Medicine and Health Sciences Commons^™

Study Of Ace And Rage Genes Polymorphism In Children With Type 1 Diabetes Presented By Renal Complications, Maha Atef Tawfik, Marwa Said Tawfik El-Sharawy, Naglaa Fathy Barsem

Menoufia Medical Journal

Objectives: To study the relation between angiotensin I converting enzyme (ACE) and receptor for advanced glycation end products (RAGE) genes in children with type 1 diabetes presented by renal complications. Background: In patients with type 1 diabetes, an association has been found between an insertion/deletion (I/D) polymorphism in the gene for ACE and the presence of diabetic nephropathy. Methods: A cross section study was conducted on 50 Egyptian children with type 1 diabetes presented by renal complications from our endocrinology, genetic unit and outpatient clinic in pediatric department, Menoufia University, during a period time from April 2021 to October 2022. …

Nursing Care Of The Pediatric Patient With Autism, Cayley Frolik

Honors Capstones

The purpose of this project is to help educate current and future nurses on ways to understand and better connect with pediatric patients with autism. Standard nursing curriculum tends to focus primarily on the clinical approach for mainstream patients. In one short year, I recognized a glaring need for nurses to learn how to care for those with autism, as well as how to support and educate their families to create the best environment for whole success. It is very difficult to understand the needs of these specific patients without the proper toolkit. It is my intention to research and …

Microstructural Alterations Of Major Thalamic Nuclei In The Chronic Pediatric Spinal Cord Injured Population, K. Kang, K. Fleming, A. Sathe, J. Muller, J. Harrop, D. Middleton, J. Heller, A. Sharan, F. Mohamed, L. Krisa, M. Alizadeh

Department of Radiology Faculty Papers

BACKGROUND: The brain undergoes reorganization following spinal cord injury (SCI), but little is known about how the thalamus is affected in pediatric SCIs.

PURPOSE: To characterize microstructural alterations in the thalamus after SCI with diffusion tensor imaging (DTI) metrics.

METHODS: 18 pediatric participants with chronic SCI (8-20 years) were stratified using the American Spinal Injury Association Impairment Scale (AIS) into groups: A, B, and C/D. DTI of the brain used a 3 T Siemens Verio MRI using the parameters: 20 directions, number of averages = 3, b = 1000 s/mm

DATA ANALYSIS: DTI metrics were acquired by superimposing the AAL3 …

Acute Stress Disorder And Post-Traumatic Stress Disorder Screening In Pediatric Trauma Patients, Samantha Irizarry, Marian Malone, Megan Waddell

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Two-thirds of U.S. children and adolescents report experiencing one or more potentially traumatic events by age seventeen. 13.4% of the North Carolina pediatric population ages 0-17 have undergone two or more traumatic adverse childhood experiences, compared to 14% of the U.S. population. Early identification reduces the by-products of underdiagnosis of ASD and PTSD, such as mental illness, developmental delays, poor academic performance, and challenges with social interactions.

LOCAL PROBLEM: The project site is a level-one pediatric trauma hospital in Charlotte, North Carolina, seeing more than 130,000 patients annually. Before project implementation, there was an absence of ASD …

Improving Access To Care For Specialty Pediatric Orthopedic Patients: Maximizing Telehealth To Achieve Outcomes, Tammy Keesey

Student Scholarly Projects

Practice Problem: The lack of resources such as transportation, insurance, and finances can negatively impact a patient’s access to much-needed specialty care. Providing education, assessing telehealth literacy, and creating a specific process for identifying appropriate telehealth visits can improve pediatric specialty access to care.

