Is There a Role for ERCP in the Management of Gallstone Pancreatitis in Children? A Western Pediatric Surgery Research Consortium Study.

Background: Guidelines for adult gallstone pancreatitis (GP) in adults recommend endoscopic retrograde cholangiopancreatography (ERCP) for ongoing biliary obstruction. Studies in children are limited by small sample sizes. We sought to explore whether factors predictive of choledocholithiasis (CDL) are correlated with ERCP findings of stones in pediatric GP.

Meconium-Related Obstruction: Contemporary Experience in a Multi-Institutional Consortium.

Purpose: Neonatal bowel obstruction secondary to inspissated meconium has been historically associated with cystic fibrosis. Increasingly, meconium-related obstruction (MRO) has been observed in preterm infants. We conducted a multicenter mixed-methods study to better characterize the contemporary experience with MRO.

Insights from a multi-institutional registry show duration of endocrine treatment for DCIS impacts second events.

Ductal carcinoma in situ (DCIS) incidence has risen rapidly with the introduction of screening mammography, yet it is unclear who benefits from both the amount and type of adjuvant treatment (radiation therapy, endocrine therapy) versus what constitutes over-treatment. Our goal was to identify the effects of adjuvant radiation therapy, or endocrine ± radiation therapy versus breast conservation surgery alone in a large multi-center registry of retrospective DCIS cases (N = 1916) with median follow up of 7.0 (IQR: 8.

Presentation, Evaluation, and Outcomes of Infants Under 3 Months With Skull Fractures.

Background: Head injuries in infants are common but challenging to assess due to minor mechanisms potentially causing significant injury, nonspecific symptoms, and the risk of nonaccidental trauma (NAT).

Study Objectives: This study evaluates clinical presentations, assessments, and outcomes in infants with skull fractures, with and without intracranial hemorrhage (ICH).

Methods: A retrospective chart review was conducted at a tertiary care children's hospital, identifying 291 infants (mean age: 6 weeks) with skull fractures via computed tomography imaging and ICD9/ICD10 codes.

Associations between visceral adipose and renal artery calcification: Results from the multi-ethnic study of atherosclerosis.

Background: Visceral adipose tissue (VAT) has been associated with higher levels of atherosclerosis. Renal artery calcification (RAC) secondary to atherosclerosis has been found to be associated with an increase in all-cause mortality.

Methods: 1 978 participants underwent CT imaging to measure VAT and RAC.

Concurrent Bone Marrow Acute Undifferentiated Leukemia and Mediastinal T-Lymphoblastic Lymphoma With Identical Fusion and and Mutations.

Acute undifferentiated leukemia (AUL) is a rare hematologic malignancy lacking lineage-specific markers. Concurrent, clonally related AUL and T-lymphoblastic lymphoma (T-LBL) has not been reported previously. Here we describe a patient who was diagnosed with AUL in the bone marrow and T-LBL in the mediastinum after a thorough immunophenotyping by flow cytometry and immunohistochemistry.

Pharmacologic Augmentation of Computerized Auditory Training in Chronic Psychosis: Preliminary Findings From a Single-Site, Double-Blind Study.

Background: Computerized auditory training (AT) modestly improves symptoms, cognition, and functioning in schizophrenia. We assessed whether d-amphetamine (AMPH) or memantine (MEM) can enhance gains from 30-h of AT.

Methods: Antipsychotic-medicated individuals with chronic psychosis (n = 68; mean age 47.

Particle uptake by macrophages triggers bifurcated transcriptional pathways that differentially regulate inflammation and lysosomal gene expression.

Exposure to particles is a driver of several inflammatory diseases. Here, we investigated macrophage responses to monosodium urate crystals, calcium pyrophosphate crystals, aluminum salts, and silica nanoparticles. While each particle induced a distinct gene expression pattern, we identified a common inflammatory signature and acute activation of lysosomal acidification genes.

Antibody Therapy for Patients with Lymphoid Malignancies: Past and Present.

Antibody therapies are a crucial component of modern lymphoid malignancy treatment and an exciting area of active research. We performed a review of modern antibody therapies used in the treatment of lymphoid malignancies, with an emphasis on landmark studies and current directions. We describe the indications for rituximab, obinutuzumab, ADCs, and bispecific antibody therapies.

Peptides rapidly transport antibiotic across the intact tympanic membrane to treat a middle ear infection.

The tympanic membrane (TM) forms an impenetrable barrier to medical therapies for middle ear (ME) diseases like otitis media. By screening a phage-displayed peptide library, we have previously discovered rare peptides that mediate the active transport of cargo across the intact membrane of animals and humans. Since the M13 filamentous bacteriophage on which the peptides are expressed are large (nearly 1 µm in length), this offers the possibility of noninvasively delivering drugs, large drug packages, or gene therapy to the ME.

Recurrence Following Operative vs. Non-Operative Management of Adhesive Small Bowel Obstruction in Children: A Multi-center Prospective Observational Study.

Objective: Data on the incidence of recurrent adhesive small bowel obstruction (ASBO) following index admission for ASBO in children are limited. We sought to determine if operative management was associated with a lower rate of recurrence compared to non-operative management (NOM).

Methods: We conducted a prospective observational study of children with ASBO admitted to nine hospitals from 10/2020 to 12/2022 who underwent a trial of NOM.

Comparison of Postoperative Antibiotic Protocols for Pediatric Complicated Appendicitis: A Western Pediatric Surgery Research Consortium Study.

Background: There is no consensus on the appropriate duration of postoperative antibiotics for complicated appendicitis in children. Commonly used antibiotic endpoints include normalization of white blood cell count (WBC) or completion of a minimum number of prespecified treatment days. We compared clinical outcomes resulting from varying postoperative antibiotic protocols for complicated appendicitis in children.

Peptide-Mediated Transport Across the Intact Tympanic Membrane Is Intracellular, with the Rate Determined by the Middle Ear Mucosal Epithelium.

The tympanic membrane forms an impenetrable barrier between the ear canal and the air-filled middle ear, protecting it from fluid, pathogens, and foreign material entry. We previously screened a phage display library and discovered peptides that mediate transport across the intact membrane. The route by which transport occurs is not certain, but possibilities include paracellular transport through loosened intercellular junctions and transcellular transport through the cells that comprise the various tympanic membrane layers.

The Financial Impact of Post Intensive Care Syndrome.

This review explores the financial consequences that survivors of critical illness often face following hospitalization in an intensive care unit (ICU). As part of the "post-intensive care syndrome" (PICS), these survivors often experience, in addition to physical and emotional challenges of PICS, major financial burdens resulting from their prolonged ICU treatments. The escalating costs of ICU care, coupled with the potential long-term effects on survivors' ability to work and maintain financial stability, have brought financial toxicity to the forefront of health care discussions.

Antibiotic stewardship in the emergency department setting: Focus on oral antibiotic selection for adults with skin and soft tissue infections.

Purpose: An advisory panel of experts was convened by the ASHP Foundation as a part of its Medication-Use Evaluation Resources initiative to provide commentary on an approach to antibiotic stewardship in the treatment of skin and soft tissue infections (SSTIs), with a focus on oral antibiotics in the emergency department (ED) setting for patients who will be treated as outpatients. Considerations include a need to update existing guidelines to reflect new antibiotics and susceptibility patterns, patient-specific criteria impacting antibiotic selection, and logistics unique to the ED setting.

Summary: While national guidelines serve as the gold standard on which to base SSTI treatment decisions, our advisory panel stressed that institutional guidelines must be regularly updated and grounded in local antimicrobial resistance patterns, patient-specific factors, and logistical considerations.