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. He joined the brand in March of 2023 as an editor before being promoted to senior editor in January 2024. Fitch graduated from Youngstown State University in Youngstown, Ohio in 2020 with a degree in telecommunications and journalism. He started his career as a news and sports videographer before becoming an on-air sports anchor at the NBC-affiliated news station in Youngstown. Fitch briefly worked as a national content writer for a Chicago-based national television station before joining the 

team. He can be reached at: jfitch@mjhlifesciences.com.

Articles

Jain breaks down key benefits of clonidine hydrochloride (ONYDA XR; Tris Pharma) to treat ADHD among patients aged 6 years and older. 

Rakesh Jain, MD, MPH discusses once-daily clonidine hydrochloride (ONYDA XR) for ADHD

These tips can help your patients have a fun, exciting, and thrilling Halloween, all while staying safe. 

How your patients can have a spooky but safe Halloween

The detected reduction in HRs for suicidal ideation among adolescents with obesity prescribed GLP1R suggests potential avenues for future research.

 GLP-1 treatment lowers suicidal ideation risk by 33% in adolescents with obesity, study finds

The product was sent to distributors by direct delivery in 35 states and Amazon.com. 

Dynacare Baby Powder recalled because of potential asbestos contamination

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Dr Bistritz is a pediatric nurse practitioner, Montefiore New Rochelle Hospital, New Rochelle, New York. 

A 15-year-old female presents to the emergency department of a community hospital with acute onset of duskiness in her left arm. 

Pallor and swelling in an athlete’s upper arm

Paul Helmuth, MD, joined us to discuss potentially practical ways to implement AI in practice, as well as the importance of being transparent with families when using the evolving technology. 

Implementing artificial AI and the importance of transparency for patients

video interview, Paul (PJ) Helmuth, MD, practicing pediatrician, Valley Medical Associates, physician clinical executive, Elsevier, Springfield, Massachusetts, discussed how artificial intelligence (AI) is being incorporated in various ways throughout the health care space, including in pediatric care.

Helmuth shared insights on the potential of AI in clinical settings and addressed the concerns of pediatricians who may be skeptical about adopting AI tools in their practice. 

"We realize that we can't hold back the tide. It's coming into our exam rooms. It's coming into the way that we take care of patients," Helmuth noted. While many health care providers are optimistic about AI’s potential to improve care quality, Helmuth acknowledged that there are concerns about the reliability of AI-driven tools. Pediatricians, like many other health care providers, are cautiously navigating this shift, balancing their own expertise with the new technology. 

One application Helmuth discussed is Elsevier’s ClinicalKey AI, which, according to its website, "combines trusted, evidence-based clinical content with conversational search powered by generative AI to support clinicians in delivering high-quality patient care."

Helmuth recounted a recent experience with a patient’s mother who had concerns about her child’s inhaler potentially stunting growth. "I said, 'Hey, we've got this AI tool, let’s ask it.' So I turned it around, I asked the question... and it [gave] an answer, and it also gave the references so we could see transparently where that happened," Helmuth said.

This example demonstrates how AI can enhance transparency and support shared decision-making between clinicians and families. “She didn’t want a computer to take care of her child," added Helmuth. "She still wants me to take care of her, but she wants to also know that I’m using the best information available to do that.” 

Helmuth highlighted that while AI can streamline tasks such as knowledge retrieval, summarizing medical records, and assisting with diagnosis, its role in pediatrics goes beyond technical functionality. The human aspect of care remains crucial. “You’re not just taking care of the child, you’re taking care of the family,” Helmuth emphasized, pointing out the importance of clear communication and collaboration with families when using AI tools. 

As AI continues to evolve, Helmuth envisions its broader integration into clinical workflows, such as aiding with diagnoses or supporting remote monitoring. He concluded, "There’s a whole lot of work being done across lots of different areas within medicine," signaling that AI will likely increasingly play a role in pediatric care while still complementing traditional approaches.

World class clinical information meets artificial intelligence. Elsevier. Accessed October 23, 2024. https://www.elsevier.com/products/clinicalkey/clinicalkey-ai?utm_campaign=US_ClinicalKey+AI+Launch2202NA240021NA&utm_source=GO_NA&utm_medium=PS&utm_content=&campid=2202NA240021&dgcid=HS_NA_US_ClinicalKey+AI+Launch_2202NA240021_GO_PS_CS&2202NA240021&gad_source=1&gclid=Cj0KCQjwveK4BhD4ARIsAKy6pMJmFeQkG6NpL4lItWwzbWS4SX2z0eMRNHAvTVkBRz9cHFYLF-dIFM8aAthsEALw_wcB 

News

Implementing artificial intelligence and the importance of transparency for patients

Brittany Bruggeman, MD, highlights the importance of newer, easier-to-use glucagon formulations in treating severe hypoglycemia in patients with type 1 diabetes.

