587 results match your criteria: "Children’s Hospital Boston and Harvard Medical School[Affiliation]"

Cardiac output assessed by non-invasive monitoring is associated with ECG changes in children with critical asthma.

J Clin Monit Comput

February 2014

Division of Medicine Critical Care, Department of Medicine, Children's Hospital Boston and Harvard Medical School, 330 Longwood Avenue 11 South, Boston, MA, 02115, USA,

The primary aim of this study was to determine changes in CI and SI, if any, in children hospitalized with status asthmatics during the course of treatment as measured by non-invasive EC monitoring. The secondary aim was to determine if there is an association between Abnormal CI (defined as <5 or >95 % tile adjusted for age) and Abnormal ECG (defined as ST waves changes) Non-invasive cardiac output (CO) recordings were obtained daily from admission (Initial) to discharge (Final). Changes in CI and SI measurements were compared using paired t tests or 1-way ANOVA.

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Effects of exercise and lifestyle modification on fitness, insulin resistance, skeletal muscle oxidative phosphorylation and intramyocellular lipid content in obese children and adolescents.

Pediatr Obes

August 2014

Program in Nutritional Metabolism and Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Division of Endocrinology, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts, USA; Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Background: Obesity is associated with poor fitness and adverse metabolic consequences in children.

Objective: To investigate how exercise and lifestyle modification may improve fitness and insulin sensitivity in this population.

Design And Subjects: Randomized controlled trial, 21 obese (body mass index ≥ 95% percentile) subjects, ages 10 to 17 years.

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Background And Aim Of The Study: The pulmonary trunk (PT) structure and function are abnormal in multiple congenital cardiovascular diseases. Existing surgical treatments of congenital malformations of the right ventricular outflow tract and PT do not provide a long-term replacement that can adapt to normal growth. Although there is strong interest in developing tissue-engineered approaches for PT conduit replacement, there remains an absence of any complete investigation of the native geometric growth patterns of the PT to serve as a necessary benchmark.

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Mitochondrial fatty acid oxidation disorders include conditions in which the transport of activated acyl-Coenzyme A (CoA) into the mitochondria or utilization of these substrates is disrupted or blocked. This results in a deficit in the conversion of fat into energy. Most patients with fatty acid oxidation defects are now identified through newborn screening by tandem mass spectrometry.

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Unlabelled: This study examined the factor structure of the Children's Depression Inventory (CDI) among children and adolescents with chronic pain using exploratory and confirmatory factor analysis in a large, multisite sample of treatment-seeking youth. Participants included 1,043 children and adolescents (ages 8-18) with a range of chronic pain complaints who presented for initial evaluation at 1 of 3 tertiary care pediatric chronic pain clinics across the United States. They completed the CDI and reported on pain intensity and functional disability.

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Objectives: Truncal valve regurgitation remains a short- and long-term risk factor for patients with truncus arteriosus. There are limited data available on techniques and outcomes of truncal valve repair (TVR). The aim of this study was to report our experience with TVR in patients of all ages.

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Aseptic meningitis.

Handb Clin Neurol

March 2014

Department of Medicine, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA. Electronic address:

This chapter describes the clinical presentation, diagnosis, and treatment of patients with both aseptic meningitis and encephalitis. It also addresses the major causes of aseptic meningitis. Although bacterial meningitis is quite rare in an era of widespread conjugate vaccines, diagnosis often depends on the results of bacterial cultures which may take several days.

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Chromosomal translocations are recurrent genetic events that define many types of cancers. Since their first description several decades ago as defining elements in cancer cells, our understanding of the mechanisms that determine their formation as well as their implications for cancer progression and therapy has remarkably progressed. Chromosomal translocations originate from double-strand breaks (DSBs) that are brought into proximity in the nuclear space and joined inappropriately by DNA-repair pathways.

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Background: Management of unbalanced common atrioventricular canal (UCAVC) defect by a single-ventricle (SV) approach frequently results in poor outcomes, especially in trisomy 21 patients. In this report we describe our results with conversion to biventricular circulation in UCAVC patients with SV palliation.

Methods: Retrospective review of patients with UCAVC undergoing biventricular conversion from prior SV palliation between 2003 and 2011 was conducted.

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Trisomy 21 is the most common viable trisomy. Although it is invariably associated with mild to severe developmental delay and intellectual disability, no gross central nervous system malformation has been consistently identified in individuals with trisomy 21. We present the case of a monozygotic twin pregnancy in which both fetuses were identified as having trisomy 21 and partial agenesis of the corpus callosum.

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Context: We have shown previously that trichloroacetic acid precipitation is an effective method of protein extraction from pancreatic fluid for downstream biomarker discovery, compared to other common extraction methods tested.

Objective: We aim to assess the utility of ultracentrifugation as an alternative method of protein extraction from pancreatic fluid.

Design: Proteins extracted from trichloroacetic acid- and ultracentrifugation-precipitated pancreatic fluid were identified using mass spectrometry techniques (in-gel tryptic digestion followed by liquid chromatography-tandem mass spectrometry; GeLC-MS/MS).

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Toxic compounds in tobacco, such as nicotine, may adversely affect pancreatic function. We aim to determine nicotine-induced protein alterations in pancreatic cells, thereby revealing links between nicotine exposure and pancreatic disease. We compared the proteomic alterations induced by nicotine treatment in cultured pancreatic cells (mouse, rat, and human stellate cells and human duct cells) using MS-based techniques, specifically SDS-PAGE (gel) coupled with LC-MS/MS and spectral counting.

