Children's Hospital of Eastern Ontario

Consented Universal Newborn Screening for Congenital Cytomegalovirus Infection Using Dried Blood Spot and Dried Saliva Spot Specimens: Implementation and Relative Programmatic Accuracy

The purpose of this research was to evaluate the implementation and relative diagnostic accuracy of dried blood spot (DBS) and dried saliva spot (DSS)-based newborn screening for congenital cytomegalovirus infection (cCMV). This prospective paired-sample pilot studied consecutive...

Cortisol Cutoffs for Adrenal Insufficiency Using Elecsys II: A Systematic Review

ABSTRACT Objective Adrenal insufficiency (AI) is associated with increased risk of morbidity and mortality if improperly managed. Adrenocorticotrophin (ACTH) stimulation testing is the most widely used AI diagnostic test. Historically, a serum cortisol threshold of 500 nmol/L (18...

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 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...

Adding‐On Wisely: Hematopathology Reflective Testing in Canada

INTRODUCTION: Reflective testing describes laboratory clinicians' discretionary addition of testing on existing samples, after initial result review. This practice has proven valuable in clinical biochemistry but faces controversy regarding consent and costs. No prior research ex...

Eye Findings Following Congenital Cytomegalovirus Newborn Screening

BACKGROUND AND OBJECTIVE: Consensus guidelines have recommended eye examinations for all newborns with congenital cytomegalovirus (cCMV) infection; however, structured ophthalmic examinations are seldom reported. Existing literature suggests ocular pathology is uncommon in cCMV,...

Validity of the center for epidemiological studies depression (CES-D) scale for depression screening in postpartum adolescents in Uganda

In Uganda, 25% of pregnancies occur among teenagers and an estimated 20.7% have postpartum depression. Postpartum depression is often underdiagnosed due to insufficient mental health resources and few validated screening tools for adolescent mothers. Addressing this gap, psychome...

Respiratory Syncytial Virus–Related Hospitalizations Among Infants Receiving Nirsevimab

Importance Respiratory syncytial virus (RSV) is a leading cause of hospitalization among infants. Nirsevimab, a long-acting monoclonal antibody that protects against severe RSV, was publicly funded for all infants in the Canadian provinces of Ontario and Quebec starting in the fa...

Fundamental movement skills among children participating in community sport programs in a northern Canadian city: implications for equitable access and physical literacy development

Fundamental movement skills (FMS) are an important component of physical literacy and are associated with children’s physical activity participation and longer-term health. However, many children demonstrate suboptimal motor competence, and opportunities for FMS development may v...

Investigating acute-to-subacute neuroanatomical outcomes and the role of sex and age in adolescent concussion: A PedCARE+MRI substudy

Background Limited research has examined acute-to-subacute neuroanatomical trajectories following adolescent concussion. To investigate acute-to-subacute longitudinal changes in cortical thickness and subcortical volume following adolescent concussion, we compared neuroanatomical...

Understanding disparities in autism diagnosis and care: A socioecological perspective

Disparities in autism spectrum disorder (ASD) identification and care are well documented across racial and ethnic, socioeconomic, and geographic lines, yet their underlying mechanisms are incompletely understood. This paper applies the Socioecological Model (SEM) as an organizin...

An Updated Evidence Assessment of the Genetic Causes of Dilated Cardiomyopathy

BACKGROUND: Evidence of the diverse genetic architecture of dilated cardiomyopathy (DCM) continues to emerge and requires reassessment of the clinical relevance of implicated disease genes. Building on the 2019-2020 Clinical Genome Resource evaluation, the DCM gene curation exper...

Pediatric Respiratory Failure and Support With Prolonged Extracorporeal Membrane Oxygenation: Multicenter Cohort Using the Extracorporeal Life Support Organization Registry, 1989–2021

OBJECTIVES: To characterize outcomes in children supported with 14 days or more of extracorporeal membrane oxygenation (ECMO) for respiratory indications. DESIGN: Retrospective analysis of the Extracorporeal Life Support Organization (ELSO) registry. SETTING: ECMO centers contrib...

Ethical and Methodological Features of Cluster Randomized Trials in Critical Care Settings: A Systematic Review

OBJECTIVES: Cluster randomized trials (CRTs) are useful for evaluating system-level interventions in critical care but raise complex ethical and methodological issues that are amplified in this setting. We aimed to describe ethical and methodological features of CRTs in critical...

Clinical Variability and Genotype‐Driven Outcomes in CHRND ‐Related Congenital Myasthenic Syndrome

BACKGROUND: Congenital myasthenic syndromes (CMS) caused by pathogenic variants in CHRND, encoding the δ-subunit of the nicotinic acetylcholine receptor (AChR), are rare, and data on genotype-phenotype correlations and long-term outcomes are limited. METHODS: We performed a retro...

Dr. Tsai et al reply

We appreciate the interest of Drs. Wang and Qu¹ in our work,² and their call for more family-friendly metrics to help convey meaningful quality of life improvements in juvenile idiopathic arthritis ( JIA). After considering the different ideas suggested in t...

Applying the commercial determinants of health framework to understand how digital platforms influence child and youth wellbeing

The influence of social media on youth mental health has been under debate in scientific communities over the last several years. In this perspective paper, we suggest that there is a need to shift focus away from finding ways to ascertain causal connections at the global scale t...

Hospitalization of Children in Foster Homes: A Canadian Cohort Study

BACKGROUND AND OBJECTIVES: In Canada, approximately 4% to 7% of children live in a foster home during their childhood. This study reports on hospitalizations of children in foster homes, with the hypothesis that rates of hospitalization are higher for children with foster home ex...

The Association Between Intranasal Steroids and Length of Stay in Children With Orbital Infections

OBJECTIVE: Little is known about the use of intranasal agents in the management of orbital infections in children. This study aims to describe intranasal corticosteroid use in children hospitalized with orbital infections and to determine whether an association exists between int...

Burden of Disease in Pediatric Tumor-Induced Osteomalacia: A Literature Review

Tumor-induced osteomalacia (TIO) is an ultra-rare, paraneoplastic syndrome caused by tumors secreting fibroblast growth factor 23 (FGF23). In children, TIO may be mistaken for more common causes of rickets and osteomalacia, including monogenic forms, leading to long diagnostic de...