The impact of current pediatric anesthesiology fellows shortfall on freestanding children's hospitals and practices.

The pediatric anesthesiology workforce is currently facing a critical shortage, which will have significant consequences for patient care and the healthcare system as a whole. The workforce is aging, and despite increasing numbers of anesthesiology residents, fewer graduates are entering the field of pediatrics. It should also be noted that fewer medical school graduates are entering pediatrics as well.

Longitudinal Assessment of T1 Mapping Trends Disease in Pediatric Patients With Heart Transplant.

Background: Surveillance for heart transplant rejection by endomyocardial biopsy is invasive and may yield false negatives. T1 and T2 mapping from cardiac magnetic resonance can demonstrate elevations with rejection. We sought to evaluate longitudinal changes in T1 and T2 mapping in pediatric patients with heart transplant.

Mechanical properties of pediatric low-grade gliomas in children with and without neurofibromatosis type 1.

Introduction: Prognoses for pediatric brain tumors are suboptimal, as even in low-grade tumors, management techniques can lead to damage in the developing brain. Therefore, advanced neuroimaging methods are critical for developing optimal management plans and improving patient care. Magnetic resonance elastography (MRE) has allowed for the characterization of adult gliomas by their mechanical properties, which are uniquely sensitive to the complex interplay of cellularity, vasculature, and interstitium.

Low Anti-Tumor Necrosis Factor Levels During Maintenance Phase Are Associated With Treatment Failure in Children With Crohn's Disease.

Background: Higher drug levels and combination therapy with low-dose oral methotrexate (LD-MTX) may reduce anti-tumor necrosis factor (TNF) treatment failure in pediatric Crohn's disease. We sought to (1) evaluate whether combination therapy with LD-MTX was associated with higher anti-TNF levels, (2) evaluate associations between anti-TNF levels and subsequent treatment failure, and (3) explore the effect of combination therapy on maintenance of remission among patients with therapeutic drug levels (>5 µg/mL for infliximab and >7.5 µg/mL for adalimumab).

Pre-clinical and clinical trials for anesthesia in neonates: gaps and future directions.

Literature examining possible deleterious effects of anesthesia exposure on the developing brain has increased substantially over the past 30 years. Initial concerning findings in animal models, both rodents and non-human primates, prompted increasingly thorough examinations in humans, including randomized controlled trials. This review will provide a concise overview of what we know about anesthesia and the developing brain: the background in animal studies, the most robust results we have in humans, and the work yet to be done.

Parent and adolescent perspectives on a novel transdisciplinary model of healthcare delivery for type 1 diabetes.

Objective: We aimed to obtain pre-adolescent/adolescent and parent input on a proposed transdisciplinary model for routine type 1 diabetes (T1D) healthcare in which an advanced practice nurse, dietitian, and psychologist with expertise in T1D and extensive cross-discipline training co-deliver care during quarterly T1D care visits using a family-focused approach.

Methods: Participants were 17 parent-youth dyads plus one additional adolescent who responded to open-ended questions about the structure and format of the proposed transdisciplinary care model via an online, private social network. A six-member coding team developed and revised a codebook, coded question responses through iterative cycles of inductive coding, and distilled major recurring themes to obtain perspectives on the transdisciplinary care model and feedback on improving the model.

The Prevalence of Anxiety and Depression in Children With Postural Orthostatic Tachycardia Syndrome (POTS): A Retrospective Study.

Introduction: Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance characterized by various symptoms such as dizziness, lightheadedness, and increased heart rate. Conflicting reports exist regarding the prevalence of anxiety and depression in adults with POTS, while data on pediatric POTS remains scarce.

Method: A retrospective analysis of pediatric patients aged 11-17 years with POTS, who underwent autonomic testing at Nemours Children's Hospital in Orlando, Florida, was conducted.

Characterizing medical decision-making in sickle cell disease during childhood: Qualitative perspectives of caregivers.

