Autologous Stem Cell Mobilization in the Age of Plerixafor.

Background: Autologous stem cell transplantation remains important in the treatment of myeloma and relapsed lymphoma. Plerixafor has been shown to significantly enhance stem cell mobilization but is very expensive.

Patients And Methods: We evaluated plerixafor use in the 3-year period after its approval in December 2008.

Outcomes following implementation of a pediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies.

Background/aims: Guidelines for referral of children to general anesthesia (GA) to complete MRI studies are lacking. We devised a pediatric procedural sedation guide to determine whether a pediatric procedural sedation guide would decrease serious adverse events and decrease failed sedations requiring rescheduling with GA.

Methods: We constructed a consensus-based sedation guide by combining a retrospective review of reasons for referral of children to GA (n = 221) with published risk factors associated with the inability to complete the MRI study with sedation.

Pediatric Disaster Triage System Utilization Across the United States.

Objectives: The study goal was to determine which pediatric disaster triage (PDT) systems are used in US states/territories and whether there is standardization to their use. Secondary goals were to understand user satisfaction with each system, user preferences, and the nature and magnitude of incidents for which the systems are activated.

Methods: A survey was developed regarding PDT systems used in each state/territory, satisfaction with those used, preference for specific systems, and type and magnitude of incidents prompting system activation.

Child Passenger Safety Training for Pediatric Interns: Does it Work?

Objective: Evaluate the efficacy of a child passenger safety (CPS) educational intervention on the CPS-related knowledge, attitude and anticipatory guidance behaviors of pediatric interns.

Methods: All subjects were surveyed at baseline and 6 months. Intervention interns attended a CPS training module which included viewing an educational video, observing a car seat inspection appointment, hands-on practice and completion of a post-intervention survey.

Left Ventricular End-Systolic Eccentricity Index for Assessment of Pulmonary Hypertension in Infants.

Background: Pulmonary hypertension (PH) is a common problem in the neonatal intensive care unit and is associated with significant morbidity and mortality. The aim of this study was to identify a quantitative echocardiographic marker of septal curvature that can be used to accurately identify PH in NICU infants with concern for PH.

Methods: Echocardiograms of infants who were prematurely born and infants with persistent pulmonary hypertension of the newborn were performed using a defined protocol for evaluation of PH.

Non-Intravenous Sedatives and Analgesics for Procedural Sedation for Imaging Procedures in Pediatric Patients.

Objectives: The purpose of this study was to describe the method of delivery, dosage regimens, and outcomes of sedatives administered by extravascular route for imaging procedures in children.

Methods: Medline, Embase, International Pharmaceutical Abstracts, and Cochrane Database of Systematic Reviews were searched using keywords "child", "midazolam", "ketamine", dexmedetomidine", "fentanyl", "nitrous oxide", and "imaging." Articles evaluating the use of extravascular sedation in children for imaging procedures published in English between 1946 and March 2015 were included.

Fetal and postnatal ovine mesenteric vascular reactivity.

Background: Intestinal circulation and mesenteric arterial (MA) reactivity may play a role in preparing the fetus for enteral nutrition. We hypothesized that MA vasoreactivity changes with gestation and vasodilator pathways predominate in the postnatal period.

Methods: Small distal MA rings (0.

Special article: 2014 Pediatric Clinical Trials Forum.

In November 2014, the American Academy of Pediatrics convened key stakeholders to discuss the feasibility of accelerating children's medical advances by creating an independent global Pediatric Clinical Trials Network. The Forum identified challenges posed by the U.S.

Diagnostic accuracy of point-of-care ultrasound for catheter-related thrombosis in children.

Background: Compared with consultative US performed by the radiology department, point-of-care US performed by non-radiology physicians can accurately diagnose deep venous thrombosis in adults.

Objective: In preparation for a multicenter randomized controlled trial, we determined the accuracy of point-of-care US in diagnosing central venous catheter-related thrombosis in critically ill children.

Materials And Methods: Children <18 years old with a central venous catheter who were admitted to the intensive care unit were enrolled.

Critical Violent Injury in the United States: A Review and Call to Action.

Objective: This review provides an overview of what is known about violent injury requiring critical care, including child physical abuse, homicide, youth violence, intimate partner violence, self-directed injury, firearm-related injury, and elder physical abuse.

Data Sources: We searched PubMed, Scopus, Ovid Evidence-Based Medicine Reviews, and the National Guideline Clearinghouse. We also included surveillance data from the Centers for Disease Control and Prevention and National Trauma Data Bank.

Survival and right ventricular performance for matched children after stage-1 Norwood: Modified Blalock-Taussig shunt versus right-ventricle-to-pulmonary-artery conduit.

