Pediatrics Commons^™

Pre-Emptive Treatment For Cytomegalovirus Viraemia To Prevent Cytomegalovirus Disease In Solid Organ Transplant Recipients, Robin Wm Vernooij, Mini Michael, Julia Mt Colombijn, Daniel S Owers, Angela C Webster, Giovanni Fm Strippoli, Elisabeth M Hodson

Faculty, Staff and Students Publications

Background: Cytomegalovirus (CMV) is a significant cause of morbidity and death in solid organ transplant recipients. Pre-emptive treatment of patients with CMV viraemia using antiviral agents has been suggested as an alternative to routine prophylaxis to prevent CMV disease. This is an update of a Cochrane review first published in 2006 and updated in 2013.

Objectives: To determine the benefits and harms of pre-emptive treatment of CMV viraemia to prevent CMV disease and death (any cause) and the indirect effects of CMV infection (acute rejection, graft loss, opportunistic infections) in solid organ transplant recipients.

Search methods: The Cochrane Kidney and …

Identification And Characterization Of A Novel Pavlovskyella (Acari: Argasidae) From Chile, Parasite Of The Culpeo Fox (Lycalopex Culpaeus), Sebastián Muñoz-Leal, Alexander R Kneubehl, Karen Ardiles, Catalina Parragué-Migone, Ignacio Troncoso-Toro, Pablo Oyarzún-Ruiz, Job E Lopez

Faculty, Staff and Students Publications

Soft ticks (Argasidae) of the subgenus Pavlovskyella Pospelova-Shtrom are worldwide distributed parasites of medical importance. However, the systematics of the subgenus are currently under debate because genetic data shows that the group is paraphyletic. Meanwhile, species of Pavlovskyella continue to be discovered. In this study a novel species of the subgenus is described from specimens collected on a fox in central Chile. The larva of this new species differentiates from other Pavlovskyella spp. by having the following combination of characters: subpyriform dorsal plate; 15 pairs of setae, 7 anterolateral, 3 central, and 5 posterolateral, and hypostome with denticles in the …

Hyperleukocytosis In A Neuroblastoma Patient After Treatment With Natural Killer T Cells Expressing A Gd2-Specific Chimeric Antigen Receptor And Il-15, Gengwen Tian, Amy N Courtney, Hangjin Yu, Saleh Bhar, Xin Xu, Gabriel A Barragán, Claudia Martinez Amador, Nisha Ghatwai, Michael S Wood, Deborah Schady, Antonino Montalbano, Shantan Reddy, Aoife M Roche, David De La Cerda, Donald Williams Parsons, Erica J Di Pierro, Frederic D Bushman, Andras Heczey, Leonid S Metelitsa

Faculty, Staff and Students Publications

The ability of immune cells to expand numerically after infusion distinguishes adoptive immunotherapies from traditional drugs, providing unique therapeutic advantages as well as the potential for unmanageable toxicities. Here, we describe a case of lethal hyperleukocytosis in a patient with neuroblastoma treated on phase 1 clinical trial (NCT03294954) with autologous natural killer T cells (NKTs) expressing a GD2-specific chimeric antigen receptor and cytokine interleukin 15 (GD2-CAR.15). This patient was the first to be treated on dose level (DL) 5 and the first patient whose product was restimulated with K562-derived artificial antigen-presenting cells (aAPCs) instead of autologous peripheral blood mononuclear cells …

Advancing Monogenic Diabetes Research And Clinical Care By Creating A Data Commons: The Precision Diabetes Consortium (Predict), Michael E Mccullough, Lisa R Letourneau-Freiberg, Rochelle N Naylor, Siri Atma W Greeley, David T Broome, Mustafa Tosur, Raymond J Kreienkamp, Erin Cobry, Neda Rasouli, Toni I Pollin, Miriam S Udler, Liana K Billings, Cyrus Desouza, Carmella Evans-Molina, Suzi Birz, Brian Furner, Michael Watkins, Kaitlyn Ott, Samuel L Volchenboum, Louis H Philipson

Faculty, Staff and Students Publications

Monogenic diabetes mellitus (MDM) is a group of relatively rare disorders caused by pathogenic variants in key genes that result in hyperglycemia. Lack of identified cases, along with absent data standards, and limited collaboration across institutions have hindered research progress. To address this, the UChicago Monogenic Diabetes Registry (UCMDMR) and UChicago Data for the Common Good (D4CG) created a national consortium of MDM research institutions called the PREcision DIabetes ConsorTium (PREDICT). Following the D4CG model, PREDICT has successfully established a multicenter MDM data commons. PREDICT has created a consensus data dictionary that will be utilized to address critical gaps in …

