1,477 results match your criteria: "Monroe Carell Jr. Children's Hospital.[Affiliation]"

The changing field of academic medicine presents unique challenges for physician-scientists, who intricately weave the complexities of research and patient care. These challenges have significantly lengthened the time needed for scientific discoveries to be applied in clinical practice. In response to these escalating demands, the training trajectory for physician-scientists has notably expanded over recent decades.

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Altered Mental Status and Delirium in Pediatric Patients.

Semin Neurol

December 2024

Division of Child and Adolescent Psychiatry, Columbia University Irving Medical Center, New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York.

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.

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Quantifying brain development in the HEALthy Brain and Child Development (HBCD) Study: The magnetic resonance imaging and spectroscopy protocol.

Dev Cogn Neurosci

December 2024

Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA; Institute of Child Development, University of Minnesota, Minneapolis, MN, USA. Electronic address:

The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. The acquisition of multimodal magnetic resonance-based brain development data is central to the study's core protocol. However, application of Magnetic Resonance Imaging (MRI) methods in this population is complicated by technical challenges and difficulties of imaging in early life.

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Common variants increase risk for congenital diaphragmatic hernia within the context of de novo variants.

Am J Hum Genet

November 2024

Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA. Electronic address:

Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly often accompanied by other structural anomalies and/or neurobehavioral manifestations. Rare de novo protein-coding variants and copy-number variations contribute to CDH in the population. However, most individuals with CDH remain genetically undiagnosed.

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Background: Obesity and metabolic dysregulation (MetD) have increasing prevalence and adversely affect asthma morbidity and therapeutic response.

Objective: To determine the role of weight and MetD on incident asthma in adulthood.

Methods: In a retrospective, longitudinal cohort of patients, we performed a time-to-asthma diagnosis analysis after a 3-year landmark period (t-t) during which weight and MetD components were evaluated.

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Article Synopsis
  • Neonates with symptomatic tetralogy of Fallot (sTOF) often require early surgical intervention, which can involve either staged repair (SR) or primary repair (PR), but both strategies expose them to low-dose ionizing radiation that may raise cancer risk.
  • This study analyzed the cumulative radiation exposure and lifetime attributable risk (LAR) of cancer in sTOF patients who underwent either SR or PR, using data from 242 neonates across multiple centers.
  • Results showed that SR resulted in significantly higher radiation exposure compared to PR and highlighted an increased LAR of cancer, particularly for females, emphasizing the need to consider radiation risk when choosing treatment options for this vulnerable group.*
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Integrating a Parenting Assessment into Practice: Pediatric Providers' Time and Perspectives.

Matern Child Health J

October 2024

Vanderbilt Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Doctors' Office Towers, 8th Floor, 2200 Children's Way, Nashville, TN, 37232, USA.

Article Synopsis
  • The study examines the implementation of the Quick Parenting Assessment (QPA) in pediatric primary care to evaluate parenting practices among low-income families.
  • The majority of assessments indicated low parenting risk, with providers spending 15-30 seconds on low-risk cases and up to a minute for high-risk cases, while finding the tool useful in enhancing communication and objectivity.
  • The results suggest that integrating the QPA into well-child visits can positively impact parenting support, emphasizing the tool's utility in value-based healthcare and preventive measures.
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Article Synopsis
  • First branchial cleft anomalies are rare issues in the head and neck area that some kids are born with, and there's not much info on how to classify or treat them properly.
  • * Expert doctors worked together to come up with better ways to identify and manage these anomalies using a method called the Delphi method.
  • * They created a new classification system and treatment guidelines to help doctors give better care to kids with these conditions.
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Practice patterns of cardiovascular magnetic resonance use in the diagnosis of pediatric myocarditis: A survey-based study.

