Digital Commons Network^™

Sex-Specific Alterations In Hepatic Cholesterol Metabolism In Low Birth Weight Adult Guinea Pigs., Ousseynou Sarr, Katherine E Mathers, Christina Vanderboor, Kristina Wiggers, Aditya Devgan, Daniel B Hardy, Lin Zhao, Timothy Regnault

Paediatrics Publications

BACKGROUND: Intrauterine growth restriction and low birth weight (LBW) have been widely reported as an independent risk factor for adult hypercholesterolaemia and increased hepatic cholesterol in a sex-specific manner. However, the specific impact of uteroplacental insufficiency (UPI), a leading cause of LBW in developed world, on hepatic cholesterol metabolism in later life, is ill defined and is clinically relevant in understanding later life liver metabolic health trajectories.

METHODS: Hepatic cholesterol, transcriptome, cholesterol homoeostasis regulatory proteins, and antioxidant markers were studied in UPI-induced LBW and normal birth weight (NBW) male and female guinea pigs at 150 days.

RESULTS: Hepatic free and …

Cervicofacial Actinomycosis In The Pediatric Population: Presentation And Management, Karan Gandhi, Benjamin D. Van Der Woerd, M. Elise Graham, Michelle Barton, Julie E. Strychowsky

Paediatrics Publications

Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and …

A Million Is More Than A Thousand: Children's Acquisition Of Very Large Number Words, Pierina Cheung, Daniel Ansari

Paediatrics Publications

Very large numbers words such as “hundred,” “thousand,” “million,” “billion,” and “trillion” pose a learning problem for children because they are sparse in everyday speech and children's experience with extremely large quantities is scarce. In this study, we examine when children acquire the relative ordering of very large number words as a first step toward understanding their acquisition. In Study 1, a hundred and twenty-five 5–8-year-olds participated in a verbal number comparison task involving very large number words. We found that children can judge which of two very large numbers is more as early as age 6, prior to entering …

Frequency Of Diabetes Team Contacts In Children And Adolescents Using Insulin Pumps, Funmbi T. Babalola, Michael R. Miller, Andrea R. Ens, Robert I. Stein, Patricia H. Gallego, Cheril L. Clarson

Paediatrics Publications

Background: The purpose of this study is to assess if a relationship exists between A1c within target (≤ 7.5%) and frequency of patient-initiated contact with diabetes team, in children with type 1 diabetes (T1DM) on an insulin pump. Additionally, to determine factors impacting frequency of contact. Methods: This was a retrospective study of children with T1DM on an insulin pump. Frequency of contact, type of contact, and A1c were collected. Study participants filled out a questionnaire at study entry. Results: One hundred and seventy-six participants were enrolled, with a mean age of 13 years. The median duration of T1DM was …

Parents’ Report Of Canadian Elementary School Children’S Physical Activity And Screen Time During The Covid-19 Pandemic: A Longitudinal Study, Emma Ostermeier, Patricia Tucker, Andrew Clark, Jamie A. Seabrook, Jason Gilliland

Paediatrics Publications

COVID-19 public health protocols have altered children’s daily routines, limiting their physical activity opportunities. The purpose of this study was to examine how the COVID-19 pandemic affected children’s (ages 10–12 years) physical activity and screen time, and to explore the impact of gender, socioeconomic status (SES), and public health constraints (i.e., facility use and social interaction) on the changes in children’s health behaviors. Online surveys were disseminated to parents at two time points: before COVID-19 (May 2019 to February 2020) and during COVID-19 (November to December 2020). Wilcoxon signed-rank tests were used to assess changes in physical activity and screen …

Health Concerns Of Adolescents And Adults With Spina Bifida, Jessica Starowicz, Caitlin Cassidy, Laura Brunton

Paediatrics Publications

Due to advancements in medical care, people with spina bifida (SB) are surviving well into adulthood, resulting in a growing number of patients transitioning to an adult sector unequipped to care for people with chronic rehabilitative and medical needs. The Transitional and Lifelong Care (TLC) program is a multidisciplinary clinical service that compensates for this gap, providing comprehensive, coordinated care to adolescents, and adults with SB. As a relatively new clinical service, objective data about the patients using the service and their needs is scant. This study sought to identify the most common health concerns among TLC patients with SB …

