Comparison of clinical and abdominal CT imaging findings in children evaluated for abusive and accidental abdominal trauma.

Background: Diagnosis of child abuse in children evaluated for a blunt abdominal trauma can be challenging due to overlapping types of injuries.

Objective: Identify clinical characteristics and CT findings that differentiate children evaluated for accidental abdominal trauma (AcAT) and abusive abdominal trauma (AbAT).

Materials And Methods: Retrospective (1/2010 to 6/2024) study on children < 3 years-old who had an abdominal CT scan for AcAT or AbAT.

Interfacility Transfer of Pediatric Supracondylar Elbow Fractures: Transfer by Ambulance Shows No Advantage in Speed of Transfer or Prevention of Complications.

Background: The treatment of supracondylar humerus (SCH) fractures is increasingly centralized in tertiary centers. Interfacility transfer from other facilities may occur by ground ambulance or privately owned vehicle (POV). The objective of this study was to determine if interfacility transfer by POV is equivalent in transfer time and perioperative complications compared with ground ambulance.

Surgical simulation of hypospadias repair - High-fidelity, reproducible and affordable animal tissue model.

Introduction: Teaching methods in hypospadias repair are still traditional. Available simulators often lack authenticity in terms of haptic feedback and realistic tissue handling.

Objective: Our aim was to develop a high-fidelity, easily reproducible, and affordable animal tissue model for the advanced surgical simulation of hypospadias repair with realistic haptic feedback and tissue handling.

Comorbidity of attention deficit hyperactivity disorder in a patient with epilepsy: Staring down the challenge of inattention versus nonconvulsive seizures.

Epilepsy is a heterogeneous disorder of recurrent seizures which often is comorbid with anxiety, depression, attention deficit hyperactivity disorder (ADHD), intellectual disability (ID), and other psychiatric manifestations. Treating both epilepsy and behavioral symptoms from psychiatric disorders can result in polypharmacy with interactions of medications leading to both worsened efficacy of antiseizure medications due to psychotropic effects and worsening of psychiatric symptoms due to antiseizure medication side effects. We aim to suggest pragmatic strategies for the neurologist in the diagnosis and management of comorbid ADHD in patients with epilepsy based on the International League Against Epilepsy (ILAE) Pediatric Commission guidelines and additional literature review.

Physical and psychosocial determinants of quality of life in children with obesity.

Background: Obesity has a negative impact on the physical and psychosocial quality of life of children. As rates of obesity continue to increase, it is important to recognize the widespread effects obesity has on children and their families.

Methods: This clinical investigation evaluated the self-reported quality of life of children with obesity in a weight management program and compared this to a parent/guardian's perspective of the child's quality of life using the Pediatric Quality of Life survey 4.

Neonatal Carotid Artery and Internal Jugular Vein Management Practices at Extracorporeal Membrane Oxygenation Decannulation: No Standard Approach.

Background: There are currently no commonly accepted standardized guidelines for management of cervical vessels at neonatal extracorporeal membrane oxygenation (ECMO) decannulation. This study investigates neonatal ECMO decannulation practices regarding management of the carotid artery and internal jugular vein, use of post-repair anticoagulation, and follow-up imaging.

Methods: A survey was distributed to the 37 institutions in the Children's Hospitals Neonatal Consortium.

Donor complications of contralateral C7 nerve transfer in Brachial Plexus Birth Injury: a systematic review.

Purpose: Contralateral C7 (CC7) nerve transfer is a reconstructive option in the upper limb when there are limited donor options. Promising results have been reported in the adult population but its role in Brachial Plexus Birth Injury (BPBI) is unclear. A major concern with this technique is the potential impact on the contralateral, unaffected limb.

Advice to Clinicians on Communication from Adolescents and Young Adults with Cancer and Parents of Children with Cancer.

Effective communication is integral to patient and family-centered care in pediatric and adolescent and young adult (AYA) oncology and improving healthcare delivery and outcomes. There is limited knowledge about whether AYAs and parents have similar communication preferences and needs. By eliciting and comparing communication advice from AYAs and parents, we can identify salient guidance for how clinicians can better communicate.

Early-Onset Ventilator-Associated Pneumonia in Pediatric Severe Traumatic Brain Injury.

Background: Early-onset ventilator-associated pneumonia (VAP) is associated with poor outcomes in patients with severe traumatic brain injury (TBI). The primary aim of this study was to describe VAP, including the microbiology of VAP and differences in frequency of VAP when various definitions are applied. The secondary aim was to determine the clinical variables associated with the development of VAP in children with severe TBI.

Age-based risk of end-stage kidney disease in patients with myelomeningocele.

Objective: We aimed to quantify end-stage kidney disease (ESKD) risk after infancy in individuals with myelomeningocele (MMC) followed by urology in the modern medical era and to assess if ESKD risk was higher after surgery related to a hostile bladder.

Methods: We retrospectively reviewed patients with MMC followed by urology at our institution born ≥ 1972 (when clean intermittent catheterization was introduced) past 1 year of age (when mortality is highest, sometimes before establishing urology care). ESKD was defined as requiring permanent peritoneal/hemodialysis or renal transplantation.

Age disparities in intestinal stem cell quantities: a possible explanation for preterm infant susceptibility to necrotizing enterocolitis.

