A5071763067- Pediatric Pain Management Techniques
- Musculoskeletal pain and rehabilitation
- Anesthesia and Pain Management
- Pain Mechanisms and Treatments
- Anesthesia and Sedative Agents
- Cardiac, Anesthesia and Surgical Outcomes
- Anesthesia and Neurotoxicity Research
- Pharmaceutical studies and practices
- Pain Management and Opioid Use
- Pharmacological Effects and Toxicity Studies
- Hemoglobinopathies and Related Disorders
- Child and Adolescent Psychosocial and Emotional Development
- Pharmacology and Obesity Treatment
- Intensive Care Unit Cognitive Disorders
- Blood transfusion and management
- Epilepsy research and treatment
- Hereditary Neurological Disorders
- Early Childhood Education and Development
- Sepsis Diagnosis and Treatment
- Neurogenetic and Muscular Disorders Research
- Opioid Use Disorder Treatment
- Spinal Dysraphism and Malformations
- Botulinum Toxin and Related Neurological Disorders
- Erythropoietin and Anemia Treatment
- Dental Anxiety and Anesthesia Techniques
Boston Children's Hospital
2015-2025
Harvard University
2014-2025
Pain and Rehabilitation Medicine
2019-2022
Boston Children's Museum
2020
University of California, San Francisco
2017
University of Basel
2014
Zero to Three
2014
Abstract Splice-switching antisense oligonucleotides (ASOs) could be used to treat a subset of individuals with genetic diseases 1 , but the systematic identification such remains challenge. Here we performed whole-genome sequencing analyses characterize variation in 235 (from 209 families) ataxia-telangiectasia, severely debilitating and life-threatening recessive disorder 2,3 yielding complete molecular diagnosis almost all individuals. We developed predictive taxonomy assess amenability...
Juvenile Idiopathic Arthritis (JIA) is the most common cause of non-infectious joint inflammation in children. Synovial results pain, swelling and stiffness. Animal adult human studies indicate that localized joint-associated may produce generalized changes pain sensitivity. The aim was to characterize sensitivity children with JIA mechanical thermal stimulus modalities using quantitative sensory testing (QST) at an affected inflamed joint, compare clinical remission. Generalized...
Neosaxitoxin (NeoSTX) is a site-1 sodium channel blocker that produces prolonged local anesthesia in animals and humans. Under Food Drug Administration-approved phase 1 Investigational New trial, the authors evaluated safety efficacy of NeoSTX alone combined with 0.2% bupivacaine (Bup) without epinephrine.The conducted double-blind, randomized, controlled trial involving healthy male volunteers aged 18 to 35 yr receiving two 10-ml subcutaneous injections. Control sites received Bup. In part...
Psychological intervention is widely recognized as an integral part of the recovery process from pediatric chronic pain, but service acquisition often limited by resource barriers. The aim this study was to assess feasibility, acceptability, and satisfaction a brief, structured, skills-based, group designed expressly address gaps in delivery. Exploratory outcomes were also assessed.Adolescents with pain (n = 102; ages 10-17 years) their mothers 105) completed self-report questionnaires at...
Summary Background Deep anesthesia in adults may be associated with electroencephalographic ( EEG ) suppression and higher rates of postoperative complications. Little is known about the impact anesthetic depth on short‐ or long‐term outcomes pediatrics. Brain activity monitoring complement clinical signs depth. This prospective observational study aimed to assess frequency degree profound using multichannel children during sevoflurane general anesthesia. Methods Children aged 0–40 months...
Abstract Patients admitted to the intensive care unit frequently have anemia and impaired renal function, but often lack historical blood results contextualize acuteness of these findings. Using data available within two hours ICU admission, we developed machine learning models that accurately (AUC 0.86–0.89) classify an individual patient’s baseline hemoglobin creatinine levels. Compared assuming be same as admission lab value, performed significantly better at classifying acute kidney...
Abstract Introduction: Sensory processing sensitivity (SPS) describes a genetically influenced trait characterized by greater depth of information , lower sensory threshold, and ease overstimulation. It is hypothesized that SPS plays crucial role in the context chronic pain. Objectives: This exploratory study examined as correlate pain intensity pain-related disability sample adolescents reporting Methods: Adolescents were contacted through social media specialized clinics. Participants...
Few studies have systematically described relationships between clinical-behavioural signs, electroencephalographic (EEG) patterns and age during emergence from anaesthesia in young children.To identify the end-tidal sevoflurane (ETsevoflurane) concentration, frontal EEG spectral properties predicting recovery of signs children 0 to 3 years age, with without exposure nitrous oxide. The hypothesis was that clinical occur sequentially emergence, for infants aged more than months, changes alpha...
