Hereditary Pyropoikilocytosis as a Modifier of Sickle Cell Disease Severity.

Mutations that alter the structure of red blood cells, including the mutations that cause sickle cell disease (SCD), are common globally because they protect against malaria. Patients with SCD rarely develop severe anemia that requires blood transfusions before 6 months of age. We present the case of a patient with SCD who developed severe anemia requiring a blood transfusion at 6 weeks old and subsequent transfusions throughout her first two and a half years of life.

Coexistence of coloboma, heart defects, atresia choanae, growth retardation, genital abnormalities, and ear anomalies (CHARGE) syndrome and heterotaxy in a newborn with athymia.

The case presented highlights a unique presentation of coloboma, heart defects, atresia choanae, growth retardation, genital abnormalities, and ear anomalies (CHARGE) syndrome along with athymia and heterotaxy to establish a possible association between these 2 well-known patterns of multiple malformations.

Efficacy and Safety of Letermovir for Cytomegalovirus Prophylaxis in Pediatric Hematopoietic Stem Cell Transplantation Recipients: A Systematic Review, Meta-Analysis, and Meta-Regression.

Objective: Letermovir (LTV) is a novel antiviral agent approved by the FDA in 2017 for CMV prophylaxis in adult CMV-seropositive allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients and approved for pediatric use in 2024. This study systematically evaluates the efficacy and safety of LTV prophylaxis for CMV infection in pediatric allo-HSCT recipients.

Methods: We systematically searched PubMed, Scopus, Web of Science, Embase, and Cochrane Library up to December 2024 for studies that evaluated the use of LTV prophylaxis in pediatric allo-HSCT recipients.

Postoperative Analgesic Effects of Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Pediatric Lower Abdominal Surgeries: A Systematic Review and Meta-Analysis.

Objective: Management of postoperative pain in pediatric patients is challenging. Traditional methods of postoperative pain management may not always provide adequate relief. We aim to compare the effect of Quadratus Lumborum Block (QLB) and Transversus Abdominis Plane Block (TAPB) on the quality of postoperative analgesia in pediatrics undergoing lower abdominal surgeries.

Acute Liver Failure: Is Acetaminophen the Only Culprit?

Epstein-Barr virus (EBV) is a common herpesvirus associated with infectious mononucleosis and rare complications such as hepatitis. EBV-associated hepatitis during acute infection may alter liver metabolism, compounding the risk of drug-induced toxicity. We report the case of a 16-year-old female with acute EBV infection who developed severe acetaminophen toxicity after reported use for migraine relief.

Increased serum GM-CSF at diagnosis of biliary atresia is associated with improved biliary drainage.

Background: The immune heterogeneity of biliary atresia (BA) presents a challenge for development of prognostic biomarkers. This study aimed to identify early immune signatures associated with biliary drainage after Kasai Portoenterostomy (KPE).

Methods: Serum samples, liver slides, and clinical data were obtained from patients enrolled in the NIDDK-supported Childhood Liver Disease Research Network.

Significant Disparities in Adolescents With Severe Traumatic Brain Injury Across Trauma Center Types: Wide Variation of Tracheostomy and Gastrostomy.

Objectives: To explore practice variations in the rate and timing of tracheostomy and gastrostomy for adolescent with severe traumatic brain injury (TBI) across trauma center types.

Design: Retrospective cohort study.

Setting: Trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program (2017-2021) included adult (ATC), mixed (MTC), and pediatric trauma centers (PTC).

Perspectives on Conducting Behavioral Intervention With Adolescents Using a Virtual Platform-A Thematic Analysis From the Viewpoint of Study Coordinators.

Background: The COVID-19 pandemic led to widespread adoption of virtual communication platforms. Virtual study visits were implemented in the pilot cluster randomized trial (CRT) stage of Teen Adherence in KidnEy transplant Improving Tracking To Optimize Outcomes (TAKE-IT TOO). The present study aimed to understand study coordinators' perspectives on conducting a behavioral intervention with adolescent kidney transplant recipients using virtual conferencing platforms.

Forecasting Pediatric Trauma Volumes: Insights From a Retrospective Study Using Machine Learning.

Introduction: Rising pediatric firearm-related fatalities in the United States strain Trauma Centers. Predicting trauma volume could improve resource management and preparedness, particularly if daily forecasts are achievable. The aim of the study is to evaluate various machine learning models' accuracy on monthly, weekly, and daily data.