Paediatric Serum Sickness-Like Reaction: A 10-Year Retrospective Cohort Study, Blanca R. Del Pozzo-Magaña, Awatif Abuzgaia, Barbara Murray, Michael J. Rieder, Alejandro Lazo-Langner

Paediatrics Publications

Background: Serum sickness-like reaction (SSLR) is an acute inflammatory condition affecting predominantly children. The pathophysiology remains unclear, but drugs are considered the main trigger. Objective: The aim of this study was to describe the clinical and laboratory features, triggers, and treatment modalities in children diagnosed with SSLR. Methods: We conducted a 10-year retrospective cohort study including all paediatric patients (0 to 18 years old) with query SSLR referred to the Adverse Drug Reactions Clinic at the Children's Hospital of Western Ontario. Diagnostic criteria included acute skin rash plus joint inflammation with or without fever. Results: We included 83 patients (47 …

The Mental Well-Being And Coping Strategies Of Canadian Adolescents During The Covid-19 Pandemic: A Qualitative, Cross-Sectional Study, Kendra Nelson Ferguson, Stephanie E. Coen, Danielle Tobin, Gina Martin, Jamie A. Seabrook, Jason A. Gilliland

Paediatrics Publications

BACKGROUND: Qualitative research is lacking on the mental well-being of adolescents during the COVID-19 pandemic. The aim of this study was to explore the feelings and emotions adolescents experienced during the first wave of the COVID-19 pandemic and the coping strategies they identified and employed to manage those emotions. METHODS: Participants living in Canada aged 13-19 years were recruited through social media platforms and youth-serving organizations. Qualitative data were gathered from 2 open-ended questions included in a youth-informed cross-sectional online survey: "What feelings and emotions have you experienced around the pandemic?" and "What coping strategies have you used during the …

Examining The Correlates Of Adolescent Food And Nutrition Knowledge, Rachel Brown, Jamie A. Seabrook, Saverio Stranges, Andrew F. Clark, Jess Haines, Colleen O’Connor, Sean Doherty, Jason A. Gilliland

Paediatrics Publications

Food literacy is a set of skills and knowledge that are integral to diet. It is common among teenagers to not have basic food literacy skills needed to consume a healthy diet. This study examined: (1) the current state of food and nutrition knowledge among adolescents 13–19 years of age in the census metropolitan area of London, ON, Canada; and (2) correlates of food knowledge and nutrition knowledge among adolescents. Data for this study were drawn from baseline youth and parent survey data collected from a larger population health intervention study. Statistical analysis of the survey data indicates that higher …

Risk Factors For Re-Hospitalization Following Neonatal Discharge Of Extremely Preterm Infants In Canada, Zakariya Bambala Puthattayil, Thuy Mai Luu, Marc Beltempo, Shannon Cross, Thevanisha Pillay, Marilyn Ballantyne, Anne Synnes, Prakesh Shah, Thierry Daboval

Paediatrics Publications

Objective: Survivors of extremely preterm birth are at risk of re-hospitalization but risk factors in the Canadian population are unknown. Our objective is to identify neonatal, sociodemographic, and geographic characteristics that predict re-hospitalization in Canadian extremely preterm neonates. Methods: This is a retrospective analysis of a prospective observational cohort study that included preterm infants born 22 to 28 weeks’ gestational age from April 1, 2009 to September 30, 2011 and seen at 18 to 24 months corrected gestational age in a Canadian Neonatal Follow-Up Network clinic. Characteristics of infants re-hospitalized versus not re-hospitalized are compared. The potential neonatal, sociodemographic, and …

Timing Of Cgm Initiation In Pediatric Diabetes: The Cgm Time Trial., Margaret L Lawson, Kate C Verbeeten, Jennilea M Courtney, Brenda J Bradley, Karen Mcassey, Cheril Clarson, Susan Kirsch, Jacqueline R Curtis, Farid H Mahmud, Christine Richardson, Tammy Cooper, Jason Chan, Ken Tang

Paediatrics Publications

OBJECTIVE: To determine whether timing of CGM initiation offering low glucose suspend (LGS) affects CGM adherence in children and youth starting insulin pump therapy.

