2,269 results match your criteria: "Alfred I. duPont Hospital for Children.[Affiliation]"

Neuroanatomical alterations in young boys and adolescents with Klinefelter syndrome.

Psychiatry Res Neuroimaging

January 2025

Stanford University School of Medicine, Department of Psychiatry and Biobehavioral Sciences, 1520 Page Mill Road, Stanford, California, 94305, United States; Stanford University School of Medicine, Department of Radiology, United States; Stanford University School of Medicine, Department of Pediatrics, United States.

Klinefelter syndrome (KS, 47,XXY) is a common sex chromosome aneuploidy in males that is characterized by pubertal developmental delays and a wide range of alterations in cognitive, social and emotional functioning. The neural bases of these behavioral symptoms, however, are unclear. A total of 130 boys and adolescents, including 67 males with KS (11.

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Resuscitation arterial waveform quantification and outcomes in pediatric bidirectional Glenn and Fontan patients.

Pediatr Res

September 2024

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.

Background: Resuscitation with chest compressions and positive pressure ventilation in Bidirectional Glenn (BDG) or Fontan physiology may compromise passive venous return and accentuate neurologic injury. We hypothesized that arterial pressure and survival would be better in BDG than Fontan patients.

Methods: Secondary analyses of the Pediatric Intensive Care Quality of CPR and Improving Outcomes from Pediatric Cardiac Arrest databases.

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Background: Tracheal intubation (TI)-associated cardiac arrest (TI-CA) occurs in 1.7% of pediatric ICU TIs. Our objective was to evaluate resuscitation characteristics and outcomes between cardiac arrest patients with and without TI-CA.

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Osteosarcoma is the most common primary bone malignancy in children and young adults, and it has few treatment options. As a result, there has been little improvement in survival outcomes in the past few decades. The need for models to test novel therapies is especially great in this disease since it is both rare and does not respond to most therapies.

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Article Synopsis
  • * A survey conducted among participants from two SCA registries received responses from 303 individuals and caregivers, covering a wide age range and various SCA types.
  • * The survey results highlighted the SCA community's main priorities for health, emphasizing the need for intervention studies and clinical treatments, indicating a strong desire for targeted research in this area.
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In this study, we leveraged machine-learning tools by evaluating expression of genes of pharmacological relevance to standard-AML chemotherapy (ara-C/daunorubicin/etoposide) in a discovery-cohort of pediatric AML patients (N = 163; NCT00136084 ) and defined a 5-gene-drug resistance score (ADE-RS5) that was predictive of outcome (high MRD1 positivity p = 0.013; lower EFS p < 0.0001 and OS p < 0.

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Background: Spinal fusion for scoliosis associated with cerebral palsy (CP) is challenging to study because specialized outcome measures are needed. Therefore, evidence in favor of the benefits of surgery has not been firmly established. This study aimed to determine if corrective spinal fusion improves health-related quality of life (HRQoL) in children with CP scoliosis at 2 years.

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Early bolus epinephrine administration during pediatric cardiopulmonary resuscitation for bradycardia with poor perfusion: an ICU-resuscitation study.

Crit Care

July 2024

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Article Synopsis
  • The study focused on pediatric in-hospital CPR events, particularly those involving bradycardia with poor perfusion, to evaluate the effects of early epinephrine on survival outcomes in children.
  • Researchers analyzed data from the ICU-RESUS trial, which involved CPR events that lasted 2 minutes or longer, examining the timing of epinephrine administration and the development of pulselessness.
  • Findings indicated that early epinephrine did not significantly improve the chances of survival or favorable neurological outcomes, while a high percentage of patients experienced pulselessness within the first few minutes of CPR.
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Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries.

Heart Lung

October 2024

Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Article Synopsis
  • A study was conducted to compare stroke incidences and mortality rates in critically ill COVID-19 patients from low-and middle-income countries (LMICs) and high-income countries (HICs).
  • The results showed that stroke incidence was significantly higher in LMICs (35.7 per 1000 admitted-days) compared to HICs (17.6 per 1000 admitted-days), with patients from LMICs also facing higher mortality rates (43.6% vs. 29.2%).
  • The findings highlight the need for better stroke diagnosis and healthcare resource allocation in LMICs, as both higher income status and the presence of stroke are associated with increased risk of death
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Article Synopsis
  • The study assesses a new algorithm for identifying Long COVID in pediatric patients, aiming to standardize how this condition is defined and recognized in the medical community.
  • Using data from 31,781 patients, the algorithm showed moderate accuracy when compared to traditional chart reviews, with an overlap rate of 62%, but also noted significant disagreement on cases.
  • The findings suggest that discrepancies may stem from varying interpretations of Long COVID symptoms, emphasizing the need for a clearer clinical definition to improve identification and support research efforts.
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Mucopolysaccharidosis III type C (MPS IIIC) is an untreatable neuropathic lysosomal storage disease caused by a genetic deficiency of the lysosomal N-acetyltransferase, HGSNAT, catalyzing a transmembrane acetylation of heparan sulfate. HGSNAT is a transmembrane enzyme incapable of free diffusion between the cells or their cross-correction, which limits development of therapies based on enzyme replacement and gene correction. Since our previous work identified neuroinflammation as a hallmark of the CNS pathology in MPS IIIC, we tested whether it can be corrected by replacement of activated brain microglia with neuroprotective macrophages/microglia derived from a heterologous HSPC transplant.

