score (percent of items with no knowledge) at follow-up was 18.0 ± 15.2%, which decreased from 24.7 ± 16.5% (P 
       
  • Reply
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Yaron Finkelstein, Teresa To
       
  • Prospective Assessment of Ultrasound Shear Wave Elastography for
           Discriminating Biliary Atresia from other Causes of Neonatal Cholestasis
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Jonathan R. Dillman, Frank W. DiPaola, Sally J. Smith, Richard A. Barth, Akihiro Asai, Simon Lam, Kathleen M. Campbell, Jorge A. Bezerra, Gregory M. Tiao, Andrew T. TroutObjectiveTo prospectively assess the diagnostic performance of ultrasound shear wave elastography (SWE) and hepatobiliary laboratory biomarkers for discriminating biliary atresia from other causes of neonatal cholestasis.Study designForty-one patients 2 mg/dL) and possible biliary atresia were prospectively enrolled. Both 2-dimensional (2D) and point ultrasound SWE were performed prior to knowing the final diagnosis. Median 2D (8) and point (10) shear wave speed measurements were calculated for each subject and used for analyses. The Mann-Whitney U test was used to compare shear wave speed and laboratory measurements between patients with and without biliary atresia. Receiver operating characteristic curve analyses and multivariable logistic regression were used to evaluate diagnostic performance.ResultsThirteen subjects (31.7%) were diagnosed with biliary atresia, and 28 subjects (68.3%) were diagnosed with other causes of neonatal cholestasis. Median age at the time of ultrasound SWE was 37 days. Median 2D (2.08 vs 1.49 m/s, P = .0001) and point (1.95 vs 1.21 m/s, P = .0014) ultrasound SWE measurements were significantly different between subjects with and without biliary atresia. Using a cut-off value of>1.84 m/s, 2D ultrasound SWE had a sensitivity = 92.3%, specificity = 78.6%, and area under the receiver operating characteristic curve (AuROC) of 0.89 (P 320 (U/L), gamma-glutamyl transferase (GGT) had a sensitivity = 100.0%, specificity = 77.8%, and AuROC of 0.85 (P 
       
  • he +J ournal+of +P ediatrics :+Recurrence+Rate+of+Streptococcal+Pharyngitis+Related+to+Oral+Penicillin&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in T he J ournal of P ediatrics : Recurrence Rate of
           Streptococcal Pharyngitis Related to Oral Penicillin
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Philip Toltzis
       
  • Neonatal Antibiotics and Prematurity Are Associated with an Increased Risk
           of Functional Gastrointestinal Disorders in the First Year of Life
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Silvia Salvatore, Maria Elisabetta Baldassarre, Antonio Di Mauro, Nicola Laforgia, Silvio Tafuri, Francesco Paolo Bianchi, Enzo Dattoli, Lucia Morando, Licia Pensabene, Fabio Meneghin, Dario Dilillo, Valentina Mancini, Valentina Talarico, Francesco Tandoi, Gianvincenzo Zuccotti, Massimo AgostiObjectiveTo assess the prevalence of functional gastrointestinal disorders (FGIDs) in the first year of life and the influence of different neonatal factors on development of FGIDs.Study designA prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up until 1 year. Gestational age, neonatal antibiotic administration, duration of hospitalization, mode of delivery, birth weight, and feeding pattern were recorded. FGIDs were classified according to Rome III criteria and assessed at 1, 3, 6, and 12 months of life.ResultsAmong 1152 newborns enrolled, 934 (81.1%) completed the study, 302 (32%) were newborns born preterm, 320 (34%) had neonatal antibiotics, and 718 (76.9%) had at least 1 FGID according to Rome III criteria (443 [47.4%] infantile colic, 374 [40.0%] regurgitation, 297 [31.8%] infant dyschezia, 248 [26.6%] functional constipation, and 34 [3.6%] functional diarrhea) throughout the first year of life. The proportion of infants born preterm presenting with FGIDs (86%) was significantly greater compared with infants born full term (72.5%) (χ2 = 21.3, P = .0001). On multivariate analysis, prematurity and neonatal use of antibiotics was significantly associated with at least 1 FGID.ConclusionsWe found a high rate FGIDs in infants, likely related to the population recruited, the long observation period, the diagnosis based on Rome III criteria, and parental reports. Preterm delivery and neonatal use of antibiotics in the first months of life are associated with an increased incidence of FGIDs, particularly infantile colic and regurgitation. In our population, cesarean delivery and feeding pattern at 1 month of life emerged as additional risk factors for infant dyschezia and functional diarrhea. Other neonatal factors associated with FGIDs need to be further explored.
       
