Pediatric Annals最新文献

As more children with congenital heart disease (CHD) survive to adulthood, reproductive health care in this demographic is becoming increasingly important. While all women with CHD can have an increased risk of morbidity associated with contraception and pregnancy, these risks can range from those that are medically manageable to catastrophic sequalae that can affect quality of life. Clinicians should discuss reproductive health before puberty and should counsel for pregnancy, family planning, and contraception. Comprehensive counseling during adulthood should include risks during the peripartum period, fetal risk, and long-term cardiovascular sequalae, and should be done with a cardiologist experienced in CHD. [Pediatr Ann. 2025;54(2):e70-e73.].

Chest pain is a common presenting complaint in children and adolescents that often causes significant anxiety for both the patient and their families. Unlike in adults, the majority of chest pain in pediatrics is noncardiac in nature. The following article outlines the important elements of the history and physical, as well as ancillary tests, that can help differentiate between the noncardiac causes of chest pain. It also highlights high-risk features concerning for cardiac causes of chest pain that require further evaluation by a pediatric cardiologist. The most common cardiac causes of chest pain are discussed, as well as the initial management and treatment for the general pediatric provider. [Pediatr Ann. 2025;54(2):e57-e63.].

Congenital heart disease (CHD) is the most common birth defect and is associated with significant morbidity and mortality. With advances in medical management and surgical techniques, most individuals with CHD now live into adulthood. Many children and adults with CHD face ongoing medical, developmental, psychological, and psychosocial challenges. Recognizing and mitigating neurodevelopmental abnormalities is an important component of the holistic care of children and adults with CHD. This article outlines the scope of neurodevelopmental abnormalities seen in children and young adults with CHD, individual risk stratification, screening and evaluation recommendations, and emerging strategies to improve neurodevelopmental outcomes. Pediatricians play a central role in identifying high-risk patients and referring for neurodevelopmental evaluation, screening low-risk patients, supporting neuroprotective practices in hospitalized patients, coordinating developmental services, and supporting children and families as they navigate the sequalae of CHD. [Pediatr Ann. 2025;54(2):e52-e56.].

Anaphylaxis is a potentially life-threatening condition that requires immediate medical treatment and evaluation. The prevalence of food allergies has risen during the last few decades, resulting in increased awareness of the potential for anaphylactic reactions and the need for patient and parent education around how to properly treat a reaction in the nonhospital setting. This article will address the epidemiology, patho-physiology, diagnostic criteria, and treatment of anaphylaxis. While anaphylaxis can result from exposure to non-food allergens (ie, medication, insect stings, environmental allergens), this article will specifically focus on the role of food allergies in anaphylaxis. [Pediatr Ann. 2025;54(2):e47-e49.].

The benefits of maintaining a physically active lifestyle in children and adolescents go beyond physical health, extending to improvements in social, mental, and emotional well-being. Focus is shifting from exercise restriction to exercise advocacy not only in the general population but also in patients with congenital and other types of heart disease. Pediatricians must be knowledgeable about the latest recommendations and debates regarding the preparticipation physical evaluation and exercise recommendations for a diverse population. This article provides a brief summary of exercise physiology and a review of worrisome symptoms with exercise. We then discuss preparticipation screening evaluations and review activity recommendations in children with heart disease with the goal of keeping as many young patients as active as possible for long-term cardiovascular health. [Pediatr Ann. 2025;54(2):e64-e69.].

Congenital adrenal hyperplasia (CAH) is a rare disorder that typically presents in childhood. Affected female infants are most often discovered at birth due to virilized external genitalia, while male infants are diagnosed after newborn screening or, when none is available, during adrenal crisis. CAH is an autosomal recessive disorder with impaired cortisol, and often aldosterone, production, requiring lifelong hormone replacement. Recognizing the presentation and understanding the treatment of CAH are critical to optimize outcomes in affected children. [Pediatr Ann. 2025;54(2):e74-e77.].

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that often presents in early childhood and, for most people, persists into adulthood. The symptom presentation and impact on functioning often evolve over time as children reach the developmental stages of childhood, adolescence, and adulthood. Children with ADHD are at risk of comorbid disorders, as well as potential cumulative adverse outcomes, if their ADHD is not adequately or appropriately treated in a timely manner. Pediatricians play a unique and critical role in educating, guiding, treating, and empowering children with ADHD and their families across the pediatric lifespan. Their role extends beyond pharmacological treatment of ADHD to ensuring favorable outcomes in social, academic, emotional, and behavioral functioning by providing anticipatory guidance and facilitating conversations that promote understanding of their child's condition. [Pediatr Ann. 2025;54(1):e34-e39.].

Coronavirus disease 2019 (COVID-19), which is now known to be caused by severe acute respiratory syndrome coronavirus 2, has been a public health threat since early 2020 and has affected millions of people worldwide. Many studies have now shown that this virus exhibits a milder infection in children compared to adults. Acute COVID-19 infection, multisystem inflammatory syndrome in children (MIS-C), and long COVID have been recently well-established in the pediatric population with a myriad of systemic manifestations. This section of the review will focus on the following systems-neurology, psychiatry, endocrinology, hematology, and oncology-under three broad lenses, such as acute COVID-19, MIS-C, and long COVID. [Pediatr Ann. 2025;54(1):e40-e44.].