Digital Commons Network^™

The Hexosamine Biosynthetic Pathway Alters The Cytoskeleton To Modulate Cell Proliferation And Migration In Aggressive Prostate Cancer, Rajina Shakya, Praveen Suraneni, Amit Rahi, Michael Y Young, Emily Cousino, Christine B Magdongon, Raju Gajjela, Basil B Mattamana, Alexander Zaslavsky, Ganesh S Palapattu, Arun Sreekumar, Dileep Varma

Faculty, Staff and Students Publications

Castration-resistant prostate cancer (CRPC) progresses despite androgen deprivation therapy, as cancer cells adapt to grow without testosterone, becoming more aggressive and prone to metastasis. CRPC biology complicates the development of effective therapies, posing challenges for patient care. Recent gene-expression and metabolomics studies highlight the Hexosamine Biosynthetic Pathway (HBP) as a critical player, with key components like GNPNAT1 (Glucosamine-phosphate N-acetyltransferase 1) being downregulated in CRPC. GNPNAT1 knockdown in pre-clinical models has been shown to increase growth and metastasis in CRPC tumors, though the mechanisms remain unclear.To investigate the cellular basis of these CRPC phenotypes, we generated a CRISPR-Cas9 knockout model of …

Influenza Infection Has Higher Risk Of Postoperative Complications Than Covid-19 In Shoulder Arthroplasty Patients, Jad J Lawand, Umar Ghilzai, Caleb Witsken, Dion Birhiray, Abdullah Ghali, Youssef M Khalafallah, Rohan G Reddy, Sameer R Khawaja, Adil Shahzad Ahmed

Faculty, Staff and Students Publications

INTRODUCTION: The COVID-19 pandemic has captured the attention of healthcare systems worldwide, and testing remains a mainstay of preoperative testing before all surgical procedures, including shoulder arthroplasty. Other viral illnesses, specifically influenza, while still having severe complications, are either overshadowed by testing for COVID-19 or not tested at all.

METHODS: A multi-institutional cohort study using the TriNetX network examined patients undergoing total or hemi shoulder arthroplasty from January 2020 to March 2024. Matched cohorts were created: one with influenza and one with COVID-19 infection, 14 days before surgery.

RESULTS: A total of 3233 and 18,209 patients were included in the …

Letter To The Editor: Evidence For A Two-Step Species-Level Pulmonary Nocardiosis Diagnostic Approach, John Halphen, Mohadese Ahmadzade, Babith Mankidy, Ashkan Berenji, Mohammad Ghasemi-Rad

Faculty, Staff and Students Publications

Pulmonary nocardiosis, a rare and diagnostically challenging infection, usually presents with heterogeneous radiographic findings, compounded by the low sensitivity of traditional confirmatory cultures. In their most recent work, Wang et al analyzed 102 patients with pulmonary nocardiosis to address these concerns, investigating species-characteristic imaging patterns, pathological associations, and the role of metagenomic next-generation sequencing (mNGS) in the diagnostic approach. High-resolution computed tomography (CT) in adult patients with pulmonary infections caused by Nocardia wallacei was demonstrated to have a sensitive (85.71%) and specific (83.34%) presentation of bronchopneumonia in relation to the five Nocardia species in the sample with CT data. The …

Perinatal Obsessive-Compulsive Symptoms And Maternal-Infant Bonding: A Longitudinal Examination Of Depression And Relationship Quality, Journa Njoh, Jonathan S Abramowitz, Rashelle Musci, Mary C Kimmel, Lauren M Osborne, Jack Samuels, Paul Nestadt, Gerald Nestadt, Eric A Storch

Faculty, Staff and Students Publications

Background

Perinatal obsessive–compulsive (OC) symptoms are common and distressing, yet their impact on early parenting outcomes such as maternal-infant bonding remains poorly understood. Although prior research links maternal depression and anxiety to bonding difficulties, less is known about how perinatal OC symptoms relate to maternal-infant bonding over time, or the extent to which maternal-partner relationship quality is associated with these outcomes, and whether depressive symptoms explain observed associations.

