Allopurinol use leading to xanthine nephrolithiasis in pediatric tumor lysis syndrome: a case series.

Tumor lysis syndrome (TLS) is a life-threatening metabolic disorder caused by massive tumor lysis. Allopurinol, a xanthine oxidase inhibitor, is initiated during chemotherapy to prevent hyperuricemia and subsequent acute kidney injury (AKI). We report two cases of xanthine nephrolithiasis during TLS in newly diagnosed hematologic malignancy patients receiving prophylactic allopurinol.

Valacyclovir or valganciclovir for cytomegalovirus prophylaxis: A randomized controlled trial in adult and pediatric kidney transplant recipients.

Background: Valganciclovir (valG), a cytomegalovirus (CMV) prophylactic agent, has dose-limiting side effects. The tolerability and effectiveness of valacyclovir (valA) as CMV prophylaxis is unknown.

Methods: We conducted a randomized, open-label, single-center trial of valA versus valG for all posttransplant CMV prophylaxis in adult and pediatric kidney recipients.

Educational and Patient Care Impacts of In Situ Simulation in Healthcare: A Systematic Review.

This systematic review was performed to assess the effectiveness of in situ simulation education. We searched databases including MEDLINE and Embase for studies comparing in situ simulation with other educational approaches. Two reviewers screened articles and extracted information.

High variability in cardiac education and experiences during United States paediatric critical care fellowships.

Background: Paediatric cardiac critical care continues to become more sub-specialised, and many institutions have transitioned to dedicated cardiac ICUs. Literature regarding the effects of these changes on paediatric critical care medicine fellowship training is limited.

Objective: To describe the current landscape of cardiac critical care education during paediatric critical care medicine fellowship in the United States and demonstrate its variability.

Decline in Pediatric Shelf Examination Performance During COVID-19.

Background Medical student education has been impacted by the ongoing coronavirus 2019 (COVID-19) pandemic. Medical students were removed from clinical settings, and the censuses in pediatric hospitals decreased. While there have been studies starting to evaluate these effects on medical students training in surgical subspecialties, the literature in pediatrics is limited.

Psychometric Testing of the Debriefing Assessment for Simulation in Healthcare (DASH) for Trainee-led, In Situ Simulations in the Pediatric Emergency Department Context.

Objectives: Effective trainee-led debriefing after critical events in the pediatric emergency department has potential to improve patient care, but debriefing assessments for this context have not been developed. This study gathers preliminary validity and reliability evidence for the Debriefing Assessment for Simulation in Healthcare (DASH) as an assessment of trainee-led post-critical event debriefing.

Methods: Eight fellows led teams in three simulated critical events, each followed by a video-recorded discussion of performance mimicking impromptu debriefings occurring after real clinical events.

Body composition assessment after pediatric liver transplant.

Background: Pediatric liver transplantation generally restores metabolic function; yet after transplantation, some children remain malnourished, have increased adiposity, and develop obesity. Measurement of body composition in the assessment of nutrition status could reduce adverse consequences in children.

Methods: Anthropometric measurements, multiple-frequency bioelectrical impedance analysis, air displacement plethysmography, and ultrasound measurements were conducted on children recruited from the liver transplant program at the University of Minnesota Masonic Children's Hospital.

Variation in COVID-19 Diagnosis by Zip Code and Race and Ethnicity in Indiana.

To describe variations in coronavirus disease 2019 (COVID-19) diagnosis by zip code race and ethnicity in Indiana. Cross-sectional evaluation of subjects with SARS-CoV-2 at Indiana University Health. We performed two separate analyses, first evaluating likelihood of COVID-19 diagnosis by race (Caucasian, African American, Asian, or other) and ethnicity (Hispanic vs.

Developing Employment Environments Where Individuals with ASD Thrive: Using Machine Learning to Explore Employer Policies and Practices.

An online survey instrument was developed to assess employers' perspectives on hiring job candidates with Autism Spectrum Disorder (ASD). The investigators used K-means clustering to categorize companies in clusters based on their hiring practices related to individuals with ASD. This methodology allowed the investigators to assess and compare the various factors of businesses that successfully hire employees with ASD versus those that do not.

Development of a 51-hospital Chicagoland regional antibiogram and comparison to local hospital and national surveillance data.

Objective: To develop a regional antibiogram within the Chicagoland metropolitan area and to compare regional susceptibilities against individual hospitals within the area and national surveillance data.

Design: Multicenter retrospective analysis of antimicrobial susceptibility data from 2017 and comparison to local institutions and national surveillance data.

Setting And Participants: The analysis included 51 hospitals from the Chicago-Naperville-Elgin Metropolitan Statistical Area within the state of Illinois.

COVID-19-associated apnea and circumoral cyanosis in a 3-week-old.

Background: Data regarding coronavirus disease 2019 (COVID-19) cases and outcomes in infants are sparse compared to older pediatric and adult populations.

