301 results match your criteria: "State Children's Hospital[Affiliation]"

Background: Hidradenitis suppurativa (HS) affects different patient populations that require unique considerations in their management. However, no HS guidelines for these populations exist.

Objective: To provide evidence-based consensus recommendations for patients with HS in 7 special patient populations: (i) pregnancy, (ii) breastfeeding, (iii) pediatrics, (iv) malignancy, (v) tuberculosis infection, (vi) hepatitis B or C infection, and (vii) HIV disease.

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Article Synopsis
  • * TGD youth face unique healthcare challenges and are at higher risk for negative mental health outcomes, yet their healthcare needs are similar to their cisgender peers.
  • * The review article aims to bridge the gap in acne care for TGD adolescents by offering guidelines for evaluation, management, and addressing their specific psychosocial and medical needs.
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Infantile hemangiomas with airway involvement: Addressing parental refusal to treat.

J Am Acad Dermatol

November 2024

Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania; Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania.

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Sensitivity and Specificity of Chimerism Tests in Predicting Leukemia Relapse Using Increasing Mixed Chimerism.

J Mol Diagn

December 2024

Penn State Cancer Institute, Hershey, Pennsylvania; Department of Pathology, Penn State College of Medicine, Hershey, Pennsylvania. Electronic address:

Chimerism test was evaluated to predict leukemia relapse. Increasing mixed chimerism (IMC), defined as recipient increase ≥0.1% in peripheral blood total cell chimerism, was used as a surrogate of disease activity.

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Variation in Use of Neuroimaging in the Care of Infants Undergoing Subspecialty Evaluations for Abuse: A Multicenter Study.

Acad Pediatr

October 2024

Division of General Pediatrics (MK Henry), Clinical Futures, and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (MK Henry), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa. Electronic address:

Objectives: 1) To quantify hospital-level variation in use of neuroimaging to screen for intracranial injury (ICI) among infants without overt signs or symptoms of head trauma undergoing subspecialty evaluations for physical abuse; 2) to assess for disproportionality in neuroimaging based on race and ethnicity and insurance type.

Methods: This was a cross-sectional study of infants age <12 months receiving subspecialty child abuse evaluations from February 2021 to December 2022 at 10 sites in CAPNET, a multicenter child abuse research network. Infants were included if they underwent a skeletal survey and lacked overt signs of possible ICI or blunt head injury.

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Article Synopsis
  • 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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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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Article Synopsis
  • There has been an increase in early onset cancer rates (under 50) since 1995, particularly among adolescents and young adults (AYAs) aged 15-39, who tend to have different types of tumors compared to children and older adults.
  • The study analyzed data from January 2016 to December 2021 using the SEER 22 database to assess age-adjusted incidence and mortality rates for various cancers by factors like sex, race, and geographic region.
  • Overall cancer incidence and mortality rates remained stable during this period, with a decline in certain cancers (e.g., ependymoma and melanoma) and increases in others (e.g., gastrointestinal cancers), highlighting the unique cancer trends and health issues faced
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Article Synopsis
  • The diagnosis and management of biliary dyskinesia in children and adolescents is inconsistent, prompting a systematic review by the American Pediatric Surgical Association to create evidence-based recommendations.
  • The review focused on key areas such as diagnostic criteria, the need for cholecystectomy, and outcomes from surgical vs. non-surgical management, but found that diagnostic criteria are unclear and reliable predictors of treatment success are lacking.
  • Pediatric-specific guidelines are needed to clarify this condition, improve diagnostic processes, and determine effective management, along with calls for more prospective studies to identify which patients could benefit from surgery.
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Article Synopsis
  • The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) aims to enhance the health outcomes of children with juvenile idiopathic arthritis (JIA) through a shared patient registry and a focus on disease activity measures.
  • With participation from 23 hospitals and over 7,200 patients, PR-COIN tracks various quality measures to assess and improve treatment effectiveness.
  • Significant improvements have been noted, including an increase in patients achieving inactive or low disease activity from 76% to 81%, along with a decrease in the average disease activity score, indicating better overall patient outcomes.
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Objective: Treatment of neonates with anorectal malformations (ARMs) can be challenging due to variability in anatomic definitions, multiple approaches to surgical management, and heterogeneity of reported outcomes. The purpose of this systematic review is to summarize existing evidence, identify treatment controversies, and provide guidelines for perioperative care.

Methods: The American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee (OEBP) drafted five consensus-based questions regarding management of children with ARMs.

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Objective: The American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee conducted a systematic review to describe the epidemiology of venous thromboembolism (VTE) in pediatric surgical and trauma patients and develop recommendations for screening and prophylaxis.

Methods: The Medline (Ovid), Embase, Cochrane, and Web of Science databases were queried from January 2000 through December 2021. Search terms addressed the following topics: incidence, ultrasound screening, and mechanical and pharmacologic prophylaxis.

