Medicine and Health Sciences Commons^™

Working Towards Inclusive And Equitable Trauma Treatment Guidelines: A Child-Centered Reflection, Eva Alisic, Jessica Roth, Vanessa Cobham, Rowena Conroy, Alexandra De Young, Gertrud Hafstad, Tobias Hecker, Rachel Hiller, Nancy Kassam-Adams, Betty Lai, Markus Landolt, Meghan L. Marsac, Soraya Seedat, David Trickey

Pediatrics Faculty Publications

Clinical practice guidelines, such as those focusing on traumatic stress treatment, can play an important role in promoting inclusion and equity. Based on a review of 14 international trauma treatment guidance documents that explicitly mentioned children, we reflect on two areas in which these guidelines can become more inclusive and equitable; a) representation of children's cultural background and b) children's opportunity to have their voice heard. While a few guidelines mentioned that treatment should be tailored to children's cultural needs, there was little guidance on how this could be done. Moreover, there still appears to be a strong white Western …

Potential Consequences Of The Red Blood Cell Storage Lesion On Cardiac Electrophysiology, Marissa Reilly, Chantel D. Bruno, Tomas M. Prudencio, Nina Ciccarelli, Devon Guerrelli, Raj Nair, Manelle Ramadan, Naomi L C Luban, Nikki Gillum Posnack

Pediatrics Faculty Publications

No abstract provided.

Balloon Atrial Septostomy As Initial Therapy In Pediatric Pulmonary Hypertension, Paul J. Critser, Patrick D. Evers, Eimear Mcgovern, Michelle Cash, Russel Hirsch

Pediatrics Faculty Publications

Balloon atrial septostomy is a palliative procedure currently used to bridge medically refractory pulmonary hypertension patients to lung transplantation. In the current report, we present balloon atrial septostomy as an initial therapy for high-risk pediatric pulmonary hypertension patients at our institution. Nineteen patients with median age of 4.3 years (range 0.1-14.3 years) underwent balloon atrial septostomy during initial admission for pulmonary hypertension. There were no procedural complications or deaths within 24 h of balloon atrial septostomy. Patients were followed for a median of 2.6 years (interquartile range 1.0-4.8 years). Three (16%) patients died, 3 (16%) underwent lung transplantation, and 1 …

Spotlight Commentary: Why We Need To Pay Attention To Toxicity Associated With Herbal Medicines, Elena Y. Enioutina, Kathleen M. Job, Catherine M.T. Sherwin

Pediatrics Faculty Publications

No abstract provided.

Renal Survival In Children With Glomerulonephritis With Crescents: A Pediatric Nephrology Research Consortium Cohort Study, Joseph G. Maliakkal, M. John Hicks, Mini Michael, David T. Selewski, Katherine Twombley, Michelle N. Rheault, Meredith Seamon, Jason M. Misurac, Cheryl L. Tran, Loretta Reyes, Joseph T. Flynn, Ali M. Onder, Alexandru R. Constantinescu, Vaishali Singh, Cynthia Pan, Abiodun Aderogba Omoloja, Qiang Wu, William E. Smoyer, Guillermo Hidalgo, Scott E. Wenderfer

Pediatrics Faculty Publications

There is no evidence-based definition for diagnosing crescentic glomerulonephritis. The prognostic implications of crescentic lesions on kidney biopsy have not been quantified. Our objective was to determine risk factors for end-stage kidney disease (ESKD) in patients with glomerulonephritis and crescents on kidney biopsy. A query of the Pediatric Nephrology Research Consortium’s Pediatric Glomerulonephritis with Crescents registry identified 305 patients from 15 centers. A retrospective cohort study was performed with ESKD as the primary outcome. Median age at biopsy was 11 years (range 1–21). The percentage of crescents was 3–100% (median 20%). Etiologies included IgA nephropathy (23%), lupus (21%), IgA vasculitis …

Evolving Role For Pharmacotherapy In Nafld/Nash, Suzanna L. Attia, Samir Softic, Marialena Mouzaki

Pediatrics Faculty Publications

Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent, dynamic disease that occurs across the age spectrum and can lead to cirrhosis and hepatocellular carcinoma. There are currently no US Food and Drug Administration (FDA) approved treatments for NAFLD; however, this is a field of active research. This review summarizes emerging pharmacotherapies for the treatment of adult and pediatric NAFLD. Investigated pharmacotherapies predominantly target bile acid signaling, insulin resistance, and lipid handling within the liver. Three drugs have gone on to phase III trials for which results are available. Of those, obeticholic acid is the single agent that demonstrates promise …

Intraoperative Laser Speckle Contrast Imaging For Real-Time Visualization Of Cerebral Blood Flow In Cerebrovascular Surgery: Results From Pre-Clinical Studies., Antonella Mangraviti, Francesco Volpin, Jaepyeong Cha, Samantha I Cunningham, Karan Raje, M Jason Brooke, Henry Brem, Alessandro Olivi, Judy Huang, Betty M Tyler, Abhishek Rege

Pediatrics Faculty Publications

No abstract provided.

