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Journal of Pediatrics
Journal Prestige (SJR): 1.522
Citation Impact (citeScore): 2
Number of Followers: 140  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0022-3476
Published by Elsevier Homepage  [3162 journals]
  • On the Gendering of Plasma: What is Transfusion-Related Acute Lung Injury
           to Bronchopulmonary Dysplasia'
    • Abstract: Publication date: Available online 14 July 2018Source: The Journal of PediatricsAuthor(s): Haresh Kirpalani, Michael J. Stark, Chad Andersen
       
  • Hamman's Sign in a Patient with Spontaneous Pneumomediastinum
    • Abstract: Publication date: Available online 14 July 2018Source: The Journal of PediatricsAuthor(s): Kazuhiro Uda, Takahiro Matsushima, Yuho Horikoshi, Hiroshi Hataya
       
  • Subsyndromal Manifestations of Depression in Children Predict the
           Development of Major Depression
    • Abstract: Publication date: Available online 13 July 2018Source: The Journal of PediatricsAuthor(s): Mai Uchida, Maura Fitzgerald, Hilary Woodworth, Nicholas Carrellas, Caroline Kelberman, Joseph BiedermanObjectiveTo evaluate the utility of assessing subsyndromal symptoms of major depressive disorder in childhood, indexed through the Child Behavior Checklist (CBCL) anxiety/depression scale, in predicting risk of developing major depressive disorder in adolescent and young adult years.Study designThe sample consisted of 537 children, 6-17 years of age, originally ascertained for a longitudinal family genetic study of youth with and without attention-deficit hyperactivity disorder and their first-degree relatives who were followed prospectively and blindly for 10 years from childhood into young adult years. Children with full diagnosis major depressive disorder at baseline were excluded. For analysis, the sample was stratified into 4 groups based on the presence or absence of parental mood disorders and by the presence or absence of subsyndromal scores on the CBCL anxiety/depression scale at baseline assessment in childhood.ResultsChildren of parents with mood disorders plus subsyndromal scores on the CBCL anxiety/depression scale at baseline (n = 22) had the highest risk for developing major depressive disorder and anxiety disorders at the 10-year follow-up when compared with the other groups. Children with either subsyndromal scores on the CBCL anxiety/depression scale at baseline alone (n = 22) or parental mood disorders alone (n = 172) had intermediate outcomes.ConclusionThe CBCL anxiety/depression scale was useful in identifying children at high risk for the development of major depressive disorder and anxiety disorders at the 10-year prospective follow-up. Furthermore, our results emphasized the importance of familial psychiatric history in youth with subthreshold symptoms of depression. Parental mood disorder and subthreshold anxiety/depressive symptoms were predictive of developing depression.
       
  • Reply
    • Abstract: Publication date: Available online 13 July 2018Source: The Journal of PediatricsAuthor(s): Carol J. Blaisdell, James Troendle, Anne Zajicek
       
  • Greater Breastfeeding in Early Infancy Is Associated with Slower Weight
           Gain among High Birth Weight Infants
    • Abstract: Publication date: Available online 12 July 2018Source: The Journal of PediatricsAuthor(s): Amy R. Goetz, Constance A. Mara, Lori J. StarkObjectiveTo examine whether feeding patterns from birth to age 6 months modify the association between birth weight and weight at 7-12 months of age.Study designLongitudinal mixed models were used to examine feeding trajectories across categories of birth weight and weight at 7-12 months of age in 1799 mother-infant dyads enrolled in the Infant Feeding Practices Study II. The percentage of breast milk received and the average daily formula consumption were calculated from birth to 6 months of age. Birth weights were classified as high (≥4000 g) and normal (≥2500 g and 1) or normal (z score ≤1). A secondary analysis was performed using categories defined by birth weight adjusted for gestational age percentiles (>90% and 10th-90th percentile).ResultsHigh birth weight (HBW) infants with high weights at 7-12 months of age demonstrated a rapid decline in the percentage of breast milk feedings compared with HBW infants with normal weights at 7-12 months of age. Normal birth weight infants with high weights at 7-12 months of age received a lower percentage of breast milk and had greater absolute intakes of formula than those with normal weights at 7-12 months of age; these associations did not vary over time. Results were similar when infants were categorized by birth weight percentiles.ConclusionsA lower proportion of breast milk feedings was associated with excess weight at 7-12 months of age in HBW infants. These findings suggest an initial target for obesity prevention programs focusing on the first 6 months after birth.
       
  • Effect of Adjusting for Tanner Stage Age on Prevalence of Short and Tall
           Stature of Youths in the United States
    • Abstract: Publication date: Available online 10 July 2018Source: The Journal of PediatricsAuthor(s): O. Yaw Addo, Kyriakie Sarafoglou, Bradley S. MillerObjectiveTo evaluate the extent to which pubertal timing alters the classification of extremes of attained stature across race-ethnicity groups of youths in the US.Study designWe performed analyses of height and Tanner staging data of 3206 cross-sectional national sample of youths ages 8-18 years (53% male, n = 1606), 72% of whom were non-Hispanic white, 9% Mexican American, and 19% non-Hispanic black . Specialized growth models were used to derive Tanner-stage-age-adjusted z scores (TSAHAZ). The prevalence of shortness (
       
  • Preterm Infant Outcomes after Randomization to Initial Resuscitation with
           FiO2 0.21 or 1.0
    • Abstract: Publication date: Available online 6 July 2018Source: The Journal of PediatricsAuthor(s): Valerie Thamrin, Ola D. Saugstad, William Tarnow-Mordi, Yueping Alex Wang, Kei Lui, Ian M. Wright, Koert De Waal, Javeed Travadi, John P. Smyth, Paul Craven, Rowena McMullan, Elisabeth Coates, Meredith Ward, Parag Mishra, Kwee Ching See, Irene G.S. Cheah, Chin Theam Lim, Yao Mun Choo, Azanna Ahmad Kamar, Fook Choe CheahObjectiveTo determine rates of death or neurodevelopmental impairment (NDI) at 2 years corrected age (primary outcome) in children
       
  • Effects of Delayed Cord Clamping on Four-Month Ferritin Levels, Brain
           Myelin Content, and Neurodevelopment: A Randomized Controlled Trial
    • Abstract: Publication date: Available online 6 July 2018Source: The Journal of PediatricsAuthor(s): Judith S. Mercer, Debra A. Erickson-Owens, Sean C.L. Deoni, Douglas C. Dean, Jennifer Collins, Ashley B. Parker, Meijia Wang, Sarah Joelson, Emily N. Mercer, James F. PadburyObjectiveTo evaluate whether placental transfusion influences brain myelination at 4 months of age.Study designA partially blinded, randomized controlled trial was conducted at a level III maternity hospital in the US. Seventy-three healthy term pregnant women and their singleton fetuses were randomized to either delayed umbilical cord clamping (DCC,>5 minutes) or immediate clamping (ICC,
       
  • A Randomized Controlled Trial of a Barrier Dressing to Reduce Nasal Injury
           in Preterm Infants Receiving Binasal Noninvasive Respiratory Support
    • Abstract: Publication date: Available online 4 July 2018Source: The Journal of PediatricsAuthor(s): Dilini I. Imbulana, Louise S. Owen, Jennifer A. Dawson, Jane L. Bailey, Peter G. Davis, Brett J. ManleyObjectiveTo determine whether the use of a hydrocolloid nasal barrier dressing during binasal continuous positive airway pressure (CPAP) therapy, compared with no barrier dressing, reduces the rate of nasal injury in very preterm and/or very low birth weight infants.Study designA single-center randomized controlled trial conducted in the neonatal intensive care unit at The Royal Women's Hospital, Melbourne. Eligible infants were born
       
  • Association Between Video Laryngoscopy and Adverse Tracheal
           Intubation-Associated Events in the Neonatal Intensive Care Unit
    • Abstract: Publication date: Available online 3 July 2018Source: The Journal of PediatricsAuthor(s): Nicole R. Pouppirt, Rula Nassar, Natalie Napolitano, Ursula Nawab, Akira Nishisaki, Vinay Nadkarni, Anne Ades, Elizabeth E. FogliaThe effect of video laryngoscopy on adverse events during neonatal tracheal intubation is unknown. In this single site retrospective cohort study, video laryngoscopy was independently associated with decreased risk for adverse events during neonatal intubation.
       
