Texas Children's Hospital is a nationally ranked, freestanding 973-bed, acute care women's and children's hospital located in Houston, Texas. It is the primary pediatric teaching hospital affiliated with Baylor College of Medicine and is located within the Texas Medical Center. The hospital provides comprehensive pediatric specialty and subspecialty care to infants, children, teens, and young adults aged 0–21 throughout Texas and features an ACS verified level I pediatric trauma center. Its regional pediatric intensive-care unit and neonatal intensive care units serve the Southern United States region and also has programs to serve children from around the world. With 973 beds, it is the largest children's hospital in the United States. In addition to its main site in the Texas Medical Center, Texas Children's Hospital has satellite campuses in the suburb of The Woodlands and at its West Campus near Houston's Energy Corridor neighborhood. Texas Children's also has a network of clinics throughout the Houston metropolitan area and maintains partnerships with sites across the world through the Texas Children's Global Health Network.Texas Children's Hospital is ranked as one of the best children's hospitals in the country and the world. The 2022-2023 edition of U.S. News & World Report ranked Texas Children's Hospital #2 amongst 200 pediatric hospitals in the nation, and it has been recognized on the U.S. News and World Report Honor Roll for fourteen consecutive years.S.S.S.S.S.
Alterations in chromatin remodeling genes have been increasingly implicated in human oncogenesis. Specifically, the biallelic inactivation of the SWI/SNF subunit SMARCB1 results in the emergence of extremely aggressive pediatric malignancies. Here, we developed embryonic mosaic mouse models of malignant rhabdoid tumors (MRTs) that faithfully recapitulate the clinical-pathological features of the human disease. We demonstrated that SMARCB1-deficient malignancies exhibit dramatic activation of the unfolded protein response (UPR) and ER stress response via a genetically intact MYC-p19ARF-p53 axis. As a consequence, these tumors display an exquisite sensitivity to agents inducing proteotoxic stress and inhibition of the autophagic machinery. In conclusion, our findings provide a rationale for drug repositioning trials investigating combinations of agents targeting the UPR and autophagy in SMARCB1-deficient MRTs.
Children diagnosed with intellectual and developmental disability (IDD), including autism spectrum disorder (ASD), often present to pediatric acute care hospitals for behavioral crises or medical care. Board Certified Behavior Analysts (BCBAs) and Registered Behavior Technicians (RBTs) have important skill sets and can partner with multidisciplinary teams to advance the care of hospitalized patients with ASD or IDD. We describe the care model used by our Behavior Analysis and ASD/IDD Team (BAAT) in an inpatient medical setting. Components of the BAAT approach include: (1) consultation triage, (2) direct behavior analytic services (including assessment, intervention, and caregiver training), (3) staff training, (4) crisis response, (5) behavioral data collection, and (6) multidisciplinary collaboration. We include representative data from 2 years of the BAAT service to demonstrate the individualized and innovative application of our approach, as well as preliminary outcome data to show the potential impact of the program. This study highlights the key role of BCBAs and RBTs in acute inpatient medical settings, particularly in optimizing the care of children with ASD or IDD and behavioral health needs, while disseminating behavior analytic practice.
There are few prospective studies of mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) for pediatric lupus nephritis (pLN) and none evaluating rituximab (RTX). The Prospective Pediatric Lupus Nephritis Registry (ProPeL-R) enrolled patients < 21 years within 4 weeks of an initial kidney biopsy diagnostic of pLN. Demographic, clinical, and laboratory data were collected prospectively at enrollment, 3 months, 6 months, and then every 6 months thereafter for up to 5 years of follow-up. For this study, we compared patients receiving initial therapy with corticosteroids (CS) and either MMF (n = 33) vs. CYC (n = 18), and those treated with CS, either MMF or CYC, with RTX (n = 20) vs. without RTX (n = 51). Histology consisted of 18
Acute kidney injury is common among critically ill children and independently associated with morbidity and mortality, particularly in those receiving kidney replacement therapy (KRT). As KRT is not innocuous, standardizing its delivery is critical for accurate outcome tracking. Establishing key performance indicators (KPIs) is essential to guide quality improvement and support decision-making through ongoing monitoring of KRT processes. This systematic review evaluated existing evidence on KPIs related to KRT delivery in critically ill pediatric populations. A comprehensive search of Ovid MEDLINE, Ovid Embase, CINAHL, and the Cochrane Library was conducted for studies published from inception to February 2025. Eligible studies reported KPIs related to dialysis processes in critically ill children receiving KRT. Critically ill children receiving all KRT modalities were assessed for KPIs according to the Donabedian framework, with each KPI stratified based on whether it measured a process related to KRT care. Six reviewers independently screened, selected, and appraised studies using the risk-of-bias tool appropriate for each study design. Data were summarized narratively. Of 7,111 citations screened, 107 studies met inclusion criteria, comprising 57 retrospective cohorts, 27 case series, 16 prospective cohorts, 4 case reports, 2 randomized controlled trials, and 1 audit. Most studies (66.7
Platelet-rich plasma (PRP) is increasingly used in orthopedic and spine surgery for its regenerative and anti-inflammatory effects, yet its clinical efficacy as an adjunct to percutaneous endoscopic lumbar discectomy (PELD) remains uncertain. A systematic search was performed in PubMed, Scopus, Cochrane Library, and Google Scholar through September 2025. Five comparative studies involving 479 patients met the inclusion criteria. Extracted outcomes included postoperative pain (VAS for low back and leg pain), functional recovery (ODI and JOA scores), MRI-based structural measurements obtained both preoperatively and postoperatively (Pfirrmann grading, intervertebral disc height, and spinal canal cross-sectional area), as well as recurrence rates. PRP demonstrated significant benefits in early postoperative pain control, with lower VAS scores for low back pain (p < 0.001) and leg pain (p < 0.001) at 3 months. Improvements in low back pain persisted at 6 months (p = 0.003), while leg pain became borderline and no longer statistically significant (p = 0.05). Functional recovery also favored PRP, with higher clinician-assessed JOA scores at 3 and 6 months (p = 0.02 and p < 0.001) and improved patient-reported ODI scores at both time points (p < 0.001). MRI-based outcomes indicated greater postoperative spinal canal expansion (p < 0.001), better preservation of intervertebral disc height (p = 0.002), and less progression in Pfirrmann degenerative grading (p < 0.001). PRP was additionally associated with a significantly reduced rate of recurrent lumbar disc herniation (p = 0.007). PRP appears to enhance both clinical and structural outcomes when used as an adjunct to PELD, contributing to improved pain relief, functional recovery, and postoperative disc integrity. While promising, these findings highlight the need for larger high-quality studies to refine PRP protocols and confirm long-term effectiveness.
