What is the pathophysiology of inflammation-induced cortical injury in the perinatal brain?

Perinatal exposure to infection/inflammation is highly associated with neural injury, and subsequent impaired cortical growth, disturbances in neuronal connectivity, and impaired neurodevelopment. However, our understanding of the pathophysiological substrate underpinning these changes in brain structure and function is limited. The objective of this review is to summarize the growing evidence from animal trials and human cohort studies that suggest exposure to infection/ inflammation during the perinatal period promotes regional impairments in neuronal maturation and function, including loss of high-frequency electroencephalographic activity, and reduced growth and arborization of cortical dendrites and dendritic spines resulting in reduced cortical volume.

Oculomotor Function in Children and Adolescents with Autism, ADHD or Co-occurring Autism and ADHD.

Oculomotor characteristics, including accuracy, timing, and sensorimotor processing, are considered sensitive intermediate phenotypes for understanding the etiology of neurodevelopmental conditions, such as autism and ADHD. Oculomotor characteristics have predominantly been studied separately in autism and ADHD. Despite the high rates of co-occurrence between these conditions, only one study has investigated oculomotor processes among those with co-occurring autism + ADHD.

Multidimensional, integrative profiling identifies BCL2L1 methylation as a predictor of MCL1 dependency in pediatric malignancies.

Pediatric high-grade gliomas (pHGGs) are the most aggressive brain tumors in children, necessitating innovative therapies to improve outcomes. Unlike adult gliomas, recent research reveals that childhood gliomas have distinct biological features, requiring specific treatment strategies. Here, we focused on deciphering unique genetic dependencies specific to childhood gliomas.

Postoperative delirium under general anaesthesia by remimazolam versus propofol: A systematic review and meta-analysis of randomised controlled trials.

Background: Remimazolam, an ultra-short-acting benzodiazepine, has similar clinical effects to propofol for sedation in general anaesthesia. However, it remains uncertain whether remimazolam could increase postoperative delirium (POD) compared with propofol.

Objectives: The purpose of our study was to compare the incidence of POD between remimazolam and propofol as sedative agents in general anaesthesia.

Increasing Use of Antenatal Magnesium Sulphate Prior to Preterm Birth for Preventing Cerebral Palsy in Australia and New Zealand, 2012-2020: A Binational Registry Study.

We assessed the use of magnesium sulphate prior to preterm birth for preventing cerebral palsy in an Australian and New Zealand registry study. Use increased markedly from 32.3% (2012) to 78.

Updates on neonatal cell and novel therapeutics: Proceedings of the Second Neonatal Cell Therapies Symposium (2024).

Cell therapies as treatments for neonatal conditions have attracted significant research and parent interest over the last two decades. Mesenchymal stromal cells, umbilical cord blood cells and neural stem cells translate from lab, to preclinical and into clinical trials, with contributions being made from all over the world. Effective and timely translation involves frequent reflection and consultation from research-adjacent fields (i.

Protocol for a multisite randomised controlled trial assessing the effect of the Telehealth for Early Developmental Intervention in babies born very preterm (TEDI-Prem) programme on neurodevelopmental outcomes and parent well-being.

Introduction: Infants born very preterm (VPT, <32 weeks' gestation) are at increased risk for neurodevelopmental impairments including motor, cognitive and behavioural delay. Parents of infants born VPT also have poorer mental health outcomes compared with parents of infants born at term.We have developed an intervention programme called TEDI-Prem (Telehealth for Early Developmental Intervention in babies born very preterm) based on previous research.

Provision of continuous renal replacement therapy in children in intensive care in Australia and New Zealand.

Objectives: The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand.

Design: retrospective, binational registry-based cohort study and electronic survey of clinical practice.

Setting: ICUs that contribute to the Australian and New Zealand Paediatric Intensive Care Registry and a survey conducted in November 2021 including ICUs accredited for paediatric intensive care training that provide CRRT for children were part of this study.

Fetal growth restriction adversely impacts trajectory of hippocampal neurodevelopment and function.

The last pregnancy trimester is critical for fetal brain development but is a vulnerable period if the pregnancy is compromised by fetal growth restriction (FGR). The impact of FGR on the maturational development of neuronal morphology is not known, however, studies in fetal sheep allow longitudinal analysis in a long gestation species. Here we compared hippocampal neuron dendritogenesis in FGR and control fetal sheep at three timepoints equivalent to the third trimester of pregnancy, complemented by magnetic resonance image for brain volume, and electrophysiology for synaptic function.

Burkholderia cenocepacia outbreak linked to taps in a neonatal intensive care unit.

Background: Burkholderia cenocepacia complex is an important cause of hospital acquired infections. We describe the management of an outbreak in a neonatal intensive care unit (NICU) due to tap colonisation.

Methods: Microbiological testing of touch (n = 26) and non-touch taps (n = 28), sinks and drains, including genomic sequencing of selected isolates.

Allergen Specific IgE is a Stronger Predictor of Remission Following Peanut Oral Immunotherapy Than Age in Children Aged 1-10 Years.

