7,686 results match your criteria: "Children’s Hospital at Westmead[Affiliation]"

Vertebral fracture assessment (VFA) images from bone density machines enable the automated machine learning assessment of abdominal aortic calcification (ML-AAC), a marker of cardiovascular disease (CVD) risk. The objective of this study was to describe the risk of a major adverse cardiovascular event (MACE, from linked health records) in patients attending routine bone mineral density (BMD) testing and meeting specific criteria based on age, BMD, height loss, or glucocorticoid use have a VFA in the Manitoba Bone Mineral Density Registry. The cohort included 10 250 individuals (mean 75.

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Objective: Monoallelic variants in the transient receptor potential melastatin-related type 3 gene (TRPM3) have been associated with neurodevelopmental manifestations, but knowledge on the clinical manifestations and treatment options is limited. We characterized the clinical spectrum, highlighting particularly the epilepsy phenotype, and the effect of treatments.

Methods: We analyzed retrospectively the phenotypes and genotypes of 43 individuals with TRPM3 variants, acquired from GeneMatcher and collaborations (n = 21), and through a systematic literature search (n = 22).

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Aim: To describe the timing and causes of post-neonatally acquired cerebral palsy (PNN-CP) and map the implementation of relevant preventive strategies against cause-specific temporal trends in prevalence.

Methods: Data for a 1975-2014 birth cohort of children with PNN-CP (brain injury between 28 days and 2 years of age) were drawn from the Victorian and Western Australian CP Registers. Descriptive statistics were used to report causal events and timing.

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Introduction: High-risk fertility behaviors (HRFB), including short birth intervals, early or late childbearing age, and high parity, are associated with adverse pregnancy outcomes. Understanding the importance of socioeconomic disparity in HRFB and the factors influencing this disparity is essential to improve maternal and child survival, Accordingly, this study investigated socioeconomic inequalities in HRFB over time and its contributing factors.

Methods: We included a total weighted sample of 11,163 and 5,527 women aged 15 to 49 years from the 2005 and 2019 Ethiopia Demographic and Health Surveys, respectively.

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Patients with restrictive cardiomyopathy (RCM) and hypertrophic cardiomyopathy (HCM) were previously considered poor candidates for mechanical circulatory support due to technical limitations related to restrictive ventricular physiology and small ventricular size, limiting the ability to provide adequate flows and decompress the heart. Literature examining use of extracorporeal membrane oxygenation (ECMO) in this population consists of a single case series reporting no survivors. We report our experience providing ECMO in children with RCM or HCM at a large pediatric quaternary cardiac center.

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Resuscitation in Paediatric Septic Shock Using Vitamin C and Hydrocortisone (RESPOND): The RESPOND Randomized Controlled Trial Protocol.

Pediatr Crit Care Med

December 2024

Children's Intensive Care Research Program, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.

Article Synopsis
  • This study investigates the effects of vitamin C and hydrocortisone on pediatric sepsis, aiming to improve survival rates without the need for inotropes/vasopressors.
  • The RESPOND trial is a randomized, open-label study involving nine PICUs in Australia and New Zealand, focusing on children under 18 with suspected or confirmed sepsis.
  • It will assess outcomes such as time alive without inotropic support, mortality rates, and quality of life, involving 384 patients to generate robust data for better treatment strategies.
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Background: Data on impact of financial penalties for non-vaccination are sparse. Australia has required full vaccination for government family assistance payment eligibility since 1998. In 2016, the No Jab, No Pay (NJNP) policy removed registered non-medical objection as exemption option and increased eligibility assessment to yearly.

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Background Kasai procedure (KPE) is a palliative intervention in infants with biliary atresia (BA) aiming to restore biliary drainage. While the measure of success in BA is the post-Kasai native liver survival, BA remains the most frequent indication for liver transplantation in children. While a considerable amount of children fail to clear their jaundice following KPE, resulting in early liver failure and transplantation, some children become jaundice-free after "successful" KPE.

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Access to Pediatric Bed Capacity According to Social Determinants of Health: All Beds Are Not Created Equal.

J Pediatr

December 2024

Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA. Electronic address:

Objective: To study pediatric inpatient hospital capacity and resources, characterizing differences according to social determinants of health (SDoH) using market share techniques.

Study Design: This cross-sectional study uses non-elective inpatient discharges (≥1 month to ≤19 years) from Healthcare Cost and Utilization Project and American Hospital Association surveys to derive hospital capacity and resources/capability. We include US hospitals with ≥1 pediatric bed and ≥1 pediatric discharge and calculate per bed capital, expenditure, and staffing, transfer rates, payer-mix, and adjusted central line-associated blood stream infection (CLABSI) rate.

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Background: Exercise capacity is reduced in patients with a Fontan circulation compared to their healthy peers secondary to altered haemodynamics of the Fontan circulation. Cardiopulmonary exercise testing is routinely used in Fontan patients to assess their cardiopulmonary response to exercise and help guide management decisions, however their results are routinely compared to normative data derived from healthy individuals.

Method: Using data available from the Pediatric Heart Network, we performed a retrospective study to derive Fontan-specific normative values in a subgroup of well-functioning adolescent patients.

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Objective: Early diagnosis and treatment of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) are crucial for a favorable prognosis. Detecting the causative autoantibodies can be challenging. Probable diagnostic criteria are useful in adults less so in children.