Methods

Data were drawn from a longitudinal study of 256 pregnant women recruited from two U.S. sites between 2020 and 2023. Participants completed self-report and clinician-administered assessments at 20 weeks (PGWK20), 34 …

Mouse White Matter Matters: Cortical Origins And Spatial Organization Of Mouse White Matter Tracts, Sofia D Gordeev, Melissa Franch, Sarah R Heilbronner

Faculty, Staff and Students Publications

White matter—the fundamental structure underlying network connectivity—lies at the heart of the brain’s computational power. White matter is organized into fiber tracts, or bundles, in both human and nonhuman primate brains. These bundles consist of long-range axonal projections with a set of shared origin and termination points and exhibit a predictable organization. However, the organization of white matter in the mouse brain remains relatively unknown. This knowledge gap is surprising given the central role of mice in neuroscience, with mouse brains serving as the dominant model for transgenics, in vivo calcium imaging, and circuit manipulation. To address this gap, we …

Proposed Standardized Nomenclature For Anomalous Aortic Origin Of A Coronary Artery: An International Multidisciplinary Initiative, Carlos M Mery, Meena Nathan, Christoph Gräni, Rajesh Krishnamurthy, Cristina Basso, Marshall L Jacobs, Julie A Brothers, Massimo A Padalino, Silvana Molossi

Faculty, Staff and Students Publications

Increasing use of advanced noninvasive imaging has provided great anatomic and morphologic details to characterize congenital coronary artery anomalies. Anomalous aortic origin of a coronary artery (AAOCA) is a subtype that may lead to myocardial ischemia with variable clinical manifestations across the lifespan. Management decision making in AAOCA is hindered by anatomic variants of differing physiologic consequences. Several systems of nomenclature have been used that lack uniformity in potentially high-risk morphologic features. The ICAAC (International Coronary Artery Anomalies Collaborative), a group of experts in coronary artery anomalies, proposes a standardized nomenclature to describe anatomy and morphologic features of AAOCA using …

Patiromer For Patients With Heart Failure At Risk Of Hyperkalemia: Care-Hk In Hf Registry, Omar Cantu-Martinez, Stephen J Greene, Khaja M Chinnakondepalli, Stefan D Anker, Biykem Bozkurt, Javed Butler, John G Cleland, Nihar Desai, Diederick E Grobbee, Ellie Kelepouris, Giuseppe Rosano, Tibor Kempf, Martin Schulz, Carla-Maria Brandes, Victoria Donachie, Andrew J Sauer

Faculty, Staff and Students Publications

Background: For patients with heart failure (HF), hyperkalemia (HK) may prevent optimal renin-angiotensin system inhibitor (RASi) use. Randomized trials show that patiromer, a contemporary potassium binder, reduces serum potassium (sK+) concentrations and HK, potentially enabling RASi optimization. We sought to assess the real-world effectiveness of patiromer in facilitating RASi optimization in HF patients at increased risk of HK.

Methods and results: The CARE-HK in HF (Cardiovascular and Renal Treatment in HF Patients with HK or at High Risk of HK) (NCT04864795) was a prospective registry of patients with chronic HF at increased risk of HK (prior or current …

Comparative Analysis Of Clearing Methods For 3d Imaging Of The Vasculature In Mineralized Mouse Tissues, Azeez O Ishola, Athira Pillai, Taeyong Ahn, Re-Join Consortium, Chih-Wei Hsu, Brendan Lee, Nele Haelterman, Joshua D Wythe

Faculty, Staff and Students Publications

Historically, visualization of vascular networks within the musculoskeletal system, particularly in mineralized tissues such as bones and joints, has been limited to conventional 2D histological approaches. Recent advances in optical tissue clearing technologies and fluorescence imaging approaches in whole, intact tissues offer an entrée to interrogate the vasculature at unprecedented resolution during both musculoskeletal development and in pathologic contexts in three dimensions. However, these clearing techniques were originally not developed for imaging hard mineralized tissues, such as the femur and tibia. Herein, we have optimized tissue decalcification conditions and compared aqueous- and solvent-based tissue clearing approaches to establish an optimal …

