Pediatri

The pandemic has taught us to expect the unexpected. Clinicians, used to relying on decades of patient histories with proven diagnostic and treatment strategies, are having to channel their creativity and forge new networks with colleagues whose professional paths rarely

In the Original Investigation titled “Childhood Asthma Incidence, Early and Persistent Wheeze, and Neighborhood Socioeconomic Factors in the ECHO/CREW Consortium,” published online May 23, 2022, an author’s name contained errors in the byline and contributions section. The author’s name has

Rumours of the demise of the observational study have been grossly exaggerated So, maybe I’ve taken some artistic licence with Mark Twain’s original version, but this methodological ‘family’ deserved a fair backing. Take the cohort design: this may have had

Our planet is in crisis. Climate change is affecting every person on earth, with rising temperatures and sea levels, increased water and air pollution, and extreme weather events having an impact on our health, wellbeing, and stability. Children, in particular,

This systematic review and meta-analysis quantifies the association of food and nonalcoholic beverage marketing with behavioral and health outcomes in children and adolescents.

Probiotics and the microbiome Paul Fleming addresses the question of whether it is time for neonatal units to provide probiotics routinely in the care of preterm infants. This editorial was commissioned in relation to a single centre report of outcomes

The view from here… On the edge of Islamabad, close to the start of the Karakoram highway and the Punjab- Khyber-Pakhtunkhwa border lies a semicircular range of mountains, the Margalla Hills. Densely forested and often engulfed in low cloud, which

Sub-Saharan Africa is facing an under-recognised burden of cancer and substantial failures in its oncology care systems. Deficiencies in care are pronounced for children with cancer, partly due to low prioritisation, with foundational issues exacerbated by the COVID-19 pandemic. In

This cohort study analyzes data for 1.9 million children to gauge the association of childhood medical complexity with health care service use and in-hospital mortality and assess the algorithms used for predictions.

Taking a second lookWarmia, Poland 1530s An extraordinary polymath called Nicolaus Copernicus is completing his work on heliocentricity, challenging (with support from both academic and theological colleagues) the ‘earth at the centre of the universe’ assumption Soho, London 1850s A

Sexually transmitted infections (STIs) are blighting the USA. Despite pandemic restrictions and limited testing capacity leading to a reduction in recorded STIs in early 2020, rates resurged once restrictions were lifted, and 2·4 million new cases were registered by the

Since the 1950s, neonatal intensive care practitioners have worked to preserve brain oxygenation. The physiological rationale that red blood cell (RBC) transfusion improved oxygen carrying capacity was a tantalizing prospect. In this issue of JAMA Pediatrics, Saito-Benz et al renew

Hurdlers Though (or maybe because) I was working in Khartoum, Sudan as events reached their climax, I still have vivid memories of the 1989 fall of ‘The Wall’ in Berlin, the city’s (and country’s) subsequent reunification and the catalytic effect

Pulse oximetry screening The use of pulse oximetry to screen newborn infants for the presence of critical congenital heart disease (CCHD) is now routine in many countries and is performed by more than 50% of UK neonatal services, but it

In this issue of JAMA Pediatrics, Catalá-López et al report the findings of a systematic review and meta-analysis assessing the risk of mortality among persons with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) and their first-degree relatives. The takeaway

“Every war is a war against children”, said Eglantyne Jebb, the founder of Save the Children, in 1919. The past month’s escalating conflict and humanitarian crisis in Ukraine are devastating the rights and health of the country’s 7·5 million children.

The COVID-19 pandemic has highlighted the importance of international research collaborations to quickly understand and successfully combat emerging and reemerging infectious pathogens globally. As SARS-CoV-2, the causative agent of COVID-19, spread across the world, the number of collaborative international studies

In this issue of JAMA Pediatrics, Catalá-López et al report the findings of a systematic review and meta-analysis assessing the risk of mortality among persons with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) and their first-degree relatives. The takeaway

The COVID-19 pandemic has highlighted the importance of international research collaborations to quickly understand and successfully combat emerging and reemerging infectious pathogens globally. As SARS-CoV-2, the causative agent of COVID-19, spread across the world, the number of collaborative international studies

In this issue of JAMA Pediatrics, Catalá-López et al report the findings of a systematic review and meta-analysis assessing the risk of mortality among persons with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) and their first-degree relatives. The takeaway

The COVID-19 pandemic has highlighted the importance of international research collaborations to quickly understand and successfully combat emerging and reemerging infectious pathogens globally. As SARS-CoV-2, the causative agent of COVID-19, spread across the world, the number of collaborative international studies

In this issue of JAMA Pediatrics, Catalá-López et al report the findings of a systematic review and meta-analysis assessing the risk of mortality among persons with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) and their first-degree relatives. The takeaway

The first taboo Events in Ukraine are so distressing, baffling and rapidly-evolving that we are still assimilating. There are many strands to potential support and, as these take shape the children there and their families will never be far from

2 years into the COVID-19 pandemic, we are humbled by the tireless work of our clinical and scientific colleagues who have treated and protected the world’s children. The clinical profile of SARS-CoV-2 infection in the young is now established: the