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Use of blended feeds in children requiring tube feeding.

J Paediatr Child Health

December 2024

General Medicine Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Aim: The use of blended tube feeding (BTF) in children is a controversial area with persistent concerns regarding the nutritional adequacy and risk of associated infections and equipment complications. Parents in Australia are electing to use BTF in their children despite local hospital guidelines, calling for further research to support its use.

Methods: A retrospective case-series study was conducted at a tertiary paediatric hospital, to characterise the paediatric population electively using BTF and evaluate their clinical outcomes.

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Background: Spiritual pain and distress are commonly unrecognised among patients receiving palliative care, yet engaging with a person's spirituality can allow healing to occur even amid suffering. Palliative care clinicians lack training in assessing and managing spiritual distress among patients.

Objectives: Development of a virtually delivered spirituality workshop to improve clinicians' understanding of their own spirituality and confidence in addressing the spiritual dimension of patients' experience.

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Autoimmune encephalitis: diagnostic challenges and tensions.

Lancet Neurol

January 2025

Kids Neuroscience Centre, Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, NSW 2145, Australia. Electronic address:

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Evaluating post-cardiac arrest blood pressure thresholds associated with neurologic outcome in children: Insights from the pediRES-Q database.

Resuscitation

December 2024

Department of Pediatrics, Division of Critical Care Medicine, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, 1184 5th Ave, New York, NY 10029, USA.

Background: Current Pediatric Advanced Life Support Guidelines recommend maintaining blood pressure (BP) above the 5th percentile for age following return of spontaneous circulation (ROSC) after cardiac arrest (CA). Emerging evidence suggests that targeting higher thresholds, such as the 10th or 25th percentiles, may improve neurologic outcomes. We aimed to evaluate the association between post-ROSC BP thresholds and neurologic outcome, hypothesizing that maintaining mean arterial pressure (MAP) and systolic blood pressure (SBP) above these thresholds would be associated with improved outcomes at hospital discharge.

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Studies have shown that there is a difference between biological sex at birth in autism spectrum disorder. There remains a lack of understanding about how the symptoms of autism differ between assigned males at birth and assigned females at birth. We looked at the presence of sex differences in a large group of autistic toddlers, children and adolescents, who were seen in a large diagnosis and assessment clinic.

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Background: Sex, as a biological construct, and gender, defined as the cultural attitudes and behaviours attributed by society, may be associated with allograft loss, death, cancer, and rejection. Other factors, such as recipient age and donor sex, may modify the association between sex/gender and post-transplant outcomes.

Objectives: We sought to evaluate the prognostic effects of recipient sex and, separately, gender as independent predictors of graft loss, death, cancer, and allograft rejection following kidney or simultaneous pancreas-kidney (SPK) transplantation.

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Supporting equitable cervical cancer elimination for Australia's culturally and linguistically diverse communities: A call for intersectoral action.

Health Promot J Austr

January 2025

Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.

Cervical cancer is a preventable disease and is related to persistent health equities. Whilst several priority populations face health inequities related to cervical cancer prevention, my co-authors and I bring special attention to those who identify as culturally and linguistically diverse (CALD). By reflecting on some of our research and work experiences, we propose four ways that governments and policymakers can enact the community engagement goals of the published and proposed cervical cancer prevention and treatment strategies for CALD communities.

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Aim: To synthesize the experiences of 15- to 34-year-olds with cerebral palsy (CP) as they participate in key life situations of young adulthood.

Method: A mixed-methods scoping review was undertaken and six electronic databases searched (January 2001 to August 2023). Participation foci and thematic outcomes were mapped to the International Classification of Functioning, Disability and Health.

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Tailoring capsid-directed evolution technology for improved AAV-mediated CAR-T generation.

Mol Ther

December 2024

Translational Vectorology Research Unit, Children's Medical Research Institute, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia; Australian Genome Therapeutics Centre, Children's Medical Research Institute and Sydney Children's Hospitals Network, Westmead, NSW 2145, Australia; Laboratory of Molecular Oncology and Innovative Therapies, Military Institute of Medicine - National Research Institute, Warsaw, Poland. Electronic address:

Chimeric antigen receptor (CAR) T cell (CAR-T) therapies present options for patients diagnosed with certain leukemias. Recent advances of the technology included a method to integrate the CAR into the T cell receptor alpha constant (TRAC) locus to take advantage of the endogenous promoter and regulatory elements for CAR expression. This method used adeno-associated viral (AAV) vectors based on AAV6 to deliver the donor template encoding the CAR construct.

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Anti-disialoganglioside (GD2) antibody therapy has provided clinical benefit to patients with neuroblastoma however efficacy is likely impaired by the immunosuppressive tumor microenvironment. We have previously defined a link between intratumoral copper levels and immune evasion. Here, we report that adjuvant copper chelation potentiates anti-GD2 antibody therapy to confer durable tumor control in immunocompetent models of neuroblastoma.

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Background: Acute application of adjunctive negative pressure wound therapy (NPWT) significantly improves time to re-epithelialization in pediatric burn patients. This adjunctive treatment has not yet been broadly or routinely adopted as a standard primary burns dressing strategy. The Implementation of Negative PRessurE for acute Pediatric burns (INPREP) trial will implement and evaluate the impact of adjunctive NPWT in parallel with co-designed implementation strategies and resources across four major pediatric hospitals.

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