6,293 results match your criteria: "Children's national medical center[Affiliation]"

Objective: To report a case of oral tongue entrapment due to a metal water bottle and review clinical considerations for managing this rare pathology.

Study Design: Case report and literature review.

Setting: Tertiary care hospital.

View Article and Find Full Text PDF

Widely prescribed for Attention-Deficit/Hyperactivity Disorder (ADHD), stimulants (e.g., methylphenidate) have been studied for their chronic effects on the brain in prospective designs controlling dosage and adherence.

View Article and Find Full Text PDF

Background: Fragile X syndrome, with an approximate incidence rate of 1 in 4000 males to 1 in 8000 females, is the most prevalent genetic cause of heritable intellectual disability and the most common monogenic cause of autism spectrum disorder. The full mutation of the Fragile X Messenger Ribonucleoprotein-1 gene, characterized by an expansion of CGG trinucleotide repeats (>200 CGG repeats), leads to fragile X syndrome. Currently, there are no targeted treatments available for fragile X syndrome.

View Article and Find Full Text PDF

Disease-modifying therapies are standard of care (SOC) for sickle cell disease (SCD), but hematopoietic cell transplantation (HCT) has curative potential. We compared outcomes prospectively through 2-years after biologic assignment to a Donor or No Donor (SOC) Arm based on the availability of an HLA-matched sibling or unrelated donor (BMTCTN 1503; NCT02766465). A donor search was commenced after eligibility confirmation.

View Article and Find Full Text PDF

Background: Annually, about 4000 US children undergo a tracheostomy procedure to provide a functional, safe airway. In the hospital, qualified staff monitor and address problems, but post-discharge this responsibility shifts entirely to caregivers. The stress and constant demands of caregiving for a child with a tracheostomy with or without ventilator negatively affect caregivers.

View Article and Find Full Text PDF

Associations of exposure to PM and its compounds with carotid intima-media thickness among middle-aged adults.

Sci Total Environ

December 2024

Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA. Electronic address:

Article Synopsis
  • Exposure to fine particulate matter (PM), particularly black carbon (BC), is linked to an increased thickness of carotid arteries, which is a risk factor for cardiovascular diseases.
  • The study analyzed data from 3,257 participants, examining how one-year exposure to various PM compounds affects carotid intima media thickness (cIMT) through linear regression and Bayesian kernel machine regression models.
  • Results indicated a significant correlation between higher BC exposure and increased cIMT, suggesting that specific PM compounds like BC may be better indicators of adverse cardiovascular health than just overall PM mass.
View Article and Find Full Text PDF

The importance of objective confirmation of airway obstruction in preschool wheezing.

Pediatr Pulmonol

January 2025

Division of Pediatric Pulmonary, Sleep Medicine and Integrative Systems Biology. Center for Genetic Research, Children's National Medical Center, George Washington University, Washington, District of Columbia, USA.

View Article and Find Full Text PDF

Objective: To evaluate oophorectomy rates in pediatric and adolescent patients who presented to a US emergency department with adnexal torsion METHODS: This study was a retrospective, cross-sectional analysis utilizing the National Emergency Department Sample data from 2016 to 2018. It included patients younger than 20 years old and of the female sex. International Classification of Diseases Version 10 and ICD 10 Procedure Coding System codes were utilized to define patients with adnexal torsion who underwent adnexal surgery.

View Article and Find Full Text PDF

Objectives: HLA DQA1*05 has been associated with the development of anti-drug antibodies (ADA) to tumor necrosis factor antagonists (anti-TNF) and treatment failure among adults with Crohn's disease (CD). However, findings from other studies have been inconsistent with limited pediatric data.

Methods: We analyzed banked serum from patients with CD < 21 years of age enrolled in COMBINE, a multi-center, prospective randomized trial of anti-TNF monotherapy vs.

View Article and Find Full Text PDF

Background: Higher drug levels and combination therapy with low-dose oral methotrexate (LD-MTX) may reduce anti-tumor necrosis factor (TNF) treatment failure in pediatric Crohn's disease. We sought to (1) evaluate whether combination therapy with LD-MTX was associated with higher anti-TNF levels, (2) evaluate associations between anti-TNF levels and subsequent treatment failure, and (3) explore the effect of combination therapy on maintenance of remission among patients with therapeutic drug levels (>5 µg/mL for infliximab and >7.5 µg/mL for adalimumab).