PICOT: The PICOT question for this project was: In pediatric orthopedic clinic patients (P), what is the impact of the active introduction of telehealth as a clinic visit option (I) versus the current standard passive process of scheduling telehealth visits (C) on the rates of access to care (O) after nine total weeks of …

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

A Pulse For Progress – Examining The Efficacy Of Best Nursing Developmental Care Practices For Children With Congenital Heart Disease At Risk For Developmental Delay In The Pcicu: A Prospective Quasi-Experimental Cohort Study, Jasmyn H. Jansen

Nursing | Student Research Posters

This paper examines the efficacy current best developmental care nursing practices in the pediatric cardiac intensive care unit (PCICU) for children with congenital heart disease (CHD). The proposed study explores the implications of the Cardiac Inpatient Neurodevelopmental Care Optimization (CINCO) program, a recent comprehensive developmental care bundle, as a universal implementation for PCICUs.

Barriers To The Diagnosis, Care, And Management Of Pediatric Patients With Ehlers-Danlos Syndrome In The United States: A Qualitative Analysis., William R. Black, Lora L. Black, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Ehlers-Danlos Syndromes (EDS) are a family of heritable connective tissue diseases. Primary practitioners are capable of diagnosing and managing EDS; however, few are knowledgeable and comfortable enough to see patients with EDS, resulting in delays in diagnosis and care. This study explores the barriers physicians experience with diagnosing, managing, and caring for patients with EDS, and potential resolutions to those barriers. Methods: As part of a larger online study, providers (n = 107) in the United States were asked to specify "What information would improve (their) comfort" in diagnosing, caring for, and managing EDS via open-ended questions. Results …

Clinical Factors Associated With Need For Neurosurgical Care In Young Children With Imaging For Macrocephaly: A Case Control Study, Jessica F. Rohde, Jeffrey Campbell, Julie Barbera, Elena Taylor, Ashok Ramachandra, Christopher Gegg, Andrea Scherer, Joseph Piatt

Department of Pediatrics Faculty Papers

BACKGROUND: Macrocephaly is present in 2.3% of children with important neurosurgical conditions in the differential diagnosis. The objective of this study was to identify clinical associations with actionable imaging findings among children with head imaging for macrocephaly.

METHODS: We conducted a case-control study of head imaging studies ordered for macrocephaly among children 24 months and younger in a multistate children's health system. Four neurosurgeons reviewed the images, determining cases to be a 'concern' if neurosurgical follow-up or intervention was indicated. Electronic health records were reviewed to collect patient-level data and to determine if surgery was performed. Controls were matched 3:1 …

How Long Does It Take To Master Laryngeal Visualization Using Flexible Nasolaryngoscopy In Children?, Kieran Boochoon, Julina Ongkasuwan, Annie Ahn, Mary Musso, Yi-Chun Carol Liu

Graduate Medical Education Research Journal

Background: To assess when residents become proficient in performing flexible nasolaryngoscopy (FNL) in the pediatric population.

Objective: To objectively evaluate the quality of FNL by year of residency training.

Methods: Ninety-five pediatric FNL’s were performed by otolaryngology residents and pediatric otolaryngology fellows (postgraduate year [PGY] 1 – 6). Three pediatric otolaryngologists rated the FNL videos (anonymized and without sound) using the Modified Cormack-Lehane scoring system (MCLS). Data analysis was performed using two-way ANOVA and Tukey-Kramer adjustment.

Results: Overall, there was a significant difference in the quality of the FNL based on the year of training (p

Conclusion: The quality …

Risk Factors For Health Impairments In Children After Hospitalization For Acute Covid-19 Or Mis-C., Aline B. Maddux, Cameron C. Young, Suden Kucukak, Laura D. Zambrano, Margaret M. Newhams, Caitlin K. Rollins, Natasha B. Halasa, Shira J. Gertz, Elizabeth H. Mack, Stephanie Schwartz, Michele Kong, Laura L. Loftis, Katherine Irby, Courtney M. Rowan, Keiko M. Tarquinio, Matt S. Zinter, Hillary Crandall, Natalie Z. Cvijanovich, Jennifer E. Schuster, Julie C. Fitzgerald, Mary A. Staat, Charlotte V. Hobbs, Ryan A. Nofziger, Steven Shein, Heidi Flori, Melissa L. Cullimore, Brandon M. Chatani, Emily R. Levy, Katri V. Typpo, Janet R. Hume, Angela P. Campbell, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.

