Successful Implementation of Nirsevimab and Factors Influencing Uptake in Neonatal Care.

Objective: To describe the implementation of nirsevimab for the prevention of respiratory syncytial virus (RSV)-associated lower respiratory tract disease in a pediatric hospital, focusing on strategies to ensure equitable access and address logistical challenges. Additionally, we aimed to identify predictors of nirsevimab deferral among eligible infants. Patients and Methods: Our hospital implemented a universal immunization campaign to all eligible infants, including those discharged from the newborn nursery, intermediate care nursery (ICN), and neonatal intensive care unit (NICU).

Utilization of Hepatitis C Virus-Infected Donor Hearts in Two Children and Two Young Adults: Initial Experience at a Pediatric Transplant Center.

Background: Although adult transplant centers are successfully transplanting organs from hepatitis C virus (HCV)-infected donors with detectable viral load by nucleic acid testing (NAT+) into HCV-negative recipients, this practice has not yet been adopted widely by the pediatric heart transplant community.

Methods: We present a case series of four patients who received heart transplants from HCV NAT+ donors at a pediatric transplant center, including two pediatric patients < 18 years of age.

Results: All recipients tolerated a 12-week course of glecaprevir/pibrentasvir and achieved a sustained virologic response with no HCV or liver complications with over 1 year of follow-up (range 1.

Application of cell-free DNA fungal polymerase chain reaction for invasive fungal disease evaluation in pediatric oncology and stem cell transplant patients.

Background: Molecular diagnostics may enable early, noninvasive detection of invasive fungal disease (IFD) in immunocompromised patients. Cell-free deoxyribonucleic acid (cfDNA) fungal polymerase chain reaction (PCR) assays were recently incorporated into institutional prolonged febrile neutropenia pathways. We aimed to evaluate the performance of plasma cfDNA PCR panels (mold and Candida panels) in pediatric oncology and hematopoietic stem cell transplant (HSCT) patients with clinical concern for IFD.

Vaccine Associated Measles Complicated by Suspected Measles Inclusion Body Encephalitis in a Pediatric Leukemia Patient and Stem Cell Transplant Recipient: A Focus on Clinical Evolution and Management.

Background: Immunocompromised individuals are at increased risk for severe disease and complications from viral infections, highlighting the importance of vaccination. However, in extremely rare situations, vaccine associated viral infections can be associated with disseminated disease and complications in immunocompromised hosts.

Case: Herein, we present a case of a 1-year-old child diagnosed with acute myeloid leukemia less than 2 weeks after receiving live viral vaccines who developed acute vaccine-strain measles virus disease, later complicated by central nervous system involvement following hematopoietic stem cell transplantation.

Laying the Groundwork for a Fulfilling Career in Pediatric Infectious Diseases: The Transition From Fellowship to Faculty.

There are limited resources for guidance on the transition from fellowship into a new faculty role in pediatric infectious diseases. This review aims to address this gap and provides a framework for a successful transition that is composed of four essential pillars-(1) stepping into your role, (2) finding your niche, (3) building your network, and (4) self-care-all of which are supported by strong mentorship/sponsorship and continual realignment with one's personal mission statement. In addition to providing general principles and guidance, this review also outlines specific steps that a junior faculty member can take to expand their influence and build a successful, fulfilling career in pediatric infectious diseases.

Impact of cell-free DNA fungal polymerase chain reaction panels on healthcare-associated infection mould investigations.

Launch of in-house sensitive cell-free deoxyribonucleic acid (cfDNA) mould polymerase chain reaction (PCR) assays increased detection of moulds meeting suspected healthcare-associated infection (HAI) criteria. Definition was based on time from admission and mould detection in culture or via molecular methods. We created a modified mould HAI algorithm incorporating clinical context into the case definition, which allowed for better capture of possible mould HAIs, decreased number of investigations, and improved utilization of Infection Prevention and Control (IPC) resources.

Vaccine-Associated Measles Encephalitis in Immunocompromised Child, California, USA.

We report a fatal case of vaccine-associated measles encephalitis in an immunocompromised child in California, USA. The infection was confirmed by whole-genome RNA sequencing of measles virus from brain tissue. We observed biased matrix-gene hypermutation consistent with persistent measles virus central nervous system infection.

