Medicine and Health Sciences Commons^™

Birth Weight And Body Mass Index Z-Score In Childhood Brain Tumors: A Cross-Sectional Study, Kuan-Wen Wang, Russell J De Souza, Adam Fleming, Donna L Johnston, Shayna M Zelcer, Shahrad Rod Rassekh, Sarah Burrow, Lehana Thabane, M Constantine Samaan

Paediatrics Publications

Children with brain tumors (CBT) are at higher risk of cardiovascular disease and type 2 diabetes compared to the general population, in which birth weight is a risk factor for these diseases. However, this is not known in CBT. The primary aim of this study was to explore the association between birth weight and body mass measures in CBT, compared to non-cancer controls. This is a secondary data analysis using cross-sectional data from the CanDECIDE study (n = 78 CBT and n = 133 non-cancer controls). Age, sex, and birth weight (grams) were self-reported, and confirmed through examination of the …

Early Procedural Pain Is Associated With Regionally-Specific Alterations In Thalamic Development In Preterm Neonates., Emma G Duerden, Ruth E Grunau, Ting Guo, Justin Foong, Alexander Pearson, Stephanie Au-Young, Raphael Lavoie, M Mallar Chakravarty, Vann Chau, Anne Synnes, Steven P Miller

Brain and Mind Institute Researchers' Publications

Very preterm human neonates are exposed to numerous invasive procedures as part of life-saving care. Evidence suggests that repetitive neonatal procedural pain precedes long-term alterations in brain development. However, to date the link between pain and brain development has limited temporal and anatomic specificity. We hypothesized that early exposure to painful stimuli during a period of rapid brain development, before pain modulatory systems reach maturity, will predict pronounced changes in thalamic development, and thereby cognitive and motor function. In a prospective cohort study, 155 very preterm neonates (82 males, 73 females) born 24-32 weeks' gestation underwent two MRIs at median …

Fasoracetam In Adolescents With Adhd And Glutamatergic Gene Network Variants Disrupting Mglur Neurotransmitter Signaling., Josephine Elia, Grace Ungal, Charlly Kao, Alexander Ambrosini, Nilsa De Jesus-Rosario, Lene Larsen, Rosetta Chiavacci, Tiancheng Wang, Christine Kurian, Kanani Titchen, Brian Sykes, Sharon Hwang, Bhumi Kumar, Jacqueline Potts, Joshua Davis, Jeffrey Malatack, Emma Slattery, Ganesh Moorthy, Athena Zuppa, Andrew Weller, Enda Byrne, Yun R. Li, Walter K. Kraft, Hakon Hakonarson

Department of Pediatrics Faculty Papers

The glutamatergic neurotransmitter system may play an important role in attention-deficit hyperactivity disorder (ADHD). This 5-week, open-label, single-blind, placebo-controlled study reports the safety, pharmacokinetics and responsiveness of the metabotropic glutamate receptor (mGluR) activator fasoracetam (NFC-1), in 30 adolescents, age 12-17 years with ADHD, harboring mutations in mGluR network genes. Mutation status was double-blinded. A single-dose pharmacokinetic profiling from 50-800 mg was followed by a single-blind placebo at week 1 and subsequent symptom-driven dose advancement up to 400 mg BID for 4 weeks. NFC-1 treatment resulted in significant improvement. Mean Clinical Global Impressions-Improvement (CGI-I) and Severity (CGI-S) scores were, respectively, 3.79 …

Peripheral Quantitative Computed Tomography Detects Differences At The Radius In Prepubertal Children With Cystic Fibrosis Compared To Healthy Controls, Catherine E. O'Brien, Gulnur Com, John L. Fowlkes, Xinyu Tang, Laura P. James

Barnstable Brown Diabetes Center Faculty Publications

Introduction

In 2015, 11.9% of people with cystic fibrosis (CF) in the United States had osteopenia, 5.1% osteoporosis, and 0.3% experienced a fracture. Screening for CF-related bone disease starts in childhood, and dual energy x-ray absorptiometry (DXA) is the recommended method. It is unknown whether peripheral quantitative computed tomography (pQCT) can detect deficits earlier than DXA. This study compared pQCT and DXA scans in a group of pre-pubertal children with CF and healthy controls.

