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Treatment outcomes among pediatric patients with problematic cannabis use and depression: A TriNetX study
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Improving Nirsevimab Administration before Discharge from a Level IV NICU: A Quality Improvement Study
Full text linkProvider use and comfortability in diagnosing and treating anxiety disorders using the GAD-7 screening tool in an Urban Academic Pediatric Clinical Setting
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Non-vitamin K oral anticoagulants and aspirin do not differ for major bleeding and intracranial hemorrhage at a mean 20 mo.
No full textCathelicidin-related antimicrobial peptide (CRAMP) is toxic during neonatal murine influenza virus infection.
No full textRespiratory viral infections are a major contributor to mortality in children under 5 years of age, and disproportionately affect preterm neonates. Previously, using our established 3-day-old neonatal murine model of influenza virus infection, we demonstrated that treatment of neonatal mice with intranasal Lactobacillus rhamnosus GG (LGG) prior to influenza viral infection improved survival. Transcriptional analysis revealed expression of the mouse cathelicidin-related antimicrobial peptide (CRAMP, encoded by CRAMP) was downregulated in LGG-treated neonates. Mouse CRAMP is a key effector protein secreted by infected epithelial cells and resident and infiltrating immune cells, but the role of CRAMP in neonatal defense to respiratory viruses is unknown. Neonatal mice with a deleted CRAMP gene (CRAMP-/-) were intranasally infected with influenza virus. CRAMP-/- neonates had improved survival over C57BL/6 neonates after influenza viral infection (75% vs. 14%, p \u3c 0.05). Next, immune cell recruitment to the lung of infected neonates was determined. Surprisingly, at 3-days postinfection, there was increased recruitment of neutrophils, inflammatory monocytes, and alveolar macrophages, coupled with increased proinflammatory cytokine and chemokine production in CRAMP-/- compared to C57BL/6 neonates. However, this changed over the first week of infection. C57BL/6 neonatal mice increased CRAMP production significantly, in direct contrast to their adult counterparts. Inflammatory cytokine production increased that indicated CRAMP amplified the innate immune response later in the infection. Furthermore, we identified pulmonary nonimmune cells as an important source of increased CRAMP levels as the infection progressed and CRAMP production drove mortality. These insights emphasize the age-specific role of CRAMP in influenza viral pathogenesis
Efficacy of probiotics in reducing the duration and severity of acute gastroenteritis in children: A meta-analysis of randomized controlled trials.
No full textOBJECTIVES: Acute gastroenteritis is a leading global health concern among children, causing significant morbidity and mortality. Despite advances in treatment, effective management remains a challenge. Probiotics aim to restore gut homeostasis by correcting intestinal dysbiosis. This systematic review and meta-analysis aims to assess the efficacy of probiotics in reducing the severity and duration of diarrhea in children with acute gastroenteritis.
METHODS: A comprehensive literature search was conducted across four major databases using the keywords acute diarrhea, pediatric, and probiotics, among others. Only double-arm randomized clinical trials (RCTs) were included, focusing on the efficacy of probiotics in treating pediatric acute diarrhea. Data analysis was performed using Stata 16.0, with a random-effects model applied to account for study variability.
RESULTS: Out of 1470 studies screened, 25 RCTs involving 5170 patients (2552 in the probiotic group and 2618 in the placebo group) met the inclusion criteria. Probiotics significantly reduced the overall duration of diarrhea (mean difference [MD]: -7.76; 95% confidence interval [CI]: -14.60 to -0.91; p = 0.03). Diarrhea frequency was notably reduced on Day 2 (MD: -1.03; 95% CI: -2.06 to 0.00; p = 0.05) and Day 5 (MD: -0.51; 95% CI: -0.83 to -0.18; p = 0.002). Probiotics also significantly reduced the duration of vomiting (MD: -0.19; 95% CI: -0.28 to -0.09; p \u3c 0.01), with a nonsignificant trend in fever reduction.
CONCLUSION: This meta-analysis demonstrates the clinical efficacy of probiotics in reducing the duration of diarrhea and vomiting in children with acute gastroenteritis. Future trials are recommended to further explore the role of specific probiotic strains and combinations to enhance treatment outcomes
Prenatal Diagnosis of Congenital Heart Disease in Liveborn Infants in the New England Region.
No full textPrenatal diagnosis of congenital heart disease requiring early cardiac catheterization or surgical intervention enables optimal delivery planning for appropriate postnatal cardiovascular intervention and care. This allows for improved morbidity and mortality. Prior national data reported prenatal diagnosis rates of 32% for congenital heart disease requiring intervention in infants in the first 6 months of life in the New England region. With improved technology, access to care and changes to the obstetrical ultrasound guidelines for mid trimester fetal study, it is expected that diagnostic rates should improve. The New England Congenital Cardiology Association (NECCA) conducted a quality improvement study to determine the rates of prenatal detection in the current era with the hypothesis that there has been improvement in detection rates in this region. Ten of fourteen medical centers delivering pediatric cardiology care in New England contributed prenatal diagnosis data for 286 infants born at the participating centers during a one year period. The overall prenatal detection rate was 68%. Detection rates ranged from 39 to 90%. When fetal echocardiogram was performed at a pediatric cardiology center, the detection rate was 95% with only 7 moderate (7/195; 3.6%) and 3 severe (3/195; 1.5%) diagnostic discrepancies. Prenatal diagnostic rate and accuracy are high among pediatric cardiology centers in the New England region, and much improved over historical data. To improve fetal detection of congenital heart disease further, future work is needed to better determine the etiology of missed prenatal diagnoses and efforts should be focused on increasing appropriate referrals to pediatric cardiology centers for fetal evaluation