1,117 results match your criteria: "Nemours Children's Hospital.[Affiliation]"

Objectives: Opioid use disorder (OUD)-associated overdose deaths have reached epidemic proportions worldwide. An important driving force for relapse is anxiety associated with opioid withdrawal. We hypothesized that our new technology, termed heterodyned whole-body vibration (HWBV) would ameliorate anxiety associated with OUD.

View Article and Find Full Text PDF

Genetically modified cell therapies (GMCT), particularly immune effector cells (IEC) such as chimeric receptor antigen (CAR) T cells, have shown promise in curing cancer and rare diseases after a single treatment course. Following close behind CAR T approvals are GMCT based on hematopoietic stem cells, such as products developed for hemoglobinopathies and other disorders. Academically sponsored GMCT products, often developed in academic centers without industry involvement, face challenges in sustaining access after completion of early phase studies when there is no commercial partner invested in completing registration trials for marketing applications.

View Article and Find Full Text PDF

Importance: Providing assisted ventilation during delayed umbilical cord clamping may improve outcomes for extremely preterm infants.

Objective: To determine whether assisted ventilation in extremely preterm infants (23 0/7 to 28 6/7 weeks' gestational age [GA]) followed by cord clamping reduces intraventricular hemorrhage (IVH) or early death.

Design, Setting, And Participants: This phase 3, 1:1, parallel-stratified randomized clinical trial conducted at 12 perinatal centers across the US and Canada from September 2, 2016, through February 21, 2023, assessed IVH and early death outcomes of extremely preterm infants randomized to receive 120 seconds of assisted ventilation followed by cord clamping vs delayed cord clamping for 30 to 60 seconds with ventilatory assistance afterward.

View Article and Find Full Text PDF

Diabetes is unique among chronic diseases because clinical outcomes are intimately tied to how the person living with diabetes reacts to and implements treatment recommendations. It is further characterised by widespread social stigma, judgement and paternalism. This physical, social and psychological burden collectively influences self-management behaviours.

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to assess the effectiveness of a computational phenotype (CP ABD) in identifying acute brain dysfunction (ABD) in pediatric sepsis patients, which occurs in about 20% of cases but is difficult to detect.
  • - Researchers tested CP ABD against traditional methods (Glasgow Coma Scale and delirium scores) using a dataset of 527 children, finding that CP ABD had the highest diagnostic performance, sensitivity (83%), and specificity (93%).
  • - The findings suggest that CP ABD is a superior tool for identifying confirmed ABD in pediatric sepsis, providing a reliable method for future research using large electronic health records.
View Article and Find Full Text PDF

A newborn girl presented to the hospital on the first day of life because of respiratory failure. She was born at home at 37 weeks' gestation with minimal prenatal care and was found to be small for gestational age. The patient was found to have partial sternal agenesis and sternal cleft, cutis aplasia, left facial hemangioma, micrognathia, wide-spaced nipples, and low-set ears.

View Article and Find Full Text PDF

Background: There is no FDA-approved left ventricular assist device (LVAD) for smaller children permitting routine hospital discharge. Smaller children supported with LVADs typically remain hospitalized for months awaiting heart transplant-a major burden for families and a challenge for hospitals. We describe the initial outcomes of the Jarvik 2015, a miniaturized implantable continuous flow LVAD, in the NHLBI-funded Pumps for Kids, Infants, and Neonates (PumpKIN) study, for bridge-to-heart transplant.

View Article and Find Full Text PDF

Purpose: To compare the outcomes of fluoroscopic versus portable placement of peripherally inserted central catheters (PICCs) and central venous catheters (CVCs) in pediatric patients.

Materials And Methods: This is a single-center, retrospective review of 346 upper-extremity PICC placements (286 fluoroscopic and 60 portable; mean age, 9.83 years [SD ± 5.

View Article and Find Full Text PDF

Molecular genetics enables more precise diagnoses of skeletal dysplasia and other skeletal disorders (SDs). We investigated the clinical utility of multigene panel testing for 5011 unrelated individuals with SD in the United States (December 2019-April 2022). Median (range) age was 8 (0-90) years, 70.

View Article and Find Full Text PDF

Chimeric Antigen Receptor T-Cell Treatment in Children.

Pediatr Rev

May 2024

Division of Pediatric Hematology, Oncology, and Cellular Therapy, Nemours Children's Hospital, Wilmington, DE.

View Article and Find Full Text PDF

Validation of new medication use algorithms as proxies for worsening disease activity in patients with juvenile idiopathic arthritis.

Pharmacoepidemiol Drug Saf

May 2024

Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey, USA.

Purpose: To facilitate claims-based research on populations with juvenile idiopathic arthritis (JIA), we sought to validate an algorithm of new medication use as a proxy for worsening JIA disease activity.

Methods: Using electronic health record data from three pediatric centers, we defined new JIA medication use as (re)initiation of disease-modifying antirheumatic drugs or glucocorticoids (oral or intra-articular). Data were collected from 201 randomly selected subjects with (101) or without (100) new medication use.

