A5019513840- Dysphagia Assessment and Management
- Gastroesophageal reflux and treatments
- Esophageal and GI Pathology
- Tracheal and airway disorders
- Child Nutrition and Feeding Issues
- Tissue Engineering and Regenerative Medicine
- Electrospun Nanofibers in Biomedical Applications
- Congenital Heart Disease Studies
- Infant Health and Development
- Cardiac Arrest and Resuscitation
- Mechanical Circulatory Support Devices
- Voice and Speech Disorders
- Infectious Aortic and Vascular Conditions
- Sepsis Diagnosis and Treatment
- Respiratory and Cough-Related Research
- Congenital Diaphragmatic Hernia Studies
- Healthcare cost, quality, practices
- Neuroscience of respiration and sleep
- Mast cells and histamine
- Child Nutrition and Water Access
- Diet and metabolism studies
- Clinical Reasoning and Diagnostic Skills
- Cardiac and Coronary Surgery Techniques
- Cystic Fibrosis Research Advances
- Blood transfusion and management
Boston Children's Hospital
2016-2025
Harvard University
2006-2025
Alfred I. duPont Hospital for Children
2006-2022
Boston Children's Museum
2022
Thomas Jefferson University
2022
Foundation Medicine (United States)
2020
DuPont (United States)
2020
Dupont Hospital
2017
Nationwide Mutual Insurance Company (United States)
2015
Emory University Hospital
2013
The primary graft-related complication during the first clinical trial evaluating use of tissue-engineered vascular grafts (TEVGs) was stenosis. We investigated role macrophages in formation TEVG stenosis a murine model. analyzed natural history macrophage infiltration at critical time points and evaluated cell seeding on neovessel formation. To assess function infiltrating macrophages, we implanted TEVGs into mice that had been depleted using clodronate liposomes. confirm this, used...
We developed a tissue-engineered vascular graft composed of biodegradable scaffold seeded with autologous bone marrow-derived mononuclear cells (BMMCs) that is currently in clinical trial and analogous mouse models to study mechanisms neovessel formation. previously reported human BMMCs were rapidly lost after implantation into immunodeficient mice as host macrophages invaded the graft. As consequence, resulting was entirely cell origin. Here, we investigate source neotissue syngeneic...
The EACTS/AEPC Guidelines represent the views of EACTS and AEPC were produced after careful consideration scientific medical knowledge evidence available at time their dating.The are not responsible in event any contradiction, discrepancy and/or ambiguity between other official recommendations or guidelines issued by relevant public health authorities, particular relation to good use healthcare therapeutic strategies.Health professionals encouraged take fully into account when exercising...
<i>Background:</i> The extracellular matrix (ECM) is a critical determinant of neovessel integrity. <i>Materials and Methods:</i> Thirty-six (polyglycolic acid + polycaprolactone poly lactic acid) tissue-engineered vascular grafts seeded with syngeneic bone marrow mononuclear cells were implanted as inferior vena cava interposition in C57BL/6 mice. Specimens characterized using immunohistochemical staining qPCR for representative ECM components addition to...
A major limitation of tissue engineering research is the lack noninvasive monitoring techniques for observations dynamic changes in single tissue-engineered constructs. We use cellular magnetic resonance imaging (MRI) to track fate cells seeded onto functional vascular grafts (TEVGs) through serial imaging. After vitro optimization, murine macrophages were labeled with ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles and scaffolds that surgically implanted as inferior vena cava...
ABSTRACT Objectives: To determine if children with laryngeal penetration on videofluoroscopic swallow study (VFSS) who received feeding interventions (thickened liquids, change in liquid flow rate, and/or method of delivery) had improved symptoms and decreased hospitalizations compared those without intervention. Methods: We performed a retrospective cohort under 2 years VFSS at our institution 2015 to initial follow‐up findings, symptom improvement follow‐up, hospitalization risk before...
The aim of the present study was to investigate prevalence oropharyngeal dysfunction with resultant aspiration in patients admitted after apparent life-threatening events (ALTE) and determine whether historical characteristics could predict this dysphagia risk.We retrospectively reviewed records all Boston Children's Hospital between 2012 2015 a diagnosis ALTE frequency evaluation for using video fluoroscopic swallow studies (VFSS) clinical feeding evaluations, swallowing subjects compare...
Summary Percutaneous endoscopic gastrostomy (PEG) was performed on 28 elderly patients (mean age 82 years) who were dysphagic and intolerant of naso-gastric feeding. Twenty-six recovering from a stroke; the interval between onset stroke PEG averaged 63 days. The procedure successful well tolerated by all patients. Nineteen (68%) still had functioning median 14 weeks after placement. One patient whose swallowing recovered tube removed 6 months its insertion. Seven (25%) subsequently died...
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but increasingly described phenomenon of immune activation organ dysfunction in association wide variety medications. This shows broad spectrum clinical presentation severity, ranging from mild to lethal. Treatment strategies suppression appear be helpful some cases, treatment failures occur frequently reported mortality rates 5% 10%. We present pediatric case DRESS associated either lamotrigine or bupropion,...
Abstract Objectives To evaluate diagnostic testing frequency/yield and determine drivers of hospital charges in a prospective cohort infants with brief resolved unexplained event (BRUE) to test the hypothesis that length stay (LOS), low‐yield testing, repeat visits increase costs. Methods We conducted study admitted after BRUE how clinical practice impacts cost care. Charge data from our institution's billing records database included room board, diagnostics, medications, professional fees...
The development of tissue-engineered vascular grafts for use in cardiovascular surgery holds great promise improving outcomes pediatric patients with complex congenital cardiac anomalies. Currently used synthetic have a number shortcomings this setting but tissue engineering approach has emerged the past decade as way to address these limitations. first clinical trial technology showed that it is safe and effective primary mode graft failure stenosis. A variety murine large animal models...
Proton pump inhibitors (PPI) are commonly prescribed to children with oropharyngeal dysphagia and resultant aspiration based on the assumption that these patients at greater risk for reflux-related lung disease. There is little data support this approach potential increased infections in treated PPI may outweigh any benefit.The aim of study was determine if there an association between hospitalization pediatric treatment PPI.We performed a retrospective cohort compare frequency length...
Infants frequently present with feeding difficulties and respiratory symptoms, which are often attributed to gastroesophageal reflux but may be because of oropharyngeal dysphagia aspiration. The Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) is a clinical measure disease now there greater understanding as mimic. We aimed determine the degree overlap between I-GERQ-R evidence dysphagia, measured by Pediatric Eating Assessment Tool-10 (Pedi-EAT-10) videofluoroscopic swallow...
The risk of persistent symptoms after a brief resolved unexplained event (BRUE) is not known. Our objective was to determine the frequency and factors for BRUE hospitalizations.We conducted prospective longitudinal cohort study infants hospitalized with an admitting diagnosis BRUE. Caregiver-reported symptoms, anxiety levels, management changes were obtained by questionnaires during 2-month follow-up period. Clinical data including repeat hospitalizations from medical record review....
Gastroesophageal reflux is common but remains a controversial disease to diagnose and treat little known about the role of testing in predicting clinical outcomes, particularly children at risk for extraesophageal complications. The aim this study was determine if rates hospitalization were affected by burden even after adjusting aspiration risk.We prospectively recruited, between 2009 2014, cohort pediatric patients with suspected who referred underwent both multichannel intraluminal...