Transforming assessment of speech in children with cleft palate via online crowdsourcing.

Objective: Speech intelligibility is fundamental to social interactions and a critical surgical outcome in patients with cleft palate. Online crowdsourcing is a burgeoning technology, with potential to mitigate the burden of limited accessibility to speech-language-pathologists (SLPs). This pilot study investigates the concordance of online crowdsourced evaluations of hypernasality with SLP ratings of children with cleft palate.

Surfactant and budesonide for respiratory distress syndrome: an observational study.

Background: In preterm infants on moderately high ventilator support, the addition of budesonide to surfactant lowered bronchopulmonary dysplasia (BPD) rates by 20% without increased morbidity or mortality. The aim of this cohort comparison was to determine the safety and efficacy of the combination in infants with milder respiratory distress syndrome (RDS).

Methods: In August 2016 we began administering budesonide (0.

Perioperative Antibiotics Are Independent Predictors for Major Complications in Pediatric Patients Undergoing Gastrostomy Placement.

Although rare, major complications after gastrostomy tube placement are a significant source of morbidity in children. The purpose of this study was to identify predictors of major complications in pediatric patients undergoing gastrostomy placement. Retrospective review of surgically placed gastrostomy tubes from 2010 to 2017 was performed.

Laparoscopic Peritoneal Dialysis Catheter Placement with Chest Wall Exit Site for Neonate with Stoma.

Neonates requiring peritoneal dialysis (PD) catheters have been shown to have complication rates up to 70%. The presence of a concurrent stoma significantly increases the risk of peritonitis, exit-site infection, and catheter failure. As such, multiple techniques have been proposed to reduce these risks, including a chest wall exit site.

Food Insecurity Screening in Pediatric Clinical Settings: A Caregivers' Perspective.

Objectives: Food insecurity (FI) has serious academic, social, and physical health consequences for children. A recent clinical recommendation suggests FI screening during child well visits. While FI screening research has considered clinician feedback, little is known about caregivers' experience of disclosing FI to health care providers.

Association between ventricular shunt catheter calcifications and the development of shunt fracture.

Background: Calcifications along ventricular catheters have been associated with shunt fractures although it is unknown whether their development predicts whether and when the shunts will fracture.

Objective: To determine whether extracranial calcifications found on a radiographic shunt series predicts whether a patient will experience a shunt catheter fracture or complication.

Materials And Methods: A retrospective review was performed of pediatric patients with a ventricular shunt placed before 18 years of age and radiographic shunt series.

Shear wave elastography correlates with liver fibrosis scores in pediatric patients with liver disease.

Background: While liver biopsy remains the gold standard, given the procedure risks and sampling errors, there is a need for reliable noninvasive biomarkers of hepatic fibrosis.

Objective: Determine the accuracy of two-dimensional shear wave elastography (2-D SWE) in predicting the histological severity of liver fibrosis in pediatric patients with known or suspected liver disease.

Materials And Methods: Subjects 0-18 years old with known or suspected liver disease and liver biopsy within 30 days (n=70) were included.

Changes in factors influencing fellowship choices among radiology residents from 2008 to 2018 and methods that may increase interest in the pediatric radiology subspecialty.

Background: Fewer residents are choosing a career in pediatric radiology, which is contributing to an ongoing shortage of pediatric radiologists.

Objective: To identify potential causes of reduced interest in pediatric radiology as a career given a projected worsening of a nationwide shortage of pediatric radiologists.

Materials And Methods: An online questionnaire using previously published questions was approved and distributed by the Program Directors in Diagnostic Radiology to diagnostic radiology residents on behalf of the Society for Pediatric Radiology (SPR).

Outcomes of processing of bone marrow harvests for hematopoietic stem cell transplantation in pediatric patients utilizing a novel red blood cell sedimentation kit.

Background: Bone marrow (BM) grafts are often subject to manipulation to minimize infusion volume, to deplete red blood cells (RBCs), to deplete plasma, and/or to achieve optimal concentration of nucleated cells (NCs) for freezing. Here, we report results of processing and infusion of four major ABO-incompatible BM grafts for allogeneic hematopoietic transplantation in pediatric patients.

Cases And Methods: Patients ranging in age from 5 months to 18 years received hematopoietic stem cell transplantation for benign or malignant indications.

Systemic Lupus Erythematosus, Evans Syndrome, and Neurofibromatosis: An Unusual Combination in Pediatric Patient.

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organ systems. Patients can have hematologic manifestations, including Evans syndrome (ES), which is characterized by immune-mediated thrombocytopenia and anemia. The association of neurofibromatosis 1 (NF1) with autoimmune disorders is rarely reported.

Hydrops Fetalis and Persistent Pulmonary Hypertension in a Neonate with Anti-E Alloimmunization.

Anti-E alloimmunization is the third most common cause of neonatal hemolytic disease, typically causing mild to moderate hemolytic anemia. We report an unusual case of severe hydrops fetalis and persistent pulmonary hypertension (PPHN) in a neonate with anti-E alloimmunization. Our case emphasizes the importance of close surveillance for development of severe fetal hemolytic anemia and possible need for antenatal intervention.

Diagnostic accuracy of non-contrast magnetic resonance enterography in detecting active bowel inflammation in pediatric patients with diagnosed or suspected inflammatory bowel disease to determine necessity of gadolinium-based contrast agents.

Background: Pediatric patients with inflammatory bowel disease (IBD) are at increased risk of gadolinium deposition given the potential need for multiple contrast-enhanced magnetic resonance enterography (MRE) exams over their lifetime.

Objective: To determine whether gadolinium-based contrast agents are necessary in assessing active bowel inflammation on MRE in pediatric patients with known or suspected IBD.