METHODS: Across 25 U.S. Overcoming COVID-19Network hospitals, we conducted a prospective cohort study of patients

RESULTS: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 …

Ut Health Rgv Covid-19 Testing Report, Jefferson T. R. Chandler, Beatriz Tapia

Research Colloquium

Purpose: This health surveillance project's goal was to organize de-identified data received from UT Health RGV with the intent to provide timely reporting to testing sites and health affairs directors. We aimed to explore how testing rates differ between counties, testing sites and age groups from March 30 through August 7, 2020. We looked at different demographics and compared the positivity rates for each testing site. For this report, we will detail information for the pediatric population (ages 0-18).

Materials and Methods: A codebook and database were created with information about COVID-19 test data to formulate reports to the testing …

Rotator Cuff Injury In The Pediatric Population: A Systematic Review Of Patient Characteristics, Treatment, And Outcomes, Kevin J. Orellana, Kathleen L. Harwood, John G. Horneff 3rd, Joseph J. King, Brendan A. Williams

Research Colloquium

Background: Rotator cuff injuries (RCIs), traditionally thought to be an adult-type pathology, have been reported in the pediatric population, but there remains limited evidence regarding this injury pattern in pediatric patients. The purpose of this study was to systematically review the literature to characterize the epidemiology, injury patterns, treatment modalities, and outcomes for pediatric patients with RCIs.

Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines reviewing Pubmed, Embase, Cochrane, and CINAHL databases. Studies reporting imaging confirmed RCIs and treatment outcomes in patientsdemographics, mechanism, injury type and injury location were …

Trauma Center Designation Effects On Clinical Outcomes In Pediatric Dog Bites: A Retrospective Study, Jessy Feng, Sabrina Orta, Alejandro Aquino, Lori Berry, Demba Fofana, Paul Berry

Research Colloquium

Introduction: Clinical outcomes associated with the American College of Surgeons (ACS) trauma center designation have been examined for many conditions. However, we sought to analyze the association between ACS pediatric trauma center designation and outcomes following pediatric dog bite trauma cases, which has rarely been studied.

Methods: The National Trauma Data Bank was queried to identify pediatric (0-19y) dog bite trauma patients admitted to ACS pediatric level I or II trauma centers from 2007-2016. Chi-Squared and Odds Ratio statistical analyses were used to compare the outcomes.

Results:We identified 6,196 pediatric dog bite trauma patients treated at ACS level …

Is Upright Exploratory Play Influenced By Partial Body Weight Support In Infants With Down Syndrome?, Sofia Hardin Spt, Christa Lum Spt, Julia Looper Pt, Phd, Reham Abuatiq, Mia Hoffman, Alyssa Fiss Pt, Phd, Heather Feldner Pt, Phd

Physical Therapy Research Symposium

Is Upright Exploratory Play Influenced by Partial Body Weight Support in Infants with Down Syndrome?

Sofia Hardin, SPT; Christa Lum, SPT

Mentor: Julia Looper, PT, PhD

Background: Children with Down syndrome (DS) typically present with delayed gross motor skills, which may negatively impact their development in other realms, such as cognition and language. The partial body-weight supported system (PBWSS) is a possible early intervention for infants with DS in physical therapy settings and in the community to facilitate motor development through exploratory play.

Purpose: To explore the effects of a PBWSS on upright play positions during exploratory play among infants …

Cardiac Tamponade: Innovative Sternotomy Simulation Model For Training Pediatric Cardiac Intensive Care Team, Tolu Akinpelu, Mohammed Alhendy, Malarvizhi Thangavelu, Karen Weaver, Nicole Muller, James Mcelroy, Daniel Nento, Utpal Bhalala

Research Symposium

Introduction: Cardiac tamponade occurring after cardiac surgery is rare but life threatening and requires simultaneous resuscitation and emergent sternotomy by the intensive care team. A simulated scenario using innovative mannequin with sternotomy wound has the capability of reproducing cardiac arrest associated with postoperative tamponade. We evaluated the face validity of this innovative mannequin, the confidence level and crisis resource management skills of the team during sternotomy to manage postoperative cardiac tamponade.