The COVID-19 pandemic has highlighted the importance of international research collaborations to quickly understand and successfully combat emerging and reemerging infectious pathogens globally. As SARS-CoV-2, the causative agent of COVID-19, spread across the world, the number of collaborative international studies

Boland RA, Davis PG, Dawson JA, et al. Outcomes of infants born at 22–27 weeks’ gestation in Victoria according to outborn/inborn birth status (Archives of Disease in Childhood – Fetal and Neonatal Edition 2017;102:F153-F161). The authors have identified an error

Control: a brief revisit Let me start by clarifying that I’m not claiming novelty for a concept (the importance of control on life quality) in circulation at least since Aristotle’s halcyon period between 300 and 400 BC. I think, though,

Metabolic epidemics have been building for decades. They haven’t created sudden and disruptive effects, but their prevalence is vast, they pose risks for cardiovascular health and premature death, and multiple interventions have been advocated—and yet they remain epidemics.

In the midst of the global COVID-19 pandemic, attention has drifted away from the endemic problem of firearm-related morbidity and mortality in the US. The Centers for Disease Control and Prevention reported in 2019, the most recent year for which

Physical activity is essential for a child’s growth, development, wellbeing, and socialisation. However, children and adolescents with disabilities still face many barriers to full participation in physical activity, and they are less likely to meet 24-h healthy movement guidelines than

What the brochure says The WHO top ten list of threats to global health feature many directly relevant to children: climate change, pollution; vaccine hesitancy; dengue; COVID-19; influenza; antimicrobial resistance – all ‘deserving members’ of this unenviable top table, though

Background Iron-deficiency anaemia disproportionately affects children in low-income and middle-income areas; Western China is a prime example. Given the health risks associated with childhood anaemia and the large heterogeneity of published studies on this subject, we conducted a systematic review

Background and objective Low language ability in early childhood is a strong predictor of later psychopathology as well as reduced school readiness, lower educational attainment, employment problems and involvement with the criminal justice system. Assessment of early language development is

The epidemic of childhood obesity remains a significant public health challenge worldwide. In the US, rates of obesity among children of all age groups have tripled from the period 1976 to 1980 to the period 2015 to 2018. In nearly

Accessible, sustainable, nourishing food is a key ingredient of a stable and healthy society. With competing global crises demanding attention, it is easy to overlook one of the universal driving forces—food insecurity. Food insecurity acts in tandem with the climate

Vogue? The state of being ‘in vogue’ implies an ephemeral, transitory period where an idea, person, subject or even philosophy catches the broader eye and consciousness. The ‘entity’ enjoys a Warholian 15 min of fame before disappearing entirely or at

Optimising therapeutic hypothermia Using the National Neonatal Research Database, Lara Shipley and colleagues studied infants≥36 weeks gestation who were admitted to UK neonatal units with moderate or severe hypoxic ischaemic encephalopathy (HIE). Between 2011 and 2016 there were 5059 infants.

This systematic review and meta-analysis investigates the association of behavioral interventions with development of social functioning and social cognitive skills among children and adolescents with social deficits.

Sometimes, squares just don’t fit ‘He’s doing it again’—what a cryptic way to launch into what should be a gentle, easily digestible wind down as the year draws to a close. Perhaps though, not as knight’s move as it first

How much can we dare to hope for during the UN Conference of the Parties (COP26) in Glasgow, UK? Youth activists have helped increase attention to the climate crisis, but they are not hopeful that COP26 will bring the changes

Vision: JAMA Pediatrics will be the most respected source of information for investigators, providers, and policy makers seeking the highest quality evidence to guide decision making.

Figure 1.

Mendes de Oliveira and colleagues now report in the Journal that variants in GNAS exons that encode the stimulatory G-protein alpha subunit (Gαs) have a strong genetic association with severe obesity, owing to reduced signaling by the melanocortin 4 receptor

For far too long, mental health has been seen, mistakenly, as synonymous with mental ill health. UNICEF’s report The State of the World’s Children 2021, launched on Oct 5 at the third Ministerial Mental Health Summit, builds on the growing

Bush JB, Cooley V, Perlman J, et al. NeoBeat offers rapid newborn heart rate assessment. Arch Dis Child Fetal Neonatal Ed 2021;106:550–2. doi: 10.1136/archdischild-2020-320901. This article has been corrected since it first published. The provenance and peer review statement has

20/20 vision There’s no doubt that trust is ‘won’ immediately in some circumstances and in young children is the default position. Usually, though, it has to be earned: and even when deserved it isn’t always granted. I wonder whether this

Autism spectrum disorder, a common neurodevelopmental disorder with onset in infancy, is characterized by deficits in social functioning and by repetitive–restrictive behaviors, such as repeated body movements, circumscribed interests, or resistance to change in routines. Pharmacologic…

Figure 1.

Mendes de Oliveira and colleagues now report in the Journal that variants in GNAS exons that encode the stimulatory G-protein alpha subunit (Gαs) have a strong genetic association with severe obesity, owing to reduced signaling by the melanocortin 4 receptor

This systematic review and meta-analysis assesses the prevalence of Clostridioides difficile detection among asymptomatic children.