Materials And Methods: We conducted a retrospective study of 77 patients (7-18 years; 68.

Abscess and symptoms duration upon presentation should guide decision algorithms for early versus interval appendectomy in children.

Background: To compare outcomes for complicated appendicitis treated with early versus interval appendectomy and to identify which patients would likely benefit from early appendectomy.

Methods: A retrospective review of complicated appendicitis was performed from 2010 to 2015. Patients were divided into early (EA) versus interval appendectomy (IA) groups.

Hydroxyurea use in young infants with sickle cell disease.

Background: Hydroxyurea (HU) reduces complications and improves quality and duration of life in sickle cell disease. Evidence supports the use of HU starting after nine months of age.

Procedures: We performed a retrospective study of patients starting HU at less than five years of age between January 1, 2008, and December 31, 2016.

Standardized text messages improve 30-day patient follow-up for ACS pediatric NSQIP cases.

Purpose: Thirty-day follow-up is a critical and challenging component of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). We hypothesized the simplicity and immediacy of text messaging would increase response rates while reducing workload.

Methods: For 6 months, text messages were the primary form of contact for first and second follow-up attempts.

Solid tumor screening recommendations in trisomy 18.

The purpose of this study was to determine whether trisomy 18 patients are at an increased risk of tumor development and require formal tumor screening recommendations. A literature search of trisomy 18 patients with reports of tumors or malignancies, and compilation of all previously reported as well as new unreported cases was performed. 67 patients with trisomy 18 were found to have documented malignancies.

Systematic Review: Online Crowdsourcing to Assess Perceptual Speech Outcomes.

Background: Speech is integral for human interaction and development. Speech assessments are critical in the growing child, especially in the surgical evaluation of patients undergoing cleft palate and speech surgeries. Online crowdsourcing enables layperson raters, allowing rapid and large-scale data collection.

The Resource Burden of Infections With Rhinovirus/Enterovirus, Influenza, and Respiratory Syncytial Virus in Children.

We reviewed the resource utilization of patients with human rhinovirus/enterovirus (HRV/ENT), influenza A/B (FLU), or respiratory syncytial virus (RSV). A total of 2013 patients with nasopharyngeal swabs positive for HRV/ENT, RSV, or FLU were included. Records were reviewed for respiratory support, vascular access procedures, emergency department care only versus admission versus pediatric intensive care unit (PICU) care, antibiotics, length of stay, and billing data.

Pancreatic heterotopia in a neonatal abdominopelvic cyst.

Pancreatic heterotopia is a rare congenital anomaly more commonly incidentally found in adults. While intra-abdominal cysts found on prenatal imaging are not uncommon, we examine a case of pancreatic heterotopia presenting in an abdominopelvic cyst on prenatal imaging. At birth, the neonate was found to have hypoglycemia unresponsive to treatment that resolved after cyst resection.

Comparison of Bubble CPAP Devices Using RAM Cannula for Extubation Failure in Very Low Birth Weight Infants: Randomized and Cohort Studies.

Introduction: Bubble continuous positive airway pressure (bCPAP) generates a variable pressure due to bubble size and frequency, and these pressure oscillations may contribute to lung recruitment and gas exchange. Single-outlet bCPAP devices generate larger pressure fluctuation than bCPAP devices with diffusers, but clinical efficacy is unclear. Our hypothesis was that a single-outlet bCPAP device (B&B Bubbler©) would decrease extubation failure and improve oxygenation compared with a bCPAP device with a diffuser (BabiPlus©).

Utility of Chest Radiographs in Children Presenting to a Pediatric Emergency Department With Acute Asthma Exacerbation and Chest Pain.

Objectives: Previous studies have not evaluated the utility of obtaining chest radiographs (CXR) in patients with acute asthma exacerbation reporting chest pain. The aims of this study were to evaluate the symptom of chest pain as a predictor for clinicians obtaining a CXR in these patients and to evaluate chest pain as a predictor of a positive CXR finding.

Methods: This was a retrospective chart review of patients, ages 2 to 18 years, presenting for acute asthma exacerbation to the emergency department from August 1, 2014, to March 31, 2016.

Poisoning, Overdoses, Toxic Exposures.

The national poison center movement originated in the Midwest with actions of the American Academy of Pediatrics in Chicago, Illinois, in 1972. The Missouri Poison Center (MPC) was established in 1974. The MPC and other regional poison centers are essential to the public health locally and nationally.

Extrapulmonary sequestration with a left internal thoracic arterial feeding vessel in an infant treated with video-assisted Thoracoscopic resection: a case report.

Background: Congenital lung malformations exist along a spectrum of pathogenesis and disease severity. Extrapulmonary sequestration (EPS), in which nonfunctional lung tissue develops without connection to the tracheobronchial tree, is one rare manifestation of this disease. Atypical vascular anatomy with a systemic feeding vessel characterizes these lesions.

Nano-evidence for joint microbleeds in hemophilia patients.

The concept of joint microbleeding in hemophilia patients was first proposed over 10 years ago. This was based on unexpected abnormalities found in medical imaging studies of asymptomatic joints. Since then, there have been no published studies confirming the presence of joint microbleeds.

Extracorporeal cardiopulmonary resuscitation in a neonate after air embolism during insufflation for laparoscopic peritoneal dialysis catheter placement.

Laparoscopy is increasingly utilized in neonatal surgery with safe and effective outcomes. Air embolism from insufflation for pneumoperitoneum is a rare but known risk of laparoscopy. Here we present a rare case of air embolism during insufflation for laparoscopic peritoneal dialysis catheter placement treated with extracorporeal cardiopulmonary resuscitation.