Association of Proton Pump Inhibitors With Hospitalization Risk in Children With Oropharyngeal Dysphagia.

Importance: Proton pump inhibitors (PPI) are commonly prescribed to children with oropharyngeal dysphagia and resultant aspiration based on the assumption that these patients are at greater risk for reflux-related lung disease. There is little data to support this approach and the potential risk for increased infections in children treated with PPI may outweigh any potential benefit.

Objective: The aim of this study was to determine if there is an association between hospitalization risk in pediatric patients with oropharyngeal dysphagia and treatment with PPI.

Feeding Interventions Are Associated With Improved Outcomes in Children With Laryngeal Penetration.

Objectives: To determine if children with laryngeal penetration on videofluoroscopic swallow study (VFSS) who received feeding interventions (thickened liquids, change in liquid flow rate, and/or method of liquid delivery) had improved symptoms and decreased hospitalizations compared with those without intervention.

Methods: We performed a retrospective cohort study of children under 2 years with laryngeal penetration on VFSS at our institution in 2015 to determine initial and follow-up VFSS findings, symptom improvement at follow-up, and hospitalization risk before and after VFSS. Proportions were compared with Fisher exact test and hospitalizations with paired t tests.

Pharmacokinetics and Safety of Single Intravenous Doses of Ceftolozane/Tazobactam in Children With Proven or Suspected Gram-Negative Infection.

Background: Drug-resistant Gram-negative bacteria are a growing threat to children; thus new antibiotics are needed to treat infections caused by these pathogens. Ceftolozane/tazobactam is active against many Gram-negative pathogens and is approved for treatment of complicated intra-abdominal and urinary tract infections in adults, but has not been evaluated in children.

Methods: This phase 1, noncomparative, open-label, multicenter study characterized the pharmacokinetics (by noncompartmental analysis), safety, and tolerability of single intravenous doses of ceftolozane/tazobactam in pediatric patients (birth [7 days postnatal] to < 18 years of age) with proven/suspected Gram-negative infection or receiving perioperative prophylaxis (clinicaltrials.

In Sickness and Health: Views on Child Health From a Mayan Village.

Introduction: Guatemala is the only country in Central America with a majority indigenous population. Most indigenous Mayans prefer to seek health advice from family members. It is important to understand the beliefs of Mayan caregivers.

Sleep, Physical Activity, and General Health Status: US Pediatricians and the General US Adult Population.

Objective: To examine US pediatricians and US adults on 3 self-reported health measures (sleep, physical activity, and general health status) and to assess factors related to these measures for each group.

Methods: Pediatrician data were collected through a 2012 American Academy of Pediatrics Periodic Survey (response rate = 64.0%).

Surgeon-associated variation in breast cancer staging with sentinel node biopsy.

Background: Sentinel lymph node biopsy is the gold standard for axillary staging in early-stage, clinically node-negative breast cancer, so it is paramount that this operation be both precise and accurate, because excessive sentinel lymph node removal increases morbidity, whereas understaging risks inadequate treatment. The goal of this study was to assess surgeon variation in the number of sentinel lymph nodes removed and the oncologic yield of sentinel lymph node biopsy for breast cancer.

Methods: All patients in the Surveillance, Epidemiology, and End Results-Medicare database who underwent operative treatment for breast cancer from 2007-2011 were eligible for inclusion.

Soil Carbon Pools in Dryland Agroecosystems as Affected by Several Years of Drought.

No-till and increased cropping intensity (CI) can increase yield and soil organic C (SOC) in the US Great Plains compared with traditional wheat ( L.)-fallow management. However, gains in SOC and other C pools may not be permanent.

Reducing Breast Cancer-Related Lymphedema (BCRL) Through Prospective Surveillance Monitoring Using Bioimpedance Spectroscopy (BIS) and Patient Directed Self-Interventions.

Background: Breast cancer-related lymphedema (BCRL) is a chronic progressive disease that results from breast cancer treatment and nodal surgery. NCCN guidelines support baseline measurements with prospective assessment for early diagnosis and treatment. We sought to determine if baseline measurement with bioimpedance spectroscopy (BIS) and serial postoperative evaluations provide early detection amenable to conservative interventions that reduce BCRL.

Presenting Signs and Symptoms do not Predict Aspiration Risk in Children.

Objectives: To determine if any presenting symptoms are associated with aspiration risk, and to evaluate the reliability of clinical feeding evaluation (CFE) in diagnosing aspiration compared with videofluoroscopic swallow study (VFSS).

Study Design: We retrospectively reviewed records of children under 2 years of age who had evaluation for oropharyngeal dysphagia by CFE and VFSS at Boston Children's Hospital and compared presenting symptoms, symptom timing, and CFE and VFSS results. We investigated the relationship between symptom presence and aspiration using the Fisher exact test and stepwise logistic regression with adjustment for comorbidities.

