child

RPR Exchange: Results of a study of the reliability and predictive value of physical examination findings for diagnosing community-acquired pneumonia in children. James W. Mold, MD, MPH

View

Abstract
Importance Community-acquired pneumonia (CAP) accounts for nearly 2 million pediatric outpatient and 375 000 emergency department (ED) visits annually in the US. Guidelines recommend relying on physical examination findings, not imaging, to diagnose CAP in youths who can be treated as outpatients.

Objective To determine the interrater reliability (IRR) of physical examination findings in youths diagnosed with CAP in EDs.

Design, Setting, and Participants This was a planned analysis from an ongoing prospective cohort study (pediatric CAP severity [PedCAPS]). Youths aged 3 months to 17 years with CAP were recruited at 7 academic pediatric EDs within the US from August 1, 2023, until May 24, 2025; participants had signs of lower respiratory tract infections, fever within 48 hours, and pneumonia on chest radiography, if performed. Youths with chronic pulmonary diseases (except asthma), sickle cell disease, immunodeficiency, cardiac disease, neurological disorders affecting respiration, and aspiration pneumonia were excluded, as were those hospitalized within the preceding 30 days or transferred from other EDs or hospitals.

Main Outcomes and Measures Two examiners evaluated the same patient within 60 minutes of each other and independently recorded their findings. IRR of physical examination findings was reported by raw agreement and Fleiss κ. A lower bound of the 95% CI of 0.4 for κ was considered acceptable reliability.

Results Among 252 youths with paired physical examinations (median [IQR] age, 5.7 [3.4-8.8] years; 127 female [50.4%]), the most frequent comorbidity was asthma (56 youths [22.2%]). In the overall study population, no physical examination finding met predefined significance for IRR. Wheezing (κ = 0.50; 95% CI, 0.39-0.62) and retractions (κ = 0.49; 95% CI, 0.37-0.60) had the highest IRR. In subanalyses of 124 youths discharged home and 128 youths who were hospitalized, IRRs of physical examinations were similar between the 2 groups.

Conclusions and Relevance In this study, individual auscultation findings, such as decreased breath sounds, crackles, or rhonchi, did not demonstrate sufficient reliability to be used alone for diagnosis.

Author/s:

Shubhada Hooli, Ron Reeder, Lauren Cutler, Laura F Sartori, Geoff Capraro, Amy Y. Cheng, Allison Cator, Matthew J. Lipshaw, Lilliam Ambroggio, Chris A. Rees, Son H. McLaren, Justin Moher, Leah Tzimenatos, Patrick S. Walsh, Chari D. Larsen, Richard M. Ruddy, Samir S. Shah, Nathan Kuppermann, Todd A. Florin

Sentinel injuries and indicators of child physical abuse

Megan George — Fri, 27 Feb 2026 01:28:27 +0000

Date Added:

February 26, 2026

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

February 17, 2026

URL:

Sentinel injuries and indicators of child physical abuse

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.251219

Keywords

child abuse

physical abuse

Signs of abuse

PMID (1):

41702620

MeSH

Child Protective Services

Sentinel indicators of child physical abuse. James W. Mold, MD, MPH

View

Signs of physical abuse in pre-cruising infants are often overlooked
Sentinel injuries are minor, unexplained injuries in pre-cruising infants that are often the first indication of physical abuse, which may precede more serious harm. In one study, more than 25% of abused infants had had a previous sentinel injury, and nearly half of the injuries were known to providers but went unaddressed.

Author/s:

Hannah McDowell, Suzanne Kathleen Robinson, Megan Cooney, Ashley Stewart-Tufescu, Tracie O. Afifi

Risk Factors for the Development of Food Allergy in Infants and Children: A Systematic Review and Meta-Analysis

Megan George — Tue, 10 Feb 2026 17:08:03 +0000

Date Added:

February 10, 2026

Journal/Publication:

JAMA

Publication Date:

February 9, 2026

URL:

Risk Factors for the Development of Food Allergy in Infants and Children: A Systematic Review and Meta-Analysis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jamapediatrics.2025.6105

Keywords

Food Hypersensitivity

PMID (1):

41661638

Major modifiable risk factors for childhood food allergies include delayed introduction of solid foods and early treatment with antibiotics. James W. Mold, MD, MPH

View

Importance: The incidence and risk (predictive) factors for early life food allergy development remain uncertain.

Objective: To estimate the incidence and quantify risk factors for food allergy development.

Data sources: MEDLINE and Embase were systematically searched to January 1, 2025. Data were analyzed from June 1, 2025, to November 25, 2025.