Case Presentation: We present a three-week-old full-term male with a history of mild hypoxic ischemic encephalopathy (HIE) who was admitted as an inpatient twice for episodes of apnea and perioral cyanosis. The patient tested positive for COVID-19 and negative for other common respiratory viruses at both admissions.

Intrathoracic hybrid lesion: an incidental finding in a patient with PHACE syndrome.

Hybrid lesions (HLs) are unique, congenital lung malformations with both cystic and solid components and vascular supply consistent with bronchopulmonary sequestration. Increase of HLs reported in recent literature suggest a common pathological mechanism occurring during embryogenesis, leading to occurrence of both malformations within a single lesion. Due to the unusual nature of HLs, gold standard approach for diagnosis is not very well-defined in the literature.

A Case of Linezolid Induced Toxicity.

Adverse effects of linezolid are typically limited to diarrhea, nausea, and headache when shorter durations are used; however, as extended durations of linezolid therapy are increasingly more common, additional monitoring parameters should be considered in these patients. We describe a unique case of hypoglycemia, lactic acidosis, and pancreatitis related to an extended duration of linezolid therapy. A 52-year-old woman presented with altered mental status, abdominal pain, and hypotension following six weeks of linezolid and ertapenem therapy.

Improving time to optimal Staphylococcus aureus treatment using a penicillin-binding protein 2a assay.

The penicillin-binding protein 2a (PBP2a) assay is a quick, accurate and inexpensive test for determining methicillin susceptibility in Staphylococcus aureus. A pre-post-study design was conducted using a PBP2a assay with and without the impact of an antimicrobial stewardship intervention to improve time to optimal therapy for methicillin-susceptible and methicillin-resistant S. aureus isolates.

A Randomized Controlled Trial of Positioning for Lumbar Puncture in Young Infants.

Objective: The lateral and sitting positions are those most widely used to perform lumbar puncture (LP) in infants. This study sought to compare LP success rates by position. Secondary outcomes were successful LP on the first attempt and rates of procedural complications.

Treatment outcomes with cefazolin versus oxacillin for deep-seated methicillin-susceptible Staphylococcus aureus bloodstream infections.

Clinical preference for a semisynthetic penicillin (oxacillin or nafcillin) over cefazolin for deep-seated methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSI) perseveres despite limited data to support this approach. A retrospective cohort study of patients treated for MSSA BSI with either oxacillin or cefazolin was performed across two medical centers in Chicago, IL. The outcome measures included documented in-hospital treatment failure, all-cause in-hospital mortality, duration of MSSA BSI, and incidence of documented adverse events.

Analysis of infant lumbar puncture success rates: sitting flexed versus lateral flexed positions.

Objectives: The primary objective was to determine whether the sitting flexed position yields higher success rates of obtaining cerebrospinal fluid (CSF) for culture. The secondary objectives were to determine whether the sitting flexed position yields higher success rates of obtaining the following: CSF for cell count, non-traumatic CSF, and CSF on the first attempt.

Methods: The study investigator performed a retrospective chart review of infants 0 to 365 days of age who had a lumbar puncture (LP) performed from January 1 to December 31 of 2010.

Diffuse Desquamating Rash Following Exposure to Vancomycin-Impregnated Bone Cement.

Objective: To describe a case of systemic desquamating dermatitis following implantation of vancomycin antibiotic-laden cement (ABLC) in a patient with prior history of Stevens-Johnson (SJS) reaction to vancomycin.

Case Summary: A 59-year-old man with a history of SJS reaction to systemic vancomycin and recurrent methicillin-susceptible Staphylococcus aureus prosthetic knee infection developed a painful, blistering rash after implantation of bone cement that had been mixed with 2 g of vancomycin. He was started empirically on steroids by his primary care provider and had desquamation about 1 week later.

Improving mobility in a client with hypochondroplasia (dwarfism): a case report.

A client with hypochondroplasia dwarfism and a medical diagnosis of spinal stenosis had found that her ability to walk had decreased over the past 7 years from easily walking 6 miles (10 K) to now needing to rest every half block (171 ft/52 m) due to muscle fatigue. Such weakness is consistent with nerve impingement due to spinal stenosis, which would not be improved by massage. However, during a preliminary assessment, it was found that both lower legs had severe fascial adhesions, possibly compressing lower leg blood vessels and nerves.

The protective value of parental sex education: a clinic-based exploratory study of adolescent females.

Study Objective: This exploratory study compared the impact of sex education provided by parents to female adolescents against the same education provided in formal settings to female adolescents.

Methods: Females, 16-24 years old, attending an adolescent medicine clinic in an urban area of the South were recruited prior to examination. Each patient completed an anonymous self-administered questionnaire.

Does knowing about an HPV infection influence behavior change? A feasibility study of females attending a teen clinic.

Objective: To test the feasibility of a brief, clinic-based, behavioral intervention designed to foster the adoption of three protective behaviors among adolescent females testing positive for any of 13 oncogenic strains of HPV. This feasibility study also included non-statistical comparisons of risk behaviors assessed at follow-up.

Design: A non-randomized clinical trial.