Prediction of short- and long-term outcomes using pre-operative ventricular size in infants with post-hemorrhagic ventricular dilation.

Purpose: Post-hemorrhagic ventricular dilation (PHVD) leads to developmental delays in premature infants, yet the optimal timing of neurosurgical interventions is unknown. Neuroimaging modalities have emerged to delineate injury and follow the progression of PHVD. Fronto-temporal horn ratio (FTHR) is used as a marker of ventricular dilation and can be a standardized tool to direct the timing of neurosurgical intervention.

The words we die by.

Hospice is a venue organized to provide a "good death" for patients and family. Since many hospice patients are bedridden and often incoherent or unconscious, many of this venue's interactions take place between hospice professionals and patients' families. The families of patients desire definitive prognoses because knowing what to expect can help them decide how to act, but for professionals such knowledge is characterized by doubt.

Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population.

Background: The COVID-19 pandemic disrupted social, political, and economic life across the world, shining a light on the vulnerability of many communities. The objective of this study was to assess injury patterns before and after implementation of stay-at-home orders (SHOs) between White children and children of color and across varying levels of vulnerability based upon children's home residence.

Methods: A multi-institutional retrospective study was conducted evaluating patients < 18 years with traumatic injuries.

Unusual Presentations of Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) often develops during adolescence, may affect any organ system, and may present with a wide variety of signs and symptoms. It is critical to recognize the unusual manifestations of SLE in order to make a prompt diagnosis. Earlier diagnosis allows for appropriate treatment and ultimately decreases morbidity and mortality.

Global Health Disparities in Childhood Rickets.

Nutritional rickets is a global health problem reflecting both historical and contemporary health disparities arising from racial, ethnic, environmental, and geopolitical circumstances. It primarily affects marginalized populations and can contribute to long-term morbidity. Deficits in bone health in childhood may also contribute to osteomalacia/osteoporosis.

Characteristics and neighborhood-level opportunity of assault-injured children in Milwaukee.

Background: Multiple studies have explored demographic characteristics and social determinants of health in relation to the risk of pediatric assault-related injuries and reinjury. However, few have explored protective factors. The Child Opportunity Index (COI) uses neighborhood-level indicators to measure 'opportunity' based on factors such as education, social environment, and economic resources.

ACE: "What Happened to You" Screening for Adverse Childhood Experiences or Trauma-Informed Care.

Trauma is common within the United States. It is important for individuals to understand how trauma may affect their health and how trauma in childhood can have adverse effects on a child's development and health. To reduce retraumatization of patients, it is imperative to use trauma-informed approaches in a clinical encounter.

Understanding Influenza and SARS-CoV-2 Vaccine Hesitancy in Racial and Ethnic Minority Caregivers.

(1) Background: We compared influenza and SARS-CoV-2 vaccine hesitancy levels in Black, Hispanic, and White parents/caregivers and identified barriers and facilitators to vaccine acceptance. (2) Methods: This was a mixed methods study. A cross-sectional survey of ED caregivers presenting with children 6mo−18yo compared vaccine hesitancy levels among diverse caregivers.

Diagnostic Time-Outs to Improve Diagnosis.

Diagnostic errors harm patients. While the underlying causes of diagnostic error and the settings in which they occur are diverse, the use of a cognitive forcing function in the form of a diagnostic time-out can mitigate the risk of diagnostic error. Barriers to the implementation of diagnostic time-outs remain.

Undiagnosed and Rare Diseases in Critical Care: The Role of Diagnostic Access.

Critically ill patients with undiagnosed and rare diseases are at high risk for cognitive diagnostic errors as well as delays in diagnosis that are the result of impaired diagnostic access. Local evaluation teams dedicated to undiagnosed and rare diseases can address both the risk and actuality of diagnostic error, as well as shortfalls in diagnostic access, particularly for patients whose diminished access is a result of critical illness. Features of successful teams are discussed.

The Great Gut Mimicker: A case report of MIS-C and appendicitis clinical presentation overlap in a teenage patient.

Background: Abdominal pain and other gastrointestinal symptoms are common presenting features of multisystem inflammatory syndrome in children (MIS-C) and can overlap with infectious or inflammatory abdominal conditions, making accurate diagnosis challenging.

Case Presentation: We describe the case of a 16-year-old female who presented with clinical symptoms suggestive of appendicitis and an abdominal computed tomography (CT) that revealed features concerning for appendicitis. After laparoscopic appendectomy, histopathology of the appendix demonstrated only mild serosal inflammation and was not consistent with acute appendicitis.

Not Throwing Away My Shot: Leveraging a Peer Vaccination Workshop to Increase Residents' Immunization Skills.

Objective: The Accreditation Council for Graduate Medical Education (ACGME) requires that pediatric residents demonstrate competence administering immunizations. Despite mandatory simulation training, less than half our residents reported immunization competence. All residents need to receive their influenza vaccination, but schedule restrictions present logistical challenges.

Comparing Board Examination Scores Between Pediatric Residents in Continuity Clinics at Different Sites.

Objective: Determine if there is a difference in medical knowledge between pediatric residents attending continuity clinic at a community-based center versus those attending an academic center, as measured by the American Board of Pediatrics In-Training Exam (in-training exam) and the American Board of Pediatrics Certification Exam (certification exam).

Methods: A retrospective evaluation of in-training and certification exam scores of pediatric residents enrolled at the Medical College of Wisconsin and Children's Hospital of Wisconsin was performed. Test scores of the group of residents participating in a community-based continuity clinic were compared to those residents attending an academic center continuity clinic.

Relationship between mother-infant mutual dyadic responsiveness and premature infant development as measured by the Bayley III at 6 weeks corrected age.

Background: The quality of mother-preterm infant interaction has been identified as a key factor in influencing the infant's later development and language acquisition. The relationship between mother-infant responsiveness and later development may be evident early in infancy, a time period which has been understudied.

Aim: Describe the relationship between mother-infant mutual dyadic responsiveness and premature infant development.

Medical and Surgical Management of Pediatric Ulcerative Colitis.

Inflammatory bowel disease (IBD) describes a spectrum of idiopathic, lifelong, and progressive intestinal inflammatory conditions that includes Crohn's disease, ulcerative colitis, and indeterminate colitis. A worldwide increase in the incidence of IBD has been observed. In comparison to adults, IBD occurring during childhood and adolescence has several unique clinical characteristics and surgical management issues.

Postoperative Immobilization and Pain Management After Repair of Bladder Exstrophy.

Surgical repair of bladder exstrophy is an ongoing challenge for pediatric urologists. Postoperative immobilization is a mainstay of care to decrease tension on the repair site and is often utilized in conjunction with pelvic osteotomies performed in the same operative setting by pediatric orthopedic surgeons. Multiple pelvic immobilization techniques have been developed in conjunction with repair techniques including special techniques for neonates.