Multiplex Polymerase Chain Reaction Versus Standard Bacterial Culture in Critically Ill Children With Suspected Pneumonia.

Background: Bacterial lower respiratory tract infection, particularly ventilator-associated pneumonia (VAP), is a significant cause of morbidity and mortality in children who require mechanical ventilation (MV). Microbiologic diagnosis has relied on bacterial culture, but reverse transcriptase polymerase chain reaction (RT-PCR) with bacterial targets is now available for clinical use. We compared the diagnostic performance of tracheal aspirate (TA) multiplex RT-PCR to culture in children requiring MV with suspected lower respiratory tract infection.

Ethnic and racial differences in children and young people with respiratory and neurological post-acute sequelae of SARS-CoV-2: an electronic health record-based cohort study from the RECOVER Initiative.

Background: Children from racial and ethnic minority groups are at greater risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but it is unclear whether they have increased risk for post-acute sequelae of SARS-CoV-2 (PASC). Our objectives were to assess whether the risk of respiratory and neurologic PASC differs by race/ethnicity and social drivers of health.

Methods: We conducted a retrospective cohort study of individuals <21 years seeking care at 24 health systems across the U.

Practice patterns for acquiring neuroimaging after pediatric in-hospital cardiac arrest.

Aims: To determine which patient and cardiac arrest factors were associated with obtaining neuroimaging after in-hospital cardiac arrest, and among those patients who had neuroimaging, factors associated with which neuroimaging modality was obtained.

Methods: Retrospective cohort study of patients who survived in-hospital cardiac arrest (IHCA) and were enrolled in the ICU-RESUS trial (NCT02837497).

Results: We tabulated ultrasound (US), CT, and MRI frequency within 7 days following IHCA and identified patient and cardiac arrest factors associated with neuroimaging modalities utilized.

Racial/ethnic differences in post-acute sequelae of SARS-CoV-2 in children and adolescents in the United States.

Racial/ethnic differences are associated with the symptoms and conditions of post-acute sequelae SARS-CoV-2 infection (PASC) in adults. These differences may exist among children and warrant further exploration. We conducted a retrospective cohort study with difference-in-differences analyzes to assess these differences in children and adolescents under the age of 21.

Digital Health for Asthma Management: Electronic Medication Monitoring for Adherence as a Case Example.

Digital health is an umbrella term for components of healthcare utilizing computer platforms, software, connectivity and sensors to augment the recording, documentation and communication of clinical information. The functions of digital health may be viewed in three domains: 1) the repository for patient information, 2) monitoring devices and 3) communication tools. Monitoring devices have provided robust information as diagnostic and prognostic tools in office and hospital settings.

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Background: Pediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI.

Methods: We analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 U.

Economic Impact of the Apoyo con Cariño Intervention: Improving Palliative Care for Hispanics with Serious Illness.

Specialty palliative care has been associated with cost savings at the end of life, while patient navigators have been independently associated with cost savings due to screening and treatment early in the course of disease. Evidence is limited regarding patient navigators and cost savings at the end of life. To determine the cost-effectiveness of a lay patient navigator intervention in improving palliative care outcomes for Hispanic persons with serious noncancer illness.

Congenital Pulmonary Airway Malformation Associated With Papillary Adenocarcinoma.

Congenital pulmonary airway malformations (CPAMs) are cystic lung lesions often detected prenatally. Resection is often recommended for potential recurrent infections and malignancy. This report describes a case of a 14-year-old female patient who presented with abdominal pain.

Venoarterial Extracorporeal Membrane Oxygenation for Support of Vasodilatory Shock in Children Due to Toxicological Ingestions.

Venoarterial extracorporeal membrane oxygenation (VA ECMO) may provide temporary hemodynamic support for patients with severe vasodilatory shock due to toxicologic ingestion. In a series of 10 cases of children less than 18 years of age who received VA ECMO support for toxicologic-induced vasodilatory shock, there were eight survivors and two nonsurvivors who died of significant neurologic injury. Upon initiation of ECMO support, survivors had decline in Vasoactive-Inotrope Scores (VIS).

Association Between Early Immunosuppression Center Variability and One-Year Outcomes After Pediatric Liver Transplant.

Background: Despite the existence of institutional protocols, liver transplant centers often have variability in early immunosuppression practices. We aimed to measure within-center variability in early immunosuppression after pediatric liver transplant (LT) and examine its association with one-year outcomes.

Methods: We analyzed pediatric LTs from 2013 to 2018 in the United Network for Organ Sharing registry, with data aggregated by center.

Diverse phenotype of Ménière's disease associated with family history, thyroid disorder, migraine and associated disorders.

Objective: To better understand the clinical phenotype of Ménière's disease (MD), we examined family history, thyroid disorder, migraine, and associated disorders in complaints of people living with MD.

Method: We designed the study as a retrospective and examined data gathered from 912 participants with MD. Their data were originally collected by the Finnish Ménière Federation (FMF).