  • T-Cell Receptor Excision Circles in HIV-Exposed, Uninfected Newborns
           Measured During a National Newborn Screening Program for Severe Combined
           Immunodeficiency
    • Abstract: Publication date: Available online 3 July 2018Source: The Journal of PediatricsAuthor(s): Josiane Warszawski, Caroline Thomas, Olivia Dialla, Valérie Garrait, Catherine Dollfus, Veronique Reliquet, Laure Clech, Cécile Dert, Laurent Mandelbrot, Marie Audrain, Stéphane Blanche, Laurent Mandelbrot, Catherine Crenn-Hebert, Corinne Floch-Tudal, Fabienne Mazy, Marine Joras, Françoise Meier, Emmanuel Mortier, Sophie Matheron, Neila ElaounSevere combined immunodeficiency screening by measuring T-receptor excision circles at birth allows evaluation of the impact of various maternal conditions on newborn immunity. The slight decrease observed in a French cohort of newborns to HIV-infected mothers can be explained by the confounding factors of prematurity and African descent.
       
  • Pancreatic Cystosis and Intrahepatic Biliopathy in a Young Adult with
           Cystic Fibrosis
    • Abstract: Publication date: Available online 2 July 2018Source: The Journal of PediatricsAuthor(s): Saif Al Qatarneh, Hilary Michel, Douglas Lindblad, John Ozolek, Veena Venkat, Daniel Weiner
       
  • Effects of Smoking Exposure in Infants on Gastroesophageal Reflux as a
           Function of the Sleep–Wakefulness State
    • Abstract: Publication date: Available online 2 July 2018Source: The Journal of PediatricsAuthor(s): Djamal Djeddi, Erwan Stephan-Blanchard, André Léké, Mohamed Ammari, Stephane Delanaud, Anne-Sophie Lemaire-Hurtel, Véronique Bach, Frédéric TelliezObjectiveTo determine whether perinatal smoking exposure is associated with gastroesophageal reflux (GER)-related changes in sleep-wakefulness states in neonates.Study designThirty-one neonates, referred for the investigation of suspected GER, were recruited and underwent multichannel impedance–pH monitoring and synchronized 8- to 12-hour polysomnography. The infants' exposure to tobacco smoke was estimated by means of a urine cotinine assay. The total number, frequency (h−1), and mean duration (minutes) of GER-pH (reflux events detected by the pH electrode only) and GER-imp (reflux events with bolus movement detected by impedance) events were determined. Intergroup differences (smoking-exposed group vs nonexposed group) were probed with nonparametric, unpaired Mann–Whitney U tests. A χ2 test was used to assess a possible intergroup difference in bolus retrograde migration during GER-imp events.ResultsAccording to the urine cotinine assay, 21 of the 31 neonates had been exposed to cigarette smoke during the perinatal period. The number (and frequency) of GER-imp was significantly greater (P = .016) in the exposed group (29 [0-90]) than in the nonexposed group (12 [2-35]). Migration of the esophageal bolus from the distal segment to the most proximal segment was significantly more frequent (P = .016) in the exposed group (83% of GER) than in the nonexposed group (41%). The GER pattern associated with smoking exposure was particularly obvious during Rapid eye movement sleep.ConclusionsThe more frequent occurrence and greater proximal migration of GER-imp in the smoking-exposed group (especially during rapid eye movement sleep) may have clinical relevance. Smoking exposure is a preventable risk factor for limiting the occurrence of GER in neonates.
       
  • Cardiometabolic Risk Factors, Metabolic Syndrome, and Chronic Kidney
           Disease Progression in Children
    • Abstract: Publication date: Available online 2 July 2018Source: The Journal of PediatricsAuthor(s): Shwetal Lalan, Shuai Jiang, Derek K. Ng, Fernanda Kupferman, Bradley A. Warady, Susan Furth, Mark M. MitsnefesObjectiveTo estimate the prevalence of metabolic syndrome (MetS) and examine its association with chronic kidney disease progression in children enrolled in the Chronic Kidney Disease in Children study.Study designMetS was defined as being overweight or obese and having ≥2 cardiometabolic risk factors (CMRFs). Incidence and prevalence of MetS were assessed using pairs of visits approximately 2 years apart.ResultsA total of 799 pairs of person-visits (contributed by 472 children) were included in the final analysis. Of these, 70% had a normal body mass index (BMI), 14% were overweight, and 16% were obese. At the first visit, the prevalence of MetS in the overweight group was 40% and in the obese group was 60%. In adjusted models, annual percent estimated glomerular filtration rate decline in those who had normal BMI and incident or persistent multiple CMRFs or those with persistent MetS was −6.33%, −6.46%, and −6.08% (respectively) compared with children who never had multiple CMRFs (−3.38%, P = .048, .045, and .036, respectively). Children with normal BMI and incident multiple CMRFs and those with persistent MetS had approximately twice the odds of fast estimated glomerular filtration rate decline (>10% per year) compared with those without multiple CMRFs and normal BMI.ConclusionChildren with chronic kidney disease have a high prevalence of MetS. These children as well as those with normal BMI but multiple CMRFs experience a faster decline in kidney function.
       
  • Clinical and Radiologic Manifestations of Bone Infection in Children with
           Cat Scratch Disease
    • Abstract: Publication date: Available online 2 July 2018Source: The Journal of PediatricsAuthor(s): Guliz Erdem, Joshua R. Watson, W. Garrett Hunt, Cody Young, Cristina Tomatis Souverbielle, Jonathan R. Honegger, Kevin A. Cassady, Megan Ilgenfritz, Stephanie Napolitano, Katalin KoranyiWe identified 13 patients with cat scratch (Bartonella henselae) bone infection among those admitted to a large tertiary care children's hospital over a 12-year period. The median age was 7 years and the median time from onset of illness to diagnosis was 10 days. Multifocal osteomyelitis involving spine and pelvis was common; no patient had a lytic bone lesion. Median treatment duration was 28 days (IQR, 24.5 days). Despite significant variations in treatment duration and antimicrobial therapy choices, all patients showed improvement.
       
  • Assessment of Nonalcoholic Fatty Liver Disease Progression in Children
           Using Magnetic Resonance Imaging
    • Abstract: Publication date: Available online 2 July 2018Source: The Journal of PediatricsAuthor(s): Marialena Mouzaki, Andrew T. Trout, Ana Catalina Arce-Clachar, Kristin Bramlage, Pierce Kuhnell, Jonathan R. Dillman, Stavra XanthakosObjectiveTo assess liver disease progression using paired magnetic resonance imaging (MRI) measurements of liver fat fraction (FF) and stiffness.Study designRetrospective cohort study including patients with nonalcoholic fatty liver disease who had undergone repeat MRI studies. Descriptive statistics were used, as well as Pearson or Spearman correlation when appropriate. Mixed model analyses were used to determine relationships between liver FF/stiffness and predictor variables.ResultsSixty-five patients (80% non-Hispanic, mean age 14 ± 3 years) were included. Time from first to last MRI was 27 ± 14 months. Over time, body mass index z score remained stable, and there were no significant differences in mean serum aminotransferases, insulin, glucose, triglycerides, low-density lipoprotein, and high-density lipoprotein (HDL) levels. However, the proportion of patients with alanine aminotransferase (ALT) 
       
  • Diagnostic Delay in Erythropoietic Protoporphyria
    • Abstract: Publication date: Available online 2 July 2018Source: The Journal of PediatricsAuthor(s): Sajel M. Lala, Hetanshi Naik, Manisha BalwaniErythropoietic protoporphyria is a photodermatosis presenting in childhood with severe pain on sun exposure. The diagnosis is often delayed because of the lack of awareness among pediatricians. We describe the diagnostic odyssey of 2 children presenting with symptoms of erythropoietic protoporphyria and report results of a survey of 129 affected individuals.
       
