Age and Weight Stratified Outcomes of Single Stage Endorectal Pull-through Procedures for Hirschsprung's Disease in Children: Analysis of NSQIP-P Data.

Background: We aimed to analyze the effect of age and weight on 30-day outcomes of single-stage endorectal pull tthrough (ERPT) procedures for Hirschsprung's Disease (HD) using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database to identify an optimal time for surgery.

Methods: We queried NSQIP-P for children <2 years with HD who underwent ERPT between 2016-2021 and did not have a preoperative stoma. Patients were stratified by age (<3 months, 3-6 months and >6 months) and weight (<4 kg, 4-8 kg, and >8 kg) at the time of surgery.

Restoring Mitochondrial Quantity and Quality to Reverse Warburg Effect and Drive Tumor Differentiation.

Reduced mitochondrial quality and quantity in tumors is associated with dedifferentiation and increased malignancy. However, it remains unclear how to restore mitochondrial quantity and quality in tumors, and whether mitochondrial restoration can drive tumor differentiation. Our study shows that restoring mitochondrial function using retinoic acid (RA) to boost mitochondrial biogenesis and a mitochondrial uncoupler to enhance respiration synergistically drives neuroblastoma differentiation and inhibits proliferation.

Pilonidal granuloma formation after an incision and drainage procedure is associated with retained hair within the sinus - A case series.

Introduction And Importance: Pilonidal disease may present with a draining secondary sinus or granuloma, but the development of these findings is not well-characterized.

Case Presentation: Two adolescent males presented with pilonidal disease. The first patient had a gluteal cleft abscess, and an incision and drainage procedure was performed.

Local Sustained Dinutuximab Delivery and Release From Methacrylated Chondroitin Sulfate.

Neuroblastoma (NB) is the most common pediatric extracranial solid tumor. High-risk NB is a subset of the disease that has poor prognosis and requires multimodal treatment regimens, with a 50% rate of recurrence despite intervention. There is a need for improved treatment strategies to reduce high-risk patient mortality.

Peri anal region is an overlooked location for pilonidal recurrence after surgical excision and closure - A case series.

Introduction And Importance: Patients with pilonidal disease (PD) often undergo wide excision of pilonidal sinuses and flap-based closures. Patients who failed these procedures can have recurrent perianal wounds obscured by hair and unrecognized even by the treating physicians. In this report, we describe a series of pilonidal patients with recurrent disease and perianal wounds.

Management and outcomes of pilonidal patients with secondary sinuses-a cohort study.

Background: Patients with pilonidal disease (PD) can present with concurrent draining secondary sinus at the superior gluteal cleft. The natural disease course in the setting of this severe phenotype is poorly characterized. We present the largest cohort of patients with PD and concurrent secondary sinus.

Standardized pilonidal protocol as rescue therapy for excision-refractory pilonidal disease.

Purpose: Severe pilonidal diseases have refractory symptoms despite multiple surgeries and optimal therapy remains unclear. We hypothesized that standardized minimally invasive protocol could be an effective rescue treatment.

Methods: We prospectively collected data from symptomatic patients who underwent ≥ 1 pilonidal excision prior to presentation at our clinic 2019-2023.

Pilonidal disease in the pregnant patient: A case report.

Introduction: Pilonidal disease in the pregnant patient is underreported and may be instigated by significant shifts in hormone levels throughout pregnancy and the postpartum period.

Presentation Of Case: An otherwise healthy primigravid 22-year-old woman developed pilonidal disease at the beginning of her pregnancy. While pregnant, her symptoms recurred once and resolved without treatment.

A standardized treatment protocol for pilonidal disease can influence the health mindset of adolescents.

Purpose: Pilonidal disease (PD) significantly impacts patients' quality of life and requires regular maintenance behaviors to achieve cure. Health mindset is a psychological construct which can influence health behaviors and outcomes, with a growth mindset being associated with better outcomes than a fixed. We propose that participation in a standardized treatment protocol can affect the health mindset for adolescents with pilonidal disease.

Comorbidities are not associated with pain symptom or recurrence in patients with pilonidal disease.

Background: Comorbidities can potentially impact the presentation or outcome of patients with pilonidal disease (PD) due to poor wound healing or increased inflammatory response. We hypothesized that certain comorbidities could lead to worse pain or higher recurrence rate.

Methods: A retrospective study was performed on all PD patients treated with standardized minimally invasive protocol at our clinic 2019-2022.

Mitochondrial uncoupler and retinoic acid synergistically induce differentiation and inhibit proliferation in neuroblastoma.

Neuroblastoma is a leading cause of death in childhood cancer cases. Unlike adult malignancies, which typically develop from aged cells through accumulated damage and mutagenesis, neuroblastoma originates from neural crest cells with disrupted differentiation. This distinct feature provides novel therapeutic opportunities beyond conventional cytotoxic methods.

Using "Appointment Tickets" to Track Visit Duration as a Quality Improvement Initiative After Incorporating Laser Epilation in a Pilonidal Care Clinic.

