Management of Twin Reversed Arterial Perfusion Sequence: A Systematic Review and Meta-Analysis.

Introduction: Twin reversed arterial perfusion (TRAP) sequence is a rare complication of monochorionic twin pregnancies characterized by placental anastomoses between a normally developed twin and an acardiac mass. Though several treatment modalities exist, the optimal management strategy is unclear. This study aimed to compare the various treatment strategies for TRAP sequence.

Sociodemographic differences in treatment of acute respiratory infections in pediatric urgent cares.

Objective: To determine whether differences exist in antibiotic prescribing for respiratory infections in pediatric urgent cares (PUCs) by patient race/ethnicity, insurance, and language.

Design: Multi-center cohort study.

Setting: Nine organizations (92 locations) from 22 states and Washington, DC.

Comparative Analysis of Large Language Models and Spine Surgeons in Surgical Decision-Making and Radiological Assessment for Spine Pathologies.

Objective: This study aimed to investigate the accuracy of large language models (LLMs), specifically ChatGPT and Claude, in surgical decision-making and radiological assessment for spine pathologies compared to experienced spine surgeons.

Methods: The study employed a comparative analysis between the LLMs and a panel of attending spine surgeons. Five written clinical scenarios encompassing various spine pathologies were presented to the LLMs and surgeons, who provided recommended surgical treatment plans.

Prophylactic Vancomycin Leads to Fewer Device Removals in Sacral Neuromodulation.

Importance: Sacral neuromodulation (SNM) requires removal for infectious complications in 3-11%.

Objective: The objective of this study was to examine the effect of preoperative antibiotic choice on all-cause SNM device removal rates.

Study Design: This was a retrospective cohort analysis, using the Health Facts Database, representing more than 750 hospitals.

Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword.

Objective: Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on risk of atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF.

Patients And Methods: A PubMed search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, vagal tone.

Six year natural progression of a clinically monitored retroperitoneal schwannoma: A case report.

Introduction And Importance: Schwannomas arise from Schwann cells, which make up the neural sheath of peripheral nerves. These tumors are usually seen in the head, neck and flexor surfaces, but can arise in the retroperitoneal space on rare occasions. This case gives the unique opportunity to watch the long term progression and speed of growth of this rare tumor and the development of symptoms over time.

Methadone metabolism and cytochrome P450 polymorphisms: a systematic review and meta-analysis.

Introduction: Confusion regarding methadone metabolism exists, hampering optimal clinical use. A systematic review was conducted to assess the impacts of cytochrome P450 (CYP) genetic polymorphisms on methadone outcomes.

Methods: MEDLINE, EMBASE, Web of Science, PsycINFO, and CENTRAL were searched to identify studies reporting methadone dose-adjusted plasma concentrations, clearance, maintenance dose, or treatment response in relation to polymorphisms in humans.

Associations Among Problematic Internet Usage in Adolescents, Parental Internet Factors, and Parent-Adolescent Communication.

Objective: Adolescents with problematic internet use (PIU) have excessive, impulsive, or risky internet use that negatively affects social, physical, and functional outcomes. The role of parents in the prevention of adolescent PIU remains unclear. The purpose of this study was to evaluate possible association between adolescent PIU, parent PIU, and internet-related parenting factors.

Selective Mutism in the Context of Autism and Bilingualism.

Juan is a 5-year-old boy who has been followed by a developmental-behavioral pediatrician and pediatric neuropsychologist since being diagnosed with language delay and autism spectrum disorder at age 2 years. He is otherwise healthy and was born at term after a healthy pregnancy. His primary language is Spanish, and he has minimal interactions in English.

Readability Metrics in Patient Education: Where Do We Innovate?

The increasing use of digital applications in healthcare has led to a greater need for patient education materials. These materials, often in the form of pamphlets, booklets, and handouts, are designed to supplement physician-patient communication and aim to improve patient outcomes. However, the effectiveness of these materials can be hindered by variations in patient health literacy.

Call to Action: Screening and Addressing Caregiver Mental Health Needs within all Pediatric Medical Subspecialty Settings as Standard of Care.

