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12-01-20 Hsc Committee Meeting Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

12-01-20 Hsc Committee Meeting Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

10-13-20 Hsc Committee Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

10-13-20 Hsc Committee Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Localized Intravascular Coagulopathy Of Venous Malformation Involving The Labia As A Mimic Of Child Sexual Abuse: A Case Report, Leslie Strickler, Lan Anh Van-Dinh, Christopher Torrez, Jessica Williams

2020 Pediatric Research Forum Session

Given location and relative rarity, ano-genital injuries in children often prompt concern for maltreatment. We present a case of localized intravascular coagulopathy as a complication of venous malformation, which mimicked abusive trauma leading to an evaluation for maltreatment. Comprehensive assessment identified the underlying medical cause. This case represents an example of the importance of objective assessment in unusual case presentations to ensure diagnostic accuracy, and appropriate direction of medical and child protection resources.

An Institutional Experience With Emicizumab In Pediatric Patients With Heophilia A, Shirley Abraham, Lisa Jung, Janet Ratte, Valerie Lowe

2020 Pediatric Research Forum Session

Background: Emicizumab is a recombinant, humanized, bispecific monoclonal antibody that substitutes for the function of FVIII by binding to activated factor IX and X. It is currently indicated for routine prophylaxis in adults and children of all ages with hemophilia A, with or without inhibitors. Despite basic guidelines provided by MASAC and the drug package insert, there is significant inter-institutional variability regarding monitoring and follow up in patients on emicizumab.

Objective: To outline our institutional experience in pediatric patients on emicizumab.

Method: Retrospective and prospective chart review of our patients on emicizumab. Information collected included age of patient, hemophilia severity, …

Cinematic Portrayal Of Infectious Disease Outbreaks, Walter Dehority

2020 Pediatric Research Forum Session

Background:

Movies are a shared cultural experience. Films likely reflect societal fears, and may provide insight into how the public perceives infectious disease outbreaks.

Methods:

A search of IMDb.com was conducted in February/March 2020 (updating a 2017 search) using 163 infection-related search terms to identify films with an emphasis on infectious diseases (as assessed by review of plot synopses on IMDb, the American Film Institute database, or Wikipedia) through December 31, 2019. Films featuring an outbreak or pandemic (as defined by the CDC, with the outbreak/pandemic required to be an important component of the story) were then selected. Cultural relevance …

Increased Incidence Of Asthma In Children With Prenatal Opioid Exposure, Isabella Cervantes, Shikhar Shrestha, Sharon Ruyak, Jessie R. Maxwell

2020 Pediatric Research Forum Session

Prenatal opioid exposure (POE) has increased dramatically in the last 10 years, with nearly 100 babies born daily in the United States with Neonatal Opioid Withdrawal Syndrome (NOWS). The impact on long-term outcomes continues to be investigated. Given the proinflammatory state that results from POE, we hypothesized that infants with POE or NOWS diagnoses during the newborn hospitalization would have an altered immune reactivity that persisted into childhood, defined by asthma diagnosis within the first 8 years.

A retrospective cohort design utilizing a comprehensive CERNER HealthFacts U.S. national database was completed, which accesses clinical data from 800 hospitals across the …

Improving Support Of Breastfeeding At A Baby-Friendly™ Designated Hospital In Albuquerque, New Mexico, Troy Hatfield, Connie Peceny, Julia M. Martinez, Priscilla Mendoza, Timothy J. Ozechowski, Rachel A. Sebastian, Emilie A. Sebesta, Mary M. Ramos

2020 Pediatric Research Forum Session

Purpose:

Breastfeeding has conclusively proven to be the healthiest feeding option for infants. Baby-Friendly™designated hospitals and birthing centers follow the Ten Steps to Successful Breastfeeding, which are considered to be the gold standard for supporting mothers who wish to breastfeed. However, even a Baby-Friendly™designated hospital may have room for improvement. The University of New Mexico Hospital (UNMH) is an urban hospital serving a predominantly Hispanic and Native American population, and the majority of pediatric patients are covered by Medicaid. Despite its Baby-Friendly™ designation, UNMH had low rates of physician documentation of discussing the health impacts of breastfeeding in the postpartum …