  • he+Journal+of +P ediatrics :+The+Effect+of+Pentobarbital+Anesthesia+on+Resuscitation+and+Brain+Damage+in+Fetal+Rhesus+Monkeys+Asphyxiated+on+Delivery&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in T he Journal of P ediatrics : The Effect of
           Pentobarbital Anesthesia on Resuscitation and Brain Damage in Fetal Rhesus
           Monkeys Asphyxiated on Delivery
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Jannicke H. Andresen, Ola Didrik Saugstad
       
  • Characteristics Associated with Successful Weight Management in Youth with
           Obesity
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Michelle C. Gorecki, Joseph M. Feinglass, Helen J. BinnsObjectiveTo identify the medical, demographic, and behavioral factors associated with a reduction of body mass index percent of the 95th percentile (BMIp95) after 1 year for patients receiving care at a tertiary care obesity management clinic.Study designA retrospective review of data from first and 12 ± 3-month follow-up visits of subjects aged 8-17 years with obesity. Data included anthropometrics, demographics, medical/psychological history, reported diet patterns, and participation in moderate/vigorous physical activity. After analyzing factors associated with 1-year follow-up, we used a forward conditional logistic regression model, controlling for subject's sex, to examine associations with a BMIp95 ≥5-point decrease at 1 year.ResultsOf 769 subjects, 184 (23.9%) had 1-year follow-up. Boys more often had follow-up (28.4% vs girls, 19.1%; P = .003). The follow-up sample was 62.0% male, 65.8% Hispanic, and 77.7% with public insurance; 33.2% achieved a ≥5-point decrease in BMIp95. In regression results, the ≥5-point decrease group was more likely to have completed an initial visit in April-September (OR 2.0, 95% CI 1.1-3.9); have increased physical activity by 1-2 d/wk (OR 3.4, 95% CI 1.4-7.8) or increased physical activity by ≥ 3 d/wk at 1 year (OR 2.7, 95% CI 1.1-6.3); and less likely to have been depressed at presentation (OR 0.4, 95% CI 0.2-0.9). Demographic and dietary factors were not significantly associated with BMIp95 group status.ConclusionsStrategies improving follow-up rates, addressing mental health concerns, and promoting year-round physical activity are needed to increase the effectiveness of obesity management clinics.
       
  • Free Vitamin D: Relationship to Insulin Sensitivity and Vascular Health in
           Youth
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Fida Bacha, Sara Klinepeter Bartz, Anca Tomsa, Susan SharmaObjectiveTo evaluate the relationship of free 25 hydroxy vitamin D [free 25(OH)D] or bioavailable vitamin D (BioD) concentrations to insulin sensitivity and cardiovascular disease risk markers in normal weight and overweight youth.Study designCross-sectional study of 79 adolescents 15.4 ± 0.2 years, 18 normal weight, 30 overweight, and 31 overweight with prediabetes who underwent peripheral arterial tonometry, dual-energy x-ray absorptiometry, and hyperinsulinemic-euglycemic clamp in subset (n = 71) for determination of reactive hyperemia index (RHI), body composition, and insulin sensitivity. 25(OH)D and vitamin D binding protein were measured; free 25(OH)D and BioD were calculated.ResultsAcross tertiles of free 25(OH)D concentrations (4.0 ± 0.2, 7.5 ± 0.3, and 17.0 ± 2.1 pg/mL, P 
       