Structural birth defects are a cause of substantial morbidity and mortality among infants, observed in 1 in 33 births and accounting for 20.6% of infant deaths. Such defects result from complex interactions among the genome, the epigenome, and the environment.

Presentation of Case. Dr. Emma C. Materne (Pediatrics): A 12-month-old boy with Hirschsprung’s disease was admitted to this hospital because of fever. Fifteen days before the current admission, the patient had a temperature of 39.7°C. His parents noticed that he

To the Editor: Congenital syphilis, a life-threatening infection caused by the transmission of Treponema pallidum from a woman to her fetus during pregnancy, can result in miscarriage, stillbirth, preterm birth, low birth weight, and infant death. Whereas many infants with

Literally literacy Though this issue won’t appear for another 3-4 weeks, given the painful events unravelling in Afghanistan, it would feel banal to the point of negligence to fail to ask ‘where are we going’ in terms of global human

The rates of mental illness in young people in the UK have dramatically risen. A 2021 report from the Children’s Commissioner showed that referrals for probable mental health disorders in UK children (aged 5–19 years) were up by 35% in

The mother clutches her daughter as the nebulized albuterol permeates the young girl’s airways. My eyes dart between the monitor and the child’s small, dark-skinned chest as it heaves up and down at an alarming rate. I smile reassuringly, but

Before my son left home on the first day of school, I took his photo — attempting, like generations of parents before me, to hit the “pause” button on life for a few seconds, capturing the start of a new

A Notice of Retraction about the article “Experimental Assessment of Carbon Dioxide Content in Inhaled Air With or Without Face Masks in Healthy Children: A Randomized Clinical Trial,” by Walach H, et al, has been published.

To the Editor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is often asymptomatic or results in only mild disease. Data on the extent of transmission of SARS-CoV-2 from children and adolescents in the household setting, including transmission

Cystic fibrosis is a life-shortening autosomal recessive disease that affects more than 80,000 people worldwide. In cystic fibrosis, deficiencies in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, an epithelial anion channel, manifest as a complex multiorgan disease,…

To the Editor: Advancements in molecular diagnostics have led to the identification of a new class of pediatric gliomas — infantile hemispheric gliomas — that arise in the cerebral hemispheres and often are histologically confirmed to be malignant (World Health

Therapeutic creep in provision of hypothermia for hypoxic ischaemic encephalopathy Three articles relate to the changing practices of UK clinicians in the provision of therapeutic hypothermia for hypoxic ischaemic encephalopathy (HIE). Lori Hage and colleagues report the clinical characteristics of

A vein of form In footballing vernacular (and I’m an ardent student) a ‘vein of form’ means a good run. For whatever reason ‘something’ gelled, continues to gel and there are no reasons to see an end to the gelling.

The COVID-19 pandemic has had huge indirect effects on health and health-care systems around the world, with one of the most severely affected being routine child immunisation services. A new report by WHO and UNICEF, published on July 15, outlines

On April 6, 2021, the Arkansas state legislature overrode a veto by the governor to pass legislation making it illegal for medical professionals to provide gender-affirming treatment to patients with gender dysphoria who are younger than 18 or to refer

This meta-analysis of individual participant data uses data from cohort studies to examine the association of very preterm birth or very low birth weight with intelligence in adulthood.

A 4-year-old girl was brought to the emergency department with a 4-day history of fever, cough, and lethargy. She was up to date with all childhood vaccinations. Three weeks earlier, she had had a presumed viral respiratory tract infection with

The 11-year-old girl knew that her mother had cancer, but it fell to me to tell her that the cancer had spread to her mother’s brain. The girl asked whether her mother would get better. “No,” I said, “but we’re

There is not one story of insulin; there are many. As a young child, Mr. J. lost his mother to what was presumed to be type 1 diabetes. He recalled taking whatever kinds of insulin he could get for his

Millions of children around the world will have spent today toiling in unsafe, unjust, and unregulated conditions. From 2000, progress towards eliminating child labour in all its forms was notable, but headway in achieving this Sustainable Development Goal by 2025

End of term report ‘Brown: you may discuss your report with the head now. You should know, there are some issues.’ Many of you will have similar recollections of mid-July during their schooldays. The annual feedback lurking, snake-like in the

As of May 21, 2021, the coronavirus disease 2019 (Covid-19) pandemic has caused more than 165 million infections across all ages globally, as well as more than 3.4 million deaths. BNT162b2 (Pfizer–BioNTech) is a Covid-19 vaccine containing nucleoside-modified messenger RNA

The prevalence of congenital diaphragmatic hernia is approximately 1 in 4000 births, and in 85% of cases, the defect is on the left side. In congenital diaphragmatic hernia, intrathoracic herniation of the abdominal viscera impairs normal airway and pulmonary vascular

This editorial is dedicated to the hope that the new COVID-19 vaccines will be as successful as rotavirus vaccines in protecting against disease. Based on their high burden of mortality in low-income countries and hospitalization in the middle-income to high-income

In April 2020, practitioners first noted a temporal association between infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome in children (MIS-C) as a rare but serious complication. Since that time, MIS-C has been reported to