Study selection: Incidence estimates included studies confirming food allergy via food challenge. Risk factor analyses included cohort, case-control, and cross-sectional studies in any language assessing children younger than 6 years using multivariable analyses.

Data extraction and synthesis: Paired reviewers independently extracted data. Random-effects meta-analyses pooled incidence and adjusted odds ratios (ORs). Risk of bias was assessed using the QUIPS tool, and certainty of evidence assessed using GRADE.

Main outcome and measure: The primary outcome was food allergy to age 6 years.

Results: A total of 190 studies involving 2.8 million participants across 40 countries were analyzed. Among studies using food challenge, overall food allergy incidence was likely 4.7% (moderate certainty). Among 176 studies identifying 342 risk factors with varying certainty, the strongest and most certain factors included prior allergic conditions (eg, atopic dermatitis [eczema] within the first year of life [OR, 3.88; risk difference [RD], 12.0%; 95% CI, 8.8%-15.7%], allergic rhinitis [OR, 3.39; RD, 10.1%; 95% CI, 6.7%-14.4%], and wheeze [OR, 2.11; RD, 5.0%; 95% CI, 2.1%-8.8%]), severity of atopic dermatitis (OR, 1.22; RD, 1.0%; 95% CI, 0.6%-1.6%), increased skin transepidermal water loss (OR, 3.36; RD, 10.0%; 95% CI, 6.3%-14.8%), filaggrin gene sequence variations (OR, 1.93; RD, 4.2%; 95% CI, 2.4%-6.4%), delayed solid food introduction (eg, peanut after age 12 months [OR, 2.55; RD, 6.8%; 95% CI, 1.9%-14.6%]), infant antibiotic use (first month [OR, 4.11; RD, 12.8%; 95% CI, 0.4%-40%], first year [OR, 1.39; RD, 1.8%; 95% CI, 0.8%-3.1%], during pregnancy [OR, 1.32; RD, 1.5%; 95% CI, 0.6%-2.5%]), male sex (OR, 1.24; RD, 1.1%; 95% CI, 0.7%-1.6%), firstborn child (OR, 1.13; RD, 0.6%; 95% CI, 0.3%-1.0%), family history of food allergy (eg, mother [OR, 1.98; RD, 4.4%; 95% CI, 2.5%-6.8%], father [OR, 1.69; RD, 3.2%; 95% CI, 1.3%-5.5%], both parents [OR, 2.07; RD, 4.8%; 95% CI, 1.3%-5.5%], siblings [OR, 2.36; RD, 6.0%; 95% CI, 4.4%-8.0%]), parental migration (OR, 3.28; RD, 9.7%; 95% CI, 4.9%-16.3%), self-identification as Black (vs White [OR, 3.93; RD, 12.1%; 95% CI, 5.2%-22.5%], vs non-Hispanic White [OR, 2.23; RD, 5.5%; 95% CI, 3.0%-8.7%]), and cesarean delivery (OR, 1.16; RD, 1.0%; 95% CI, 0.3%-1.2%). Factors like low birth weight, postterm birth, maternal diet, and stress during pregnancy showed no significant risk difference.

Conclusions and relevance: In this meta-analysis, the most credible risk factors associated with development of childhood food allergy are a combination of major and minor risk factors, including early allergic conditions (atopic march/diathesis), delayed allergen introduction, genetics, antibiotic exposure, demographic factors, and birth-related variables.

Author/s:

Nazmul Islam, Alexandro W L Chu, Falana Sheriff, Farid Foroutan, Gordon H Guyatt, Romina Brignardello-Petersen, Paul Oykhman, Alfonso Iorio, Ariel Izcovich, Katherine M Morrison, Yetiani Roldan Benitez

What Parents Need to Know About Sleep in Children

Megan George — Tue, 06 Jan 2026 14:26:08 +0000

Date Added:

January 6, 2026

Journal/Publication:

JAMA Pediatrics

Publication Date:

December 22, 2025

URL:

What Parents Need to Know About Sleep in Children

Type:

Patient Education Materials

Format:

Poster

DOI (1):

10.1001/jamapediatrics.2025.5376

Keywords

PMID (1):

41428340

MeSH

sleep initiation and maintenance disorders

Information for parents about sleep in children. James W. Mold, MD, MPH

View

Half of all children have sleep issues at some point during childhood.

When a child does not sleep well, the entire family feels the impact. Sleep supports growth and development and prevents other illnesses. Poor sleep can lead to daytime irritability, trouble focusing, behavioral issues, and learning difficulties. Poor sleep is also associated with long-term problems, such as obesity, breathing problems, and heart problems.