  • Acrodermatitis-Like Rash in Kawasaki Disease
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Ankur Kumar Jindal, Devika Laishram, Surjit Singh
       
  • Ureterocele Causing Bladder Outlet Obstruction
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Campbell Grant, Christopher Bayne
       
  • A Painless Bulky Lesion of the Tongue
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Salvatore Garofalo, Riccardo Guanà, Luisa Ferrero, Alessia Cerrina, Maria Grazia Cortese, Elisabetta Teruzzi, Jürgen Schleef
       
  • Varicocele with an Abdominal Mass
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Vijai Williams, Vinay Munikoty, Amita Trehan
       
  • Acute Pancreatitis in a Patient with Maple Syrup Urine Disease: A
           Management Paradox
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Nina B. Gold, Jennifer A. Blumenthal, Ann E. Wessel, Deborah R. Stein, Adam Scott, Victor L. Fox, Amy Turner, Amy Kritzer, Farrah Rajabi, Katherine Peeler, Wen-Hann TanMaple syrup urine disease (MSUD) is an inborn error of metabolism that causes elevated leucine in the setting of acute illnesses. We describe an 8-year-old boy with MSUD who developed acute pancreatitis and subsequent leucinosis. This case highlights the complexities of fluid management in patients with MSUD.
       
  • Severe Cardiac Involvement Is Rare in Patients with Late-Onset Pompe
           Disease and the Common c.-32-13T>G Variant: Implications for Newborn
           Screening
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Mrudu Herbert, Heidi Cope, Jennifer S. Li, Priya S. KishnaniBased on a review of a large patient cohort, published literature, and 3 newborn screening cohorts, we concluded that children diagnosed through newborn screening with late-onset Pompe disease and the common heterozygous c.-32-13T>G variant require frequent cardiac follow-up with electrocardiography for arrhythmias. However, there is limited evidence for performing repeated echocardiography for cardiomyopathy.
       
  • Paracetamol Serum Concentrations in Neonates Treated Enterally for Ductal
           Closure: A Pilot Study
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Alona Bin-Nun, Daniel Fink, Francis B. Mimouni, Nurit Algur, Cathy HammermanWe determined serum paracetamol concentrations 4 hours after the eighth dose in infants treated enterally for ductal closure. Serum paracetamol concentrations correlated (P = .0026) with ductal response. No patent ductus arteriosus in a baby with paracetamol levels
       
  • Intravenous Fish Oil Lipid Emulsion Prevents Catheter-Related Thromboses
           in Pediatric Patients with Intestinal Failure
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Mohammad M. Jami, Vrinda Bhardwaj, Russell J. MerrittA central venous catheter is a risk factor for deep vein thrombosis. We compared the incidence of deep vein thrombosis in children with intestinal failure patients receiving soy oil lipid emulsion (n = 35) vs fish oil lipid emulsion (n = 35). Ten deep vein thrombosis occurred in the soy oil lipid emulsion group, and none in the fish oil lipid emulsion group (P 
       
  • Out-of-Home Care and the Educational Achievement, Attendance, and
           Suspensions of Maltreated Children: A Propensity-Matched Study
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Miriam J. Maclean, Catherine L. Taylor, Melissa O'DonnellObjectiveTo estimate the influence of out-of-home care on reading scores, attendance, and suspensions by comparing a matched sample of maltreated children who entered out-of-home care and maltreated children who remained at home.Study designLinked administrative data for all children born in Western Australia between 1990 and 2010 was used, focusing on those with substantiated maltreatment before year 9 achievement tests (n = 3297). Propensity score modelling was used to address differences in preexisting risk factors (child, family, neighborhood characteristics, maltreatment history, and reading scores) and compare outcomes for children placed in out-of-home care and those remaining in in-home care.ResultsBoth groups of maltreated children had poor educational outcomes. After accounting for group differences in risk characteristics, there was no difference in year 9 reading achievement for the out-of-home care and in-home care groups. There was no difference in suspensions for the groups. The only significant difference was children in out-of-home care had fewer school absences than children in in-home care.ConclusionsOut-of-home care was not found to be a significant factor in the adverse educational outcomes of these children; however, there is a clear need for further educational support to address poor outcomes for children involved with child protection services.
       
  • Insufficient Sleep and Incidence of Dental Caries in Deciduous Teeth among
           Children in Japan: A Population-Based Cohort Study
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Hongyan Chen, Shiro Tanaka, Korenori Arai, Satomi Yoshida, Koji KawakamiObjectivesTo examine whether late bedtime and short nighttime sleep duration at age 18 months are associated with risk of caries in deciduous teeth.Study designPopulation-based cohort study using health check-up data of 71 069 children born in Kobe City, Japan, who were free of caries at age 18 months and had information on sleep variables at age 18 months and records of dental examinations at age 3 years. Sleep variables were assessed by standardized parent-reported questionnaires, and the incidence of caries in deciduous teeth was defined as the occurrence of at least 1 decayed, missing, or filled tooth assessed by qualified dentists without radiographs. Logistic regression was used to estimate the effects of late bedtime and short sleep duration on dental caries with adjustment for clinical and lifestyle characteristics.ResultsOverall, 11 343 (16.0%) cases of caries were observed at age 3 years. aORs for children with late or irregular bedtimes compared with those with bedtimes before 21:00 were 1.26 (95% CI 1.19-1.33), 1.48 (1.38-1.58), 1.74 (1.58-1.92), 1.90 (1.58-2.29), and 1.66 (1.53-1.81) for bedtimes at 21:00, 22:00, 23:00, 0:00, and irregular bedtime, respectively. aORs for children with short or irregular sleep duration compared with those with sleep duration of ≥11 hours were 1.30 (95% CI 1.15-1.47), 1.16 (1.09-1.24), 1.11 (1.05-1.18), and 1.35 (1.25-1.46) for sleep duration of ≤ 8, 9, 10 hours, and irregular sleep duration, respectively.ConclusionsIn this exploratory study, late bedtime and short sleep duration were both consistently associated with increased risk of caries in deciduous teeth.
       
  • Multi-Stakeholder Informed Guidelines for Direct Admission of Children to
           Hospital
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): JoAnna K. Leyenaar, Megan Shevenell, Paul A. Rizzo, Vanessa L. Hill, Peter K. LindenauerObjectivesTo develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes.Study designWe conducted deliberative discussions at 1 children's hospital and 2 community hospitals, engaging parents of hospitalized children and inpatient, outpatient, and emergency department physicians and nurses to identify shared and dissenting perspectives regarding direct admission processes and outcomes. Discussions were audio-recorded, professionally transcribed, and analyzed using a general inductive approach. We then convened a national panel to prioritize guideline components and outcome measures using a RAND/UCLA Modified Delphi approach.ResultsForty-eight stakeholders participated in 6 deliberative discussions. Emergent themes related to effective multistakeholder communication, resources needed for high quality direct admissions, written direct admission guidelines, including criteria to identify children appropriate for and inappropriate for direct admission, and families' needs. Building on these themes, Delphi panelists endorsed 71 guideline components as both appropriate and necessary at children's hospitals and community hospitals and 13 outcomes to evaluate hospital admission systems. Guideline components include (1) pre-admission communication, (2) written guidelines, (3) hospital resources to optimize direct admission processes, (4) special considerations for pediatric populations that may be at particular risk of nosocomial infection and/or stress in emergency departments, (5) communication with families referred for direct admission, and (6) quality reviews to evaluate admission systems.ConclusionsThese direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration.
       