Translating Multi-Omics Into Healthcare: Requisites For Scalable And Equitable Implementation, Birute Tumiene, David R Adams, Robert Allaway, Maria J Barrero, Chun-Hung Chan, Víctor Faundes, Vanessa S Fear, Polina Glezer, Claudia Fuchs, Tudor Groza, Elisa J F Houwink, Saumya Shekhar Jamuar, Mary Catherine V Letinturier, Richa Madan Lomash, Ratna Dua Puri, Juergen K V Reichardt, Ruty Mehrian-Shai, Francois H Van Der Westhuizen, Gaurav K Varshney, Shinya Yamamoto, Gareth Baynam

Faculty, Staff and Students Publications

Multi-omics in combination with advanced computational methodologies synthesizes diverse omics data to provide deeper insights into molecular interactions and offers transformative potential for unravelling phenomenon behind disease complexities, improving diagnostics, disease prevention, and personalized treatments. This integrative strategy enables our understanding of gene-environment relationships, chronic disease progression, and the intricate molecular pathways involved in health. Effective multi-omics analyses require robust data sharing, accessibility, interoperability, and governance, which are critical for linking genomic elements to phenotypic traits. The Global Alliance for Genomics and Health advocates for responsible data-sharing practices, by promoting key principles such as transparency and equity. By emphasizing a …

Incidence Of Autoimmune Diseases In Children With Atopy Treated With Dupilumab, Stanislaw J Gabryszewski, Kathryn Hirabayashi, Morgan Botdorf, Mitchell Maltenfort, Christopher B Forrest, Theresa W Guilbert, Madeline Schutt, Hiroki Morizono, Gerardo Vazquez Garcia, Anna Cristina Garza-Mayers, Joseph Demetrius Hernandez, Sara Anvari, Suchitra Rao, Jonathan M Spergel

Faculty, Staff and Students Publications

Background: The type 2 inflammation-blocking agent dupilumab has gained traction as an effective treatment of multiple atopic diseases. New-onset autoimmune manifestations have been infrequently reported in dupilumab-treated atopic patients, primarily among adults. Autoimmune outcomes in atopic children on dupilumab are less clear.

Objective: We aimed to determine if dupilumab treatment of atopic children is associated with increased autoimmune or autoinflammatory disease diagnosis risk.

Methods: Using a multi-institutional electronic health record database composed of 10 PEDSnet academic health systems, we performed a retrospective cohort study of children aged 6-17 with atopy (ie, moderate-to-severe atopic dermatitis and/or persistent asthma, as defined by …

Residual Risk Of Hyperkalemia Among Patients With Heart Failure Treated With Both Sglt2i And Arni, Stephen J Greene, Shachi Patel, Khaja Chinnakondepalli, Stefan D Anker, Michael Böhm, Biykem Bozkurt, Javed Butler, John Gf Cleland, Andrew J Coats, Nihar Desai, Victoria Donachie, Ellie Kelepouris, Giuseppe Rosano, Carla-Maria Brandes, Andrew J Sauer

Faculty, Staff and Students Publications

No abstract provided.

Net Benefit Of Surveillance Varies By Hepatocellular Carcinoma Risk In Patients With Cirrhosis, Akash Patel, Elena Gavrila, Sruthi Yekkaluri, Yujin Hoshida, Ruben Hernaez, Amit G Singal

Faculty, Staff and Students Publications

Background: The risk of hepatocellular carcinoma (HCC) and net benefit of surveillance may differ between patients with cirrhosis. We compared the benefits and harms of HCC surveillance across risk strata in patients with cirrhosis.

Methods: We leveraged a cohort of patients with cirrhosis from a pragmatic RCT of HCC surveillance outreach enrolled between March 2018 and April 2021. Patients were stratified into low-, intermediate-, and high-risk categories based on published thresholds for three validated clinical risk scores. We calculated HCC incidence rates and moderate-to-severe physical harms for each risk stratum.

