El Paso Children's Hospital

Correction to: Nature Communicationshttps://doi.org/10.1038/s41467-025-62319-3, published online 7 August 2025 In this article the author name Adele Mitrotti was incorrectly written as Adele Mittrori. In addition, several affiliations were incorrect: the affiliation for Monika Miklaszewska and Katarzyna Zachwieja should have been ‘Department of Pediatric Nephrology and Hypertension, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland’; for Isabella Pisani, ‘Nephrology Unit, Parma University Hospital, Parma, Italy’; for Valeria Grandinetti, ‘Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy’; and for Olga Baraldi, ‘Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.’ The original article has been corrected.

Craniosynostosis can lead to progressive cranial and skull base deformities and can be associated with increased intracranial pressure (ICP), ophthalmological manifestations, behavioral changes, and developmental delay. Most published data on the incidence of elevated ICP include older children undergoing open surgical correction. Endoscopic-assisted release of fused sutures with postoperative helmet therapy is an established method for managing craniosynostosis presenting at an early age; however, the immediate effect of this approach on ICP in a young cohort has not been previously reported. Prospective data on 52 children undergoing endoscopic-assisted release of stenosed cranial sutures were included. Individuals were excluded if they underwent open correction or had previous cranial surgery. Individuals underwent a standardized endoscopic approach for each suture type. ICP was measured using an intraparenchymal sensor both before creation of the neosuture and after complete release of the stenosed suture. An ICP reading of >10 mm Hg was considered elevated. The mean age was 5.3 months, range 1 to 32 months, and 94% was younger than 12 months. The mean opening pressure was 12.7 mm Hg, and the mean closing pressure was 2.9 mm Hg. Opening ICP ≥10 mm Hg was present in 58%, ≥15 mm Hg was present in 31%, and ≥20 mm Hg was present in 23%. No patient had an ICP above 10 mm Hg at closing. The mean percentage change in ICP among all craniosynostosis cases was a 64% decrease. Optic disk swelling was identified in 28 children preoperatively and improved in 22 children at follow-up. Elevated ICP may occur in infants with craniosynostosis at higher rates than previously reported. Endoscopic-assisted craniectomy has an immediate effect on lowering ICP and improving postoperative ophthalmological findings.

Early onset sepsis (EOS) is an important cause of neonatal morbidity and mortality. Timely administration of antibiotics is crucial in management. We initiated a quality improvement project to improve timely administration of antibiotics. Primary drivers of change identified by the team were improving delivery of antibiotics from pharmacy and improving time to admit in the electronic medical record (EMR) in order to improve overall timeliness of antibiotics administration. Timings of antibiotics administration was tracked by using a control chart. Timings of antibiotics and outcomes of pre-intervention (December 2016) were compared with post intervention of PDSA cycles (January 2017-November 2018). There was statistically significant improvement in time to admission in electronic medical records over the time periods of pre-intervention, PDSA I and PDSA II (p-value < 0.05) (Table1). Also, time to delivery of antibiotics from pharmacy was significantly reduced between PDSA cycles from 21 minutes to 9 minutes with improvement in overall workflow. An average time to infusion of antibiotics decreased from 70 minutes to 48 minutes. There was also overall improvement in number of neonates receiving antibiotics under 1 hour of decision making from 37% to 77%. In our study we were able to successfully implement our "antibiotics under one hour" goal. The ability to achieve this objective can be met across multi-institutions rendering care to newborns if the approach is multidisciplinary. Deleting obstructions in the process that involve admission, registration and entry into the EMR effectively reduced time.

Automobile and motorcycle accidents are the leading causes of adolescent morbidity and mortality.

To characterize the use and delivery of cough and cold medicines in children younger than 6 presenting to an inner-city pediatric emergency department (PED) following 2007 FDA warnings. A cross-sectional observational study was performed using a convenience sampling of PED patients during the fall of 2010. Caregivers were presented with 6 commonly used cough medicine preparations and were asked to demonstrate if and how they would administer these to their children. In all, 65 patients and their caregivers consented and participated in the study. During the demonstration, 82% (53/65) stated that they would treat with cough or cold medicines, and 72% (38/53) incorrectly dosed the medication they desired to give. Despite current recommendations, cough and cold medicines are still used in children younger than 6 years of age. A significant portion of caregivers report that they are still unaware of public warnings, potential side effects, and interactions with other medications.

Rapid-onset obesity, hypoventilation, hypothalamic dysfunction, and autonomic dysfunction is an increasingly common diagnosis in patients who are being seen at tertiary care children's hospitals. We present two cases of anesthetics from the authors' own experience in addition to a comprehensive review of the disorder and anesthetic implications.