Texas Children's Hospital

Aberrant one-carbon metabolism and ancestral genetics underlie edematous severe acute malnutrition

Edematous severe childhood malnutrition is distinct from the non-edematous form of malnutrition and remains a major cause of under-five mortality. Its etiology remains unclear, although aberrant one-carbon metabolism has emerged as a potential contributor. Here, we assess genetic...

Living With Known Unknowns: Prognostic Uncertainty in Congenital Cytomegalovirus Following Diagnosis

OBJECTIVE: To examine how parents experience and navigate prognostic uncertainty following a diagnosis of congenital cytomegalovirus (cCMV) and identify implications for clinical communication and newborn screening. METHODS: We conducted in-depth qualitative interviews with 41 bi...

Endoscopic Retrograde Cholangiopancreatography in Pediatric Pancreas Divisum: Systematic Review

Background: Pancreas divisum (PD) may be associated with recurrent acute pancreatitis (RAP) or chronic pancreatitis (CP), but data on ERCP outcomes in children with PD are limited. We conducted a systematic review of the clinical, technical, and safety outcomes of ERCP for PD in...

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...

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...

Lash Ptosis and Entropion after Congenital Ptosis Surgery: Mechanisms and Treatment

PURPOSE: This perspective proposes a clinically useful framework for understanding upper eyelid lash ptosis and entropion after congenital ptosis surgery, linking potential mechanisms to prevention and management. METHODS: A focused literature review was performed. RESULTS: Posto...

Impact of Extent of Surgical Resection on Survival in Patients With High-risk Neuroblastoma

Objective: The impact of extent of resection of the primary tumor on outcomes in patients with high-risk neuroblastoma (HRNB) remains uncertain. We evaluated this issue in patients with HRNB treated on a prospective trial of multimodality therapy. Summary of Background Data: Pati...

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...

Acute Kidney Injury After Extracorporeal Membrane Oxygen in Children: Phenotypes and Prognosis in a Single-Center Cohort, 2020–2023

OBJECTIVES: To evaluate the association between acute kidney injury (AKI) phenotypes and major adverse kidney events at 30 days (MAKE30) after initiating extracorporeal membranous oxygenation (ECMO). DESIGN: Retrospective cohort study. SETTING: Neonatal, pediatric and cardiac cri...

Opportunistic Prenatal Genetic Testing During Fetoscopic Laser Surgery for Twin–Twin Transfusion Syndrome

ABSTRACT Objective To evaluate the feasibility, uptake and diagnostic yield of opportunistic prenatal genetic testing performed during FSLP for TTTS. Methods We conducted a retrospective cohort study of monochorionic pregnancies undergoing FSLP for TTTS at a single tertiary fetal...

Immune correlates of protection are exposure-dependent: evidence from the Dominican Republic

Immune protection against infection is often treated as a fixed property of a person’s immune response. But infection risk also depends on the number of infectious contacts a person experiences, which generally increases as community transmission rises. This matters for vaccine e...

Inter-rater and intra-rater reliability of quantitative ultrasound in preterm infants: an observational cohort study.

= 81). The MiniOmni was the QUS device, and the smallest probe, CS probe (length 24 mm, range 2200-4700 m/s, and max depth 4.5 mm), was used for all subjects. Measurements were taken at the mid-tibia location. Inter-rater reliability was calculated using 2-way random-effects intr...

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...

Post Intensive Care Syndrome in Pediatrics—What the General Pediatrician Needs to Know About Life After Critical Illness

As mortality from pediatric critical illness has declined, post intensive care syndrome in pediatrics (PICS-p) has emerged as a framework to describe the broad and often long-lasting morbidities experienced by survivors of pediatric critical illness. PICS-p encompasses new or wor...

Delayed Sternal Closure After Pediatric Heart Transplant

Delayed sternal closure (DSC) is frequently used after pediatric heart transplantation when immediate closure may compromise hemodynamics or respiratory mechanics. However, limited data describe the timing, safety, infection risk, and physiologic effects of DSC in this population...

Pediatric Laryngeal Reinnervation: Current Evidence, Techniques, and Outcomes

This review examines the current evidence for laryngeal reinnervation as a treatment for pediatric neuronal vocal fold movement impairment (VFMI), evaluating both non-selective and selective techniques, patient selection criteria, surgical considerations, and functional outcomes....

SLC7A6OS Founder Mutation: A Rare Cause of Progressive Myoclonus Epilepsy Dated to 1100 Years Ago

BACKGROUND: SLC7A6OS c.191A>G is a rare, autosomal recessive cause of progressive myoclonus epilepsy (PME). The c.191A>G variant, first discovered in two families from Türkiye and Portugal, was recently identified in three additional probands from the USA, all of Puerto Rican anc...

L‐Cysteine and N‐Acetylcysteine Supplementation Improves Clinical Outcome in a Patient With COXPD10

ABSTRACT MTO1 is a nuclear gene that encodes a mitochondrial protein essential for modifying mitochondrial transfer RNAs (tRNAs) and stabilizing codon‐anticodon interactions to ensure accurate and efficient mitochondrial protein synthesis and oxidative phosphorylation. Mitochondr...

Platinum chemotherapy ages the liver

Platinum-based drugs cause mutations and liver aging in children treated for cancer

Neutropenic Diet Versus Liberalized Diet in Patients With Cancer: A Systematic Review and Meta-Analysis

Purpose Neutropenic diet (ND) has historically been recommended to reduce infectious complications in patients with cancer. Although its use has declined over the past decade, recent studies, particularly in patients undergoing hematopoietic stem-cell transplantation (HSCT), have...