METHODS: A 5-site RCT of pump-naïve subjects (aged 5-18 years) with type 1 diabetes (T1D) for at least 1 year compared simultaneous pump and CGM initiation offering LGS vs standard pump therapy with CGM initiation delayed for 6 months. Primary outcome was CGM adherence (hours per 28 days) (MiniMed™ Paradigm™ Veo™ system; CareLink Pro™ software) over 6 months after CGM initiation. Secondary outcome HbA1c was measured centrally. Linear mixed-models and ordinary least squares models were fitted …

Pannexin 1 Binds Β-Catenin To Modulate Melanoma Cell Growth And Metabolism, Samar Sayedyahossein, Kenneth Huang, Zhigang Li, Christopher Zhang, Alexandra M. Kozlov, Danielle Johnston, Daniel Nouri-Nejad, Lina Dagnino, Dean H. Betts, David B. Sacks, Silvia Penuela

Paediatrics Publications

Melanoma is the most aggressive skin malignancy with increasing incidence worldwide. Pannexin1 (PANX1), a member of the pannexin family of channel-forming glycoproteins, regulates cellular processes in melanoma cells including proliferation, migration, and invasion/metastasis. However, the mechanisms responsible for coordinating and regulating PANX1 function remain unclear. Here, we demonstrated a direct interaction between the C-terminal region of PANX1 and the N-terminal portion of β-catenin, a key transcription factor in the Wnt pathway. At the protein level, β-catenin was significantly decreased when PANX1 was either knocked down or inhibited by two PANX1 blockers, Probenecid and Spironolactone. Immunofluorescence imaging showed a disrupted pattern …

Correlates Of Lifetime And Past Month Vape Use In A Sample Of Canadian University Students, Jamie A. Seabrook, Jasna Twynstra, Jason A. Gilliland

Paediatrics Publications

Introduction: This study examines correlates of lifetime (ie, ever vaped) and past month vape use among students aged 17 to 19 years, 20 to 25 years, and 26+ years from Western University in London, Ontario. The secondary objective is to assess lifetime and past month vape use among students not of legal age to purchase vaping products in Ontario (ie, those 17 to 18 years only). Methods: Using Qualtrics, a cross-sectional survey was sent via email to all students at Western University (N = 38 442), assessing their current and past risk-taking behaviors, mental health, sociodemographic characteristics, as well as …

Examining How Children's Gender Influences Parents’ Perceptions Of The Local Environment And Their Influence On Children's Independent Mobility, Alina Medeiros, Andrew F. Clark, Gina Martin, Jamie A. Seabrook, Jason Gilliland

Paediatrics Publications

Physical inactivity among children is a public health concern. Children's ability to travel independently is associated with increased physical activity and social connectedness. Consequently, it is concerning that children's independent mobility has decreased in recent years. Studies have highlighted that rates of independent mobility vary by gender; this study analyzed how correlates of independent mobility vary between boys (n = 476) and girls (n = 618) attending 32 elementary schools in Southwestern Ontario. Hierarchical logistic regression modeling methods were used. All analyzes were stratified by gender. For boys, age was negatively associated with travel with peers. Having one or more …

Hyoscine Butylbromide Versus Acetaminophen For Nonspecific Colicky Abdominal Pain In Children: A Randomized Controlled Trial., Naveen Poonai, Kriti Kumar, Kamary Coriolano, Graham Thompson, Shaily Brahmbhatt, Emily Dzongowski, Holly Stevens, Priti Gupta, Michael Miller, Sharlene Elsie, Dhandapani Ashok, Gary Joubert, Rod Lim, Andreana Bütter, Samina Ali

Paediatrics Publications

BACKGROUND: Less than two-thirds of children with abdominal pain in the emergency department receive analgesia. We sought to determine whether hyoscine butylbromide was superior to acetaminophen for children with nonspecific colicky abdominal pain.

