No abstract

We demonstrated a change in the epidemiological patterns of pediatric septic arthritis and identified risk factors associated with comorbidities of osteomyelitis and bacteremia/septicemia.

Level II.

Background The Coronavirus Disease 2019 (COVID-19) pandemic has changed the lives of children and parents, raising concerns about child maltreatment. Objective We examined the prevalence of abusive parenting behavior during the pandemic of the COVID-19 and its relations with physical, psychological, and social factors and positive parenting behavior. Participants and setting An online survey was performed during the COVID-19 state of emergency in Japan. Participants were 5344 parents of children aged 0–17 years. Methods We conducted an anonymous online survey using multiple platforms, including websites of child-related organizations and social networking services (SNS). Multiple logistic regression analyses were performed to identify factors associated with abusive behavior. Results One-fifth of parents reported abusive behaviors, whereas over 80% of parents reported positive parenting behaviors (e.g., empathizing with a child). Abusive parenting behaviors were associated with longer screen time (6+ hours per day: OR, 1.44; 95%CI, 1.05–1.98), poor maternal mental health (K6 = 13+: OR, 2.23; 95%CI, 1.71–2.89), and the occurrence of domestic violence (OR, 4.54; 95%CI, 3.47–5.95). Positive parenting behaviors, especially showing empathy, were associated with lower risks of abusive behaviors (OR, 0.51: 95%CI, 0.39–0.66). Conclusions Positive parenting behavior is essential to the prevention of child maltreatment during the COVID-19 pandemic.

Several studies revealed the epidemiology of Kawasaki disease-related hospitalizations among children in the USA and other countries. However, disparities of developing coronary artery aneurysms by race/ethnicity, patient socioeconomic status, and geographic locations remain unknown in the USA. Hospital discharge record data of patients with Kawasaki disease aged 19 years or younger were obtained from the 2003, 2006, 2009, and 2012 Kid's Inpatient Database. The data were weighted to estimate the annual hospitalization rates with respect to age, gender, and race/ethnicity in the USA. Multivariable logistic regression was conducted to ascertain the factors associated with the development of coronary artery aneurysms. Total annual hospitalization rates of Kawasaki disease showed a decreasing trend, ranging from 6.54 per 100,000 children in 2003 to 6.11 per 100,000 children in 2012 (p < 0.001). The proportions of coronary artery aneurysms among patients with Kawasaki disease ranged from 2.25 to 3.20%. Factor associated with the development of coronary artery aneurysms was hospitals in West (OR 2.15, 95% CI 1.42-3.26). Race/ethnicity, health insurance status, and household income were not associated with the development of coronary artery aneurysms. Total hospitalization rates of Kawasaki disease showed a decreasing trend. Children admitted to hospitals in West region were more likely to develop coronary artery aneurysms.

No abstract

At the national level, IgA vasculitis-related hospitalizations among children in the USA are scarce. Furthermore, nationwide epidemiology and hospital course of children with IgA vasculitis have not been fully described in the USA, and disparities by race/ethnicity remain unknown. Hospital discharge records of patients aged 19 years or younger were obtained from the 2003, 2006, 2009, and 2012 Kids' Inpatient Database, and they were weighted to estimate the annual hospitalization rates with respect to age, gender, and race/ethnicity in the USA. Annual hospitalization rates were calculated using weighted case estimates and US census data. Negative binomial regression was used to ascertain the factors associated with length of hospital stay. Total annual hospitalization rates showed a significant decreasing trend, ranging from 2.45 per 100,000 children in 2003 to 1.89 per 100,000 children in 2012 (p < 0.001). The peak ages of the hospitalized children with IgA vasculitis were 2 and 7 years, and male-to-female ratios were 1.38-1.44. Factors associated with length of hospital stay were patients' ages (10-14 and 15-19 years), race/ethnicity (Hispanic, Asian, and Pacific Islander), comorbid electrolyte abnormality, GI hemorrhage, intussusception, renal symptoms, and GI symptoms. The annual hospitalization rates for IgA vasculitis are declining in the USA across multiple age groups. GI and renal manifestations are associated with increased length of hospital stay.

Pediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations.