1,745 results match your criteria: "Primary Children's Hospital.[Affiliation]"

Vocal tics can occur in neuropsychiatric disorders and result in familial distress. Management is challenging, particularly in children with developmental delay. A 5-year-old with cerebral dysgenesis presented with a high amplitude, high-frequency vocal tic.

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 Recombinant fusion protein linking coagulation factor IX (FIX) with albumin (rIX-FP) has been shown to be an effective, well-tolerated treatment for patients with severe hemophilia B who had previously received factor replacement therapy. This study investigated the safety and efficacy of rIX-FP in previously untreated patients (PUPs).  Patients with moderately severe/severe hemophilia B (≤2% FIX) previously untreated with FIX replacement products received rIX-FP (25-75 IU/kg) prophylaxis weekly or on-demand treatment over ≥50 exposure days (EDs).

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Development, contributions, and future directions of a multicenter child abuse research network.

Curr Probl Pediatr Adolesc Health Care

March 2024

Division of General Pediatrics, PolicyLab, and Clinical Futures, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.

CAPNET is a multicenter child abuse pediatrics research network developed to support research that will make the medical care of potentially abused children more effective, safe, and fair. CAPNET currently collects detailed clinical data from child physical abuse evaluations from 11 leading pediatric centers across the U.S.

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Patients with many forms of congenital heart disease (CHD) and hypertrophic cardiomyopathy undergo surgical intervention to relieve left ventricular outflow tract obstruction (LVOTO). Cardiovascular Computed Tomography (CCT) defines the complex pathway from the ventricle to the outflow tract and can be visualized in 2D, 3D, and 4D (3D in motion) to help define the mechanism and physiologic significance of obstruction. Advanced cardiac visualization may aid in surgical planning to relieve obstruction in the left ventricular outflow tract, aortic or neo-aortic valve and the supravalvular space.

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Growing interest in therapeutic development for rare diseases necessitate a systematic approach to the collection and curation of natural history data that can be applied consistently across this group of heterogenous rare diseases. In this study, we discuss the challenges facing natural history studies for leukodystrophies and detail a novel standardized approach to creating a longitudinal natural history study using existing medical records. Prospective studies are uniquely challenging for rare diseases.

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Over 50% of patients with systemic LCH are not cured with front-line therapies, and data to guide salvage options are limited. We describe 58 patients with LCH who were treated with clofarabine. Clofarabine monotherapy was active against LCH in this cohort, including heavily pretreated patients with a systemic objective response rate of 92.

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Transition to Weight-Based High-Flow Nasal Cannula Use Outside of the ICU for Bronchiolitis.

JAMA Netw Open

March 2024

Department of Pediatrics, Division of Pediatric Hospital Medicine, University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City.

Importance: Most children's hospitals have adopted weight-based high-flow nasal cannula (HFNC) bronchiolitis protocols for use outside of the intensive care unit (ICU) setting. Whether these protocols are achieving their goal of reducing bronchiolitis-related ICU admissions remains unknown.

Objective: To measure the association between hospital transition to weight-based non-ICU HFNC use and subsequent ICU admission.

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Objectives: Cardiac surgery-associated acute kidney injury (CS-AKI) is associated with adverse outcomes. Single-center studies suggest that the prevalence of CS-AKI is high after the Norwood procedure, or stage 1 palliation (S1P), but multicenter data are lacking.

Design: A secondary analysis of the Neonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) multicenter cohort who underwent S1P.

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Article Synopsis
  • A study investigated the impact of pre-existing immunocompromising conditions (ICCs) on pediatric patients with acute COVID-19 admitted to intensive care across 55 hospitals in the U.S.!
  • Out of 1,274 patients, 105 had ICCs, which were linked to higher in-hospital mortality (11.4% vs. 4.6%) and longer hospital stays, although initial disease severity was similar between those with and without ICCs.!
  • Despite the challenges, most patients with ICCs survived and left the hospital without new severe health issues, highlighting a positive aspect of the outcomes for these vulnerable patients.!
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  • The study investigates the effects of oral vancomycin on inflammatory bowel disease (IBD) in patients with primary sclerosing cholangitis (PSC) using data from the Paediatric PSC Consortium.
  • A retrospective cohort of 113 PSC-IBD patients was analyzed, comparing 70 treated with vancomycin to 210 untreated ones, focusing on clinical remission after one year.
  • Results show vancomycin significantly improves odds of both clinical and endoscopic remission, highlighting the need for further randomized controlled trials to confirm these findings and assess safety and dosing.
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  • Defining prognostic factors for T-lymphoblastic lymphoma (T-LL) is complex, as shown in the AALL1231 trial that included children and young adults with T acute lymphoblastic leukemia or T-LL, comparing standard therapy with the addition of bortezomib.
  • In the trial, 41% of patients provided bone marrow samples to measure minimal residual disease (MRD) after treatment, revealing that those with MRD levels below 0.1% had a significantly better event-free survival rate (89%) compared to those with MRD at or above 0.1% (64%).
  • Cox regression analysis indicated that having MRD levels at or above 0.1%
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Diagnostic accuracy of serum matrix metalloproteinase-7 as a biomarker of biliary atresia in a large North American cohort.