A Case Report Of Moderate Factor X Deficiency, Harpreet Kaur, Tanmoy Das, Poonam Wade, Murtuja Shaikh

Digital Journal of Clinical Medicine

Factor X deficiency is a rare coagulation disorder with a varied clinical spectrum. It can present at any age, but most severe cases present in childhood. There are no evidence-based management guidelines for the management of factor X deficiency due to limited literature. Detailed history, clinical examination and specialized tests (coagulation profile, mixing studies, factor assay) are required for the diagnosis of factor X deficiency. In this case report, we are discussing the case of a 1-month-old, 12-day-old female child who presented with the complaint of spontaneous bleeding from the nose since 1 day with no other bleeding manifestations from …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Proteomic Characterization And Comparison Of The Infective And Adult Life Stage Secretomes From Necator Americanus And Ancylostoma Ceylanicum, Yide Wong, Bruce A Rosa, Luke Becker, Mali Camberis, Graham Legros, Bin Zhan, Maria Elena Bottazzi, Ricardo T Fujiwara, Edita Ritmejeryte, Thewarach Laha, Sujittra Chaiyadet, Piyanan Taweethavonsawat, Paul J Brindley, Bethany K Bracken, Paul R Giacomin, Makedonka Mitreva, Alex Loukas

Faculty, Staff and Students Publications

More than 470 million people globally are infected with the hookworms Ancylostoma ceylanicum and Necator americanus, resulting in an annual loss of 2.1 to 4 million disability-adjusted-life-years. Current infection management approaches are limited by modest drug efficacy, the costs associated with frequent mass drug administration campaigns, and the risk of reinfection and burgeoning drug resistance. Subunit vaccines based on proteins excreted and secreted (ES) by hookworms that reduce worm numbers and associated disease burden are a promising management strategy to overcome these limitations. However, studies on the ES proteomes of hookworms have mainly described proteins from the adult life stage …

Use Of A Mouse Model For The Isolation Of Borrelia Puertoricensis From Soft Ticks, Edwin Vázquez-Guerrero, Alexander R Kneubehl, Guadalupe C Reyes-Solís, Carlos Machain-Williams, Aparna Krishnavajhala, Paulina Estrada-De Los Santos, Job E Lopez, José Antonio Ibarra

Faculty, Staff and Students Publications

The isolation of tick-borne relapsing fever (TBRF) spirochetes has proven to be a useful tool to understand their distribution in geographic areas where the tick vectors inhabit. However, their isolation and culture are not easy and in general an animal model is needed to achieve this task. Here, argasid ticks were collected from a neighborhood in Ciudad Caucel, and they were identified as Ornithodoros (Alectorobius) puertoricensis. To determine whether these were infected with TBRF bacteria they were fed with healthy mice but only a low burden of spirochetes was observed. An immunosuppressed mouse model was used to feed the ticks …

Impact Of Methicillin-Resistant Staphylococcus Aureus Surveillance And Decolonization In The Nicu: The Texas Children’S Hospital Experience, Nahid Hiermandi, Catherine Foster, Judith Campbell, Krystal Purnell, Elizabeth Tocco, Tjin Koy, Kenneth Nobleza, Duc Nguyen, Lucila Marquez

Faculty, Staff and Students Publications

OBJECTIVE: To determine the impact of screening and decolonization on methicillin-resistant

STUDY DESIGN: This is a single-center retrospective cohort study comparing patient characteristics among MRSA-colonized and MRSA-infected infants, rates of MRSA infection before and after screening with targeted decolonization, and MRSA infection among those receiving single or combined decolonization agents.

SETTING: Texas Children's Hospital Pavilion for Women is a 42-bed level three neonatal intensive care units (NICU) in Houston, TX.

PATIENTS: Neonates admitted to the NICU from 2012 to 2022 were included in analysis of MRSA colonization and infection. The gestational age ranged from 22 weeks to 42 weeks.