METHODS: We randomly allocated children aged 8-17 years with nonspecific colicky abdominal pain who presented to the pediatric emergency department of London Health Sciences Centre, London, Ontario to receive hyoscine butylbromide, 10 mg given orally, or acetaminophen, 15 mg/kg given orally (maximum 975 mg). We considered the minimal clinically important difference for the primary outcome (self-reported pain at 80 min) to be 13 mm on a 100 …

A Live-Online Mindfulness-Based Intervention For Children Living With Epilepsy And Their Families: Protocol For A Randomized Controlled Trial Of Making Mindfulness Matter©., Klajdi Puka, Karen Bax, Andrea Andrade, Margo Devries-Rizzo, Hema Gangam, Simon Levin, Maryam N Nouri, Asuri N Prasad, Mary Secco, Guangyong Zou, Kathy N Speechley

Paediatrics Publications

BACKGROUND: Epilepsy extends far beyond seizures; up to 80% of children with epilepsy (CWE) may have comorbid cognitive or mental health problems, and up to 50% of parents of CWE are at risk for major depression. Past research has also shown that family environment has a greater influence on children's and parents' health-related quality of life (HRQOL) and mental health than epilepsy-related factors. There is a pressing need for low-cost, innovative interventions to improve HRQOL and mental health for CWE and their parents. The aim of this randomized controlled trial (RCT) is to evaluate whether an interactive online mindfulness-based intervention …

A National Spinal Muscular Atrophy Registry For Real-World Evidence., Victoria L Hodgkinson, Maryam Oskoui, Joshua Lounsberry, Saïd M'Dahoma, Emily Butler, Craig Campbell, Alex Mackenzie, Hugh J Mcmillan, Louise Simard, Jiri Vajsar, Bernard Brais, Kristine M Chapman, Nicolas Chrestian, Meghan Crone, Peter Dobrowolski, Susan Dojeiji, James J Dowling, Nicolas Dupré, Angela Genge, Hernan Gonorazky, Simona Hasal, Aaron Izenberg, Wendy Johnston, Edward Leung, Hanns Lochmüller, Jean K Mah, Alier Marerro, Rami Massie, Laura Mcadam, Anna Mccormick, Michel Melanson, Michelle M Mezei, Cam-Tu E Nguyen, Colleen O'Connell, Erin K O'Ferrall, Gerald Pfeffer, Cecile Phan, Stephanie Plamondon, Chantal Poulin, Xavier Rodrigue, Kerri L Schellenberg, Kathy Selby, Jordan Sheriko, Christen Shoesmith, Garth Smith, Monique Taillon, Sean Taylor, Jodi Warman Chardon, Scott Worley, Lawrence Korngut

Paediatrics Publications

BACKGROUND: Spinal muscular atrophy (SMA) is a devastating rare disease that affects individuals regardless of ethnicity, gender, and age. The first-approved disease-modifying therapy for SMA, nusinursen, was approved by Health Canada, as well as by American and European regulatory agencies following positive clinical trial outcomes. The trials were conducted in a narrow pediatric population defined by age, severity, and genotype. Broad approval of therapy necessitates close follow-up of potential rare adverse events and effectiveness in the larger real-world population.

METHODS: The Canadian Neuromuscular Disease Registry (CNDR) undertook an iterative multi-stakeholder process to expand the existing SMA dataset to capture items …

Developing And Implementing A Novel Mentorship Model (4+ 1) For Maternal, Newborn And Child Health In Rwanda, Anaclet Ngabonzima, Cynthia Kenyon, Celestin Hategeka, Aimee Josephine Utuza, Paulin Ruhato Banguti, Isaac Luginaah, David F Cechetto

Paediatrics Publications

BACKGROUND: There are a number of factors that may contribute to high mortality and morbidity of women and newborns in low-income countries. These include a shortage of competent health care providers (HCP) and a lack of sufficient continuous professional development (CPD) opportunities. Strengthening the skills and building the capacity of HCP involved in the provision of maternal, newborn and child health (MNCH) is essential to ensure quality care for mothers, newborns and children. To address this challenge in Rwanda, mentorship of HCPs was identified as an approach that could help build capacity, improve the provision of care and accelerate the …

