3,868 results match your criteria: "Penn State Hershey Children’s Hospital[Affiliation]"

To investigate the perceptions of lactation experiences of neurology faculty and the impact of lactation time on academic achievement. This was a cross-sectional study utilizing a survey administered across 19 academic neurology centers in the United States. Respondents self-identified as having children and answered questions about lactation at work.

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Introduction: Medical trainees are delaying childbearing due to competing demands of career, financial constraints, and limited parental leave. Delaying childbearing increases the risk of obstetric complications, with up to one-quarter of female physicians facing infertility. Education on family planning and fertility is rarely discussed among medical trainees, and research on medical trainees' knowledge of fertility and infertility is minimal.

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  • This study compares the effectiveness of extubation methods in extremely low-birth-weight (ELBW) infants, focusing on two non-invasive ventilation techniques: synchronized non-invasive positive-pressure ventilation using neurally adjusted ventilatory assist (sNIPPV with NAVA) and conventional non-invasive positive-pressure ventilation (NIPPV).
  • A total of 60 ELBW infants were randomized to receive either sNIPPV with NAVA or NIPPV, with the primary outcome being the need for reintubation and secondary outcomes including the severity of bronchopulmonary dysplasia (BPD) and oxygen requirements.
  • The findings revealed that although extubation failure rates were similar for both groups, the NAVA group showed significantly
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Background: Patients with Ehlers-Danlos syndromes (EDS) often experience high rates of joint subluxations and dislocations, and associated pain that may require surgical interventions. Orthopaedic surgical management is challenging in this population, and patients will often undergo multiple unsuccessful surgeries. Outcomes data specific to patients with EDS are sparse in the orthopaedic surgery literature.

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  • The study aimed to review existing clinical practice guidelines (CPGs) for low back pain (LBP) to identify recommendations that could be classified as low-value and suggested for deimplementation.
  • A total of 21 CPGs were analyzed, resulting in the identification of 135 low-value recommendations grouped into categories such as surgery, medications, and physical therapies, with specific interventions strongly advised against, like traction and opioids.
  • The findings indicated no significant relationship between the quality of the guidelines and the nature or quantity of these low-value recommendations, highlighting a need for careful consideration in LBP management practices among clinicians.
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Importance: There remains a lack of representation of Black physicians in the physician workforce despite decades of national efforts to increase diversity. Historically Black Colleges and Universities (HBCUs) contribute to increasing representation in the workforce in the US. There is limited literature exploring the experiences of HBCU premedical students navigating the journey to medical school.

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  • * Although vaccination efforts have reduced measles cases globally, recent outbreaks in the U.S. show that public health goals for elimination have not been met, with none of the World Health Organization regions achieving measles elimination by 2020.
  • * Key factors for the resurgence of measles outbreaks include vaccine hesitancy, the importation of the virus through international travel, and waning immunity, emphasizing the need for comprehensive public health strategies to combat the disease.
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Neurally Adjusted Ventilatory Assist to Monitor Diaphragmatic Activity in Infantile Botulism.

Pediatrics

November 2024

Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Penn State Health Children's Hospital, Hershey, Pennsylvania.

Article Synopsis
  • Infantile botulism is a serious neuromuscular condition that can lead to paralysis and respiratory complications, prompting the need for mechanical ventilation.
  • A case study of an infant in Pennsylvania highlighted the effective use of Neurally Adjusted Ventilatory Assist (NAVA) alongside botulism immune globulin to monitor and support diaphragm function during recovery.
  • The findings suggest that using a NAVA catheter is beneficial for tracking diaphragm activity, ultimately aiding in decision-making for extubation in infants recovering from infantile botulism.
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The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.

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Objective: Previous studies have shown an association between alteplase for line clearance and central line-associated bloodstream infections (CLABSIs). The objective of this study was to evaluate the use of post-alteplase antibiotics as a CLABSI reduction strategy in pediatric intensive care unit (PICU) patients.

Methods: This was a single center, retrospective, observational study evaluating PICU patients from -January 1, 2014, through August 1, 2021, conducted at a tertiary academic PICU.

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Early-career surgeons must be exposed to a sufficient number of surgical cases of varying complexity in a mentored environment to allow them to solidify, sustain and build on the skills gained in training. Decreased operative volumes at military treatment facilities and assignments that do not include strong mentoring environments can place military surgeons at a disadvantage relative to their civilian counterparts during this critical time following training. The challenge of lower operative volumes in the current interwar lull has been exacerbated by the decline in beneficiary care conducted within the Military Healthcare System.

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  • * The survey had a 28.6% completion rate with 201 responses, revealing that while about half of the institutions using SP platforms have done so for over 2 years, structured training is limited, leading to concerns about hands-on experience and the learning curve associated with SP procedures.
  • * Despite recognizing the clinical benefits of SP surgery, many trainees do not view proficiency in it as essential for career advancement; however, predictors of future SP implementation include academic aspirations and the availability of SP platforms
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Background: There is an unmet need for early detection of heart failure decompensation, allowing patients to be managed remotely and avoid hospitalization.