Evaluation of recurrence patterns and survival in modern series of young women with breast cancer.

The data on oncologic outcomes in young women with breast cancer (BC) are dated as it relates to recurrences and mortality. Our goal was to assess these outcomes in a modern series of young women with BC. A retrospective chart review identified women ≤40 years old with stage I-III BC diagnosed from 2006 to 2013 at our institution.

Radiographically guided shave margins may reduce lumpectomy re-excision rates.

Minimizing margin re-excision optimizes patient care by providing appropriate oncologic resection and reducing costs. This study aims to assess margin positivity rate in two groups: shave margin based on gross specimen (control group, CG) vs shave margin based on intraoperative imaging (radiographic group, RG). A total of 182 patients who underwent lumpectomy for stage O-III breast cancer at a single institution from January 2013 to January 2014 were evaluated.

Oral Capecitabine Achieves Response in Metastatic Eccrine Carcinoma.

The low prevalence rate and limited literature on eccrine carcinoma (EC) pose a challenge to properly diagnosing and treating this rare malignancy. EC lesions tend to present similarly to other cutaneous neoplasms and dermatitis-like conditions. Efficacious treatment guidelines have not been established for patients diagnosed with EC, and few treatment regimens have demonstrated clinical benefit.

Association between pelvic organ prolapse types and levator-urethra gap as measured by 3D transperineal ultrasound.

Objectives: To evaluate the association between pelvic organ prolapse (POP) types and levator-urethra gap (LUG) as measured by 3-dimensional transperineal tomographic ultrasound.

Methods: A retrospective study was carried out on 98 women with symptomatic POP. Three-dimensional transperineal tomographic ultrasound images and POP quantification coordinates were reviewed.

Expanding access to primary healthcare for women through a microfinance institution: A case study from rural Guatemala.

The utilization of existing social networks is increasingly being recognized as a powerful strategy for delivering healthcare services to underserved populations in low- and middle-income countries. In Guatemala, multiple barriers prevent access to healthcare services for rural and indigenous populations, and strategies for delivering healthcare in more efficient ways are needed. The case study we describe here is a unique collaboration between a microfinance institution (Friendship Bridge) and a primary care organization (Wuqu' Kawoq | Maya Health Alliance) to scale up healthcare through an existing lending-borrowing social network.

Time to treatment and survival in triple negative breast cancer patients receiving trimodality treatment in the United States.

Background: Time from diagnosis to treatment for breast cancer patients has been linked to outcomes. Our goal was to assess the relationship between survival, time to first treatment (TFT), and time to treatment completion (TTC) in Stage I-III triple negative breast cancer (TNBC) receiving trimodality therapy (surgery, chemotherapy, and radiation).

Methods: National Cancer Database (NCDB) was queried for TNBC patients diagnosed with Stage I-III disease from 2010 to 2011 who received all treatments (surgery, chemotherapy, radiation) within 18 months of diagnosis.

Induction of Antiviral Immune Response through Recognition of the Repeating Subunit Pattern of Viral Capsids Is Toll-Like Receptor 2 Dependent.

Although viruses and viral capsids induce rapid immune responses, little is known about viral pathogen-associated molecular patterns (PAMPs) that are exhibited on their surface. Here, we demonstrate that the repeating protein subunit pattern common to most virus capsids is a molecular pattern that induces a Toll-like-receptor-2 (TLR2)-dependent antiviral immune response. This early antiviral immune response regulates the clearance of subsequent bacterial superinfections, which are a primary cause of morbidities associated with influenza virus infections.

Are Patients Traveling for Intraoperative Radiation Therapy?

Purpose: One benefit of intraoperative radiation therapy (IORT) is that it usually requires a single treatment, thus potentially eliminating distance as a barrier to receipt of whole breast irradiation. The aim of this study was to evaluate the distance traveled by IORT patients at our institution.

Methods: Our institutional prospective registry was used to identify IORT patients from 10/2011 to 2/2017.

A Systematic Process for Weaning Children With Aspiration From Thickened Fluids.

Importance: Thickening of fluids is a common strategy for feeding patients with oropharyngeal dysphagia but has known risks and should be stopped once it is safe to do so. Weaning children from thickened fluids safely can be challenging, and novel methods are required.

Objective: To describe the use of a systematic weaning process (SWP) for children who received thickened liquids owing to oropharyngeal dysphagia and identified risk of aspiration.

Dietary Manipulations That Induce Ketosis Activate the HPA Axis in Male Rats and Mice: A Potential Role for Fibroblast Growth Factor-21.

In response to an acute threat to homeostasis or well-being, the hypothalamic-pituitary-adrenocortical (HPA) axis is engaged. A major outcome of this HPA axis activation is the mobilization of stored energy, to fuel an appropriate behavioral and/or physiological response to the perceived threat. Importantly, the extent of HPA axis activity is thought to be modulated by an individual's nutritional environment.