Mucosal impedance discriminates GERD from non-GERD conditions.

Background & Aims: Current diagnostic tests for gastroesophageal reflux disease (GERD) are suboptimal and do not accurately and reliably measure chronicity of reflux. A minimally invasive device has been developed to assess esophageal mucosal impedance (MI) as a marker of chronic reflux. We performed a prospective longitudinal study to investigate MI patterns in patients with GERD and common nonreflux conditions, to assess MI patterns before and after treatment with proton pump inhibitors and to compare the performance of MI and wireless pH tests.

Novel risk factors for recurrent Clostridium difficile infection in children.

Objectives: Clostridium difficile, a common cause of antibiotic-associated diarrhea, has been reported to recur in high rates in adults. The rates and risk factors for recurrent C difficile infection (rCDI) in children have not been well established.

Methods: We conducted a retrospective cohort study of 186 pediatric patients seen at a tertiary care referral center for a 5-year period diagnosed as having a primary C difficile infection.

Utilization of inhaled corticosteroids for infants with bronchopulmonary dysplasia.

Objective: To determine demographic and clinical variables associated with inhaled corticosteroid administration and to evaluate between-hospital variation in inhaled steroid use for infants with bronchopulmonary dysplasia (BPD).

Design: Retrospective Cohort Study.

Setting: Neonatal units of 35 US children's hospitals; as recorded in the Pediatric Health Information System (PHIS) database.

Assessment of presence and grade of activity in ileal Crohn's disease.

Background/aims: To assess the sensitivity of magnetic resonance enterography (MRE) in the diagnosis of Crohn's disease (CD) activity and correlation between endoscopic and MRE scores in predicting the activity grade.

Materials And Methods: Twenty-five ileal CD patients with clinical and biochemical evidence of activation underwent ileocolonoscopy and MRE within 7 days of their application. Simplified endoscopic scoring of CD (SES-CD) and MRE scores was done and compared with each other and other parameters of activation (CRP, leukocyte count, platelet count).

Inhaled bronchodilator use for infants with bronchopulmonary dysplasia.

Objective: To identify factors associated with bronchodilator administration to infants with bronchopulmonary dysplasia (BPD) and evaluate inter-institutional prescribing patterns.

Study Design: A retrospective cohort study of <29-week-gestation infants with evolving BPD defined at age 28 days within the Pediatric Health Information System database. Controlling for observed confounding with random-effects logistic regression, we determined demographic and clinical variables associated with bronchodilator use and evaluated between-hospital variation.

Changing job seekers' image perceptions during recruitment visits: the moderating role of belief confidence.

The purpose of this study was to understand how an important construct in social psychology-confidence in one's beliefs-could both (a) influence the effectiveness of organizations' recruiting processes and (b) be changed during recruitment. Using a sample of recruits to a branch of the United States military, the authors studied belief confidence before and after recruits' formal visits to the organization's recruiting stations. Personal sources of information had a stronger influence on recruits' belief confidence than impersonal sources.

Abnormal sensory reactivity in preterm infants during the first year correlates with adverse neurodevelopmental outcomes at 2 years of age.

Background: Sensory experience is the basis for learning in infancy. In older children, abnormal sensory reactivity is associated with behavioural and developmental disorders. We hypothesised that in preterm infants, abnormal sensory reactivity during infancy would be associated with perinatal characteristics and correlate with 2-year neurodevelopmental outcomes.

Aminoglycoside-mediated relaxation of the ductus arteriosus in sepsis-associated PDA.

Sepsis is strongly associated with patency of the ductus arteriosus (PDA) in critically ill newborns. Inflammation and the aminoglycoside antibiotics used to treat neonatal sepsis cause smooth muscle relaxation, but their contribution to PDA is unknown. We examined whether: 1) lipopolysaccharide (LPS) or inflammatory cytokines cause relaxation of the ex vivo mouse DA; 2) the aminoglycosides gentamicin, tobramycin, or amikacin causes DA relaxation; and 3) newborn infants treated with aminoglycosides have an increased risk of symptomatic PDA (sPDA).