  • Prenatal, Perinatal, and Early Childhood Factors Associated with Childhood
           Obstructive Sleep Apnea
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Ting Chen, Mary E. Hughes, Hongjian Wang, Guoying Wang, Xiumei Hong, Li Liu, Yuelong Ji, Colleen Pearson, Shenghui Li, Lingxin Hao, Xiaobin WangObjectivesTo investigate prenatal, perinatal, and early childhood factors, including cord and early childhood plasma leptin, on a clinical diagnosis of obstructive sleep apnea (OSA) among children in the Boston Birth Cohort.Study designWe conducted a secondary analysis of 2867 mother–child pairs from the Boston Birth Cohort who were enrolled between 1998 and 2014 at Boston Medical Center and followed from birth to age 16 years. Child's OSA was defined based on clinical diagnoses documented in the medical record. Plasma leptin was measured in cord and early childhood blood samples. Logistic regression was used to examine individual and combined effects of early life factors on the risk of OSA, adjusting for potential confounders.ResultsThe mean age of the study children was 6.39 years (SD = 3.77); 49.3% were girls, and 209 (7.3%) had ever been diagnosed with OSA. Four significant risk factors for OSA were identified: maternal obesity/diabetes during pregnancy (OR, 1.63; 95% CI, 1.21-2.21; P = .001), preterm/low birth weight (OR, 1.74; 95% CI, 1.30-2.32; P 
       
  • he+Journal+of +P ediatrics :+Proteolytic+and+Lipolytic+Deficiency+of+the+Exocrine+Pancreas&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in T he Journal of P ediatrics : Proteolytic and Lipolytic
           Deficiency of the Exocrine Pancreas
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Brandon Arnold
       
  • Short Sleep Duration and Later Overweight in Infants
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Tuuli Tuohino, Isabel Morales-Muñoz, Outi Saarenpää-Heikkilä, Olli Kiviruusu, Tiina Paunio, Petteri Hovi, Kirsi H. Pietiläinen, E. Juulia PaavonenObjectiveTo provide further knowledge about the longitudinal association between sleep duration and overweight in infants.Study designThe data for this study are from the CHILD-SLEEP birth cohort (n = 1679). The sleep data are based on parent-reported total sleep duration collected at 3, 8, 18, and 24 months. For a subgroup of 8-month old participants (n = 350), an actigraph recording was also made. Growth data were derived from the child health clinic records. A logistic regression model was used to study the association between sleep duration and later weight development.ResultsShorter sleep duration in 3-month-old infants was cross-sectionally associated with lower weight-for-length/height (all P values ≤ .026) and body mass index (all P values ≤ .038). Moreover, short sleep duration at the age of 3 months was associated with greater weight-for-length/height z score at the age of 24 months (aOR 1.56; 95% CI 1.02-2.38) as well as with a predisposition to gain excess weight between 3 and 24 months of age (aOR 2.61; 95% CI 1.75-3.91). No significant associations were found between sleep duration at 8, 18, or 24 months and concurrent or later weight status. Actigraph-measured short night-time sleep duration at the age of 8 months was associated with greater weight-for-length at the age of 24 months (aOR 1.51; 95% CI 1.02-2.23).ConclusionsShort total sleep duration at the age of 3 months and short night-time sleep duration at the age of 8 months are associated with the risk of gaining excess weight at 24 months of age.
       
  • The Precarious Imperative of Home Nursing for Technology-Dependent
           Children
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Chris Feudtner
       
  • Use of Lung Ultrasound to Improve Timeliness of Surfactant Replacement in
           Respiratory Distress Syndrome: Are we Ready'
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Abhay Lodha, Vineet Bhandari
       
  • The Continuity Research Network (CORNET): What's in it for You'
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Iman Sharif, Hollyce Tyrrell
       
  • The Journal of Pediatrics—Goals and Successes
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): William F. Balistreri, Meghan McDevitt
       
  • Sleep during infancy and later overweight
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Stephen R. Daniels
       
  • Functional gastrointestinal disorders—Are some preventable'
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Ivor D. Hill
       
  • Breakthrough seizures, but which benzodiazepines to the rescue'
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Paul G. Fisher
       
  • Thinking differently about sudden unexpected infant deaths
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Raye-Ann deRegnier
       
  • It's 10 o'clock. Do you know who is caring for your child'
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): Jane A. Oski
       
  • Information for Readers
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s):
       
  • Hierarchical Data Structures and Multilevel Modeling
    • Abstract: Publication date: September 2019Source: The Journal of Pediatrics, Volume 212Author(s): James I. Hagadorn, Michele L. Shaffer
       