As one of its signature priorities, the Trump administration implemented substantial changes to immigration policy, which profoundly affected the health and welfare of immigrant children and families. Actions by the Biden administration to end these policies are critically important, but

In April 2020, practitioners first noted a temporal association between infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome in children (MIS-C) as a rare but serious complication. Since that time, MIS-C has been reported to

In the spring of 2020, the rapid emergence of multisystem inflammatory syndrome in children (MIS-C) — a presumed postinfectious complication of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) — necessitated decisions regarding…

Maeda Y, Nakamura M, Ninomiya H, et al. Trends in intensive neonatal care during the COVID-19 outbreak in Japan. Arch Dis Child Fetal Neonatal Ed 2021;106:327–29. doi: 10.1136/archdischild-2020-320521 The authors have noticed an error in table 1 of their short

Survival of the fittest Our not-too-distant past is decorated with artefacts: strategies that became popular for perfectly tenable reasons, had a Warholian 15 min of (perfectly justified) fame and then, as new perspectives developed were consigned to the museums of

Since the sudden emergence of multisystem inflammatory disease in children (MIS-C) in April 2020 as a novel and severe presentation of coronavirus disease 2019 (Covid-19), nearly 4000 cases of MIS-C and 35 deaths have been reported in the United States

In 2020, the size and severity of the world’s food crises reached a new peak in a global hunger surge that started 5 years ago. The Global Report on Food Crises, released on May 5, found that 155 million people

The prevalence of congenital diaphragmatic hernia is approximately 1 in 4000 births, and in 85% of cases, the defect is on the left side. In congenital diaphragmatic hernia, intrathoracic herniation of the abdominal viscera impairs normal airway and pulmonary vascular

Congenital diaphragmatic hernia is a surgically correctable defect, but it causes pulmonary hypoplasia, which is characterized by underdeveloped airways and pulmonary vessels. Congenital diaphragmatic hernia is associated with a high risk of neonatal death and complications, mostly because of…

The prevalence of congenital diaphragmatic hernia is approximately 1 in 4000 births, and in 85% of cases, the defect is on the left side. In congenital diaphragmatic hernia, intrathoracic herniation of the abdominal viscera impairs normal airway and pulmonary vascular

This national cohort study evaluates whether socioeconomic disadvantage is associated with autism spectrum disorder prevalence and the likelihood of accessing autism services in racial/ethnic minority groups and disadvantaged groups among school pupils in England.

To the Editor: Approximately 30 years after the start of the Human Genome Project, we sequenced the genome of an infant with encephalopathy in just over 11 hours. The results led to a clinical diagnosis of thiamine metabolism dysfunction syndrome

Severe combined immunodeficiency due to adenosine deaminase (ADA) deficiency (ADA-SCID) is an inborn error of metabolism that results in the accumulation of adenosine and deoxyadenosine, inhibition of DNA synthesis and repair, and substantial abnormalities of thymocyte development. Patients with…

Background Parental separation has been associated with adverse child mental health outcomes in the literature. For school-aged children, joint physical custody (JPC), that is, spending equal time in both parents’ homes after a divorce, has been associated with better health

On April 6, 2021, the Arkansas state legislature overrode a veto by the governor to pass legislation making it illegal for medical professionals to provide gender-affirming treatment to patients with gender dysphoria who are younger than 18 or to refer

Acute otitis media is one of the most common indications for both seeking medical care and prescribing antibiotics for children. The disorder is attributable to eustachian-tube dysfunction, which is most often caused by viral upper respiratory infections, and its prevalence

A level playing field I guess the ‘brochure’ never claimed that (much as we want it to be wrong) the world is balanced and equitable. As the selections illustrate, it is, though, what we should continue to aspire to –

Children need protecting. Most people would agree, but the implications vary wildly. On April 6, 2021, amid a flood of new bills to curb the rights of transgender and gender diverse (trans) youth in the USA, Arkansas became the first

Next to the common cold, acute otitis media is the most frequently diagnosed illness in children in the United States. Caused predominantly by Streptococcus pneumoniae and nontypeable Haemophilus influenzae, acute otitis media is also the leading indication for antimicrobial treatment

Acute otitis media is one of the most common indications for both seeking medical care and prescribing antibiotics for children. The disorder is attributable to eustachian-tube dysfunction, which is most often caused by viral upper respiratory infections, and its prevalence

Next to the common cold, acute otitis media is the most frequently diagnosed illness in children in the United States. Caused predominantly by Streptococcus pneumoniae and nontypeable Haemophilus influenzae, acute otitis media is also the leading indication for antimicrobial treatment

Severe combined immunodeficiency due to adenosine deaminase (ADA) deficiency (ADA-SCID) is an inborn error of metabolism that results in the accumulation of adenosine and deoxyadenosine, inhibition of DNA synthesis and repair, and substantial abnormalities of thymocyte development. Patients with…

We called it the “cold light.” It looked like a small blue button with a power cord attached to the end of it. At its center was a single round eye that emitted a light, crimson in color and piercing