INTERVENTIONS: …

Comparative Analysis Of Aav Serotypes For Transduction Of Olfactory Sensory Neurons, Benjamin D W Belfort, Johnathan D Jia, Alexandra R Garza, Anthony M Insalaco, J P Mcginnis, Brandon T Pekarek, Joshua Ortiz-Guzman, Burak Tepe, Hu Chen, Ascent-Pd Investigators, Zhandong Liu, Benjamin R Arenkiel

Faculty, Staff and Students Publications

Olfactory sensory neurons within the nasal epithelium detect volatile odorants and relay odor information to the central nervous system. Unlike other sensory inputs, olfactory sensory neurons interface with the external environment and project their axons directly into the central nervous system. The use of adeno-associated viruses to target these neurons has garnered interest for applications in gene therapy, probing olfactory sensory neuron biology, and modeling disease. To date, there is no consensus on the optimal AAV serotype for efficient and selective transduction of olfactory sensory neurons

Initiating Insulin Pumps In Youth With New-Onset Type 1 Diabetes: A Quality Improvement Initiative, Mili Vakharia, Sarah K Lyons, Don Buckingham, Mark Rittenhouse, Siripoom Mckay, Rona Sonabend, Grace Kim

Faculty, Staff and Students Publications

Introduction: Insulin pump therapy is recommended for youth with type 1 diabetes (T1D) as it enhances quality of life and improves glycemic management. We led a quality improvement initiative to increase insulin pump use in youth younger than 18 years of age with recently diagnosed T1D (duration < 1 y) from a baseline of 17% to 27% from January 2021 to December 2023. As a balancing measure, we evaluated the diabetes-related ketoacidosis (DKA) rate in the same cohort as nonpump users.

Methods: We implemented the following plan-do-study-act cycles: (1) development and implementation of pump initiation algorithm, including minimal safe start criteria and education on ketosis management with pump action plan, (2) establishing clinic follow-up within 90 days of pump start, (3) expansion of the pump algorithm at additional clinic locations, (4) early patient/caregiver education …

Maintenance Therapy With A P2y12 Receptor Inhibitor After Cangrelor In Patients With Acute Coronary Syndrome The Electra-Sirio 2 Investigators’ Viewpoint, Jacek Kubica, Piotr Adamski, Robert Gajda, Aldona Kubica, Małgorzata Ostrowska, Gavino Casu, Diana A Gorog, Paul A Gurbel, Tomasz Hajdukiewicz, Miłosz Jaguszewski, Young-Hoon Jeong, Agata Kosobucka-Ozdoba, Zuzana Motovska, Piotr Niezgoda, Maciej Piasecki, Przemysław Podhajski, Paolo Raggi, Uzeyir Rahimov, Jolanta M Siller-Matula, Grzegorz Skonieczny, Łukasz Szarpak, Paweł Szymański, Udaya Tantry, Eliano P Navarese

Faculty, Staff and Students Publications

According to the ESC guidelines, cangrelor may be considered in P2Y12-inhibitor-naïve acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The aim of this review is to summarize available evidence on the optimal maintenance therapy with P2Y12 receptor inhibitor after cangrelor. Transitioning from cangrelor to a thienopyridine, but not ticagrelor, can be associated with a drug-drug interaction (DDI); therefore, a ticagrelor loading dose (LD) can be given any time before, during, or at the end of a cangrelor infusion, while a LD of clopidogrel or prasugrel should be administered at the time the infusion of cangrelor ends or within …

Anti-Racist And Anti-Colonial Content Within Us Global Health Curricula, Sanemba Aya Fanny, Amy Rule, Heather L Crouse, James C Hudspeth, Bethany Hodge, Marideth Rus, Heather Haq

Faculty, Staff and Students Publications

There is a growing interest to address pervasive racist and colonialist practices in global health (GH). However, there is a paucity of information on anti-racist and anti-colonial (ARAC) education for GH trainees. This study aimed to identify curricular strengths and gaps in ARAC content for pediatric, family medicine and emergency medicine trainees participating in GH. We conducted a cross-sectional survey of GH programs' ARAC curricular content from May 2021 to January 2022. The survey was distributed to 148 GH program educational leaders via email. Descriptive statistics were used to describe quantitative data and comments were reviewed for common themes. The …

Role Of Posterior Carbon Fiber Implants In Spine Tumor Surgery, Christopher A Alvarez-Breckenridge, Robert North, Claudio Tatsui, Naresh Kumar, Sheng-Fu Lo, Karim Mohammed, Jeremy Reynolds, Aron Lazary, Ilya Laufer, Jorrit Jan Verlaan, Ziya Gokaslan, Alessandro Luzzati, Riccardo Cecchinato, John Shin, Francis Hornicek, Alexander Disch, Matthew Goodwin, Rory Goodwin, Arjun Sahgal, Alessandro Gasbarrini, Stefano Boriani

Faculty, Staff and Student Publications

Study design: Narrative Review.