View Article and Find Full Text PDF
Article Synopsis
  • Viral lower respiratory tract infection (vLRTI) is a major cause of pediatric hospitalization and mortality globally, yet the immune responses involved are not well understood.
  • A study analyzed over 1,300 proteins in tracheal aspirate and plasma from critically ill children, identifying significant protein changes linked to vLRTI and developing a diagnostic tool with high accuracy.
  • Key findings included increased interferon and T cell responses in the lower airway, distinct protein profiles in plasma, and novel protein biomarkers that could enhance diagnostic approaches for severe vLRTI.
View Article and Find Full Text PDF

Who says what to whom through what channel? Formative communication research on antibiotic resistance messaging for urgent care patients.

Antimicrob Steward Healthc Epidemiol

October 2024

Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.

Objective: To explore the source, message, channel, and receiver effects on patient concern for antibiotic resistance, willingness to reduce antibiotic use, and expectations for an antibiotic prescription in a prepandemic sample.

Methods: We used data reported from a national cross-sectional survey of adults who had visited an urgent care center within the last year. Data were collected from April 4 to April 9, 2017.

View Article and Find Full Text PDF
Article Synopsis
  • - Glomerulopathy leads to damage in the filtration barrier of the kidneys, often resulting in nephrotic syndrome (NS), which currently has limited treatment options primarily involving steroids with mixed effectiveness.
  • - A 7-year-old boy with a history of NS underwent genetic testing and biopsy, revealing abnormal changes, and after an initial steroid response, he was treated with anakinra and adalimumab, achieving remission without treatment for the past year.
  • - The case highlights the interplay of genetic and environmental factors in glomerular diseases and suggests that early intervention with biologic treatments may promote kidney recovery and reduce the need for steroids, indicating a need for further research.
View Article and Find Full Text PDF

Re-evaluating fistula management in cleft palate: longitudinal changes and risk determinants after double-opposing Z-plasty.

Int J Oral Maxillofac Surg

October 2024

Department of Plastic Surgery, CHA Bundang Medical Center, Gyeonggi-do, Republic of Korea; Medical Big Data Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.

Longitudinal follow-up data of 1557 patients with cleft palate (CP) was used to identify risk factors for palatal fistula (PF) formation after double-opposing Z-plasty (DOZ), performed by a single surgeon. Overall, 104 (6.7%) of the patients developed PF, all of which were identified within the first month following DOZ.

View Article and Find Full Text PDF
Article Synopsis
  • Researchers investigated how machine learning could improve predicting cardiomyopathy risk in childhood cancer survivors using echocardiograms from multiple centers.
  • They designed deep convolutional neural networks (DCNNs) to analyze different sets of echocardiographic data and gauge model performance using standard metrics like F1-score and AUPRC.
  • Results showed that the DCNN effectively distinguished between survivors who developed cardiomyopathy and those who didn't, suggesting a potential tool for early prediction in at-risk patients.
View Article and Find Full Text PDF

Background: Multiple clinical trials evaluating therapies for cerebral malaria (CM) have failed to demonstrate improved outcomes. This may derive from inclusion of children at all risk levels, including those at low risk of mortality or neurologic morbidity, limiting power to detect significant differences between intervention arms. One solution is enrichment, enrolling clinical trial participants at higher risk of adverse outcomes.

View Article and Find Full Text PDF

Curriculum Innovation: Design and Implementation of Synchronous and Asynchronous Curricula to Enhance Residents' EEG Knowledge and Experience.

Neurol Educ

December 2023

From the Department of Neurology (A.F.), Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Department of Neurology (J.J.M.), Yale School of Medicine, New Haven, CT; Department of Neurology (D.B.H.), Children's National Medical Center, Washington, DC; Department of Neurology (R.M.G.), Washington University School of Medicine and St. Louis Childrens Hospital, MO; Department of Neurology (J.P.), University of Pennsylvania, Philadelphia; Minnesota Epilepsy Group, P.A. (N.A., K.S.), Roseville, MN; Division of Pediatric Neurology (J.M.C.), Connecticut Childrens, University of Connecticut School of Medicine, Hartford, CT; American Epilepsy Society (A.K.), Chicago, IL; Department of Neurology (F.A.L.), Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY; and Department of Neurology (D.J.W.), St. Louis University, MO.