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Background: Significant variation in management strategies for lymphatic malformations (LMs) in children persists. The goal of this systematic review is to summarize outcomes for medical therapy, sclerotherapy, and surgery, and to provide evidence-based recommendations regarding the treatment.

Methods: Three questions regarding LM management were generated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

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Background: Despite widespread initiatives to reduce ionizing radiation for appendicitis diagnosis, computed tomography (CT) scanning postoperatively remains common. The Pediatric Surgery Quality Collaborative (PSQC) aimed to identify differences between children's hospitals with high and low postoperative CT usage for complicated appendicitis.

Methods: Using National Surgery Quality Improvement Program Pediatric data from PSQC children's hospitals, we compared postoperative CT imaging for complicated appendicitis (April 2020-March 2021).

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A Systematic Review of Psycho-Spiritual Interventions in the NICU: Supporting Parents' Mental Health and Psychological Well-Being.

Adv Neonatal Care

April 2024

Author Affiliations: Penn State Harrisburg, Middletown, Pennsylvania (Dr Brelsford); Penn State College of Medicine, Hershey, Pennsylvania (Dr Doheny); and Penn State Children's Hospital, Hershey, Pennsylvania (Ms Stoner).

Background: The presence of psychospiritual supports and interventions for neonatal intensive care unit (NICU) parents is unclear.

Purpose: This systematic review examines the psychological and medical literature for psychospiritual interventions designed to support parents' mental health and psychological well-being during or after the NICU experience.

Data Sources: Data sources include PubMed, PsycINFO, and Cochrane Library (Cochrane Database of Systemic Reviews, Cochrane Central Register of Controlled Trials) with peer-reviewed studies published between 2013 and 2023.

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Diffuse neurofibroma is a rare type of neurofibroma uncommonly reported in infancy. It is a slow growing tumor originating in the peripheral nerve sheath. We present the case of a 17-month-old boy with diffuse neurofibroma of the scalp associated with hypertrichosis.

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Background: Mercaptopurine is an important component of acute lymphoblastic leukemia (ALL) and lymphoma (LLy) maintenance therapy. The 6-thioguanine nucleosides (6-TGN) are believed to be the primary contributor to myelosuppression and immunosuppressive effects, while 6-methylmercaptopurine (6-MMPN) is believed to be responsible for several toxicities including hepatotoxicity, pancreatitis, and hypoglycemia. Previous reports suggest the addition of allopurinol may reduce these toxicities.

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3D printing in pediatric surgery.

Semin Pediatr Surg

February 2024

Division of Pediatric Surgery, Assistant Professor of Surgery and Pediatrics, Penn State Children's Hospital, 500 University Drive, Hershey, PA 17033, United States.

Pediatric surgery presents a unique challenge, requiring a specialized approach due to the intricacies of compact anatomy and the presence of distinct congenital features in young patients. Surgeons are tasked with making decisions that not only address immediate concerns but also consider the evolving needs of children as they grow. The advent of three-dimensional (3D) printing has emerged as a valuable tool to facilitate a personalized medical approach.

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Introduction: While minimally invasive surgery (MIS) approaches are commonly utilized in the elective surgical setting for pediatric ulcerative colitis (UC), their role in urgent and emergent disease is less clear. We aim to assess trends in the surgical approaches for pediatric UC patients requiring urgent and emergent colectomies and their associated outcomes.

Methods: Retrospective review of 81 pediatric UC patients identified in National Surgical Quality Improvement Program Pediatric who underwent urgent or emergent colectomy (2012-2019).

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The imaging evaluation of acute abdominal pain in children with suspected appendicitis has evolved to include rapid abdominopelvic MRI (rMRI) over recent years. Through a collaborative effort between the Magnetic Resonance Imaging (MRI) and Emergency and Trauma Imaging Committees of the Society for Pediatric Radiology (SPR), we conducted a survey on the utilization of rMRI to assess practice specifics and protocols. Subsequently, we present a proposed consensus rMRI protocol derived from the survey results, literature review, and discussion and consensus between committee members.

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Introduction: Computed tomography (CT) scans are often used when cross-sectional imaging is required for evaluation of postappendectomy abscess, exposing children to a source of ionizing radiation. Our aim was to decrease the use of CT scans in pediatric postappendectomy patients by 50% in 12 mo and to sustain those results for 1 y.

Methods: A comprehensive magnetic resonance imaging protocol was introduced in 2018 at a tertiary children's hospital within a general health system to replace CT scans in suspected pediatric postappendectomy abscess.

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JCO ARST1321 was a phase II study designed to compare the near complete pathologic response rate after preoperative chemoradiation with/without pazopanib in children and adults with intermediate-/high-risk chemotherapy-sensitive body wall/extremity non-Rhabdomyosarcoma Soft Tissue Sarcoma (ClinicalTrials.gov identifier: NCT02180867). Enrollment was stopped early following a predetermined interim analysis that found the rate of near complete pathologic response to be significantly greater with the addition of pazopanib.

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