Treatment of focal anaplastic Wilms tumor: A report from the Children's Oncology Group AREN0321 and AREN03B2 studies.

Background: In the fifth National Wilms Tumor Study, patients received vincristine and dactinomycin (VA) without radiation for stage I focal anaplastic Wilms tumor (FAWT) and VA plus doxorubicin (DD4A) and radiation for stage II-IV FAWT. Four-year event-free survival (EFS) and overall survival (OS) for stage I FAWT were 67.5% and 88.

Prehospital endotracheal intubation success rates for critical care nurses versus paramedics.

Objectives: Prehospital endotracheal intubation (ETI) is a lifesaving procedure with known complications. To reduce ETI-associated morbidity and mortality, organizations prioritize first-pass success (FPS). However, there are few data evaluating the association of FPS with clinician licensure.

BIS Guided Titration of Sevoflurane in Pediatric Patients Undergoing Elective Surgery: A Randomized Controlled Trial.

Background: In pediatric patients, the use of processed EEG monitoring may reduce the amount of anesthesia administered while maintaining adequate depth of anesthesia.

Aims: The primary aim of this study was to evaluate whether use of a BIS monitor to guide sevoflurane administration might reduce the average end tidal sevoflurane concentration used in children 4-18 years of age.

Methods: Participants in three age groups (4-8, 9-12, and 13-18 years) were randomized to either the BIS guided group or the control group.

Rhabdoid Tumor of the Kidney and Soft Tissues: Results from National Wilms Tumor Study-5 and Children's Oncology Group Study AREN0321.

Purpose: National Wilms Tumor Study-5 (NWTS-5) and AREN0321 evaluated the outcomes of children with rhabdoid tumor of the kidney (RTK) and malignant rhabdoid tumor of soft tissues (MRT).

Patients And Methods: Eligible patients with RTK were enrolled prospectively on NWTS-5 (1995-2002) and treated with carboplatin and etoposide alternating with cyclophosphamide (Regimen RTK). Patients with RTK or MRT were enrolled on AREN0321 (2005-2012) and received vincristine, doxorubicin, and cyclophosphamide alternating with carboplatin, cyclophosphamide, and etoposide (Regimens UH-1 or dose-reduced Revised UH-1).

Updates on neurologic manifestations of mitochondrial disease.

Purpose Of Review: Primary mitochondrial disease (PMD) is diverse both genetically and phenotypically. Neurologic manifestations are present at a high rate and often pose complications for providers. The review will discuss common manifestations and how advances in genetic testing have broadened understanding of PMDs.

Ophthalmic Manifestations in a Diverse Pediatric Population with Type I and Type II Stickler Syndrome.

Objective: To characterize and compare our cohorts of pediatric patients with types I and II Stickler syndrome, with a focus on ophthalmic features.

Design: Retrospective cohort study.

Subjects: Twenty-six patients (22 families) with clinical and genetic diagnoses of type I or II Stickler syndrome.

The development and implementation of a preventive integrated behavioral health program in two academic pediatric continuity clinics.

The American: Academy of Pediatrics advocates for a preventive approach to children's mental health (MH) care and pediatric primary care providers (PCPs) are in a unique position to promote the emotional health of their patients, integrate systems for screening and assessment of MH conditions and provide MH intervention and ongoing clinical follow-up. Integration of a behavioral health service into pediatric primary care has the potential to increase the clinical confidence and MH competency of PCPs and improve patient health outcomes through increased access to and delivery of quality MH care in the primary care setting.

Method: This article describes the step-by-step process of developing and implementing a custom integrated behavioral health (IBH) program into two different academic pediatric primary care clinics located in New York, NY and Chicago, IL.

Tcf21 as a founder transcription factor in specifying Foxd1 cells to the juxtaglomerular cell lineage.

Renin is crucial for blood pressure regulation and electrolyte balance, and its expressing cells arise from Forkhead box D1-positive (Foxd1) stromal progenitors. However, factors guiding these progenitors toward renin-secreting cell fate remain unclear. Tcf21, a basic helix-loop-helix (bHLH) transcription factor, is essential in kidney development.

Disparities in Continuous Glucose Monitoring Among Patients Receiving Care in Federally Qualified Health Centers.

Importance: While continuous glucose monitoring (CGM) has been found to improve diabetes care processes and outcomes, adoption remains low.

Objective: To examine the association between CGM prescriptions and individual characteristics among patients with type 1 or 2 diabetes (T1D and T2D, respectively).

Design, Setting, And Participants: Retrospective cross-sectional study using electronic health record data for patients with T1D or T1D from 275 clinic sites nationwide between January 2014 and February 2021.

