Children's Hospital of Los Angeles

Physical Parameters Influencing the Rate of Subretinal Injection: A Microfluidic Analysis

Purpose: Subretinal injection during vitrectomy has become an important technique owing to the growing number of cell and gene therapy trials for retinal disease. Reducing the injection rate can mitigate trauma or shear forces on the retinal pigment epithelium, yet many surgeons...

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...

Development and validation of a cefepime population pharmacokinetic model to guide treatment for patients with hospital-acquired pneumonia requiring renal replacement

ABSTRACT Cefepime is used in critically ill pneumonia patients, but dosing in renal replacement therapy (RRT) is complicated by altered renal function, extracorporeal removal, and variability in pulmonary epithelial lining fluid (ELF) exposure. We sought to develop an integrated...

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...

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...

Safety of a 4‐Week Pediatric Home Mechanical Ventilated Pathway—A Single Center's Retrospective Study

BACKGROUND/OBJECTIVE: Pediatric Home Mechanical Ventilator (HMV) Programs have supported children with chronic respiratory failure since the 1970s, yet optimal caregiver training duration remains unclear. This study evaluated the safety and effectiveness of a standardized 4-week...

Phosphorylated tau 217 in young adults with Down syndrome and Down syndrome regression disorder

Abstract Background Down syndrome regression disorder (DSRD) causes a rapid loss of cognitive, behavioral, and daily living skills, usually in adolescents and young adults with Down syndrome. Because people with Down syndrome have a high lifetime risk of Alzheimer’s disease, we e...

Tangier Disease

Abstract Purpose of Review We describe two patients with Tangier disease (TD) and provide a narrative review of its clinical features, genetics, diagnosis, and management. A literature search of PubMed and Google Scholar was performed to identify English-language publications on...

Nanofabricated Biomaterials Model Tumor Extracellular Matrix Topography

In vitro studies of cancer cell behavior are often limited in translational capability due to the absence of in vivo characteristics, such as the tumor microenvironment (TME), that largely govern this behavior. The TME includes a dense, highly organized network of proteins that f...

Virtual parenting intervention to promote positive parenting and prevent child anxiety and depression symptoms among filipino americanfamilies: protocol for a randomized controlled trial

Filipino youth in the U.S. experience higher rates of depression, suicidal ideation, anxiety, and substance use when compared to other Asian subgroups and non-Hispanic whites, yet are less likely to seek help or receive preventive care. Evidence-based parenting interventions have...

Applying Natural Language Processing to Address Healthcare Bias: Using CARE-SD to Evaluate the Distribution of Stigmatizing Language in Clinical Notes

Electronic health records (EHRs) are a critical medium through which patient stigmatization is perpetuated among healthcare teams. We identified doubt markers and stigmatizing labels in MIMIC-III, a de-identified EHR, via expanded lexicon matching and machine learning classifiers...

Universal Newborn Screening for Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in a Safety-Net Well-Baby Nursery: A Quality Improvement Initiative

Background: G6PD deficiency is among the leading causes of neonatal hyperbilirubinemia and kernicterus. Following a 2022 New York State Department of Health recommendation to test high-risk neonates, we implemented universal G6PD deficiency screening in the well-baby nursery. Obj...

Revisiting the Original Narakas Classification of Brachial Plexus Birth Injuries

Purpose Accurate classification of brachial plexus birth injury (BPBI) is critical for predicting outcomes and guiding early intervention. In 1987, Narakas introduced the first widely adopted system. Over time, misquotations and reinterpretations have obscured the work, conflatin...

Prevalence and Characteristics of Mental Health Interventions Following Pediatric Hospitalization

BACKGROUND AND OBJECTIVES: As survival after pediatric critical illness improves, attention has shifted to post-intensive care syndrome and the long-term mental health of pediatric intensive care unit (PICU) survivors, who have high rates of posttraumatic stress, anxiety, and dep...

Red Blood Cell Transfusion for Preterm and Term Infants in the NICU

Red blood cell (RBC) transfusion practices in neonatal intensive care units are variable. Determining which patients should be transfused, and the specific hemoglobin or hematocrit thresholds, remains a recurring challenge in neonatal intensive care. Although some well-conducted...

Impact of Fidaxomicin De-Restriction on Clostridioides difficile Episodes in Hospitalized Pediatric Cellular Therapy Patients

Abstract Background Pediatric patients undergoing cellular therapy (CT) with hematopoietic cell transplantation (HCT) or chimeric antigen receptor T-cell (CAR-T) therapy are vulnerable to Clostridioides difficile infection (CDI). Recent guidelines recommend fidaxomicin treatment...

E-cigarette use and nicotine dependence among hospitalized youth: influence of nicotine metabolism and CYP2A6 variability

Background Youth e-cigarette use is a public health concern, yet cessation approaches remain suboptimal. In adults, faster nicotine metabolism is linked with better cessation outcomes with varenicline compared to nicotine replacement therapy (NRT). This remains unexplored in yout...

High-Value Care in Pediatric Critical Care: Intravenous to Enteral Gastrointestinal Medications

Advancing pediatric critical care medicine includes identifying and reducing health care costs while maintaining—and even enhancing—the delivery of high-value care. Gastrointestinal (GI) prophylaxis (PPX) is commonly prescribed for children in the pediatric intensive care unit (P...

Cumulative Opioid Exposures in the First Year of Life and Cognitive Neurodevelopment in High-Risk Infants

BACKGROUND: High-risk infants with significant neonatal-perinatal morbidities often require opioids, but prolonged exposures can impair neurodevelopment. We evaluated the effect of cumulative opioid exposures in the first year of life, measured by morphine milligrams equivalents...

Efficacy and Safety of Time-Restricted Eating in Adults With Type 1 Diabetes: A Randomized Controlled Trial

OBJECTIVE: Many adults with type 1 diabetes (T1D) have overweight or obesity, underscoring the need for effective dietary weight loss strategies in this population. Time-restricted eating (TRE) has emerged as a popular approach for weight loss; however, its efficacy and safety in...