Childhood sleep problems fall into 4 main categories. The most common is behavioral insomnia. This happens when a child has trouble falling or staying asleep, often because they need a specific habit or aid (like rocking or feeding) to settle. Without this help, they struggle to soothe themselves to sleep.

A second category is parasomnias, which are sleep disturbances like night terrors, sleepwalking, and teeth grinding. Night terrors are sudden episodes in which a child screams or appears panicked early in the night. While frightening to witness, the child is unaware of the episode and will have no memory of it. These are usually harmless and temporary.

A third category is bed-wetting, which is also common up to around age 7 years and is usually normal. If it continues regularly after that, discuss with a health care professional to rule out underlying issues or find strategies to help.

Sleep apnea is the final category and is a more serious condition involving repeated pauses in breathing during sleep. Sleep apnea can be caused by enlarged tonsils or excess weight. Children may snore loudly, gasp, or appear restless at night. This disrupted sleep can affect their mood, behavior, and ability to learn. Some children may need overnight sleep studies to diagnose sleep apnea and provide interventions to decrease lifetime illness.

Speak to your child’s pediatrician if you have concerns. Note if your child snores loudly 3 or more nights per week, especially if they gasp or choke during sleep. Excessive daytime sleepiness, frequent headaches or stomachaches, or sleep consistently lasting less than the recommended amount (less than 9 hours for school-aged children) are also signs that your child may have a more serious sleep condition.

All sleep problems need attention. The best way to support better sleep is to create consistent routines that support sleep, known as good sleep hygiene. Keep the same bedtime and waking time every day, including weekends. Establish a calm wind-down routine (like a bath or quiet reading) for 20 to 45 minutes before bed. Turn off all screens and end exciting activities at least 1 hour before bedtime, and make sure the bedroom is cool, dark, and quiet without televisions and screens. Pay attention to both nighttime signs (like snoring or waking) and daytime behaviors (like crankiness, trouble concentrating, or hyperactivity). For children who have trouble falling asleep on their own, put them to bed when they are drowsy but still awake so they learn how to independently fall asleep. They will need this skill every time they wake up in the middle of the night, which could happen 2 to 3 times. With consistency, many sleep issues improve, helping your child rest well at night and feel their best during the day.

Author/s:

Cynthia-Mae M Hunt, Lindsay A Thompson

What Parents and Teens Need to Know About Testicular Pain

Hope Smashey — Wed, 26 Nov 2025 02:04:51 +0000

Date Added:

November 25, 2025

Publisher:

JAMA Pediatrics

Publication Date:

November 24, 2025

URL:

What Parents and Teens Need to Know About Testicular Pain

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jamapediatrics.2025.4332

Keywords

Spermatic Cord Torsion

male

child

PMID (1):

41284282

MeSH

Spermatic Cord Torsion

male

child

Information for parents about testicular torsion. James W. Mold, MD, MPH

Free full text

View

This JAMA Pediatrics Patient Page describes the symptoms and treatment for testicular torsion in boys.

Author/s:

Maria Isabel Angulo, Geisel R. Collazo, Lindsay A. Thompson

What RSV Is and Why Immunization Matters

Megan George — Tue, 04 Nov 2025 15:48:19 +0000

Date Added:

November 4, 2025

Journal/Publication:

JAMA Pediatrics Patient Page

Publication Date:

September 29, 2025

URL:

What RSV Is and Why Immunization Matters

Type:

Patient Education Materials

Format:

Poster

DOI (1):

10.1001/jamapediatrics.2025.3096

Keywords

pediatrics

RSV

respiratory synytial virus vaccines

immunizations

vaccines

PMID (1):

41021255

MeSH

infant

child

Respiratory Syncytial Virus Infections

Respiratory Syncytial Virus Vaccines* / therapeutic use

Respiratory Syncytial Virus Vaccines* / administration & dosage

Respiration Disorders

Information for parents about RSV. James W. Mold, MD, MPH

View

This JAMA Pediatrics Patient Page describes respiratory syncytial virus (RSV) in children and how to prevent its spread.