Objective: The management of spinal tumors requires a multi-disciplinary approach including surgery, radiation, and systemic therapy. Surgical approaches typically require posterior segmental instrumentation to maintain long-term spinal stability. Carbon fiber reinforced pedicle screws (CFRP) are increasingly used in the oncologic setting due to reductions in both imaging artifacts and radiotherapy perturbations compared to titanium implants. We performed a review of the literature and highlight advantages and future areas of study for CFRP.

Methods: We performed a systematic review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and identified 10 articles …

Instagram Versus Reality: Who Are Actually Plastic Surgeons?, Nikhi P Singh, Mary M Holohan, Cameron Harmon, Kasra N Fallah, Jeffrey Gross, Aadarsh Patel, Carter J Boyd, Matthew R Greives, Jorge De La Torre, Gayle Gordillo, Timothy W King

Faculty, Staff and Student Publications

Background: Instagram has become one of the most powerful marketing tools available to plastic surgeons because patients have increasingly turned to online resources to find physicians. Within, we review the online presence of self-ascribed plastic surgeons in the United States to identify potential misinformation and dishonest advertising.

Methods: The Inflact database was queried for the search terms: "plastic surgeon/surgery," "plastic and reconstructive surgeon/surgery," "aesthetic surgeon/surgery," and "cosmetic surgeon/surgery." US physician account information, history of medical training, American Board of Plastic Surgery (ABPS) certification status, and posts were reviewed.

Results: In total, 1399 physicians practicing within the United States were identified. …

Synthetic Versus Biologic Mesh For Complex Open Ventral Hernia Repair: 3-Year Follow-Up Of A Pilot Randomized Controlled Trial, Naila H Dhanani, Nicole B Lyons, Kyung Hyun Lee, Oscar A Olavarria, Aris R Arakelians, Julie L Holihan, Lillian S Kao, Ali Siddiqui, Connor Hogan, Tunmi Anwoju, Zuhair Ali, Mike K Liang

Faculty, Staff and Student Publications

Background: Biologic mesh is often used in complex hernia repair, but there has been limited clinical evidence to date to support this practice. The aim of this study was to compare clinical and patient-reported outcomes of biologic versus synthetic mesh for complex open ventral hernia repair (OVHR) at 3 years.

Methods: Patients from a single center, randomized, controlled, pilot trial comparing biologic versus synthetic mesh in complex OVHR were followed for 3 years. The primary outcome focused on major complications, namely mesh infections, hernia recurrences, reoperations, and deaths. Secondary outcomes included surgical site infections, surgical site occurrences, and patient-reported outcomes. …

Poor Oral Health Is Associated With Social Vulnerability In Critically Ill Trauma Patients, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Chelsea J Guy-Frank, Gabrielle E Hatton, Kayli A Quinton, Sophia Syed, Erin E Fox, Charles E Wade, Kimberly A Mankiewicz, Lillian S Kao

Faculty, Staff and Student Publications

Background: Social factors affect oral health status, and poor oral health has been associated with worse health outcomes. Using the Oral Health Risk Assessment Value Index (OHRAVI), a bedside tool for non-dentists to assess oral health, we investigated the interplay of oral health with social drivers of health and social vulnerability, as measured by the Social Vulnerability Index (SVI), in severely injured patients.