Postoperative management of pediatric patients undergoing single-stage laryngotracheal reconstruction in the United States: A survey of ASPO members.

Introduction: The postoperative management of single-stage laryngotracheal reconstruction (ssLTR) plays a significant role in the surgery's outcomes. The relatively prolonged period in which the child remains intubated and sedated to allow graft healing may be complicated by pulmonary sequelae, airway obstruction, withdrawal symptoms, and eventually failed extubation. This study aims to assess post-ssLTR practices among pediatric otolaryngologists.

Use of a percutaneous bone fiducial screw for elevating simple closed depressed skull fractures: illustrative cases.

Background: Depressed skull fractures in infants often present as "ping-pong ball" fractures with inward buckling of the calvarium, secondary to trauma. Management varies widely, and few concrete guidelines exist in the literature to guide decision-making when choosing a methodology for fracture elevation. The authors present two cases of attempted depressed skull fracture elevation with traction on a percutaneously placed bone fiducial screw, followed by a review of the literature, in order to further investigate the factors considered when selecting an intervention.

Infectious Morbidity and All-cause Mortality of Infants HIV-exposed Uninfected Compared to Infants HIV-unexposed Uninfected in Botswana.

Some studies have reported increased infectious morbidity and all-cause mortality risk among infants HIV-exposed uninfected compared with infants HIV-unexposed uninfected. In a retrospective analysis of infants enrolled in the Botswana-based Tshilo Dikotla study, we found no difference in the prevalence of infectious hospitalizations or deaths from any cause in the first year of life by perinatal HIV exposure.

Deprescribing Antidepressants in Children and Adolescents: A Systematic Review of Discontinuation Approaches, Cross-Titration, and Withdrawal Symptoms.

Antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly used to treat depressive, anxiety, and obsessive-compulsive disorders in youth. Yet, data on discontinuing these medications, withdrawal symptoms, and strategies to switch between them are limited. We searched PubMed and ClinicalTrials.

Navigating Stigma Against At-Risk Sexual and Gender Minority Populations to End the HIV Epidemic in Sub-Saharan Africa.

In the past year, new laws criminalizing same-sex conduct and the promotion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights have emerged as barriers to addressing the HIV epidemic in sub-Saharan Africa (SSA). An augmented approach to addressing HIV within the region's disproportionately affected LGBTQ populations, particularly transgender women and gay, bisexual, and other men who have sex with men (MSM), is imperative for achieving the international goal of ending the HIV epidemic by 2030. In this article, we present recommendations to bolster the continuum of HIV care for MSM and transgender women in SSA.

The CHD severity classification system: development of a tool to assist with disease stratification for CHD research.

Background: Complexity stratification for CHD is an integral part of clinical research due to its heterogenous clinical presentation and outcomes. To support our ongoing research efforts into CHD requiring disease severity stratifications, a simplified CHD severity classification system was developed and verified, with potential utility for clinical researchers without specialist CHD knowledge or access to clinical/medical records.

Method: A two-tiered analysis approach was undertaken.

Subclinical Myocardial Fibrosis in South African Youth With HIV: Results From the CTAAC-Heart Study.

Background: Few data exist on myocardial fibrosis and inflammation in youth with HIV.

Methods: We performed cardiovascular magnetic resonance (CMR) on a cross section of South African youth: youth with perinatally acquired HIV (YPHIV) undergoing antiretroviral therapy (ART), youth with nonperinatally acquired HIV (YNPHIV) receiving ART, and youth without HIV. Quantile regression models were fit to assess the association between HIV status and CMR outcomes: subclinical fibrosis (late gadolinium enhancement [LGE] mass and fraction, native T1, extracellular volume) and inflammation (native T1, T2 mapping).

Altered Mental Status and Delirium in Pediatric Patients.

Mental status is the collection of an individual's consciousness, perception, emotion, memory, and cognition at a particular point in time, which is inferred by the clinician through careful observation and interaction. The pediatric mental status assessment must be approached with an understanding of cognitive, language, and psychosocial development. Alterations must then be comprehensively and clearly described.

Outcomes of heliox use in children with respiratory compromise: A 10-year single institution experience.

Objective: Heliox, a mixture of helium and oxygen, has been shown to improve laminar airflow and decrease airway resistance in children. This study aims to describe the outcomes of heliox use in children with respiratory compromise and to identify variables associated with a need for airway surgical intervention.

Methods: A retrospective cohort study of patients who received heliox between 2012 and 2022 at a tertiary care children's hospital.