Methods

This was a cross-sectional study of children at Tanner stage 1. A pQCT scan of the radius at proximal and distal sites was performed plus …

Fgf23 And Left Ventricular Hypertrophy In Children With Ckd., Mark M. Mitsnefes, Aisha Betoko, Michael F. Schneider, Isidro B. Salusky, Myles Selig Wolf, Harald Jüppner, Bradley A. Warady, Susan L. Furth, Anthony A. Portale

Manuscripts, Articles, Book Chapters and Other Papers

Background and objectives: High plasma concentration of fibroblast growth factor 23 (FGF23) is a risk factor for left ventricular hypertrophy (LVH) in adults with CKD, and induces myocardial hypertrophy in experimental CKD. We hypothesized that high FGF23 levels associate with a higher prevalence of LVH in children with CKD.

Design, setting, participants, & measurements: We performed echocardiograms and measured plasma C-terminal FGF23 concentrations in 587 children with mild-to-moderate CKD enrolled in the Chronic Kidney Disease in Children (CKiD) study. We used linear and logistic regression to analyze the association of plasma FGF23 with left ventricular mass index (LVMI) and LVH …

Cabot Rings And Marked Anisopoikilocytosis In Imerslund-Gräsbeck Syndrome., Derrick L. Goubeaux, Weijie Li

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Mental Disorder In Children With Physical Conditions: A Pilot Study, Alexandra Butler, Ryan J Van Lieshout, Ellen Louise Lipman, Harriet L Macmillan, Andrea Gonzalez, Jan Willem Gorter, Kathy Georgiades, Kathy N Speechley, Michael H Boyle, Mark A Ferro

Paediatrics Publications

Objectives

Methodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up.

Design

Prospective pilot study.

Setting

Two children's tertiary-care hospitals.

Participants

Children aged 6-16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents.

Outcome Measures

Response, …

Cutaneous Manifestations In The Fingertips After A Supracondylar Humerus Fracture In A 6-Year-Old Girl: A Case Report, Dan M. Quan, Kristin M. Loker, Lauren Mercer, David M. Bennett, Deana M. Mercer

UNM Orthopaedic Research Journal

A 6-year-old girl jumped from a swing and fell on her left arm, presenting to our clinic with a supracondylar fracture of the distal humerus. The child underwent closed reduction and percutaneous pinning. At 3-week follow-up, anterior interosseous nerve palsy was noted with concurrent manifestations in the median nerve distribution. Our patient was treated nonoperatively; at 8-week follow-up spontaneous resolution of cutaneous and motor symptoms was observed. Healthcare professionals should be aware that cutaneous lesions may develop after injury to the median nerve of the proximal forearm, which can result from supracondylar humerus fractures.

Radiographic Features And Remodeling Of Proximal Radius Osteomyelitis In A 14-Month-Old Child With Long-Term Follow-Up: A Case Report, Christopher L. Shultz, Deana M. Mercer

UNM Orthopaedic Research Journal

Pediatric primary hematogenous osteomyelitis is uncommon. Studies have been mainly small case series with limited clinical and radiographic followup. We present a child with primary hematogenous osteomyelitis and osteolysis of the proximal radius. Inflammatory laboratory values were normal, and blood and elbow aspirate cultures were negative for osteomyelitis. Diagnosis was made by findings of magnetic resonance imaging. The patient was successfully treated with intravenous antibiotics. At 4-year follow-up, she had normal range of motion and near symmetric proximal radial morphological features radiographically. To our knowledge, this is the most long-term radiographic follow-up of a patient with spontaneous osteomyelitis. The reported …

Orthopaedic-Based Treatment Of Laurin- Sandrow Syndrome In A 13-Month-Old Child: A Case Report, Marcella R. Woiczik, John C. Carey, David M. Bennett, Brielle Payne Plost