Author/s:

Alistair Mukondiwa, Callie L. Brown, Lindsay A. Thompson

Efficacy and safety of respiratory syncytial virus vaccines

Megan George — Tue, 21 Oct 2025 13:29:57 +0000

Date Added:

October 21, 2025

Journal/Publication:

Cochrane Database Syst Rev

Publication Date:

September 29, 2025

URL:

Efficacy and safety of respiratory syncytial virus vaccines

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1002/14651858.CD016131

Keywords

vaccine efficacy

respiratory synytial virus vaccines

PMID (1):

41016728

MeSH

Vaccine Efficacy* / statistics & numerical data

Respiratory Syncytial Virus Vaccines* / therapeutic use

Respiratory Syncytial Virus Vaccines* / immunology

Respiratory Syncytial Virus Vaccines* / adverse effects

Respiratory Syncytial Virus Vaccines* / administration & dosage

Respiratory Syncytial Virus Infections* / epidemiology

Respiratory Syncytial Virus Infections* / mortality

Randomized Controlled Trials as Topic

A meta-analysis of results of trials of the RSV vaccine. (It works and is safe.) James W. Mold, MD, MPH

View

Rationale: Respiratory syncytial virus (RSV) is a highly transmissible pathogen that causes varying degrees of respiratory illness across all age groups. The safety and efficacy profiles of available RSV vaccines, a critical consideration for their integration into public health strategies and clinical practice, remain uncertain.

Objectives: To assess the benefits and harms of RSV vaccines compared to placebo, no intervention, vaccines for other respiratory infections, other RSV vaccines, or monoclonal antibodies (mAbs) across all human populations.

Search methods: We conducted a comprehensive literature search of CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and the WHO ICTRP following standard systematic review methodology from 2000 to April 2024.

Eligibility criteria: We included both randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) involving all human populations comparing RSV vaccines with placebo, no intervention, vaccines for other respiratory infections, other RSV vaccines, or mAbs. We excluded studies focused on dose-finding schedules and immunogenicity assessment.

Outcomes: Benefits included frequency of RSV illness (both lower and upper respiratory illness) confirmed by laboratory tests (RSV-associated lower respiratory tract illness and RSV-associated acute respiratory illness); hospitalisation due to RSV disease (both lower and upper respiratory illness) confirmed by laboratory tests; mortality from illness caused by RSV (confirmed by laboratory test); all-cause mortality; and admission to an intensive care unit. Harms included serious adverse events (SAEs) related to vaccination, including neurological disorders such as Guillain-Barré syndrome.

Risk of bias: We assessed risk of bias in RCTs using Cochrane's RoB 2 tool.

Synthesis methods: We used standard Cochrane methods.

Included studies: We identified 14 RCTs: five trials (101,825 participants) on older adults; three trials (12,010 participants) on maternal vaccination and effects on infants; one trial (300 participants) on women of childbearing age; and five trials (192 participants) on infants and children. We identified no NRSIs.

Synthesis of results: RSV prefusion vaccine versus placebo in older adults These vaccines reduced RSV-associated lower respiratory tract illness with vaccine efficacy (VE) of 77% (95% confidence interval (CI) 0.70 to 0.83; risk ratio (RR) 0.23, 95% CI 0.17 to 0.30; 4 RCTs, 99,931 participants; high-certainty evidence) and RSV-associated acute respiratory illness with VE of 67% (95% CI 0.60 to 0.73; RR 0.33, 95% CI 0.27 to 0.40; 3 RCTs, 94,339 participants; high-certainty evidence). There may be little to no difference in mortality from illness caused by RSV, all-cause mortality, and SAEs related to vaccination (low-certainty evidence). RSV postfusion F protein-based vaccine versus placebo in older adults There is probably little to no difference in RSV-associated lower respiratory tract illness with VE of -0.37% (95% CI -1.96 to 0.37; RR 1.37, 95% CI 0.63 to 2.96; 1 RCT, 1894 participants; moderate-certainty evidence) and RSV-associated acute respiratory illness with VE of -0.07% (95% CI -1.15 to 0.47; RR 1.07, 95% CI 0.53 to 2.15; 1 RCT, 1894 participants; moderate-certainty evidence). There may be little to no difference in mortality from illness caused by RSV, all-cause mortality, and SAEs related to vaccination (low-certainty evidence). Maternal RSV F protein-based vaccine versus placebo in infants These vaccines reduced medically attended RSV-associated lower respiratory tract illness with VE of 54% (95% CI 0.28 to 0.71; RR 0.46, 95% CI 0.29 to 0.72; 3 RCTs, 12,010 participants; high-certainty evidence), medically attended RSV-associated severe lower respiratory tract illness with VE of 74% (95% CI 0.44 to 0.88; RR 0.26, 95% CI 0.12 to 0.56; 3 RCTs, 12,010 participants; high-certainty evidence), and hospitalisation due to RSV disease with VE of 54% (95% CI 0.27 to 0.71; RR 0.46, 95% CI 0.29 to 0.73; 2 RCTs, 11,502 participants; high-certainty evidence) in infants. There may be little to no difference in mortality from illness caused by RSV, all-cause mortality, and SAEs related to vaccination in mothers and infants (low-certainty evidence). Live-attenuated RSV vaccines versus placebo in infants and children The evidence is very uncertain regarding all-cause medically attended acute respiratory illness (MAARI) with VE of 26% (95% CI -0.01 to 0.46; RR 0.74, 95% CI 0.54 to 1.01; 5 RCTs, 171 participants; very low-certainty evidence) and RSV-associated MAARI with VE of 38% (95% CI -0.24 to 0.69; RR 0.62, 95% CI 0.31 to 1.24; 5 RCTs, 192 participants; very low-certainty evidence). There may be little to no difference in SAEs related to vaccination (low-certainty evidence). RSV recombinant F nanoparticle vaccine versus placebo in women of childbearing age The evidence is very uncertain regarding new RSV infections with VE of 50% (95% CI 0.08 to 0.73; RR 0.50, 95% CI 0.27 to 0.92; 1 RCT, 300 participants; very low-certainty evidence). There may be little to no difference in mortality from illness caused by RSV, all-cause mortality, and SAEs related to vaccination (low-certainty evidence). Phase III trials consistently demonstrated low risk of bias. Whilst phase I and II trials occasionally raised concerns about selection bias in the randomisation process, the overall evidence was deemed robust.