Background: Laser epilation (LE) is effective in decreasing pilonidal disease (PD) recurrence, but laser use has not been a standard practice in pediatric surgery clinic. We hypothesized that "appointment tickets" can 1) track utilization and clinic visit delays, 2) inform patients of their clinic progress in real time.

Methods: An observation study was performed on LE patients treated at our PD clinic 3/2021-7/2022.

Regular epilation alone is an acceptable treatment for symptom-free pilonidal patients.

Introduction: Patients with mild pilonidal disease often experience symptom resolution without excision. We hypothesized that treating symptom-free/asymptomatic pilonidal patients with regular epilation alone had similar recurrence rate as patients who were also treated surgically.

Method: Patient data were prospectively collected 2/2019-11/2022 at our Pilonidal Clinic.

Concurrent application of interferon-gamma and vincristine inhibits tumor growth in an orthotopic neuroblastoma mouse model.

Purpose: Tumor-associated macrophages are present within neuroblastoma, and interferon-gamma (IFN-γ) can polarize macrophages into cancer-inhibiting M1 type. We hypothesize that treating neuroblastoma with interferon-gamma (IFN-γ) can suppress tumor growth, and the concurrent treatment with IFN-γ and vincristine can lead to enhanced tumor killing as compared to vincristine alone.

Methods: We loaded IFN-γ or vincristine into silk biomaterials and recorded the amount released over time.

Increasing Amount of Hair Reduction using Laser Correlates with Lower Probability of Recurrence in Patients with Pilonidal Disease.

Background: Hair at the gluteal cleft plays a key role in the development and recurrence of pilonidal disease (PD). We hypothesized that more hair reduction achieved using laser could correlate with lower chance of PD recurrence.

Methods: PD patients who underwent laser epilation (LE) were categorized by Fitzpatrick skin type, hair color, and hair thickness.

Mitochondrial Uncoupling Induces Epigenome Remodeling and Promotes Differentiation in Neuroblastoma.

Unlabelled: The Warburg effect is the major metabolic hallmark of cancer. According to Warburg himself, the consequence of the Warburg effect is cell dedifferentiation. Therefore, reversing the Warburg effect might be an approach to restore cell differentiation in cancer.

Adoption of a standardized treatment protocol for pilonidal disease leads to low recurrence.

Background: Pilonidal disease may present as acute abscesses or chronic draining sinuses. There is no standardized treatment and recurrence rates can be as high as 30%. Within our five-hospital network we have established a standardized treatment protocol including minimally invasive surgical trephination and aggressive epilation.

Burden of pilonidal disease and improvement in quality of life after treatment in adolescents.

Purpose: Pilonidal Disease (PD) affects adolescents in different aspects. We hypothesized that patients with different gender, ethnicity, and age have different quality of life (QOL) measurements which could improve with minimally invasive treatment (MIT).

Methods: 131 PD patients underwent MIT (laser epilation ± trephination) from 2019 to 2021.

Combining inhibitors of Brd4 and cyclin-dependent kinase can decrease tumor growth in neuroblastoma with MYCN amplification.

Introduction: High-risk neuroblastoma is a deadly disease; poor prognosticators are MYCN-amplification and TERT-overexpression. We hypothesized that Gene Set Enrichment Analysis (GSEA) could identify pathways associated with MYCN-amplification and that inhibition of these pathways could decrease tumor growth.

Methods: We analyzed the Neuroblastoma-Kocak dataset (GSE45547, n = 649) and identified pathways associated with MYCN-amplification.

Stage 4S Neuroblastoma: Molecular, Histologic, and Immunohistochemical Characteristics and Presence of 2 Distinct Patterns of MYCN Protein Overexpression-A Report From the Children's Oncology Group.

Stage 4S neuroblastoma (4SNB) is associated with spontaneous tumor regression and an excellent prognosis. However, a small group of the patients have a poor prognosis. One hundred eighty-five stage 4SNB cases filed at the Children's Oncology Group Neuroblastoma Pathology Reference Laboratory were studied.

Development of a dinutuximab delivery system using silk foams for GD2 targeted neuroblastoma cell death.

Neuroblastoma is the most common extracranial solid tumor of childhood and is associated with poor survival in high risk patients. Recently, dinutuximab (DNX) has emerged as an effective immunotherapy to treat patients with high risk neuroblastoma. DNX works through the induction of cell lysis via complement-dependent cytotoxicity (CDC) or antibody dependent cellular cytotoxicity (ADCC).

Enhancing sustained-release local therapy: Single versus dual chemotherapy for the treatment of neuroblastoma.

Background: Neuroblastoma is the most common pediatric extracranial solid malignancy with limited effective treatment. We have shown that sustained-release, single drugs delivered locally through a silk-based biomaterial are effective in decreasing orthotopic neuroblastoma xenograft growth. We further optimized this approach and hypothesized that increasing doses of local chemotherapy or delivering 2 chemotherapeutic agents simultaneously inhibit additional tumor growth.