1,333 results match your criteria: "McMaster Children's hospital[Affiliation]"

Prediction of emergency department revisits among child and youth mental health outpatients using deep learning techniques.

BMC Med Inform Decis Mak

February 2024

Department of Psychiatry & Behavioural Neurosciences, McMaster University, 1280 Main St W, Hamilton, Ontario, L8S 4K1, Canada.

Background: The proportion of Canadian youth seeking mental health support from an emergency department (ED) has risen in recent years. As EDs typically address urgent mental health crises, revisiting an ED may represent unmet mental health needs. Accurate ED revisit prediction could aid early intervention and ensure efficient healthcare resource allocation.

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Aim: A major barrier to performing cardiac arrest trials is the requirement for prospective informed consent, which is often infeasible during individual medical emergencies. In an effort to improve outcomes, some governments have adopted legislation permitting research without prior consent (RWPC) in these circumstances. We aimed to outline key differences between legislation in four Western locations and explore the effects of these differences on trial design and implementation in cardiac arrest research.

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Background: Direct oral anticoagulants are commonly prescribed for adults and increasingly also for children requiring anticoagulation therapy. While household medications should not be accessible to children, accidental, and intentional overdoses occur.

Key Clinical Question: How should apixaban overdose in children be managed?.

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Introduction: Bronchiolitis is the most common viral lower respiratory tract infection in children under 2 years of age. Respiratory support with high-flow nasal cannula (HFNC) is increasingly used in this patient population with limited understanding of the patients most likely to benefit and considerable practice variability of use. This study aims to understand the factors associated with failure of HFNC support among patients with bronchiolitis and to describe the current practice variations of HFNC use in patients with bronchiolitis in Canadian hospitals including fluid management and parameters to initiate, escalate and discontinue HFNC support.

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Background: Social ABCs is a caregiver-mediated Naturalistic Developmental Behavioral Intervention for toddlers with confirmed/suspected Autism Spectrum Disorder (ASD), with evidence in controlled research settings. Information is lacking on implementation in community settings. We reported on the treatment effectiveness of this program within a community setting, and the current paper describes the implementation phase of this work.

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The 2017 classification of the epilepsies of International League Against Epilepsy (ILAE) defined three diagnostic levels, including seizure type, epilepsy type and epilepsy syndrome. Epilepsy syndromes have been recognized as distinct electroclinical entities well before the first ILAE classification of Epilepsies and Epilepsy Syndromes in 1985. A formally accepted classification of epilepsy syndromes was not available, and hence, the 2017-2021 Nosology and Definitions Task Force of ILAE was formulated.

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Pediatric orbital lesions: ocular pathologies.

Pediatr Radiol

May 2024

Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, Canada.

Orbital pathologies can be broadly classified as ocular, extra-ocular soft-tissue (non-neoplastic and neoplastic), osseous, and traumatic. In part 1 of this orbital series, the authors will discuss the differential diagnosis and key imaging features of pediatric ocular pathologies. These include congenital and developmental lesions (microphthalmos, anophthalmos, persistent fetal vasculature, coloboma, morning glory disc anomaly, retinopathy of prematurity, Coats disease), optic disc drusen, infective and inflammatory lesions (uveitis, toxocariasis, toxoplasmosis), and ocular neoplasms (retinoblastoma, retinal hamartoma, choroidal melanoma, choroidal nevus).

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Objective: Sepsis often prompts clinicians to start empirical antibiotics in suspected neonates while awaiting diagnosis. The next-generation testing with point-of-care (POC) techniques offers a lead-time advantage that could bridge the gap by providing a timely diagnosis.

Materials And Methods: We conducted a prospective diagnostic study in 82 neonates enrolled between May and October 2022 in a level III neonatal intensive care unit.

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Development of the Pediatric Integrated Nutrition Pathway for Acute Care (P-INPAC) using a modified Delphi technique.

Appl Physiol Nutr Metab

May 2024

Division of Paediatric Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.

One in three hospitalized children have disease-related malnutrition (DRM) upon admission to hospital, and all children are at risk for further nutritional deterioration during hospital stay; however, systematic approaches to detect DRM in Canada are lacking. To standardise and improve hospital care, the multidisciplinary pediatric working group of the Canadian Malnutrition Taskforce aimed to develop a pediatric, inpatient nutritional care pathway based on available evidence, feasibility of resources, and expert consensus. The working group ( = 13) undertook a total of four meetings: an in-person meeting to draft the pathway based on existing literature and modelled after the Integrated Nutrition Pathway for Acute Care (INPAC) in adults, followed by three online surveys and three rounds of online Delphi consensus meetings to achieve agreement on the draft pathway.

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Is an all-age service the answer to poor transitions for adolescents with eating disorders?

Eur Eat Disord Rev

May 2024

Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

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Imported congenital malaria caused by : A case report.

Ther Adv Infect Dis

February 2024

Division of Pediatric Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada.

We describe a 5-week-old term infant with severe congenital malaria in a non-endemic setting. She presented with diarrhea, poor feeding, lethargy, hepatosplenomegaly, and severe anemia. She was fortuitously diagnosed with malaria on routine blood smear, and successfully treated with intravenous artesunate.