Results: Of 2142 patients with cirrhosis followed for a median …

K2p Channels As Key Regulators Of Cardiovascular And Pulmonary Vascular Function, Hala Y Abdelnasser, Xinchun Pi, Lavannya M Pandit, Bradley K Mcconnell

Faculty, Staff and Students Publications

Two-pore domain potassium (K2P) channels are the most recently identified family of potassium channels. They are regarded as the largest group of background “leak” channels, encoded by 15 mammalian KCNK genes, and divided into six subfamilies (TWIK, TREK, TASK, TALK, THIK, and TRESK). These channels have a role in stabilizing the resting membrane potential. Their widespread presence in the heart and vasculature supports cellular homeostasis by regulating cardiac rhythm, vascular tone, and protection against ischemic stress. The TASK, TWIK, and TREK subfamilies are the most abundantly expressed K2P channel subfamilies in the cardiovascular system, and dysregulation of specific members has …

Tulane Virus Protease As A Structural Surrogate For Inhibitor Screening Of Human Norovirus Proteases, Son Pham, Nikhil Sharma, Banumathi Sankaran, Jalen Nguyen, Mary K Estes, Joseph M Hyser, B V Venkataram Prasad

Faculty, Staff and Students Publications

Human norovirus (HuNoV) is a significant cause of gastroenteritis worldwide, affecting people of all age groups. There are currently no vaccines or drugs available, leaving susceptible populations vulnerable to severe or protracted illness. A HuNoV cultivation system is pivotal for screening norovirus antivirals. While the human intestinal enteroid cultivation system allows robust replication of multiple HuNoV strains, it presents technical and cost barriers. Tulane virus (TV), a surrogate for HuNoV, replicates well in monkey kidney cell lines and is closely related to norovirus in cellular biology. Here, we determined the structures of TV protease (TV-Pro) alone and in complex with …

Heterogeneity And Plasticity Of The Naive Cd4+ T Cell Compartment, Alia Sajani, Evelien Schaafsma, Walburga Croteau, Mohamed Eltanbouly, Elizabeth C Nowak, Chao Cheng, Christopher M Burns, Mary Jo Turk, Randolph J Noelle, J Louise Lines

Faculty, Staff and Students Publications

This study describes the transcriptional heterogeneity of murine and human naive CD4+ T cells as comprising multiple discrete clusters that impact CD4+ T cell fate and trajectories. Naive CD4+ T cells experiencing inflammatory environments exhibit an altered transcriptional state that biases their differentiation trajectories.

Conserved Neutrophil Degranulation Transcripts In Hiv-Tb Coinfected Children Across East And Southern Africa, Eric Katagirya, Busisiwe Mlotshwa, Samuel Kyobe, Savannah Mwesigwa, Gaone Retshabile, Lesedi Williams, Marion Amujal, John Mukisa, Gerald Mboowa, David P Kateete, Misaki Wayengera, Sununguko Wata Mpoloka, Angella N Mirembe, Ishmael Kasvosve, Koketso Morapedi, Makhosazana Dlamini, Betty Nsangi, Grace P Kisitu, Adeodata R Kekitiinwa, Gabriel Anabwani, Moses L Joloba, Eddie Mujjwiga Wampande, Dithan Kiragga, Florence Anabwani-Richter, Chester W Brown, Graeme Mardon, Neil A Hanchard, Mogomotsi Matshaba, And For The Collaborative African Genomics Network (Cafgen)

Faculty, Staff and Students Publications

Background: HIV-tuberculosis (HIV-TB) coinfection poses a significant public health challenge among children in high-burden African regions. Most previous transcriptomic studies have concentrated on adults and non-African populations, primarily analyzing gene-level differential expression. This approach overlooks multi-isoform complexity and may obscure both inherent and pathogen-induced intragenic heterogeneity. This multi-center case-control study aimed to identify and characterize the transcript-level landscape of HIV-TB coinfection in children from different African regions.