  • Gastrostomy Tube Feeding in Extremely Low Birthweight Infants: Frequency,
           Associated Comorbidities, and Long-term Outcomes
    • Abstract: Publication date: Available online 16 August 2019Source: The Journal of PediatricsAuthor(s): Mollie G. Warren, Barbara Do, Abhik Das, P. Brian Smith, Ira Adams-Chapman, Sudarshan Jadcherla, Erik A. Jensen, Ricki F. Goldstein, Ronald N. Goldberg, C. Michael Cotten, Edward F. Bell, William F. Malcolm, Mollie Gross Warren, Barbara Do, Abhik Das, Phillip Brian Smith, Ira Adams-Chapman, Sudarshan Jadcherla, Erik A. Jensen, Ricki F. GoldsteinObjectiveTo assess the frequency of gastrostomy tube (GT) placement in extremely low birth weight (ELBW) infants, associated comorbidities, and long-term outcomes.Study designAnalysis of ELBW infants from 25 centers enrolled in the National Institute of Child Health and Human Development Neonatal Research Network's Generic Database and Follow-up Registry from 2006 to 2012. Frequency of GT placement before 18-22 months, demographic and medical factors associated with GT placement, and associated long-term outcomes at 18-22 months of corrected age were described. Associations between GT placement and neonatal morbidities and long-term outcomes were assessed with logistic regression after adjustment for center and common co-variables.ResultsOf the 4549 ELBW infants included in these analyses, 333 (7.3%) underwent GT placement; 76% had the GT placed postdischarge. Of infants with GTs, 11% had birth weights small for gestational age, 77% had bronchopulmonary dysplasia, and 29% severe intraventricular hemorrhage or periventricular leukomalacia. At follow-up, 56% of infants with a GT had weight
       
  • The Benefits of Oral Rehydration on Orthostatic Intolerance in Children
           with Postural Tachycardia Syndrome
    • Abstract: Publication date: Available online 9 August 2019Source: The Journal of PediatricsAuthor(s): Marvin S. Medow, Kenneth Guber, Shilpan Chokshi, Courtney Terilli, Paul Visintainer, Julian M. StewartObjectiveTo evaluate whether equal volumes of oral rehydration solution (ORS) or intravenous (IV) saline provide similar improvements in cardiovascular status during controlled orthostatic challenge when administered to subjects with postural tachycardia syndrome (POTS) with orthostatic intolerance.Study designWe studied the neurovascular response to fluid loading during orthostatic stress using lower body negative pressure (LBNP) in 10 subjects with POTS with orthostatic intolerance and 15 controls, and on subsequent days before and 1 hour after IV saline infusion or ingestion of ORS.ResultsSubjects with POTS exhibited reduced tolerance to LBNP (P 
       
  • Normal Hemoglobin A1c Variability in Early Adolescence: Adult Criteria for
           Prediabetes Should Be Applied with Caution
    • Abstract: Publication date: Available online 9 August 2019Source: The Journal of PediatricsAuthor(s): Megan M. Kelsey, Philip S. Zeitler, Kimberly Drews, Christine L. ChanAmerican Diabetes Association adult criteria are used to screen youth for diabetes, but little is known about normal glycemia in youth. In the HEALTHY Study (total n = 8814), hemoglobin A1c was ≥5.7% in 2% of normal weight youth. This suggests need for cautious interpretation of prediabetes hemoglobin A1s in youth.
       
  • Upper Airway Pathology Contributes to Respiratory Symptoms in Children
           Born Very Preterm
    • Abstract: Publication date: Available online 8 August 2019Source: The Journal of PediatricsAuthor(s): Shannon J. Simpson, Zoe Champion, Graham L. Hall, Noel French, Victoria ReynoldsObjectiveTo evaluate the role of upper airway dysfunction, indicated by altered vocal quality (dysphonia), on the respiratory symptoms of children surviving very preterm birth.Study designChildren born  .05), except for the oscillatory mechanics measures, which were all at least 0.5 z score lower in the dysphonic group (Xrs8 mean difference = −0.91 z scores, P = .003; fres = 1.06 z scores, P = .019; AX = −0.87 z scores, P = .010; Rrs8 = 0.63 z scores, P = .068).ConclusionsThe upper airway may play a role in the respiratory symptoms experienced by some very preterm children and should be considered by clinicians, especially when symptoms are in the presence of normal lung function and are refractory to treatment.
       
 
 
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