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Donor, Recipient, and Parent Characteristics Associated with Poor Pediatric Sibling Hematopoietic Stem Cell Donor Pre-Donation Health-Related Quality-of-Life; Early Results of the Donorkids QL Study
No full textThe 2025 Tandem Meetings of ASTCT and CIBMTR, February 12 - 15, 2025 Honolulu, H
Prophylactic antibiotic use in trauma patients with non-operative facial fractures: A prospective AAST multicenter trial
No full textBACKGROUND Craniofacial trauma affects approximately 3 million individuals in the United States annually. Historically, low overall data quality and inadequate sample size have limited the development of clinical practice guidelines for prophylactic antibiotic use in facial fractures. We sought to examine the current use patterns and effects of prophylactic antibiotics in non-operative facial fractures. METHODS A prospective analysis of adult patients with nonoperative facial fractures was conducted across 19 centers from January 2022 to December 2023. Kruskal-Wallis H, Mann-Whitney U, Pearson\u27s χ(2), Fisher\u27s exact tests, and logistic regression models were used to evaluate the association between antibiotic duration (no antibiotics, ≤ 24 hours, and \u3e 24 hours) and facial fracture-associated infectious complications. RESULTS Among 1,835 patients, 1,168 (63.7%) received no antibiotics and 667 (36.4%) received antibiotics (≤ 24 hours, n = 264 (14.4%); \u3e 24 hours, n = 403 (22.0%). Nineteen (1.0%) patients developed infectious complications (0.7% in the no antibiotic group vs. 1.7% with antibiotics). Most patients (99.0%) did not develop an infection despite the majority (63.7%) receiving no antibiotics. Injuries were predominately closed fractures (86.3%), without mucosal disruption (83.9%) or foreign bodies (97.7%). Antibiotic administration had a statistically significant association with the occurrence of infectious complications (p = 0.050). However, no significant association was seen between antibiotic duration and infectious complications following multivariable logistic regression, adjusting for confounders (≤ 24 hours: adjusted odds ratio, 1.24; 95% confidence interval, 0.30-5.14; p = 0.766; \u3e 24 hours: adjusted odds ratio, 1.32; 95% confidence interval, 0.37-4.69; p = 0.668). CONCLUSION Despite most patients not receiving antibiotics, infection rates remained low. This indicates prophylactic antibiotic use does not reduce the risk of fracture-associated infections for most injury patterns. While a randomized trial is optimal to validate these data, at this time, there is no evidence to support presumptive antibiotics for closed non-operative facial fractures
Effectiveness and Safety of Brachial Plexus Nerve Stimulation for Refractory Neuropathic Pain in the Upper Extremities: A Systematic Review and Meta-Analysis
No full textBackground: Peripheral nerve stimulation (PNS) has emerged as a promising treatment for refractory neuropathic pain in the upper extremities, particularly for patients unresponsive to conventional therapies. This systematic review and meta-analysis aims specifically to evaluate the effectiveness and safety of nerve stimulation of the brachial plexus (BP) for managing chronic neuropathic pain in the upper extremities. Methods: A comprehensive literature search was conducted following PRISMA guidelines across major databases, including PubMed, Scopus and Embase. Five studies met the inclusion criteria, encompassing a total of 157 patients with BP or other peripheral nerve injuries. The primary outcome measures included pain reduction and quality of life improvement, assessed through validated pain scales such as the Numerical Rating Scale (NRS) and patient-reported outcomes. Results: This meta-analysis demonstrated significant reductions in pain scores following BP nerve stimulation (MD: −4.88, 95% CI: −5.80 to −3.96, p \u3c 0.05). Additionally, improvements in quality of life were observed, with over 30% enhancement in Short Form (SF)-36 scores. The overall complication rate was low, with only 9.2% of patients experiencing adverse events, such as lead migration or postoperative infection. Conclusions: These findings suggest that PNS at the level of the BP is both a safe and effective intervention for the management of refractory neuropathic pain in the upper extremities
Standardizing NGS Testing for All Pediatric Oncology Patients: A Quality Improvement Approach
Get PDFFrom Knowledge to Action: Assessing the Influence of Provider Education on Vaccine Importance
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