Authors' conclusions: RSV prefusion vaccines reduced RSV-associated lower respiratory tract illness and acute respiratory illness in older adults. There may be little to no difference in SAEs related to vaccination in older adults. Maternal vaccination with RSV F protein-based vaccines reduced medically attended RSV-associated lower respiratory tract illness and severe cases in infants. There may be little to no difference in SAEs related to vaccination in mothers and infants. The evidence is very uncertain regarding the effects of RSV vaccine on women of childbearing age, and the effects of live-attenuated RSV vaccines on infants and children; there may be little to no difference in SAEs related to vaccination.

Funding: This review was funded by the EU4Health Programme under a service contract with the European Health and Digital Executive Agency (HaDEA).

Registration: The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023439128).

Author/s:

K M Saif-Ur-Rahman, Catherine King, Seán Olann Whelan, Matthew Blair, Seán Donohue, Caoimhe Madden, Kavita Kothari, Isolde Sommer, Thomas Harder, Nicolas Dauby, Ida Rask Moustsen-Helms, Simona Ruta, Julie Frère, Viktoria Schönfeld, Eero Poukka, Irja Lutsar, Kate Olsson, Angeliki Melidou, Karam Adel Ali, Kerry Dwan, Declan Devane

What Parents Should Understand About Lipid Screening in Children

Hope Smashey — Wed, 08 Oct 2025 01:35:37 +0000

Date Added:

October 7, 2025

Journal/Publication:

JAMA Pediatrics

Publication Date:

October 1, 2025

Issue:

Volume:

179

URL:

What Parents Should Understand About Lipid Screening in Children

Type:

Patient Education Materials

DOI (1):

10.1001/jamapediatrics.2025.2713

Keywords

Lipids

child

parents

PMID (1):

40853685

MeSH

Information for parents regarding lipid screening in children. James W. Mold, MD, MPH

Free full text

View

This JAMA Pediatrics Patient Page describes what parents should consider in deciding whether to have their child screened for high lipid levels.

Author/s:

Michael Silverstein, Michael J Barry, Lindsay A Thompson

Efficacy and Safety of GLP-1 RAs in Children and Adolescents With Obesity or Type 2 Diabetes: A Systematic Review and Meta-Analysis

Megan George — Tue, 16 Sep 2025 13:46:37 +0000

Date Added:

September 16, 2025

Journal/Publication:

JAMA Pediatrics

Publication Date:

September 15, 2025

URL:

Efficacy and Safety of GLP-1 RAs in Children and Adolescents With Obesity or Type 2 Diabetes: A Systematic Review and Meta-Analysis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jamapediatrics.2025.3243

Keywords

diabetes

Diabetes and Endocrinology

PMID (1):

40952752

MeSH

diabetes mellitus, type 2

Glycated Hemoglobin

overweight

Glucagon-Like Peptide-1 Receptor Agonists

glucagon-like peptide 1

Prediabetic State

blood pressure

pediatric obesity

Digestive System Diseases

A review of what we know about the use of GLP-1 RAs in children and adolescents. James W. Mold, MD, MPH

View

Importance Obesity affects 1 in 5 children and adolescents, increasing the risk of type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are among the few pharmacotherapy options available for this population, necessitating a comprehensive evaluation of efficacy and safety.

