246 results match your criteria: "Penn State Health Children's Hospital.[Affiliation]"

This perspective work by academic neonatal providers is written specifically for the audience of newborn care providers and neonatologists involved in neonatal hypoglycemia screening. Herein, we propose adding a screen for congenital hyperinsulinism (CHI) by measuring glucose and ketone (i.e.

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Levetiracetam Dosing Based on Glasgow Coma Scale Scores in Pediatric Traumatic Brain Injury Patients.

Neuropediatrics

August 2024

Department of Pediatrics, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, Pennsylvania, United States.

Introduction: Severe traumatic brain injury (TBI) increases the risk of early posttraumatic seizures (EPTS). Guidelines suggest the use of prophylactic antiseizure agents, including levetiracetam. This study aims to evaluate the feasibility of using levetiracetam dosing based on Glasgow Comas Scale (GCS) scores with higher doses used for more severe TBI.

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Background: Most high-risk neuroblastoma patients who relapse succumb to disease despite the existing therapy. We recently reported increased event-free and overall survival in neuroblastoma patients receiving difluoromethylornithine (DFMO) during maintenance therapy. The effect of DFMO on cellular processes associated with neuroblastoma tumorigenesis needs further elucidation.

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Background Handoffs between medical providers serve a crucial patient safety function. While most published literature on the topic studies the handover process among physicians, robust literature is available on interdisciplinary medical communication. Little is known about the downstream effects of effective physician handover on subsequent physician and nursing interactions.

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Article Synopsis
  • The study aimed to investigate how congenital anomalies at the atlanto-occipital joint affect the stability of the craniovertebral junction (CVJ) in children with Chiari malformation type I and syringomyelia, focusing on the prevalence of certain anomalies and their connection to occipitocervical fusion (OCF) after surgery.
  • Researchers analyzed data from patients in the Park-Reeves Syringomyelia Research Consortium, comparing those who underwent posterior fossa decompression with OCF to those who only had posterior fossa decompression, while ensuring both groups were similar in age, sex, and symptoms.
  • Results indicated that the group which underwent both procedures had significantly higher angles
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Background Handoffs serve a critical patient safety function in the transition between caregivers. In 2006, the Joint Commission on Accreditation of Healthcare Organizations strongly recommended the implementation of "a standardized approach to 'handoff' communications, including an opportunity to ask and respond to questions." Numerous studies have investigated the quality and efficacy of patient handoffs and the utility of structured handoff curriculums, particularly in the context of patient safety and outcomes.

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Article Synopsis
  • The study aimed to identify factors linked to successful second attempts at neonatal tracheal intubation and the risk of complications after a failed first attempt.
  • Conducted in 18 academic NICUs using a large data set, it analyzed cases where neonates needed two or more intubation attempts from October 2014 to December 2021.
  • Results showed that success rates for second attempts improved significantly when changes were made to the intubator, stylet use, or endotracheal tube size, with specific changes reducing the chances of severe desaturation.
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Background: Nasal tracheal intubation (TI) represents a minority of all TI in the pediatric intensive care unit (PICU). The risks and benefits of nasal TI are not well quantified. As such, safety and descriptive data regarding this practice are warranted.

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Nutritional assessment and dietary intervention among survivors of childhood cancer: current landscape and a look to the future.

Front Nutr

January 2024

Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY, United States.

Over 85% of childhood cancer patients become long-term survivors. Still, cancer and its therapies are associated with a myriad of long-term complications such that childhood cancer survivors (CCS) endure excess disease burden, morbidity, and mortality throughout their lifetimes. Existing literature suggests that CCS maintain poor dietary intake and nutritional status.

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Background: Children with relapsed central nervous system (CNS tumors), neuroblastoma, sarcomas, and other rare solid tumors face poor outcomes. This prospective clinical trial examined the feasibility of combining genomic and transcriptomic profiling of tumor samples with a molecular tumor board (MTB) approach to make real‑time treatment decisions for children with relapsed/refractory solid tumors.

Methods: Subjects were divided into three strata: stratum 1-relapsed/refractory neuroblastoma; stratum 2-relapsed/refractory CNS tumors; and stratum 3-relapsed/refractory rare solid tumors.

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Objective: This study investigates the difference in the rates of bronchopulmonary dysplasia in very low birth weight infants before and after the introduction of neurally adjusted ventilatory assist (NAVA).

Study Design: A retrospective cohort study comparing rates of Bronchopulmonary dysplasia (BPD) before and after implementation of NAVA. Eligibility criteria included all very low birth weight VLBW neonates needing ventilation.

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Artificial intelligence in pediatric surgery.

Semin Pediatr Surg

February 2024

Division of Pediatric Surgery, Penn State Health Children's Hospital, 500 University Drive, Hershey, PA 17033, United States.

Artificial intelligence (AI) is rapidly changing the landscape of medicine and is already being utilized in conjunction with medical diagnostics and imaging analysis. We hereby explore AI applications in surgery and examine its relevance to pediatric surgery, covering its evolution, current state, and promising future. The various fields of AI are explored including machine learning and applications to predictive analytics and decision support in surgery, computer vision and image analysis in preoperative planning, image segmentation, surgical navigation, and finally, natural language processing assist in expediting clinical documentation, identification of clinical indications, quality improvement, outcome research, and other types of automated data extraction.