Methods: Our retrospective study included dentulous critically ill trauma patients who were previously assigned an OHRAVI score (range 0-3; unhealthy score >1). Patient demographics, comorbidities, and self-reported social drivers were obtained from health records. SVI was calculated …

Efficacy And Safety Of Once-Daily Roflumilast Cream 005% In Pediatric Patients Aged 2-5 Years With Mild-To-Moderate Atopic Dermatitis (Integument-Ped): A Phase 3 Randomized Controlled Trial, Lawrence F Eichenfield, Rocco Serrao, Vimal H Prajapati, John C Browning, Lisa Swanson, Tracy Funk, Mercedes E Gonzalez, Adelaide A Hebert, Mark Lee, Mark Boguniewicz, Eric L Simpson, Melissa S Seal, David Krupa, Diane Hanna, Scott Snyder, Patrick Burnett, David H Chu, Erin Almaraz, Robert C Higham, David R Berk

Faculty, Staff and Student Publications

Background/objectives: Efficacy and safety of roflumilast cream 0.15% were demonstrated in patients aged ≥ 6 years with atopic dermatitis (AD) in two Phase 3 trials. This Phase 3 parallel-group, double-blind trial (INTEGUMENT-PED; NCT04845620) compared the efficacy and safety of roflumilast cream 0.05% and a vehicle in patients aged 2-5 years with AD.

Methods: Patients aged 2-5 years with mild-to-moderate AD were treated with once-daily roflumilast cream 0.05% or vehicle for 4 weeks. The primary efficacy endpoint was Validated Investigator Global Assessment for AD (vIGA-AD) Success (0 [Clear] or 1 [Almost Clear] plus ≥ 2-grade improvement from baseline) at Week …

Dance-Related Fractures Occur In The Upper And Lower Extremities At Similar Rates: An Analysis Of The 2004-2023 National Electronic Injury Surveillance System Database, Senah E. Stephens, Joshua F. Edwards, Lisa K. Cannada

Department of Medicine Faculty Publications

Introduction

In the United States, 21% of adolescents participate in dance. Dancers are susceptible to injuries, particularly of the lower extremity, due to extreme positioning, dynamic overload, and repetitive movements.

Objectives

(1) to report the prevalence and describe demographic characteristics of dance-related fractures and (2) to analyze variables associated with disposition status.

Methods

The National Electronic Injury Surveillance System (NEISS) database, published by the US Consumer Product Safety Commission, was used to investigate dance-related fractures diagnosed in a sample of 100 emergency departments over 20 years. Descriptive statistics and demographic variables were analyzed using chi square tests. Age was analyzed …

A Computational Approach For Intramural Length Estimation In Anomalous Aortic Origin Of A Coronary Artery, Vikram Shah, Lauren Ferrino, Dana Reaves-O'Neal, Tam T Doan, Shagun Sachdeva, Craig G Rusin, Dan Lior, Charles Puelz, Prakash M Masand, Silvana Molossi

Faculty, Staff and Students Publications

Introduction: Anomalous aortic origin of a coronary artery (AAOCA) is associated with sudden cardiac death. The intramural (IM) length is considered high-risk, yet radiologic measurements by computed tomography angiography (CTA) show variable agreement with measurements at surgery. We aimed to develop a semi-automatic computational method to estimate IM length in a retrospective cohort of surgical AAOCA patients.

Methods: In 58 patients [49 right(R), 9 left(L)], CTA images were used to generate 3D segmentations of the aorta and a centerline of the anomalous coronary. The distance from the centerline to the aortic segmentation was calculated. The IM length was estimated from …

Evidence-Based Evaluation To Promote High-Value Care In Pediatric Critical Care: It Is Time To Fully Adopt, Maya Dewan, Rajit K Basu, Erin Bennett, Lily B Glater-Welt, Mark Hall, Benson S Hsu, Lia Lowrie, Venessa Lynn Pinto, Alexandre T Rotta, Edward Seferian, Linda Siegel, Heather A Wolfe, Vijay Srinivasan

Faculty, Staff and Students Publications

Introduction: Evidence-based recommendations for high-value care in pediatric critical care are needed. We sought to develop recommendations to identify unnecessary interventions, enhance outcomes, and promote efficient, patient-centered practices.

Methods: Using a modified Delphi process, a multi-institutional panel of pediatric intensivists from a national pediatric critical care quality improvement group identified 30 potential topics and selected 20 high- and medium-priority topics for further evaluation, and narrowed them to 10 by consensus voting. A structured scoping review of literature published between 2014 and 2023 identified 10 practices, which were critically assessed using the PICOST framework. The panel selected 5 priority recommendations based …

