Digital Commons Network^™

Health Care Transitions For Adolescents And Young Adults With Special Health Care Needs: Where Are We Now?, Nicole Mubanga, Dennis J. Baumgardner, Jessica J. F. Kram

Dennis J. Baumgardner, MD

Eventually, all adolescents must “graduate” from pediatric-oriented to adult-oriented health care. This transition, most often occurring during young adulthood, is especially important for adolescents with special health care needs and involves not only primary care physicians, but also both pediatric and adult subspecialists. Several studies support the benefit of transitional programs for adolescents and young adults with special health care needs. Additionally, the American Academy of Pediatrics named transitional care as one of its top priorities. However, transitional programs have yet to become an established norm among hospitals and providers, specifically outside of children’s hospitals. This topic synopsis aims to …

Vitamin D Status In Pediatric Irritable Bowel Syndrome, Benjamin U. Nwosu, Louise Maranda, Ninfa Candela

Benjamin U. Nwosu

IMPORTANCE: Irritable bowel syndrome (IBS) is associated with significant morbidity in children and adolescents, and the therapeutic efficacy of available treatment options is limited. The role of vitamin D supplementation in pediatric IBS is unclear as the vitamin D status of pediatric patients with IBS is unknown. Equally, the relationship of vitamin D status with psychosomatic symptoms in children and adolescents is unclear. AIM: To characterize the vitamin D status of pediatric patients with IBS using a case-control study design. HYPOTHESIS: Serum 25-hydroxyvitamin D [25(OH)D] concentration will be similar between patients with IBS and controls. SUBJECTS AND METHODS: A retrospective …

Late-Occurring Vancomycin-Associated Acute Kidney Injury In Children Receiving Prolonged Therapy, Chad A. Knoderer, Allison L. Gritzman, Kristen R. Nichols, Amy C. Wilson

Kristen R. Nichols

Background: Acute kidney injury (AKI) in patients receiving vancomycin has been associated with trough concentrations ≥15 mg/L and longer therapy duration. The objective of this study was to determine the incidence and factors associated with late AKI in children receiving ≥8 days of vancomycin therapy. Methods: Children aged 30 days to 17 years who were admitted to our institution and received intravenous vancomycin for at least 8 days during January to December of 2007 and 2010 and had a suspected or proven gram-positive infection were included. Late AKI was categorized as AKI occurring after the first 7 days of therapy …

Asthma Knowledge, Control, And Administration Techniques In Hispanic Caregivers Of Pediatrics, Kelly J. Wright, Joshua Arnold, Rachel Culp, Kyle Hultz, Benjamin Robertson, Jon Wilkie, Amy Wuobio

Kelly J. Wright, R.Ph., Pharm.D.

Objectives: The objectives of this study were to (1) describe asthma knowledge, control, and administration techniques in Hispanic caregivers of pediatric asthma patients in primary care clinics and (2) determine the association between asthma knowledge and control. Methods: A pilot, cross-sectional study was conducted by administering a survey to Spanish-speaking primary caregivers of children under 12 years old with a current diagnosis of asthma. The survey contained: demographic questions (8 items), a modified version of the Asthma Control Test (ACT, 5 self-assessment items, 5-point, Likert-type scale), knowledge (21 items, correct/incorrect response), and inhaler use (1 item, rank ordering steps for …

Outcomes Of Extended-Infusion Piperacillin/Tazobactam In Pediatric Patients., Kristen R. Nichols, Katie Andricopulos, Ashley S. Crumby, Elaine G. Cox, Chad A. Knoderer

Kristen R. Nichols

Poster presented at: ID Week 2013, October 2013, San Francisco, California.

Linezolid-Associated Thrombocytopenia In Children With Renal Impairment, Chad A. Knoderer, Kristen R. Nichols, Heather L. Deyoung, Sara J. Jones, Elaine G. Cox

Kristen R. Nichols

Poster presented at ID Week, October 2013, San Francisco, California.

Use Of Sildenafil To Facilitate Weaning From Inhaled Nitric Oxide In Children With Pulmonary Hypertension Following Surgery For Congenital Heart Disease, Jaclyn E. Lee, Simon C. Hillier, Chad A. Knoderer

Chad A. Knoderer

Pulmonary hypertension frequently complicates the postoperative management of patients after congenital cardiac surgery. Inhaled nitric oxide is an effective treatment option, but rebound pulmonary hypertension can occur upon its withdrawal. Sildenafil may facilitate its withdrawal by restoring cyclic guanosine monophosphate availability via phosphodiesterase-5 inhibition. The purpose of this study was to evaluate the use of sildenafil in facilitating weaning from inhaled nitric oxide after congenital cardiac surgery in patients who had previously failed weaning, and to compare the effects of sildenafil on pulmonary and systemic hemodynamics. Children who received sildenafil after cardiovascular surgery during a 23-month period at Riley Hospital …

Linezolid-Associated Thrombocytopenia In Children With Renal Impairment, Chad A. Knoderer, Kristen R. Nichols, Heather L. Deyoung, Sara J. Jones, Elaine G. Cox

Chad A. Knoderer

Poster presented at ID Week, October 2013, San Francisco, California.