New glucagon formulations simplify emergency treatment for type 1 diabetes patients

Brittany Bruggeman, MD, a pediatric endocrinologist at the University of Florida and type 1 diabetes (T1D) physician scientist, highlighted crucial advancements in diabetes management, particularly regarding the use of glucagon for severe hypoglycemic events. 

Bruggeman emphasized the critical importance of having glucagon readily accessible for patients with T1D. “Glucagon is what I like to think of as the EpiPen of diabetes, and so it's very important that everybody with T1D, or even type 2 on insulin, has glucagon immediately available to them,” she said during an interview at the 

2024 American Academy of Pediatrics National Conference & Exhibition.

Recent developments in glucagon formulations have made it much easier to administer, especially in emergency situations. Bruggeman noted that older versions required users to mix a powder and liquid before injection, a process that could be confusing and time-consuming. “What we used to have to do is mix a powder and a liquid together before injecting the person with glucagon, which made it really tough for people in the lay public to know how to use this, and even, like school nurses and things, had to have special trainings,” she explained. 

However, new formulations of glucagon have simplified the process, making it more accessible to non-medical personnel. “Now there's a formulation that is a nasal spray, and so literally, you just spray the powder into the person's nose,” Bruggeman said, highlighting how this change has improved usability. Additionally, there are now shelf-stable liquid versions of glucagon that function similarly to an EpiPen, allowing for a quick injection without needing to mix anything.

Bruggeman stressed the importance of awareness among healthcare professionals and the public regarding these advancements. “It's really important that the lay public, pediatricians, [and] everyone knows about glucagon, and that if someone with T1D is on insulin, they need to have access to this in order to treat them if they had a severe hypoglycemic event,” she said. 

New glucagon formulations simplify emergency treatment for T1D patients

Octavio Ramilo, MD, highlights key developments in the effort to prevent RSV disease in recent years, highlights vaccines and monoclonal antibodies. 

The evolution of RSV disease prevention in infants

 video interview, Octavio Ramilo, MD, chair, Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, highlighted challenges and breakthroughs to prevent respiratory syncytial virus (RSV) among the infant population. 

RSV is the leading cause of infant hospitalization in the United States, with an estimated 58,000–80,000 children younger than 5 years hospitalized each year because of the disease, according to the Centers for Disease Control and Prevention (CDC).

The CDC also notes that "nearly every child will get RSV by the time they are 2 years old."

"For 60 years, we've been trying to develop new preventive strategies for RSV in children, and it has been very difficult because [of] the immune system of children," Ramilo said. "We cannot use the traditional vaccine strategy of 2, 4 and 6 months, because, number one, this infection affects the very early in life... even before they can get their routine vaccines. Second, the immune system of infants is immature, so they cannot respond so well to these attempts to do a traditional vaccination."

Developments in recent years have moved the needle in a big way for the prevention of RSV disease.

"A few years ago, there was a major observation in the RSV field, and it was the development of the clarification of the structure of the RSV fusion protein, or RSV F," explained Ramilo, who noted there are 2 forms of the protein.

"One is the pre-fusion form, and the other is the post-fusion and that allows [us] to understand what part of the protein induced more protein-neutralizing antibodies, which led to No. 1, the development of the maternal vaccines using this protein F in the pre-fusion conformation, and also to develop new monoclonal antibodies against different targets that induce very potent neutralizing antibodies," said Ramilo. 

The FDA approvals of the monoclonal antibody 

nirsevimab (Beyfortus; Sanofi and AstraZeneca) 

 have for the first time allowed for the prevention of RSV disease in this patient population, says Ramilo. In addition, 

 (Merck) is being investigated as another potential monoclonal antibody tool to prevent RSV disease.

Click here to listen to Ramilo discussing the clinical development and recently-released clinical data for clesrovimab.

