6,748 results match your criteria: "Wilhelmina Children’s Hospital[Affiliation]"

Immune responses demand the rapid and precise regulation of gene protein expression. Splicing is a crucial step in this process; ~95% of protein-coding gene transcripts are spliced during mRNA maturation. Alternative splicing allows for distinct functional regulation, as it can affect transcript degradation and can lead to alternative functional protein isoforms.

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Fungal primary and opportunistic pathogens: an ecological perspective.

FEMS Microbiol Rev

September 2024

Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education of Guizhou & Key Laboratory of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Guizhou Medical University, 561113 Guiyang, China.

Article Synopsis
  • Fungal primary pathogenicity is described as a strategic interaction where the host helps improve the fungus's fitness, while opportunistic strains merely survive by using host tissues in ways they are not specifically designed for.
  • There are two main types of primary pathogens: environmental pathogens that adapt to specific hosts through a double life cycle, and those that spread directly between hosts, risking epidemics through shifts to susceptible populations.
  • Some environmental fungi can transition from opportunistic to primary pathogens by leveraging similar survival traits across very different hosts, often linked to their ability to withstand extreme conditions.
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Background: Juvenile idiopathic arthritis (JIA) refers to a heterogeneous group of rheumatic conditions in children. Novel drugs have greatly improved disease outcomes; however, outcomes are impacted by limited awareness of the importance of early diagnosis and adequate treatment, and by differences in access across health systems. As a result, patients with JIA continue to be at risk for short- and long-term morbidity, as well as impacts on virtually all aspects of life of the child and family.

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The trajectory of hematopoietic stem cell transplantation (HSCT) is often accompanied by physically disabling complications that impair physical performance of pediatric patients. However, knowledge about when impairments in physical performance arise and the factors contributing to these impairments is limited. Therefore, we conducted a retrospective analysis of physical performance 100 days post-HSCT in patients aged 3-18 years.

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Background: Recurrent respiratory tract infections (rRTIs) are a common reason for immunodiagnostic testing in children, which relies on serum antibody level measurements. However, because RTIs predominantly affect the respiratory mucosa, serum antibodies may inaccurately reflect local immune defences. We investigated antibody responses in saliva and their interplay with the respiratory microbiota in relation to RTI severity and burden in young children with rRTIs.

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Article Synopsis
  • Haematology patients experiencing high-risk neutropenia are susceptible to bloodstream infections linked to mucosal barrier injuries, particularly during episodes of fever.
  • A study involving 416 neutropenic haematology patients identified risk factors for these infections, noting that certain conditions like low MASCC scores and specific fungal colonizations significantly increased risk.
  • Findings revealed that while low citrulline levels at fever onset correlated with candidaemia, they did not indicate the likelihood of bacterial infections; moreover, quinolone antibiotics appeared beneficial.
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Objectives: The International Society of Paediatric Oncology-Renal Tumour Study Group (SIOP-RTSG) discourages invasive procedures to determine the histology of paediatric renal neoplasms at diagnosis. Therefore, the histological subtype of Wilms' tumours (WT) is unknown at the start of neoadjuvant chemotherapy. MR-DWI shows potential value as a non-invasive biomarker through apparent diffusion coefficients (ADCs).

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Repurposing CD19-directed immunotherapies for pediatric t(8;21) acute myeloid leukemia.

Haematologica

December 2024

Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Wolfson Childhood Cancer Research Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; University Medical Center Utrecht, Utrecht University, Utrecht.

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Article Synopsis
  • * Antifungal prophylaxis has reduced IFD occurrences but has also changed the types of fungal pathogens seen, necessitating broader screening methods for early diagnosis and treatment.
  • * A study analyzed blood samples from high-risk patients using advanced PCR techniques, revealing that many detectable fungi were typically non-pathogenic, highlighting the need for repeated testing and accurate identification to guide effective treatment.
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Myopathic manifestations across the adult lifespan of patients with malignant hyperthermia susceptibility: a narrative review.