Instituting Robotic Pediatric Urologic Surgery In The Canadian Healthcare System: Evaluating The Feasibility And Outcomes Of Robot-Assisted Pyeloplasty And Ureteric Reimplantation, Noah Stern, Peter Wang, Sumit Dave

Paediatrics Publications

Introduction: Robotic pediatric urologic surgery has gained widespread adoption over the last decade. This article describes our experience in instituting the first pediatric urologic robotic surgery program in Canada. We evaluated the feasibility and safety of instituting pediatric robot-assisted urologic surgery and report our early outcomes for robot-assisted pyeloplasty (RAP) and ureteric reimplantation (RUR). Methods: We prospectively evaluated all patients undergoing RAP and RUR by a single surgeon from June 2013 to March 2019. Demographic and clinical data were prospectively collected and included sex, age, and preoperative grade of hydronephrosis or reflux. Descriptive statistics were performed, and comparisons were made …

Priority Outcomes In Critically Ill Children: A Patient And Parent Perspective, Nora Fayed, Saoirse Cameron, Douglas Fraser Md, Phd, Frcpc, Jill I Cameron, Samah Al-Harbi, Racquel Simpson, Maha Wakim, Lily Chiu, Karen Choong

Paediatrics Publications

BACKGROUND: Outcomes in pediatric critical care research are typically selected by the researcher.

OBJECTIVES: (1) To identify outcomes prioritized by patients and their families following a critical illness and (2) to determine the overlap between patient-centered and researcher-selected study outcomes.

METHODS: An exploratory descriptive qualitative study nested within a longitudinal cohort study conducted in 2 pediatric intensive care units (PICUs). Participants were purposively sampled from the primary cohort to ensure adequate demographic representation. Qualitative descriptive approaches based on naturalistic observation were used to collect data and analyze results. Data were coded by using the International Classification of Functioning, Disability, and …

Fri0547 The Effect Of Corrected Inflammation, Oxidative Stress And Endothelial Dysfunction On Fmd Levels In Patients With Selected Chronic Diseases: A Quasi-Experimental Study., Mahmut Ilker Yilmaz, Micol Romano, Mustafa Kemal Basarali, Abdelbaset Elzagallaai, Murat Karaman, Zeynep Demir, Muhammet Fatih Demir, Fatih Akcay, Melik Seyrek, Nuri Haksever, David Piskin, Rolando Cimaz, Michael Rieder, Erkan Demirkaya

Paediatrics Publications

While the pathophysiology of chronic disorders varies there are three basic mechanisms - inflammation, oxidative stress and endothelial dysfunction - that are common in many chronic diseases. However, the failure of these mechanisms to work synchronously can lead to morbidity complicating the course of many chronic diseases. We analyzed data of 178 patients from cohorts with selected chronic diseases in this quasi-experimental study. Endothelial dysfunction was determined by flow-mediated dilatation (FMD) and asymmetric dimethylarginine (ADMA) levels. Serum ADMA, high sensitive C-reactive protein (hs-CRP), serum PTX3, malondialdehyde (MDA), Cu/Zn-superoxide dismutase (Cu/Zn-SOD), glutathione peroxidase (GSH-Px) levels and FMD were studied in baseline …

A Systematic Review For The Management Of The Genetically Defined Il-1-Mediated Autoinflammatory Diseases, Caps, Traps, Mkd And Dira, R. Berard, M. Romano, Zs Arici, D. Piskin, O. Jones, K. Durrant, R. Goldbach-Mansky, M. Gattorno, E. Demirkaya

Paediatrics Publications

No abstract provided.

The Impact Of Covid-19 On Canadian Urology Residents, Ernest Pang Chan, Leandra Stringer, Peter Z.T. Wang, Sumit Dave, Jeffrey D. Campbell

Paediatrics Publications

No abstract provided.

