3,173 results match your criteria: "Royal Hospital for Sick Children[Affiliation]"

Male patients with childhood, adolescent, and young adult cancer are at an increased risk for infertility if their treatment adversely affects reproductive organ function. Future fertility is a primary concern of patients and their families. Variations in clinical practice are barriers to the timely implementation of interventions that preserve fertility.

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Female patients with childhood, adolescent, and young adult cancer are at increased risk for fertility impairment when treatment adversely affects the function of reproductive organs. Patients and their families desire biological children but substantial variations in clinical practice guidelines reduce consistent and timely implementation of effective interventions for fertility preservation across institutions. As part of the PanCareLIFE Consortium, and in collaboration with the International Late Effects of Childhood Cancer Guideline Harmonization Group, we reviewed the current literature and developed a clinical practice guideline for fertility preservation in female patients who were diagnosed with childhood, adolescent, and young adult cancer at age 25 years or younger, including guidance on risk assessment and available methods for fertility preservation.

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Background: In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet-PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross-sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging.

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Aims: The migration percentage (MP) is one criterion used for surgery in dislocated or displaced hips in children with cerebral palsy (CP). The MP at which a displaced hip can no longer return to normal is unclear. The aim of this paper was to identify the point of no return of the MP through a large population-based study.

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Spermatogonia Loss Correlates with LAMA 1 Expression in Human Prepubertal Testes Stored for Fertility Preservation.

Cells

January 2021

NORDFERTIL Research Lab Stockholm, Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, and Karolinska University Hospital, 171 64 Solna, Sweden.

Fertility preservation for male childhood cancer survivors not yet capable of producing mature spermatozoa, relies on experimental approaches such as testicular explant culture. Although the first steps in somatic maturation can be observed in human testicular explant cultures, germ cell depletion is a common obstacle. Hence, understanding the spermatogonial stem cell (SSC) niche environment and in particular, specific components such as the seminiferous basement membrane (BM) will allow progression of testicular explant cultures.

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Article Synopsis
  • The REDUCE-RISK trial aims to compare the effectiveness of different treatments for pediatric low-risk and high-risk Crohn disease, specifically methotrexate, azathioprine, 6-mercaptopurine, and adalimumab.
  • A systematic review was conducted to assess existing economic evaluations related to adalimumab treatment for inflammatory bowel diseases in both children and adults, focusing on studies that measure life years gained or quality-adjusted life years.
  • The review found 12 relevant studies, none involving children, highlighting the economic viability of adalimumab but pointing out gaps in data about children's school attendance, parental productivity, and quality of life measures in current evaluations.
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Emergency clinicians worldwide are demonstrating increasing concern about the effect of climate change on the health of the populations they serve. The movement for sustainable healthcare is being driven by the need to address the climate emergency. Globally, healthcare contributes significantly to carbon emissions, and the healthcare sector has an important role to play in contributing to decarbonisation of the global economy.

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Article Synopsis
  • Many teenagers and young adults with cancer don't participate in clinical trials due to limited opportunities, which health professionals believe can be improved.
  • A study involving 35 healthcare professionals revealed a consensus on strategies to enhance access, focusing on patient consolidation, reducing bureaucratic hurdles, boosting research personnel, and making trial designs more practical.
  • Although changing the current care, research, and resource systems is challenging, stakeholders must collaborate to enhance access for TYA and patients with rare diseases, with further discussions needed to establish priorities.
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Introduction: Thetanix (gastroresistant capsules containing lyophilized Bacteroides thetaiotaomicron) is a live biotherapeutic, under development for Crohn's disease, that antagonizes transcription factor nuclear factor kappa B, reducing proinflammatory cytokines, particularly tumor necrosis factor alpha. We aimed to assess safety and tolerability in adolescents with Crohn's disease in remission.

Methods: Subjects who were 16-18 years with Crohn's in remission (weighted pediatric Crohn's disease activity index <12.

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Article Synopsis
  • The COVID-19 pandemic resulted in decreased pediatric healthcare utilization during the national lockdown in Scotland, with fewer primary care and emergency department visits compared to previous years.
  • Emergency admissions to pediatric intensive care units (PICUs) also fell notably, particularly for respiratory diseases, but rates for injury-related admissions remained unchanged.
  • Despite these reductions, the overall mortality rates in children during the lockdown period did not significantly differ from those in previous years.
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To explore the feasibility of using Saccadic Vector Optokinetic Perimetry (SVOP) to differentiate glaucomatous and healthy eyes. A prospective case-control study was performed using a convenience sample recruited from a single university glaucoma clinic and a group of healthy controls. SVOP and standard automated perimetry (SAP) was performed with testing order randomised.

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Systemic lupus erythematosus (SLE) is a systemic autoimmune/inflammatory disease. Patients diagnosed with juvenile-onset SLE (jSLE), when compared to individuals with adult-onset SLE, develop more severe organ involvement, increased disease activity and greater tissue and organ damage. In adult-onset SLE, clinical characteristics, pathomechanisms, disease progression and outcomes do not only vary between individuals and age groups, but also ethnicities.

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Differential Expression of Interferon-Alpha Protein Provides Clues to Tissue Specificity Across Type I Interferonopathies.

J Clin Immunol

April 2021

Université de Paris, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, 24 boulevard du Montparnasse, 75015, Paris, France.