J Cardiovasc Magn Reson

December 2024

Division of Pediatric Cardiology and Pediatric Radiology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA; Le Bonheur Children's Hospital, Memphis, Tennessee, USA. Electronic address:

Background: Cardiovascular magnetic resonance (CMR) is used to diagnose myocarditis in adults and children based on the original Lake Louise criteria (LLC) and more recently the revised LLC. The major change included in the revised LLC was the incorporation of parametric mapping, which significantly increases the sensitivity and specificity of diagnosis. Subsequently, scientific statements have recommended the use of parametric mapping in the diagnosis of myocarditis in children.

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Nontraumatic Pediatric Head and Neck Emergencies: Resource for On-Call Radiologists.

Radiographics

October 2024

From the Department of Radiology, Monroe Carell Jr Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37232 (A.M.F., L.J., R.K., D.C.M., E.S., T.T., S.P., A.S.); Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ (J.V.); and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA (K.S.).

The vast array of acute nontraumatic diseases encountered in the head and neck of pediatric patients can be intimidating for radiologists in training in a fast-paced emergency setting. Although there is some overlap of pediatric and adult diseases, congenital lesions and developmental variants are much more common in the pediatric population. Furthermore, the relative incidences of numerous infections and neoplasms differ between pediatric and adult populations.

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Study Design: Retrospective cohort study.

Objective: This study aims to assess the validity of the Thoracolumbar Injury Classification and Severity Score (TLICS) in patients ≤10 years-old.

Summary Of Background Data: TLICS is a validated measure developed to help facilitate clinical decision-making regarding thoracolumbar spinal trauma in adults.

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Article Synopsis
  • Robotic surgery is transforming minimally invasive approaches, particularly benefiting pediatric surgeons through enhanced precision due to the small surgical areas involved.
  • A unique collaboration between pediatric and adult robotic surgeons facilitated the integration of robotic surgery in an academic setting, evaluating its outcomes against traditional laparoscopic techniques.
  • Results showed that robotic cholecystectomy (RC) is on par with laparoscopic cholecystectomy (LC) in key metrics like procedure duration and patient recovery, highlighting the feasibility and advantages of robotic surgery for pediatric patients.
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The Development of a Pediatric Catatonia Clinical Roadmap for Clinical Care at Vanderbilt University Medical Center.

J Acad Consult Liaison Psychiatry

December 2024

Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center at Village of Vanderbilt, Nashville, TN.

Background: Pediatric catatonia is associated with a high degree of morbidity and mortality in children. However, pediatric catatonia is highly responsive to treatment if rapidly identified and appropriate interventions are administered. To our knowledge, there are no current publications which propose a systematic approach for the management of pediatric catatonia.

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Introduction: Although the ACGME and other accrediting organizations are increasingly emphasizing the importance of clinical learning environments that value diversity, equity, and inclusion, faculty development surrounding behavioral skills that promote inclusivity in the learning environment still needs cultivation. We designed a virtual longitudinal faculty development curriculum focused on direct observation, feedback, and practice of behavioral skills to acknowledge and address microaggressions in the learning environment.

Methods: We used Kern's six steps of curriculum development to create four voluntary virtual workshops offered twice throughout the academic year, with topics including: (1) recognizing and naming microaggressions, (2) apologizing when harm has been experienced, (3) setting expectations surrounding microaggressions, and (4) debriefing microaggressions.

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Background: In phase 3 VOYAGE (NCT02948959; Evaluation of Dupilumab in Children With Uncontrolled Asthma), dupilumab showed clinical efficacy with an acceptable safety profile in children aged 6 to 11 years with uncontrolled moderate to severe type 2 asthma (blood eosinophils ≥150 cells/μL or FeNO ≥20 ppb).

Objective: We analyzed dupilumab's efficacy in children with type 2 asthma by high- or medium-dose inhaled corticosteroids (ICS) at baseline.

Methods: Children were randomized to receive add-on dupilumab 100/200 mg (by body weight ≤30 kg/>30 kg) every 2 weeks or placebo for 52 weeks and stratified by high- or medium-dose ICS at baseline.