Malignant high-grade glioma accounts for 8 to 10% of pediatric brain tumors and is regularly fatal, with a rapid course. Survival rates have not improved in 30 years; the 3-year event-free survival among patients with newly diagnosed tumors who are

Childhood undernutrition is a global health challenge that produces impaired ponderal and linear growth (wasting and stunting), immune and metabolic dysfunction, altered development of the central nervous system (CNS), and other abnormalities. Acute malnutrition in children is classified by the…

In deference to the equivocal A common (if not universal) human phenotype is the need for an answer—ideally a definitive, dichotomous one—a yes/no with no shades of grey. I don’t take sides on this nor am I being deliberately Machiavellian—conclusive

A preterm male infant was born at 26+0 weeks of gestation via caesarian section due to pre-eclampsia. Birth weight was 560 g (intrauterine growth restriction). He was vigorous at birth and was transferred to the neonatal intensive care unit with

An outpouring of anger marked March, 2021, as thousands took to the streets to protest violence and discrimination against women. The contexts varied hugely across settings such as Turkey, Australia, Mexico, the UK, and the USA, but the frustration was

In a male neonate born at 37 weeks of gestation, a narrow stalk of small bowel and proximal colon protruded through a 1.5-cm defect in the abdominal wall. A diagnosis of gastroschisis had been made antenatally on the basis of

“How much longer?” is a question all too familiar to parents. This is also a question that scientists ask themselves when trying to find a truly effective treatment for patients with the Hutchinson–Gilford progeria syndrome (HGPS) and other genetic diseases.

This systematic review and network meta-analysis compares 4 umbilical cord management strategies for preterm infants: immediate cord clamping, delayed cord clamping, umbilical cord milking, and umbilical cord milking and delayed umbilical cord clamping.

For physicians in the 19th century, caring for sick infants and children still meant presiding at inevitable death after inevitable death. The organized public health struggle against infant mortality had not yet taken shape in 1883, when Dr. Rebecca Crumpler

A 16-year-old girl presented to her pediatrician for evaluation of recent weight gain, irritability, weakness, and skin changes. Her mother reported that her daughter’s grades at school had declined and that she had left the cheerleading team owing to fatigue.

For physicians in the 19th century, caring for sick infants and children still meant presiding at inevitable death after inevitable death. The organized public health struggle against infant mortality had not yet taken shape in 1883, when Dr. Rebecca Crumpler

Presentation of Case. Dr. Neil D. Fernandes (Pediatrics): A 16-year-old boy was admitted to this hospital because of headache, nausea, vomiting, and abdominal pain. The patient had been well until 17 months before this admission, when he began to have

In September 2008, Katalin Karikó, Drew Weissman, and their colleagues at the University of Pennsylvania modified messenger RNA (mRNA) using nucleoside analogues. These modifications stabilized the molecule and eliminated its capacity for inducing innate immunity, thereby making mRNA a promising…

Spinal muscular atrophy is a rare, progressive, recessive neuromuscular disease that is caused by deletions or loss-of-function mutations in the survival of motor neuron 1 gene (SMN1), which result in insufficient levels of SMN protein. Humans have a paralogous gene

Presentation of Case. Dr. Alexandra T. Lucas (Pediatrics): A 19-year-old man was admitted to the pediatric intensive care unit (PICU) of this hospital because of shock, multiple organ failure, and rash. The patient had been well until 20 hours before

21 July 1969 Collins wishes his colleagues, Aldrin and Armstrong, luck as they transfer to ‘the Eagle’. Some hours later, Armstrong places his foot on the lunar surface, declaring ‘…one small step for man, one giant leap for mankind’. The

In the past few decades, the growing demand for patient and public involvement in health research has meant that research about young people has increasingly shifted towards greater involvement of children and adolescents as co-creators of knowledge. On Feb 10,

Spinal muscular atrophy is a rare, progressive, recessive neuromuscular disease that is caused by deletions or loss-of-function mutations in the survival of motor neuron 1 gene (SMN1), which result in insufficient levels of SMN protein. Humans have a paralogous gene

Presentation of Case. Dr. Alexandra T. Lucas (Pediatrics): A 19-year-old man was admitted to the pediatric intensive care unit (PICU) of this hospital because of shock, multiple organ failure, and rash. The patient had been well until 20 hours before

Spinal muscular atrophy is a rare, progressive, recessive neuromuscular disease that is caused by deletions or loss-of-function mutations in the survival of motor neuron 1 gene (SMN1), which result in insufficient levels of SMN protein. Humans have a paralogous gene

Presentation of Case. Dr. Alexandra T. Lucas (Pediatrics): A 19-year-old man was admitted to the pediatric intensive care unit (PICU) of this hospital because of shock, multiple organ failure, and rash. The patient had been well until 20 hours before

Spinal muscular atrophy is a rare, progressive, recessive neuromuscular disease that is caused by deletions or loss-of-function mutations in the survival of motor neuron 1 gene (SMN1), which result in insufficient levels of SMN protein. Humans have a paralogous gene

Figure 1.

Vision: JAMA Pediatrics will be the most respected source of information for investigators, providers, and policy makers seeking the highest quality evidence to guide decision making.

Figure 1.