  • Development of an International Odor Identification Test for Children: The
           Universal Sniff Test
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Valentin A. Schriever, Eduardo Agosin, Aytug Altundag, Hadas Avni, Helene Cao Van, Carlos Cornejo, Gonzalo de los Santos, Gad Fishman, Claudio Fragola, Marco Guarneros, Neelima Gupta, Robyn Hudson, Reda Kamel, Antti Knaapila, Iordanis Konstantinidis, Basile N. Landis, Maria Larsson, Johan N. Lundström, Alberto Macchi, Franklin Mariño-SánchezObjectiveTo assess olfactory function in children and to create and validate an odor identification test to diagnose olfactory dysfunction in children, which we called the Universal Sniff (U-Sniff) test.Study designThis is a multicenter study involving 19 countries. The U-Sniff test was developed in 3 phases including 1760 children age 5-7 years. Phase 1: identification of potentially recognizable odors; phase 2: selection of odorants for the odor identification test; and phase 3: evaluation of the test and acquisition of normative data. Test—retest reliability was evaluated in a subgroup of children (n = 27), and the test was validated using children with congenital anosmia (n = 14).ResultsTwelve odors were familiar to children and, therefore, included in the U-Sniff test. Children scored a mean ± SD of 9.88 ± 1.80 points out of 12. Normative data was obtained and reported for each country. The U-Sniff test demonstrated a high test—retest reliability (r27 = 0.83, P 
       
  • Efficacy of Growth Hormone Treatment in Children with Type 1 Diabetes
           Mellitus and Growth Hormone Deficiency—An Analysis of KIGS Data
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Walter Bonfig, Anders Lindberg, Martin Carlsson, Wayne Cutfield, David Dunger, Cecilia Camacho-Hübner, Reinhard W. HollObjectiveTo analyze first-year treatment growth response and growth hormone (GH) dosage in prepubertal patients with the combination of type 1 diabetes mellitus (T1DM) and growth hormone deficiency (GHD).Study designA total of 69 patients with T1DM and GHD treated with GH have been enrolled in KIGS (Pfizer International Growth Database). Of these, 24 prepubertal patients had developed T1DM before GHD and were included in this analysis. Of 30 570 patients with GHD without T1DM, 15 024 were prepubertal and served as controls. Values are expressed as mean ± SD.ResultsPatients with T1DM and GHD had similar characteristics compared with the GHD-alone group. Neither age (10.2 ± 3.13 vs 8.42 ± 3.46 years, P = .14), height SDS corrected for midparental height SDS at start of treatment (−1.62 ± 1.38 vs −1.61 ± 1.51, P = .80), nor GH dosage (0.24 ± 0.08 mg/kg/wk vs 0.20 ± 0.04 mg/kg/wk, P = .09) were different between those with and without T1DM. First-year catch-up growth was comparable between the 2 patient groups (first treatment year height velocity 7.54 ± 3.11 cm/year compared with 8.35 ± 2.54 cm/year in control patients, P = .38). Height SDS of children with T1DM and GHD improved from −2.62 ± 1.04 to −1.88 ± 1.11 over 1 year of GH treatment.ConclusionShort-term response to GH therapy appeared similar in subjects with T1DM who then developed GHD and in those with GHD alone. Thus, T1DM does not appear to compromise GH response in children with GHD and should not exclude GH treatment in these children. GH treatment was safe in both subgroups of patients.
       
  • Social Determinants of Health Are Associated with Markers of Renal Injury
           in Adolescents with Type 1 Diabetes
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Laura A.M. Cummings, Antoine Clarke, Etienne Sochett, Denis Daneman, David Z. Cherney, Heather N. Reich, James W. Scholey, David B. Dunger, Farid H. MahmudObjectiveTo examine the relationship between the social determinants of health and markers of early renal injury in adolescent patients with type 1 diabetes (T1D).Study designRenal outcomes included estimated glomerular filtration rate (eGFR) and albumin–creatinine excretion ratio (ACR). Differences in urinary and serum inflammatory markers also were assessed in relation to social determinants of health. Regression analysis was used to evaluate the association between the Ontario Marginalization Index (ON-Marg) as a measure of the social determinants of health, patient characteristics, ACR, eGFR, and renal filtration status (hyperfiltration vs normofiltration).ResultsParticipants with T1D (n = 199) with a mean age of 14.4 ± 1.7 years and diabetes duration of 7.2 ± 3.1 years were studied. Mean eGFR was 122.0 ± 19.4 mL/min/1.73 m2. Increasing marginalization was positively associated with eGFR (P 
       
  • A Brain Marker for Developmental Speech Disorders
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Angela T. Morgan, Merina Su, Sheena Reilly, Gina Conti-Ramsden, Alan Connelly, Frédérique J. LiégeoisObjectiveTo characterize the organization of speech- and language-related white matter tracts in children with developmental speech and/or language disorders.Study designWe collected magnetic resonance diffusion-weighted imaging data from 41 children, ages 9-11 years, with developmental speech and/or language disorders, and compared them with 45 typically developing controls with the same age range. We used probabilistic tractography of diffusion-weighted imaging to map language (3 segments of arcuate fasciculus, extreme capsule system) and speech motor (corticobulbar) tracts bilaterally. The corticospinal and callosal tracts were used as control regions. We compared the mean fractional anisotropy and diffusivity values between atypical and control groups, covarying for nonverbal IQ. We then examined differences between atypical subgroups: developmental speech disorder (DSD), developmental language disorder, and co-occurring developmental speech and language disorder.ResultsFractional anisotropy in the left corticobulbar tract was lower in the DSD than in the control group. Radial and mean diffusivity were higher in the DSD than the developmental language disorder, co-occurring developmental speech and language disorder, or control groups. There were no group differences for any metrics in the language or control tracts.ConclusionsAtypical development of the left corticobulbar tract may be a neural marker for DSD. This finding is in line with reports of speech disorder after left corticobulbar damage in children and adults with brain injury. By contrast, we found no association between diffusion metrics in language-related tracts in developmental language disorder, and changes for language disorders are likely more complex.
       
  • Neurodevelopment of Infants with and without Craniofacial Microsomia
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Matthew L. Speltz, Kathleen A. Kapp-Simon, Alexis L. Johns, Erin R. Wallace, Brent R. Collett, Leanne Magee, Brian G. Leroux, Daniela V. Luquetti, Carrie L. HeikeObjectivesTo determine whether infant cases with craniofacial microsomia (CFM) evidence poorer neurodevelopmental status than demographically similar infants without craniofacial diagnoses (“controls”), and to examine cases' neurodevelopmental outcomes by facial phenotype and hearing status.Study designMulticenter, observational study of 108 cases and 84 controls aged 12-24 months. Participants were assessed by the Bayley Scales of Infant and Toddler Development-Third Edition and the Preschool Language Scales-Fifth Edition (PLS-5). Facial features were classified with the Phenotypic Assessment Tool for Craniofacial Microsomia.ResultsAfter adjustment for demographic variables, there was little difference in Bayley Scales of Infant and Toddler Development-Third Edition or Preschool Language Scales-Fifth Edition outcomes between cases and controls. Estimates of mean differences ranged from –0.23 to 1.79 corresponding to standardized effect sizes of −.02 to 0.12 (P values from .30 to .88). Outcomes were better among females and those with higher socioeconomic status. Among cases, facial phenotype and hearing status showed little to no association with outcomes. Analysis of individual test scores indicated that 21% of cases and 16% of controls were developmentally delayed (OR  0.68, 95% CI 0.29-1.61).ConclusionsAlthough learning problems have been observed in older children with CFM, we found no evidence of developmental or language delay among infants. Variation in outcomes across prior studies may reflect differences in ascertainment methods and CFM diagnostic criteria.
       
  • Review of Interventions and Radiation Exposure from Chest Computed
           Tomography in Children with Blunt Trauma
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Victor Hsiao, Genevieve Santillanes, Daniel Malek, Ilene ClaudiusObjectiveTo determine the radiation risk to a child undergoing trauma evaluation with chest computed tomography (CCT) for every clinically actionable injury identified.Study designThis observational, cross-sectional study included all blunt trauma patients under 18 years of age undergoing CCT in a single urban emergency department. Via a retrospective chart review, therapeutic interventions done exclusively for chest injuries identified on CCT scan were identified. Effective radiation from each CCT was calculated and averaged and the dose required to diagnose 1 management-changing chest injury was determined.ResultsOf 209 children undergoing CCT over a 19-month period, 168 were victims of blunt trauma. Ten required an intervention specifically for a chest injury identified on CCT (suggesting development of 1 malignancy per 37 actionable injures identified). None required an intervention for an injury exclusively noted on CCT, as all 10 actionable injuries were apparent via other modalities (radiograph, ultrasound examination, clinical examination).ConclusionAlthough 10 uniquely actionable injuries were identified on CCT, none were found only on CCT. Because CCTs rarely modified management, the amount of radiation administered per management change was sufficiently high to recommend reconsideration of current imaging practice in this single-center study.
       