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Detection of precursory, seizure-related activity in electroencephalograms (EEG) is a clinically important and difficult problem in the field of epilepsy. Seizure detection methods often aim to identify specific features and correlations between preictal EEG signals that differentiate them from interictal/nonictal signals. Typically, these methods use information from nonictal EEGs to establish detection thresholds, and do not otherwise incorporate their characteristics into the detection.

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A subspace signal processing approach is proposed for improved scalp EEG-based localization of broad-focus epileptic seizures, and estimation of the directions of source arrivals (DOA). Ictal scalp EEGs from adult and pediatric patients with broad-focus seizures were first decomposed into dominant signal modes, and signal and noise subspaces at each modal frequency, to improve the signal-to-noise ratio while preserving the original data correlation structure. Transformed (focused) modal signals were then resynthesized into wideband signals from which the number of sources and DOA were estimated.

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Objective: The purpose of our study was to correlate the results of the radionuclide salivagram with the corresponding chest radiography findings on patients being evaluated for salivary aspiration to determine the utility of the salivagram.

Materials And Methods: We identified 222 patients younger than 21 years who underwent salivagram and chest radiography within 3 months of each other. Salivagrams were blindly interpreted by two readers and chest radiographs were blindly interpreted by two other readers.

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We report an adolescent with chronic, recurrent upper gastrointestinal bleeding in whom extensive prior investigations failed to reveal the source of bleeding. Angiography accurately identified a bleeding Dieulafoy lesion of the duodenum which was successfully embolized. The clinical history, angiographic appearances and treatment of this rare lesion are presented.

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The early history of the pediatric cooperative group trials is reviewed, and the surgeons who played a critical role in their formation are discussed. The vital information provided from the tumor specimens submitted as part of the protocols is presented, as well as how this information advanced our management of infants and children treated on current protocols of the Children's Oncology Group. Finally, a survey of the surgeons currently active in the clinical trials defined the "critical lessons" learned from the sequence of protocols by the cooperative groups which have advanced our surgical treatment of patients today.

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Background: Chronic pancreatitis (CP) is currently diagnosed using invasive endoscopic as well as radiation and non-radiation-based imaging techniques. However, urine can be safely and non-invasively collected and as such may offer a superior alternative to current techniques of CP diagnosis. We use mass spectrometry-based methods to discover proteins which are exclusive to or differentially abundant in urine of chronic pancreatitis patients.

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Objective: The purpose of this study was to compare the image quality of thoracic CT angiography (CTA) studies performed with two techniques--with general anesthesia and without general anesthesia--for infants and for children younger than 5 years.

Materials And Methods: All consecutively registered infants and young children (age, ≤ 5 years) who underwent contrast-enhanced thoracic CTA from November 2005 to October 2010 were categorized into two groups: general anesthesia and awake (i.e.

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Background: There are over 30 cases of prenatally diagnosed sacral extensions or human 'tails' in the literature, including isolated and syndromic etiologies. Most cases were reported to resolve by the second trimester and postnatal course was benign. Our objective was to describe the prenatal findings, associated anomalies, and clinical outcome of a series of seven fetuses diagnosed prenatally with fetal sacrococcygeal extension.

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Impact of trauma system development on pediatric injury care.

Pediatr Surg Int

March 2013

Trauma Program, Department of Surgery, Children's Hospital Boston and Harvard Medical School, 300 Longwood Avenue, Fegan 3, Boston, MA 02115, USA.

Article Synopsis
  • Trauma systems are designed to improve survival rates by directing severely injured pediatric patients to specialized trauma centers, and this study evaluates their effectiveness on triage and injury death rates.
  • Data from injured children under 15 years old in New England between 1996 and 2006 showed that, while hospitalization rates for injuries decreased in both trauma system and non-trauma system states, the decline was more significant in trauma system states.
  • Although trauma systems increased the admission of severely injured and brain-injured children to trauma centers more rapidly, overall mortality rates and triage efficiency remained similar across both groups.
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Mass Spectrometry-Based (GeLC-MS/MS) Comparative Proteomic Analysis of Endoscopically (ePFT) Collected Pancreatic and Gastroduodenal Fluids.

Clin Transl Gastroenterol

May 2012

1] Department of Pathology, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts, USA [2] Proteomics Center at Children's Hospital Boston, Boston, Massachusetts, USA [3] Center for Pancreatic Disease, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital and Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.

Objectives: The secretin-stimulated endoscopic pancreatic function test (ePFT) allows for the safe collection of gastroduodenal and pancreatic fluid from the duodenum. We test the hypothesis that these endoscopically collected fluids have different proteomes. As such, we aim to show that the ePFT method can be used to collect fluid enriched in pancreatic proteins to test for pancreatic function.

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Thrombocytopenia is a common problem among sick neonates admitted to the neonatal intensive care unit. Frequently, platelet transfusions are given to thrombocytopenic infants in an attempt to decrease the incidence or severity of hemorrhage, which is often intracranial. Whereas there is very limited evidence to guide platelet transfusion practices in this population, preterm infants in the first week of life (the highest risk period for bleeding) are nearly universally transfused at higher platelet counts than older infants or children.

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Objective: To investigate the association between overeating (without loss of control) and binge eating (overeating with loss of control) and adverse outcomes.

Design: Prospective cohort study.

Setting: Adolescents and young adults living throughout the United States.

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