Impact Of Elevated Serum Triglycerides On Children With Acute Recurrent Or Chronic Pancreatitis From Insppire-2, Zachary M Sellers, Matthew J Giefer, Fuchenchu Wang, Gretchen A Cress, Maisam A Abu-El-Haija, Ankur Chugh, Reuven Z Cohen, Elissa M Downs, Douglas S Fishman, A Jay Freeman, Cheryl E Gariepy, Tanja Y Gonska, Amit S Grover, Doug Lindblad, Quin Y Liu, Asim Maqbool, Jacob A Mark, Brian A Mcferron, Megha S Mehta, Veronique D Morinville, Kenneth Ng, Robert A Noel, Chee Y Ooi, Emily R Perito, Madhura Y Phadke, Wenly Ruan, Sarah Jane Schwarzenberg, David M Troendle, Michael Wilschanski, Yuhua Zheng, Ying Yuan, Mark E Lowe, Aliye Uc, Consortium For The Study Of Chronic Pancreatitis, Diabetes And Pancreatic Cancer

Faculty, Staff and Students Publications

Objective: To determine if mild-moderate hypertriglyceridemia (HTG) is associated with increased development of chronic pancreatitis (CP) or pancreatitis-associated complications in children with acute recurrent or CP.

Study design: Longitudinal data from the INternational Study group of Pediatric Pancreatitis: In search for a cuRE-2 (INSPPIRE-2) cohort of children with acute recurrent or CP (n = 559) were analyzed. Subjects were divided into normal triglycerides (< 150 mg/dL; 1.7 mmol/L), any HTG (≥150 mg/dL; ≥1.7 mmol/L), mild-moderate HTG (150-499 mg/dL; 1.7-5.6 mmol/L), moderate HTG (500-999 mg/dL; 5.6-11.3 mmol/L), and severe HTG groups (≥1000 mg/dL; ≥11.3 mmol/L), based on highest serum triglyceride value. Laboratory, imaging, pancreatitis and hospital events, complications, and quality of life data were analyzed.

Results: In children with acute recurrent or CP and HTG, there was no increase in the number of pancreatitis attacks per person-years, nor an increase in CP prevalence. However, HTG severity was associated with increased pancreatic …

Difficulties In Diagnosing Lactose Malabsorption, Richard Kellermayer

Faculty, Staff and Students Publications

No abstract provided.

Correction: Inclusion Of Patient-Centered, Non-Microbiological Endpoints And Biomarkers In Tuberculosis Drug Trials, Andrew R Dinardo, Wilbert Sabiiti, Stephen H Gillespie, Sophia B Georghiou, Norbert Heinrich, Norbert Hittel, Sami Taghlabi, Danna Carrero Longlax, Mikashmi Kohli, Ursula Panzner, Collins Musia, Christoph Lange, Anca Vasiliu, Rob J W Arts, Anna M Mandalakas, Morten Ruhwald, Lieven J Stuyver, Reinout Van Crevel

Faculty, Staff and Students Publications

This corrects the article "Inclusion of patient-centered, non-microbiological endpoints and biomarkers in tuberculosis drug trials", 1570989.

Bearing Witness: Témoignage As A Tool For Child Advocacy During Armed Conflict, Anik Patel, Amber Alayyan, Heather A Haq, Parminder S Suchdev, Naji Hattar, Jeffrey Goldhagen, David J Schonfeld, Tanya Haj-Hassan, Lia Harris, Seema Jilani, Ayesha Kadir, Paul H Wise, Lisa Umphrey

Faculty, Staff and Students Publications

Children affected by armed conflict suffer devastating physical, emotional, and social harm. War uproots families, forcing many to flee as refugees or internally displaced persons, while others remain trapped in dangerous environments. In these crises, children face disproportionate risks-violence, exploitation, disrupted education, and collapsed healthcare systems. Their unique vulnerabilities require urgent, targeted action to protect their health, rights, and development. Beyond immediate care, the humanitarian principle of témoignage-bearing witness-is essential. Rooted in humanitarian ethics, témoignage means speaking out about injustice, amplifying the voices of those affected, and driving systemic change. It challenges traditional notions of neutrality and calls on humanitarian …

Multidisciplinary Approach To Treating Complex Immune Dysregulation Disorders: An Adaptive Model For Institutional Implementation, Lauren A Henderson, Roshini S Abraham, Aisha Ahmed, Lindsey Blount, Scott W Canna, Natalia S Chaimowitz, Shanmuganathan Chandrakasan, Bria Coates, James A Connelly, Megan A Cooper, Christine N Duncan, Anthony French, Melissa Hazen, Michelle L Hermiston, Brian Nolan, Anish Ray, Melissa J Rose, Lisa Forbes Satter, Grant Schulert, Sara Kristen Sexson Tejtel, Tiphanie Vogel, Kelly Walkovich, Matt S Zinter, Edward M Behrens