UNM Orthopaedic Research Journal

Laurin-Sandrow syndrome (LSS) is a rare condition with only a few published cases in studies. This syndrome, originally described by Laurin in 1964 and again by Sandrow in 1970, can involve digit duplication with mirror hand and foot deformity, ulnar and tibial dimelia, and abnormalities of the knee, ankle, and nasal passages. A 7-month-old male infant presented to our clinic with limited function of his hands and feet due to multiple abnormalities. Results of clinical and radiographic examinations were suggestive of LSS, confirmed by a geneticist. Amputations through the knees, reconstructive pollicization of the right hand, and surgical removal of …

Disruption To Functional Networks In Neonates With Perinatal Brain Injury Predicts Motor Skills At 8 Months, Annika C Linke, Conor Wild, Leire Zubiaurre-Elorza, Charlotte Herzmann, Hester Duffy, Victor K Han, David S C Lee, Rhodri Cusack

Paediatrics Publications

Objective

Functional connectivity magnetic resonance imaging (fcMRI) of neonates with perinatal brain injury could improve prediction of motor impairment before symptoms manifest, and establish how early brain organization relates to subsequent development. This cohort study is the first to describe and quantitatively assess functional brain networks and their relation to later motor skills in neonates with a diverse range of perinatal brain injuries.

Methods

Infants (n = 65, included in final analyses: n = 53) were recruited from the neonatal intensive care unit (NICU) and were stratified based on their age at birth (prematurevs. term), and on whether neuropathology …

A Guide For Occupational Therapists: Utilizing Trauma-Informed Care To Guide Intervention For Children In Foster Care, Courtney Crabill, Katie Hanson

Occupational Therapy Capstones

The purpose of this scholarly project was to create a guide for trauma-informed interventions for occupational therapists specifically to use with foster care children. Currently, there are approximately 600,000 children living in foster care in the United States (Child Welfare League of America, 2015). Children in the foster system who have experienced or witnessed violent actions often demonstrate post-traumatic stress like symptoms and diagnoses. Often times these experiences affect their development, coping skills, emotional regulation, and relationships and attachments (Lynch et al., 2017; Deutsch et al., 2015; Heim et al., 2010). It is estimated that between 40% and 60% of …

Technoference: Parent Distraction With Technology And Associations With Child Behavior Problems., Brandon T. Mcdaniel Phd, Jenny S Radesky

Health Services and Informatics Research

Heavy parent digital technology use has been associated with suboptimal parent-child interactions, but no studies examine associations with child behavior. This study investigates whether parental problematic technology use is associated with technology-based interruptions in parent-child interactions, termed "technoference," and whether technoference is associated with child behavior problems. Parent reports from 170 U.S. families (child age = 3.04 years) and actor-partner interdependence modeling showed that maternal and paternal problematic digital technology use predicted greater technoference in mother-child and father-child interactions; then, maternal technoference predicted both mothers' and fathers' reports of child externalizing and internalizing behaviors. Results suggest that technological interruptions are …

Management Of Acute Pancreatitis In The Pediatric Population: A Clinical Report From The North American Society For Pediatric Gastroenterology, Hepatology And Nutrition Pancreas Committee., M. Abu-El-Haija, S. Kumar, J. A. Quiros, K. Balakrishnan, B. Barth, S. Bitton, J. F. Eisses, E. J. Foglio, V. Fox, V. D. Morinville, +10 Additional Authors

Journal Articles

BACKGROUND:Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS:The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using several preselected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed. The authorship met to discuss the evidence, statements, and voted on recommendations. A consensus of at least 75% was required to approve a recommendation. RESULTS:The diagnosis of pediatric AP should follow the published INternational Study …

Is Video Game-Based Therapy Effective In Increasing The Physical Abilities Of Children Diagnosed With Cerebral Palsy?, Alycia K. Ramsey

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not video game-based therapy is effective in increasing the physical abilities of children diagnosed with cerebral palsy.

STUDY DESIGN: Systematic review of three English language randomized controlled trials (RCTs), all published after 2006.

