Boston Children's Hospital

Social Risk Screening and Referrals in the Pediatric Inpatient Setting

BACKGROUND/OBJECTIVES: Many professional organizations recently recommended inpatient screening for social risks. Although prior studies have explored social risk screening rates in children's hospitals, many excluded community hospitals and lacked detail on screening practices....

Changes in Coronal and Sagittal Plane Alignment After Transphyseal ACL Reconstruction Performed Within Two Years of Skeletal Maturity: Results From the PLUTO Study Group

Background: For patients with open physes approaching skeletal maturity, transphyseal anterior cruciate ligament reconstruction (ACLR) with soft tissue autograft and metaphyseal fixation is often preferred. Although iatrogenic physeal injury is rare, growth disturbances have been...

The impact of non-medical determinants of health on patient-reported outcomes in pediatric lupus: A CARRA registry study

Objectives Social determinants of health (SDOH) and race are associated with disease activity, including lower achievement of the low lupus disease activity state (LLDAS), but it is unknown whether these factors are associated with patient-reported outcomes (PROs). Among a cohort...

Characterizing In-Home Safety Challenges and Strategies for Children With Medical Complexity

OBJECTIVES: Medical advances have allowed more children with medical complexity (CMC) to live at home, but previous research has linked implanted tubes to patient safety events. We aimed to characterize challenges and strategies parents use to deliver their children's tube-relate...

Real-World Versus Centers for Medicare and Medicaid Services Estimates of Pediatric Retinal Detachment Repair Times

Purpose: To compare real-world pediatric retinal detachment (RD) repair times with the Centers for Medicare and Medicaid Services (CMS) estimates for complex RD surgeries. Methods: A cross-sectional survey was performed of complex pediatric RD perioperative times from pediatric r...

Evaluating OpenEvidence Across Pediatric Subspecialties: A Guideline-Anchored Expert Review

OBJECTIVE: To evaluate the quality, safety, and citation characteristics of OpenEvidence across pediatric subspecialties. METHODS: Guideline-anchored clinical questions spanning high, moderate, and low evidence certainty across 6 pediatric subspecialties were submitted to OpenEvi...

Proton Radiotherapy Decreases Incidence of Radiation‐Induced Second Malignant Neoplasms Compared to Photon Radiotherapy in Patients With Retinoblastoma

Retinoblastoma is the most common primary intraocular neoplasm in children. Use of radiotherapy has decreased due to the incidence of second malignant neoplasms (SMNs). In our study, photon (n = 42) and proton (n = 66) radiotherapy cohorts had median follow-up of 28.7 and 18.2 ye...

Toxin-mediated tRNATrp depletion drives Trp-codon-dependent reprogramming in Mycobacterium tuberculosis while selectively enriching the PDIM biosynthetic machinery

Mycobacterium tuberculosis (Mtb) must adapt to host-imposed stresses that limit its growth and ability to establish an infection. One important immune-regulated host defense mechanism involves competition between host and pathogen for tryptophan (Trp). Although Mtb is a Trp proto...

Care of the Sexual or Gender Minority Community Living with Cystic Fibrosis: A Survey of United States and Canadian Multidisciplinary Health Care Providers

PURPOSE: Lesbian, gay, bisexual, transgender, queer, intersex, asexual, or another sexual or gender minority (LGBTQIA+) people face health inequities and commonly report health care avoidance. We examined how multidisciplinary subspecialist providers care for LGBTQIA+ people with...

Interim Update on Reactive Infectious Mucocutaneous Eruption ( RIME )

ABSTRACT Reactive infectious mucocutaneous eruption (RIME), a term describing blistering skin and mucosal lesions, is a term coined by a group of Pediatric Dermatology Research Alliance (PeDRA) researchers and first published in 2021. Since that time, the literature has grown wit...

Managing growth and puberty concerns in individuals with Duchenne muscular dystrophy: Updated guidance and future directions

Long-term glucocorticoid therapy is standard of care for individuals with Duchenne muscular dystrophy (DMD) but often results in impaired growth and delayed or incomplete puberty, impacting their physical and psychosocial health. Although DMD endocrine care has evolved, leading t...

“An Even Playing Field”: Non-Clinical Simulation for Leadership Development Among Pediatric Interns

Background Graduate training programs are tasked with preparing trainees to lead clinical teams. Currently, there is little consensus on how to develop their interpersonal leadership skills, and pediatric programs tend to focus on senior residents. Targeting pediatric interns wit...

Prediction of cardiovascular outcomes using electrocardiography from overnight polysomnography.

STUDY OBJECTIVES: Polysomnography (PSG) is the gold standard for diagnosing sleep disorders, which are recognized as cardiovascular risk factors. Single-lead electrocardiograms (ECGs) are recorded during PSG but rarely analyzed, presenting an opportunity to leverage overnight ECG...

Therapeutic Horseback Riding for Youth With Autism and Psychiatric Comorbidities: A Randomized Trial

OBJECTIVE: Autism spectrum disorder care is often complicated by co-occurring psychiatric symptoms. Equine-assisted services show promise for improving behavioral outcomes in this population. We aimed to examine benefits of equine-assisted services for youth with autism at higher...

Beyond the ‘Big Three’: Prospective Associations Between Cumulative Lifestyle Protective Factors and Subsequent Adolescent Wellbeing

ABSTRACT Introduction Lifestyle factors are increasingly recognized as important correlates of adolescent mental health and wellbeing. However, existing research has largely focused on sleep, nutrition, and physical activity in isolation, with less attention to cumulative multido...

Medicaid utilization in children: Condition‐specific incidence and spending

Abstract Medicaid insures over half of US children, yet gaps remain in understanding how funds are allocated across the care of nonchronic conditions, the care of chronic conditions, and preventative services. We conducted a retrospective analysis of 7.2 million Medicaid‐enrolled...

An international multicenter analysis of the outcome of pediatric first variceal hemorrhage

Background & Aims: Management of portal hypertension in children including primary prophylaxis of variceal bleeding is controversial due to limited understanding of mortality risk after first variceal hemorrhage (1VH). This international multicenter study was designed to advance...

Neonatal Urticaria as the First Manifestation of Neonatal Onset Multisystem Inflammatory Disease Treated Empirically With Anakinra

ABSTRACT Urticarial eruptions in neonates, especially within hours to days of birth, should prompt workup for cryopyrin‐associated periodic syndrome (CAPS) disorders. This report details a 9‐h‐old neonate with urticaria as the first manifestation of neonatal onset multisystem inf...

Structural basis for regulating lipopolysaccharide transmembrane transport

Gram-negative bacteria are surrounded by a multilayered cell envelope with a mostly impermeable outer membrane that provides intrinsic resistance to many antibiotics1–5. The outer membrane is an asymmetrical bilayer with phospholipids in the inner leaflet and lipopolysaccharide (...

Prognostic implications of complications during VA-ECMO for cardiogenic shock

PURPOSE: Veno-arterial extracorporeal oxygenation (VA-ECMO) provides comprehensive cardiopulmonary support in patients with cardiogenic shock (CS), but may result in complications. While complications rates are known, their impact on risk of death remains largely unknown. METHODS...