"The first one that was approved is nirsevimab," said Ramilo. "These antibodies are very unique compared to the previous antibodies that we used to have. They are more potent, and they have been genetically engineered so they can last longer. They have a prolonged half life, so one dose of the antibody will cover the whole the complete 5, 6 months of the RSV season. That has been really important, and we begin to experience improvements with this strategy."

Related: Tina Tan: Higher uptake in nirsevimab, maternal vaccine expected this RSV season 

' editor-in-chief Tina Tan, MD, FAAP, FIDSA, FPIDS, talks RSV immunization and the availability of prevention tools.

Click here to watch this 2-minute video interview.

1. RSV in infants and young children. Centers for Disease Control and Prevention. Updated August 30, 2024. Accessed October 22, 2024. https://www.cdc.gov/rsv/infants-young-children/index.html 

2. Fitch, J. Nirsevimab-alip FDA approved to prevent RSV in neonates, infants. 

. July 17, 2023. Accessed October, 2022. https://www.contemporarypediatrics.com/view/nirsevimab-alip-fda-approved-to-prevent-rsv-in-neonates-infants

3. Fitch, J. FDA approves Pfizer’s maternal vaccine to prevent RSV in infants. 

. August 21, 2023. Accessed October 22, 2024. https://www.contemporarypediatrics.com/view/fda-approves-pfizer-s-maternal-vaccine-to-prevent-rsv-in-infants 

4. Fitch, J. Clesrovimab: A potential new player to protect against RSV. 

. October 18, 2024. Accessed October 22, 2024. https://www.contemporarypediatrics.com/view/clesrovimab-a-potential-new-player-to-protect-against-rsv 

Octavio Ramilo, MD, highlights key developments in the effort to prevent RSV disease in recent years, highlights vaccines and monoclonal antibodies.

Melissa Fickey, MD, explains TMS therapy for major depressive disorder, and highlights key positive data for NeuroStar TMS Therapy, which was presented at the American Academy of Child and Adolescent Psychiatry (AACAP) meeting in Seattle, Washington. 

Understanding TMS therapy for major depressive disorder

 was joined by Melissa Fickey, MD, a board-certified child, adolescent, and adult psychiatrist at Embracing Life Wellness Center in Riverview, Florida, to discuss transcranial magnetic stimulation (TMS) for major depressive disorder (MDD) in adolescents and young adults.

"Essentially, by delivering magnetic pulses to the emotional regulation center, it’s forming action potentials across the neurons to get the neurons to fire on their own,” Fickey explained.

The discussion comes after data for NeuroStar TMS Therapy, an FDA-cleared TMS treatment, was presetned at the American Academy of Child and Adolescent Psychiatry (AACAP) meeting in Seattle, Washington, taking place from October 14 - 19, 2024. 

Investigators sought to determine the outcomes of adolescents and young adults aged 12 to 21 years with depression and anxiety who were treated with TMS in community settings. Data were extracted from a treatment registry of 1283 patients with MDD, of which 682 were aged 12 to 19 years and 601 were aged 20 to 21 years. The primary outcome measures were the Patient Health Questionnaire-9 (PHQ–9) and Generalized Anxiety Disorder-7 (GAD–7).

According to results, in completer sample (n = 1169) 59.4% and 36.4% me the PHQ-9 response and remission criteria, respectively. Marked dose-response effects were observed, with antidepressant effectiveness improving with longer treatment courses (

"The trajectory of improvement showed the greatest symptom reduction over the first 10 sessions, with no plateau before treatment termination," stated the study authors. In addition, there was a significant correlation between percentage change in PHQ-9 and GAD-7 scores (

Fickey explained how this type of treatment can be beneficial not only for the child, but with this data, to reassure families as well.

"I know that it can be very difficult dealing with parents and children that struggle with depression. As a child psychiatrist myself, I know that on the first line these pediatricians, they're experiencing it as well, and they might be trying to treat these patients before we even get to see them to help intervene," said Fickey.

"Now that we have this, I think it can help the conversation of treatment so that they feel more comfortable, perhaps, and a non-medication route... I know it can feel helpless as a provider when you see this family dynamic, [but] now you can offer this non-medication option and have the FDA data to back it." 

Fitch, J. TMS treatment improves depressive symptoms, anxiety in adolescents. 