  • Reduction of Radiography with Point-of-Care Elbow Ultrasonography for
           Elbow Trauma in Children
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Julia Tokarski, Jeffrey R. Avner, Joni E. RabinerObjectivesTo determine whether point-of-care elbow ultrasound (US), with history and physical examination, can decrease radiography for patients with elbow trauma. Secondary outcomes included evaluation of pediatric emergency department (PED) length of stay (LOS) and test performance characteristics.Study designThis was a prospective study of patients up to age 21 years with elbow trauma necessitating radiography. After clinical examination and before radiography, pediatric emergency physicians performed elbow ultrasonography of the posterior fat pad and determined whether radiography was required. All patients underwent elbow radiography and received clinical follow-up. Times for US and radiography were recorded.ResultsA total of 100 patients with a mean age of 7.9 years were enrolled, 42 of whom had a fracture. In 23 patients, the physician determined that radiography could be eliminated. Elbow US combined with clinical suspicion for fracture had a sensitivity of 100% (95% CI, 92%-100%). Elbow US took a median of 3 minutes (IQR, 2-5 minutes), and completion and interpretation of elbow radiography took a median of 60 minutes (IQR, 43-84 minutes). The overall sensitivity of elbow US was 88% (95% CI, 75%-96%).ConclusionsElbow US has a high sensitivity to rule out fracture and is best used in patients with a low clinical suspicion of fracture. The use of conventional radiography and PED LOS may be reduced in patients with a low clinical concern for fracture and normal elbow US.
       
  • The Neu-Prem Trial: Neuromonitoring of Brains of Infants Born Preterm
           During Resuscitation—A Prospective Observational Cohort Study
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Anup C. Katheria, M.J. Harbert, Sunil B. Nagaraj, Kathy Arnell, Debra M. Poeltler, Melissa K. Brown, Wade Rich, Kasim O. Hassen, Neil FinerObjectiveTo determine whether monitoring cerebral oxygen tissue saturation (StO2) with near-infrared spectroscopy (NIRS) and brain activity with amplitude-integrated electroencephalography (aEEG) can predict infants at risk for intraventricular hemorrhage (IVH) and death in the first 72 hours of life.Study designA NIRS sensor and electroencephalography leads were placed on 127 newborns
       
  • Maternal Black Race and Persistent Wheezing Illness in Former Extremely
           Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Katherine C. Wai, Anna M. Hibbs, Martina A. Steurer, Dennis M. Black, Jeanette M. Asselin, Eric C. Eichenwald, Philip L. Ballard, Roberta A. Ballard, Roberta L. Keller, Suzanne Hamilton Strong, Jill Immamura-Ching, Margaret Orfanos-Villalobos, Cassandra Williams, David J. Durand, Jeffrey D. Merrill, Dolia Horton, Loretta Pacello, April Willard, William E. Truog, Cheryl GauldinObjectiveTo evaluate the relationship between maternal self-reported race/ethnicity and persistent wheezing illness in former high-risk, extremely low gestational age newborns, and to quantify the contribution of socioeconomic, environmental, and biological factors on this relationship.Study designWe assessed persistent wheezing illness determined at 18-24 months corrected (for prematurity) age in survivors of a randomized trial. Parents/caregivers were surveyed for wheeze and inhaled asthma medication use quarterly to 12 months, and at 18 and 24 months. We used multivariable analysis to evaluate the relationship of maternal race to persistent wheezing illness, and identified mediators for this relationship via formal mediation analysis.ResultsOf 420 infants (25.2 ± 1.2 weeks of gestation and 714 ± 166 g at birth, 57% male, 34% maternal black race), 189 (45%) had persistent wheezing illness. After adjustment for gestational age, birth weight, and sex, infants of black mothers had increased odds of persistent wheeze compared with infants of nonblack mothers (OR = 2.9, 95% CI 1.9, 4.5). Only bronchopulmonary dysplasia, breast milk diet, and public insurance status were identified as mediators. In this model, the direct effect of race accounted for 69% of the relationship between maternal race and persistent wheeze, whereas breast milk diet, public insurance status, and bronchopulmonary dysplasia accounted for 8%, 12%, and 10%, respectively.ConclusionsAmong former high-risk extremely low gestational age newborns, infants of black mothers have increased odds of developing persistent wheeze. A substantial proportion of this effect is directly accounted for by race, which may reflect unmeasured environmental influences, and acquired and innate biological differences.Trial registrationClinicalTrials.gov: NCT01022580.
       
  • Initial Metabolic Profiles Are Associated with 7-Day Survival among
           Infants Born at 22-25 Weeks of Gestation
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Scott P. Oltman, Elizabeth E. Rogers, Rebecca J. Baer, James G. Anderson, Martina A. Steurer, Matthew S. Pantell, J. Colin Partridge, Larry Rand, Kelli K. Ryckman, Laura L. Jelliffe-PawlowskiObjectiveTo evaluate the association between early metabolic profiles combined with infant characteristics and survival past 7 days of age in infants born at 22-25 weeks of gestation.Study designThis nested case-control consisted of 465 singleton live births in California from 2005 to 2011 at 22-25 weeks of gestation. All infants had newborn metabolic screening data available. Data included linked birth certificate and mother and infant hospital discharge records. Mortality was derived from linked death certificates and death discharge information. Each death within 7 days was matched to 4 surviving controls by gestational age and birth weight z score category, leaving 93 cases and 372 controls. The association between explanatory variables and 7-day survival was modeled via stepwise logistic regression. Infant characteristics, 42 metabolites, and 12 metabolite ratios were considered for model inclusion. Model performance was assessed via area under the curve.ResultsThe final model included 1 characteristic and 11 metabolites. The model demonstrated a strong association between metabolic patterns and infant survival (area under the curve [AUC] 0.885, 95% CI 0.851-0.920). Furthermore, a model with just the selected metabolites performed better (AUC 0.879, 95% CI 0.841-0.916) than a model with multiple clinical characteristics (AUC 0.685, 95% CI 0.627-0.742).ConclusionsUse of metabolomics significantly strengthens the association with 7-day survival in infants born extremely premature. Physicians may be able to use metabolic profiles at birth to refine mortality risks and inform postnatal counseling for infants born at
       
  • he+Journal+of+Pediatrics :+Platelet+Counts+in+Healthy+Premature+Infants&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in The Journal of Pediatrics : Platelet Counts in Healthy
           Premature Infants
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Ashish Gupta, James Padbury
       
  • Natural History of Postnatal Cardiopulmonary Adaptation in Infants Born
           Extremely Preterm and Risk for Death or Bronchopulmonary Dysplasia
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Hussnain Mirza, Jorge A. Garcia, Elizabeth Crawford, Julie Pepe, Matthew Zussman, Rajan Wadhawan, William OhObjectiveTo study the natural history of postnatal cardiopulmonary adaptation in infants born extremely preterm and establish its association with death or bronchopulmonary dysplasia (BPD).Study designThis was a prospective, observational, cohort study of infants born extremely preterm (
       
  • Suction Mask vs Conventional Mask Ventilation in Term and Near-Term
           Infants in the Delivery Room: A Randomized Controlled Trial
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Laila Lorenz, Christoph M. Rüegger, Eoin O'Currain, Jennifer A. Dawson, Marta Thio, Louise S. Owen, Susan M. Donath, Peter G. Davis, C. Omar F. KamlinObjectiveTo compare the suction mask, a new facemask that uses suction to create a seal between the mask and the infant's face, with a conventional soft, round silicone mask during positive pressure ventilation (PPV) in the delivery room in newborn infants>34 weeks of gestation.Study designSingle-center randomized controlled trial in the delivery room. The primary outcome was mask leak.ResultsForty-five infants were studied at a median gestational age of 38.1 weeks (IQR, 36.4-39.0 weeks); 22 were randomized to the suction mask and 23 to the conventional mask. The suction mask did not reduce mask leak (49.9%; IQR, 11.0%-92.7%) compared with the conventional mask (30.5%; IQR, 10.6%-48.8%; P = .51). The suction mask delivered lower peak inspiratory pressure (27.2 cm H2O [IQR, 25.0-28.7 cm H2O] vs 30.4 cm H2O [IQR, 29.4-32.5 cm H2O]; P 
       