What Procedural Skills Are Practiced By Pediatricians In New Mexico?, Christal P. Chow, Anne Greene, Grace Mccauley

2020 Pediatric Research Forum Session

Background:

By the end of residency, pediatric residents are expected to be competent in 13 clinical procedures (bag mask ventilation, neonatal endotracheal intubation, umbilical catheter placement, lumbar puncture, simple laceration repair, incision and drainage of abscess, reduction of simple dislocation, temporary splinting of fractures, giving immunizations, bladder catheterization, peripheral intravenous catheter placement, removal of foreign body, and venipuncture). These procedural skills were initially identified as essential for practice in the general pediatric setting. However, procedures performed vary based on location, patient population, practice type, tertiary care support, etc. There are few studies available that evaluate the procedural skills used in …

A Technical Assistance Model To Facilitate Use Of The School Health Index To Assess Chronic Health Condition Management In Schools, Grace L. Mccauley, Sarah Sanders, Anne Marlow-Geter, Elizabeth Yakes Jimenez

2020 Pediatric Research Forum Session

Introduction:

Chronic health conditions, such as asthma and food allergies, affect a substantial proportion of school-aged children in New Mexico (NM). School health services, policies, programs, and practices can affect daily management of chronic pediatric health conditions. The Center for Disease Control and Prevention’s School Health Index (SHI) is a self-assessment and planning guide that evaluates school services, policies, and programs for promoting health and safety. Our aim was to determine if a technical assistance (TA) model could effectively support school districts in using the SHI to complete a chronic disease needs assessment (CDNA).

Methods:

Seven public and one charter …

Erlotinib Therapy For Recurrent Respiratory Paillomatosis And Extralaryngeal Spread In Pediatrics, Shirley Abraham, John Kuttesch, Erica Bennett

2020 Pediatric Research Forum Session

Background:

Recurrent respiratory papillomatosis (RRP) can be a potentially life-threatening condition and a treatment challenge. Local therapies are associated with significant scarring and detrimental effects on voice and respiratory status. EGFR inhibitors have been reported to be an effective adjunctive therapy in patients with RRP.

Objective:

To report our institutional experience with Erlotinib in two pediatric patients with severe RRP.

Method:

Retrospective chart review of 2 pediatric patients with severe RRP.

Results:

Patient 1 is a 19y/o female who was referred to us at the age of 11. Patient was diagnosed with respiratory papillomatosis at birth. Since age 1.5yrs, she …

Comparison Of Virulence Gene Carriage In Staphylococcus Aureus Isolates Colonizing Human Skin And Those Associated With Soft Tissue Osteoarticular Infections, Kylie Disch, Jon Femling, Parisa Mortaji, Kurt Schwalm, Aimee Yousey, Rebekkah Varjabedian, Darrell Dinwiddie, Walter Dehority

2020 Pediatric Research Forum Session

Background:

Osteoarticular infections (OAI), most commonly caused by S. aureus, cause extreme morbidity in children and may result in permanent sequelae (e.g. limb-length discrepancies). However, S. aureus is also a common colonizing bacteria of skin and a cause of soft tissue abscesses. Virulence determinants for S. aureus are likely complex, and may include the genetic composition of the isolate, the host immune response and the transcriptomic profile of the organism. A necessary first-step in characterizing these virulence factors includes assessing virulence gene carriage between S. aureus isolates from children with OAIs and from less virulent isolates.

Methods:

S. aureus …

Pathogen-Specific Neurocognitive Outcomes In Tropical Childhood Encephalitis, Christal Chow, Ashan Jayawickrama, Jithangi Wanigasinghe, Piyadasa Kodituwakku, Kurt Schwalm, Darrell Dinwiddie, John Phillips, Walter Dehority

2020 Pediatric Research Forum Session

Background:

Childhood encephalitis causes long-term neurocognitive disability, which may lead to secondary disabilities such as poor academic achievement and social isolation. This is particularly problematic in resource limited, tropical countries, where the burden of vector-borne viral encephalitis is substantial, yet the resources for identifying the myriad of pathogens involved and characterizing the resulting neurocognitive sequelae are limited. To our knowledge, comprehensive assessments of neurocognitive function following tropical childhood encephalitis have not been performed. We hypothesize that the risk of neurocognitive sequelae is pathogen-specific, and that the use of portable, on-site metagenomic Next Generation Sequencing of CSF in Sri Lankan children …