Client and staff experiences assessing adverse childhood experiences in a clinical setting: Results from the First Nations ACE Study.

Background: Conducting culturally-relevant research with Indigenous populations requires a balance of approaches that benefit Indigenous communities, while perceiving and mitigating the potential risk of harm when engaging in research-related activities. Reducing the burden of research is especially useful for research with Indigenous populations as ongoing systemic marginalization and discrimination through historical colonial practices may result in a higher likelihood of experiencing harm from research activities. One way to ensure that stakeholder experiences with the research processes are not burdensome, and to understand how study implementation practices are perceived across research teams, supporting organizations, and individual participants is to build this into the study method.

"For COVID" or "With COVID": Classification of SARS-CoV-2 Hospitalizations in Children.

Objectives: Pediatric hospitalization rates are used as a marker of coronavirus disease 2019 (COVID-19) disease severity in children but may be inflated by the detection of mild or asymptomatic infection via universal screening. We aimed to classify COVID-19 hospitalizations using an existing and novel approach and to assess the interrater reliability of both approaches.

Methods: This retrospective cohort study characterized severity of illness and likelihood of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as the cause of hospitalization in pediatric patients <18 years of age.

Assessment of Sensitivity and Specificity of Patient-Collected Lower Nasal Specimens for Severe Acute Respiratory Syndrome Coronavirus 2Testing.

This prognostic study compares the diagnostic equivalence of patient-collected lower nasal specimens with that of health care worker–collected oropharyngeal specimens for sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing.

Oral Antibiotics for Treating Children With Community-Acquired Pneumonia Complicated by Empyema.

No consensus exists on management of children with community-acquired pneumonia complicated by empyema (CAP-Em). We evaluated outpatient oral (O-Abx) compared with parenteral antibiotics (OPAT) in children with CAP-Em. We also evaluated inflammatory markers to guide length of treatment.

A feasibility study to determine if minimally trained medical students can identify markers of chronic parasitic infection using bedside ultrasound in rural Tanzania.

Background: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the population is infected with one or more intestinal parasites.

Acute and chronic immune biomarker changes during interferon/ribavirin treatment in HIV/HCV co-infected patients.

Chronic viral infections lead to persistent immune activation, which is alleviated by eradicating or suppressing the infection. To understand the effects of interferon treatment on immune system activation by chronic infections, we evaluated kinetic patterns of a broad spectrum of serum biomarkers during HCV treatment in HIV/HCV co-infected patients. HCV viral load and 50 biomarkers were analysed at baseline and 27 time points during pegylated interferon-alpha and ribavirin (IFN/RBV) treatment of 12 HIV/HCV co-infected patients.

Immune biomarker differences and changes comparing HCV mono-infected, HIV/HCV co-infected, and HCV spontaneously cleared patients.

Background: Immune biomarkers are implicated in HCV treatment response, fibrosis, and accelerated pathogenesis of comorbidities, though only D-dimer and C-reactive protein have been consistently studied. Few studies have evaluated HIV/HCV co-infection, and little longitudinal data exists describing a broader antiviral cytokine response.

Methods: Fifty immune biomarkers were analyzed at baseline (BL) and HCV end of treatment follow-up(FU) time point using the Luminex 50-plex assay in plasma samples from 15 HCV-cleared, 24 HCV mono- and 49 HIV/HCV co-infected patients receiving antiretroviral treatment, who either did or did not receive pegylated-interferon/ribavirin HCV treatment.

Breast cancer predictive factor testing: the challenges and importance of standardizing tissue handling.

The introduction of breast biomarkers into clinical practice and their critically important role in adjuvant treatment decisions has created new challenges for the surgical pathology laboratory. In most institutions, the current standards for collection and preservation of clinical samples have been in place for decades and have focused on tissue preservation for morphologic examination, with little if any attention paid to preserving the quality of macromolecules that may be in the tissue. Because of the importance of these markers for determining the most appropriate treatments available for each patient, there is a need for standardizing pre-analytic variables, with the goal of developing standardized methods of tissue procurement and processing, and documenting how these variables affect the quality of tissue for biomarker testing and molecular analysis.