Objective To assess the efficacy and safety of GLP-1 RAs in children and adolescents (<18 years) with obesity, prediabetes, or T2D.

Data Sources A systematic search was conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized clinical trials (RCTs) published from inception until February 28, 2025. Data analysis was completed from January 2025 to April 2025.

Study Selection RCTs comparing GLP-1 RAs to placebo in children and adolescents with obesity, overweight, prediabetes, or T2D with reported safety and efficacy data were included.

Data Extraction and Synthesis Two reviewers independently extracted data on sample size, population, interventions, follow-up, and outcomes. Risk of bias was assessed using version 2 of the Cochrane risk of bias tool (RoB2). Efficacy outcomes (except lipids) were analyzed as estimated treatment differences, lipids as estimated treatment ratios, and safety via rate ratios. A random-effects inverse variance model was used for all outcomes.

Main Outcomes and Measures The primary efficacy outcomes were change in hemoglobin A1c (HbA1c) (in percentage points), fasting glucose (in milligrams per deciliter), body weight (in kilograms), body mass index (BMI, calculated as weight in kilograms divided by height in meters squared), BMI z scores or percentiles, BMI standard deviation score (SDS), lipid outcomes, and blood pressure. Exploratory efficacy outcomes included obstructive sleep apnea and metabolic dysfunction–associated steatohepatitis or metabolic dysfunction–associated steatotic liver disease. Safety outcomes included gastrointestinal adverse effects (GI AEs), infections, hepatobiliary disorders, suicidal ideation or behaviors, depression, hypoglycemia, and adverse event discontinuations.

Results A total of 18 RCTs (11 in obesity, 6 in T2D, and 1 in prediabetes) with 1402 participants (838 GLP-1 RA users and 564 placebo) were included (mean [range] age, 13.7 [6-17] years; 831 female participants (59.3%); median [IQR] treatment duration, 0.51 [0.25-1.00] years). GLP-1 RAs significantly reduced HbA1c (−0.44%; 95% CI, −0.68% to −0.21%), fasting glucose (−9.92 mg/dL; 95% CI, −16.20 to −3.64), body weight (−3.02 kg; 95% CI, −4.98 to −1.06), BMI (−1.45; 95% CI, −2.40 to −0.49), BMI SDS (−0.20; 95% CI, −0.36 to −0.05), BMI percentile (−7.24%; 95% CI, −12.97% to −1.51%), and systolic blood pressure (−2.73 mm Hg; 95% CI, −4.04 to −1.43) and increased GI AE (log[rate ratio] [RR], 0.75). Other AEs, including suicidal ideation or behaviors, showed no significant differences.

Conclusions and Relevance In this systematic review and meta-analysis of 18 trials, GLP-1 RAs significantly improved glycemic, weight, and cardiometabolic outcomes in children and adolescents with T2D or obesity. Available data over a relatively short follow-up suggested suicidal ideation or behaviors were not significantly different, although GI AEs warrant attention in long-term management.

Author/s:

Pareeta Kotecha, Wenxi Huang, Ya-Yun Yeh

2024 edition of the Rourke Baby Record

Hope Smashey — Sat, 13 Sep 2025 19:21:41 +0000

Date Added:

September 13, 2025

Journal/Publication:

Canadian Family Physician

Publication Date:

September 13, 2025

Issue:

Volume:

Pages:

553-561

URL:

2024 edition of the Rourke Baby Record

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.46747/cfp.7109553

Keywords

child

infant

Baby

PMID (1):

40940145

MeSH

Culturally Competent Care

primary health care

Vegetarians

Eating

This is an article explaining and updating a tool used in many Canadian practices that care for babies and their mothers. The actual Baby Record can b downloaded free at https://www.rourkebabyrecord.ca

Free full text

View

Objective: To assist busy primary care providers caring for infants and young children and their families by providing them with the most recent recommendations and supportive evidence included in the 2024 edition of the Rourke Baby Record (RBR).

Quality of evidence: Articles from pediatric preventive care literature (January 2019 to March 2023) were reviewed for relevance and quality of evidence. When available, evidence from systematic reviews, relevant clinical guidelines, and clinical trials were incorporated. In the absence of high-level evidence, observational studies and expert opinion on the topic were included. Primary research studies were reviewed and critically appraised using a modified protocol.