Objective: The objective of this topical review is to provide rationale for the development of standards of care to address the mental health needs of caregivers of youth with chronic and acute conditions.

Methods: In this topical review, we describe the relationship between pediatric medical conditions and caregiver mental health, the state of available screening and intervention options, standards of care in medicine, existing caregiver mental health standards in pediatric subspecialty populations, and exemplar caregiver mental health programs that were developed in response to standards. Finally, we will describe our rationale for this standard of care, provide a call to action, and describe anticipated challenges in developing and implementing such standards.

Teaching Residents at Night: Exploration of a Novel Curriculum.

Background: Implementation of a successful night curriculum has been a historical barrier to education during night rotations. Residents are tasked with teaching students and peers at night, often with little educational material to support this. To address the need for engaging night curriculum for pediatric residents, we aimed to (1) develop and implement a night curriculum with an emphasis on residents as teachers (RaTs) and (2) explore residents' experience with the RaT curriculum through a secondary qualitative analysis of reflections.

Gonadal Tumors in Individuals with Turner Syndrome and Y-Chromosome Mosaicism: A Retrospective Multisite Study.

Study Objective: To evaluate the prevalence of germ cell tumors and the clinical monitoring practices for those who deferred prophylactic gonadectomy in a large North American cohort of individuals with Turner syndrome with Y-chromosome mosaicism (TS+Y).

Method: A query of the medical records at multiple North American children's hospitals was done using ICD codes related to Turner Syndrome. A retrospective chart review was conducted on those patients between ages 0 to 30 years with Y-mosaicism.

The DESSH Clinic: A New Multidisciplinary Clinic to Address the Complex Needs of Individuals with a Rare Genetic Disorder.

DeSanto-Shinawi (DESSH) syndrome is a rare autosomal dominant condition caused by pathogenic variants in the WAC gene. DESSH syndrome was first identified in 2015 in six patients, but has since been diagnosed in more than 200 individuals worldwide. Patients exhibit a variable degree of developmental delay (DD), intellectual disability (ID), hypotonia, gastrointestinal and eye abnormalities, epilepsy, behavioral difficulties, and recognizable facial features.

Pediatricians' Practices and Desired Resources for Addressing Intimate Partner Violence.

To explore pediatricians' perspectives on supporting intimate partner violence (IPV) survivors, including (a) clinical practices and resource use, (b) ideal resources, and (c) barriers to the use of existing resources, we conducted dyadic and individual virtual interviews with pediatricians recruited through Twitter and the American Academy of Pediatrics Council, section, and chapter listservs. The interviews were approximately 60 minutes in length, audio recorded, and transcribed verbatim. We used a thematic analysis approach and hybrid deductive-inductive coding.

Salivary cortisol is not associated with dexamethasone response in preterm infants with evolving bronchopulmonary dysplasia.

Objective: Short-term treatment efficacy of systemic dexamethasone (DEX) in preterm infants with bronchopulmonary dysplasia (BPD) is highly variable. Our objective was to assess if salivary cortisol may serve as a reliable biomarker of steroid response.

Study Design: Multi-site prospective observational cohort study.

Child and family characteristics associated with verbal communication difficulties in adolescents with autism and other developmental disabilities.

Background: Verbal communication difficulties are associated with a range of adolescent and adult outcomes in individuals with autism spectrum disorder (ASD). Yet there is limited information about contextual factors associated with verbal communication difficulties beyond early childhood, and how youth with ASD compare to youth with other developmental disabilities (DD).

Aims: The current study examined verbal communication difficulties among adolescents with ASD and other DD, and child and family characteristics associated with these difficulties in later in life.

Prognostic value of transient ischemic dilation on Rubidium-82 positron emission tomography myocardial perfusion imaging.

Background: Transient ischemic dilation (TID) of the left ventricular (LV) cavity is considered a high-risk marker in patients with abnormal single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Stress image acquisition with rubidium-82 (Rb) PET occurs at peak stress compared to 30-60 minutes post-stress with SPECT. We aimed to evaluate the prognostic value of TID in patients undergoing Rb PET MPI.