Hepatology

July 2024

Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Article Synopsis
  • High serum levels of matrix metalloproteinase-7 (MMP-7) have been identified as a potential diagnostic biomarker for biliary atresia (BA) in infants with cholestasis, showing strong accuracy in a large North American study.
  • MMP-7 demonstrated a high area under the receiver operating characteristic (AUROC) score of 0.90, with a sensitivity of 94.03% and a specificity of 77.78% at a cutoff of 52.8 ng/mL, outperforming other clinical markers such as gamma-glutamyl transferase.
  • Results support using MMP-7 in clinical settings to improve diagnostic efficiency for BA, as cutoff values vary with different
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Cystic fibrosis (CF) is a progressive, genetic, multi-organ disease affecting the respiratory, digestive, endocrine, and reproductive systems. CF can affect any aspect of the gastrointestinal (GI) tract, including the esophagus, stomach, small intestine, colon, pancreas, liver, and gall bladder. GI pathophysiology associated with CF results from CF membrane conductance regulator (CFTR) dysfunction.

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Overlap chronic GVHD is associated with adverse survival outcomes compared to classic chronic GVHD.

Bone Marrow Transplant

May 2024

Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Emory University, Atlanta, GA, USA.

Chronic graft-versus-host-disease (cGVHD) is divided into two subtypes: classic (absence of acute GVHD features) and overlap cGVHD ('ocGVHD'), in which both chronic and acute GVHD clinical features are present simultaneously. While worse outcomes with ocGVHD have been reported, there are few recent analyses. We performed a secondary analysis of data from the ABA2 trial (N = 185), in which detailed GVHD data were collected prospectively and systematically adjudicated.

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A Simple and Scalable Zebrafish Model of Sonic Hedgehog Medulloblastoma.

bioRxiv

February 2024

Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA.

Medulloblastoma (MB) is the most common malignant brain tumor in children and is stratified into three major subgroups. The Sonic hedgehog (SHH) subgroup represents ~30% of all MB cases and has significant survival disparity depending upon TP53 status. Here, we describe the first zebrafish model of SHH MB using CRISPR to mutate , the primary genetic driver in human SHH MB.

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Background: Fluoroquinolones (FQs) are effective for oral step-down therapy for gram-negative bloodstream infections but are associated with unfavorable toxic effects. Robust data are lacking for trimethoprim-sulfamethoxazole (TMP-SMX) and high-bioavailability β-lactams (HBBLs).

Methods: In this multicenter observational cohort study, we simulated a 3-arm registry trial using causal inference methods to compare the effectiveness of FQs, TMP-SMX, or HBBLs for gram-negative bloodstream infections oral step-down therapy.

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Aims: Common to adult electrophysiology studies (EPSs), intracardiac echocardiography (ICE) use in paediatric and congenital heart disease (CHD) EPS is limited. The purpose of this study was to assess the efficacy of ICE use and incidence of associated complications in paediatric and CHD EPS.

Methods And Results: This single-centre retrospective matched cohort study reviewed EPS between 2013 and 2022.

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Article Synopsis
  • Anorectal malformations (ARM) are rare and complex, making research and best practice recommendations difficult, prompting the formation of the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) in 2016 and the creation of a national data registry.
  • This study aimed to evaluate the accuracy of the PCPLC database by comparing 30-day surgical outcomes for ARM patients under 12 months old with data from the NSQIP-P database.
  • The results showed a high 91% concordance rate between the two databases in recorded complications, improving to 93% when excluding complications not tracked by PCPLC, suggesting a strong validation of PCPLC data for ARM patients.
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  • The study examines the use of left atrial strain (LAS) in children with multisystem inflammatory syndrome (MIS-C) and its relation to cardiac injury and inflammation.
  • Results showed that LAS parameters were significantly lower in MIS-C patients compared to healthy controls and those with cardiac injury had even more reduced LAS metrics.
  • The findings suggest that LAS could be a reliable diagnostic tool for detecting cardiac dysfunction in MIS-C and correlates with inflammatory markers, highlighting its potential use in clinical settings.
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Background: Mitchell syndrome is a rare, neurodegenerative disease caused by an ACOX1 gain-of-function mutation (c.710A>G; p.N237S), with fewer than 20 reported cases.

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