The Development of a Pediatric Catatonia Clinical Roadmap for Clinical Care at Vanderbilt University Medical Center.

Background: Pediatric catatonia is associated with a high degree of morbidity and mortality in children. However, pediatric catatonia is highly responsive to treatment if rapidly identified and appropriate interventions are administered. To our knowledge, there are no current publications which propose a systematic approach for the management of pediatric catatonia.

Pharmacologic restraint use for children experiencing mental health crises in pediatric hospitals.

Background: Children in mental health crises are increasingly admitted to children's hospitals awaiting inpatient psychiatric placement. During hospitalization, patients may exhibit acute agitation prompting pharmacologic restraint use.

Objective: To determine hospital-level incidence and variation of pharmacologic restraint use among children admitted for mental health conditions in children's hospitals.

Association of Race/Ethnicity and Social Determinants with Rehospitalization for Mental Health Conditions at Acute Care Children's Hospitals.

Objective: To evaluate associations of race/ethnicity and social determinants with 90-day rehospitalization for mental health conditions to acute care nonpsychiatric children's hospitals.

Study Design: We conducted a retrospective cohort analysis of mental health hospitalizations for children aged 5-18 years from 2016 to 2018 at 32 freestanding US children's hospitals using the Children's Hospital Association's Pediatric Health Information System database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Risk factors for rehospitalization were modeled using mixed-effects multivariable logistic regression.

Fatal Lymphoproliferative Disease in Two Siblings Lacking Functional FAAP24.

Hereditary defects in several genes have been shown to disturb the normal immune response to EBV and to give rise to severe EBV-induced lymphoproliferation in the recent years. Nevertheless, in many patients, the molecular basis of fatal EBV infection still remains unclear. The Fanconi anemia-associated protein 24 (FAAP24) plays a dual role in DNA repair.

Prolonged detection of human bocavirus DNA in nasopharyngeal aspirates of children with respiratory tract disease.

Increasing evidence suggests that the recently identified human bocavirus (hBoV) is a cause of acute respiratory illness. However, the duration of hBoV shedding from the respiratory tract as demonstrated by positive hBoV polymerase chain reaction is unclear. We describe the virologic and clinical characteristics of 6 immunocompetent children with hBoV persistence in the respiratory tract for up to 4.

Detection of WU polyomavirus DNA by real-time PCR in nasopharyngeal aspirates, serum, and stool samples.

Background: The human WU polyomavirus (WUPyV) has been recently described as a novel virus in respiratory tract samples.

Objective: To investigate the viral load of WUPyV in nasopharyngeal aspirates (NPAs), stool, and serum samples of pediatric patients with acute respiratory tract diseases.

Study Design: We established a real-time PCR for WUPyV DNA and tested NPA obtained between 2002 and 2007 from pediatric in-patients with acute respiratory tract diseases.

Sixteen years of global experience with the first refrigerator-stable varicella vaccine (Varilrix).

Without vaccination, chickenpox (varicella) will affect almost every person in the world during their lifetime. The burden of disease due to varicella is often unrecognized. Varilrix is a varicella vaccine derived from the Oka strain of varicella virus.

Viral exanthems in childhood--infectious (direct) exanthems. Part 2: Other viral exanthems.

The group of the non-classic infectious exanthems are mostly maculopapular or vesicular. The latter changes are typical for infections with varicella-zoster virus and Coxsackie viruses. Congenital cytomegalovirus infections are characterized by petechiae and purpura, while the papular-purpuric gloves and socks syndrome is usually associated with parvovirus B19.

Viral exanthems in childhood. Part 3: Parainfectious exanthems and those associated with virus-drug interactions.

Viruses cause not only direct infectious exanthems, but also parainfectious exanthems, which provoke skin alterations via interactions with the immune system. These distinct exanthems, for instance Gianotti-Crosti syndrome and pityriasis lichenoides group, do not reflect a specific pathogen but can occur in the course of many viral infections. In addition, some exanthems result from the interaction between viruses and drugs.

Viral exanthems in childhood--infectious (direct) exanthems. Part 1: Classic exanthems.

Exanthems during childhood occur quite often and are mostly harmless in nature. Among different trigger factors, viruses are of prime importance. Viral exanthems may manifest as a macular, maculopapular, papular, urticarial or vesicular rash.

Abscess-forming lymphadenopathy and osteomyelitis in children with Bartonella henselae infection.