Methods: We analyzed whole-blood RNA sequencing data from 97 children with and without tuberculosis from Uganda (East Africa) and from Botswana and Eswatini (Southern Africa). Reads were quality-controlled, and low-abundance transcripts filtered out. …

Precision Percutaneous Coronary Intervention, Travis M Wilson, Uzair Munaf, Nafhat Shaikh, Affan Rizwan, Riyan Siddiqui, Hafeez Ul Hassan Virk, Mahboob Alam, Umair Khalid, Muzamil Khawaja, Tanawat Attachaipanich, Larisa H Cavallari, Tania Ahuja, Michael G Nanna, Samin K Sharma, Lloyd W Klein, Gary S Mintz, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Precision-based percutaneous coronary intervention (PCI) integrates contemporary strategies across the pre-, intra-, and post-procedural phases to improve outcomes and minimize complications. Emerging evidence underscores the value of these strategies in reducing adverse events and improving procedural efficiency. While artificial intelligence and pharmacogenomics hold long-term promise for enhancing personalization, their clinical utility in PCI remains in the early stages of development.

Plant-Based Dietary Patterns Are Associated With Slower Epigenetic Aging, Hyunju Kim, Christina A Castellani, Jiantao Ma, Alexis C Wood, Audrey Ting, Morgan E Grams, Bing Yu, Kelly Ruggles, James S Floyd, Dan E Arking, Casey M Rebholz

Faculty, Staff and Students Publications

Greater adherence to plant-based diets is associated with health benefits. Dietary intake can modify DNA methylation patterns, but it is unknown whether plant-based diets in a largely non-vegetarian population are associated with DNA methylation-based epigenetic aging measures. We examined the associations between 4 different types of plant-based diets indices (PDI) [overall PDI, provegetarian diet, healthy PDI, and unhealthy PDI] and epigenetic aging. We used data from the Atherosclerosis Risk in Communities (ARIC) Study (N=2,810) and National Health and Nutrition Examination Survey (NHANES, N=2,056). PDIs negatively scored higher intake of animal products and positively scored higher intake of all or selected …

Immunotherapy Of Tsa-1.C4 Or In Combination With Bnz Confers Protection Against Trypanosoma Cruzi Infection With A Distinct Cytokine Response, Landy Magaly Pech-Pisté, Victor Dzul-Huchim, Christian Florian Teh-Poot, Fabian Gusovsky, Kathryn Jones, Peter Hotez, Liliana Estefanía Villanueva-Lizama, Maria Elena Bottazzi, Jaime Ortega-Lopez, Julio Vladimir Cruz-Chan

Faculty, Staff and Students Publications

Chagas disease is a poverty-related neglected tropical disease caused by the protozoan Trypanosoma cruzi affecting approximately 6.3 million people, predominantly in the Americas. Approximately 30% of T. cruzi infections progress to chronic cardiomyopathy and 10% of these cases end in death from cardiac failure. The first-line drug Benznidazole (BNZ) require a prolonged treatment regimen and can be highly toxic. Here, we evaluate a therapeutic vaccine in T. cruzi-infected mice, based on the recombinant Trypomastigote Surface Antigen 1 (TSA-1.C4) protein and the emulsified adjuvant E6020, and in combination with a suboptimal dose of BNZ. We observed a reduced burden parasite in …

Self-Clustering Of Three Cbx2 Molecules Drives Prc2 To Promote Facultative Heterochromatinization Of Polycomb Target Genes, Steven Ingersoll, Abby Trouth, J Carlos Angel, Xinlong Luo, Axel Espinoza, Joey Wen, Chengjie Zhu, Joseph Tucker, Kalkidan Astatike, Christopher J Phiel, Hatim Sabaawy, Tatiana G Kutateladze, Tao P Wu, Tingting Yao, Chao Lu, Srinivas Ramachandran, Xiaojun Ren

