276 results match your criteria: "The Children's Hospital of Philadelphia and The Perelman School of Medicine[Affiliation]"

Congenital Hyperinsulinism: An Historical Perspective.

Horm Res Paediatr

April 2023

Congenital Hyperinsulinism Center, Division of Endocrinology and Diabetes, Department of Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Congenital hyperinsulinism is the most common cause of persistent hypoglycemia in neonates, infants, and children. Since the first case descriptions in the 1950s, the field has advanced significantly. It was the development of the insulin radioimmunoassay by Yalow and Berson a decade later that made it possible to demonstrate that this form of persistent hypoglycemia was caused by insulin, and a few years later, Drash described the successful treatment of children with hyperinsulinism with the antihypertensive diazoxide, which until today remains the only approved treatment for hyperinsulinism.

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Article Synopsis
  • Infants with congenital heart defects face a heightened risk of neurodevelopmental disabilities, but the effects of daily environmental chemical exposure on their development remain unclear.
  • A study tracked 140 infants post-cardiac surgery, measuring various chemical exposure biomarkers and assessing neurodevelopmental outcomes at 18 months using specific developmental scales.
  • Findings revealed that higher exposure to certain chemicals, especially phthalates, correlated with significantly lower language and motor scores, indicating that these environmental factors may negatively influence neurodevelopment in this vulnerable population.*
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Mitochondrial Redox Signaling in Aging-Related Diseases--In Honor of Dr. Bruce N. Ames: A Pioneer in Mitochondrial Redox Signaling on Aging Research.

Free Radic Biol Med

October 2022

Center for Molecular and Mitochondrial Medicine and Genetics and the Department of Biological Chemistry, University of California, Irvine, CA, USA; Center for Mitochondrial and Epigenomic Medicine, Department of Pediatrics, Division of Human Genetics, Children's Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, PA, USA.

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Preface.

Free Radic Biol Med

October 2022

Center for Molecular and Mitochondrial Medicine and Genetics and the Department of Biological Chemistry, University of California, Irvine, CA, USA; Center for Mitochondrial and Epigenomic Medicine, Department of Pediatrics, Division of Human Genetics, Children's Hospital of Philadelphia and The Perelman School of Medicine, University of Pennsylvania, PA, USA.

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Pediatric traumatic hemorrhagic shock consensus conference research priorities.

J Trauma Acute Care Surg

January 2023

From the Department of Surgery (R.T.R.), Division of Pediatric Surgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, Alabama; Division of Anesthesiology and Critical Care Medicine (M.M.B.), Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pediatrics (M.A.B.), Brooke Army Medical Center, Uniformed Services University; Division of Trauma and Burn Surgery (R.S.B.), Children's National Hospital, Washington, DC; Department of Surgery (B.A.G.), University of Pittsburgh School of Medicine, UPMC Children's Hospital, Pittsburgh, Pennsylvania; Division of Pediatric Surgery (M.J.), Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon; Department of Oncology (C.D.J.), Sydney Kimmel Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland; Cancer and Blood Disorders Institute (C.D.J.), Johns Hopkins All Children's Hospital, St. Petersburg, Florida; Department of Surgery (C.M.L.), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Pediatrics (J.C.L.), Division of Emergency Medicine, Division of Critical Care Medicine (J.A.M.), and Department of Pathology and Laboratory Medicine (K.K.N.), Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio; Department of Emergency Medicine (D.K.N.), Davis School of Medicine, University of California, Sacramento, California; Department of Anesthesiology and Critical Care (P.A.S.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Divisions of Pediatric Surgery (A.M.V.) and Critical Care (A.M.V.), Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; Division of Pediatric Hematology and Oncology (T.E.W.), and Department of Pathology (T.E.W.), Oregon Health and Science University, Portland, Oregon; and Department of Surgery and Critical Care Medicine (P.C.S.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Background: Traumatic injury is the leading cause of death in children and adolescents. Hemorrhagic shock remains a common and preventable cause of death in the pediatric trauma patients. A paucity of high-quality evidence is available to guide specific aspects of hemorrhage control in this population.