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The addition of the proteasome inhibitor bortezomib to standard chemotherapy did not improve survival in pediatric acute myeloid leukemia (AML) when all patients were analyzed as a group in the Children's Oncology Group phase 3 trial AAML1031 (NCT01371981). Proteasome inhibition influences the chromatin landscape and proteostasis, and we hypothesized that baseline proteomic analysis of histone- and chromatin-modifying enzymes (HMEs) would identify AML subgroups that benefitted from bortezomib addition. A proteomic profile of 483 patients treated with AAML1031 chemotherapy was generated using a reverse-phase protein array.

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Unilateral absence of intra-pericardial pulmonary artery is a rare congenital malformation. If untreated, it can lead to morbidity and mortality in adulthood. Early intervention and restoration of physiologic pulmonary blood flow is necessary.

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Neonatal compartment syndrome, although rare, has a classic presentation with sentinel skin findings and development of swelling, erythema, and tenderness of the affected extremity. Neonatal compartment syndrome requires prompt surgical intervention to preserve the affected limb and ensure its normal growth and development. Our patient was born at term via vaginal delivery complicated by a compound presentation involving the left upper extremity.

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MLLT10 gene rearrangements with KMT2A occur in pediatric acute myeloid leukemia (AML) and confer poor prognosis, but the prognostic impact of MLLT10 in partnership with other genes is unknown. We conducted a retrospective study with 2080 children and young adults with AML registered on the Children's Oncology Group AAML0531 (NCT00372593) and AAML1031 trials (NCT01371981). Transcriptome profiling and/or karyotyping were performed to identify leukemia-associated fusions associated with prognosis.

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We sought to define the cooccurring mutational profile of FLT3-ITD-positive (ITDpos) acute myeloid leukemia (AML) in pediatric and young adult patients and to define the prognostic impact of cooperating mutations. We identified 464 patients with FLT3-ITD mutations treated on Children's Oncology Group trials with available sequencing and outcome data. Overall survival, event-free survival (EFS), and relapse risk were determined according to the presence of cooccurring risk stratifying mutations.

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Therapeutic targeting in pediatric acute myeloid leukemia with aberrant HOX/MEIS1 expression.

Eur J Med Genet

December 2023

Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.

Article Synopsis
  • Advances in managing childhood acute myeloid leukemia (AML) have been made, but about one third of patients still face fatal outcomes due to challenges like chemoresistance and relapses.
  • Insights into the genetics of AML have revealed specific patient subsets linked to abnormalities in HOXA, MEIS1, and other key genes, suggesting avenues for targeted therapies.
  • Menin inhibitors show promise in preclinical and early-phase clinical trials for treating specific types of AML, and the PedAL/EUPAL project aims to facilitate further testing of these new agents in children.
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Background: Pediatric acute myeloid leukemia (AML) therapy is associated with substantial short- and long-term treatment-related cardiotoxicity mainly due to high-dose anthracycline exposure. Early left ventricular systolic dysfunction (LVSD) compromises anthracycline delivery and is associated with inferior event-free and overall survival in pediatric AML. Thus, effective cardioprotective strategies and cardiotoxicity risk predictors are critical to optimize cancer therapy delivery and enable early interventions to prevent progressive LVSD.

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Article Synopsis
  • The study investigated the effectiveness of extracorporeal membrane oxygenation (ECPR) for pediatric patients who did not respond to traditional cardiopulmonary resuscitation (CPR) methods, focusing on early hemodynamics and end-tidal carbon dioxide (ET CO2) levels as potential indicators for survival and neurologic outcomes.
  • Data was collected from 97 ECPR patients across 18 ICUs from 2016-2021, revealing that most patients were under one year old and had congenital heart disease; only 41% of patients survived with favorable neurologic outcomes.
  • The study found no significant differences in blood pressure measures or chest compression rates between those who survived
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Chest compressions for pediatric organized rhythms: A hemodynamic and outcomes analysis.

Resuscitation

January 2024

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Aim: Pediatric cardiopulmonary resuscitation (CPR) guidelines recommend starting CPR for heart rates (HRs) less than 60 beats per minute (bpm) with poor perfusion. Objectives were to (1) compare HRs and arterial blood pressures (BPs) prior to CPR among patients with clinician-reported bradycardia with poor perfusion ("BRADY") vs. pulseless electrical activity (PEA); and (2) determine if hemodynamics prior to CPR are associated with outcomes.

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