Bartonella henselae is the agent of cat-scratch disease (CSD), a chronic lymphadenopathy among children and adolescents. A systemic infection is very rare and most of these cases are found in patients with immunodeficiency. Here, cases involving four children of 6-12 years of age are reported.

Varicella-related deaths in children and adolescents--Germany 2003-2004.

Aim: Although varicella is acknowledged as a rare cause of death in children, there are few comprehensive data with respect to the clinical course leading to death.

Methods: A nationwide, active surveillance was carried out in Germany for children up to age 17 years who were admitted to a paediatric hospital for varicella or associated complications, including deaths.

Results: A total of 10 children with varicella-associated death were reported over period of 2 years, yielding a mortality rate of 0.

Varicella vaccination in children with atopic eczema.

Chickenpox in children may be complicated by local or systemic bacterial infections. Group A streptococci and S. aureus are the predominant pathogens.

Real-time PCR for diagnosis of human bocavirus infections and phylogenetic analysis.

The human bocavirus (hBoV) was first described in 2005 in respiratory tract samples. The clinical relevance of hBoV is still unclear. The aim of our study was to establish a real-time PCR assay for the detection and quantification of hBoV DNA, to apply the real-time assay for the analysis of stool and serum samples for the presence of hBoV DNA, and to perform a phylogenetic analysis of the hBoV positive samples.

Safety, reactogenicity, and immunogenicity of live attenuated varicella vaccine in children between 1 and 9 years of age with atopic dermatitis.

Introduction: Infection with varicella-zoster virus (VZV) is known to facilitate secondary bacterial infection, which is cause for particular concern in children with atopic dermatitis. This 2-year study assessed the safety, reactogenicity, and immunogenicity of a live attenuated Oka strain varicella vaccine (Varilrix, GlaxoSmithKline Biologicals) in 160 children aged 1-9 years with atopic dermatitis randomized to vaccination at the start of either the 1st or 2nd study year (VAR-1Y and VAR-2Y, respectively). Mean SCORing Atopic Dermatitis (SCORAD) scores at baseline were 19.

Frequent detection of bocavirus DNA in German children with respiratory tract infections.

Background: In a substantial proportion of respiratory tract diseases of suspected infectious origin, the etiology is unknown. Some of these cases may be caused by the recently described human bocavirus (hBoV). The aim of this study was to investigate the frequency and the potential clinical relevance of hBoV in pediatric patients.

Membranous nephropathy associated with familial chronic ulcerative colitis in a 12-year-old girl.

Glomerulonephritis is a rare complication in patients with inflammatory bowel disease. We report a case of membranous nephropathy (MN) in a 12.6-year-old girl with chronic ulcerative colitis.

Bruton's tyrosine kinase is activated upon CD40 stimulation in human B lymphocytes.

Bruton's tyrosine kinase (Btk) is known to be involved in a broad array of signal transduction pathways necessary for the proliferation, survival and development of B cells. Mutations in the Btk gene are causually linked to the development of X-linked agammaglobulinemia (XLA) in humans. We show here, that CD40 ligation leads to tyrosine phosphorylation of Btk in the human immature B cell line MHH-PREB-1.

Estimation of the time-dependent vaccine efficacy from a measles epidemic.

We present a method to estimate the time-dependent vaccine efficacy from the cohort-specific vaccination coverage and from data on the vaccination status of cases and apply it to a measles epidemic in Germany which involved 529 cases, 88 of whom were vaccinated and 370 unvaccinated (for the remaining 71 cases the vaccination status is unknown). Our epidemiological model takes into account that maternal antibodies prevent successful vaccination and that vaccine immunity may be lost over time. Model parameters are estimated from the data using maximum likelihood.

Unimpaired activation of c-Jun NH2-terminal kinase (JNK) 1 upon CD40 stimulation in B cells of patients with X-linked agammaglobulinemia.

X-linked agammaglobulinemia (XLA) is caused by mutations in the gene encoding the cytoplasmic Bruton's tyrosine kinase (Btk). Btk has been shown to play an essential role in the development of B1 (CD5+) and conventional circulating mature B cells (B2) in mouse and man. It has been shown in earlier studies that Btk is involved in both the BCR- and CD40-mediated signaling pathways.

Autoimmune lymphoproliferative syndrome associated with severe humoral immunodeficiency and monoclonal gammopathy.

A boy of Caucasian origin with a new subtype of autoimmune lymphoproliferative syndrome (ALPS) is described. The clinical picture was dominated by chronic noninfectious lymphadenopathy, splenomegaly, and recurrent bacterial infections. At the age of 6 the patient died of pneumococcal meningitis.