The Journal of Pediatrics

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In the article “Variation in Hospitalization Rates Following Emergency Department Visits in Children with Medical Complexity” by Coller et al (J Pediatr 2019; 214:113–20.e1), a middle initial was not inclulded in an author's name. The author's correct name is Christian D. Pulcini, MD, MEd, MPH.

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Geospatial Analyses of Accessibility to Down Syndrome Specialty Care

To assess whether the location of 71 Down syndrome specialty care clinics in the US make them inaccessible to a considerable portion of the American population.

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Left Ventricular Dysfunction and Persistent Perfusion Abnormalities in Infants with Congenital Diaphragmatic Hernia

Congenital diaphragmatic hernia (CDH) is a complex disease that causes severe hypoxemic respiratory failure and significant morbidity and mortality.1 In the most severe cases, CDH is characterized by lung hypoplasia, severe pulmonary hypertension (PH), and cardiac dysfunction.2 Despite many advances in therapeutic options for CDH, the related PH and poor cardiac function often remain refractory to medical interventions, such as inhaled nitric oxide (iNO) therapy, and persist as the most common indications for extracorporeal membrane oxygenation therapy (ECMO) in the newborn period.

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A Child with Whorls and Streaks: Look Beyond the Skin!

A 5-year-old-boy, born to nonconsanguineous parents, presented with global developmental delay and seizures. As a neonate, he had right focal tonic seizures and later developed asymmetric infantile spasms, generalized tonic seizures, and atypical absence seizures. He was on multiple antiepileptic drugs with only partial response. Examination showed microcephaly, right hemiparesis, and whorled hypopigmented patches over the trunk and left thigh (Figure 1; available at Magnetic resonance imaging of the brain showed left hemimegalencephaly (Figure 2).

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Tracheal Tugging

A 1-month-old female patient was referred to our hospital with a history of noisy breathing and poor weight gain. The noisy breathing worsened when the patient was crying or feeding, and feeding was sometimes difficult due to respiratory distress. The patient was delivered vaginally at term with a birth weight of 2.3 kg. On examination, her pulse rate, respiratory rate, body temperature, and oxygen saturation were 158 beats per minute, 44 breaths per minute, 37.2°C, and 99% on room air, respectively.

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Breastfeeding, Baby-Friendly, and Safety: Getting the Balance Right

Breastfeeding has multiple health and social benefits and is regarded by most experts, including the American Academy of Pediatrics, as the optimal feeding practice for newborns. Even so, in the US, rates of breastfeeding initiation and continued breastfeeding at 6 and 12 months remain well below Healthy People 2020 national goals. In 1991, the World Health Organization and the United Nations Children's Fund launched the Baby-Friendly Hospital Initiative to improve breastfeeding initiation at birth and breastfeeding duration through the first year of life.

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Just Say No to iNO in Preterms—Really?

Persistent pulmonary hypertension of the newborn (PPHN) can complicate the clinical course of neonates born term and preterm with acute hypoxemic respiratory failure (HRF) and contributes to high morbidity and mortality.1,2 In a study of infants born at term and near-term, PPHN occurred in approximately 2 per 1000 live births.3 In contrast, the prevalence of PPHN among 12 954 infants born extremely preterm from a Japanese cohort was reported at 8.1%, with the trend increasing over the past decade due to increased survival of infants with extremely low birth weight and the growing awareness of PPHN in infants born preterm.

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