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Assessing pediatric perioperative affect: A concise review of research and clinically relevant scales.

Paediatr Anaesth

March 2023

Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesiology, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Stanford, California, USA.

Perioperative anxiety and distress are common in pediatric patients undergoing general anesthesia and increase the risk for immediate and long-term postoperative complications. This concise review outlines key research and clinically-relevant scales that measure pediatric perioperative affect. Strengths and weaknesses of each scale are highlighted.

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Background: The Single Ventricle Reconstruction (SVR) Trial was the first randomized clinical trial of a surgical approach for treatment of congenital heart disease. Infants with hypoplastic left heart syndrome (HLHS) and other single right ventricle (RV) anomalies were randomized to a modified Blalock Taussig Thomas shunt (mBTTS) or a right-ventricular-to-pulmonary-artery shunt (RVPAS) at the time of the Norwood procedure. The aim of the Long-term Outcomes of Children with HLHS and the Impact of Norwood Shunt Type (SVR III) study is to compare early adolescent outcomes including measures of cardiac function, transplant-free survival, and neurodevelopment, between those who received a mBTTS and those who received an RVPAS.

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Context: Autosomal dominant and rarely de novo gain-of-function variants in the gene are associated with precocious male puberty, while somatic variants have been found in isolated Leydig cell adenomas and Leydig cell hyperplasia. Bilateral diffuse Leydig cell tumor formation in peripheral precocious male puberty has not been reported.

Case Description: We present a boy with gonadotropin-independent precocious puberty and rapid virilization beginning in infancy resistant to standard therapy.

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Documented Visio-Vestibular Examination and Anticipatory Guidance for Pediatric Concussion Patients.

Pediatr Emerg Care

March 2023

Sports Medicine and Performance Center, Children's Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Objectives: Pediatric concussion patients are frequently managed in the primary care or acute care settings. Optimal care includes vision and vestibular assessments, as well as targeted anticipatory guidance for return to school and activity. We aimed to examine clinical practices related to the evaluation and management of concussion patients at children's hospital-based emergency department (ED) and primary care/urgent care settings.

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Article Synopsis
  • Acute lymphoblastic leukemia (ALL) is the most common cancer in children, and a study of 2,754 patients reveals that despite a low mutation burden, each case typically has about four important genetic alterations.
  • Researchers identified 376 potential driver genes linked to various functions like gene regulation and cell processes, with many patients having unique gene changes associated with leukemia.
  • The study highlights a difference in mutation patterns between B-ALL subtypes, with certain genetic alterations having significant implications for prognosis and potential treatment strategies.
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Aim: Cardiac arrest often results in severe neurologic injury. Improving care for these patients is difficult as few noninvasive biomarkers exist that allow physicians to monitor neurologic health. The amount of low-frequency power (LFP, 0.

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The mitochondrial adenine nucleotide transporters in myogenesis.

Free Radic Biol Med

August 2022

Center for Molecular and Mitochondrial Medicine and Genetics and the Department of Biological Chemistry, University of California, Irvine, CA, USA; Center for Mitochondrial and Epigenomic Medicine, Department of Pediatrics, Division of Human Genetics, Children's Hospital of Philadelphia and The Perelman School of Medicine, University of Pennsylvania, PA, USA. Electronic address:

Adenine Nucleotide Translocator isoforms (ANTs) exchange ADP/ATP across the inner mitochondrial membrane, are also voltage-activated proton channels and regulate mitophagy and apoptosis. The ANT1 isoform predominates in heart and muscle while ANT2 is systemic. Here, we report the creation of Ant mutant mouse myoblast cell lines with normal Ant1 and Ant2 genes, deficient in either Ant1 or Ant2, and deficient in both the Ant1 and Ant2 genes.

