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April 2025
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10 Reads
JAMA The Journal of the American Medical Association
This Viewpoint discusses the urgent need to form an analogous taxonomy for digital media use that identifies patterns of use, irrespective of content, that could be problematic, particularly for children and adolescents.
April 2025
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1 Read
Transgender Health
April 2025
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18 Reads
The risk of cardiovascular outcomes following SARS-CoV-2 infection has been reported in adults, but evidence in children and adolescents is limited. This paper assessed the risk of a multitude of cardiac signs, symptoms, and conditions 28-179 days after infection, with outcomes stratified by the presence of congenital heart defects (CHDs), using electronic health records (EHR) data from 19 children’s hospitals and health institutions from the United States within the RECOVER consortium between March 2020 and September 2023. The cohort included 297,920 SARS-CoV-2-positive individuals and 915,402 SARS-CoV-2-negative controls. Every individual had at least a six-month follow-up after cohort entry. Here we show that children and adolescents with prior SARS-CoV-2 infection are at a statistically significant increased risk of various cardiovascular outcomes, including hypertension, ventricular arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, thromboembolism, chest pain, and palpitations, compared to uninfected controls. These findings were consistent among patients with and without CHDs. Awareness of the heightened risk of cardiovascular disorders after SARS-CoV-2 infection can lead to timely referrals, diagnostic evaluations, and management to mitigate long-term cardiovascular complications in children and adolescents.
April 2025
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9 Reads
Pediatric Long COVID has been associated with a wide variety of symptoms, conditions, and organ systems, but distinct clinical presentations, or subphenotypes, are still being elucidated. In this exploratory analysis, we identified a cohort of pediatric (age <21) patients with evidence of Long COVID and no pre-existing complex chronic conditions using electronic health record data from 38 institutions and used an unsupervised machine learning-based approach to identify subphenotypes. Our method, an extension of the Phe2Vec algorithm, uses tens of thousands of clinical concepts from multiple domains to represent patients’ clinical histories to then identify groups of patients with similar presentations. The results indicate that cardiorespiratory presentations are most common (present in 54% of patients) followed by subphenotypes marked (in decreasing order of frequency) by musculoskeletal pain, neuropsychiatric conditions, gastrointestinal symptoms, headache, and fatigue.
April 2025
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9 Reads
JAMA Network Open
Importance It remains unclear whether children and adolescents with SARS-CoV-2 infection are at heightened risk for long-term kidney complications. Objective To investigate whether SARS-CoV-2 infection is associated with an increased risk of postacute kidney outcomes among pediatric patients, including those with preexisting kidney disease or acute kidney injury (AKI). Design, Setting, and Participants This retrospective cohort study used data from 19 health institutions in the National Institutes of Health Researching COVID to Enhance Recovery (RECOVER) initiative from March 1, 2020, to May 1, 2023 (follow-up ≤2 years completed December 1, 2024; index date cutoff, December 1, 2022). Participants included children and adolescents (aged <21 years) with at least 1 baseline visit (24 months to 7 days before the index date) and at least 1 follow-up visit (28 to 179 days after the index date). Exposures SARS-CoV-2 infection, determined by positive laboratory test results (polymerase chain reaction, antigen, or serologic) or relevant clinical diagnoses. A comparison group included children with documented negative test results and no history of SARS-CoV-2 infection. Main Outcomes and Measures Outcomes included new-onset chronic kidney disease (CKD) stage 2 or higher or CKD stage 3 or higher among those without preexisting CKD; composite kidney events (≥50% decline in estimated glomerular filtration rate [eGFR], eGFR ≤15 mL/min/1.73 m ² , dialysis, transplant, or end-stage kidney disease diagnosis), and at least 30%, 40%, or 50% eGFR decline among those with preexisting CKD or acute-phase AKI. Hazard ratios (HRs) were estimated using Cox proportional hazards regression models with propensity score stratification. Results Among 1 900 146 pediatric patients (487 378 with and 1 412 768 without COVID-19), 969 937 (51.0%) were male, the mean (SD) age was 8.2 (6.2) years, and a range of comorbidities was represented. SARS-CoV-2 infection was associated with higher risk of new-onset CKD stage 2 or higher (HR, 1.17; 95% CI, 1.12-1.22) and CKD stage 3 or higher (HR, 1.35; 95% CI, 1.13-1.62). In those with preexisting CKD, COVID-19 was associated with an increased risk of composite kidney events (HR, 1.15; 95% CI, 1.04-1.27) at 28 to 179 days. Children with acute-phase AKI had elevated HRs (1.29; 95% CI, 1.21-1.38) at 90 to 179 days for composite outcomes. Conclusions and Relevance In this large US cohort study of children and adolescents, SARS-CoV-2 infection was associated with a higher risk of adverse postacute kidney outcomes, particularly among those with preexisting CKD or AKI, suggesting the need for vigilant long-term monitoring.
March 2025
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11 Reads
JAMA Pediatrics
March 2025
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2 Reads
JAMA Pediatrics
This Viewpoint explores the potential utilities of artificial intelligence for achieving inclusive health care for people with intellectual and developmental disabilities.
