Tofacitinib in Pediatric Ulcerative Colitis: A Retrospective Multicenter Experience.

Background: Tofacitinib has recently been approved for treatment of moderate-to-severe ulcerative colitis (UC) in adults, yet pediatric data are limited. This international multicenter study describes the effectiveness and safety of tofacitinib in pediatric UC.

Methods: This is a retrospective review of children diagnosed with UC treated with tofacitinib from 16 pediatric centers internationally.

Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy.

Background: No approved treatment for peanut allergy exists for children younger than 4 years of age, and the efficacy and safety of epicutaneous immunotherapy with a peanut patch in toddlers with peanut allergy are unknown.

Methods: We conducted this phase 3, multicenter, double-blind, randomized, placebo-controlled trial involving children 1 to 3 years of age with peanut allergy confirmed by a double-blind, placebo-controlled food challenge. Patients who had an eliciting dose (the dose necessary to elicit an allergic reaction) of 300 mg or less of peanut protein were assigned in a 2:1 ratio to receive epicutaneous immunotherapy delivered by means of a peanut patch (intervention group) or to receive placebo administered daily for 12 months.

The Supported vs Unsupported Ross in Pediatric Patients: Neoaortic Root and Ventricular Function.

Background: The supported Ross is used to mitigate the neoaortic root dilation that has been described with the unsupported Ross. There is limited literature assessing the efficacy of the supported Ross in young patients. In this study, the fate of the neoaortic root was compared in the supported and unsupported Ross procedure in adolescent patients.

"Acquired" Brugada syndrome in a cardiac allograft.

Introduction: Brugada syndrome is an inherited channelopathy characterized by arrhythmia and an increased risk of sudden cardiac death (SCD). Implantation of a defibrillator for primary or secondary prevention is the only effective strategy to decrease the risk of SCD in Brugada syndrome. We present a case in which a cardiac donor had a pathogenic variant for Brugada syndrome, discovered on genetic testing after transplantation.

Rejection surveillance in pediatric heart transplant recipients: Critical reflection on the role of frequent and long-term routine surveillance endomyocardial biopsies and comprehensive review of non-invasive rejection screening tools.

Background: Despite significant medical advances in the field of pediatric heart transplantation (HT), acute rejection remains an important cause of morbidity and mortality. Endomyocardial biopsy (EMB) remains the gold-standard method for diagnosing rejection but is an invasive, expensive, and stressful process. Given the potential adverse consequences of rejection, routine post-transplant rejection surveillance protocols incorporating EMB are widely employed to detect asymptomatic rejection.

Adverse Events Associated with Cardiac Catheterization in Children Supported with Ventricular Assist Devices.

Children on ventricular assist device (VAD) support can present several unique challenges, including small patient size, univentricular or biventricular congenital heart disease (1V- or 2V-CHD) and need for biventricular VAD (BiVAD) support. While cardiac catheterization can provide valuable information, it is an invasive procedure with inherent risks. We sought to evaluate the safety of catheterization in pediatric patients on VAD support.

Pediatric autoimmune gastritis: clinical correlates and histologic features.

Autoimmune gastritis is a well-known pathologic entity, but there are few studies that examine its clinical and histologic presentation in children. This is a single institution, retrospective study performed on patients diagnosed from 2011 through 2019. Patients were identified by their pathologic diagnosis within the laboratory information system.

Pediatric Chest Radiographic and CT Findings of Electronic Cigarette or Vaping Product Use-associated Lung Injury (EVALI).

Background Electronic cigarette or vaping product use-associated lung injury (EVALI) is a serious public health concern with substantial morbidity and mortality, particularly in young individuals. Purpose To evaluate chest radiographic and chest CT findings of EVALI in the pediatric population. Materials and Methods This was a retrospective study of children who presented to a tertiary pediatric hospital from December 2018 to December 2019.

Early experience with the HeartMate 3 continuous-flow ventricular assist device in pediatric patients and patients with congenital heart disease: A multicenter registry analysis.

Background: The HeartMate 3 ventricular assist device (VAD) is a newer centrifugal continuous-flow VAD used for bridge-to-transplant and destination therapy in adults. However, there is limited experience regarding its use in children and adults with complex congenital heart disease (CHD).

Methods: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) is a multicenter learning network comprised of pediatric hospitals implanting VADs in children and adults with complex CHD.

Validating peritonsillar abscess drainage rates using the Pediatric hospital information system data.

Objectives: To evaluate the accuracy of the Children's Hospital Association's Pediatric Health Information System (PHIS) registry data in determining surgical drainage rates as compared to a chart review on the same cohort of children with diagnosis of peritonsillar abscess.

Study Design: Retrospective analysis.