Main message: Notable updates in the 2024 edition of the RBR include the promotion of early relational health for families; identification of targeted support and resources as opposed to labelling of high-risk groups; guidance on culturally safe care; clarification and evidence-based adjustments of the age of achievement of some developmental surveillance milestones; recommendations on plant-based beverages, vegetarian, and vegan diets; screening considerations for iron deficiency; dangers of ingestion of button batteries and cannabis edibles; literacy and socioemotional benefits of reading, singing, and storytelling; the importance of unstructured outdoor play; the environment's effect on children's health; the significance of sentinel injuries; acholic stools; and the normal presence and abnormal persistence of developmental (primitive) reflexes.

Conclusion: Building on its 40-year history, the 2024 RBR provides freely available, evidence-informed recommendations to guide clinicians in providing effective, up-to-date, and comprehensive preventive pediatric care. Despite the challenging and evolving landscape of primary health care delivery, the RBR will continue to support primary care providers.

Author/s:

Anne Rowan-Legg, Patricia Li, Bruce Kwok, Leslie Rourke, Denis Leduc, James Rourke, Imaan Bayoumi

2024 edition of the Rourke Baby Record

Hope Smashey — Sat, 13 Sep 2025 19:21:20 +0000

Date Added:

September 13, 2025

Journal/Publication:

Canadian Family Physician

Publication Date:

September 13, 2025

Issue:

Volume:

Pages:

553-561

URL:

2024 edition of the Rourke Baby Record

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.46747/cfp.7109553

Keywords

child

infant

Baby

PMID (1):

40940145

MeSH

Culturally Competent Care

primary health care

Vegetarians

Eating

Free full text

View

Author/s:

Anne Rowan-Legg, Patricia Li, Bruce Kwok, Leslie Rourke, Denis Leduc, James Rourke, Imaan Bayoumi

Understanding and Managing Headaches in Children and Teens

Megan George — Tue, 05 Aug 2025 14:39:21 +0000

Date Added:

August 5, 2025

Journal/Publication:

JAMA Pediatrics

Publication Date:

August 1, 2025

URL:

Understanding and Managing Headaches in Children and Teens

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jamapediatrics.2025.1111

Keywords

headache

neurology

pediatric

PMID (1):

40549366

MeSH

headache

tension-type headache

Information for parents about headaches in children. James W. Mold, MD, MPH

View

This JAMA Pediatrics Patient Page discusses symptoms and treatment of headaches in children and teens.

Author/s:

Cynthia-Mae M Hunt, Lindsay A Thompson

Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths

Megan George — Fri, 25 Jul 2025 13:43:37 +0000

Date Added:

July 25, 2025

Journal/Publication:

JAMA

Publication Date:

June 18, 2025

URL:

Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2025.7829

Keywords

PMID (1):

40531519

MeSH

adolescent

Adolescent Behavior / psychology

Addictive* / epidemiology

Behavior, Addictive* / psychology

A review of the adverse consequences of addictive screen use behaviors by adolescents. James W. Mold, MD, MPH

View

Importance: Increasing child and adolescent use of social media, video games, and mobile phones has raised concerns about potential links to youth mental health problems. Prior research has largely focused on total screen time rather than longitudinal addictive use trajectories.

Objectives: To identify trajectories of addictive use of social media, mobile phones, and video games and to examine their associations with suicidal behaviors and ideation and mental health outcomes among youths.

Design, setting, and participants: Cohort study analyzing data from baseline through year 4 follow-up in the Adolescent Brain Cognitive Development Study (2016-2022), with population-based samples from 21 US sites.

Exposures: Addictive use of social media, mobile phones, and video games using validated child-reported measures from year 2, year 3, and year 4 follow-up surveys.

Main outcomes and measures: Suicidal behaviors and ideation assessed using child- and parent-reported information via the Kiddie Schedule for Affective Disorders and Schizophrenia. Internalizing and externalizing symptoms were assessed using the parent-reported Child Behavior Checklist.

