911 results match your criteria: "University Children's Medical Institute[Affiliation]"

Background: In endemic COVID-19, immunocompromised children are vulnerable until vaccinated but the optimal primary vaccination regime and need for booster doses remains uncertain.

Methods: We recruited 19 immunocompromised children (post-solid organ transplantation, have autoimmune disease or were on current or recent chemotherapy for acute lymphoblastic leukemia), and followed them from the start of primary vaccination with BNT162b2 mRNA SARS-CoV-2 until 1-year post-vaccination. We investigated the quality of vaccine immunogenicity, and longevity of hybrid immunity, in comparison to healthy children.

View Article and Find Full Text PDF

Infection prevention and control (IPC) programs form the basis of minimizing spread of pathogens in the healthcare setting and beyond. The COVID-19 pandemic amplified the demand for IPC. However, the environmental impact of IPC practices has yet to be addressed and attempts to quantify its climate implications have been sparse.

View Article and Find Full Text PDF

This study aimed to explore Singaporean fathers' perceived influence over their children's eating habits. A descriptive qualitative study design was used. Convenience sampling was used to recruit fathers of children aged 3-21 years old from a general paediatric outpatient clinic in a tertiary public hospital.

View Article and Find Full Text PDF

Evaluating post-cardiac arrest blood pressure thresholds associated with neurologic outcome in children: Insights from the pediRES-Q database.

Resuscitation

December 2024

Department of Pediatrics, Division of Critical Care Medicine, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, 1184 5th Ave, New York, NY 10029, USA.

Background: Current Pediatric Advanced Life Support Guidelines recommend maintaining blood pressure (BP) above the 5th percentile for age following return of spontaneous circulation (ROSC) after cardiac arrest (CA). Emerging evidence suggests that targeting higher thresholds, such as the 10th or 25th percentiles, may improve neurologic outcomes. We aimed to evaluate the association between post-ROSC BP thresholds and neurologic outcome, hypothesizing that maintaining mean arterial pressure (MAP) and systolic blood pressure (SBP) above these thresholds would be associated with improved outcomes at hospital discharge.

View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on preventing early childhood caries (ECC), a common disease in kids, by empowering parents with technology-enabled support to improve their children's diets and oral hygiene practices.
  • Participants will include mother-child pairs from Singapore who will either receive traditional educational materials or attend online sessions designed to enhance parental involvement and support; various assessments will track the incidence of caries and other related outcomes.
  • With ethical approval in place, the study aims to publish its findings in peer-reviewed journals, contributing valuable insights on the effectiveness and cost-effectiveness of the intervention.
View Article and Find Full Text PDF

Should newborn genetic testing for autism be introduced?

J Med Ethics

December 2024

Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

This manuscript provides a review of the potential role of newborn genetic testing for autism, and whether the state has an inherent responsibility to facilitate and subsidise this. This is situated within the broader construct of benefits and limitations of genetic testing currently. Potential benefits of such presymptomatic genetic testing include facilitating earlier diagnosis and access to appropriate intervention which can improve the treatment outcome for the child and indirectly benefit caregivers and society by reducing the care needs of the child and adult in future.

View Article and Find Full Text PDF

Global burden of disease attributable to metabolic risk factors in adolescents and young adults aged 15-39, 1990-2021.

Clin Nutr

December 2024

MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. Electronic address:

Background: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally.

Aims: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15-39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database.

Methods: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults.

View Article and Find Full Text PDF

Teaching NeuroImage: Prognostication of X-Linked Adrenoleukodystrophy Based on the Loes Neuroimaging Score.

Neurology

December 2024

From the Khoo Teck Puat-National University Children's Medical Institute (C.Y.S.L., N.B.H.N., V.H., K.Y.L., J.B.L.), Department of Paediatrics, National University Health Systems; Department of Paediatrics (N.B.H.N., V.H., K.Y.L., J.B.L.), Yong Loo Lin School of Medicine, National University of Singapore; and Department of Diagnostic Imaging (C.Y.), National University Health System, Singapore.

View Article and Find Full Text PDF

Asian birth cohort studies on allergic diseases: The A2BC network initiative.

Pediatr Allergy Immunol

November 2024

Department of Pediatrics, Childhood Respiratory Allergy Center, Humidifier Disinfected Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

The Asia Allergy Birth Cohort (A2BC) network consolidates data from multiple independently established birth cohorts across Asia to enhance research on host-environment interactions in allergic diseases. These cohorts, established at different times with various methodologies, are reliable data sources. Our aim is to introduce the content, variables, and outcomes of these cohorts while highlighting their differences, laying the groundwork for future collaborative research.

View Article and Find Full Text PDF

Background: Body mass index (BMI) trajectories have been used to assess the growth of children with respect to their peers, and to anticipate future obesity and disease risk. While retrospective BMI trajectories have been actively studied, models to prospectively predict continuous BMI trajectories have not been investigated.

Materials And Methods: Using longitudinal BMI measurements between birth and age 10 y from a mother-offspring cohort, we leveraged a multi-task Gaussian process approach to develop and evaluate a unified framework for modeling, clustering, and prospective prediction of BMI trajectories.

View Article and Find Full Text PDF

The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production.

Am J Clin Nutr

November 2024

School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore; Department of Obstetrics and Gynaecology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia. Electronic address:

Background: The development of the breast for lactation occurs throughout pregnancy. It is unknown whether pregnancy complications resulting in poor fetal growth can affect breastfeeding (BF) success.

Objectives: We examined whether fetal growth-related pregnancy complications were associated with earlier BF cessation and changes in the concentrations of human milk biomarkers of low milk production.

