Journal of Pediatrics

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OBJECTIVE: To determine the clinical manifestations, management, and outcomes of pediatric granuloma annulare. STUDY DESIGN: We searched MEDLINE via PubMed, Latin American and Caribbean Health Sciences (LILACS), and EMBASE from inception to January 2021. We included all original reports of patients < 18 years of age with a diagnosis of GA and all original reports describing any intervention, including topical or systemic agents, in these patients. Two authors independently extracted socio-demographics and clinical data of the study patients, and treatment(s) used...

Our institution's annual bereaved family event was modified to a virtual format during the COVID-19 pandemic. While necessary to comply with physical distancing directives, the transition also provided greater accessibility for families. Virtual events were feasible and appreciated by attendees. Future hybrid bereavement events should be considered to allow families more flexibility and accessibility.

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OBJECTIVE: To evaluate the neurodevelopmental outcome at school age in children newly diagnosed with fetal neonatal alloimmune thrombocytopenia (FNAIT). STUDY DESIGN: This observational cohort study included children diagnosed with FNAIT between 2002 and 2014. Children were invited for cognitive and neurological testing. Behavioral questionnaires and school performance results were obtained. A composite outcome of neurodevelopmental impairment (NDI) was used, defined and subdivided into mild-to- moderate and severe NDI...

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OBJECTIVES: To evaluate whether implementing more restrictive NICU platelet transfusion guidelines following the PlaNeT-2 randomized controlled trial (transfusion threshold changed from 50,000/μL to 25,000/μL for most neonates) was associated with fewer NICU patients receiving a platelet transfusion, without adversely affecting outcomes. STUDY DESIGN: Multi-NICU retrospective analysis of platelet transfusions, patient characteristics, and outcomes during three years before vs...

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OBJECTIVE: To assess whether access to smartphone video capture of infantile spasms at initial presentation is associated with improved time to diagnosis and treatment. METHODS: We conducted a collaborative retrospective cohort study of 80 consecutive infants with confirmed infantile epileptic spasms syndrome initially presenting from 2015-2021 at two United States pediatric centers. Statistical methods used included Mann-Whitney U test to assess the difference in lead times to EEG, diagnosis, and treatment between groups with and without video capture...

OBJECTIVES: To evaluate the effectiveness of newborn screening for sickle cell disease in eastern Jamaica by determining what proportion of screen-positive infants were registered with the Sickle Cell Unit (SCU) by two months (60 days) of age and identifying parents' perceptions of facilitators and barriers impacting age at registration. STUDY DESIGN: This cross-sectional study used a mixed method approach. Ages at diagnosis confirmation and first clinic visit were recorded for screen-positive infants born between February 1, 2015, and November 15, 2017...

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OBJECTIVE: To assess the hemodynamic safety and efficacy of umbilical cord milking (UCM) compared with early cord clamping (ECC) in non-vigorous newborn infants enrolled in a large multicenter randomized cluster-crossover trial. STUDY DESIGN: Two-hundred-twenty-seven non-vigorous term/near-term infants who were enrolled in the parent UCM vs. ECC trial consented for this sub-study. An echocardiogram was performed at 12±6 hours of age by sonographers blinded to randomization...

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Through this review of published literature, it is clear that children benefit in measurable ways when they receive care from trained pediatric subspecialists. The improved outcomes provided by pediatric subspecialists supports the care provided in the patient's pediatric medical home and emphasizes the importance of care coordination between all components of the pediatric workforce. The AAP highlights this in a recent policy statement by stating the care provided by pediatric clinicians "encompasses diagnosis and treatment of acute and chronic health disorders; management of serious and life-threatening illnesses; and when appropriate, referral of patients with more complex conditions for medical subspecialty or surgical specialty care" Explicit in this statement is the emphasis on the role of complex care coordination between pediatric specialist and primary care pediatricians and that collaboration and guidance by the pediatrician is central to providing optimal care of patients...

OBJECTIVES: To examine whether presenting a 30% or a 60% chance of survival in different survival information formats would influence hypothetical periviable birth treatment choice and whether treatment choice would be associated with participants' recall or their intuitive beliefs about the chances of survival. STUDY DESIGN: An internet sample of women (N = 1,052) were randomized to view a vignette with either a 30% or 60% chance of survival with intensive care during the periviable period...

OBJECTIVE: To compare neurodevelopmental outcomes at two years corrected age (CA) between infants born very preterm (VP) who did or did not receive a post-discharge responsive parenting intervention (TOP program) between discharge home and 12 months CA. STUDY DESIGN: The Systemic Hydrocortisone to Prevent Bronchopulmonary Dysplasia (SToP-BPD) study showed no differences between treatment groups in motor and cognitive development using the Dutch Bayley Scales of Infant Development, and behavior using the Child Behavior Check List at two years CA...

OBJECTIVE: To evaluate the clinical utility of the Child SCAT5 in an outpatient specialty clinic sample of children ages 5-9. STUDY DESIGN: Ninety-six children within 30 days of a concussion (M=8.90+5.78 days) and 43 age and sex-matched healthy controls completed the Child SCAT5, including balance items, cognitive screening, parent and child symptom and severity reports, as well as each individual parent- and child-rated symptom severity (0-3). A series of receiver operating characteristic (ROC) curves with area under the curve (AUC) analysis were performed to evaluate the clinical utility of the Child SCAT5 components to discriminate concussion...

OBJECTIVE: To describe the characteristics and emergency medical services (EMS) interventions, appropriateness of medication dosing, and factors associated with use of any or multiple doses of benzodiazepines for children with seizures in the prehospital setting from a nationally representative dataset. METHODS: We performed a retrospective study of EMS encounters within the National Emergency Medical Services Information System between 2019-2021, including children (<18 years) with an impression of seizures...

OBJECTIVE: To evaluate potential effect modification by health insurance coverage on racial and ethnic disparities in cancer survival among U.S. children and adolescents. STUDY DESIGN: Data from 54,558 individuals diagnosed with cancer at ≤ 19 years between 2004 and 2010 were obtained from the National Cancer Database. Cox proportional hazards regression was used for analyses. An interaction term between race/ethnicity and health insurance type was included to examine racial/ethnic disparities in survival by each insurance status category...

OBJECTIVE: Whether preterm twin infants are at a greater risk of neonatal and neurodevelopmental outcomes than preterm singleton infants is currently unclear. This information is relevant for parental counseling in pregnancies at risk of extreme preterm birth. We aimed to compare neonatal and early-childhood outcomes of preterm twins and preterm singletons and explore the association of chorionicity with outcomes. STUDY DESIGN: This was a national retrospective cohort study of singleton and twin infants admitted at 230/7 -286/7 weeks to level-III NICU's in Canada (2010-2020)...