Objective: Early survival advantages after Norwood with right-ventricle-(RV)-to-pulmonary-artery conduit (NW-RVPA) over Norwood-operation with a Blalock-Taussig shunt (NW-BT) are offset by concerns regarding delayed RV dysfunction. We compared trends in survival, RV dysfunction, and tricuspid valve regurgitation (TR) between NW-RVPA and NW-BT for propensity-matched neonates with critical left ventricular outflow tract obstruction (LVOTO).

Methods: In an inception cohort (2005-2014; 21 institutions), 454 neonates with critical LVOTO underwent Norwood stage 1.

Surgical management of competing pulmonary blood flow affects survival before Fontan/Kreutzer completion in patients with tricuspid atresia type I.

Objectives: To determine the association between surgical management of pulmonary blood flow (PBF) at initial and staged procedures with survival to Fontan/Kreutzer operation (Fontan) in patients with tricuspid atresia.

Methods: Infants aged <3 months with tricuspid atresia type I (n = 303) were enrolled from 34 institutions (1999-2013). Among those who underwent surgical intervention (n = 302), initial procedures were: systemic to pulmonary artery shunt (SPS; n = 189; 62%); pulmonary artery banding (PAB; n = 50; 17%); and superior cavopulmonary connection (SCPC; n = 63; 21%).

Practice Patterns in Pediatric Critical Care Medicine: Results of a Workforce Survey.

Objective: To obtain current data on practice patterns of the U.S. pediatric critical care medicine workforce.

A pediatrician's practical guide to diagnosing and treating hereditary spherocytosis in neonates.

Newborn infants who have hereditary spherocytosis (HS) can develop anemia and hyperbilirubinemia. Bilirubin-induced neurologic dysfunction is less likely in these neonates if the diagnosis of HS is recognized and appropriate treatment provided. Among neonates listed in the USA Kernicterus Registry, HS was the third most common underlying hemolytic condition after glucose-6-phosphate dehydrogenase deficiency and ABO hemolytic disease.

Mortality of pediatric surgical conditions in low and middle income countries in Africa.

Background: There are ongoing efforts to improve the quality of surgical care for children in low and middle-income countries (LMICs) in Africa. The purpose of this study was to review the recent literature and estimate the mortality associated with pediatric surgical conditions in this setting.

Methods: We completed a comprehensive search for studies that: (1) reported outcomes associated with pediatric surgical conditions; (2) were conducted in LMICs in Africa; and (3) were published between 2007 and 2012.

Prevalence of post-thrombotic syndrome after cardiac catheterization.

Background: As the survival of children with cardiac disease increases, chronic complications of deep venous thrombosis from cardiac catheterization, particularly post-thrombotic syndrome, may be important to monitor for and treat, if needed. We aimed to determine the prevalence of this syndrome in children who underwent cardiac catheterization.

Procedure: We conducted a cross-sectional study of children <18 years old at least 1 year from first catheterization through the femoral vein.

Recent trends in the operative experience of junior pediatric surgical attendings: a study of APSA applicant case logs.

Purpose: Pediatric surgical education and workforce have changed significantly in the past decade. To document trends in the operative experiences of junior pediatric surgeons, we examined case logs submitted by applicants for membership to APSA.

Methods: Case logs for 164 APSA membership applicants from 2006 to 2013 were reviewed.

In situ pediatric trauma simulation: assessing the impact and feasibility of an interdisciplinary pediatric in situ trauma care quality improvement simulation program.

Objective: This study aimed to evaluate the feasibility and measure the impact of an in situ interdisciplinary pediatric trauma quality improvement simulation program.

Methods: Twenty-two monthly simulations were conducted in a tertiary care pediatric emergency department with the aim of improving the quality of pediatric trauma (February 2010 to November 2012). Each session included 20 minutes of simulated patient care, followed by 30 minutes of debriefing that focused on teamwork, communication, and the identification of gaps in care.

The pediatrician and child maltreatment: principles and pointers for practice.

Child abuse and neglect are inherently challenging problems for pediatricians. It is hoped that this article makes this work easier, albeit not easy, and highlights the many ways that pediatricians can make a valuable difference in the lives of these vulnerable children and their families.

Gun buyback programs: a venue to eliminate unwanted guns in the community.

Background: The United States has a high rate of death due to firearms, and gun buyback programs may mitigate these high death rates. Understanding the demographics, motivation, and geographic region of participants may improve program efficacy.

Methods: Three Injury Free Coalition for Kids gun buyback programs, in collaboration with the local police, were studied: Phoenix, Arizona; Worcester, Massachusetts; and New Haven, Connecticut.

Variability in IRBs regarding parental acceptance of passive consent.

Objective: Passive, opt-out recruitment strategies have the potential to improve efficiency and enlarge the participant pool for clinical studies. We report on the feasibility of using a passive consent strategy for a multicenter pediatric study.

Methods: We assessed the response to passive and active control recruitment strategies used in a multicenter pediatric cohort study and describe the variability in acceptance among institutional review boards (IRBs) and parents of pediatric patients.