Stressful life events (SLEs) have been associated with adjustment problems in adolescence (APA) cross-sectional studies. Using a longitudinal cohort, we examined the influence of these and predefined covariates on APA compared internalizing externalizing trajectories among children many versus few SLEs.Data were obtained from Study Early Child Care Youth Development. One thousand three hundred sixty-four their families followed child's birth until age 15 years. Adjustment at years defined as...
Evidence supports treatment of pediatric complex regional pain syndromes (CRPS) with physical and occupational therapy cognitive-behavioral therapy. Some patients have persistent and/or limb dysfunction despite these treatments. We performed a retrospective study CRPS treated by continuous epidural or peripheral perineural local anesthetic infusions along inpatient rehabilitation at Boston Children's Hospital.After approval from the institutional review board, electronic medical records were...
ABSTRACT: Objective: Parental depressive symptoms have been associated with and adjustment problems in adolescents. However, longitudinal studies assessing both mothers' fathers' over time their association adolescents' outcomes are sparse. Methods: Data were obtained from the Study of Early Child Care Youth Development. A total 1364 children families followed child's birth until age 15 years. Adolescents' evaluated via self-reported questionnaire at ages 11 to Adjustment years defined as...
Objectives: The objective of this study was to compare children and adolescents with overlapping chronic pains (OCP) those single (SCP) among youth presenting in specialized clinical settings, an effort identify potential risk factors for developing pains. Methods: A total 1235 ages 8 18 seen a tertiary care multidisciplinary pain clinic or headache completed self-report measures pain, disability, psychological functioning history characteristics at the time initial visit. Information...
Typical sickle cell disease (SCD) vaso-occlusive pain episode (VOE) management includes opioids, which are often inadequate and can be associated with significant side effects. Ketamine, a dissociative anesthetic, is potentially effective adjunct to VOE management.This study aimed characterize ketamine use for in pediatric SCD.This retrospective case series summarizes single-center experience regarding the of inpatient 156 admissions from 2014 2020.Continuous low-dose infusion was most...
The management of pediatric pain typically consists individualized treatment plans and interventions that have not been systematically evaluated. There is an emerging need to create systems can support the translation clinical discoveries, facilitate assessment current interventions, improve collection patient-centered data beyond routine information. We present development repository, a custom-built system developed at Boston Children's Hospital by multidisciplinary service. Repository...
OBJECTIVES: Pediatric pain management has rapidly changed over the last 2 decades. In this study, we describe changing practices and adverse events (AEs) related to patient-controlled analgesia (PCA) and/or nurse-controlled (NCA) a 22-year period. METHODS: After institutional review board approval, retrospective data from single tertiary-care pediatric hospital were collected between 1994 2016. Subgroup analyses done for surgical medical case patients. We reported number of times that PCA...
To evaluate differences in how mothers and fathers perceive respond to their adolescents' chronic pain before after The Comfort Ability Program (CAP), a 1-day cognitive-behavioral intervention, compare outcomes between mother-father dyads who attended the intervention alone.Parents completed Pain Catastrophizing Scale (PCS) Helping for Health Inventory (HHI) at baseline (preintervention) 1 week, month, 3 months intervention. Confirmatory factor analyses evaluated construct validity...
OBJECTIVES Analgesic medications are commonly prescribed in pediatrics, with prescribing practices frequently extrapolated from adult trials. Gabapentinoids (gabapentin and pregabalin) widely used as analgesics but labeled pediatrics only for epilepsy. We aim to (1) define trends pediatric gabapentinoid (label off-label) over 7 years, (2) evaluate use chronic pain clinic (CPC) patients during 2018. METHODS Retrospective data a tertiary-care hospital were collected between 2013 2019. Annual...
Several neurological disorders may be amenable to treatment with gene-targeting therapies such as antisense oligonucleotides (ASOs) or viral vector-based gene therapy. The US FDA has approved several of these treatments; many others are in clinical trials. Preclinical toxicity studies ASO candidates have identified dose-dependent neurotoxicity patterns. These include degeneration dorsal root ganglia, the cell bodies peripheral sensory neurons. Quantitative testing (QST) refers a series...
Opioids are indicated for moderate-to-severe pain caused by trauma, ischemia, surgery, cancer and sickle cell disease, vaso-occlusive episodes (SCD-VOC). There is only limited evidence regarding the appropriate number of doses to prescribe specific indications. Therefore, we developed implemented an opioid prescribing algorithm with dosing guidelines procedures conditions. We aimed reach sustain 90% compliance within 1 year implementation.We conducted this quality improvement effort at a...