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Objective: The objective of this retrospective review was to evaluate whether or not pulsatile flow improves cerebral hemodynamics and clinical outcomes in pediatric congenital cardiac surgery patients.

Methods: This retrospective study included 284 pediatric patients undergoing congenital cardiac surgery with cardiopulmonary bypass support utilizing nonpulsatile (n = 152) or pulsatile (n = 132) flow. Intraoperative cerebral gaseous microemboli counts, pulsatility index, and mean blood flow velocity at the right middle cerebral artery were assessed using transcranial Doppler ultrasound.

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The authors reply.

Pediatr Crit Care Med

January 2024

Department of Pediatrics, Penn State College of Medicine, Penn State Hershey Pediatric Cardiovascular Research Center, Penn State Health Children's Hospital, Hershey, PA.

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That head lag is impressive! Infantile botulism in the NICU: a case report.

Matern Health Neonatol Perinatol

January 2024

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Penn State Health Children's Hospital, 500 University Dr, Hershey, PA, 17033, USA.

Background: Infantile botulism (IB) is a devastating and potentially life-threatening neuromuscular disorder resulting from intestinal colonization by Clostridium botulinum and the resultant toxin production. It can present with constipation, descending paralysis, and, potentially, respiratory failure. Botulism is a diagnosis that is more commonly seen in the pediatric intensive care unit (PICU) or on the general pediatric wards and would not typically be managed in the neonatal intensive care unit (NICU), and therefore requires high clinical suspicion to ensure prompt diagnosis and treatment.

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Objectives: Our objective was to understand the perspectives of current and recently graduated pediatric residents concerning the impact of the COVID-19 pandemic, and subsequent curriculum changes, to their education.

Introduction: Residency programs have experienced unprecedented alterations to education in the form of changing expectations, schedules, and opportunities during the COVID-19 pandemic. Little is known regarding resident perceptions of how these changes impact their education and ultimate career preparation.

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Objectives: Children with trisomy 21 often have anatomic and physiologic features that may complicate tracheal intubation (TI). TI in critically ill children with trisomy 21 is not well described. We hypothesize that in children with trisomy 21, TI is associated with greater odds of adverse airway outcomes (AAOs), including TI-associated events (TIAEs), and peri-intubation hypoxemia (defined as > 20% decrease in pulse oximetry saturation [Sp o2 ]).

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Background: Acute kidney injury (AKI) occurs commonly in pediatric septic shock and increases morbidity and mortality. Early identification of high-risk patients can facilitate targeted intervention to improve outcomes. We previously modified the renal angina index (RAI), a validated AKI prediction tool, to improve specificity in this population (sRAI).

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Cardiac electrical abnormalities in childhood acute lymphoblastic leukemia survivors: a systematic review.

Cardiooncology

November 2023

Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, 2100, Boulevard Édouard Montpetit, Montreal, QC, H3C 3J7, Canada.

Purpose: The aim was to provide evidence about the prevalence, incidence, and risk factors of cardiac electrical abnormalities in childhood acute lymphoblastic leukemia (ALL) survivors.

Methods: We included all original studies reporting the incidence and/or prevalence of cardiac electrical abnormalities and/or risk factors associated with cardiac electrical abnormalities in childhood ALL survivors (< 21 years old at the time of their initial cancer diagnosis) who were post-treatment. Searches of the databases PubMed, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions(R), Ovid All EBM Reviews, Ovid Embase, and ISI Web of Science were completed in May 2023.

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Article Synopsis
  • The study examines the relationship between being underweight or obese and negative airway outcomes during tracheal intubation in critically ill children aged 0-17, using data from a national registry between 2013-2020.
  • Findings show that underweight (27.5% of patients) and obese (8.2% of patients) children are at a higher risk of experiencing adverse intubation-related events and severe hypoxemia compared to those of normal weight (57.1%).
  • It was noted that underweight children are particularly vulnerable, having higher incidences of oxygenation and ventilation failure as the reason for intubation, and they face a greater chance of negative airway outcomes compared to normal weight peers.
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Purpose: Long-term survival in high-risk neuroblastoma (HRNB) is approximately 50%, with mortality primarily driven by relapse. Eflornithine (DFMO) to reduce risk of relapse after completion of immunotherapy was investigated previously in a single-arm, phase II study (NMTRC003B; ClinicalTrials.gov identifier: NCT02395666) that suggested improved event-free survival (EFS) and overall survival (OS) compared with historical rates in a phase III trial (Children Oncology Group ANBL0032; ClinicalTrials.

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Holistic care and symptom management for pediatric kidney transplant recipients.

Pediatr Nephrol

June 2024

Division of Pediatric Nephrology and Hypertension, Departments of Pediatrics and Humanities, Penn State College of Medicine, Penn State Health Children's Hospital, 90 Hope Drive, PO Box 855, Hershey, PA, 17036, USA.

While many aspects of life may improve substantially for children and young people undergoing kidney transplant, there may be new challenges including symptoms that can be detrimental to health-related quality of life. Addressing symptoms requires attention to patient and family perspectives and a holistic approach grounded in symptom management. The interdisciplinary pediatric nephrology transplant team should be attuned to the prevalence of common symptoms including fatigue, anxiety, depression, post-traumatic stress, pain, and sleep disturbances, as well as poor body image and sexual health.

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