A Randomized, Controlled Trial Of Catheter-Related Infectious Event Rates Using Antibiotic-Impregnated Catheters Versus Conventional Catheters In Pediatric Cardiovascular Surgery Patients, Elaine G. Cox, Chad A. Knoderer, Aimee Jennings, John W. Brown, Mark D. Rodefeld, Scott G. Walker, Mark W. Turrentine

Chad A. Knoderer

We conducted a randomized, controlled clinical trial to determine whether a difference in catheter-associated blood stream infection (CABSI) incidence existed between children who underwent cardiac surgery and had a central venous catheter impregnated with minocycline and rifampin versus those who had a conventional, nonimpregnated catheter after cardiac surgery. Due to a lower number of infections than expected, the study was terminated early. Among 288 evaluable patients, the rates of CABSI and line-related complications were similar between the 2 groups.

Impact Of Decmedetomidine On Opioid And Benzodiazepine Dosing Requirements In Children., Amy E. Helvie, Chad A. Knoderer, Iftekhar D. Kalsekar, Brandon T. Kibby, Michael S. Mazurek

Chad A. Knoderer

Poster presented at: Annual Update on Pediatric Cardiovascular Disease; February 2008; Scottsdale Arizona.

Clinical Issues Surrounding Once-Daily Aminoglycoside Dosing In Children, Chad A. Knoderer, Julie A. Everett, William F. Buss

Chad A. Knoderer

Aminoglycoside antibiotics are first-line treatment for many infectious diseases in the pediatric population and are effective in adults. The traditional dosing interval in children is every 8–12 hours. Studies in adults reported equivalent efficacy and equal or less toxicity with once-daily regimens. Despite many studies in the adult population, this approach has yet to become standard practice in most pediatric hospitals. Reasons for lack of acceptance of this strategy in children include rapid aminoglycoside clearance, unknown duration of postantibiotic effect, safety concerns, and limited clinical and efficacy data.

Chronic Outpatient Sildenafil Therapy For Pulmonary Hypertension In A Child After Cardiac Surgery, Chad A. Knoderer, E. S. Ebenroth, J. W. Brown

Chad A. Knoderer

We report the case of a 14-month-old male with d-transposition of the great arteries, ventricular septal defect, and pulmonary hypertension successfully treated with long-term sildenafil following cardiac surgery. To our knowledge, this is the first published report of long-term sildenafil treatment in a child after corrective cardiac surgery.

Fenoldapam For Acute Kidney Injury In Children, Chad A. Knoderer, Jeffrey D. Leiser, Corina Nailescu, Mark W. Turrentine, Sharon P. Andreoli

Chad A. Knoderer

We report two cases of children with severe cardiomyopathy requiring treatment with ventricular assist devices who developed acute kidney injury and were treated with fenoldopam. Therapy with fenoldopam appeared successful in one case in that renal replacement therapy was avoided with improvement in urine output and renal function. These are the first reported cases of fenoldopam use in children with acute kidney injury receiving mechanical circulatory support.

Improving Cultural Approaches To Pediatric Palliative Care In Central Massachusetts, Nancy E. Harger, Rn, Ms Lis, Usmani Naheed, Md, Jennifer Costa, Pnp, Estela Mcdonough

Nancy E. Harger

Objectives: To determine the impact of a web tool developed to improve health care providers' ability and comfort in caring for a diverse patient population in the hospital setting. Methods: The pediatric palliative care team including a pediatric oncologist and a nurse practitioner in association with a clinical medical librarian and a hospital-based interpreter, collaborated to create a resource using SpringShare software to create a library guide. The purpose is to provide cultural and palliative care information resources, books, and journal articles to assist health care workers at UMass Memorial Children's Medical Center in caring for children from the diverse …

The Use Of A Kiosk-Model Bilingual Self-Triage System In The Pediatric Emergency Department, Madhumita Sinha, Kai-Ning Khor, Ashish Amresh, David Drachman, Alan Frechette

Ashish Amresh

Tummy Ache, Vomiting, Diarrhea, Oh My! Pediatric Gastroenteritis, Erik E. Langenau

Erik E. Langenau

A review of the incidence, recognition, and treatment of childhood Acute Gastroenteritis (AGE) in the United States.

Implementing Infant Hearing Screening At Maternal And Child Health Clinics: Context And Interactional Processes, De Wet Swanepoel, René Hugo, Brenda Louw

Brenda Louw