Introduction: Sickle cell disease (SCD) is the most common genetic disorder among children. As the most common type of SCD, sickle cell anemia (SCA) is associated with severe complications across the lifespan. As parents/caregivers hold primary disease management responsibility during childhood, their involvement in disease management activities, including medical decision-making, is critical to successful and timely management of pediatric SCD.

Vein of Galen Aneurysmal Malformation Presenting As Persistent Pulmonary Hypertension in a Newborn: A Case Report.

We present a case of a newborn infant with a vein of Galen aneurysmal malformation (VOGM) who was admitted to our neonatal intensive care unit (NICU) with the diagnosis of persistent pulmonary hypertension of the newborn (PPHN). Further work-up at our institution, which included an echocardiogram and cranial ultrasound revealed VOGM. The patient was transferred to a children's center for further management of the vascular malformation where the patient subsequently died from high cardiac output heart failure.

Creation to Dissemination: A Roadmap for Health Equity Research.

Health equity is the point at which all individuals have an equal opportunity to experience optimal health and thriving. The current state of health care is far from this ideal as numerous populations experience health disparities: differences in health or health outcomes that negatively impact groups who experience systemic disadvantage. All research has the potential to widen, maintain, or close health disparities.

Leading a Palliative Care Team Through Times of Growth And Change.

High-functioning palliative care teams are essential to high-quality care for individuals with serious illness and their families. Such teams are flexible and adapt to change. However, recent high turnover and understaffing, compounded by a pandemic, challenge even the most resilient and adaptable teams.

ChatGPT-4 Surpasses Residents: A Study of Artificial Intelligence Competency in Plastic Surgery In-service Examinations and Its Advancements from ChatGPT-3.5.

Background: ChatGPT, launched in 2022 and updated to Generative Pre-trained Transformer 4 (GPT-4) in 2023, is a large language model trained on extensive data, including medical information. This study compares ChatGPT's performance on Plastic Surgery In-Service Examinations with medical residents nationally as well as its earlier version, ChatGPT-3.5.

Quantifying the Spectrum of Early Motor and Language Milestones in Sex Chromosome Trisomy.

Background And Objectives: Sex chromosome trisomy (SCT) is a common chromosomal abnormality associated with increased risks for early developmental delays and neurodevelopmental disorders later in childhood. Our objective was to quantify the spectrum of early developmental milestones in SCT. We hypothesized later milestone achievement in SCT than the general population.

Concurrent ependymal and ganglionic differentiation in a subset of supratentorial neuroepithelial tumors with EWSR1-PLAGL1 rearrangement.

Neuroepithelial tumors with fusion of PLAGL1 or amplification of PLAGL1/PLAGL2 have recently been described often with ependymoma-like or embryonal histology respectively. To further evaluate emerging entities with PLAG-family genetic alterations, the histologic, molecular, clinical, and imaging features are described for 8 clinical cases encountered at St. Jude (EWSR1-PLAGL1 fusion n = 6; PLAGL1 amplification n = 1; PLAGL2 amplification n = 1).

Evaluating the Efficacy of Large Language Models in CPT Coding for Craniofacial Surgery: A Comparative Analysis.

Background: The advent of Large Language Models (LLMs) like ChatGPT has introduced significant advancements in various surgical disciplines. These developments have led to an increased interest in the utilization of LLMs for Current Procedural Terminology (CPT) coding in surgery. With CPT coding being a complex and time-consuming process, often exacerbated by the scarcity of professional coders, there is a pressing need for innovative solutions to enhance coding efficiency and accuracy.

The Role of Vitamin D Levels in Optimizing Treatment for Pediatric Inflammatory Bowel Disease (IBD) Patients and an Examination Into Different Factors That Influence IBD Treatment Outcomes.

Background Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), presents significant challenges, particularly in pediatric patients. Vitamin D deficiency has been associated with IBD, but its role in disease activity and remission remains unclear. This study investigates the relationship between serum vitamin D levels and IBD markers, including Pediatric Crohn's Disease Activity Index (PCDAI), Pediatric Ulcerative Colitis Activity Index (PUCAI), fecal calprotectin levels, and endoscopy findings.