Br J Anaesth

October 2024

Malignant Hyperthermia Investigation Unit, Department of Anesthesiology and Pain Management, University Health Network, Toronto, ON, Canada. Electronic address:

Malignant hyperthermia susceptibility (MHS) designates individuals at risk of developing a hypermetabolic reaction triggered by halogenated anaesthetics or the depolarising neuromuscular blocking agent suxamethonium. Over the past few decades, beyond the operating theatre, myopathic manifestations impacting daily life are increasingly recognised as a prevalent phenomenon in MHS patients. At the request of the European Malignant Hyperthermia Group, we reviewed the literature and gathered the opinion of experts to define MHS-related myopathy as a distinct phenotype expressed across the adult lifespan of MHS patients unrelated to anaesthetic exposure; this serves to raise awareness about non-anaesthetic manifestations, potential therapies, and management of MHS-related myopathy.

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Background: While communicable diseases have long been the primary focus of healthcare in Africa, the rising impact of paediatric and congenital heart disease (CHD) cannot be overlooked. This research aimed to estimate the frequency and pattern of heart diseases in children who underwent their first echocardiography at a national cardiac referral hospital in Tanzania.

Methods: A retrospective observational study was conducted on children aged 0 to 18 years referred for first-time cardiological evaluation from January 2017 to December 2022.

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Liquid biopsies are emerging as an alternative source for pediatric cancer biomarkers with potential applications during all stages of patient care, from diagnosis to long-term follow-up. While developments within this field are reported, these mainly focus on dedicated items such as a specific liquid biopsy matrix, analyte, and/or single tumor type. To the best of our knowledge, a comprehensive overview is lacking.

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Objectives: The COVID-19 pandemic and related lockdown measures disrupted global healthcare provision, including opioid prescribing. In North America, opioid sales declined while opioid-related deaths increased. In Europe, the effect of the pandemic on prescribing is not yet known.

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Fungal infections pose an increasing threat to public health. New pathogens and changing epidemiology are a pronounced risk for nosocomial outbreaks. To investigate clonal transmission between patients and trace the source, genotyping is required.

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Experiences with a national team-based learning program for advance care planning in pediatric palliative care.

BMC Palliat Care

August 2024

Julius Center for Health Sciences and Primary Care, Center of Expertise in Palliative Care Utrecht, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.

Background: Advance Care Planning (ACP) enables patients and relatives to define and share values, goals and preferences for future medical treatment and care. The IMplementing Pediatric Advance Care Planning Toolkit (IMPACT), developed in the Netherlands, is a method for conducting ACP in pediatric palliative care. Healthcare professionals who were trained to use IMPACT, indicated their need for ongoing support to practice ACP communication skills optimally over time.

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Our understanding of the normal variation in the upper respiratory tract (URT) microbiota across the human lifespan and how these relate to host, environment, and health is limited. We studied the microbiota of 3,104 saliva (<10 year-olds)/oropharynx (≥10 year-olds) and 2,485 nasopharynx samples of 3,160 Dutch individuals 0-87 years of age, participating in a cross-sectional population-wide study (PIENTER-3) using 16S-rRNA sequencing. The microbiota composition was strongly related to age, especially in the nasopharynx, with maturation occurring throughout childhood and adolescence.

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The association of quantitative PSMA PET parameters with pathologic ISUP grade: an international multicenter analysis.

Eur J Nucl Med Mol Imaging

December 2024

Division of Oncology/Unit of Urology, Soldera Prostate Cancer Lab, URI, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Purpose: To assess if PSMA PET quantitative parameters are associated with pathologic ISUP grade group (GG) and upgrading/downgrading.

Methods: PCa patients undergoing radical prostatectomy with or without pelvic lymph node dissection staged with preoperative PSMA PET at seven referral centres worldwide were evaluated. PSMA PET parameters which included SUV, PSMA, and total PSMA accumulation (PSMA) were collected.

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Bardet-Biedl syndrome improved diagnosis criteria and management: Inter European Reference Networks consensus statement and recommendations.

Eur J Hum Genet

November 2024

CINBIO, Universidad de Vigo, Grupo de Investigación en Enfermedades Raras, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), Vigo, Spain.