Association Of A Simplified Finnegan Neonatal Abstinence Scoring Tool With The Need For Pharmacologic Treatment For Neonatal Abstinence Syndrome, Lori A. Devlin, Janis L. Breeze, Norma Terrin, Enrique Gomez Pomar, Henrietta S. Bada, Loretta P. Finnegan, Kevin E. O'Grady, Hendrée E. Jones, Barry Lester, Jonathan M. Davis

Pediatrics Faculty Publications

Importance: Observer-rated scales, such as the Finnegan Neonatal Abstinence Scoring Tool (FNAST), are used to quantify the severity of neonatal abstinence syndrome (NAS) and guide pharmacologic therapy. The FNAST, a comprehensive 21-item assessment tool, was developed for research and subsequently integrated into clinical practice; a simpler tool, designed to account for clinically meaningful outcomes, is urgently needed to standardize assessment.

Objectives: To identify FNAST items independently associated with the decision to use pharmacologic therapy and to simplify the FNAST while minimizing loss of information for the treatment decision.

Design, Setting, and Participants: This multisite cohort study included 424 neonates …

Perinatal Drug Abuse And Neonatal Drug Withdrawal, Samarth Shukla, Lisa B. Zirkin, Enrique Gomez Pomar

Pediatrics Faculty Publications

Drug abuse and addiction have significantly increased over the last few decades; specifically, opioid abuse and dependence have increased to epidemic proportions. This increased use of drugs includes women of childbearing age and those who are pregnant. Drug abuse during pregnancy is a serious health risk for both mother and newborn infant. Infants exposed to maternal drugs in fetal life develop signs of drug withdrawal during early neonatal life. This group of withdrawal signs is known as neonatal abstinence syndrome (NAS). Although NAS is not a fatal condition, it results in significant illness and prolonged hospitalization.

Investigation Into The Reproducibility Of The Association Of Cord Blood Magnesium Concentration And Cerebral Palsy Or Death In Children, Christopher Luke Dixon, Xiaoxi Liu, Alfred Balch, Maged Costantine, Catherine M. Sherwin

Pediatrics Faculty Publications

Objective: To evaluate the association of cord blood magnesium concentrations at the time of birth with cerebral palsy (CP) and neonatal death. Study Design: A secondary analysis of a randomized controlled trial that randomized women at imminent risk of delivery between 24 and 31 weeks of gestation to receive magnesium sulfate or placebo. This ‘study’s primary outcome was a composite of either moderate to severe CP or death. Secondary outcomes included CP, moderate to severe CP, neonatal death, and neonatal head ultrasound findings. We used a logistic regression model to evaluate the relationship between the concentration of magnesium in cord …

The Reliability Of Histamine Pharmacodynamic Response Phenotype Classification In Children With Allergic Disease., Kumar Ss, Liu X, Sherwin Cm, Jones Bl

Pediatrics Faculty Publications

We have identified distinct histamine pharmacodynamic response phenotypes in children with allergic disease utilizing histamine iontophoresis with laser Doppler (HILD). These response phenotypes may be relevant in guiding therapeutic decision making for agents targeting the allergic response pathways. However, the reliability of these response phenotypes has not been assessed. Therefore, we performed HILD in children with allergic rhinitis and/or asthma on two to three separate occasions. HILD response-time data were analyzed in NONMEM using a linked effect PKPD model. Examination of observed vs. classified response phenotypes predicted response plots and the sum of residuals. The intraclass correlation coefficient (ICC) was …

Development Of An International Data Repository And Research Resource: The Prospective Studies Of Acute Child Trauma And Recovery (Pact/R) Data Archive, Nancy Kassam-Adams, Justin A. Kenardy, Douglas L. Delahanty, Meghan L. Marsac, Richard Meiser-Stedman, Reginald D. V. Nixon, Markus A. Landolt, Patrick A. Palmieri

Pediatrics Faculty Publications

Background: Studies that identify children after acute trauma and prospectively track risk/protective factors and trauma responses over time are resource-intensive; small sample sizes often limit power and generalizability. The Prospective studies of Acute Child Trauma and Recovery (PACT/R) Data Archive was created to facilitate more robust integrative cross-study data analyses.

Objectives: To (a) describe creation of this research resource, including harmonization of key variables; (b) describe key study- and participant-level variables; and (c) examine retention to follow-up across studies.

Methods: For the first 30 studies in the Archive, we described study-level (design factors, retention rates) and participant-level …

Therapeutic Potential Of Citrulline As An Arginine Supplement: A Clinical Pharmacology Review, Jahidur Rashid, Shaun S. Kumar, Kathleen M. Job, Xiaoxi Liu, Candice D. Fike, Catherine M. T. Sherwin

Pediatrics Faculty Publications

Supplemental arginine has shown promise as a safe therapeutic option to improve endogenous nitric oxide (NO) regulation in cardiovascular diseases associated with endothelial dysfunction. L-arginine, an endogenous amino acid, was reported in clinical studies in adults to improve cardiovascular function in hypertension, pulmonary hypertension, pre-eclampsia, angina, and mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome. L-citrulline, a natural precursor of L-arginine, is more bioavailable than L-arginine because of hepatic first-pass metabolism avoidance and longer circulation time. Although not yet well studied, arginine/citrulline has immense therapeutic potential in some life-threatening diseases of children. However, optimal clinical development of arginine or …