Purpose: Preterm infants are more susceptible to necrotizing enterocolitis (NEC) than term Queryinfants. This may be due to a relative paucity of Lgr5 or Bmi1-expressing intestinal stem cells (ISCs) which are responsible for promoting intestinal recovery after injury. We hypothesized that the cellular markers of Lgr5 and Bmi1, which represent the two distinct ISC populations, would be lower in younger mice compared to older mice.

Chest CT in the evaluation of child abuse - When is it useful?

Background: Indications for chest CT in evaluation of child abuse are unknown.

Objective: Determine which groups of children can best benefit from chest CT.

Participants And Setting: 10-year (1/2010 to 12/2019) retrospective study of children <3 years who had chest CT within 3 days of the initial skeletal survey.

Radiologists' Diagnostic Performance in Differentiation of Rickets and Classic Metaphyseal Lesions on Radiographs: A Multicenter Study.

Despite evidence supporting the specificity of classic metaphyseal lesions (CML) for the diagnosis of child abuse, some medicolegal practitioners claim that CML result from rickets rather than trauma. The purpose of this study was to evaluate radiologists' diagnostic performance in differentiating rickets and CML on radiographs. This retrospective seven-center study included children younger than 2 years who underwent knee radiography from January 2007 to December 2018 and who had either rickets (25-hydroxyvitamin D level < 20 ng/mL and abnormal knee radiographs) or knee CML and a diagnosis of child abuse from a child abuse pediatrician.

Surgical history of Hirschsprung disease.

Harald Hirschsprung presented the first comprehensive and detailed description of clinical outcomes in patients with congenital megacolon. In the century following his discovery, we have seen realization of the etiology, diagnosis, and treatment of Hirschsprung disease. In this article we describe the surgical management of Hirschsprung disease starting with Orvar Swenson, who pioneered the field with the first full thickness transrectal dissection followed by several additional innovative surgeons who have contributed to the modifications that have brought us to the modern surgical management of Hirschsprung Disease.

Approaches for Discussing Clinical Trials with Pediatric Oncology Patients and Their Families.

Purpose Of Review: This manuscript aims to describe evidence-based best practices to guide clinicians in communicating with pediatric patients and their families about clinical trial enrollment.

Recent Findings: The standard paradigm for discussing clinical trial enrollment with pediatric oncology patients and their families inconsistently enables or facilitates true informed consent. Evidence exists to suggest that adopting a shared decision-making approach may improve patient and family understanding.

Rheumatologic diseases in patients with inborn errors of immunity in the USIDNET registry.

There is a gap in clinical knowledge regarding associations between specific inborn errors of immunity (IEIs) and rheumatologic diseases. This study reports the frequency of rheumatologic conditions in a large cohort of patients with IEI using the USIDNET (United States Immunodeficiency Network) registry. We used the USIDNET registry to conduct the analysis.

Whole-Spine MRI in Children With Suspected Abusive Head Trauma.

Abusive head trauma (AHT) in children has recently been associated with findings on cervical spine MRI. The purpose of this study was to evaluate whether whole-spine MRI in children with suspected AHT shows additional abnormalities not identified on cervical spine MRI. This retrospective study included 256 children younger than 3 years old (170 boys, 86 girls; mean age, 5.

Incidence of nephrolithiasis after bladder augmentation in people with spina bifida.

Introduction: Risks of nephrolithiasis after bladder augmentation in people with spina bifida (SB) remain unclear. Annual incidence of nephrolithiasis in the general population is 0.01% for 10-14 years old, 0.

The assessment of microbiome changes and fecal volatile organic compounds during experimental necrotizing enterocolitis.

Introduction: Necrotizing enterocolitis (NEC) remains a devastating disease that affects the gastrointestinal tract of the preterm infant. Volatile organic compounds (VOCs) have emerged as a non-invasive biomarker in many diseases. We hypothesized that fecal VOC profiles would be significantly different between control and NEC pups in a NEC mouse model.

Health outcomes associated with improvement in mouth breathing in children with OSA.

Purpose: Children with mouth breathing (MB) report poor quality of life. It is unknown whether improvement in MB is associated with improvement in behavior or quality of life. We hypothesized that in children with MB and obstructive sleep apnea (OSA), improvement in MB is associated with improvement in behavior and quality of life, independent of improvement in OSA.

Predictors of Caregiver Strain for Parents of Children with Autism Spectrum Disorder.

Parents of children with autism spectrum disorder (ASD) face higher levels of caregiver strain compared to parents of children with other disabilities. This study examined child clinical features that predict high levels of caregiver strain for 374 parents of children with ASD. Caregiver strain was measured using the Caregiver Strain Questionnaire (CGSQ) objective, subjective internalized, and subjective externalized subscales.

Use of retrograde pyelogram to plan for miniature open incision in pediatric pyeloplasty.

Introduction: As robotic-assisted surgery becomes increasingly utilized for pediatric ureteropelvic junction (UPJ) obstruction, open surgeons have countered by using muscle-splitting, miniature (≤2 cm) incisions. To prepare for this type of incision during pyeloplasty, it is necessary to define the exact location of the UPJ. The use of retrograde pyelogram (RPG) at the time of pyeloplasty helps the surgeon to identify the exact location of UPJ, and thus be able to use a muscle-splitting, miniature incision for open pyeloplasty.