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Article Synopsis
  • There is a genetic link to childhood acute lymphoblastic leukemia (ALL), particularly involving non-coding variants at the ARID5B gene locus, which are linked to leukemia risk but have unclear functional effects.
  • Researchers analyzed the ARID5B gene in over 5,000 children with ALL and identified variants that could impact the gene's expression and susceptibility to leukemia, confirming their findings using advanced genomic techniques.
  • A highly significant risk variant (rs7090445) was found within an enhancer region that affects the binding of the transcription factor MEF2C, suggesting a crucial role for this mechanism in the development of ALL.
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Background: Children with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children's Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subset of National Cancer Institute standard-B-ALL (SR AR B-ALL). We longitudinally measured CIPN, overall and by treatment group.

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Background: Intraoperative isoelectric electroencephalography (EEG) has been associated with hypotension and postoperative delirium in adults. This international prospective observational study sought to determine the prevalence of isoelectric EEG in young children during anesthesia. The authors hypothesized that the prevalence of isoelectric events would be common worldwide and associated with certain anesthetic practices and intraoperative hypotension.

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Rarely, immunophenotypically immature B-cell precursor acute lymphoblastic leukemia (BCP-ALL) carries an immunoglobulin- MYC rearrangement (IG-MYC-r). This can result in diagnostic confusion with Burkitt lymphoma/leukemia and use of individualized treatment schedules of unproven efficacy. Here we compare the molecular characteristics of these conditions and investigate historic clinical outcome data.

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Background: The Pediatric and Congenital Electrophysiology Society (PACES) is a global organisation committed to the care of children and adults with CHD and arrhythmias.

Objective: To evaluate the global needs and potential inequities as it relates to cardiac implantable electronic devices.

Methods: ARROW (Assessment of Rhythm Resources arOund the World) is an online survey about cardiac implantable electronic devices, sent electronically to physicians within the field of Cardiology, Pediatric Cardiology, Electrophysiology and Pediatric Electrophysiology.

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Article Synopsis
  • The study aimed to enhance the treatment of T-cell acute lymphoblastic leukemia (T-ALL) and lymphoblastic lymphoma (T-LL) by testing the proteasome inhibitor bortezomib and reducing the use of prophylactic cranial radiation (CRT) in newly diagnosed patients.
  • In a clinical trial involving over 800 patients, a modified chemotherapy regimen was used, comparing outcomes between patients who received bortezomib and those who did not, with the goal of assessing event-free survival (EFS) and overall survival (OS).
  • Results indicated that bortezomib significantly improved EFS and OS for T-LL patients, while allowing a dramatic reduction in CRT usage
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Transcriptome sequencing has identified multiple subtypes of B-progenitor acute lymphoblastic leukemia (B-ALL) of prognostic significance, but a minority of cases lack a known genetic driver. Here, we used integrated whole-genome (WGS) and -transcriptome sequencing (RNA-seq), enhancer mapping, and chromatin topology analysis to identify previously unrecognized genomic drivers in B-ALL. Newly diagnosed (n = 3221) and relapsed (n = 177) B-ALL cases with tumor RNA-seq were studied.

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Background: Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infants and children, and carries a considerable risk of neurological damage and developmental delays if diagnosis and treatment are delayed. Despite rapid advances in diagnosis and management, long-term developmental outcomes have not significantly improved in the past years. CHI remains a disease that is associated with significant morbidity, and psychosocial and financial burden for affected families, especially concerning the need for constant blood glucose monitoring throughout patients' lives.

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Objective: To develop and test a measure of patient-centered care (PCC) culture in hospital-based perinatal care.

Data Sources: Data were obtained from US perinatal hospitals: one provided survey development data and 14 contributed data for survey testing.

Study Design: We used qualitative and quantitative methods to develop the mother-infant centered care (MICC) culture survey.

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Inherited noncoding genetic variants confer significant disease susceptibility to childhood acute lymphoblastic leukemia (ALL) but the molecular processes linking germline polymorphisms with somatic lesions in this cancer are poorly understood. Through targeted sequencing in 5,008 patients, we identified a key regulatory germline variant in GATA3 associated with Philadelphia chromosome-like ALL (Ph-like ALL). Using CRISPR-Cas9 editing and samples from patients with Ph-like ALL, we showed that this variant activated a strong enhancer that upregulated GATA3 transcription.

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