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Meet the Editors

. 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

"In aggregation with other robust observational studies, these results can inform the management of asthma and allergic rhinitis in this patient group," wrote the study authors.

Study: No association between montelukast and neuropsychiatric adverse event risk

"The greatest risk reductions were demonstrated in those who experienced obesity remission during childhood," stated study authors.

Pediatric obesity treatment yields lower morbidity, mortality risk in young adults

Robert Frenck, MD, offers several practical tips to use when discussing pediatric vaccination among vaccine-hesitant parents. 

Discussing pediatric vaccination with vaccine-hesitant parents

Principal investigator Lewis Romer, MD, of Johns Hopkins Medicine joined us to discuss the actively-recruiting MoD PAH trial, and explains the role the pediatrician can play in care and recruitment. 

Pediatric pulmonary arterial hypertension and the pediatrician

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The patient, an 8-year-old male who recently immigrated to the United States from El Salvador, initially presented to the emergency department (ED) for a cough. The next day, he went to the general pediatrics clinic for follow-up and was noted to have a significant history of recurrent fractures.

Child with a history of multiple fractures

**Editor's Note** Please note that starting January 1, 2025, we will be switching to an online-exclusive publication process. This will allow us to publish case submissions quicker without having to deal with the variables that come along with print publication. All cases will still be eligible for print publication consideration, but publication in our print magazine is not guaranteed and will be up to the editor's discretion. 

Do you have a puzzling pediatric case that you’d like to share with the readers of 

We are looking for intriguing diagnoses that have stumped the experts—a diagnostic “Puzzler”—to help our physicians enhance their day-to-day practices. If you have such a story to tell, tell us.

Here’s what to do: Before you begin, we suggest that first you review the Puzzler 

https://www.contemporarypediatrics.com/case-studies

. Please note the specific style required for writing Puzzler manuscripts.

Next, prepare a draft of your case, including a summary of the presenting symptoms, a case overview, a 

table of the differential diagnosis (MANDATORY)

, and the special aspects of your case that qualify it as a Puzzler, and send it to us. Please note that the differential diagnosis table should also be discussed in the body text. We’ll review your draft and let you know what you need to add or revise before we send the manuscript to peer review for evaluation.

Puzzlers vary in length, and we suggest a minimum of 1,200 words up to a maximum of 2,000 words, but that is because of the complexity of some cases and whether some patients returned for many assessments before their diagnoses were determined. Also, some authors describe the pathophysiology of the differentials in great detail. Please also note no more than 3 authors are allowed per article.

What's most important is to show us the process that you used to analyze the case, including:

Why you decided to order certain tests and why you did not order others.

Peer consultations or why you elected to contact other specialists.

Lab values including vital signs or blood tests.

Labs and values if your patient was attended to in the emergency department or other hospital departments such as radiology or neurology.

Discussion related to the possible diagnoses.

Final diagnosis, treatment, prognosis, and follow-up.

Remember to indicate numbered citations within the body of the text and include a complete list of corresponding literature/references at the end of the manuscript. (Do not use any citation management programs or unlink them.) 

Limit references to 25. No references (unless it is a seminal study) can be older than 10 years.

We prefer primary research as references, but some cases are so obscure that authors will need to pull from a variety of sources. However, 

. Be advised that peer reviewers are adamant that the disease/disorder you describe was actually diagnosed and not determined by index of suspicion on the basis of ruling out various differentials. We use AMA11 as our publication style, which uses superscript citation numbers and a corresponding numbered reference list. Please create your citations and references in this style.  Check this recent article posted online at 

https://www.contemporarypediatrics.com/view/the-rx-of-adhd

 for examples of reference style. IMPORTANT NOTE WITH AMA 11TH EDITION: PLEASE PUT DOI OR WEBSITES/URLS AT THE END OF THE REFERENCE LINE.

When you send your draft manuscript, also 

. These image files must be high-resolution jpg or tiff files (minimum of 300 dpi) and as large in size as possible. We suggest a minimum of 7 horizontal inches. The images must be original photos with clear permissions to use, not images from copyrighted sources. Send as separate attachments with your e-mail submission; do not embed images into your manuscript document.