Baseline Results From The Strategic Implementation Of Screening, Brief Intervention And Referral To Treatment (Sbirt) In School‐Based Health Centers Initiative, Grace Mccauley, Timothy Ozechowski, Julia Martinez, Elizabeth Yakes Jimenez, Mary M. Ramos

2020 Pediatric Research Forum Session

Introduction:

The rates of substance use among teens in NM are among the highest in the US. Regular use of illicit drugs during adolescence can compromise mental and physical health and contribute to poorer longer-term outcomes. The Strategic Implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT) in School‐Based Health Centers (SBHCs) [SISS] initiative implements and evaluates the SBIRT model, with a goal of identifying, reducing, and preventing substance use in New Mexico (NM) adolescents. For this analysis, we describe baseline data on the provision of SBIRT to adolescents at‐risk for substance abuse.

Methods:

From October to December 2019, …

The Window Ductus, A Rare Finding, And The Importance Of Perinatal Echocardiography, Storm Dorrough, Gavin Mccullough, Michelle Grenier

2020 Pediatric Research Forum Session

Category: Case Report

We present a case of an unusual form of the ductus arteriosus termed “window ductus,” and highlight the importance of early recognition echocardiogram. The patient presented as a 22 week fetus due to advanced maternal age, maternal cardiomyopathy, and an abnormal 4-chamber view on the fetal anatomy ultrasound. Fetal images were consistent with polyvalvular disease with redundancy of the mitral, tricuspid and aortic valves. There was an extremely abnormal pulmonic valve that was thickened, stenotic, and regurgitant due to relative immobility of the cusps, creating a narrow, tunnel-like orifice and post-stenotic dilated main pulmonary artery. The right …

Semmes Weinstein Sensory Testing At The Fingertip: Should 2.83 Be The Norm?, Emily Moore, Ogochukwu Nwagbologu, Samantha Specht, Rebecca A. Dutton, Patricia Siegel

2020 Pediatric Research Forum Session

Category: In-Progress Research

The Semmes-Weinstein monofilament test (SWM) is an objective test of sensation that is commonly used to identify sensory impairments in the hand.

Objective:

To determine if male and female subjects aged 25 and older with no history of sensory symptoms or known neurologic conditions would feel the 2.83 (normal) Semmes Weinstein monofilament, and if a relationship between the detected monofilament and grip strength exists.

Outcome Measures:

Ability to detect the 2.83 (normal) monofilament at the fingertip. Participants were dichotomized into two groups: the 2.83 “normal” (ability to detect the 2.83 monofilament in three or …

Characterization Of The Intraarticular Cytokine Response In Children With Septic Arthritis, Walter Dehority, Kathryn Helmig, Scott Plaster, Nathan Huff, Andrew Parsons, Selina Silva

2020 Pediatric Research Forum Session

Background:

Acute septic arthritis (ASA) is the most common pediatric orthopaedic infection, and may be associated with severe sequelae. An improved understanding of the intra-articular inflammatory response in ASA may facilitate the use of immunomodulatory agents to attenuate the deleterious effects of the host immunological response on synovial tissue, help monitor disease progression and differentiate ASA from non-infectious arthritides. To our knowledge, no study has characterized the intra-articular cytokine response in children with ASA in detail. Given this, we attempted to validate a multi-plex cytokine assay for use in the blood and synovial fluid of children with ASA.

Methods:

Twelve …

Healers Of Tomorrow Zia Youth Project, Eliana Garcia, Emelia Pino, Anthony Fleg, Daisy Belmares-Ortega, Kevin Dileanis, Talyia Torres

2020 Pediatric Research Forum Session

This youth advocacy effort follows the story of high school student Emelia Pino and Healers of Tomorrow leaders as they work to address health inequities in her home of Zia Pueblo, one of the communities hit hardest in New Mexico by the pandemic.