Introduction And Problem Statement: There is a need for structured EEG education opportunities to enhance neurology resident education. To address this need, the American Epilepsy Society (AES) supported the development and implementation of both synchronous and asynchronous EEG courses.

Objectives: To produce EEG curricula that enhance resident EEG learning, increase interest in EEG and improve participants' knowledge, and to ensure that courses were highly used and available to the broadest range of learners.

View Article and Find Full Text PDF

Pediatric Urinary Tract Infections.

Urol Clin North Am

November 2024

Division of Urology, Children's National Medical Center, 111 Michigan Avenue Northwest, Washington, DC 20010, USA; Department of Urology and Pediatrics, George Washington University School of Medicine and Health Sciences. Electronic address:

Urinary tract infection (UTI) is frequent in the first year of life with bowel and bladder dysfunction, GU tract abnormalities, neurogenic bladder, and the intact prepuce conveying an increased risk. Urine culture is the gold standard for diagnosis. Antibiotics are tailored to resistance patterns.

View Article and Find Full Text PDF

Leukoencephalopathy With Calcifications and Cysts.

Neurology

November 2024

From the Department of Neurology (F.J.J., H.E., J.O.-M.), University of Pennsylvania, Philadelphia; St. Luke's Neurology Associates (A.M.), Bethlehem, PA; and Division of Genetics and Metabolism (J.L.F.), Children's National Medical Center, Washington, DC.

View Article and Find Full Text PDF

AI-based fully automatic analysis of retinal vascular morphology in pediatric high myopia.

BMC Ophthalmol

September 2024

Klinik und Poliklinik für Augenheilkunde, Ophthalmology Department of Klinikum rechts der Isar, Technische Universität München, 81675, Munich, Germany.

Purpose: To investigate the changes in retinal vascular structures associated with various stages of myopia by designing automated software based on an artificial intelligence model.

Methods: The study involved 1324 pediatric participants from the National Children's Medical Center in China, and 2366 high-quality retinal images and corresponding refractive parameters were obtained and analyzed. Spherical equivalent refraction (SER) degree was calculated.

View Article and Find Full Text PDF

Differential inclusion of NEB exons 143 and 144 provides insight into NEB-related myopathy variant interpretation and disease manifestation.

HGG Adv

January 2025

Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address:

Biallelic pathogenic variants in the gene encoding nebulin (NEB) are a known cause of congenital myopathy. We present two brothers with congenital myopathy and compound heterozygous variants (NC_000002.12:g.

View Article and Find Full Text PDF

Cardiac catheterization for congenital heart disease (CHD) performed under fluoroscopic guidance still lacks definition and requires exposure to ionizing radiation and contrast agents, with most patients needing multiple procedures through their lifetime, leading to cumulative radiation risks. While fusion overlay techniques have been employed in the past to aid, these have been limited to a single plane, while interventions are traditionally performed under biplane fluoroscopy. We describe our initial experience performing cardiac catheterizations guided by an enhanced biplane GuideCCI system (Siemens Healthcare, Germany) augmented by 3D magnetic resonance imaging and computed tomography modeling.

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to identify clinical and polysomnographic features of severe obstructive sleep apnea (OSA) in infants under 12 months, analyzing data from 207 infants referred for sleep-disordered breathing.
  • - Results indicated that 43% of these infants had severe OSA, with age being the strongest predictor; particularly, infants three months or younger were at significantly higher risk and often exhibited additional complications like craniofacial abnormalities.
  • - The most common management approach for these infants was observation with no interventions, while surgical options varied with age, including procedures like mandibular distraction osteogenesis for younger infants and adenoidectomy for those aged 4 to 12 months.
View Article and Find Full Text PDF

Background: With improved survival of adults with congenital heart disease (CHD) comes a need to understand the lifelong outcomes of this population. The aim of this paper is to describe the rationale and design of Congenital Heart Disease Project to Understand Lifelong Survivor Experience (CHD PULSE), a study to determine long-term medical, neurocognitive, and psychosocial outcomes among adults with a history of intervention for CHD and to identify factors associated with those outcomes.

Methods: CHD PULSE is a cross-sectional survey conducted from September 2021 to April 2023 among adults aged 18 and older with a history of at least 1 intervention for CHD at 1 of 11 participating U.

View Article and Find Full Text PDF