Four European Reference Networks (ERN-EYE, ERKNet, Endo-ERN, ERN-ITHACA) have teamed up to establish a consensus statement and recommendations for Bardet-Biedl syndrome (BBS). BBS is an autosomal recessive ciliopathy with at least 26 genes identified to date. The clinical manifestations are pleiotropic, can be observed in utero and will progress with age.

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Article Synopsis
  • * A case study highlights a 46-year-old woman with chromoblastomycosis, confirming the diagnosis through skin examinations and fungal cultures, while also revealing co-infestation by fly larvae.
  • * The patient was successfully treated with voriconazole and terbinafine, highlighting the need for awareness and understanding of chromoblastomycosis in occupationally exposed individuals in affected regions.
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Trends and causes of maternal mortality in Indonesia: a systematic review.

BMC Pregnancy Childbirth

July 2024

Department of Obstetrics, Birth Centre Wilhelmina's Children Hospital, Division Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands.

Background: The maternal mortality ratio (MMR) in Indonesia is among the highest in Southeast Asia. We aim to describe trends in the MMR and causes of maternal deaths in Indonesia over the past decades, regionally and nationally.

Methods: We performed a systematic review and conducted a search using PubMed, Embase, Global Health, CINAHL, Cochrane, Portal Garuda, and Google Scholar from the inception of the database to April 2023.

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Background: Among patients with nephroblastoma, those with bilateral disease are a unique population where maximising tumour control must be balanced with preserving renal parenchyma.

Methods: The SIOP 2001 protocol recommended surgery after neoadjuvant cycle(s) of Dactinomycin and Vincristine (AV) with response-adapted intensification, if needed. Adjuvant treatment was given based on the lesion with the worst histology.

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Article Synopsis
  • Maternal Tdap vaccination between 20 and 24 weeks of gestation is crucial for protecting newborns from severe pertussis by enhancing transplacental antibody transfer, especially for preterm infants.
  • The study's objective was to compare antibody levels of infants vaccinated in early- to late-term stages following Tdap doses given at earlier gestational weeks (20-24) with those given at later stages (30-33 weeks) during a multicenter cohort study in the Netherlands.
  • The primary outcome measured was the geometric mean concentration of anti-pertussis toxin antibodies in infants at 2 months old to evaluate the effectiveness of early Tdap vaccination versus later vaccination.
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Article Synopsis
  • * Researchers analyzed 562 patients across four IEI subgroups (combined immunodeficiency, severe combined immunodeficiency, neutrophil disorders, and hemophagocytic lymphohistiocytosis-related disorders), focusing on event-free survival (EFS) as the main outcome.
  • * The study concluded that targeting a cumulative busulfan exposure (AUCNONMEM) of around 80 mg × h/L can improve EFS and donor chimer
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Objective: Non-disease-specific WHO-CHOICE unit costs are often used in cost and cost-effectiveness studies in the absence of country-specific data. This study aims to compare reported country-specific disease costs and the corresponding WHO-CHOICE estimates. We use generically defined "diarrhea" (including rotavirus diarrhea) and pathogen-specific "respiratory syncytial virus (RSV)" disease as examples.

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Busulfan Exposure Target Attainment in Adults Undergoing Allogeneic Hematopoietic Cell Transplantation: A Single Day Versus a Multiple Day Therapeutic Drug Monitoring Regimen.

Transplant Cell Ther

October 2024

Department of Clinical Pharmacy, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands; Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.

Busulfan exposure has previously been linked to clinical outcomes, hence the need for therapeutic drug monitoring (TDM). Study objective was to evaluate the effect of day 1 TDM-guided dosing (regimen d1) versus days 1 + 2 TDM-guided dosing (regimen d1 + 2) on attaining adequate busulfan exposure. In this observational study, we included all adults who received an allogeneic HCT with intravenous once daily busulfan over 4 days as part of the conditioning regimen at the University Medical Centre Utrecht or between July 31, 2014 and November 12, 2021.

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