Journal of Pediatrics最新文献

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Risk of Celiac Disease Before and After Nationwide Infant Rotavirus Vaccination: A Population-Based Study 全国婴儿轮状病毒疫苗接种前后乳糜泻的风险：一项基于人群的研究

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-10 DOI: 10.1016/j.jpeds.2025.114938

Maria Östman , Lars C. Stene PhD , German Tapia PhD , Laura Kivelä MD, PhD , Kalle Kurppa MD, PhD , Ketil Størdal MD, PhD , The Human Exposomic Determinants of Immune Mediated Diseases (HEDIMED) Investigator Group

Objective

To study the association between rotavirus vaccination and risk of celiac disease, which remains debated.

Study design

We conducted a nationwide register-based study including 740 744 children born during 2007-2019 from the Norwegian Birth Registry individually linked to the Norwegian Patient Registry for celiac disease diagnosis. With follow-up until 5 years of age, 2795 were diagnosed with celiac disease. The main analysis was an interrupted time series analysis to assess break in trend of celiac disease incidence before compared with after vaccine introduction in September 2014. Furthermore, we linked the cohort to the Norwegian Immunization Register and compared the risk of celiac disease between fully vaccinated and nonvaccinated children. In sensitivity analyses, we excluded children born 1 year before to 1 year after vaccine introduction to mitigate the effect of herd immunity.

Results

There was no significant break in trend after rotavirus vaccine introduction (P = .46). Hazard ratio (HR) of celiac disease was 0.96 (95% CI 0.89-1.04) if born after compared with before vaccination started, and 1.00 (95% CI 0.92-1.09) when excluding children born in 2013-2015. In fully vaccinated compared with nonvaccinated the HR was 0.99 (95% CI 0.92-1.07), consistent in robustness analyses. Including a requirement for gluten-free diet support in the celiac disease case definition gave similar results (HR 1.06, 95% CI 0.98-1.15).

Conclusions

This study did not find an association between rotavirus vaccine and the risk of early-onset celiac disease.

目的：研究轮状病毒疫苗接种与乳糜泻风险之间的关系，这一点仍有争议。研究设计：我们进行了一项全国性的基于登记的研究，包括2007-2019年出生的740,744名儿童，这些儿童来自挪威出生登记处，与挪威患者登记处的乳糜泻诊断相关联。随访至5岁2,795人被诊断为乳糜泻。主要分析是中断时间序列分析，以评估2014年9月引入疫苗前与引入疫苗后乳糜泻发病率趋势的中断。此外，我们将队列与挪威免疫登记联系起来，比较了完全接种疫苗和未接种疫苗的儿童患乳糜泻的风险。在敏感性分析中，我们排除了接种疫苗前1年至接种疫苗后1年出生的儿童，以减轻群体免疫的影响。结果：轮状病毒疫苗接种后，该趋势无明显中断（P=0.46）。与接种疫苗前相比，接种疫苗后出生的乳糜泻风险比（HR）为0.96 (95% CI 0.89-1.04)，排除2013-2015年出生的儿童时为1.00 （95% CI 0.92-1.09）。与未接种疫苗相比，完全接种疫苗的风险比为0.99 (95% CI 0.92-1.07)，与鲁棒性分析一致。在乳糜泻病例定义中包括对无谷蛋白饮食支持的要求也得到了类似的结果（HR 1.06, 95% C: 0.98-1.15）。结论：本研究未发现轮状病毒疫苗与早发性乳糜泻风险之间的关联。

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引用次数: 0

Knowledge and Barriers to Safe Sleep Counseling Among Pediatric Emergency Department Clinicians and Trainees 儿科急诊科临床医生和培训生对安全睡眠咨询的知识和障碍。

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-09 DOI: 10.1016/j.jpeds.2025.114937

Mary Beth Howard MD, MSc , Leticia M. Ryan MD, MPH , Kevin J. Psoter PhD , Barry S. Solomon MD, MPH , Olivia A. Wilson-Lall BS , Rachel Moon MD

Objectives

To assess knowledge of the American Academy of Pediatrics (AAP) safe sleep recommendations, identify barriers to education, and explore strategies to improve education delivery in the acute care setting among pediatric emergency department (ED) clinicians and trainees.

Study design

We conducted a cross-sectional survey of pediatric ED clinicians and trainees at a tertiary care children's hospital. The survey assessed knowledge of AAP safe sleep recommendations, current counseling practices, perceived barriers, and suggested interventions. Descriptive statistics and stratified analyses were performed.