  • Relationship between Epigenetic Maturity and Respiratory Morbidity in
           Preterm Infants
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Anna K. Knight, Alicia K. Smith, Karen N. Conneely, Philippa Dalach, Yuk J. Loke, Jeanie L. Cheong, Peter G. Davis, Jeffrey M. Craig, Lex W. Doyle, Christiane ThedaObjectiveTo assess associations between epigenetic maturity of extremely preterm babies (born at less than 28 weeks of gestation), neonatal interventions, and respiratory outcomes, including the administration of surfactant and postnatal corticosteroids, duration of assisted ventilation, and development of bronchopulmonary dysplasia (BPD).Study designDNA was extracted from neonatal blood spots collected after birth from 143 extremely preterm infants born 1991-1992 in Victoria, Australia and used to determined DNA methylation (DNAm). A DNAm based gestational age was determined using our previously published method. The residual of DNAm gestational age and clinically estimated gestational age (referred to as “gestational age acceleration”) was used as a measure to assess developmental maturity. Associations between gestational age acceleration and respiratory interventions and morbidities were determined.ResultsInfants with higher gestational age acceleration were less likely to receive surfactant (P = .009) or postnatal corticosteroids (P = .008), had fewer days of assisted ventilation (P = .01), and had less BPD (P = .02). Respiratory measures are known to correlate with gestational age; however, models comparing each with clinically estimated gestational age were improved by the addition of the gestational age acceleration measure in the model.ConclusionsGestational age acceleration correlates with respiratory interventions and outcomes of extremely preterm babies. Surfactant and postnatal corticosteroid use, assisted ventilation days, and BPD rates were all lower in babies who were epigenetically more mature than their obstetrically estimated gestational age. This suggests that gestational age acceleration is a clinically relevant metric of developmental maturity.
       
  • Neonatal Intensive Care Unit Length of Stay Reduction by Heart Rate
           Characteristics Monitoring
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Jonathan R. Swanson, William E. King, Robert A. Sinkin, Douglas E. Lake, Waldemar A. Carlo, Robert L. Schelonka, Peter J. Porcelli, Christina T. Navarrete, Eduardo Bancalari, Judy L. Aschner, Jose A. Perez, T. Michael O'Shea, M. Whit WalkerObjectiveTo examine the effect of heart rate characteristics (HRC) monitoring on length of stay among very low birth weight (VLBW;
       
  • Prophylactic Dextrose Gel Does Not Prevent Neonatal Hypoglycemia: A
           Quasi-Experimental Pilot Study
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Sarah M. Coors, Joshua J. Cousin, Joseph L. Hagan, Jeffrey R. KaiserObjectiveTo test the hypothesis that prophylactic dextrose gel administered to newborn infants at risk for hypoglycemia will increase the initial blood glucose concentration after the first feeding and decrease neonatal intensive care unit (NICU) admissions for treatment of asymptomatic neonatal hypoglycemia compared with feedings alone.Study designThis quasi-experimental study allocated asymptomatic at-risk newborn infants (late preterm, birth weight 4000 g, and infants of mothers with diabetes) to receive prophylactic dextrose gel (Insta-Glucose; Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey); other at-risk infants formed the control group. After the initial feeding, the prophylactic group received dextrose gel (0.5 mL/kg) rubbed into the buccal mucosa. The blood glucose concentration was checked 30 minutes later. Initial glucose concentrations and rate of NICU admissions were compared between the prophylactic group and controls using bivariate analyses. A multivariable linear regression compared first glucose concentrations between groups, adjusting for at-risk categories and age at first glucose concentration.ResultsThere were 236 subjects (72 prophylactic, 164 controls). The first glucose concentration was not different between the prophylactic and control groups in bivariate analysis (52.1 ± 17.1 vs 50.5 ± 15.3 mg/dL, P = .69) and after adjusting for covariates (P  = .18). Rates of NICU admission for treatment of transient neonatal hypoglycemia were 9.7% and 14.6%, respectively (P = .40).ConclusionsProphylactic dextrose gel did not reduce transient neonatal hypoglycemia or NICU admissions for hypoglycemia. The carbohydrate concentration of Insta-Glucose (77%) may have caused a hyperinsulinemic response, or alternatively, exogenous enteral dextrose influences glucose homeostasis minimally during the first few hours when counter-regulatory mechanisms are especially active.Trial registrationClinicalTrials.gov: NCT02523222.
       
  • Cost Analysis of Treating Neonatal Hypoglycemia with Dextrose Gel
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Matthew J. Glasgow, Jane E. Harding, Richard Edlin, Jane Alsweiler, J. Geoffery Chase, Deborah Harris, Benjamin Thompson, Trecia Ann Wouldes, CHYLD Steering Group, Judith Ansell, Anne Jaquiery, Kelly Jones, Sapphire Martin, Christina McQuoid, Jenny Rogers, Heather Stewart, Anna Tottman, Kate Williamson, Ellen Campbell, Coila Bevan, Tineke CrawfordObjectiveTo evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care.Study designWe used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring.ResultsIn the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring.ConclusionsUse of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12608000623392.
       
  • Classifying Injuries in Young Children as Abusive or Accidental:
           Reliability and Accuracy of an Expert Panel Approach
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Douglas J. Lorenz, Mary Clyde Pierce, Kim Kaczor, Rachel P. Berger, Gina Bertocci, Bruce E. Herman, Sandra Herr, Kent P. Hymel, Carole Jenny, John M. Leventhal, Karen Sheehan, Noel ZuckerbraunObjectiveTo assess interrater reliability and accuracy of an expert panel in classifying injuries of patients as abusive or accidental based on comprehensive case information.Study designData came from a prospective, observational, multicenter study investigating bruising characteristics of children younger than 4 years. We enrolled 2166 patients with broad ranges of illnesses and injuries presenting to one of 5 pediatric emergency departments in whom bruises were identified during examination. We collected comprehensive data regarding current and past injuries and illnesses, and provided deidentified, standardized case information to a 9-member multidisciplinary panel of experts with extensive experience in pediatric injury. Each panelist classified cases using a 5-level ordinal scale ranging from definite abuse to definite accident. Panelists also assessed whether report to child protective services (CPS) was warranted. We calculated reliability coefficients for likelihood of abuse and decision to report to CPS.ResultsThe interrater reliability of the panelists was high. The Kendall coefficient (95% CI) for the likelihood of abuse was 0.89 (0.87, 0.91) and the kappa coefficient for the decision to report to CPS was 0.91 (0.87, 0.94). Reliability of pairs and subgroups of panelists were similarly high. A panel composite classification was nearly perfectly accurate in a subset of cases having definitive, corroborated injury status.ConclusionsA panel of experts with different backgrounds but common expertise in pediatric injury is a reliable and accurate criterion standard for classifying pediatric injuries as abusive or accidental in a sample of children presenting to a pediatric emergency department.
       
  • Racial and Ethnic Disparities and Bias in the Evaluation and Reporting of
           Abusive Head Trauma
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Kent P. Hymel, Antoinette L. Laskey, Kathryn R. Crowell, Ming Wang, Veronica Armijo-Garcia, Terra N. Frazier, Kelly S. Tieves, Robin Foster, Kerri Weeks, Kent P. Hymel, Mark S. Dias, E. Scott Halstead, Ming Wang, Vernon M. Chinchilli, Bruce Herman, Robin Foster, Douglas R. Willson, Mark Marinello, Veronica Armijo-Garcia, Sandeep K. NarangObjectiveTo characterize racial and ethnic disparities in the evaluation and reporting of suspected abusive head trauma (AHT) across the 18 participating sites of the Pediatric Brain Injury Research Network (PediBIRN). We hypothesized that such disparities would be confirmed at multiple sites and occur more frequently in patients with a lower risk for AHT.Study designAggregate and site-specific analysis of the cross-sectional PediBIRN dataset, comparing AHT evaluation and reporting frequencies in subpopulations of white/non-Hispanic and minority race/ethnicity patients with lower vs higher risk for AHT.ResultsIn the PediBIRN study sample of 500 young, acutely head-injured patients hospitalized for intensive care, minority race/ethnicity patients (n = 229) were more frequently evaluated (P 
       