Incidence of and risk factors for postoperative pneumonia in dogs anesthetized for diagnosis or treatment of intervertebral disk disease.

Objective: To determine incidence of and risk factors for postoperative pneumonia in dogs anesthetized for diagnosis or treatment of intervertebral disk disease (IVDD).

Design: Retrospective case-control study.

Animals: 707 dogs that underwent general anesthesia for the diagnosis or treatment of IVDD between 1992 and 1996 or between 2002 and 2006.

Using blood plasma for monitoring organochlorine contaminants in juvenile white sturgeon, Acipenser transmontanus, from the lower Columbia River.

Organochlorine (OC) pesticide concentrations in blood plasma samples from 88 juvenile white sturgeon collected from the lower Columbia River were measured and compared to plasma sex steroid and OC tissue levels previously measured in corresponding fish. Significant squared correlation coefficients between summation operator DDT concentrations in sturgeon plasma and gonads and livers were 0.37 and 0.

Effect of comestibles on symptoms of interstitial cystitis.

Purpose: Anecdotal evidence suggests that patients with painful bladder syndrome/interstitial cystitis report symptom exacerbation after consuming particular foods, beverages and/or supplements. We determined the prevalence of the effect of comestibles on painful bladder syndrome/interstitial cystitis symptoms and identified particular comestible items more likely to affect such symptoms.

Materials And Methods: A validated questionnaire designed to detect whether food, beverages and/or supplements have an effect on bladder symptoms was administered to 104 patients meeting National Institute for Diabetes and Digestive and Kidney Diseases criteria for interstitial cystitis.

The journey of an early lamaze childbirth educator.

The author, who accomplished the majority of her work as a childbirth educator while based in Tampa, Florida, journals the experience of being an early pioneer in promoting Lamaze childbirth in the United States, beginning in the 1960s. Many aspects of her story are common to the stories of other childbirth educators who also pioneered the childbirth movement in the United States during the same time frame. This history is presented for its potential usefulness to those who continue to work to advance the Lamaze International goal of promoting normal birth.

Analysis of outcomes of single polypropylene mesh in total pelvic floor reconstruction.

Aims: A 2.5-year outcome analysis was performed on patients who underwent transvaginal repair of total pelvic organ prolapse with single polypropylene mesh. A description of the repair technique using a tension-free 4-point fixation is also reviewed.

Efficiency of questionnaires used to screen for interstitial cystitis.

Purpose: Questionnaires for the evaluation of interstitial cystitis are widely used, but their value in discriminating interstitial cystitis from other diagnoses among patients with urological symptoms has not been determined. We assessed the validity of 2 frequently used interstitial cystitis questionnaires-the O'Leary-Sant Symptom Index and Problem Index and the Pain, Urgency, Frequency Symptom Scale-for screening for interstitial cystitis.

Materials And Methods: The Pain, Urgency, Frequency Symptom Scale and the O'Leary-Sant Symptom Index and Problem Index were administered to the same 220 patients at a urology clinic before diagnosis.

Hypothesis: the humoral immune response to oral bacteria provides a stimulus for the development of rheumatoid arthritis.

Rheumatoid arthritis (RA) and adult periodontitis share common pathogenetic mechanisms and immunologic and pathological findings. One oral pathogen strongly implicated in the pathogenesis of periodontal disease, Porphyromonas gingivalis, possesses a unique microbial enzyme, peptidylarginine deiminase (PAD), the human equivalent of which has been identified as a susceptibility factor for RA. We suggest that individuals predisposed to periodontal infection are exposed to antigens generated by PAD, with de-iminated fibrin as a likely candidate, which become systemic immunogens and lead to intraarticular inflammation.

Effects of pneumoperitoneal gases and pressures on transitional cell carcinoma adhesion, growth, apoptosis and necrosis: an in vitro study.

Purpose: We studied the effects of insufflation gas and pressure on the adhesion, growth, apoptosis and necrosis of transitional cell carcinoma (TCC) in an in vitro model.

Materials And Methods: Tumor adhesion and cell growth of AY-27 rat TCC was measured after 3-hour incubation with CO2, N2 and He insufflation at different pressures (0, 10 and 15 mm Hg) in vitro. The effects of these gases on the rate of tumor cell apoptosis and necrosis were compared.