Methods: The simulation case scenario was developed using innovative sternotomy mannequin for children’s hospital cardiac intensive care unit (CICU) teams. The case involved a 3-year old male, intubated, mechanically …

Trends In Length Of Stay: Experience From A Tertiary Care Pediatric Rehabilitation Unit In Saudi Arabia., Sami Ullah, Ahmad Zaheer Qureshi, Waqas Sami, Amara Ilyas, Sherif Samir Abdelmaksoud Tantawy, Sarah Samir Abdulakarim Alqatari, Hasan Shacfe, Colleen Ann Wunderlich

Internet Journal of Allied Health Sciences and Practice

Background: Pediatric rehabilitation units offer unique challenges due to complex rehabilitation needs of children based on their age group and diagnosis. Length of stay (LOS) is an indirect measure of hospital cost and efficiency of a clinical service and it is important to determine the factors affecting LOS in hospitalized children undergoing inpatient rehabilitation. Methods: Record of 350 children (males: 222, female: 128) who underwent inpatient pediatric rehabilitation program at King Fahad Medical City, Riyadh Saudi Arabia during 2011 to 2018 were reviewed. Diagnoses were categorized into cerebral palsy, spinal cord injury, traumatic brain injury, non-traumatic brain injury and others. …

Radio-Pathomic Approaches In Pediatric Neurooncology: Opportunities And Challenges, Ariana M. Familiar, Aria Mahtabfar, Anahita Fathi Kazerooni, Mahsa Kiani, Arastoo Vossough, Angela Viaene, Philip B. Storm, Adam C. Resnick, Ali Nabavizadeh

Department of Neurosurgery Faculty Papers

With medical software platforms moving to cloud environments with scalable storage and computing, the translation of predictive artificial intelligence (AI) models to aid in clinical decision-making and facilitate personalized medicine for cancer patients is becoming a reality. Medical imaging, namely radiologic and histologic images, has immense analytical potential in neuro-oncology, and models utilizing integrated radiomic and pathomic data may yield a synergistic effect and provide a new modality for precision medicine. At the same time, the ability to harness multi-modal data is met with challenges in aggregating data across medical departments and institutions, as well as significant complexity in modeling …

Barriers And Facilitators Of Family Rules And Routines During Pediatric Cancer Treatment., Carolyn R. Bates, Isabella K. Pallotto, Rachel Moore, Lynne Covitz, Meredith Dreyer

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Pediatric nurses work closely with families of children with new cancer diagnoses and can provide essential supports to promote coping and adjustment. This cross-sectional qualitative study aimed to gather caregiver perspectives on barriers and facilitators to adaptive family functioning during the early phases of cancer treatment, with a focus on family rules and routines.

METHODS: Caregivers (N = 44) of a child diagnosed with cancer and receiving active treatment completed a semi-structured interview about their engagement in family rules and routines. Time since diagnosis was abstracted from the medical record. A multi-pass inductive coding strategy was utilized to extract …

How Did That Get There? A Case Series Of Adolescent Foreign Bodies, Justin Ian Hanson, Paul Bomar, Sarah Kleist, Denver Rogalla, Lori Crihfield, Scott Gutovitz

HCA Healthcare Journal of Medicine

Introduction

Pediatric foreign bodies (FBs) come in many shapes and sizes, and the method by which they enter the body can greatly impact the level of acuity at presentation. Most FBs in children are found in those younger than 5 years old, but the following 3 cases were found in adolescent patients.