Results

Of 226 eligible clinicians and trainees, 182 responded (80.5%). Most were pediatric residents (47.5%) or nurses (33.9%). Knowledge was high (mean score: 5.5/6, standard deviation: 0.7), with no significant differences across roles or experience levels. Major barriers to counseling included time constraints (86.3%) and competing clinical priorities (77.6%), followed by language or cultural barriers (38.3%). Although 71.0% provided education when observing unsafe sleep practices, only 29.5% documented counseling. Clinician and trainees endorsed system-level supports such as multilingual resources (65.0%), provision of cribs or sleep sacks (56.3%), electronic medical record prompts (53.0%), and referral pathways for safe sleep resources (53.6%).

Conclusions

Although pediatric ED clinicians and trainees demonstrate strong knowledge of AAP recommendations, system-level barriers limit consistent counseling. Addressing these barriers represents a critical opportunity to reduce the heightened risk of sleep-related infant death during illness. Embedding safe sleep education into ED workflows may strengthen sudden unexpected infant death prevention efforts and reduce infant mortality.

目的：评估美国儿科学会（AAP）安全睡眠建议的知识，确定教育障碍，并探讨在儿科急诊科（ED）临床医生和培训生中改善急性护理环境教育的策略。研究设计：我们对一家三级儿童医院的儿科急诊科临床医生和实习生进行了横断面调查。该调查评估了美国儿科学会安全睡眠建议的知识、当前的咨询实践、感知到的障碍和建议的干预措施。进行描述性统计和分层分析。结果：226名符合条件的临床医生和培训生中，182人（80.5%）回应。大多数是儿科住院医师（47.5%）或护士（33.9%）。知识水平较高（平均得分5.5/6，标准差0.7），不同角色或经验水平之间无显著差异。咨询的主要障碍包括时间限制（86.3%）和临床优先事项竞争（77.6%），其次是语言或文化障碍（38.3%）。尽管71.0%的人在观察不安全睡眠习惯时提供了教育，但只有29.5%的人记录了咨询。临床医生和学员支持系统级支持，如多语言资源（65.0%）、提供婴儿床或睡袋（56.3%）、电子病历提示（53.0%）和安全睡眠资源转诊途径（53.6%）。结论：尽管儿科急诊科临床医生和受训者对AAP建议有很强的了解，但系统层面的障碍限制了咨询的一致性。解决这些障碍是降低疾病期间与睡眠有关的婴儿死亡风险的关键机会。将安全睡眠教育纳入ED工作流程可以加强sud预防工作并降低婴儿死亡率。

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引用次数: 0

Severe and Enduring Anorexia Nervosa and Quality of Life: If, When, and How Palliative Care Should be Involved in Patient Care 严重和持久的神经性厌食症和生活质量：是否，何时，以及如何姑息治疗应该参与患者护理。

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-09 DOI: 10.1016/j.jpeds.2025.114940

Rory Bade MD , Michaela Blakeslee BA , Paula Cody MD, MPH

引用次数: 0

Comparing the Burden of Social Needs Across Pediatric Care Settings 比较不同儿科护理机构的社会需求负担

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-08 DOI: 10.1016/j.jpeds.2025.114922

Robert A. Dudas MD

引用次数: 0

Antibiotic Prophylaxis for Gastrointestinal Surgery in Very Young Infants: The Value of National Data and Interpretation by Experts 幼儿胃肠手术的抗生素预防：国家数据的价值和专家的解释

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-08 DOI: 10.1016/j.jpeds.2025.114921

Sarah S. Long MD

引用次数: 0

Pediatric Palliative Care: Are We There Yet? 儿童姑息治疗：我们还在那里吗？

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-08 DOI: 10.1016/j.jpeds.2025.114918

Paul G. Fisher MD

引用次数: 0

Information for Readers 读者资讯

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-08 DOI: 10.1016/S0022-3476(25)00451-2

引用次数: 0

A Better Way to Assess Central Obesity? 评估中心性肥胖的更好方法？

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-08 DOI: 10.1016/j.jpeds.2025.114920

Joseph T. Flynn MD, MS

引用次数: 0

Listening to the Adolescent Voice on Medication Adherence 倾听青少年关于药物依从性的声音

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-08 DOI: 10.1016/j.jpeds.2025.114917

Robert A. Dudas MD

引用次数: 0

How Would Universal Newborn Screening for Congenital Cytomegalovirus Infection Play out? 新生儿先天性巨细胞病毒感染的普遍筛查如何发挥作用？

IF 3.5 2区医学 Q1 PEDIATRICS

Journal of Pediatrics

Pub Date : 2025-12-08 DOI: 10.1016/j.jpeds.2025.114919

Sarah S. Long MD

引用次数: 0

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