March 2025
Journal of Adolescent Health
March 2025
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5 Reads
Journal of Adolescent Health
March 2025
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4 Reads
Journal of Adolescent Health
... Les compressions dans le financement de la recherche figurent parmi le cortège d'initiatives de la nouvelle administration américaine visant à utiliser le pouvoir économique comme une arme politique de promotion d'intérêts tantôt économiques, tantôt protectionnistes ou idéologiques. Comme l'ont soulevé les rédactions de nombreuses revues médicales, presque toutes ces mesures entraîneront des répercussions néfastes sur la santé humaine aux États-Unis et ailleurs [2][3][4][5] . La peur et la cons ternation sont des réactions naturelles aux décrets-lois que l'on sait préjudiciables, et elles devraient être validées. ...
Reference:
Défendre la limite
February 2025
JAMA The Journal of the American Medical Association
... 6 In the gastrointestinal tract, lingering symptoms of gastrointestinal injury after the subsidence of pulmonary infection may be an important factor in the ongoing development of COVID-19. 7,8 However, complications of intestinal ulceration due to COVID-19 infection remain unreported. Given these mechanisms, we present a case highlighting the severe gastrointestinal complications, specifically small bowel ulcers, associated with chronic COVID-19 infection. ...
February 2025
JAMA Network Open
... Our study utilizes data from the Researching COVID to Enhance Recovery (RECOVER) electronic health records (EHR) system to conduct a thorough evaluation of cardiovascular signs, symptoms, and conditions in children and adolescents with and without CHDs, to understand the post-acute cardiovascular impacts 28 to 179 days after SARS-CoV-2 infection. In our study, we followed a definition commonly used in pediatric literature 8,[25][26][27] , focusing on features occurring between 28 and 179 days after the index date. This timeframe aligns with the post-acute phase while capturing meaningful cardiovascular outcomes in children and adolescents. ...
December 2024
EClinicalMedicine
... In fact, a recent, large population study from the United States has also found a significant role of vaccination in reducing the risk of Long Covid in children. 66 Our study is not without limitations. First, this is a single-center study, although all children with a positive Sars-CoV-2 infection were referred to participate from outpatient family pediatricians and not only from our Institution. ...
February 2024
... Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis may be involved. (2,5,6) Viral croup often presents similarly to an upper respiratory infection, with 12-72 h of low-grade fever and coryza. Narrowing of the larynx leads to stridor, increased respiratory rate, respiratory retractions, and a barking cough. ...
September 2024
... Research on nirmatrelvir-ritonavir's effectiveness in younger populations, particularly adolescents, remains limited, with most clinical effectiveness data comes from adult populations. While the drug is recommended for adolescents with risk factors for severe disease [17][18][19] , pharmacokinetic and pharmacodynamic data are lacking, and evidence on its use, safety, and effectiveness in this population is scarce 20 . Adolescents may exhibit different immune responses and clinical outcomes compared with adults 21,22 , raising questions about the generalizability of adult trial results although a phase 2/3 clinical trial assessing the safety and efficacy of nirmatrelvir-ritonavir treatment in children 6 to 17 years of age with COVID-19 is currently underway 23 . ...
July 2024
... The implications of these studies are in harmony with the research we have already cited that emphasises the crucial importance of interaction, and particularly parental interaction, in early language learning and development. Webb et al. (2024), working with children aged 18-21 months, found that infants who played with tablet computers had reduced engagement with adults. The infants did not attempt any language-related responses when playing a tablet game. ...
July 2024
JAMA Network Open
... Out of the many potential causes, screens play a part. Over 500 empirical papers, including both observational and experimental studies, support the negative link between screen time and sleep Hartstein et al., 2024). The time spent on screens often replace part of the sleeping time . ...
May 2024
... Some of the diversity in trans young people's embodiment is within group (i.e., not all trans girls desire to change their body), but more diversity in embodiment goals exists between subgroups of trans individuals. One study of trans young people in the US found significant differences between gender identity subgroups in the types of GAMC desired; for example, compared to trans women, nonbinary individuals were less likely to want both puberty blockers and gender-affirming hormones, but more likely to want only pubertal blockers (Sequeira et al., 2025). Result from a Canadian study of trans youth in clinical care found that while hormone therapy was desired by all youth attending clinics, surgery was not desired by all, and type of surgery differed by groups, with trans masculine youth wanting more generally top surgery, while trans feminine youth tended to desire more bottom surgery and nonbinary youth felt constrained by binary medical protocols (Pullen Sansfaçon et al., 2019). ...
May 2024
LGBT Health
... The goal of this study is to identify subphenotypes in a large cohort of pediatric patients with evidence of non-MIS-C Long COVID [15]. Prompted by the need to analyze a wide range of clinical variables to detect the many potential manifestations of Long COVID as well as their co-occurrences, we employ an unsupervised machine-learning method based on clinical concept embeddings, an extension of the Phe2Vec automated disease phenotyping algorithm, which is an adaptation of a natural language processing method to clinical data [16]. ...
May 2024