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Article Synopsis
  • The study aimed to evaluate the impact of an early rehabilitation program on critically ill children’s functioning, health-related quality of life (HRQL), and parental stress after they leave the Pediatric Intensive Care Unit (PICU).
  • Conducted at two hospitals in Ontario, Canada, the intervention involved a rehabilitation bundle including pain management, delirium prevention, and early mobilization for children expecting to stay in the PICU for 48 hours.
  • The results showed that after the rehabilitation bundle was implemented, there was no significant improvement in children’s recovery or decreased parental stress, with many children still experiencing functional decline and low HRQL at discharge and follow-ups.
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Context: PICUs across Canada restricted family presence (RFP) in response to the COVID-19 pandemic from allowing two or more family members to often only one family member at the bedside. The objective of this study was to describe the experiences and impact of RFP on families of critically ill children to inform future policy and practice.

Hypothesis: RFP policies negatively impacted families of PICU patients and caused moral distress.

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Objectives: A biopsychosocial approach to understanding and treating pain is crucial; however, there are limited socially targeted interventions for adolescents with chronic pain (ACP). Peer support interventions implemented with other populations are associated with positive outcomes. ACPs perceive peer support to have high potential value.

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Article Synopsis
  • Many autistic kids and teens struggle with emotional and behavior problems, affecting 40-70% of them, and this can lead to serious difficulties in their lives.
  • Family issues, like feeling isolated or having parents with mental health problems, can make these struggles worse and make it harder for families to get help.
  • The study is testing a program called FCU® that helps families manage these challenges better and looks at how it works for autistic kids in a real-life setting in Ontario, Canada.
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Article Synopsis
  • Pediatric low-grade glioma (pLGG) is mainly caused by genomic changes in the MAPK pathway, particularly KIAA1549::BRAF fusions and BRAF V600E mutations, making it suitable for targeted therapies like tovorafenib instead of traditional treatments.
  • The combination of dabrafenib and trametinib is FDA-approved for BRAF V600E-pLGG but not effective for tumors with BRAF fusions, as it may worsen tumor growth.
  • The LOGGIC/FIREFLY-2 trial is assessing tovorafenib against standard chemotherapy in patients under 25 with pLGG and BRAF mutations, focusing on overall response rate and safety.
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Malnutrition affects up to one in three Canadian children admitted to hospital. Awareness among pediatric healthcare providers (HCPs) of the prevalence and impacts of hospitalized malnutrition is critical for optimal management. The purpose of this study was to determine perceptions of malnutrition among pediatric HCP across two major academic health sciences centres, and to determine how the use of a standardized pediatric nutritional screening tool at one institution affects responses.

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Frequency, distribution and prognostic meaning of ALK-partner genes other than NPM1 in ALK-positive anaplastic large-cell lymphoma (ALCL) are unknown. Forty-nine of 316 ALCL diagnosed in the NHL-BFM study group showed no nuclear ALK expression suggestive of a variant ALK-partner; 41 were analysed by genomic capture high-throughput sequencing or specific RT-PCRs. NPM1::ALK was detected in 13 cases.

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Importance: Childhood cancer survivors (CCS) are at risk for late effects of different organ systems. The currently available screening recommendations for those treated with high-dose methotrexate (HD-MTX) are not uniform and the available literature is limited.

Objective: We aim to assess the prevalence and severity of late effects in CCS treated with HD-MTX at a single centre in Switzerland.

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Type 1 Diabetes in Ontario Schools: Policy and Practice.

Can J Diabetes

June 2024

Division of Endocrinology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.

Objectives: Type 1 diabetes (T1D) is a challenging chronic condition. Young children with T1D require daily support to manage their condition while at school. In 2018, Ontario established a provincial policy to ensure safe and equitable school participation for children with diabetes.

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Article Synopsis
  • The study aimed to implement an early rehabilitation bundle in two Canadian Pediatric Intensive Care Units (PICUs), focusing on improving patient care through specific interventions.
  • Key components of the intervention included prioritizing pain management, monitoring for delirium, and promoting early mobilization among children under 18 admitted to the PICU.
  • While the implementation improved compliance and reduced certain sedative use without compromising patient safety or comfort, it did not have a significant impact on overall clinical outcomes like delirium rates or PICU length of stay.
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The importance of animal specificity in animal experimentation, part II: Physiological challenges and opportunities in relation to pediatric urology.

J Pediatr Urol

April 2024

Department of Pediatric Surgery, Surgical Clinic C, Rigshospitalet, Copenhagen University, Clinical Medicine, Copenhagen, Denmark; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. Electronic address:

Article Synopsis
  • Animal experimentation in Pediatric Urology requires understanding physiological differences between species and selecting appropriate disease models instead of just healthy animals.
  • Diseased models can better simulate human pathologies, especially for conditions like congenital malformations and effects of prenatal factors.
  • Properly formulating research questions is essential before choosing the right animal models and species for these studies.
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