Biliary Disorders, Anomalies, and Malignancies in Children.

Biliary abnormalities in children are uncommon, and the spectrum of biliary disorders is broader than in adult patients. Unlike in adults, biliary disorders in children are rarely neoplastic and are more commonly rhabdomyosarcoma rather than cholangiocarcinoma. Pediatric biliary disorders may be embryologic or congenital, such as anatomic gallbladder anomalies, anomalous pancreaticobiliary tracts, various cholestatic processes, congenital cystic lesions, or genetic conditions.

Giant Cell Tumor of Bone, Rare Inferior Orbit Location.

Giant cell tumor of bone (GCTB) typically presents in the epiphysis of long bones and occurs in the skull in less than 1% of cases. When GCTB is diagnosed in the skull, it is primarily seen in the temporal and sphenoid bones. GCTB is an osteoclastic stromal tumor that is locally aggressive and tends to recur.

Epithelial overexpression of IL-33 induces eosinophilic esophagitis dependent on IL-13.

Background: Eosinophilic esophagitis (EoE) is an increasingly common inflammatory condition of the esophagus; however, the underlying immunologic mechanisms remain poorly understood. The epithelium-derived cytokine IL-33 is associated with type 2 immune responses and elevated in esophageal biopsy specimens from patients with EoE.

Objective: We hypothesized that overexpression of IL-33 by the esophageal epithelium would promote the immunopathology of EoE.

Missed Opportunities in Guideline-Based Fatty Liver Screening Among 3.5 Million Children.

Objective: Determine screening rates and examine socio-demographic characteristics of metabolic dysfunction-associated steatotic liver disease (MAFLD) screening in a large population of obese children.

Methods: We used Explorys (IBM) which contains aggregated population-level electronic health record data from approximately 360 hospitals and 317,000 providers across the United States to determine MAFLD screening rates. In children 10 to 14 years, obesity was determined based on body mass index ≥ 95%, or encounter with an international classification of disease obesity code.

Unilateral periocular spasm.

Hemifacial spasm is an uncontrollable, recurrent facial muscular contraction that typically occurs on one side of the face, cannot be suppressed, and can last the entire day and during sleep. The most common underlying cause of facial nerve compression is an enlarged or abnormal tracking blood vessel at the brainstem level. Clinical diagnoses are frequently based on a patient's medical history and physical examination.

Circulating biomarkers of airflow limitation across the life span.

Background: Airflow limitation is a hallmark of chronic obstructive pulmonary disease, which can develop through different lung function trajectories across the life span. There is a need for longitudinal studies aimed at identifying circulating biomarkers of airflow limitation across different stages of life.

Objectives: This study sought to identify a signature of serum proteins associated with airflow limitation and evaluate their relation to lung function longitudinally in adults and children.

Early real-world experience monitoring circulating tumor DNA in resected early-stage non-small cell lung cancer.

Objective: The study objective was to evaluate the impact of monitoring circulating tumor DNA on the detection and management of recurrence in patients with resected early-stage non-small cell lung cancer.

Methods: Between October 2021 and March 2023, postoperative circulating tumor DNA was monitored in patients with non-small cell lung cancer (N = 108). Longitudinal blood samples (n = 378 samples) were collected for prospective circulating tumor DNA analysis at 3-month intervals after curative-intent resection.

Predicting Penicillin Allergy: A United States Multicenter Retrospective Study.

Background: Using the reaction history in logistic regression and machine learning (ML) models to predict penicillin allergy has been reported based on non-US data.

Objective: We developed ML positive penicillin allergy testing prediction models from multisite US data.

Methods: Retrospective data from 4 US-based hospitals were grouped into 4 datasets: enriched training (1:3 case-control matched cohort), enriched testing, nonenriched internal testing, and nonenriched external testing.

Practical Overview of I-Ioflupane Imaging in Parkinsonian Syndromes.

Parkinsonian syndromes are a heterogeneous group of progressive neurodegenerative disorders involving the nigrostriatal dopaminergic pathway and are characterized by a wide spectrum of motor and nonmotor symptoms. These syndromes are quite common and can profoundly impact the lives of patients and their families. In addition to classic Parkinson disease, parkinsonian syndromes include multiple additional disorders known collectively as Parkinson-plus syndromes or atypical parkinsonism.

Fever in infants ages 8 to 60 days: An updated guideline for evaluation.

Fever in infants under age 60 days is a leading cause of ED, urgent care, and primary care visits. Most infants present as well-appearing, and guidelines for the workup and appropriate management of these children have varied over the decades. Additionally, testing availability, accuracy, and changing bacterial prevalence patterns have rendered many guidelines obsolete.

Early national trends of lung allograft use during donation after circulatory death heart procurement in the United States.

Objective: Innovative technology such as normothermic regional perfusion and the Organ Care System has expanded donation after circulatory death heart transplantation. We wanted to investigate the impact of donation after circulatory death heart procurement in concurrent lung donation and implantation at a national level.

Methods: We reviewed the United Network for Organ Sharing database for heart donation between December 2019 and March 2022.

Left ventricular outflow tract obstruction in patients with Ebstein anomaly.

Objective: In this study, we investigated the clinical characteristics of patients with Ebstein anomaly and left ventricular outflow tract (LVOT) obstruction as well as possible mechanisms of obstruction as assessed by 2-dimensional echocardiography.

Methods: We queried our institutional echocardiography and surgical databases for patients with the diagnosis of Ebstein anomaly seen from 1985 through 2022. Fourteen patients had the additional diagnosis of LVOT obstruction identified from transthoracic echocardiography.

Congenital heart surgery outcomes in patients with positive respiratory viral swabs.

Objective: To examine whether or not viral positive patients experienced worse outcomes and assess differences in surgical outcomes between viral-positive patients with and without viral symptoms within 30 days of surgery.

Methods: This retrospective study reviewed charts of pediatric patients who underwent congenital heart surgery and routine viral testing at a single institution over a consecutive 3-year period (2017-2019). Patients with a history of heart transplants, pacemaker changes, or implants, and mediastinal washouts were excluded from the study.

Orthodontic treatment of an open bite after splint therapy for a patient with idiopathic condylar resorption.

In the treatment of orthodontic patients with idiopathic condylar resorption, symptoms of temporomandibular joint disorders and constantly changing occlusions caused by an instability of mandibular position make it difficult for orthodontists to confirm definitive orthodontic diagnosis and treatment plans. Therefore, these patients' temporomandibular joint (TMJ) structures need to be stabilized with splint therapy before active tooth movement to identify and maintain the true mandibular position. For some idiopathic condylar resorption patients, orthognathic surgery can cause further resorption on the vulnerable condyles of the mandible; thus, effective orthodontic camouflage treatment after joint stabilization should be considered.

Use of a dual-purpose implant scan body to obtain both digital and analog records for complete arch fixed implant restorations.

A technique is described for capturing relative dental implant positions for an implant-supported fixed prosthesis in a completely edentulous arch with a novel implant indexing apparatus that also functions as a scannable verification device. A series of intraoral scans are made to record the contours and occlusal records of the existing prosthetics and soft tissue. The individual scans are aligned by using a dental software program to design either an interim or definitive prosthesis.