Objectives: The purpose of this study was to compare a strategy utilizing data from a wearable HF sensor for management following a HF hospitalization to usual care.

Methods: Eligible subjects were discharged from the hospital within the previous 10 days and had a HF event in the previous 6 months.

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Skin injury: Associations with variables related to perfusion and pressure.

Anaesth Intensive Care

November 2024

Institute for Health and Equity, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI 53226, USA.

Article Synopsis
  • Skin injuries, particularly hospital-acquired pressure injuries (HAPIs), pose a significant challenge in critically ill patients, and the study examined how perfusion-related factors might contribute to these injuries.
  • The study involved 533 adult patients in an intensive care unit, analyzing the relationship between various perfusion factors (like vasopressor use and mechanical circulatory support) and the risk of developing HAPIs compared to immobility factors such as long-term mechanical ventilation.
  • Results indicated that perfusion-related issues are more strongly associated with skin injury risk than immobility, suggesting that understanding these factors could lead to new treatment and prevention strategies for skin injuries in critically ill patients.
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  • Developmental and epileptic encephalopathies (DEEs) are serious childhood epilepsy syndromes with frequent seizures and significant cognitive impairments, often not responding to standard treatments.
  • Recent advancements in neuromodulation techniques like deep brain stimulation (DBS) and responsive neurostimulation (RNS) show promise in managing these conditions by targeting specific brain networks involved in seizures.
  • Initial findings, particularly with DBS for Lennox-Gastaut syndrome (LGS), indicate some effectiveness, but mixed results across various DEEs highlight the need for a better understanding of brain networks to guide optimal treatment strategies.
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  • Bipolar disorder is a serious mental health problem that affects people all over the world and can lead to other health issues, especially heart problems.
  • People with bipolar disorder are more likely to have heart diseases and may face a higher chance of dying from them.
  • It's important to learn how bipolar disorder affects the body so that we can better help those who have it stay healthy and manage their heart health.
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Pediatric Long COVID has been associated with a wide variety of symptoms, conditions, and organ systems, but distinct clinical presentations, or subphenotypes, are still being elucidated. In this exploratory analysis, we identified a cohort of pediatric (age <21) patients with evidence of Long COVID and no pre-existing complex chronic conditions using electronic health record data from 38 institutions and used an unsupervised machine learning-based approach to identify subphenotypes. Our method, an extension of the Phe2Vec algorithm, uses tens of thousands of clinical concepts from multiple domains to represent patients' clinical histories to then identify groups of patients with similar presentations.

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  • Hereditary angioedema (HAE) is a chronic disease requiring effective long-term preventive treatments, prompting a study to evaluate the safety and efficacy of garadacimab, a new medication for HAE.
  • In an interim analysis of the ongoing phase 3 VANGUARD study, involving 161 patients, most treatment-emergent adverse events (TEAEs) were mild, with injection-site reactions being the most common, and no serious complications linked to garadacimab were reported.
  • The results showed a significant reduction in HAE attacks, with 60% of patients remaining attack-free, indicating that garadacimab offers a safe and effective long-term treatment option for patients with
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Purpose: NRG-RTOG0617 demonstrated a detrimental effect of uniform high-dose radiation in stage III non-small cell lung cancer. NRG-RTOG1106/ECOG-ACRIN6697 (ClinicalTrials.gov identifier: NCT01507428), a randomized phase II trial, studied whether midtreatment F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) can guide individualized/adaptive dose-intensified radiotherapy (RT) to improve and predict outcomes in patients with this disease.

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Timing of Onset of Garadacimab for Preventing Hereditary Angioedema Attacks.

Clin Exp Allergy

December 2024

Allergy and Immunology, Tenured Professor of Medicine, Pediatrics and Biomedical Sciences, Hershey, Pennsylvania, USA.

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Association of COX-inhibitors with cancer patients' survival under chemotherapy and radiotherapy regimens: a real-world data retrospective cohort analysis.

Front Oncol

September 2024

Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Comprehensive Center for Precision Oncology, Universidade de São Paulo, São Paulo, SP, Brazil.

Article Synopsis
  • The study investigates the effects of non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors (coxibs) on cancer outcomes, emphasizing their potential role in overcoming chemotherapy resistance.
  • Using data from 2008-2022, it compares treated patients (those receiving coxibs, aspirin, or ibuprofen) to control patients, employing statistical techniques to ensure fair comparison and reliable results over five years.
  • Findings indicate that coxibs and ibuprofen are linked to better survival rates in cancer patients, while aspirin shows mixed results, increasing mortality in females but aiding survival in males; further research is encouraged to explore these trends.
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