DATA SOURCES: Two cross-over RCTs and one single-blind RCT, which analyzed video game-based therapy in children diagnosed with cerebral palsy. All studies were found using PubMed.

OUTCOME MEASURED: Each of the articles analyzed the effects of video game-based therapy on physical abilities, which were assessed by upper limb function, stable balance, and coordination. These …

Temporal And Geospatial Trends Of Pediatric Cancer Incidence In Nebraska Over A 24-Year Period, Evi A. Farazi, Shinobu Watanabe-Galloway, L. Westman, B. Rettig, P. Hunt, R. Cammack, John W. Sparks, Don W. Coulter

Journal Articles: Epidemiology

BACKGROUND: Data from the Surveillance, Epidemiology, and End Results (SEER) revealed that the incidence of pediatric cancer in Nebraska exceeded the national average during 2009-2013. Further investigation could help understand these patterns.

METHODS: This retrospective cohort study investigated pediatric cancer (0-19 years old) age adjusted incidence rates (AAR) in Nebraska using the Nebraska Cancer Registry. SEER AARs were also calculated as a proxy for pediatric cancer incidence in the United States (1990-2013) and compared to the Nebraska data. Geographic Information System (GIS) mapping was also used to display the spatial distribution of cancer in Nebraska at the county level. Finally, …

Shared Genetic And Environmental Influences On Fear, Anxiety, Posttraumatic Stress, And Brain Morphometry, Chelsea Sawyers

Theses and Dissertations

Anxiety disorders (ADs) and stress-related disorders are some of the most common psychiatric disorders in the United States. Like other c0mplex psychiatric illness, genetics and neuroimaging research has focused on understanding their underlying neurobiology. Areas within the fear-network play important roles in threat perception, fear conditioning/learning, cognitive processing, and modulation of fear responses including contextual modulation and extinction and have been implicated in ADs as well as stress disorders such as posttraumatic stress disorder (PTSD). The primary gap in the current search for underlying biological mechanisms is in whether biomarkers associated with disorders share genetic influences with the disorders they …

Use Of Caudal Epidural Catheter In A Child With Cerebral Palsy With Prior Posterior Spine (T1-Sacrum) Fusion., Divya Dixit, Mary C. Theroux, Kirk W. Dabney, Freeman Miller

Department of Anesthesiology Faculty Papers

No abstract provided.

The S.P.I.R.I.T. Program: Spirituality Promotion Interdependence Resiliency Inclusive Therapy, Alycia Heisler, Brianna Safranski

Occupational Therapy Capstones

Purpose: Native American children and adolescents are some of the most underserved people in the United States (Warzak, Dogan, & Godfrey, 2011). Common mental health problems this population typically experiences are depression, suicidal thoughts or ideation, traumatic experiences, substance use, and results of historical trauma (Brockie, Dana-Sarco, Wallen, Wilcox, & Campbell, 2015). They have the highest rates of these mental health problems, more than any other ethnic group (Evans-Campbell, Walters, Pearson, & Campbell, 2012). There is a need for preventative programs to be implemented with elementary school-aged Native American children and adolescents (Ohl, Mitchell, Cassidy, & Fox, 2008; Stigler, …

Occupational Therapy Practice Trends For Occupations Impacted By Puberty In Children With Asd, Sydney Larson, Kelsey Hemberger

Occupational Therapy Capstones

Introduction: Adolescents face physical, social, cognitive, and emotional changes during the developmental stage of puberty. Pubertal changes can be difficult for neurotypical adolescents to cope with, but especially for individuals with autism spectrum disorder (ASD). Specifically, adolescents with ASD experience challenges with adapting to physical and emotional changes, managing new hygiene routines, abiding to social norms, and inappropriate sexual behaviors (Beddows & Brooks, 2016; Cridland, Caputi, Jones, & Magee, 2015; Cridland, Jones, Caputi, & Magee, 2014). While occupational therapy plays a role in helping adolescents with ASD, a lack of occupational therapy literature on this topic leads to unknown …

Inter-Rater Agreement And Validity Of A Tackling Performance Assessment Scale In Youth American Football, Eric Schussler, Richard J. Jagacinski, Susan E. White, Ajit M. Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Long term neurologic injury and concussion have been identified as risks from participation in American football. Altering tackling form has been recommended to reduce the risk of neurologic injury caused by head accelerations when tackling. The purpose of this research is to determine the inter-rater agreement and validity of the Qualitative Youth Tackling System (QYTS), a six-item feedback scale to correct tackling form, when utilized by novice and expert raters.