Case Presentation

We report on 3 adolescent patients who presented to a single community-based emergency department with the chief complaint of abdominal pain and were found to have complications of abdominal FBs. If undiagnosed, the initial indolent courses of FBs can lead to serious complications, as shown in …

Covid-19 Disease Characterization And Outcomes Comparison In Pediatrics, Rachel Rowland, Abigail Schauble, Brendon Cornett

HCA Healthcare Journal of Medicine

Background

It has been reported that children experience less severe COVID-19 symptoms than adults; however, the literature that supports this idea is evolving. The purpose of this study was to retrospectively characterize hospitalized COVID-19-positive pediatric patients with a focus on the assessment of risk factors for poorer outcomes, mortality, and evaluation of interventions utilized and associated clinical outcomes.

Methods

We conducted a multi-center retrospective chart review of patients 18 years old or younger who were COVID-19 positive and admitted to any US HCA Healthcare Pediatric service line between January 1, 2020, and November 30, 2020. We identified 6081 children across …

How Nurses Perceive Their Task Load When Caring For Behavioral Mental Health Patients In The Pediatric Emergency Department, Emily Cameron, Robert Cornette

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Introduction: Pediatric behavioral mental health patients are being seen more frequently in the emergency department setting. With this ever-growing number of cases comes the need for trained staff, including registered nurses, to care for these children during a mental health crisis. With this increase comes increased stress of nurses’ workload. The purpose of this project was to identify nurses’ perceptions of their workload when completing three identified tasks: communication, procedures, and initial intakes. Methods: The National Aeronautics and Space Administration (NASA) Task Load Index tool was used to measure nurses’ perceptions of how difficult each task was to complete. …

Phosphorus: The Forgotten Electrolyte In The Paediatric Intensive Care Unit, Fady Mohamed Elgendy, Wafaa Abdelaziz Eladrosy, Muhammad Said El-Mekkawy

Menoufia Medical Journal

Objective To evaluate prevalence of hypophosphatemia and hyperphosphatemia and their association with outcome among critically ill children. Background Phosphorus is essential element for various biological functions but data about serum phosphorus level abnormalities among critically ill children are limited. Patients and methods Prospective observational study including children admitted into Pediatric Intensive Care Unit (PICU). Serum phosphorus was measured on admission, day4, day8, and day12. Pediatric Sequential Organ Failure Assessment (pSOFA) score was calculated on admission. Hypophosphatemia and hyperphosphatemia risk factors were determined. Results Hypophosphatemia and hyperphosphatemia were generally non-severe. Hypophosphatemic patients had higher frequency of sepsis on admission compared with …

Assessment Of Serum Copeptin Levels In Pediatric Patients With Sickle Cell Anemia, Mahmoud Ahmed El-Hawy, Amira M.F. Shehata, Basem Abd El-Fattah El-Gazzar, Ahmed Mostafa Ahmed Esmaiel, Mai El-Sayad Abd El-Hamid El-Saeedy

Menoufia Medical Journal

Objectives: To assess the serum copeptin levels in children with Sickle cell anemia. Background: Sickle cell anemia (SCA) is one of the most common hereditary diseases in the world. Copeptin is the C-terminal part of the prohormone for provasopressin and seems clinically relevant in various clinical conditions. Methods: This is a case control study conducted on 62 subjects, 31 pediatric patients with Sickle cell anemia and 31 healthy children, all aged 1 year to 18 to assess the serum copeptin levels in children with Sickle cell anemia. Who attended pediatric hematology clinics of the Menoufia university hospitals, during a period …

Assessment Of Serum Asymmetric Dimethylarginine Level In Children With Beta-Thalassemia, Seham M. Ragab, Sally M. El-Hefnawy, Eman R.A. Selima, Asmaa A. Mohmoud, Sara A. Elshehaby

Menoufia Medical Journal

Objective

The aim was to evaluate serum asymmetric dimethylarginine (ADMA) level in pediatric patients who received a diagnosis of beta-thalassemia as a predictor of endothelial dysfunction.

Background

Beta-thalassemia is one of most common global autosomal recessive disorders. It causes poor growth and skeletal abnormalities along with hemolytic anemia that regularly involves long-term blood transfusions.

