Boston Children's Hospital

The Multidimensional Nature of Pediatric Patient Complexity

OBJECTIVE: Patient complexity is defined in a variety of ways and is associated with health care costs and use. In this study, we evaluate whether pediatric inpatient complexity represents a single construct or multiple domains using multiple measures of diagnostic burden, health...

Expanding Access to Care: Implementation of a Pediatric and Young Adult Laser Hair Removal Program for Hidradenitis Suppurativa

ABSTRACT Laser hair removal (LHR) is an effective adjunctive therapy for hidradenitis suppurativa (HS), but access is often limited by inconsistent insurance coverage. A retrospective review was conducted of 21 pediatric and young adult patients enrolled in an LHR program for HS...

The landscape of allele-specific expression in human kidneys

Allele-specific expression (ASE), the preferential expression of one gene copy, is a key mechanism of genomic regulation. However, its role in human kidney disease remains poorly understood. In this study, we generated a high-quality, genome-wide ASE map using paired whole-genome...

Intensity of Healthcare Utilization Among Pediatric Hospice Patients Receiving Concurrent Care.

BACKGROUND: As children with life-threatening con- ditions near end-of-life, their disease burden and care requirements tend to increase, leading to high intensity of care in the hospital. Previous studies have examined patterns of healthcare usage among these children receiving...

Management of Combined Vascular Malformations.

Combined vascular malformations are complex, heterogeneous lesions increasingly classified by anatomic components and genetic drivers, specifically the PI3K/AKT/mTOR pathway (PROS) and RASA1 mutations. These syndromes, including Klippel-Trenaunay, CLOVES, and capillary malformati...

Assessing and Addressing Frailty in Candidates for Lung Transplantation: An ISHLT Consensus Statement.

The ISHLT Consensus document for the selection of lung transplant candidates recommends frailty assessment as part of a comprehensive candidacy evaluation. Missing from this and other recent consensus documents were practical recommendations on which frailty measures to consider...

Barrier immune memory is programmed by intestinal epithelial cell presentation of cytosol-delivered bacterial antigens

Intestinal epithelial cells can present antigen to CD4 T cells. Here the authors show that epithelial cells must present translocated bacterial antigen for local CD4 resident memory T cells to be established.

Integrative ALS therapy: gene targeted therapy by base editing and potential exercise rehabilitation as synergistic strategies for functional recovery

[Purpose] A key pathological hallmark of amyotrophic lateral sclerosis (ALS) is transactive response DNA-binding protein 43 (TDP-43, encoded by TARDBP) proteinopathy. Mutations in TARDBP and cellular stress can drive nuclear clearance and cytoplasmic aggregation of TDP-43. TDP-43...

Accumulating safety data for remote ischemic conditioning in acute pediatric neurological conditions

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is the most common infection-triggered encephalopathy in East Asian children and one for which existing neuroprotective strategies are limited. Despite the use of therapeutic hypothermia (TH) or targete...

Clinical Practice Guideline for the Diagnosis and Treatment of Urinary Tract Infection in Children From 8 Days to 5 Years of Age

Urinary tract infection (UTI) is one of the most common bacterial infections in infants and young children, with a prevalence of 7% in infants with fever. This clinical practice guideline (CPG) provides an update of the literature and clinical recommendations of the 2011 American...

Hearts too small for body size after doxorubicin for childhood acute lymphoblastic leukemia: Grinch Syndrome

Cardiovascular disease is a major cause of morbidity and mortality in childhood cancer survivors. We assessed the very long-term cardiac structure and function of adult survivors of childhood leukemia treated with anthracycline-based therapy. One hundred fifteen patients with hig...

Urinary Tract Infection Diagnosis—A Companion to the American Academy of Pediatrics’ 2026 Clinical Practice Guideline on the Diagnosis and Management of Urinary Tract Infection: Technical Report

Accurate diagnosis is essential to appropriate care. Although urinary tract infection (UTI) is one of the most common bacterial infections in children, there is no gold standard for its diagnosis. During the American Academy of Pediatrics' revision of its Clinical Practice Guidel...

Effectiveness of early initiation of idursulfase in infants and very young children with mucopolysaccharidosis II: a retrospective chart review in siblings

Introduction Enzyme replacement therapy (ERT) with intravenous idursulfase is the standard of care for patients with mucopolysaccharidosis II (MPS II; Hunter syndrome). Data are limited for children aged ≤12 months. This retrospective study evaluated outcomes with early ERT. Meth...

Variations in diagnosis and management of hemodynamically significant patent ductus arteriosus across neonatal intensive care units in the Children’s Hospitals Neonatal Consortium

Abstract Objective Collate patent ductus arteriosus (PDA) guidelines among Children’s Hospitals Neonatal Consortium (CHNC) centers and identify variations in the diagnosis and management of hemodynamically significant PDA (hsPDA). Study Design: A descriptive survey requesting wri...

Trends in Regionalization of Pediatric Inpatient and Critical Care by Medical Complexity

BACKGROUND AND OBJECTIVES: Pediatric inpatient and critical care services are increasingly regionalizing: shifting from smaller hospitals to larger specialty centers. Children with medical complexity (CMC) and with technology dependence (TD) account for a disproportionate share o...

Sexually transmitted infection testing among U.S. adolescents in relation to U.S. Preventive Services Task Force screening guidelines

BACKGROUND: This study examined whether sexually transmitted infection (STI) testing patterns aligned with U.S. Prevention Services Task Force (USPSTF) screening recommendations among a large sample of U.S. adolescents. METHODS: Data were from Inclusive Care and Access to Resourc...

Inhibition of PLK1 helps to restrict c-Met-induced growth and therapeutic resistance of renal cancer cells

Acquired therapeutic resistance is a major problem in the treatment of advanced renal cell carcinoma (RCC). The receptor tyrosine kinase (RTK) c-Met is hyperactive in RCC and plays a major role in the survival of tumor cells during therapy-induced oxidative stress. Although c-Met...

Age-Associated Cognitive Deviations in Early-Onset Psychosis Patients and Their Siblings

OBJECTIVE: The objective of this study was to test for cognitive impairments and cross-sectional age-associated cognitive deviations in a large, diagnostically diverse, cross-sectional sample of children and adolescents with early-onset psychosis (EOP), their siblings, and nonpsy...

Stabilizing telerobotic endobronchial imaging and interventions in breathing lungs with a helical brace

Physiological motion in dynamic luminal organs, such as respiration-induced lung displacement, compromises the stability of tool-tissue interaction during telerobotic endoluminal imaging and interventions. However, existing devices for stabilizing the distal end of a catheter or...

Ultra-slow release of hydrophilic drugs via multilamellar–multivesicular liposomes formed by unsaturated phospholipids

Abstract Maintaining therapeutic drug concentrations at a target site while limiting systemic exposure is difficult for hydrophilic drugs, which rapidly diffuse from the injection site. Liposomes are widely used carriers, yet designs based on rigid, saturated phospholipids aim to...