. October 17, 2024. Accessed October 18, 2024. https://www.contemporarypediatrics.com/view/study-tms-treatment-improves-depressive-symptoms-anxiety-in-adolescents 

Octavio Ramilo, MD, joins us to discuss new clesrovimab phase 2b/3 study data presented at IDWeek 2024 in Los Angeles, California. 

video interview, Octavio Ramilo, MD, chair, Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, highlighted key phase 2b/3 data for clesrovimab (Merck), an investigational monoclonal antibody designed to protect infants from RSV during their first season. 

The potential preventative tool demonstrated positive phase 2b/3 study data (MK-1654-004; NCT04767373), which was presented at IDWeek 2024, in Los Angeles, California. 

Clesrovimab met all prespecified endpoints in a placebo-controlled, phase 2b/3 pivotal trial evaluating a single dose in healthy preterm and full-term infants aged birth to 1 year. Results were consistent through both the 5-month and 6-month time points. 

According to the announcement, reduction in incidence of RSV-associated medically attended lower respiratory infections (MALRI) that required 1 or more indicator of lower respiratory infection or severity compared to placebo through 5 months post-dose, was 60.4% (95% CI: 44.1, 71.9, [

A key secondary endpoint was RSV-associated hospitalizations, for which clesrovimab reduced these hospitalizations by 84.2% (95% CI: 66.6, 92.6, [

 <0.001]) through 5 months compared to placebo. A third endpoint was RSV-associated lower respiratory infection hospitalizations, which were reduced 90.9% with clesrovimab treatment compared to placebo through 5 months (95% CI: 76.2, 96.5). In addition, clesrovimab reduced the incidence of severe MALRI (tertiary endpoint) by 91.7% (95% CI: 62.9, 98.1), according to the Merck announcement. 

Octavio Ramilo, MD discloses the following:

Consultancies or paid advisory boards - Pfizer, Sanofi, Merck

Grants received/research funding - NIH, Gates Foundation, Janssen, Merck

Lecture fees for speaking at the invitation of a commercial sponsor - Pfizer, Sanofi, Merck 

Fitch, J. IDWeek: Clesrovimab reduces RSV disease, hospitalization in healthy infants. 

. October 17, 2024. Accessed October 18, 2024. https://www.contemporarypediatrics.com/view/idweek-clesrovimab-reduces-rsv-disease-hospitalization-health-infants

Clesrovimab: A potential new player to protect against RSV

Matthew Davis, MD, FAAP on current, key pediatric health care themes

At the 2024 American Academy of Pediatrics National Conference & Exhibition, Matthew M. Davis, MD, MAPP, executive vice-president, enterprise physician-in-chief, and chief scientific officer of Nemours Children's Health, shared key themes in children's health that are at the forefront of current discussions. These include mental and behavioral health, the role of artificial intelligence (AI) in pediatrics, and addressing social needs for children and families. 

"The first of these is a familiar one, which is, how are kids doing with regard to their mental and behavioral health?" Davis remarked, emphasizing that mental health remains a significant concern in the wake of the pandemic. He highlighted the ongoing challenge of insufficient behavioral health care professionals to meet the growing demand.

"While behavioral health care has expanded, there are still too few behavioral health care professionals to take care of all the need that we have in our communities," he explained. Davis noted that pediatricians are often on the front line of managing children's mental health and stressed the need for continuous improvement in care approaches. "We need to continually refresh our approaches, because it can be really challenging to support families in this way." 

Davis also addressed the growing interest and concerns surrounding AI in pediatric care. "It's on everybody's mind. It's in virtually every commercial, it seems like right now," he said, pointing out that many parents are wary of AI's role in their children's health care. Davis reassured that AI would complement rather than replace pediatricians.

"Parents want to be sure that at the end of the day, a pediatrician is going to make the decision about what needs to happen for their child, not a computer algorithm." He envisions a future where AI and human intelligence work in tandem, creating "that elegant combination of that familiarity and support that a pediatrician has with AI." 

The third major theme Davis discussed is the importance of addressing social determinants of health. "The nation has become much more aware of how social factors like poverty and food insecurity and housing insecurity are very real concerns for millions of kids," he said. "We need to connect pediatricians to those social programs in order to make sure that there's a fabric of support around families and their kids." 

These key issues—mental health, AI, and social determinants—highlight the evolving landscape of pediatric care and the need for integrated, innovative solutions to ensure children's well-being. 

The ongoing challenges of mental health, artificial intelligence, and the addressing of social determinants of health are key themes of pediatric health care are topics of discussion with Matthew Davis, MD, FAAP in this video interview.

Janice F Bistritz, DNP, CPNP, MS

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