104 results match your criteria: "and The George Washington University School of Medicine[Affiliation]"

Objectives: To examine the relationship between adequacy of caloric nutritional support during the first week after severe traumatic brain injury (TBI) and outcome.

Design: Single-center retrospective cohort, 2010-2022.

Setting: Tertiary care children's hospital with a level 1 trauma center.

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Life After Neonatal Seizures: Characterizing the Longitudinal Parent Experience.

Pediatr Neurol

December 2024

Departments of Pediatrics and Population Health Sciences, Duke University School of Medicine, Durham, NC, USA, Duke-Margolis Center for Health Policy, Washington, District of Columbia. Electronic address:

Background: Parents of neonates with seizures report persistent symptoms of depression, anxiety, and posttraumatic stress. We aimed to characterize the parent experience of caring for children impacted by neonatal seizures, including longitudinal assessment across childhood.

Methods: This prospective, observational, multicenter study was conducted at Neonatal Seizure Registry (NSR) sites in partnership with the NSR Parent Advisory Panel.

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Introduction: Research has shown the importance of diversity in improving patient care. Medical students from backgrounds underrepresented in medicine (UIM) face unique challenges, including minority tax, stereotype threat, and expectations to be the sole representative of their identity group. Mentors must be aware of these challenges and develop skills to address them.

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Article Synopsis
  • The study investigated the clinical features and long-term outcomes of myocarditis linked to COVID-19 vaccination, focusing on 333 affected patients under 30 compared to 100 with MIS-C.
  • Findings indicated that C-VAM patients were mostly young white males, experienced milder symptoms initially, but had higher rates of myocardial injury as shown by cardiac imaging.
  • Despite a generally benign course and no reported cardiac deaths during follow-up, 60% of patients still showed evidence of myocardial injury after approximately six months.
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Objectives: To examine career trajectory and academic profile of Pediatric Critical Care Medicine (PCCM) physicians, with special focus on gender differences.

Design: Observational cross-sectional study of PCCM fellowship graduates using publicly available data.

Setting: Publicly available databases including National Provider Identifier registry, American Board of Pediatrics, Doximity, official hospital websites, and Scopus.

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Importance: The use of evidence-based standardized outcome measures is increasingly recognized as key to guiding clinical decision-making in mental health. Implementation of these measures into clinical practice has been hampered by lack of clarity on what to measure and how to do this in a reliable and standardized way.

Objective: To develop a core set of outcome measures for specific neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder (ADHD), communication disorders, specific learning disorders, and motor disorders, that may be used across a range of geographic and cultural settings.

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Objective: To assess cognitive, behavioral, and adaptive functions in children and young adults with hemophilia treated according to contemporary standards of care.

Study Design: Evolving Treatment of Hemophilia's Impact on Neurodevelopment, Intelligence, and Other Cognitive Functions (eTHINK) is a US-based, prospective, cross-sectional, observational study (September 2018 through October 2019). Males (aged 1-21 years) with hemophilia A or B of any severity, with or without inhibitors, were eligible.

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Background: Human genetic contribution to HIV progression remains inadequately explained. The type 1 interferon (IFN) pathway is important for host control of HIV and variation in type 1 IFN genes may contribute to disease progression. This study assessed the impact of variations at the gene and pathway level of type 1 IFN on HIV-1 viral load (VL).

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Background: Nonacog beta pegol (N9-GP) is an extended half-life PEGylated factor (F)IX product with established efficacy and short-term safety in persons with hemophilia B (HB). Long-term safety has been evaluated for polyethylene glycol exposure but not N9-GP.

Objectives: To assess safety, neurodevelopmental, and efficacy outcomes of children with HB receiving N9-GP prophylaxis across 2 open-label, single-arm, phase 3 studies: paradigm5 (previously treated patients [PTPs]) and paradigm6 (previously untreated patients [PUPs]) in this interim analysis.

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Background: On the fifth National Wilms Tumor Study, treatment for clear cell sarcoma of the kidney (CCSK) included combined vincristine, doxorubicin, cyclophosphamide, and etoposide (regimen I) plus radiation therapy (RT), yielding 5-year event-free survival (EFS) rates of 100%, 88%, 73%, and 29% for patients who had with stage I, II, III, and IV disease, respectively. In the Children's Oncology Group study AREN0321 of risk-adapted therapy, RT was omitted for stage I disease if lymph nodes were sampled, and carboplatin was added for stage IV disease (regimen UH-1). Patients who had stage II/III disease received regimen I with RT.