Results: The analytic sample (n = 4285) had a mean age of 10.0 (SD, 0.6) years; 47.9% were female; and 9.9% were Black, 19.4% Hispanic, and 58.7% White. Latent class linear mixed models identified 3 addictive use trajectories for social media and mobile phones and 2 for video games. Nearly one-third of participants had an increasing addictive use trajectory for social media or mobile phones beginning at age 11 years. In adjusted models, increasing addictive use trajectories were associated with higher risks of suicide-related outcomes than low addictive use trajectories (eg, increasing addictive use of social media had a risk ratio of 2.14 [95% CI, 1.61-2.85] for suicidal behaviors). High addictive use trajectories for all screen types were associated with suicide-related outcomes (eg, high-peaking addictive use of social media had a risk ratio of 2.39 [95% CI, 1.66-3.43] for suicidal behaviors). The high video game addictive use trajectory showed the largest relative difference in internalizing symptoms (T score difference, 2.03 [95% CI, 1.45-2.61]), and the increasing social media addictive use trajectory for externalizing symptoms (T score difference, 1.05 [95% CI, 0.54-1.56]), compared with low addictive use trajectories. Total screen time at baseline was not associated with outcomes.

Conclusions and relevance: High or increasing trajectories of addictive use of social media, mobile phones, or video games were common in early adolescents. Both high and increasing addictive screen use trajectories were associated with suicidal behaviors and ideation and worse mental health.

Author/s:

Yunyu Xiao, PhD, Yuan Meng, PhD, Timothy T. Brown, PhD

Has This Child Experienced Physical Abuse? The Rational Clinical Examination Systematic Review

Megan George — Fri, 11 Jul 2025 13:37:15 +0000

Date Added:

July 11, 2025

Journal/Publication:

The Rational Clinical Examination

Publication Date:

April 21, 2025

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2025.2216.

Keywords

The Rational Clinical Examination

Trauma and Injury

child abuse

Psychiatry and Behavioral Health

Child and Adolescent Psychiatry

PMID (1):

40257808

MeSH

Craniocerebral Trauma

Fractures, Multiple

Guidance for clinicians regarding how to evaluate children for suspected child abuse. James W. Mold, MD, MPH

View

Importance: Nearly 100 000 children experience physical abuse each year in the US. Among approximately 2000 annual deaths related to child maltreatment, more than 40% resulted from physical abuse, and half of those children were younger than 1 year. Many of these young children had unidentified abusive injuries before the fatal event.

Objective: To determine the accuracy of clinical and radiologic findings for identifying physical abuse among children who have sustained an injury.

Data Sources and Study Selection: MEDLINE, PubMed Central, and Embase were searched for articles published from 1970 to September 2024. Three authors identified studies describing clinical and radiologic characteristics in children and adolescents undergoing assessment for physical abuse.

Data Extraction and Synthesis: The number of children with and without each clinical or radiologic finding, and the presence or absence of physical abuse, which had been determined by expert panels, predefined criteria, or standardized scales that quantify the level of concern for abuse, were recorded.

Main Outcomes and Measures: The sensitivity, specificity, and likelihood ratios (LRs) of each finding for the presence of physical abuse were calculated and the range or calculated summary measures were reported when the finding was evaluated in more than 1 study.

Results: Of 7378 unique articles, 18 studies met inclusion criteria. The prevalence of physical abuse in these 18 studies ranged from 5% to 79%. Studies that were focused on skin findings in children evaluated for trauma showed that the presence of oral injury such as a torn frenulum (positive LR, 6.6 [95% CI, 3.2-14.0]), bruising on the buttocks (positive LR range, 15-83) or neck (positive LR range, 2.2-84), patterned bruises (positive LR range, 2.0-66), and subconjunctival hemorrhage (positive LR range, 5.4-130) were associated with increased likelihood of physical abuse. In studies of hospitalized children with head injury, the presence of retinal hemorrhages (positive LR, 11.0 [95% CI, 4.0-32.0]), seizures (positive LR, 3.9 [95% CI, 2.4-6.5]), hypoxic ischemic injury (positive LR, 3.4 [95% CI, 1.8-6.4]), or a subdural hematoma (positive LR, 3.2 [95% CI, 2.6-3.8]) increased the likelihood of physical abuse. In studies examining children who underwent skeletal surveys, a single fracture (positive LR, 5.9 [95% CI, 2.9-12.0]) or multiple fractures (positive LR, 3.8 [95% CI, 2.4-6.0]) increased the likelihood of physical abuse.

Conclusions and Relevance: A detailed physical examination that reveals oral injury, bruises on the buttocks or neck, patterned bruises, and subconjunctival hemorrhage in young children should alert clinicians to the possibility of physical abuse. Findings on neuroimaging and ophthalmologic evaluation in infants and young children with head trauma can help clinicians determine the likelihood of physical abuse.

Author/s:

Sonal N Shah, Hiu-Fai Fong, Suzanne B Haney, Mary Clyde Pierce, Nancy S Harper, Mark I Neuman