Faculty, Staff and Students Publications

Phase separation is increasingly recognized in facultative heterochromatinization of Polycomb target genes; however, the mechanisms underlying this process remain obscure. Using single-molecule imaging and tracking, we show that individual condensates in mouse embryonic stem cells (mESCs) contain approximately 3 CBX2 molecules and numerous Polycomb repressive complex (PRC)1 and PRC2 subunits and indicate that the composition and dynamics of condensates are developmentally regulated. We reveal that CBX2 clusters PRC2 and controls the spatial distribution of both PRC2 and H3K27me3. Using genomic approaches, we demonstrate that CBX2 binds to condensate initiation sites, which are enriched for PRC2 nucleation sites. CBX2 deletion causes …

Immunotherapy Of Tsa-1.C4 Or In Combination With Bnz Confers Protection Against Trypanosoma Cruzi Infection With A Distinct Cytokine Response, Landy Magaly Pech-Pisté, Victor Dzul-Huchim, Christian Florian Teh-Poot, Fabian Gusovsky, Kathryn Jones, Peter Hotez, Liliana Estefanía Villanueva-Lizama, Maria Elena Bottazzi, Jaime Ortega-Lopez, Julio Vladimir Cruz-Chan

Faculty, Staff and Students Publications

Chagas disease is a poverty-related neglected tropical disease caused by the protozoan Trypanosoma cruzi affecting approximately 6.3 million people, predominantly in the Americas. Approximately 30% of T. cruzi infections progress to chronic cardiomyopathy and 10% of these cases end in death from cardiac failure. The first-line drug Benznidazole (BNZ) require a prolonged treatment regimen and can be highly toxic. Here, we evaluate a therapeutic vaccine in T. cruzi-infected mice, based on the recombinant Trypomastigote Surface Antigen 1 (TSA-1.C4) protein and the emulsified adjuvant E6020, and in combination with a suboptimal dose of BNZ. We observed a reduced burden parasite in …

Impact Of Long-Term Nitrogen Scavenger Therapy On Clinical Outcome In Individuals With Urea Cycle Disorders, Roland Posset, Friederike Epp, Sven F Garbade, Florian Gleich, Andrea L Gropman, Sandesh C S Nagamani, Georg F Hoffmann, Stefan Kölker, Matthias Zielonka

Faculty, Staff and Students Publications

Principles of long-term medical management in individuals with urea cycle disorders (UCDs) encompass (1) a low protein diet, (2) supplementation of arginine and/or citrulline along with essential amino acids, nutrients, vitamins and trace elements, and (3) use of nitrogen scavenging agents to reduce recurrent hyperammonemic events (HAEs). These principles aim at providing metabolic stability, elimimation of chronic complications, and achievement of normal development as well as growth. A retrospective comparative analysis was performed by studying 138 individuals with male ornithine transcarbamylase deficiency (mOTC-D), citrullinemia type 1 (CTLN1) and argininosuccinic aciduria (ASA) based on in vitro residual enzymatic activity for severity-adjustment. …

“Real-World Prognostic Performance Of Different Severe And Advanced Heart Failure Definitions: Data From The Swedish Heart Failure Registry”, Federica Guidetti, Lars H Lund, Lina Benson, Camilla Hage, Felix Lindberg, Christian Basile, Alessandro Villaschi, Francesca Musella, Davide Stolfo, Raffaele Scorza, Guillame Baudry, Charlotta Ljungman, Oscar Braun, Valeria Valente, Biykem Bozkurt, Marco Metra, Gianluigi Savarese

Faculty, Staff and Students Publications

Background: A valid definition of severe heart failure (HF) is essential for earlier identification, timely referral for advanced therapies, and to optimize clinical trial design.

Objectives: To assess the prevalence, prognostic performance, and 1-year outcomes associated with different definitions of severe and advanced HF (AdvHF) in patients with heart failure with reduced ejection fraction (HFrEF).