Background: Remission is the desired outcome following OIT as it allows individuals to discontinue treatment and eat the allergen freely. Early initiation of OIT in infants and toddlers has been embraced as an approach to increase the likelihood of remission. However, there is no high-quality evidence supporting younger age as an independent factor driving remission; available studies are limited by small samples of younger subjects and lack of adjustment for confounding covariates, particularly peanut-specific IgE (sIgE) levels which is closely correlated with age.

Health-related Quality of Life in children and adolescents treated for acute lymphoblastic leukaemia (ALL), compared with healthy peers: a longitudinal study of early survivorship.

Purpose: Survival for childhood Acute Lymphoblastic Leukaemia (ALL) has surpassed 90%, making quality of survival an important endpoint in treatment outcomes. This study examined health-related quality of life (HRQoL) trajectories in early survivorship for patients post-ALL treatment compared with a matched group of healthy peers, and explored the association of individual factors (age, sex) and treatment intensity with HRQoL outcomes.

Methods: Eighty-three paediatric patients aged 4-16 years who recently completed treatment for ALL were recruited to the study, alongside 53 age- and sex-matched healthy children.

Enhancing Pediatric Magnetic Resonance Imaging Preparation: A Qualitative Study of Current Practices and the Role of Virtual Reality Tools.

Background And Objectives: How children prepare for magnetic resonance imaging (MRI) can help reduce the need for sedation and improve access to pediatric health care. Embedding virtual reality (VR) tools within routine preparation for MRI may support this process. The aim of this study was to qualitatively describe the process of preparing a child for MRI in a tertiary health care setting.

Synchronous bilateral adrenalectomy for ACTH-independent Cushing's syndrome in children: multidisciplinary management.

Objective: Adreno CorticoTropic Hormone (ACTH)-independent Cushing's syndrome (CS) in children is very rare but potentially fatal. In bilateral nodular hyperplasia, synchronous bilateral adrenalectomy (SBA) represents the definitive treatment to correct hypercortisolism. We aim to report the multidisciplinary management of this rare condition.

Cost-effectiveness of Oral Immunotherapy for Egg Allergy According to Age of Therapy Commencement.

Background: Egg oral immunotherapy (OIT) can induce desensitization or remission of egg allergy in children.

Objective: To determine the cost-effectiveness of OIT for raw egg allergy in school-age children compared with egg avoidance, and the most cost-effective age at which to commence treatment.

Methods: A decision-analytic Markov model estimated the health and cost outcomes of 1,000 children aged 4 years with egg allergy, comparing different ages of OIT commencement (ages 4-12, inclusive) versus ongoing egg avoidance.

Feasibility and safety of autologous cord blood derived cell administration in extremely preterm infants: a single-centre, open-label, single-arm, phase I trial (CORD-SaFe study).

Background: Evidence from preclinical studies in small and large animal models has shown neuroprotective effects of intravenous administration of umbilical cord blood derived cells (UCBCs). This study aimed to evaluate the feasibility of umbilical cord blood (UCB) collection, extraction of UCBCs, and subsequent safety of intravenous autologous administration of UCBCs in extremely preterm infants (born <28 weeks gestation).

Methods: A single-centre, open-label, single-arm, safety and feasibility clinical intervention trial was conducted at Monash Medical Centre and Monash Children's Hospital, Melbourne, Australia.

A multitiered analysis platform for genome sequencing: Design and initial findings of the Australian Genomics Cardiovascular Disorders Flagship.

Purpose: The Australian Genomics Cardiovascular Disorders Flagship was a national multidisciplinary collaboration. It aimed to investigate the feasibility of genome sequencing (GS) and functional genomics to resolve variants of uncertain significance (VUS) in the clinical management of patients and families with cardiomyopathies, primary arrhythmias, and congenital heart disease (CHD).

Methods: Between April 2019 and December 2021, 600 probands meeting cardiovascular disorder criteria from 17 cardiology and genetics clinics across Australia were enrolled in the Flagship and underwent GS.

Reducing severe intraventricular haemorrhage rates in <26-week preterm infants with bedside assessment and care bundle implementation.

Aim: To assess staff adherence to a 'Preterm Brain Injury Prevention Bundle', and its effectiveness in reducing severe intraventricular haemorrhage (IVH) rates and risk factors in extremely preterm infants born at <26 weeks' gestation.

Methods: Adherence to the bundle was assessed using a novel bedside assessment tool, with immediate feedback to bedside staff post-assessment. Data on IVH rates and associated risk factors were stratified by IVH severity, and compared between pre- and post-bundle implementation.

Reducing unplanned extubation in the neonatal intensive care unit: a quality improvement project.

Background And Aim: Unplanned extubation (UE) is an adverse event that can occur for neonates that are intubated and mechanically ventilated. UE is recognised as an important quality measure in the neonatal intensive care unit (NICU) due to the negative impact these events may have on the neonate. We aimed to use quality improvement (QI) methodology to reduce the rate of UE to the global standard of <1/100 ventilation days.