pediatrics

Pediatric sialorrhea (drooling)

Author/s: 
Karan Gandhi, Julie E Strychowsky, Breanna A Chen

Sialorrhea is common in children with neurologic impairment

Sialorrhea can be normal in children with typical development until age 4 years. It occurs in as many as 44% of children with cerebral palsy.1 It typically results from poor oral motor control and fluctuates alongside the child’s developmental trajectory. Reversible contributors such as nasal obstruction, dental issues, and medication effects (e.g., benzodiazepines and clozapine) should be considered.

Eating Family Meals Together at Home

Author/s: 
Callie L Brown, Melissa C Kay, Lindsay A Thompson

Eating meals at home together as a family is important for both parents and children.

Eating dinner together at least 3 or 4 times per week has positive effects on child development and has been linked to children’s lower rates of overweight and obesity, substance abuse, teen pregnancy, depression, and eating disorders; higher self-esteem; and better academic performance. Eating family meals also has nutritional benefits. Families who eat dinner together eat more fruits and vegetables and fewer fried foods and sugary drinks. Family meals also help adults and children learn to like a variety of foods.

Age and Probability of Spontaneous Umbilical Hernia Closure

Author/s: 
Katherine He, Dionne A Graham, Louis Vernacchio, Jonathan Hatoun, Laura Patane, Shannon L Cramm, Shawn J Rangel

This cohort study of children younger than 6 years uses electronic health records to investigate whether a child’s age is associated with the probability of spontaneous umbilical hernia closure and to refine guidelines for surgical repair.

What Is Childhood Leukemia?

Author/s: 
Jenny Ruiz, Colleen Mathews, Erika Friehling

Childhood leukemia is the most common type of cancer that affects children. Leukemia is a cancer of white blood cells that starts in bone marrow (the soft center part of bones), which produces blood cells. Once a leukemic cell develops, it multiplies quickly in the bone marrow and can prevent healthy blood cells from forming. Leukemic cells can spread to various parts of the body, including the fluid that surrounds the brain and spinal cord (cerebrospinal fluid) and other organs such as the liver and kidneys. The cause of childhood leukemia is usually unknown, but in some rare cases, inherited genetic factors may play a role in development of childhood leukemia.

What Parents Should Know About Gun Safety in the Home and Vehicle

Author/s: 
Rebecca J. Palmer, Leila H. DeWitt, Lindsay A. Thompson

This Patient Page describes safety measures parents can take to protect children from gun violence.

Guns are now the leading cause of death for children in the US.

Guns are even more lethal than motor vehicle crashes. The reasons for this gun violence increase in children are multiple, including a rapid rise in gun purchases, an increase in depression and anxiety in children and adolescents, and widespread stress from a global pandemic. The causes of these injuries and deaths vary by age. Younger children are more commonly injured unintentionally. Curious toddlers can find guns and fire them quickly. Older children and adolescents are more likely to be harmed by homicide or suicide.

The most important factor for children being injured or killed by guns is having a gun in the home where a child lives or the car where a child rides. Adults must make sure their guns are stored safely to prevent access by a child or adolescent. There are gun locks, safes, and other techniques to promote safer storage. As an additional safety measure, caregivers should strongly consider removing guns entirely from the home or vehicle, especially when children are older than about 11 years. These youths know how to find and access guns, even if they are stored safely. Considering the increase in mood disorders and risk of suicidal behaviors in older children and adolescents, they should not be around guns.

Parents and caregivers should follow the Be SMART framework to improve gun safety:

S: Secure all guns in your home and vehicle.

M: Model responsible behavior around guns.

A: Ask about unsecured guns in other homes.

R: Recognize the role of guns in suicide.

T: Tell others to Be SMART.

A retrospective cohort study of 12,306 pediatric COVID‑19 patients in the United States

Author/s: 
Parcha, V., Booker, K.S., Kalra, R., Kuranz, S., Berra, L., Arora, G., Arora, P.

Children and adolescents account for ~ 13% of total COVID-19 cases in the United States. However, little is known about the nature of the illness in children. The reopening of schools underlines the importance of understanding the epidemiology of pediatric COVID-19 infections. We sought to assess the clinical characteristics and outcomes in pediatric COVID-19 patients. We conducted a retrospective cross-sectional analysis of pediatric patients diagnosed with COVID-19 from healthcare organizations in the United States. The study outcomes (hospitalization, mechanical ventilation, critical care) were assessed using logistic regression. The subgroups of sex and race were compared after propensity score matching. Among 12,306 children with lab-confirmed COVID-19, 16.5% presented with respiratory symptoms (cough, dyspnea), 13.9% had gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain), 8.1% had dermatological symptoms (rash), 4.8% had neurological (headache), and 18.8% had other non-specific symptoms (fever, malaise, myalgia, arthralgia and disturbances of smell or taste). In the study cohort, the hospitalization frequency was 5.3%, with 17.6% needing critical care services and 4.1% requiring mechanical ventilation. Following propensity score matching, the risk of all outcomes was similar between males and females. Following propensity score matching, the risk of hospitalization was greater in non-Hispanic Black (RR 1.97 [95% CI 1.49-2.61]) and Hispanic children (RR 1.31 [95% CI 1.03-1.78]) compared with non-Hispanic Whites. In the pediatric population infected with COVID-19, a substantial proportion were hospitalized due to the illness and developed adverse clinical outcomes.

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