  • Long-Term Outcome of Sacrococcygeal Teratoma: A Controlled Cohort Study of
           Urinary Tract and Bowel Dysfunction and Predictors of Poor Outcome
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Mette Hambraeus, Lars Hagander, Pernilla Stenström, Einar Arnbjörnsson, Anna BörjessonObjectiveTo evaluate urinary tract and bowel function in children with sacrococcygeal teratoma, compare the findings with healthy children, and assess predictors of poor outcome.Study designThis was a controlled cohort study of all patients operated for sacrococcygeal teratoma at a tertiary pediatric surgery center, 2000-2013. Urinary and bowel function were compared with healthy control patients matched for age and sex. Perioperative and histopathologic risk factors were analyzed.ResultsIn total, 17 patients with sacrococcygeal teratoma and 85 healthy control patients were included in the study. Patients with sacrococcygeal teratoma more often were reported to have uncontrolled voiding (12% vs 0%, P 
       
  • he+Journal+of+Pediatrics :+Significance+of+Leukemia+Clusters&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in The Journal of Pediatrics : Significance of Leukemia
           Clusters
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Paul Graham Fisher
       
  • Risk of Fractures in Youths with Celiac Disease—A Population-Based
           Study
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Cristina Canova, Gisella Pitter, Loris Zanier, Lorenzo Simonato, Karl Michaelsson, Jonas F. LudvigssonObjectiveTo assess the risk of any fracture requiring hospital care in a cohort of individuals with celiac disease diagnosed in childhood/adolescence compared with reference individuals matched by age and sex.Study designOur study cohort consisted of 213 635 people born and residing in Friuli-Venezia Giulia Region, Italy, in 1989-2011. We selected, through pathology reports, hospital discharge records, or co-payment exemptions, 1233 individuals with celiac disease (aged 0-17 years at diagnosis) and compared them with 6167 reference individuals matched by sex and year of birth. Fractures were identified through hospital discharge records. We calculated hazard ratios (HRs) for any fracture after celiac disease diagnosis (or index date for reference individuals) with Cox regression and ORs for any fracture before celiac disease diagnosis with conditional logistic regression.ResultsDuring the follow-up period (maximum 23 years), 22 individuals with celiac disease (9394 person-years) and 128 reference individuals (47 308 person-years) experienced a fracture, giving an overall HR of 0.87 (95% CI 0.55-1.37). The risk was not modified by sex, age at diagnosis, or calendar period of diagnosis. We obtained similar HRs when excluding fractures occurring after the age of 18 years and adjusting for maternal education or vitamin D supplementation. The odds of previous fracture also did not differ between subjects with celiac disease and reference individuals (22 and 96 cases, respectively: OR 1.15; 95% CI 0.72-1.84).ConclusionsWe did not find any evidence of an increased risk of fractures during childhood and youth among patients with celiac disease.
       
  • Impact of Psychosocial Risk on Outcomes among Families Seeking Treatment
           for Obesity
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Thao-Ly T. Phan, Fang Fang Chen, Alison Taggi Pinto, Courtney Cox, Jennifer Robbins, Anne E. KazakObjectivesTo test the hypothesis that children with elevated psychosocial risk would have increased attrition and worse weight outcomes in weight management treatment.Study designThis was a prospective cohort study of 100 new patients, aged 4-12 years, in a weight management clinic. Parents completed the Psychosocial Assessment Tool. Logistic regression analyses were conducted to calculate the odds of attrition from the clinic and a nonmeaningful change in body mass index (BMI) z-score (ie,
       
  • Learning and Encouragement Effects on Six-Minute Walking Test in Children
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Natalia Morales Mestre, Nicolas Audag, Gilles Caty, Gregory ReychlerObjectivesTo evaluate learning and encouragement effects on the 6-minute walk test in children between 6 and 12 years of age.Study designTwo 6-minute walk tests separated by a 10-minute resting period were performed by healthy children between 6 and 12 years of age to evaluate the learning (part 1) and encouragement effects (part 2; randomization with and without encouragement). Distance and cardiorespiratory variables were used as outcomes.Results148 children were recruited. The intraclass correlation coefficient estimates were 0.927 (95% CI, 0.893-0.951; part 1) and 0.844 (95% CI, 0.744-0.907; part 2). The test-retest agreement was verified for distance (P = .679) with a bias of 1.1 m (95% CI, −4 to 6), but the increase in distance with encouragement was significantly and clinically relevant (P 
       
  • A Mediation Analysis on the Relationship of Physical Fitness Components,
           Obesity, and Academic Performance in Children
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Adrià Muntaner-Mas, Pere Palou, Josep Vidal-Conti, Irene Esteban-CornejoObjectivesTo examine the relationship between a battery of obesity indicators and physical fitness components with academic performance in children and to explore the combined and mediation role of the physical fitness components in the relationship between obesity and academic performance in children.Study designA cross-sectional study including data from 250 Spanish schoolchildren (Balearic Islands) between 10 and 12 years of age (mean age, 10.98 ± 0.76 years) was conducted. Obesity measures (body mass index, body fat, waist circumference, hip circumference, and waist-to-height ratio), physical fitness components (cardiorespiratory fitness, muscular fitness, and speed-agility), and academic performance (Spanish language, Catalan language, English language, natural sciences, social sciences, arts, physical education, religion, and grade point average [GPA]) were collected.ResultsAll obesity measures were negatively related to at least 3 of the 10 academic indicators, including GPA (β range, −0.135 to −0.229; all P 
       
  • Clinically Actionable Hypercholesterolemia and Hypertriglyceridemia in
           Children with Nonalcoholic Fatty Liver Disease
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Kathryn E. Harlow, Jonathan A. Africa, Alan Wells, Patricia H. Belt, Cynthia A. Behling, Ajay K. Jain, Jean P. Molleston, Kimberly P. Newton, Philip Rosenthal, Miriam B. Vos, Stavra A. Xanthakos, Joel E. Lavine, Jeffrey B. Schwimmer, Stephanie H. Abrams, Sarah Barlow, Ryan Himes, Rajesh Krisnamurthy, Leanel Maldonado, Rory Mahabir, April CarrObjectiveTo determine the percentage of children with nonalcoholic fatty liver disease (NAFLD) in whom intervention for low-density lipoprotein cholesterol or triglycerides was indicated based on National Heart, Lung, and Blood Institute guidelines.Study designThis multicenter, longitudinal cohort study included children with NAFLD enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network. Fasting lipid profiles were obtained at diagnosis. Standardized dietary recommendations were provided. After 1 year, lipid profiles were repeated and interpreted according to National Heart, Lung, and Blood Institute Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction. Main outcomes were meeting criteria for clinically actionable dyslipidemia at baseline, and either achieving lipid goal at follow-up or meeting criteria for ongoing intervention.ResultsThere were 585 participants, with a mean age of 12.8 years. The prevalence of children warranting intervention for low-density lipoprotein cholesterol at baseline was 14%. After 1 year of recommended dietary changes, 51% achieved goal low-density lipoprotein cholesterol, 27% qualified for enhanced dietary and lifestyle modifications, and 22% met criteria for pharmacologic intervention. Elevated triglycerides were more prevalent, with 51% meeting criteria for intervention. At 1 year, 25% achieved goal triglycerides with diet and lifestyle changes, 38% met criteria for advanced dietary modifications, and 37% qualified for antihyperlipidemic medications.ConclusionsMore than one-half of children with NAFLD met intervention thresholds for dyslipidemia. Based on the burden of clinically relevant dyslipidemia, lipid screening in children with NAFLD is warranted. Clinicians caring for children with NAFLD should be familiar with lipid management.
       