IκB kinase activity drives fetal lung macrophage maturation along a non-M1/M2 paradigm.

In preterm infants, exposure to inflammation increases the risk of bronchopulmonary dysplasia, a chronic, developmental lung disease. Although macrophages are the key cells that initiate lung inflammation, less is known about lung macrophage phenotype and maturation. We hypothesized that fetal lung macrophages mature into distinct subpopulations during mouse development, and that activation could influence macrophage maturation.

Feasibility of event-related potential methodology to evaluate changes in cortical processing after rehabilitation in children with cerebral palsy: a pilot study.

This study examined the feasibility of using event-related potentials (ERPs) to measure changes in cortical processing following an established rehabilitative intervention (constraint-induced movement therapy, CIMT) for children with cerebral palsy (CP). Sixteen participants with a diagnosis of hemiparetic CP, with a median age of 6 years, were assessed pre and immediately post CIMT and at 6-month follow-up, using a picture-word match/mismatch discrimination task and standard neurobehavioral measures. Intervention effects were evident in improved performance on behavioral tests of sensory and motor function and the increased mean ERP amplitude of the N400 match/mismatch response on the side ipsilateral to the lesion.

Escape from neutralization by the respiratory syncytial virus-specific neutralizing monoclonal antibody palivizumab is driven by changes in on-rate of binding to the fusion protein.

The role of binding kinetics in determining neutralizing potency for antiviral antibodies is poorly understood. While it is believed that increased steady-state affinity correlates positively with increased virus-neutralizing activity, the relationship between association or dissociation rate and neutralization potency is unclear. We investigated the effect of naturally-occurring antibody resistance mutations in the RSV F protein on the kinetics of binding to palivizumab.

Validation of a brain MRI relaxometry protocol to measure effects of preterm birth at a flexible postnatal age.

Background: Magnetic resonance imaging (MRI) is a useful tool to study brain growth and organization in preterm neonates for clinical and research purposes, but its practicality can be limited by time and medical constraints. The aim of this study was to determine if MRI relaxometry of the deep nuclei, as opposed to white matter, would reflect the influence of gestational age at birth on structures essential to motor development, regardless of postnatal age at the time of imaging.

Results: This was a prospective observational study of infants without brain injury on conventional neuroimaging who were cared for in the neonatal intensive care unit (NICU) at Vanderbilt.

Early life establishment of site-specific microbial communities in the gut.

Fecal sampling is widely utilized to define small intestinal tissue-level microbial communities in healthy and diseased newborns. However, this approach may lead to inaccurate assessments of disease or therapeutics in newborns because of the assumption that the taxa in the fecal microbiota are representative of the taxa present throughout the gastrointestinal tract. To assess the stratification of microbes in the newborn gut and to evaluate the probable shortcoming of fecal sampling in place of tissue sampling, we simultaneously compared intestinal mucosa and fecal microbial communities in 15 neonates undergoing intestinal resections.

A pacifier-activated music player with mother's voice improves oral feeding in preterm infants.

Objectives: We conducted a randomized trial to test the hypothesis that mother's voice played through a pacifier-activated music player (PAM) during nonnutritive sucking would improve the development of sucking ability and promote more effective oral feeding in preterm infants.

Methods: Preterm infants between 34 0/7 and 35 6/7 weeks' postmenstrual age, including those with brain injury, who were taking at least half their feedings enterally and less than half orally, were randomly assigned to receive 5 daily 15-minute sessions of either PAM with mother's recorded voice or no PAM, along with routine nonnutritive sucking and maternal care in both groups. Assignment was masked to the clinical team.

Practice Variance, Prevalence, and Economic Burden of Premature Infants Diagnosed With GERD.

Objective: To determine the practice variance, prevalence, and economic burden of clinically diagnosed gastroesophageal reflux disease (GERD) in preterm infants.

Methods: Applying a retrospective cohort study design, we analyzed data from 18 567 preterm infants of 22 to 36 weeks' gestation and >400 g birth weight from the NICUs of 33 freestanding children's hospitals in the United States. GERD prevalence, comorbidities, and demographic factors were examined for their association with average length of stay (LOS) and hospitalization cost.