Methods

This cross-sectional study included 60 children divided equally in two groups. The patient group was previously diagnosed with beta-thalassemia major (β-TM), and the control group was healthy subjects who were age, sex, and socioeconomically matched with the patient group. Both groups were evaluated regarding complete …

Feasibility Of Establishing A Neonatal Hearing Screening Program And Measuring Hearing Loss Among Neonates In Dakahlia Governorate, Soheir S. Abou El-Ella, Maha A. Tawfik, Naglaa F. Barseem, Reham M. Abobakr

Menoufia Medical Journal

Objectives

The aim was to evaluate the incidence of hearing impairment among neonates in a rural setup and detect permanent hearing impairment of moderate to severe degree in the frequency range important for speech recognition in neonates, at earliest possible time and help to provide appropriate intervention (medical/surgical/rehabilitation) following the detection of a permanent hearing impairment.

Background

Deafness is the most common curable childhood handicap. It is a well-recognized fact that unidentified hearing impairment can adversely affect optimal speech and language development and therefore academic, social, and emotional development. Universal neonatal hearing screening programs have been implemented in many developed …

Copeptin As A Diagnostic And Prognostic Biomarker For Sepsis In Pediatric Intensive Care Unit, Zein A. Omar, Fady M. El-Gendy, Eman A. Badr, Walaa M. Nabil Ibrahim

Menoufia Medical Journal

Objective

Assessment the role of copeptin as a diagnostic and prognostic biomarker for sepsis in a pediatric intensive care unit (PICU).

Background

Copeptin has been proposed as a promising biomarker for the diagnosis and prognosis of pediatric sepsis in patients with systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock.

Patients and methods

This prospective case–control study was conducted on 75 patients with sepsis admitted to the PICU of Menoufia University Hospital and 25 healthy controls. All patients are subjected to a detailed history, physical examination, and laboratory investigations. Pediatric Sequential Organ Failure Assessment, Pediatric Risk of Mortality III …

Role Of Suction-Based Airway Clearance Devices In Pediatric Foreign Body Airway Obstruction, Rebecca Braver

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

• Foreign body airway obstruction (FBAO) represents a significant cause of morbidity and mortality in the pediatric population. Factors including pediatric anatomy, chewing and swallowing difficulties, developmental stages, habits and behaviors, and children’s toys and foods increase risk of FBAO in children.^1,2
• BLS guidelines for FBAO management in responsive children ages 1-8 call for a series of subdiaphragmatic abdominal thrusts, which increase intrathoracic pressure to force air and the foreign body out of the airway.^3,4 Abdominal thrusts have higher reports of injury compared to all other FBAO interventions, with risk of thoracic, vascular, and gastro-esophageal injury.^5-7
• Novel …

Referral Patterns For Pediatric Sports-Related Concussion In One New England Health Care System, Joseph Benert, Amy Haskins Phd, Christina T. Holt, Krystian Bigosinski

Journal of Maine Medical Center

Introduction: Patients with concussion may benefit from care provided by professionals from multiple disciplines based on the constellation of symptoms being reported. This study analyzed referral patterns from primary care and sports medicine clinicians for pediatric patients with sports-related concussion in one health care system.

Methods: A retrospective chart review identified referrals placed to physical therapy, occupational therapy, speech pathology, optometry, psychology, neuropsychology, audiology, neurology, ophthalmology, otolaryngology, psychiatry, and sports medicine for pediatric patients with sports-related concussion. These patients were evaluated at MaineHealth family medicine, internal medicine/pediatrics, pediatrics, and sports medicine clinics in southern Maine between February 2019 and June …

My Happy Baby Is Back: Zero Balancing, Craniosacral Therapy And A Baby’S Journey To Becoming Mobile, Veronica Quarry

Journal of Transformative Touch

Alison began receiving ZB and CST at 13 months of age due to gross motor delays: at that age she was only able to sit somewhat rigidly. After the first session, Alison changed` from being very unhappy and seemingly frustrated to being happy and more calm. Within one month of weekly sessions, Alison was able to be on her tummy, began to crawl, became more agile in seated play, was squatting and standing and took her first steps.