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Enhanced Risk Stratification for Children and Young Adults with B-Cell Acute Lymphoblastic Leukemia: A Children's Oncology Group Report.

Leukemia

April 2024

Department of Biostatistics, Colleges of Medicine, Public Health and Health Professions, University of Florida, Gainesville, FL, USA.

Article Synopsis
  • * A multivariable Cox model was developed using data from over 21,000 patients to predict relapse-free survival (RFS) and establish more precise risk groups through the COG Prognostic Index (PI).
  • * The PI effectively differentiates between low and high relapse risks and identifies specific subgroups within moderate and high-risk patients, potentially guiding more personalized treatment strategies based on their predicted outcomes.
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In October 2022, the FDA Oncology Center of Excellence hosted an educational symposium entitled, "Considering Functional Outcomes as Efficacy Endpoints in Pediatric Low-Grade Glioma (pLGG) Clinical Trials." The symposium brought together patient advocates, regulators from the FDA and the European Medicines Agency (EMA), and an international group of academic thought leaders in the field of pediatric neuro-oncology to discuss the potential role of functional outcomes, including visual acuity, motor function, and neurocognitive performance, as endpoints in clinical trials enrolling patients with pLGG. The panel discussed challenges and opportunities regarding the selection, implementation, and evaluation of clinical outcome assessments in these functional domains and outlined key considerations for their inclusion in future clinical trial design and role in new drug development.

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Background: The Mirasol® Pathogen Reduction Technology System was developed to reduce transfusion-transmitted diseases in platelet (PLT) products.

Study Design And Methods: MiPLATE trial was a prospective, multicenter, controlled, randomized, non-inferiority (NI) study of the clinical effectiveness of conventional versus Mirasol-treated Apheresis PLTs in participants with hypoproliferative thrombocytopenia. The novel primary endpoint was days of ≥Grade 2 bleeding with an NI margin of 1.

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Background: Patients with stage IV favorable histology Wilms tumor (FHWT) with extrapulmonary metastases (EPM) constitute a small subset of patients with FHWT. Because of their rarity and heterogeneity, optimal FHWT treatment is not well understood. Children's Oncology Group protocol AREN0533 assigned patients with FHWT and EPM to intensified chemotherapy, regimen M, after initial DD-4A chemotherapy.

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Objectives: Test the hypothesis that within patient clinical instability measured by deterioration and improvement in mortality risk over 3-, 6-, 9-, and 12-hour time intervals is indicative of increasing severity of illness.

Design: Analysis of electronic health data from January 1, 2018, to February 29, 2020.

Setting: PICU and cardiac ICU at an academic children's hospital.

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Background: Infection with human immunodeficiency virus type 1 (HIV) typically results from transmission of a small and genetically uniform viral population. Following transmission, the virus population becomes more diverse because of recombination and acquired mutations through genetic drift and selection. Viral intrahost genetic diversity remains a major obstacle to the cure of HIV; however, the association between intrahost diversity and disease progression markers has not been investigated in large and diverse cohorts for which the majority of the genome has been deep-sequenced.

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Problem: Incorporating patient and family voices in the development of entrustable professional activities (EPAs) is not standard practice. Care of children with medical complexity (CMC) is an area of pediatrics that relies on family partnership, and families of CMC are ideal partners in EPA development given their expertise in their child's care and experience interacting with the health care system. The authors describe their model for partnering with families to develop EPAs and reflect on the unique contributions of family leaders to the process.

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The State of Inpatient Child Neurology: A Survey of North American Academic Programs.

Neurology

October 2022

From the Departments of Neurology and Pediatrics (K.B.N.), University of California, San Francisco, Benioff Children's Hospital San Francisco; Department of Pediatrics (J. Palaganas), Weill Cornell Medicine, New York Presbyterian Hospital; Departments of Neurology and Pediatrics (N.S.A., C.A.P.), Children's Hospital of Philadelphia and the University of Pennsylvania; Neurology Division (M.L.H.), Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus; Section of Child Neurology (R.M.), Department of Pediatrics, Children's Hospital Colorado and the University of Colorado, Aurora; Division of Neurology (M.M.), Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Ontario, Canada; Section of Child Neurology (J. Piantino), Department of Pediatrics, Oregon Health & Science University, Portland; and Center for Neuroscience (E.W.), Children's National Hospital and the George Washington University School of Medicine and Health Science, Washington, D.C.

