Third Proceedings of The North American Airway Collaborative (NoAAC): Consensus Statement on Trial Design for Airway Stenosis.

Importance: Airway stenosis is a rare but debilitating disorder that significantly degrades the quality of life in affected patients. Treatments are primarily surgical, and disease management lacks established medical therapies. The North American Airway Collaborative held its third symposium at The Johns Hopkins Hospital in Baltimore, Maryland, on April 15, 2024, focused on strategies to advance the care of these patients.

The ACTION VAD registry: A collective five-year experience.

Background: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) began in 2018 as a collaborative learning health system committed to improving outcomes in pediatric heart failure, including children and adults with congenital heart disease, supported with ventricular assist devices (VADs). This report describes patient and device characteristics, and outcomes through 1-year post-implant.

Methods: The ACTION VAD registry report was created from data submitted to the ACTION learning network from April 2018 to June 2023.

Single-molecule systems for the detection and monitoring of plasma-circulating nucleosomes and oncoproteins in diffuse midline glioma.

The analysis of cell-free tumor DNA (ctDNA) and proteins in the blood of patients with cancer potentiates a new generation of non-invasive diagnostic approaches. However, confident detection of tumor-originating markers is challenging, especially in the context of brain tumors, where these analytes in plasma are extremely scarce. Here, we apply a sensitive single-molecule technology to profile multiple histone modifications on individual nucleosomes from the plasma of patients with diffuse midline glioma (DMG).

Tenecteplase for the Treatment of Pediatric Arterial Ischemic Stroke: A Safety Surveillance Report.

Objectives: Intravenous tenecteplase (TNK) is increasingly used to treat adult patients with acute arterial ischemic stroke, but the risk profile of TNK in childhood stroke is unknown. This study aims to prospectively gather safety data regarding TNK administration in children.

Methods: Since December 2023, a monthly email survey was sent to participants recruited from the International Pediatric Stroke Study and Pediatric Neurocritical Care Research Group querying recent experience with TNK in childhood stroke.

Efficacy of endoscopic sinus surgery in patients under six years old.

Objectives: To examine safety and efficacy of very young patients under the age of six who underwent endoscopic sinus surgery (ESS) at our institution for the indications of either complicated acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS).

Methods: Retrospective cohort review of patients under six years old who underwent ESS for sinonasal pathology between 2016 and 2023 at a freestanding pediatric hospital. Age, sex, weight, diagnosis, laterality of disease, medications, types and number of surgical interventions, usage of image guidance, and outcomes were obtained from the medical record.

Anal Sphincter Reconstruction Using the Posterior Sagittal Approach for Pediatric Perineal Trauma.

Traumatic perineal injuries are rare but can result in significant morbidity, particularly when the anal sphincter is injured. The management of such injuries in the pediatric population is rarely noted in the literature. We aimed to describe reconstruction in such patients using lessons learned in reoperative anorectal malformation surgery.

Early Continuous Electroencephalography, Clinical Parameters, and Short-Term Functional Outcomes in Pediatric Traumatic Brain Injury: Single-Center, Retrospective Cohort, 2010-2020.

Objectives: Traumatic brain injury (TBI) is a leading cause of pediatric morbidity and mortality. This study first investigates clinical characteristics and continuous electroencephalography (cEEG) parameters associated with short-term functional outcomes in pediatric patients following TBI. Second, we use these data for a hypothesis-generating model about outcomes.

Misinformation and Readability of Social Media Content on Pediatric Ankyloglossia and Other Oral Ties.

Importance: Diagnosis of pediatric ankyloglossia and other oral ties is increasing in part due to social media, leading to more frenotomies and excess medicalization of often normal anatomy.

Objective: To assess the accuracy and readability of social media content on pediatric ankyloglossia and other oral ties.

Design, Setting, And Participants: In this cross-sectional study, the top 200 posts on an image-based social media platform tagged with #tonguetie, #liptie, or #buccaltie were collected using a de novo account on March 27, 2023.

A Dangerous Hiding Spot: The Unrecognized Danger Posed by Child-Sized Helium Balloons.