After we receive your manuscript, our editors and peer reviewers will review your draft and let you know if we accept your submission for publication. 

Puzzler is one of the departments for which we receive the most submissions, so it may be several months after submission before you receive feedback from us.

If we do accept your submission for publication, we will contact you with further instructions.

Send your submissions in Microsoft Word format to 

, via e-mail to mpetronelli@mjhlifesciences.com

Guidelines for PUZZLER, Contemporary Pediatrics

 poll. Take a look at the following case below. After reading through the description, choose a multiple choice answer and try to guess the correct patient diagnosis.

on Monday, January 6 at 12:00 PM ET for the full case presentation, differential diagnoses, and the correct patient diagnosis. 

This case was provided by Amar Davé, MD, FAAP and Pahroul Davé, APRN

A boy aged 10 years presented to the outpatient office with a history of painful nodules on the plantar surface of his bilateral feet 8 to 10 hours after spending time in a hot tub. He was unable to bear weight or put on socks and shoes due to his pain. The photos were taken soon after the painful and red papules appeared. The lesions affected the whole plantar aspect of both feet. Over the following 4 days, the nodules became less painful and red. 

Medical advice was sought on the fifth day of symptoms, and by this time, the child was improving clinically. He was stable with subcutaneous, mildly painful, fleshy nodules mostly populating the medial arch of the foot. His remaining clinical examination results were within a normal range. Further questioning of the child’s mother revealed that other children exposed to the hot tub experienced painful feet but without lesions. 

Due to the patient’s improving symptoms and the self-limiting nature of the illness, no tests or labs were ordered as the child was not acutely ill. No peer consultations or specialists were utilized.

Click here for the full case presentation, differential diagnoses, and the correct patient diagnosis, in a separate article.

The photos in this case were taken soon after the painful and red papules appeared.

News

Case Studies

Can you diagnose this boy with painful nodules on his feet?

Caring for someone with blood cancer means pulling a double shift—providing them with help, comfort, and compassion, while managing your own stress and fatigue. We know this is a role you didn’t expect but have risen to meet as best you can. It’s a role that is critical and can be both heartbreaking and rewarding.

The Leukemia & Lymphoma Society (LLS) knows that caregivers have roles they didn’t expect but have risen to meet as best they can. We also know how critical their role is to you, their loved one. This National Family Caregivers Month, we want to acknowledge caregivers and the sacrifices they make.

To ensure that caregivers get answers to their questions and feel supported throughout their patient’s diagnosis, treatment, and survivorship, LLS provides free resources and services developed just for them. Our Information Specialists are highly trained oncology social workers and nurses who personally assist in treatment, financial, and emotional challenges. They can help with communicating effectively with healthcare team members and get answers to questions they have as caregivers.

The LLS Caregiver Workbook and Worksheets provide a guide for managing all aspects of their patient’s blood cancer and space to track all activities related to diagnosis and treatment to help bridge care between healthcare professional teams that may support their patient.

LLS has also created online spaces where caregivers can connect with one another to discuss the successes and challenges in their role supporting a person with blood cancer. 

 is an online gathering space where caregivers can join various groups to ask questions, get support and receive education resources. The weekly online 

 is moderated by a licensed clinical professional who helps guide and support conversations between caregivers.

This, and every month, we appreciate all caregivers as we work together to help blood cancer patients live longer, healthier lives. 

If anyone you know needs caregiver support, LLS can help.

https://lls.org/article/patient-referral-form

NOINDEX

NOFOLLOW

November is National Family Caregivers Month!

We are pleased to share that the Vaccine Education Center (VEC) now has a dedicated 

. Previously, our vaccine videos were posted on the 

Children’s Hospital of Philadelphia YouTube channel

 where you can still find many of our videos.

The new VEC YouTube channel will serve as the hub for our vaccine-related videos moving forward. It will also include playlists featuring videos from the other two channels, and we will curate content-specific playlists to make finding related videos easier. For example, we recently added a measles-specific playlist, as well as one with videos related to pertussis.

We continue to publish our monthly newsletter, 

, which reviews federal, state, and local government roles in vaccine policy and describes four ways to influence policy change.