While taking part in The Healers of Tomorrow Program, a mentorship program for underrepresented high school students, Emelia conveyed the hardships her people were experiencing to program leaders. This kickstarted allied relief efforts in response to rising COVID-19 cases. Emilia and her mentors worked alongside several organizations, including NHI and Protect New Mexico, to gather PPE and …

Effects Of Race/Ethnicity On Appendicitis Pain Management, Alfonso Belmonte, Christal Chow, Maria Heubeck, Deirdre Hill, Harry Snow

2020 Pediatric Research Forum Session

Background:

Race is a well-researched factor that contributes to variation in care of multiple diagnoses such as asthma, antibiotic prescribing, and pain control. This is also true for appendicitis. As the 6th most common cause for inpatient stay, it costs on average of $7,800 per patient. Despite efforts to standardize care, race and ethnicity continue to play a role in treatment and outcomes on pediatric appendicitis.

We hope to further explore the effects that race/ethnicity have in medical care, diagnosis and complications of acute pediatric appendicitis. We hope that identifying these effects will help providers to actively address race/ethnic health …

Ambivalence In How To Address Adolescent Marijuana Use Among School-Based Health Center Providers, Rachel A. Sebastian, Lara M. Gunderson, Cathleen E. Willging, Mary M. Ramos

2020 Pediatric Research Forum Session

Objective:

As part of a larger study to evaluate the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) at school-based health centers (SBHCs), we interviewed SBHC providers regarding their perceptions of substance use among adolescents seen at their SBHCs, experiences providing care for students with substance use and other mental health issues, and their concerns around marijuana specifically.

Methods:

We interviewed 12 primary and behavioral health providers who worked at five SBHCs in New Mexico. The interviews lasted approximately 1 hour and were digitally recorded and professionally transcribed. Two research team members independently analyzed the transcripts. We undertook …

Lamotrigine Overdose Presenting As Shock And Pulmonary Edema, Savannah P. Ellenwood, John A. Mason, Nathaniel E. Link, Robert C. Hellinga, Natasha C. James, Anjali V. Subbaswamy

2020 Pediatric Research Forum Session

Abstract:

Lamotrigine is a broad-spectrum anti-epileptic drug with a good safety profile used to treat general and focal epilepsy. Toxicity is uncommon and usually mild, and symptoms usually include rash, headache, nausea, abdominal pain, somnolence, dizziness, and aggravated seizure activity. More severe adverse reactions are rare, but have been reported and include encephalopathy, hypotension, wide complex tachycardia, cardiac arrest, and death. Lamotrigine drug levels do not consistently correlate with either therapeutic effect or toxicity, though higher levels are thought to have a higher risk of toxicity. Also, the level is typically a send out test with a 1 to 3 …

Ocho Pasos: A Quality Improvement Pilot To Improve Outpatient Clinic Breastfeeding Support, Julia M. Martinez, Timothy J. Ozechowski, Rachel A. Sebastian, Emilie A. Sebesta, Mary M. Ramos

2020 Pediatric Research Forum Session

Purpose of Study:

Only a third of US mothers achieve three months of exclusive breastfeeding (BF) despite the American Academy of Pediatrics (AAP) recommendation to exclusively BF for six months. National experts have recently published evidence-based guidelines for outpatient clinics to support longer durations of BF. Our pilot study sought to evaluate the feasibility of an intervention to improve support for BF in outpatient primary care clinics.

Methods Used:

We compared evidence-based BF-friendly guidelines from the AAP, Academy of Breastfeeding Medicine, California’s 9 Steps, and Washington’s 10 Steps to create Ocho Pasos (Eight Steps),guidelines tailored to the New Mexico population. …

Food And Housing Insecurity Screening Practices Among Unmh Pediatric Providers, Crystal Avila-Schroeder, Kyle Randolph, Lorena Galvan, Ana Duran, Maria Velazquez-Campbell

2020 Pediatric Research Forum Session

Introduction:

The American Academy of Pediatrics recommends food insecurity (FI) screening at all pediatric visits. Despite an existing EMR screening tool, how our pediatric providers screen FI and housing insecurity (HI) is unknown. Our objective was to collect formative data on FI and HI screening practices of UNMH pediatric providers to allow for the design of a quality improvement (QI) project.

Methods:

We performed a baseline cross-sectional survey with UNMH pediatric residents and attendings in May 2020.