Endoscopic mucosal resection of Barrett's esophagus detects high prevalence of subsquamous intestinal metaplasia.

Aim: To report the prevalence of Subsquamous intestinal metaplasia (SSIM) in patients undergoing endoscopic mucosal resection (EMR) for staging of Barrett's esophagus (BE).

Methods: Thirty-three patients with BE associated neoplasia underwent EMR at our institution between September 2009 and September 2011; 22 of these patients met study inclusion criteria. EMR was targeted at focal abnormalities within the BE segment.

High-throughput multi-analyte Luminex profiling implicates eotaxin-1 in ulcerative colitis.

Accurate and high-throughput technologies are needed for identification of new therapeutic targets and for optimizing therapy in inflammatory bowel disease. Our aim was to assess multi-analyte protein-based assays of cytokines/chemokines using Luminex technology. We have reported that Luminex-based profiling was useful in assessing response to L-arginine therapy in the mouse model of dextran sulfate sodium colitis.

Population analysis of Escherichia coli isolates with discordant resistance levels by piperacillin-tazobactam broth microdilution and agar dilution testing.

Population analysis was performed for 42 Escherichia coli isolates to determine whether heterogeneity of resistance was a factor in piperacillin-tazobactam category differences between agar dilution and broth microdilution. Of 20 isolates discordant between methods, 80% were heterogeneous. Of 22 isolates in agreement, 59% were homogeneous.

Use of a computerized C-reactive protein (CRP) based sepsis evaluation in very low birth weight (VLBW) infants: a five-year experience.

Background: Serial C-reactive protein (CRP) values may be useful for decision-making regarding duration of antibiotics in neonates. However, established standard of practice for its use in preterm very low birth weight (<1500 g, VLBW) infants are lacking.

Objective: Evaluate compliance with a CRP-guided computerized decision support (CDS) algorithm and compare characteristics and outcomes of compliant versus non-compliant cases.

The Role of skn-1 in methylmercury-induced latent dopaminergic neurodegeneration.

Mercury (Hg) is a persistent environmental bioaccumulative metal, with developmental exposure to methylmercury (MeHg) resulting in long-term health effects. We examined the impact of early-life exposure to MeHg and knockdown of skn-1 on dopaminergic (DAergic) neurodegeneration in the nematode Caenorhabditis elegans. SKN-1, a the major stress-activated cytoprotective transcription factors, promotes the transcription of enzymes that scavenge free radicals, synthesizes glutathione and catalyzes reactions that increase xenobiotic excretion.

Pelvic mesh complications in women before and after the 2011 FDA public health notification.

Objectives: On July 13, 2011, the US Food and Drug Administration (FDA) released a public health notification with concerns regarding vaginal mesh for the treatment of pelvic organ prolapse. Our study compares the frequency and type of mesh complications related to female pelvic floor disorders presenting to our center before and after this notification.

Methods: We performed a retrospective cohort study comparing the percentage of women found to have mesh complications related to pelvic floor disorders for the year preceding and the 6 months following the FDA notification.

Incidence of catheter-related bloodstream infections in neonates following removal of peripherally inserted central venous catheters.

Objectives: Catheter-associated bloodstream infections are a significant source of morbidity and healthcare cost in the neonatal ICU. Previous studies examining the prevalence of bloodstream infections after removal of peripherally inserted central venous catheters in neonates are equivocal.

Design: A retrospective cohort study.

Adverse neurodevelopmental outcomes after exposure to phenobarbital and levetiracetam for the treatment of neonatal seizures.

Objective: Compare neurodevelopment after levetiracetam (LEV) and phenobarbital (PB) for neonatal seizures.

Study Design: Retrospective study of infants who received antiepileptic drugs (AEDs) for neonatal seizures. Effect of cumulative exposure to LEV and PB on outcomes of death, cerebral palsy (CP) and Bayley Scales of Infant Development (BSID) scores were evaluated at 24 months corrected age.