Methods: We included 15,153 patients with EF < 40%, HF duration >6 months, and no prior left ventricular assist device or heart transplant, from the Swedish Heart Failure Registry. Several definitions of severe/AdvHF were evaluated: a simplified Heart Failure Association (HFA) definition (NYHA III-IV, EF < 30%, ≥2 HF hospitalizations in 12 months), the GALACTIC-Severe-definition (NYHA III-IV, EF < 30%, ≥1 hospitalization in 6 months), and variations adding/removing criteria such as NT-proBNP levels and diuretic dose to the HFA-AdvHF definition. Predictive performance and 1-year outcomes were analyzed.

Results: The HFA-definition identified …

The Agreement Between Pulse Oximetry And Measured Arterial Oxygen Saturations In Postoperative Functionally Univentricular Patients, Fabio Savorgnan, Sebastian Acosta, Joshua Prabhu, Pranathi Pilla, Vikram Shah, Saul Flores, Rohit S Loomba

Faculty, Staff and Students Publications

Background: Pulse oximetry is widely used to estimate arterial oxygen saturation, yet accuracy may vary for a number of reasons. Data on children with functionally univentricular circulation are limited. The primary aim of this study was to evaluate the agreement between arterial oxygen saturation measured by blood gas and pulse oximetry in children with functionally univentricular circulations. Methods: A retrospective analysis was performed of paired arterial blood gas and pulse oximetry oxygen saturation measurements following Norwood, Glenn, or Fontan procedures. Signed difference was defined as arterial oxygen saturation by blood gas-arterial oxygen saturation by pulse oximetry. Bland-Altman analyses, …

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Use Of Tpa And Dnase Or Tpa Alone For Fibrinolysis, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela M Statile, Derek J Williams, Sheena Patel, Mark I Neuman, Samir S Shah

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. In this report, the panel provides recommendations for intrapleural fibrinolysis with tissue plasminogen activator (tPA) alone over tPA and dornase alfa (DNase) in children (3 months to 18 years) with complicated parapneumonic effusion and empyema. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according …

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Choice Of Chest Tube Size, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela Statile, Derek J Williams, Sheena Patel, Mark I Neuman, Samir S Shah

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Infectious Diseases Society of America. In this paper, the panel provides recommendations on the appropriate size of thoracostomy tube for drainage. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Use Of Pleural Fluid Drainage Versus Observation, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela M Statile, Derek J Williams, Sheena Patel, Mark I Neuman, Samir S Shah

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Infectious Diseases Society of America. In this paper, the panel provides recommendations for pleural fluid drainage in children (3 months to 18 years) with parapneumonic effusion and empyema. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Use Of Chest Ultrasound In Children With Parapneumonic Effusion, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela M Statile, Derek J Williams, Sheena Patel, Samir S Shah, Mark I Neuman

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. In this paper, the panel provides recommendations for the role of chest ultrasound to evaluate parapneumonic effusion and empyema. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

2026 Clinical Practice Guideline Update By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: The Use Of Pleural Fluid Drainage Compared To Surgical Debridement, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela M Statile, Derek J Williams, Sheena Patel, Samir S Shah, Mark I Neuman

Faculty, Staff and Students Publications

This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Infectious Diseases Society of America. In this paper, the panel provides recommendations on the choice of pleural fluid drainage by chest tube with fibrinolysis versus mechanical debridement. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

Clinical Practice Guideline By The Infectious Diseases Society Of America And The Pediatric Infectious Diseases Society: 2026 Guideline Update On The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age, Shawn D St Peter, Krow Ampofo, Thomas Brogan, Michael D Cabana, Claudia Espinosa, Todd A Florin, Jeffrey S Gerber, Michelle Gill, Debra L Palazzi, Mark Sawyer, Angela M Statile, Derek J Williams, Sheena Patel, Mark I Neuman, Samir S Shah

Faculty, Staff and Students Publications

As the first part of an update to the clinical practice guideline on the management of community-acquired pneumonia in infants and children older than 3 months of age, we present six updated recommendations. The updated recommendations span the characterization and management of pneumonia with parapneumonic effusion. The panel's recommendations are based on evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.