View Article and Find Full Text PDF
Article Synopsis
  • * A study analyzed over 12,000 TCD/TCDi reports from 28 institutions and found inconsistencies in assessment methods, abnormal velocity definitions, and interpretation of scans, making it difficult to identify key measurements like the time-averaged mean maximum velocity (TAMMV).
  • * The research calls for standardization in reporting TCD/TCDi results, better training for medical personnel, and quality assurance measures to ensure effective use of these diagnostic
View Article and Find Full Text PDF

Evidence from medicine and other fields has shown that gender diversity results in better decision making and outcomes. The incoming workforce of congenital heart specialists (especially in pediatric cardiology) appears to be more gender balanced, but past studies have shown many inequities. Gender-associated differences in leadership positions, opportunities presented for academic advancement, and recognition for academic contributions to the field persist.

View Article and Find Full Text PDF

Introduction: Although 200 000 adolescents undergo anterior cruciate ligament reconstruction (ACLR) surgery annually, no benchmarks for pediatric post-ACLR pain management exist. We created a multicenter, prospective, observational registry to describe pain practices, pain, and functional recovery after pediatric ACLR.

Methods: Participants (n=519; 12-17.

View Article and Find Full Text PDF

Objective: Accurate triage of minor head injuries remains a challenge for mature trauma systems. More than one-third of trauma transfers are overtriaged, and minor head injuries predominate. Overtriage is inefficient, wasteful of resources, and burdensome for families.

View Article and Find Full Text PDF

Introduction: Infants are at risk for thrombotic conditions due to multiple risk factors such as congenital heart defects and sepsis. According to the American College of Chest Physicians (ACCP) 2012 guidelines, enoxaparin may be given for thrombotic conditions at a dose of 1.5 mg/kg/dose every 12 h for patients less than 2 months of age and 1 mg/kg/dose every 12 h for those older than 2 months.

View Article and Find Full Text PDF

Targeting Caregiver Psychopathology in Parent Management Training for Adolescents: A Scoping Review of Commercially Available Treatment Resources.

Child Youth Care Forum

April 2024

Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, USA.

Background: While parent management training (PMT) has been shown to be an effective treatment for adolescents with externalizing concerns, evidence suggests that effectiveness is not equitable across all types of families. Research suggests that caregiver psychopathology may adversely affect PMT success for adolescents. However, it remains unclear whether research on caregiver psychopathology is integrated within adolescent PMT resources (e.

View Article and Find Full Text PDF

Commentary: More is more?

J Thorac Cardiovasc Surg

December 2024

Department of Cardiovascular Services, Nemours Children's Hospital, Orlando, Fla. Electronic address:

View Article and Find Full Text PDF

Objective: Examine associations between time spent in academic activities perceived as meaningful and professional well-being among academic pediatrics faculty.

Methods: The sample comprised 248 full-time pediatric faculty (76% female, 81% white, non-Hispanic, 41% instructor or assistant professor) across the United States who completed an online survey in November 2019. Survey items included sociodemographic and professional characteristics, professional well-being measures (Stanford Professional Fulfillment Index; Maslach Burnout Inventory; Intention to Leave Academic Medicine), perceived meaningfulness of academic activities and assigned time to those activities.

View Article and Find Full Text PDF
Article Synopsis
  • Collagen VI-related dystrophies (COL6-RDs) include a range of conditions such as Ullrich congenital muscular dystrophy (UCMD), which features severe muscle weakness and respiratory issues, and Bethlem muscular dystrophy, which has milder and later-presenting symptoms.
  • Some patients with symptoms typical of COL6-RDs were previously undiagnosed until a deep intronic variant in COL6A1 was identified, leading to a severe form of UCMD in a cohort of 44 patients, except for one with a milder phenotype.
  • The study suggests that a new pseudoexon skipping therapy could effectively reduce the severity of UCMD symptoms by targeting the abnormal transcripts
View Article and Find Full Text PDF

Background: Adolescent Idiopathic Scoliosis (AIS) affects 2%-4% of the general pediatric population. While surgical correction remains one of the most common orthopedic procedures performed in pediatrics, limited consensus exists on the perioperative anesthetic management.

Aims: To examine the current state of anesthetic management of typical AIS spine fusions at institutions which have a dedicated pediatric orthopedic spine surgeon.

View Article and Find Full Text PDF

Unilateral absence of intra-pericardial pulmonary artery is a rare congenital malformation. If untreated, it can lead to morbidity and mortality in adulthood. Early intervention and restoration of physiologic pulmonary blood flow is necessary.

View Article and Find Full Text PDF

The role of an abbreviated ultrasound in the evaluation of necrotizing enterocolitis.

Pediatr Radiol

May 2024

Department of Radiology, Nemours Children's Health System, Florida, Orlando, FL, USA.

Background: Bowel ultrasound is a useful diagnostic tool in the diagnosis and management of necrotizing enterocolitis (NEC) but can be time-consuming and requires technical expertise, particularly for assessing pneumatosis. Previous literature on sonographic evaluation of NEC has focused on a full bowel ultrasound protocol, but the utility of an abbreviated protocol primarily aimed at identifying high-risk sonographic findings without focused bowel assessment has not been well studied.

Objective: This study aims to describe the diagnostic accuracy of an abbreviated ultrasound protocol for identifying high-risk NEC findings.

View Article and Find Full Text PDF