Scene – 1953, provincial theatre: final act. Frisson of suspense ripples through audience. Main protagonist: detective inspector. ‘Why haven’t I realised before?’ Injured victim: ‘Why didn’t you just open your eyes’. Adversary-doppelgänger: Placing musket (softly but dramatically) on the floor. ‘So, you’ve finally foiled me. I thought

Imagine a highly contagious virus circulating in the community. Many infected children have fever and some general misery but recover without incident. Rarely, devastating complications occur, leading to hospitalization, severe illness, and occasional deaths. Susceptible adults fare worse, with…

Gaertner VD, Flemmer SA, Lorenz L, et al. Physical stimulation of newborn infants in the delivery room. Archives of Disease in Childhood- Fetal and Neonatal Edition 2018;103:F132-36. doi: 10.1136/archdischild-2016-312311 The authors have noticed that the results in Table 1 were

Two decades ago, WHO and the International Agency for the Prevention of Blindness launched VISION 2020: The Right to Sight, a global initiative aiming to eliminate avoidable blindness by 2020. On Feb 16, The Lancet Global Health Commission on Global

Objective To ascertain the extent to which community paediatricians are involved in the care of children with mental health conditions in order to determine which difficulties are appropriate for single or joint surveillance by the British Paediatric Surveillance Unit (BPSU)

Vaccination is a powerful method of disease prevention that is relevant to people of all ages and in all countries, as the Covid-19 pandemic illustrates. Vaccination can improve people’s chances of survival, protect communities from new and reemerging health threats,

Vision: JAMA Pediatrics will be the most respected source of information for investigators, providers, and policy makers seeking the highest quality evidence to guide decision making.

“Just that,” said the fox. “To me you are still nothing more than a little boy who is just like a hundred thousand other little boys. And I have no need of you. And you, on your part, have no

The mechanisms by which antigens specifically sensitize lymphocytes to induce immunity are well recognized. The past decade has witnessed an increased awareness of the importance of specific sensitization of monocytes, natural killer cells, and dendritic cells. This sensitization results from…

Sickle cell disease is a common inherited disease affecting approximately 100,000 persons in the United States; worldwide, about 400,000 infants are born with sickle cell disease each year. Sickle hemoglobin (HbS) is a variant of normal adult hemoglobin (HbA) that

Background The incidence of retinopathy of prematurity (ROP) is higher in Indonesia than in high-income countries. In order to reduce the incidence of the disease, a protocol on preventing, screening and treating ROP was published in Indonesia in 2010. To

A growing number of young people are worried, depressed, and angry about climate change. It isn’t hard to imagine why. It’s stressful enough to navigate emotional development and shifting identity, without the added apocalyptic backdrop of the COVID-19 pandemic and

The Covid-19 pandemic has moved hunger out of the shadows in the United States. Record numbers of Americans, including one in four families with school-age children, don’t have reliable access to food. Congress has authorized several innovative programs and substantial

Objective Young febrile infants represent a vulnerable population at risk for serious bacterial infections (SBI). We aimed to evaluate the diagnostic accuracy of components of the complete blood count in comparison with C-reactive protein (CRP) to predict SBI among febrile

What’s going on… It’s now almost exactly 50 years since the release of Marvin Gaye’s seminal album, one of the few records worthy of the accolade, the fruit of months of work with The Funk Brothers at the Hitsville USA

In 1920, during a meeting of the New York Pathological Society, James Ewing described an unusual tumor in a 14-year-old girl as a “diffuse endothelioma of bone.” The tumor had initially been diagnosed as an osteosarcoma, but its architecture, the

Figure 1.

To the Editor: In mid-March 2020, many countries decided to close schools in an attempt to limit the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing coronavirus disease 2019 (Covid-19). Sweden was one of the few

Introduction Over the last 20 years, excess maternal pre-pregnancy weight (overweight and obesity) and gestational weight gain have become the most common morbidities in pregnancy. These morbidities may pose a threat to fetal immunological development through associated metabolic dysfunction and

This genetic association study evaluates changes in weight and body mass index associated with single-nucleotide variants in children with overweight and obesity.

The treatment of women with epilepsy during pregnancy requires a balance between maintaining stable control of maternal seizures and the potential adverse effects of some antiepileptic drugs on the developing fetus. Convulsive seizures are dangerous to both the mother and

Preterm birth is a leading cause of death in infants and children younger than 5 years of age globally. Infants born preterm are also at increased risk for a wide range of short-term and long-term respiratory, infectious, metabolic, and neurologic

In 1900, the year the U.S. Census Bureau created the first iteration of the U.S. birth certificate, nearly all births occurred at home, often attended by family members and midwives without specialized training. During the 20th century, as the medical

While COVID-19 has dominated conversations about health and the presidential election in 2020, the March of Dimes report card, released on Nov 17, reveals another health crisis in the USA. Infant and maternal mortality—two key indicators of population health—remain unacceptably

In the 5 years since one of us published “#BlackLivesMatter — A Challenge to the Medical and Public Health Communities” in the Journal, we have seen a sea change in the recognition of racism as a durable feature of U.S.