Faculty, Staff and Students Publications

Patients with immune dysregulation may present with varying combinations of autoimmunity, autoinflammation, immunodeficiency, atopy, lymphoproliferation, and/or malignancy, often with multisystem involvement. Recognizing specific patterns of immune dysregulation, coordinating and interpreting complex diagnostic testing, and choosing initial (often empiric) treatment can be challenging. Centers are increasingly assembling multidisciplinary teams (MDTs) to standardize evaluation and optimize treatment of patients with complex immune dysregulation (immune dysregulation MDTs [immMDTs]). However, published information on the composition and function of immMDTs is sparse, and there is little guidance for those seeking to establish or optimize an immMDT. To inform this review, we assembled a panel of …

Hypertriglyceridemia In New-Onset Type 1 Pediatric Diabetes, Colleen A Macke, Iman Al-Gadi, Nidhi Bansal, Sarah K Lyons, Aikaterini A Nella

Faculty, Staff and Students Publications

Hypertriglyceridemia (HTG) in the setting of newly diagnosed diabetes is common in both adult and pediatric populations, as insulin deficiency promotes lipolysis and impairs triglyceride (TG) clearance. Severe HTG (defined as TG levels above 1000 mg/dL) in pediatric patients with new-onset type 1 diabetes mellitus (T1D) is rare; the true incidence and sequela of this phenomenon have not been well characterized. We present a single-center experience on severe HTG in pediatric patients with new-onset T1D between 2013 and 2022 and summarize the cases previously reported in the literature. Our cases display variability in their presentation and in their association with …

Reflections On Directing 25 Years Of The Annual Transition Conference, Albert C Hergenroeder

Faculty, Staff and Students Publications

Albert C. Hergenroeder, MD, Professor of Pediatrics, Chief, Adolescent Medicine and Sports Medicine, Baylor College of Medicine The paper is based on the author's opening address for the 25th annual Chronic Illness and Disability: Transition from Pediatric to Adult-based care conference at Baylor College of Medicine/Texas Children's Hospital conference delivered October 10, 2024.

Dual Inhibitor Of Mdm2 And Nfat1 For Experimental Therapy Of Breast Cancer: In Vitro And In Vivo Anticancer Activities And Newly Discovered Effects On Cancer Metabolic Pathways, Wei Wang, Marlene Aguilar, Sayantap Datta, Abigail Alley, Meheret Tadesse, Xinshi Wang, Xia Gao, Ruiwen Zhang

Faculty, Staff and Students Publications

INTRODUCTION: The oncogene MDM2 has garnered attention not only for its role in cancer as a negative regulator of the tumor suppressor p53 but also for its p53-independent oncogenic activities. MDM2 also involves metabolic reprogramming, such as serine metabolism, respiration, mitochondrial functions, the folate cycle, and redox balance. Traditional MDM2 inhibitors blocking the protein-protein binding between MDM2 and p53 have shown limited clinical success in various stages of clinical trials, most likely due to low efficacy, drug toxicity, and drug resistance, highlighting the need for a novel, p53-independent strategy to inhibit MDM2. The present study investigated the antitumor effects of …

Aerodigestive Sequelae And Triple Endoscopy After Congenital Tracheoesophageal Fistula Repair In Children, Whitney Jin, Eric H Chiou, Shailendra Das, Kathleen E Hosek, Elton M Lambert

Faculty, Staff and Students Publications

Children post-tracheoesophageal fistula (TEF) repair may present with chronic respiratory and gastrointestinal symptoms that can affect quality of life.

OBJECTIVE: To identify factors associated with positive findings on triple endoscopy following neonatal TEF repair.

STUDY DESIGN: Case series with retrospective review of patients.

SETTING: Tertiary care center aerodigestive program.

METHODS: Children with neonatally repaired congenital TEF who had a triple endoscopy between 2011 and 2022 were reviewed. The presence of chronic cough, recurrent pulmonary infections, lipid-laden macrophages (LLM), and airway and esophageal anomalies were among the variables analyzed. Chi-square and Kruskal-Wallis univariate analysis was performed.

RESULTS: The mean age was …