Anticipatory guidance on balloons typically highlights the danger of choking on uninflated balloon fragments. One type of balloon injury that is not widely discussed is suffocation due to crawling inside a large foil helium-containing balloon. A six-year-old female presented to a community hospital emergency department (ED) after being found on the floor inside a 50-inch foil balloon in the shape of the number "7.

Switchable Adhesion of Hydrogels to Plant and Animal Tissues.

The ability to "switch on" adhesion between a thin hydrogel and a biological tissue can be useful in biomedical applications such as surgery. One way to accomplish this is with an electric field, a phenomenon termed electroadhesion (EA). Here, it is shown that cationic gels can be adhered by EA to tissues across all of biology.

Surgical Efficacy Analysis of Traumatic Posterior Fossa Epidural Hematoma in Children.

Objective: To investigate the treatment effect and prognosis of posterior fossa epidural hematoma in children by different surgical methods.

Methods: The clinical data of 41 children with traumatic posterior fossa epidural hematoma treated by surgery in the Department of Neurosurgery from June 2015 to October 2023 were retrospectively analyzed. Among them, 32 cases underwent minimally invasive skull trepanation and drainage and 9 cases underwent craniotomy and hematoma removal.

Lack of association of first and second-line medication dosing and progression to refractory status epilepticus in children.

Purpose: Evaluate the relationship between first and second-line medication dosing and progression to refractory status epilepticus (RSE) in children.

Methods: This is a retrospective analysis of prospectively collected data from September 2014 to February 2020 of children with status epilepticus (SE) who received at least two antiseizure medications (ASMs). We evaluated the risk of developing RSE after receiving a low total benzodiazepine dose (lower than 100 % of the minimum recommended dose for each benzodiazepine dose administered within 10 min) and a low first non-benzodiazepine ASM dose (lower than 100 % of the minimum recommended dose of non-benzodiazepine ASM given as the first single-dose) using a logistic regression model, adjusting for confounders such as time to ASMs.

Controversies in Artificial Intelligence in Neurosurgery.

Artificial intelligence (AI) has evolved from science fiction to a technology infiltrating everyday life. In neurosurgery, clinicians and researchers are exploring ways to implement this powerful tool to improve the safety and efficiency of the perioperative process. Current applications include preoperative diagnosis, intraoperative detection and recommendations, and technical skills assessment and feedback.

Expert opinion on use of vagus nerve stimulation therapy in the management of pediatric epilepsy: A Delphi consensus study.

Purpose: To provide consensus-based recommendations for use of vagus nerve stimulation (VNS) therapy in the management of pediatric epilepsy.

Methods: Delphi methodology with two rounds of online survey was used to build consensus. A steering committee developed 43 statements related to pediatric epilepsy and the use of VNS therapy, which were evaluated by a panel of 12 neurologists/neurosurgeons with expertise in pediatric epilepsy, who graded their agreement with each statement on a scale of 1 ("I do not agree at all") to 5 ("I strongly agree").

Interventional Strategies for Children with Progressive Pulmonary Hypertension Despite Optimal Therapy. An Official American Thoracic Society Clinical Practice Guideline.

Background: Pulmonary hypertension in children often progresses despite optimal therapy. This document provides an evidence-based clinical practice guideline for the management of children with progressive pulmonary hypertension despite optimal therapy.

Methods: A multidisciplinary panel identified pertinent questions regarding the management of children with pulmonary hypertension that has progressed despite optimal therapy, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop clinical recommendations.

The PPP - Perineal Body Preserving PSARP (Posterior Sagittal Anorectoplasty) for Anorectal Malformation with Rectovestibular Fistula in Females-Report of Early Outcomes.

Introduction:  The perineal body preserving posterior sagittal anorectoplasty (PSARP) (PPP) is a novel modification of the original PSARP for female patients with rectovestibular fistulas designed to eliminate the risk of perineal body dehiscence. This study aims to examine the outcomes following PPP.

Methods:  A retrospective, single-institution study was performed examining female patients with rectovestibular fistula who underwent PPP between January /2020 and December 2023.