Article Synopsis
  • Inpatient child neurology programs are vital for pediatric care, and researchers aimed to assess the structure and challenges of these programs in North America.
  • A survey was conducted among child neurologists from various academic programs, with a response rate of 71%, primarily from program directors and senior staff.
  • The findings revealed issues such as high workload, out-of-hours documentation, and frequent phone calls related to patient care, which contribute to faculty burnout and indicate a need for better support and resources in these programs.
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Profiles of Symptom Suffering and Functioning in Children and Adolescents Receiving Chemotherapy.

Cancer Nurs

February 2023

Author Affiliations: School of Nursing, Fudan University (Dr Cheng), Shanghai, China; Departments of Population Health Sciences and Pediatrics, Duke Cancer Institute, Duke University School of Medicine (Dr Reeve and Ms Mann), Durham, North Carolina; School of Nursing, Clemson University (Dr Withycombe), South Carolina; Division of Oncology, Children's National Hospital (Dr Jacobs); and Department of Pediatrics, The George Washington University (Dr Jacobs), Washington, DC; Department of Pediatric Oncology and Center for Population Sciences, Dana-Farber Cancer Institute and Boston Children's Hospital (Dr Mack), Boston, Massachusetts; Division of Pediatric Palliative Care and Division of Pediatric Oncology, Children's Hospital and Medical Center (Dr Weaver), Omaha, Nebraska; Department of Nursing Science, Professional Practice and Quality, Children's National Hospital (Drs Waldron and Hinds); and Department of Pediatrics, The George Washington University (Drs Waldron and Hinds), Washington, DC; Department of Pediatrics, University of Pittsburgh School of Medicine (Dr Mauer); and Division of Palliative Medicine and Supportive Care, UPMC Children's Hospital of Pittsburgh (Dr Mauer), Pennsylvania; Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital (Dr Baker), Memphis, Tennessee; and Division of Biostatistics & Study Methodology, Children's National Hospital (Dr Wang); and The George Washington University School of Medicine and Health Sciences (Dr Wang), Washington, DC.

Background: Some children and adolescents receiving chemotherapy experience few symptom-related adverse events, whereas others experience multiple adverse events. If oncology nurses could identify patients likely to have pronounced chemotherapy-related adverse events, tailored supportive care could be matched to these patients' symptom burdens.

Objective: The aim of this study was to identify symptom profiles in children and adolescents before and after chemotherapy, and the sociodemographic and psychological factors associated with profile classification and change.

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Importance: In children undergoing heart surgery, nitric oxide administered into the gas flow of the cardiopulmonary bypass oxygenator may reduce postoperative low cardiac output syndrome, leading to improved recovery and shorter duration of respiratory support. It remains uncertain whether nitric oxide administered into the cardiopulmonary bypass oxygenator improves ventilator-free days (days alive and free from mechanical ventilation).

Objective: To determine the effect of nitric oxide applied into the cardiopulmonary bypass oxygenator vs standard care on ventilator-free days in children undergoing surgery for congenital heart disease.

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Purpose: The utility of circulating tumor DNA (ctDNA) analyses has not been established in the risk stratification of Wilms tumor (WT). We evaluated the detection of ctDNA and selected risk markers in the serum and urine of patients with WT and compared findings with those of matched diagnostic tumor samples.

Patients And Methods: Fifty of 395 children with stage III or IV WT enrolled on Children's Oncology Group trial AREN0533 had banked pretreatment serum, urine, and tumor available.

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Article Synopsis
  • During the first 6 weeks of COVID-19 Shelter-in-Place orders, there was a 54% reduction in hospital encounters for children with neurologic conditions compared to the same period in the previous 3 years.
  • The patients seen during this period were younger, with significant drops in cases of migraines (72%) and acute neurologic issues such as status epilepticus and traumatic brain injury (56% reductions across the board).
  • Those who were hospitalized required more intensive care and diagnostic testing, indicating a need for continued neurologic hospital services amid concerns about delayed care for serious conditions.
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