Oral Delivery of miR146a Conjugated to Cerium Oxide Nanoparticles Improves an Established T Cell-Mediated Experimental Colitis in Mice.

Dysregulated inflammation and oxidative stress are strongly implicated in the pathogenesis of inflammatory bowel disease. We have developed a novel therapeutic that targets inflammation and oxidative stress. It is comprised of microRNA-146a (miR146a)-loaded cerium oxide nanoparticles (CNPs) (CNP-miR146a).

Real-world effectiveness and causal mediation study of BNT162b2 on long COVID risks in children and adolescents.

Background: The impact of pre-infection vaccination on the risk of long COVID remains unclear in the pediatric population. We aim to assess the effectiveness of BNT162b2 on long COVID risks with various strains of the SARS-CoV-2 virus in children and adolescents, using comparative effectiveness methods. We further explore if such pre-infection vaccination can mitigate the risk of long COVID beyond its established protective benefits against SARS-CoV-2 infection using causal mediation analysis.

Comorbidity Among Adults With Epilepsy - United States, 2021-2022.

While it is known that epilepsy often co-occurs with psychiatric disorders, few studies have examined nonpsychiatric comorbidity. We analyzed 2021 and 2022 National Health Interview Survey Sample Adult data. Compared with adults with no epilepsy, the 1.

Self-Harm as a Contributor to the Opioid Epidemic: Data From the Toxicology Investigators Consortium Registry.

Objectives: Although considerable focus has been placed on understanding the causes of opioid drug overdoses, the intentions for such overdoses are not well characterized. We investigated the motivations behind nonfatal opioid exposures resulting in serious adverse health outcomes.

Methods: We analyzed prospectively collected data on nonfatal opioid overdoses in the multicenter Toxicology Investigators Consortium (ToxIC) Core Registry between 2014 and 2021.

Synchrotron-Based Phase-Contrast Micro-CT Combined With Histology to Decipher Differences Between Hereditary and Sporadic Pediatric Pulmonary Veno-Occlusive Disease.

Pulmonary veno-occlusive disease (PVOD) is a lethal variant of pulmonary hypertension. The degree of pulmonary arterial involvement varies. Here, we compare two PVOD patients who were transplanted at 8 years of age, whereof one is a homozygous mutation carrier.

Musculoskeletal Ultrasound Practices of Graduates of a Blended-Learning Program: A Survey of Rheumatologists From the United States.

Objective: Not much is known regarding musculoskeletal ultrasound (MSUS) practices of rheumatologists in the United States. We sought to determine the current use of MSUS among past participants of the Ultrasound School of North American Rheumatologists (USSONAR) training program and, by extension, MSUS-practicing rheumatologists and to understand barriers to its MSUS use.

Methods: An online survey was sent to 374 participants in the eight-month USSONAR blended course (Fundamentals in Musculoskeletal Ultrasound and Train the Trainer) between 2009 and 2020.

Setmelanotide in patients aged 2-5 years with rare MC4R pathway-associated obesity (VENTURE): a 1 year, open-label, multicenter, phase 3 trial.

Background: Setmelanotide, a melanocortin-4 receptor (MC4R) agonist, has been shown to reduce hunger and weight in patients aged 6 years and older with proopiomelanocortin (POMC) deficiency (including biallelic variants in proprotein convertase subtilisin/kexin type 1 [PCSK1]), leptin receptor (LEPR) deficiency, or Bardet-Biedl syndrome (BBS). No approved therapies for patients younger than 6 years old currently exist. The phase 3, open-label VENTURE trial aimed to evaluate the efficacy and safety of setmelanotide in patients aged 2-5 years with POMC or LEPR deficiency or BBS.

Integrating an Ethics Advisory Committee Into Public Health Response: A Case Study of COVID-19, Infection Prevention and Control, and Essential Work in the United States.

A lack of infection prevention and control protections for essential industries in the United States led to increased risk and incidence of COVID-19 among essential workers during the COVID-19 pandemic. When the nation deems an industry essential during a disease outbreak, an ethical obligation exists to safeguard the health of workers who are at increased risk of being exposed to disease. The Global Center for Health Security at the University of Nebraska Medical Center began work to rapidly develop and disseminate infection prevention and control guidance for essential industries, such as meat processing.

Liberation from Respiratory Support in Bronchopulmonary Dysplasia.

Objective: To estimate the association between the mode of respiratory support administered at 36 weeks' post-menstrual age (PMA) with time-to-liberation from respiratory support (LRS) in infants with grade 2/3 bronchopulmonary dysplasia (BPD).

Study Design: Daily respiratory support data were abstracted for infants born <32 weeks' gestation with grade 2/3 BPD enrolled in the Children's Hospitals Neonatal Database between 2017 and 2022. The main exposure was the mode of respiratory support received at 36 weeks' PMA: high flow nasal cannula >2 L/min (HFNC), continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV), or mechanical ventilation (MV).