As the first anniversary of the first adult COVID-19 cases approaches, we reflect on what we’ve learned since December 2019 and could be excused a frisson of excitement about what the soon-to-be-released vaccines might offer. More on this story soon

Coronavirus disease 2019 (Covid-19) has affected tens of millions of people globally since it was declared a pandemic by the World Health Organization on March 11, 2020. Older adults, persons with certain coexisting conditions, and front-line workers are at highest

In the late 1990s, there was no drug approved by the Food and Drug Administration (FDA) with a labeled indication for preventing recurrent preterm birth in women with a previous preterm birth. The risk of such recurrence was and is

Low grade intraventricular haemorrhage and cerebral palsy Nicky Hollebrandse and colleagues describe the neurodevelopmental outcomes at 8 years of almost 500 extremely preterm infants born before 28 week’s gestation and relate these to the presence and severity of intraventricular haemorrhage

This study examines the association between parents’ limited comfort with English (LCE) and adverse events in a cohort of hospitalized children.

Sickle cell disease is a common inherited disease affecting approximately 100,000 persons in the United States; worldwide, about 400,000 infants are born with sickle cell disease each year. Sickle hemoglobin (HbS) is a variant of normal adult hemoglobin (HbA) that

Throughout the United States, health status and outcomes, access to care, and socioeconomic status vary by race and ethnic group. This Interactive Perspective, which uses data aggregated by the Health Opportunity and Equity (HOPE) Initiative, allows readers to view and

The increasing incidence of type 2 diabetes and of health consequences related to complications from inadequate glycemic control is of major concern, even in the midst of a worldwide pandemic. Despite the introduction of new adjunctive medicines, recombinant insulins, and

Approximately 7 million neonates worldwide need resuscitation at birth. Birth asphyxia is the third leading cause of neonatal death, accounting for approximately 700,000 deaths each year. Wide-scale implementation of evidence-based interventions has improved perinatal outcomes, but United Nations…

The increasing incidence of type 2 diabetes and of health consequences related to complications from inadequate glycemic control is of major concern, even in the midst of a worldwide pandemic. Despite the introduction of new adjunctive medicines, recombinant insulins, and

Approximately 7 million neonates worldwide need resuscitation at birth. Birth asphyxia is the third leading cause of neonatal death, accounting for approximately 700,000 deaths each year. Wide-scale implementation of evidence-based interventions has improved perinatal outcomes, but United Nations…

The increasing incidence of type 2 diabetes and of health consequences related to complications from inadequate glycemic control is of major concern, even in the midst of a worldwide pandemic. Despite the introduction of new adjunctive medicines, recombinant insulins, and

A quickening of the pulse It’s late October as I’m completing this Atoms. The autumn golds are fading (or falling), dusk arrives early and the Easterlies are building over the Baltic. This change of season is all rather exhilarating and,

Type 1 diabetes is an autoimmune disease characterized by progressive loss of pancreatic beta cells that leads to lifelong dependence on insulin therapy. More than 13 million people are affected by type 1 diabetes, and the incidence increases by 3

Since 1922, insulin has been the sole effective treatment for type 1 diabetes, which is now known to be the result of T-cell–mediated autoimmune destruction of pancreatic beta cells. In 1982, the approval of synthetic recombinant human insulin by the

8 months into the pandemic, the UK Government’s inadequate consideration of young people in the COVID-19 response is causing lasting harm to a whole generation. Although children and adolescents are generally less clinically vulnerable to COVID-19 than are adults, the

Postlicensure studies of rotavirus vaccines have shown varying risks of intussusception in different settings worldwide. The association of intussusception with rotavirus vaccination was identified in 1998, when RotaShield (Wyeth–Lederle Vaccines), the first licensed rotavirus vaccine, was…

Migraine is a ubiquitous neurologic disorder that is estimated to affect approximately 1 billion people worldwide, predominantly females. According to the Global Burden of Disease Study 2016, migraine is the second leading cause of disability and accounts for more disability

Figure 1.

On October 5, 2020, the Center for Drug Evaluation and Research (CDER) of the Food and Drug Administration (FDA) proposed withdrawal of approval of Makena (hydroxyprogesterone caproate injection), the only drug approved for the prevention of recurrent preterm birth. Here

This cohort study examines the degree of alignment between child self-report and caregiver-proxy report for Patient-Reported Outcomes Measurement Information System pediatric health-related quality of life domains among children with cancer and identifies factors associated with better child and caregiver-proxy congruence.

Figure 1.

