Using grounded theory to develop a theory of change for a violence intervention program.

Hospital-based violence intervention programs (HVIP) are critical to interrupting the cycle of violence. These interventions are considered "complex" in that they have many mechanisms of change and related outcomes. Few HVIPs clearly identify the underlying mechanisms of intervention and explicitly link those with key outcomes however, limiting the field's ability to know what works best and for whom.

Identifying Risk Factors and Advancing Services for Violently Injured Low-Income Black Youth.

Violent exposure among low-income, Black youth has reached alarming rates. Using administrative data that centers racial equity to understand risk factors and aid in prevention is a promising approach to address this complex problem. Medical records were linked to a comprehensive county-level integrated data system using a case-control design.

Factors influencing disease recurrence after ileocolic resection in adult and pediatric onset Crohn's disease.

Background: Factors influencing recurrence of ileocecal Crohn's disease (CD) after surgical resection may differ between adolescents and adults.

Methods: CD patients who underwent ileocecectomy were retrospectively divided into pediatric onset (age at diagnosis ≤ 16 years, n = 34) and adult onset (>16, n = 108) patients to evaluate differences in risks of endoscopic and clinical recurrence.

Results: In 142 patients, rates of any recurrence, endoscopic recurrence, and clinical recurrence at 5 years were 78%, 88%, and 65%, respectively.

Trauma induced left ventricular apical ballooning syndrome in a 15 year old: a rare case of Tako-tsubo cardiomyopathy.

We present a case of a 15 year old girl who developed transient left ventricular apical ballooning syndrome, Tako-tsubo cardiomyopathy, after a significant motor vehicle accident. On post-trauma day three she developed heart failure with mid-to-apical left ventricular wall dysfunction with an EF of 10%-15%. The patient eventually regained full cardiac function by post-trauma day seven.

Three siblings with Chance fractures: the importance of 3-point restraints.

Pediatric Chance fractures are uncommon injuries. They are the result of a flexion-distraction force applied to the spine, and most commonly occur from motor vehicle accidents in which passengers are wearing lap seat belts as opposed to 3-point restraints with a chest strap. Neurologic injuries are rarely associated with Chance fractures in children, but accompanying intraabdominal injuries are often found and carry a potential for significant morbidity.

Teratomas in infants and children.

Purpose Of Review: Teratomas are rare neoplasms composed of tissue elements derived from the germinal layers of the embryo. Although they may originate anywhere along the midline, teratomas are most commonly found in sacrococcygeal, gonadal, mediastinal, retroperitoneal, cervicofacial and intracranial locations. Clinical behavior varies significantly by site and size.

Colon cleansing with oral sodium phosphate in adolescents: dose, efficacy, acceptability, and safety.

Background And Aims: Standardized bowel preparation in children and adolescents has not been established. Our aim was to compare two bowel preparation regimens and determine which was more effective, acceptable, and safer for children undergoing colonoscopy.

Methods: We compared the efficacy and acceptability of a 1-day regimen with oral sodium phosphate solution (NaP solution) (1 mL/kg/day, maximum 90 mL in two divided doses; regimen A) to our standard 3-day regimen magnesium citrate (4 mL/kg/day x 3 days, maximum 237 mL, followed by an enema the morning of colonoscopy; regimen B).

Neuroblastoma impairs chemokine-mediated dendritic cell migration in vitro.

Background/purpose: Chemokine receptor (CCR7 [cysteine chemokine receptor 7]) and ligand (CCL19) interactions trigger dendritic cell (DC) recruitment from sites of antigen uptake to secondary lymphoid organs for T-cell priming and tumor lysis. Inhibition of this interaction may allow some aggressive tumors to evade immune detection. Although we have shown dysfunctional DC migration in murine neuroblastoma (NB) in vivo, the molecular mechanisms of impairment are unknown.

The Bianchi procedure: a 20-year single institution experience.

Background/purpose: The emergence of improved outcomes for small bowel (SB) transplantation has raised questions regarding the utility of autologous intestinal lengthening for patients with short bowel syndrome (SBS). Chronic immunosuppression, multiple hospitalizations, and posttransplant lymphoproliferative disease are significant adverse factors. The purpose of this study is to evaluate the 20-year single institution experience with the Bianchi procedure and analyze its role in the management of pediatric SBS.

Enteral formula use in children after small bowel transplant.

The ultimate goal of intestinal transplantation (ITx) is the maintenance of nutritional status enterally/orally. We retrospectively identified children who had received ITx since the inception of our Intestinal Care Center in December 1996 (n = 24; median age, 2.6 years).

Murine neuroblastoma attenuates dendritic cell cysteine cysteine receptor 7 (CCR7) expression.