View Article and Find Full Text PDF

Health claims for many probiotic-labeled products are poorly substantiated. This technical review addressed the clinical question: "Do probiotics have a role in the management of the following conditions in childhood?" Evidence supports efficacy for probiotic strains of Saccharomyces boulardii, Lactobacillus reuteri, and Lactobacillus rhamnosus GG for improving outcomes of acute gastroenteritis, of S. boulardii and L.

View Article and Find Full Text PDF

Background: Epidemiological data on pediatric inflammatory bowel disease (PIBD) have been reported in Asian countries. However, short-term follow-up data, especially in Southeast Asian countries, are limited.

Purpose: Analyze and compare the baseline and 1-year follow-up (1FU) data for PIBD in Asian children.

View Article and Find Full Text PDF

Selective Feeding-An Under-Recognised Contributor to Picky Eating.

Nutrients

October 2024

Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore 119228, Singapore.

: Amongst children presenting to an interdisciplinary clinic with complaints of picky eating, we aim to identify the proportion who have underlying selective feeding and to describe its implications on growth and nutrition, as well as parental coping responses. : We conducted a retrospective chart review of first-visit consults from January 2020 to July 2022. Caregiver and child mealtime behaviours were assessed using the standardised Caregiver's Feeding Styles Questionnaire (CFSQ) and by direct observation.

View Article and Find Full Text PDF

Diet, growth, nutritional status and predictors of severity of feeding difficulties in autistic children with co-occurring pediatric feeding disorder.

Early Hum Dev

December 2024

Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Paediatric Gastroenterology, Nutrition, Hepatology and Liver Transplantation, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.

Background: Feeding difficulties are commonly reported in autistic children. However, there is limited data on the presentation, severity, and impact of feeding difficulties in autistic children in Asia.

Aims: To describe the dietary patterns, growth and nutritional status of autistic children with pediatric feeding disorder (PFD), and identify factors associated with more severe feeding difficulties.

View Article and Find Full Text PDF

The cost of caring for patients and their families in the midst of interconnected resource, ethical, moral, legal and practical considerations compromises a physician's emotional and physical well-being and therefore patient care. Whilst the cost of caring is historically best associated with compassion fatigue, data has suggested that this may extend to other related concepts, such as vicarious trauma, secondary traumatic stress and burnout. In particular, palliative care physicians are especially vulnerable as they witness and encounter more cases of death and dying.

View Article and Find Full Text PDF

This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist.

View Article and Find Full Text PDF

Case report: Dichloroacetate-induced methaemoglobinaemia in a G6PD-deficient neonate.

Pediatr Blood Cancer

January 2025

Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore.

A 3-week-old neonate with glucose-6-phosphate dehydrogenase (G6PD) deficiency and primary lactic acidosis developed haemolytic jaundice and methaemoglobinaemia following treatment with dichloroacetate (DCA), a standard treatment for primary lactic acidosis. While this mechanism has been reported in the sheep model, it has not been described in humans. Our case reinforces the uncommon observation that a G6PD-deficient individual experiencing oxidative stress may develop concurrent methaemoglobinaemia.

View Article and Find Full Text PDF

Background: Bilateral hemorrhagic thalamic lesions in dengue encephalitis resemble lesions seen in acute necrotizing encephalopathy (ANE). We investigate whether dengue-associated ANE (DANE) should be considered an ANE variant or a mimic.

Methods: Systematic review of dengue encephalitis literature from PubMed and SCOPUS (inception to December 31, 2022).

View Article and Find Full Text PDF
Article Synopsis
  • Despite the primary focus on clinical skills in healthcare education, developing psycho-social competencies like empathy is vital for both patient and professional benefits.
  • Current approaches to teaching empathy are often inconsistent, with little research on comprehensive, empathy-centered curricula.
  • This study will evaluate the impact of a new, focused curriculum on empathy among healthcare freshmen in Singapore, utilizing mixed methods to gather both quantitative and qualitative data.
View Article and Find Full Text PDF

Background: Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.

Methods: In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular thrombectomy plus best medical practice or best medical treatment alone.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the effectiveness and safety of rituximab for treating childhood steroid-resistant nephrotic syndrome (SRNS) across 28 pediatric nephrology centers globally.
  • Researchers found that children with a longer history of calcineurin inhibitors (CNIs) treatment before rituximab had lower remission rates compared to those with shorter treatment periods.
  • Overall, rituximab showed enhanced remission rates in a portion of SRNS patients, was mostly safe, and achieving complete remission was linked to better kidney survival outcomes.
View Article and Find Full Text PDF

Sleep, Well-Being, and Cognition in Medical Interns on a Float or Overnight Call Schedule.

JAMA Netw Open

October 2024

Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Article Synopsis
  • Extended work hours and night shifts in healthcare can negatively impact physicians' sleep, well-being, and patient care, suggesting that alternative work schedules with shorter hours may help alleviate these problems.
  • An observational study tracked interns at a Singapore hospital for 8 weeks to compare the effects of irregular, extended shifts versus more regular, restricted-hour schedules on sleep, well-being, and cognitive performance.
  • Results indicated that participant well-being and sleep patterns varied significantly between those on irregular call schedules and those on a float schedule, highlighting the potential benefits of more predictable work hours for healthcare professionals.
View Article and Find Full Text PDF
Article Synopsis
  • The project aims to reduce neonatal deaths in premature infants, particularly very low birth weight (VLBW) infants, in low- and middle-income countries by forming an international collaboration called AsianNeo with various Asian countries.
  • AsianNeo includes nine neonatal networks from countries like Indonesia, Japan, and South Korea, and will conduct four main studies focused on assessing resources, outcomes, and quality improvements in neonatal care.
  • The study has received ethical approval and will share findings through educational programs, conferences, and medical journals to enhance neonatal care quality across the participating countries.
View Article and Find Full Text PDF