  • Treating Obstructive Sleep Apnea and Chronic Intermittent Hypoxia Improves
           the Severity of Nonalcoholic Fatty Liver Disease in Children
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Shikha S. Sundaram, Ann C. Halbower, Jelena Klawitter, Zhaoxing Pan, Kristen Robbins, Kelley E. Capocelli, Ronald J. SokolObjectiveTo determine the effects of treating obstructive sleep apnea/nocturnal hypoxia on pediatric nonalcoholic fatty liver disease (NAFLD) severity and oxidative stress.Study designBiopsy proven participants (n = 9) with NAFLD and obstructive sleep apnea/hypoxia were studied before and after treatment with continuous positive airway pressure (CPAP) for sleep disordered breathing, including laboratory testing and markers of oxidative stress, urine F(2)-isoprostanes.ResultsAdolescents (age 11.5 ± 1.2 years; body mass index, 29.5 ± 3.8 kg/m2) with significant NAFLD (mean histologic necroinflammation grade, 2.3 ± 0.9; fibrosis stage, 1.4 ± 1.3; NAFLD Activity Score summary, 4.8 ± 1.6) had obstructive sleep apnea/hypoxia by polysomnography. At baseline, they had severe obstructive sleep apnea/hypoxia, elevated aminotransferases, the metabolic syndrome, and significant oxidative stress (high F(2)-isoprostanes). Obstructive sleep apnea/hypoxia was treated with home CPAP for a mean 89 ± 62 days. Although body mass index increased, obstructive sleep apnea/hypoxia severity improved on CPAP and was accompanied by reduced alanine aminotransferase, metabolic syndrome markers, and F(2)-isoprostanes.ConclusionsThis study provides strong evidence that treatment of obstructive sleep apnea/nocturnal hypoxia with CPAP in children with NAFLD may reverse parameters of liver injury and reduce oxidative stress. These data also suggest CPAP as a new therapy to prevent progression of NAFLD in those children with obesity found to have obstructive sleep apnea/nocturnal hypoxia.
       
  • he+Journal+of+Pediatrics :+Mefenamic+Acid:+An+Antipyretic+for+Use+in+Children&rft.title=Journal+of+Pediatrics&rft.issn=0022-3476&rft.date=&rft.volume=">50 Years Ago in The Journal of Pediatrics : Mefenamic Acid: An Antipyretic
           for Use in Children
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Pooja Dewan, Piyush Gupta
       
  • Impact of Esophageal Atresia on the Success of Fundoplication for
           Gastroesophageal Reflux
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Samantha A. Pellegrino, Sebastian K. King, Elizabeth McLeod, Alisa Hawley, Jo-Anne Brooks, John M. Hutson, Warwick J. TeagueObjectivesFundoplication is commonly performed in patients with a history of esophageal atresia (EA), however, the success of this surgery is reduced, as reflected by an increased rate of redo fundoplication. We aimed to determine whether EA impacts the prevalence of fundoplication, its timing, and performance of a redo operation.Study designA single-center, retrospective review of all patients undergoing fundoplication over a 20-year period (1994-2013) was performed. Redo fundoplication was used as a surrogate for surgical failure.ResultsA total of 767 patients (patients with EA 85, those who did not have EA 682) underwent fundoplication during the study period. Median age (months) at primary fundoplication was lower in patients with EA (7.2 vs those who did not have EA 23.3; P 
       
  • Catheter-Related Venous Thrombosis in Hospitalized Pediatric Patients with
           Inflammatory Bowel Disease: Incidence, Characteristics, and Role of
           Anticoagulant Thromboprophylaxis with Enoxaparin
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Carrie E. Diamond, Carole Hennessey, Jennifer Meldau, Christine J. Guelcher, Michael F. Guerrera, Laurie S. Conklin, Karun V. Sharma, Yaser A. DiabObjectiveTo describe the incidence and characteristics of central venous catheter (CVC)-related thrombosis in hospitalized pediatric patients with active inflammatory bowel disease (IBD) and report the potential usefulness of anticoagulant thromboprophylaxis (AT).Study designWe conducted a retrospective study of patients who were admitted to our children's hospital in the last 2 years with active IBD and required a CVC and identified all patients with an objectively confirmed symptomatic CVC-related thrombosis. To assess the usefulness of a recently implemented institutional AT protocol, we compared the frequency of CVC-related thrombosis, nadir hemoglobin, and red blood cell transfusion requirements in patients who received AT with those who did not during the study period.ResultsA total of 40 patients with IBD who required 47 consecutive hospitalizations were included. AT was administered during 24 of 47 hospitalizations (51%). Patients who received AT were similar to those who did not receive AT with regard to demographics, IBD phenotypes, extent of colonic involvement, and thrombotic risk factors. CVC-related thrombosis occurred in 5 of 23 hospitalizations (22%) in which AT was withheld compared with 0 of 24 hospitalizations (0%) in which patients received AT (P = .02). The red blood cell transfusion requirements and nadir hemoglobin were not significantly different between the 2 groups.ConclusionsWe observed a high incidence of CVC-related thrombosis in hospitalized children with IBD. Administration of AT in our population was associated with significant reduction in CVC-related thrombosis without evidence of increased bleeding.
       
  • Life after Critical Illness in Children—Toward an Understanding of
           Pediatric Post-intensive Care Syndrome
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): R. Scott Watson, Karen Choong, Gillian Colville, Sheri Crow, Leslie A. Dervan, Ramona O. Hopkins, Hennie Knoester, Murray M. Pollack, Janet Rennick, Martha A.Q. Curley
       
  • Bias and Objectivity When Evaluating Social Risk Factors for Physical
           Abuse: of Babies and Bathwater
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Daniel M. Lindberg
       
  • New Paradigms for Pulmonary Vein Stenosis Treatment: When Surgery and
           Transcatheter Therapy Aren't Good Enough
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Usama B. Kanaan, William T. Mahle
       
  • Acetaminophen in the Neonatal Intensive Care Unit: Shotgun Approach or
           Silver Bullet
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): John N. van den Anker, Karel Allegaert
       
  • Whither the Jones Criteria'
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Stanford T. Shulman, Robert S. Baltimore
       
  • The Jones Criteria for the Diagnosis of Acute Rheumatic Fever: Updated but
           Not Abandoned
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Michael Gewitz
       
  • The Elephant in the Examination Room: Addressing Parent and Child Mobile
           Device Use as a Teachable Moment
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Danielle Erkoboni, Jenny Radesky
       
  • Does learning or encouragement influence results for the 6-minute walk
           test'
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Stephen R. Daniels
       
  • Paracetamol for ductal closure: Inching closer, but cautiously!
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Clyde J. Wright
       
  • Cardiac surgery and hearing loss
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Stephen R. Daniels
       
  • Dental caries—something to sink your teeth into
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Denise M. Goodman
       
  • No answers yet for the prevention of neonatal hypoglycemia
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Raye-Ann deRegnier
       
  • Psychosocial factors and attrition from weight management
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Stephen R. Daniels
       
  • Negative association between obesity and academic performance—Physical
           fitness may help mediate the effects
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Reginald Washington
       
  • You say “to-ma-to,” I say “to-mah-to,” you say “covariate,” I
           say…
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Matthew J. Gurka
       
  • Thanks to our Valued Reviewers—2017
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s):
       
  • Information for Readers
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s):
       
  • Food Insecurity and Children's Rights to Adequate Nutrition in Europe
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Massimo Pettoello-Mantovani, Jochen Ehrich, Michele Sacco, Pietro Ferrara, Ida Giardino, Tudor Lucian Pop
       
  • Reply
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Valentina Shakhnovich, P. Brian Smith, Huali Wu, Michael Cohen-Wolkowiez, Gregory L. Kearns
       
  • Pantoprazole pharmacokinetics in obese children: normalized to lean or
           ideal weight'
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): John H.P. Friesen
       
  • Critical issues underlying expenditures for adolescent idiopathic
           scoliosis surgery: questioning the surgical treatment motivation
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Jun Zhang, Chi-Jiao Ma, Xiao-Feng Xin, Hai-Qiang Wang
       
  • Deficiencies in the conduct and reporting of pediatric clinical trials
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Barbara J. Moore, Stacey H. Popko, Laurent S. Tao
       
  • Prenatal superior to postnatal myelomeningocele surgery
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Denise Araujo Lapa
       
  • Fluid overload in critically ill children is associated with increased
           mortality
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Manpreet Virk, Ayse Akcan-Arikan
       
  • Sudden unexpected infant death rates differ by age at death
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Carrie K. Shapiro-Mendoza
       
  • Subthreshold phototherapy during birth hospitalization may prevent
           readmission for phototherapy
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Jon F. Watchko
       
  • Corporal punishment associated with dating violence
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Elizabeth T. Gershoff
       
  • Extensive Bluish–Black Spots
    • Abstract: Publication date: July 2018Source: The Journal of Pediatrics, Volume 198Author(s): Indar Kumar Sharawat, Renu Suthar, Chirag K. Ahuja, Naveen Sankhyan
       
 
 
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