Whilst upregulation of type I interferon (IFN) signaling is common across the type I interferonopathies (T1Is), central nervous system (CNS) involvement varies between these disorders, the basis of which remains unclear. We collected cerebrospinal fluid (CSF) and serum from patients with Aicardi-Goutières syndrome (AGS), STING-associated vasculopathy with onset in infancy (SAVI), presumed monogenic T1Is (pT1I), childhood systemic lupus erythematosus with neuropsychiatric features (nSLE), non-IFN-related autoinflammation (AI) and non-inflammatory hydrocephalus (as controls). We measured IFN-alpha protein using digital ELISA.

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A View from the past into our collective future: the oncofertility consortium vision statement.

J Assist Reprod Genet

January 2021

Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA.

Article Synopsis
  • The Oncofertility Consortium is an international initiative focused on addressing the reproductive concerns of cancer patients, individuals transitioning genders, and others facing treatments that may affect fertility.
  • The consortium operates as a community of practice, sharing knowledge and strategies among specialists from various fields to improve healthcare outcomes and quality of life for patients.
  • Their ongoing mission is to combine scientific advancements with patient needs, aiming to create a supportive network that adapts to future challenges in reproductive health and survivorship.
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Aim: To describe the point prevalence of cerebral palsy (CP) and distribution of gross and fine motor function in individuals registered in a CP-North surveillance programme.

Method: Aggregate data of individuals with CP aged 6 to 19 years, sex, CP subtype, and gross and fine motor function levels were collected from each programme. Overall and age-specific point prevalence of CP was calculated for each programme using 95% confidence intervals.

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The surgical treatment of severe Scheuermann's kyphosis.

Bone Joint J

January 2021

Scottish National Spine Deformity Centre, Royal Hospital for Sick Children, Edinburgh, UK.

Aims: To report the surgical outcome of patients with severe Scheuermann's kyphosis treated using a consistent technique and perioperative management.

Methods: We reviewed 88 consecutive patients with a severe Scheuermann's kyphosis who had undergone posterior spinal fusion with closing wedge osteotomies and hybrid instrumentation. There were 55 males and 33 females with a mean age of 15.

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Anticoagulant treatment of pediatric cerebral venous thrombosis has not been evaluated in randomized trials. We evaluated the safety and efficacy of rivaroxaban and standard anticoagulants in the predefined subgroup of children with cerebral venous thrombosis (CVT) who participated in the EINSTEIN-Jr trial. Children with CVT were randomized (2:1), after initial heparinization, to treatment with rivaroxaban or standard anticoagulants (continued on heparin or switched to vitamin K antagonist).

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Article Synopsis
  • The study aimed to assess how changes in the prescribing of biological treatments for ulcerative colitis (UC) in the UK affected colectomy rates between 2005 and 2018.
  • It found a significant rise in the initiation of maintenance biological therapy, from 0.05 to 1.26 per 100 UC patients, while colectomy rates dropped from 1.47 to 0.44 per 100 patients in the same timeframe.
  • The results suggest that increased use of biological therapy after 2015 is linked to a notable decline in colectomy rates, indicating a positive impact on patient outcomes.
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Article Synopsis
  • Identifying monogenic IBD patients is essential for tailored management, and the position statement provides recommendations for using genomics in this evaluation across different age groups.
  • A systematic review by pediatric IBD specialists led to recommendations for next-generation DNA sequencing in routine clinical practice, but routine genetic testing is advised only for specific cases based on age of onset and family history.
  • A diagnostic algorithm with a gene panel of 75 genes has been developed to assist clinicians, emphasizing the importance of genetic testing before procedures like hematopoietic stem cell transplantation.
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Entropy quantification algorithms are becoming a prominent tool for the physiological monitoring of individuals through the effective measurement of irregularity in biological signals. However, to ensure their effective adaptation in monitoring applications, the performance of these algorithms needs to be robust when analysing time-series containing missing and outlier samples, which are common occurrence in physiological monitoring setups such as wearable devices and intensive care units. This paper focuses on augmenting Dispersion Entropy (DisEn) by introducing novel variations of the algorithm for improved performance in such applications.

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The human adult structural connectome has a rich nodal hierarchy, with highly diverse connectivity patterns aligned to the diverse range of functional specializations in the brain. The emergence of this hierarchical complexity in human development is unknown. Here, we substantiate the hierarchical tiers and hierarchical complexity of brain networks in the newborn period, assess correspondences with hierarchical complexity in adulthood, and investigate the effect of preterm birth, a leading cause of atypical brain development and later neurocognitive impairment, on hierarchical complexity.

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Background: Cancer is rare amongst adolescents and young adults (AYA). Previous research has reported (healthy) AYA's knowledge of risk factors and symptoms as limited, with this potentially leading to delays in help-seeking and diagnosis.

Objectives: We explored AYA's views on their cancer knowledge prior to diagnosis and if/how they perceived this as having affected their experiences of diagnosis and care.

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Background: Clinical studies indicate chemotherapy agents used in childhood cancer treatment regimens may impact future fertility. However, effects of individual agents on prepubertal human testis, necessary to identify later risk, have not been determined. The study aimed to investigate the impact of cisplatin, commonly used in childhood cancer, on immature (foetal and prepubertal) human testicular tissues.

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Precis: Normal age-corrected threshold sensitivity values were determined for a new eye tracking perimeter and compared with standard automated perimetry (SAP).

Purpose: The purpose of this study was to determine threshold visual field sensitivities in normal subjects performing saccadic vector optokinetic perimetry (SVOP), a new eye tracking perimeter.

Patients And Methods: A total of 113 healthy participants performed SVOP and SAP in both eyes with the order of testing randomized.

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