Late Referrals Of Pediatric Patients With Elevated Blood Pressure, Guido Filler, Laura Torres-Canchala

Paediatrics Publications

Editorial Commentary

New Horizons In The Genetic Etiology Of Systemic Lupus Erythematosus And Lupus-Like Disease: Monogenic Lupus And Beyond, Erkan Demirkaya, Sezgin Sahin, Micol Romano, Qing Zhou, Ivona Aksentijevich

Paediatrics Publications

Systemic lupus erythematosus (SLE) is a clinically and genetically heterogeneous autoimmune disease. The etiology of lupus and the contribution of genetic, environmental, infectious and hormonal factors to this phenotype have yet to be elucidated. The most straightforward approach to unravel the molecular pathogenesis of lupus may rely on studies of patients who present with early-onset severe phenotypes. Typically, they have at least one of the following clinical features: childhood onset of severe disease (<5 >years), parental consanguinity, and presence of family history for autoimmune diseases in a first-degree relative. These patients account for a small proportion of patients with lupus …

Feeling Green, Aisha Ghare, Kristopher D. Langdon, Ruba Kiwan, Andrea Andrade, Adrianna Ranger, Robert Hammond

Paediatrics Publications

No abstract provided.

Prioritization And Management Recommendations Of Pediatric Urology Conditions During The Covid-19 Pandemic, Daniel T. Keefe, Mandy Rickard, Peter Anderson, Darius Bagli, Anne Sophie Blais, Stéphane Bolduc, Luis H. Braga, Natasha Brownrigg, Michael Chua, Sumit Dave, Joana Dos Santos, Luis Guerra, Allen H. Hayashi, Mélise A. Keays, Soojin Kim, Martin A. Koyle, Linda C. Lee, Armando J. Lorenzo, Dawn Maclellan, Landan Macdonald, Andrew E. Macneily, Peter D. Metcalfe, Katherine Moore, Rodrigo L.P. Romao, Peter Z.T. Wang

Paediatrics Publications

No abstract provided.

The Cost-Utility Of Measles-Mumps-Rubella Immunization Strategies During A Mumps Outbreak, Kikanwa Anyiwe, David Naimark, Oliver Baclic, Vinita Dubey, Marina Salvadori, Man Wah Yeung, Matthew Tunis, Beate Sander

Paediatrics Publications

No abstract provided.

Estimation Of Gfr In Patients With Cystic Fibrosis: A Cross-Sectional Study, Andrea Wallace, April Price, Erin Fleischer, Michael Khoury, Guido Filler

Paediatrics Publications

Background: Patients with cystic fibrosis (CF) have frequent infectious complications requiring nephrotoxic medications, necessitating monitoring of renal function. Although adult studies have suggested that cystatin C (CysC)-based estimated glomerular filtration rate (eGFR) may be preferable due to reduced muscle mass of patients with CF, pediatric patients remain understudied. Objective: Our objective was to determine which eGFR formula is best for estimating glomerular filtration rate (GFR) in pediatric patients with CF. Methods: A total of 17 patients with CF treated with nephrotoxic antibiotics were recruited from the Children’s Hospital at London Health Sciences Centre, London, Ontario, Canada. 99Tc DTPA GFR (measured …

Utility Of Clinical Features With Fine Needle Aspiration Biopsy For Diagnosis Of Warthin Tumor., Thomas So, Axel Sahovaler, Anthony Nichols, Kevin Fung, John Yoo, Michele M Weir, S Danielle Macneil

Paediatrics Publications

BACKGROUND:
Conservative management of Warthin tumor (WT) may be a viable alternative to surgery, but there are concerns of missed malignancies on fine needle aspiration biopsy (FNAB). The purpose of this study is to measure the sensitivity and positive predictive value of FNAB for WT, and to identify clinical features associated with WT that can aid in this diagnosis.

METHODS:
Retrospective analysis of patients from January 1, 2006 to April 30, 2017 at a tertiary care center in London, Ontario, Canada. All patients with a diagnosis of WT on FNAB or resection were included. Electronic medical records were identified for …