Methods: Our analysis included 200 children, ages 2 to 17 years, treated for a peritonsillar abscess from 2011 to 2016.

Double-Blind, Randomized, Placebo-Controlled Trial Comparing the Effects of Antithrombin Versus Placebo on the Coagulation System in Infants with Low Antithrombin Undergoing Congenital Cardiac Surgery.

Objectives: To determine whether precardiopulmonary bypass (CPB) normalization of antithrombin levels in infants to 100% improves heparin sensitivity and anticoagulation during CPB and has beneficial effects into the postoperative period.

Design: Randomized, double-blinded, placebo-controlled prospective study.

Setting: Multicenter study performed in 2 academic hospitals.

Telemedicine in pediatric surgery.

Importance: Telemedicine is an emerging strategy for healthcare delivery that has the potential to expand access, optimize efficiency, minimize cost, and enhance patient satisfaction.

Objective: To review the current spectrum, potential strategies, and implementation process of telemedicine in pediatric surgery.

Design: Review and opinion design.

Iron Deficiency Anemia in Adolescents Who Present with Heavy Menstrual Bleeding.

Study Objective: To assess the clinical severity and initial treatment of iron deficiency anemia (IDA) in female adolescents with heavy menstrual bleeding (HMB) in our center.

Design: Retrospective cohort study of electronic medical records via search of administrative records using International Classification of Diseases Ninth Revision codes for IDA or unspecified anemia and disorders of menstruation.

Setting: Children's Medical Center in Dallas, Texas.

Comparison of Complications of Robot-Assisted Laparoscopic and Open Appendicovesicostomy in Children.

Purpose: Robot-assisted laparoscopic appendicovesicostomy in children has become increasingly popular. However, the literature on this technique mainly consists of small case series with only 1 small comparison to an open cohort. We compared the number of complications and surgical revisions required with open and robotic surgery in children undergoing appendicovesicostomy at our institution.

Family-centered rounds.

Family-centered rounds (FCRs) are multidisciplinary rounds that involve medical teams partnering with patients and families in daily medical decision-making. Multiple FCR benefits have been identified including improving patient satisfaction, communication, discharge planning, medical education, and patient safety. Main barriers to FCRs are variability in attending rounding, duration of rounds, physical constrains of large teams and small rooms, specific and sensitive patient conditions, and lack of training of residents, students, and faculty on how to conduct effective and effecient FCRs.

Unruptured sinus of valsalva aneurysm in a neonate with hypoplastic left heart syndrome: echocardiographic diagnosis and features.

An unruptured sinus of Valsalva aneurysm is usually asymptomatic, and a rare, often incidental echocardiographic diagnosis. Its presentation in the neonatal period is extremely rare. We describe this finding in a neonate with hypoplastic left heart syndrome, which has not been previously reported in the literature.

Foreskin reconstruction does not increase urethroplasty or skin complications after distal TIP hypospadias repair.

Aim: To compare urethral and skin complications between consecutive patients undergoing distal TIP (tubularized incised plate) hypospadias repair with prepucioplasty versus circumcision.

Methods: Prospective case-cohort study comparing urethroplasty and skin complications between consecutive patients undergoing distal TIP with prepucioplasty versus circumcision. Those with <1 month follow-up or prior circumcision were excluded.

Anesthesiology residents' medical school debt influence on moonlighting activities, work environment choice, and debt repayment programs: a nationwide survey.

Background: The amount of education debt incurred by medical school graduates in the United States has grown considerably over the last 30 years; it has outpaced inflation to reach a mean of $158,000. With this dramatic increase in education debt, there has been limited information on how medical school debt loads of anesthesiology physicians impact their decisions concerning moonlighting and future career choices. Our aim was to survey current anesthesiology interns, residents, and fellows to assess the correlation between the amount of medical school debt they had collected and (1) their outlook toward moonlighting activities, (2) future career plans, and (3) choice of employer with a debt repayment program.

Melanotic neuroectodermal tumor of infancy: report of one calvarial lesion with T1 shortening and one maxillary lesion.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare tumor which commonly involves the mandible, maxilla and calvarium. We report two infants with this rare tumor. T1 shortening due to melanin content has been rarely described in MNTI.

Management of penile curvature in children.

Purpose Of Review: Ventral penile curvature occurs in both hypospadias and so-called 'chordee without hypospadias', and so its correction is a topic of relevance to pediatric urologists.

Recent Findings: Dorsal plication and ventral corporal incision with grafting are the two most commonly used methods to straighten ventral penile curvature. Urethral plate elevation from the corpora has previously been reported to reduce bending, and in the past year this maneuver has been combined with ventral corporal grafting or with dissection of the formed urethra to the bulb to achieve straightening while conserving the plate for urethroplasty.