Background/purpose: Dendritic cell (DC) migration from tumors to T-cell priming sites is critical in developing antitumor cytotoxicity. Cysteine cysteine receptor 7 (CCR7), a promigratory chemokine receptor, regulates DC recruitment to secondary lymphoid organs. Tumors may inhibit CCR7 expression to evade immunodetection.

Neuroblastoma-induced inhibition of dendritic cell IL-12 production via abrogation of CD40 expression.

Background/purpose: CD40 expression by dendritic cells (DCs) critically regulates their maturation/antitumor activity. CD40-CD40 ligand (CD40L) signaling stimulates DC-mediated IL-12 production/cytotoxicity. Recent studies suggest that neuroblastoma (NB)-derived gangliosides impair DC maturation, IL-12 secretion, and NK/T-cell activity.

Results of growth trophic therapy in children with short bowel syndrome.

Purpose: In addition to the structural, ultrastructural, and functional changes that occur after extensive enterectomy or in utero bowel loss that results in short bowel syndrome (SBS), a complex array of humoral responses take place that may also affect adaptation of the remaining small intestine as well as nutritional status or growth. These include alterations in the levels of circulating hormones and trophic substances such as growth hormone (GH) and insulinlike growth factors (IGF-1 and IGFBP-3). The purpose of this investigation is to report on the management/treatment of 3 children with SBS (>4 years in duration) and growth failure.

Neuroblastoma and dendritic cell function.

Neuroblastoma, the most common extracranial solid tumor of childhood, remains a challenge for clinicians and investigators in pediatric surgical oncology. The absence of effective conventional therapies for most patients with neuroblastoma justifies the application of novel, biology-based, experimental approaches to the treatment of this deadly disease. The observation that some aggressive neuroblastomas, particularly in infants, may spontaneously regress suggested that immune-mediated mechanisms may be important in the biology of this disease.

Is there a role for surgery beyond colonic aganglionosis and anorectal malformations in children with intractable constipation?

Purpose: The aim of this study was to assess benefit of surgery in the treatment of childhood constipation in children without aganglionosis or anorectal malformations.

Methods: Retrospective chart review and follow-up questionnaire of 19 children (10 girls, age 7.6 +/- 3.

Wandering spleen: a rare cause of abdominal pain.

Torsion of a wandering spleen is a rare cause of abdominal pain in children. The most common presentation is acute abdominal pain, although signs and symptoms vary widely. Due to the risk of splenic infarction, rapid and accurate diagnosis is essential.

Serum growth factors and growth indices pre- and post-pediatric intestinal transplantation.

Background/purpose: Although intestinal transplantation (ITx) has succeeded in liberating children with intestinal failure from total parenteral nutrition (TPN), positive growth has yet to be achieved in the majority of patients. This investigation aims to evaluate levels of serum growth factors as they relate to growth parameters and nutritional outcomes.

Methods: Serum measures of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) that had been obtained before and after transplantation were reviewed (with Institutional Review Board approval) in a subset of pediatric ITx recipients.

Advanced neuroblastoma impairs dendritic cell function in adoptive immunotherapy.

Background/purpose: The authors previously described the complete regression of established neuroblastoma (NB) by the adoptive transfer of syngeneic interleukin-12 transduced dendritic cells (DC) from naive mice. However, some malignancies, like NB, abrogate DC immunostimulation. The authors hypothesize that IL-12 transduction of DC from NB-bearing mice will have the same antitumor properties.

Synergistic interleukin-18 and low-dose interleukin-2 promote regression of established murine neuroblastoma in vivo.

Background/purpose: Severe systemic toxicities have limited the clinical applications of the potent cytokine, interleukin-2 (IL-2). Recent studies have shown that IL-18 synergizes with IL-2 to enhance cytolytic activity in vitro. Combination therapy allows for IL-2 dose reduction, thus, limiting its toxicity while augmenting natural killer cell activity.

Cellular mechanisms of interleukin-12-mediated neuroblastoma regression.

Background/purpose: Interleukin-12 (IL-12) is a proinflammatory cytokine with potent antitumor effects. Previous studies from the authors laboratory showed regression of established neuroblastoma in mice vaccinated with IL-12 transduced dendritic cells (DC). Although regression was associated with intense T cell infiltration, the precise role of T cells is unknown.

Surgical management of open versus laparoscopic adrenalectomy: outcome analysis.

Purpose: The authors sought to compare the outcome of children undergoing open versus laparoscopic adrenalectomy for an adrenal tumor.

Methods: Medical records of children that underwent an adrenalectomy from 1990 through 1999 were reviewed. Sixty-four adrenalectomies were performed: 27 pheochromocytomas, 36 neuroblastomas, and 1 virilizing tumor.