New YouTube channel! Also, review of vaccines and governance  

Results from a recent study revealed that compulsive and addictive elements can contribute to the risk of disordered eating. Study investigator Susan Carnell, PhD, explains these findings.

Addictive behaviors surrounding social media could lead to binge eating

, Susan Carnell, PhD, explained details of a study she co-authored titled, "Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence," published in 

Carnell is an associate professor in the Division of Child and Adolescent Psychiatry at Johns Hopkins University School of Medicine.

"The reason we did this study is because we were interested to understand more about the effects on social media," Carnell previously said. "We were particularly interested in eating disorders because we know that there is potential for social media to impact mental health, but perhaps particularly eating disorders, because of the certain content to do with social comparison, which could lead to body dissatisfaction and disordered eating." 

The study utilized data from the Adolescent Brain Cognitive Development (ABCD) study, a large-scale, longitudinal project conducted across 21 sites in the United States. "They recruited a large number of children when they were 9 to 10 years old, and they've been following them every year," Carnell said. "We were able to use this data to look at the relationship between social media use, and we looked at both time spent using social media and also addictive behaviors around social media."

Results demonstrated that time spent on social media by itself was not directly associated with binge eating, though individuals with high levels of addictive behaviors surrounding social media at baseline were 3.5 times more likely than those who had no addictive behaviors to develop binge eating by 14 to 15 years of age.

In the above video, Carnell explains, "I think our results suggest that there are some children who may be particularly vulnerable to the addictive nature of social media, which is kind of designed to make us want to keep clicking, or perhaps to binge eating, or perhaps to a third factor which could influence both, like anxiety or depression, which could lead to both of these behaviors."

"So I think our results suggest that those might be the things to key in on, perhaps even more than overall time spent on social media, which might be okay for some kids, but maybe more problematic for others," said Carnell.

Click here to watch Carnell explain initial study details, reason for the study, and the first video in this series with Susan Carnell, PhD.

1.Shi X, Duck SA, Jansen E, et al. Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence. 

2. Fitch, J. Social media use and binge eating in early adolescence. 

. January 6, 2025. Accessed January 9, 2025. https://www.contemporarypediatrics.com/view/social-media-use-and-binge-eating-in-early-adolescence 

Susan Carnell, PhD explains social media addiction symptoms, but not time on social media, were cross-sectionally and prospectively associated with binge eating. 

Social media use and binge eating in early adolescence

Susan Carnell, PhD, associate professor in the Division of Child and Adolescent Psychiatry at Johns Hopkins University School of Medicine, and co-author of the "Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence," publication in 

, recently discussed the link between social media use and the development of binge eating behaviors in adolescents. 

Carnell and her team aimed to explore the impact of social media on eating disorders, focusing on how social comparison and content could drive body dissatisfaction.

"The reason we did this study is because we were interested to understand more about the effects on social media," Carnell explained. "We were particularly interested in eating disorders because we know that there is potential for social media to impact mental health, but perhaps particularly eating disorders, because of the certain content to do with social comparison, which could lead to body dissatisfaction and disordered eating." 

"Social media time, just time spent using social media, increased with age. So it was on average, about 1 hour a day, when children were 11 to 12 [years of age], and then it went up to over 2 hours when they were in adolescence," Carnell noted. "Actually the children who showed persistent binge eating, it went up to over 3 hours per day." 

However, the researchers found a key distinction. "We actually didn't find that social media time, time spent on social media by itself, was associated with binge eating," Carnell explained. "However, those who had high levels of these addictive behaviors around social media at baseline were about 3.5 times more likely than those who had no addictive behaviors to develop binge eating by 14 to 15." 

Carnell's research highlights the importance of addressing addictive social media behaviors in adolescents to mitigate the risk of developing disordered eating patterns. These findings suggest that while time spent on social media is not inherently harmful, the compulsive and addictive elements can contribute to the risk of disordered eating. 

Shi X, Duck SA, Jansen E, et al. Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence. 

Susan Carnell, PhD explains social media addiction symptoms, but not time on social media, were cross-sectionally and prospectively associated with binge eating.

Emily C King, MD, MS

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