Preterm birth is a leading cause of death in infants and children younger than 5 years of age globally. Infants born preterm are also at increased risk for a wide range of short-term and long-term respiratory, infectious, metabolic, and neurologic

Boland RA, Davis PG, Dawson JA, et al. Outcomes of infants born at 22–27 weeks’ gestation in Victoria according to outborn/inborn birth status (Archives of Disease in Childhood – Fetal and Neonatal Edition 2017;102:F153-F161). The authors have identified an error

Is i magen The Swedish expression ‘att ha lite is i magen’ (literally to have some ice in the stomach) like many idiomatic aphorisms, is hard to translate directly. The advantage, of course, is the flexibility that being unbound to

Some of the most challenging mitochondrial disorders arise from mutations in mitochondrial DNA (mtDNA), a high-copy-number genome that is maternally inherited. These disorders manifest with marked clinical heterogeneity, in part because tissues generally contain a mixture of both nonmutant and…

The health prospects for Americans will be decided on Nov 3, the date of the 2020 US election. President Donald Trump, vying for a second term in office, is running against Democratic candidate Joe Biden. They each present radically differing

The ultimate goal of human papillomavirus (HPV) vaccination is to prevent invasive cervical cancer by preventing infection with major oncogenic types of HPV. As of December 2019, a total of 124 countries and territories had implemented national immunization programs for

Mitochondrial diseases are a heterogeneous group of disorders with varying clinical features caused by impaired function of the mitochondrial respiratory chain. The underlying cause can be gene mutations affecting either the nuclear DNA or the mitochondrial DNA (mtDNA), both of

This pharmacokinetic simulation study estimates appropriate pediatric-specific dosing regimens for hydroxychloroquine and remdesivir in the treatment of pediatric patients with COVID-19.

The ultimate goal of human papillomavirus (HPV) vaccination is to prevent invasive cervical cancer by preventing infection with major oncogenic types of HPV. As of December 2019, a total of 124 countries and territories had implemented national immunization programs for

Familial hypercholesterolemia is a genetic condition characterized by an elevated plasma concentration of low-density lipoprotein (LDL) cholesterol starting at birth and an increased risk of premature atherosclerotic cardiovascular disease. With an estimated prevalence of 1 in 250 in the general…

During previous public health emergencies, the issue of whether public health agencies should recommend that women avoid becoming pregnant because of potential risks to themselves and their newborns has been controversial. The ongoing Covid-19 pandemic has again led to questions

Congenital adrenal hyperplasia (CAH) — one of the most common autosomal recessive disorders — is potentially life-threatening in its classic (severe) form and may be asymptomatic or cause female infertility in its nonclassic (mild) form. The most common type of

Although there has been a 90% decline in diarrhea-related deaths since the 1980s, diarrheal diseases remain a major public health problem. In 2018, approximately 500,000 children died from diarrhea. Most deaths from diarrhea among children could be avoided if children

Ketoacidosis and fluids The debate around fluid resuscitation and maintenance in DKA has been smouldering for years, the recent, large PECARN FLUID trial providing some guidance, but, not drawing a line under all the issues In the light of the

R. was a teenager when his osteosarcoma came roaring back, with vertebral metastases that left him paralyzed and bed-bound. He’d been told he was going to die, but his mother, a tower of strength, was determined to keep things positive.

Since April, 2016, thousands of Iraqi and Syrian civilians, displaced by a decade of war, have been living in refugee camps in northeastern Syria. In the largest camp, Al Hol, 90% of the 65 000 residents are women and children, two

Attention deficit–hyperactivity disorder (ADHD) is characterized by hyperactivity and impulsivity, by inattention, or by a combination of hyperactivity, impulsivity, and inattention that is inconsistent with developmental level and impairs daily function. The disorder is commonly diagnosed in…

This cross-sectional study of pediatric emergency department visits evaluates changes over time and hospital variation in advanced imaging use.

For the past 6 months, policymakers and the U.S. public have weighed economic against public health considerations in debating what limits to set on individual and collective behaviors in attempting to control the Covid-19 pandemic. As fall approaches, attention has

The glycemic target of a glycated hemoglobin level of less than 7% (as recommended by the American Diabetes Association) is attained by less than 20% of children with type 1 diabetes. The use of a closed-loop system that automates insulin

To the Editor: The discoverers of ivermectin, a broad-spectrum parasiticide that is widely used in humans and animals, were awarded the Nobel Prize in Physiology or Medicine in 2015. This drug is reputed to be remarkably safe thanks to its

Now we are three! Having launched The Lancet Child & Adolescent Health in September, 2017, this issue marks our third anniversary. In these crucial early years, we have grown in knowledge and reach, founded a trusted platform for the best

Imaging the encephalopathy of prematurity Julia Kline and colleagues assessed MRI findings at term in 110 preterm infants born before 32 weeks’ gestation and cared for in four neonatal units in Columbus, Ohio. Using automated cortical and sub-cortical segmentation they

Rheumatic fever Is there any disease group more ’deserving’ of a place at the neglected tropical disease table than the post streptococcal illnesses, glomerulonephritis and rheumatic fever? These dropped off the radar of most high income countries in the second

Figure 1.

Some of the most challenging mitochondrial disorders arise from mutations in mitochondrial DNA (mtDNA), a high-copy-number genome that is maternally inherited. These disorders manifest with marked clinical heterogeneity, in part because tissues generally contain a mixture of both nonmutant and…

Zika virus is a flavivirus that is transmitted to humans primarily by the bite of an infected mosquito of the aedes genus. Sexual transmission and transmission of Zika virus from mother to fetus have also been reported. Congenital Zika virus

Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract disease and hospitalizations for respiratory illness among infants and young children, resulting in largely predictable annual epidemics worldwide. RSV is a leading cause of infant deaths, primarily