Results:

Fifty-two individuals completed the survey (40.4% attendings, 59.6% residents). In inpatient settings, 67.8% of residents and 33.3% of attendings screen FI occasionally …

Screening For And Diagnosing Malnutrition In Hospitalized Pediatric Patients, Samuel Thompson, Erin Lamers-Johnson, Kathryn Kelley, Lindsay Woodcock, Julie Long, Courtney Bliss, Jenica K. Abram, Alison Steiber, Elizabeth Yakes Jimenez

2020 Pediatric Research Forum Session

Background:

Malnutrition is often underdiagnosed, and consequently undertreated, in hospitalized patients. A nationwide study is being conducted to validate indicators (the Malnutrition Clinical Characteristics [MCC]) to diagnose malnutrition in hospitalized patients.

Methods:

For the full study, sixty pediatric hospitals will collect patient medical history, patient STRONGKids malnutrition screening score, and nutrition intervention data. Six hundred pediatric patients will be randomly selected from the cohort to be assessed for the MCC and the Nutrition Focused Physical Exam (NFPE). Medical outcomes will be collected for all patients for a three-month period thereafter. Baseline data from a subset of sites that have started …

Prenatal Alcohol Exposure And Placental Insufficiency Results In Reduced Neuronal Complexity In The Rat Prefrontal Cortex, Nathaniel Pavlik, Jessie Newville, Clement P. Jose, Suzy Davies, Jennifer Wagner, Jonathan Brigman, Daniel Savage, Jessie R. Maxwell

2020 Pediatric Research Forum Session

Prenatal Alcohol Exposure (PAE) can produce long-term neurodevelopmental deficits and impaired executive function. Alcohol exposure during gestation is associated with impaired fetal development caused by placental insufficiency. The impact following PAE and placental insufficiency (PI) remains unknown. Utilizing a three-dimensional (3D) Sholl analysis, we hypothesized that PAE+PI will result in decreased neuronal complexity within the frontal cortex, a region critical to executive functioning.

Pregnant Long-Evans rats voluntarily drank 5% ethanol or saccharin water until embryonic day 18 (E18) to mimic moderate PAE. On E19, a laparotomy was performed to occlude the uterine artery for 60 minutes to induce PI. The …

An Approach To Neutrosophic Dialogue And A Response To Wef's Great Reset: How Dialogue Is Required In Order To Preserve Social Justice With Anger Management, Victor Christianto, Florentin Smarandache

Branch Mathematics and Statistics Faculty and Staff Publications

In recent debates, there are arguments on the role of anger in order to preserve social justice. For instance, in open democracy net, there is promoted phrase: "anger is the language of social justice." Others call for anger fueled with love (Sisonke Msimangs). Is that true? Is it achievable, the so-called "anger with love?"

Racism In Healthcare, Elizabeth Dwyer

Black History at UNM

Living with the daily experience of racism can have direct, adverse effects on the health and wellbeing of Black, Indigenous, and People of Color (BIPOC) communities. Dr. Tracie Collins, former Dean, UNM College of Population Health, and current Secretary of Health of New Mexico, and Dr. Felisha Rohan-Minjares, Professor, UNM’s Department of Family and Community Medicine, explain how bias and racism impact health, treatment, and outcomes.

Sexual Dysfunction After Rectal Cancer Treatment, Sarah M. Popek

Clinical and Translational Science Center Scholarly Output

Introduction: Treatment for rectal cancer results in sexual dysfunction. Sexual function is a component of the HR-QOL (health related quality of life) measures. The incidence of sexual dysfunction following treatment for rectal cancer and its impact on the HR-QOL is not well delineated, particularly on women.

Objectives: To prospectively assess the degree of sexual dysfunction that occurs after treatment for Stage I-III rectal cancer and the corresponding short term (<3 months) and long term (<2 years) effect on the Quality of Life measure for oncology (QOL-30).

Methods: Validated questionnaires will be administered to assess sexual function and quality of life. The International Index of Erectile Dysfunction will be administered to male patients and …

Sustaining Successful Efforts To Increase Home Visiting Referrals, Theresa H. Cruz, Ivy Vitanzos Cervantes, Leona K. Woelk

Reports & Documents

No abstract provided.