Children's Hospital Colorado

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...

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...

Predicting Underweight Status in Infants With Cleft Lip and/or Palate in 10 US Children's Hospitals

ObjectiveTo develop and compare models predicting which infants with cleft lip and/or palate (CL/P) will be underweight at 4 months, using multicenter electronic health record data.DesignUsing data from birth to 3 months, we evaluated 63 anthropometric, clinical, healthcare-utili...

Gut microbial metabolism of peanuts generates immunoregulatory metabolites

Background. Complementary feeding practices and timing are thought to significantly influence early life immune development, with the early introduction of allergenic foods being especially important for prevention of food allergy. We hypothesized that allergen-containing foods s...

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...

Development of an Achievable Benchmarks of Care Report Card for Pediatric Hospital Medicine

OBJECTIVES: To develop an Achievable Benchmarks of Care (ABCs) report card for common conditions managed by pediatric hospital medicine (PHM). METHODS: We performed a retrospective cross-sectional study of encounters for 13 common pediatric conditions between January 1, 2023, and...

Evaluation of a Commercial Pediatric Sepsis Early Detection Alert in the Emergency Department

Importance Screening tools have been implemented with the goal of improving early detection of pediatric sepsis, with limited evidence of effectiveness. The Epic Systems Pediatric Sepsis Early Detection Model (PESM) and its associated clinical alert have been widely implemented i...

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...

The Childhood Liver Disease Research Network's prospective characterization of pediatric primary sclerosing cholangitis.

BACKGROUND: Primary sclerosing cholangitis (PSC) is a rare biliary fibrosing disease that leads to significant morbidity and the need for liver transplantation. The Childhood Liver Disease Research Network is conducting a prospective, observational longitudinal study to define th...

Early life factors documented in electronic health records predict recurrent acute otitis media

Recurrent acute otitis media (rAOM; defined as ≥3 AOM episodes in 6 months or ≥4 episodes in 12 months) affects 10–15% of children in the United States and is a leading cause of healthcare utilization and antibiotic prescriptions. Prospective identification of children at risk of...

Safety Considerations for Hospitalized Children and Adolescents With Obesity

Children and adolescents with obesity make up a growing proportion of hospitalized patients. As a result, pediatric hospital providers are increasingly providing care for patients whose weight meaningfully influences safety during admissions. This review provides practical, evide...

Impact of post‐chemotherapy classification on outcomes in stage III and IV unilateral favorable histology Wilms tumor: Pooled data from Children’s Oncology Group AREN0532, AREN0533, and AREN03B2 studies

Abstract Background Improvements in therapy for patients with favorable histology Wilms tumor (FHWT) have relied on refinement of risk stratification for therapeutic assignment through identification of favorable and unfavorable prognostic factors. Although well established in In...

Clinical Characteristics of Enterovirus D68 Respiratory Disease in Colorado Children Over a Decade: 2014-2025

BACKGROUND: Enterovirus D68 (EV-D68) causes cyclical outbreaks worldwide. Though EV-D68 can rarely cause acute flaccid myelitis, it commonly causes respiratory disease. In particular, EV-D68 causes outbreaks of severe asthma-like respiratory disease, but few systems have the capa...

The Impact of Tablet-Based Screening on Trichomonas Testing in the Pediatric Emergency Department

OBJECTIVES: Sexually transmitted infections (STIs) are a public health concern for adolescents and young adults, with half of STIs diagnosed annually among 15 to 24-year-olds. Trichomonas vaginalis is a high-prevalence STI, linked with increased risk for HIV and premature births....

National Outcomes of Sepsis in Publicly Insured Children: 2021–2023

OBJECTIVE To identify incidence and factors associated with sepsis mortality. METHODS We conducted a cohort study of all US publicly insured children younger than age 19 years hospitalized with a diagnosis code–based definition of sepsis in 2021–2023 using the Transformed Medicai...

Clinicians’ Experiences With Law Enforcement in a Pediatric Emergency Department

BACKGROUND AND OBJECTIVES: Law enforcement officers (LEOs) are frequently present in emergency departments, where their roles may include accompanying patients, investigating injuries, or responding to safety concerns. Existing research on LEO presence in health care has focused...

Responding With Evidence and Access for Childhood Headaches ( REACH ) study: A comparative effectiveness trial of cognitive behavioral therapy monotherapy versus combined cognitive behavioral therapy–pharmacotherapy with amitriptyline for the prevention of childhood migraine—The study protocol

Migraine is one of the most common chronic health problems in children and adolescents, resulting in high levels of functional disability. Symptoms frequently persist into and impact the course of adulthood for affected individuals. Current practice recommendations include a comb...

Infectious Adverse Events in Pediatric Paracorporeal Ventricular Assist Devices: An Analysis of the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) Registry

Infectious adverse events (IAEs) are common in children supported with paracorporeal ventricular assist devices (VADs). This study aimed to identify risk factors for IAEs from the Advanced Cardiac Therapy Improving Outcomes Network (ACTION) registry. We conducted a retrospective...

Fragmentation patterns of human telomeric chromatin in plasma cfDNA

ABSTRACT The unique chromatin structure at telomeres protects the linear ends of chromosomes from DNA surveillance machineries. Here, we demonstrate that circulating cell-free DNA (cfDNA) from plasma can map chromatin structure at telomeres. We find that the telomeric 6-mer repea...

Validation of AACN’s Healthy Work Environment Assessment Tool–Team

Background In 2024, the American Association of Critical-Care Nurses (AACN) updated the Healthy Work Environment Assessment Tool (HWEAT), renamed HWEAT-Team. Objective Validating HWEAT-Team for interprofessional use. Methods This was a multisite, descriptive, nonexperimental corr...