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Article Synopsis
  • Opioid medications are essential for critically ill infants but can lead to withdrawal; this study explored the feasibility of an acupressure protocol for treating withdrawal in a pediatric cardiac intensive care unit.
  • Acupressure stickers were used on infants, and results showed that withdrawal weaning phases were significantly shorter for those receiving acupressure, while parents and most healthcare providers had a positive reaction to the treatment.
  • The study concluded that acupressure is a safe, feasible, and accepted treatment, paving the way for further research with larger sample sizes to enhance care for infants reliant on sedative medications.
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Background: Entrustable Professional Activities (EPAs) have emerged as a valuable tool in medical education, enabling the assessment of trainee competence in a real-world context. Despite its growing popularity in other medical specialties, the use of EPAs in pediatric surgery is still relatively new.

Methods: This article provides an overview of the development and application of EPAs in pediatric surgery.

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Background: The majority of opioid analgesics prescribed for pain after ambulatory pediatric surgery remain unused. Most parents do not dispose of these leftover opioids or dispose of them in an unsafe manner. We aimed to evaluate the association of optimal opioid disposal with a multidisciplinary quality improvement (QI) initiative that proactively educated parents about the importance of optimal opioid disposal practices and provided a home opioid disposal kit before discharge after pediatric ambulatory surgery.

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Synoptic operative notes for pediatric surgical oncology provide standardized and structured documentation of surgical procedures performed on pediatric patients with cancer. These reports capture essential details such as preoperative diagnosis, intraoperative findings, surgical technique, and tumor characteristics in a concise and uniform format. By promoting consistency, accuracy, and completeness in reporting, synoptic operative notes facilitate effective communication among multidisciplinary healthcare teams, enhance quality assurance efforts, and streamline data extraction for research purposes.

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Neuroblastoma is the most common extracranial solid tumor diagnosed in children. This inaugural version of the NCCN Guidelines for Neuroblastoma provides recommendations for the diagnosis, risk classification, and treatment of neuroblastoma. The information in these guidelines was developed by the NCCN Neuroblastoma Panel, a multidisciplinary group of representatives with expertise in neuroblastoma, consisting of pediatric oncologists, radiologists, pathologists, surgeons, and radiation oncologists from NCCN Member Institutions.

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Triggered.

J Grad Med Educ

August 2024

is a PGY-6 Fellow, Hospice and Palliative Medicine Fellowship, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.

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What an anesthesiologist should know about pediatric arrhythmias.

Paediatr Anaesth

December 2024

Department of Anesthesiology, Division of Pediatric Cardiac Anesthesiology, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.

Article Synopsis
  • Identifying and treating pediatric arrhythmias is crucial for anesthesiologists, as these conditions can often emerge during anesthesia without prior ECG data, with supraventricular tachycardia being the most prevalent type.
  • * Patients with inherited heart conditions, such as channelopathies or cardiomyopathies, are more vulnerable to arrhythmias, which can be triggered by events like intubation or surgery.
  • * Treatment options include intravenous antiarrhythmics, as common Valsalva maneuvers are often ineffective, and there are significant risks associated with conditions like Wolff-Parkinson-White syndrome that can lead to life-threatening arrhythmias.*
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Objectives: The aim of this study was to compare the guardian-perceived 3-month cosmetic outcome for pediatric lacerations repaired with absorbable sutures, Dermabond, or Steri-Strips. Secondarily, pain and satisfaction with the procedure from both guardian and provider perspectives were compared.

Methods: In this randomized controlled trial, we enrolled a convenience sample of children aged 0 to <18 years who presented with simple linear lacerations (≤5 cm in length, ≤0.

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Purpose: The goal of this study is to characterize the self-reported prevalence of psychiatric comorbidities among patients with adolescent scoliosis.

Methods: Eligible patients across the US were surveyed using ResearchMatch, a validated online platform. The survey collected patient demographics, type of scoliosis, scoliosis treatment received, and the mental health diagnoses and interventions.

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