Live Attenuated Vaccine Administration in Children Treated With Methotrexate or Dupilumab.

Background And Objectives: A wholesale recommendation against use of live virus vaccines in patients treated with any medication classified as an immunosuppressant has been based on global theoretical concerns rather than clinical outcomes for specific drugs.

Methods: A retrospective search of electronic medical records identified patients seen by the Allergy and/or Dermatology services between 2017 and 2023 at a pediatric tertiary center who received a live attenuated vaccine during the 6 week interval prior to the first prescription for methotrexate or dupilumab until 6 weeks after the last prescription for either medication. Individual charts of identified patients were manually reviewed for evidence of adverse events.

Oscillatory Blood Pressure Values in Newborn Infants: Observational Data Over Gestational Ages.

Introduction: Normative blood pressure (BP) values on preterm infants exist but are based on small cohorts of infants. Utilizing electronic medical records (EMR), we can explore earlier gestational ages (GA) and follow their progression to 40 weeks corrected gestational age (CGA).

Methods: A retrospective cohort study of infants within the SSM Health System from July 1, 2013 through June 30, 2023.

The implementation of molecular tumor profiling in the practice of pediatric cancer pathology: The pathologists' experience.

Background: The increased accessibility and utilization of molecular testing including next-generation sequencing (NGS) has impacted the practice of pediatric pathology, with diagnostic, prognostic, and therapeutic implications for our patients. This survey is the first to describe the utilization of molecular testing in the routine practice of pediatric pathology for the care of children with known or suspected solid tumors.

Procedure: The Society for Pediatric Pathology Practice Committee distributed a survey to our membership asking 25 questions about training, practice setting, molecular ordering practices, and barriers to testing.

Review of Low Titer Group O Whole Blood (LTOWB) Transfusion in Initial Resuscitation of Pediatric Trauma Patients: Assessing Potential Benefits.

Background: Hemorrhagic shock secondary to trauma is a leading cause of pediatric mortality in the United States. Timely intervention is crucial to prevent many of these deaths. Children and adults exhibit distinct responses to trauma due to varying blood volume ratios and injury patterns.

Parental Health Literacy and Acute Care Utilization in Children With Medical Complexity.

Objective: Health literacy is the ability to find, understand, and use information and services to inform health-related decisions and actions. Inadequate health literacy is associated with health disparities, poor health outcomes, and increased emergency department (ED) visits and hospitalizations. Children with medical complexity (CMC) have high rates of acute health care utilization.

Characterizing Pediatric Patients at Risk for Violence-Related Injuries at a Trauma Center in the Midwest United States.

Introduction: Hospital-based violence intervention programs (HVIPs) have emerged nationwide to help address the societal and economic costs of violence. Little literature exists regarding selecting those patients most likely to benefit from intensive case management. The study aims to describe the pediatric patient population presenting at a Level 1 ACS trauma center with a chief complaint of violent trauma and identify the characteristics of patients most at risk.

Oral sodium supplementation on growth and hypertension in preterm infants: an observational cohort study.

Objective: To evaluate the association between enteral sodium supplementation on growth and hypertension (HTN) in preterm infants.

Study Design: A retrospective cohort study of infants born between 22-32 weeks and weighing 450-1500 grams (N = 821). Enteral sodium supplementation amounts, systolic blood pressures (SBP), weight gain, and other infant and maternal risk factors for HTN were electronically extracted.

Experiential Learning as a Path to Critical Consciousness in the Medical Curriculum: A Qualitative Study.

Objectives: Clinical settings are increasingly focused on addressing patients' social needs, thus medical education must prepare future clinicians for this task. Critical consciousness, an awareness that puts health within a broader social, historical, and cultural context, could help shape students' understanding of patient social needs. Our paper explores how experiential learning through participation in a social care intervention deepened students' critical consciousness, or their understanding of the systems and structures that make it difficult for patients to meet their basic needs.

The Role of Social Determinants in Diagnosis Timing for Fetal Care Center-Eligible Conditions: A Scoping Review.

Timely identification of fetal conditions enables comprehensive evaluation, counseling, postnatal planning, and prenatal treatments. This study assessed the existing evidence on how social determinants of health (SDOH) influence diagnosis timing of fetal conditions appropriate for care in fetal care centers (FCCs). Eligible studies were conducted in the U.