Hypothesis: Experienced raters will have higher levels of agreement with each other and with motion capture when compared to novice raters. Methods: Both novice and experienced raters viewed video …

Schistosoma Mansoni And Other Intestinal Parasitic Infections In Schoolchildren And Vervet Monkeys In Lake Ziway Area, Ethiopia, Dejene Teklemariam, Mengistu Legesse, Abraham Degarege, Song Liang, Berhanu Erko

Journal Articles: Epidemiology

OBJECTIVE: To assess Schistosoma mansoni and other intestinal parasitic infections in schoolchildren and vervet monkeys (Chlorocebus aethiops) in Bochessa Village, Ziway, Ethiopia.

RESULTS: Fecal specimens from selected schoolchildren and droppings of the vervet monkeys were collected and microscopically examined for intestinal parasites using the Kato-Katz thick smear and formol-ether concentration techniques. The prevalences of S. mansoni, Trichuris trichiura, Ascaris lumbricoides, Enterobius vermicularis, hookworms, Hymenolepis nana and Taenia species among the children were 35.7, 26.9, 24.1, 2.1, 2.1, 1.07 and 2.1%, respectively (by Kato-Katz) and 39.3, 36.1, 35.6, 2.9, 10.0, 4.3, and 2.9%, respectively (by formol-ether concentration). Prevalence of S. mansoni …

Interrelationships Of Functional Status And Health Conditions In Children With Cerebral Palsy: A Descriptive Study., Doreen Bartlett, Emily Dyszuk, Barbara Galuppi, Jan Willem Gorter

Physical Therapy Publications

PURPOSE: To examine the relationship among the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS) in children with cerebral palsy (CP) and to determine the average number and effect of health conditions.

METHODS: Participants were 671 children with CP aged 2 to 12 years from Canada and the United States. Cross-tabulation of functional classifications and averages were computed for the number and impact of health conditions and comparisons among groups.

RESULTS: A total of 78 of the 125 possible classification combinations were recorded. Most frequent were GMFCS I, MACS …

Risk Factors For Short- And Long-Term Outcomes In Children With Stec-Hus/D, Judith Sebestyen Vansickle, Tarak Srivastava, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Background. Hemolytic uremic syndrome (HUS) is one of the common causes for acute kidney injury in childhood. Objective. The goals of our study were to identify risk factors for short-term complications and long-term outcomes of chronic kidney disease (CKD) in Shiga toxin-producing Escherichia coli (STEC)-HUS and other diarrhea positive (D+) HUS. Methods. Retrospective chart review was obtained of 58 pediatric patients treated for STEC-HUS and other D+ HUS between February 2002 and January 2011. Results. Thirty-three patients (56.9%) required dialysis. Dialysis was more likely initiated if a patient was a female (P < .012), oliguric (urine output < 0.5 mL/kg/h, P < .0005), or hemoglobin (HGB) level >10 g/dL …

Assessing Asthma-Specific Health-Related Quality Of Life In Children With An Ecological Systems Approach, Jamyia Clark

Walden Dissertations and Doctoral Studies

Despite initiatives and management efforts to minimize exacerbation and adverse outcomes, asthma remains a leading cause of childhood chronic disease in the United States. Environmental, personal, and social factors have been associated with an increase of asthma morbidity. However, little is known about how they cumulatively affect children's quality of life. This study applied a multifactorial conceptual model grounded by the ecological systems theory framework to ascertain which environmental, personal, and social factors were cumulatively associated with adverse health-related quality of life (HRQoL) in children with asthma ages 5-17 years. A national, cross-sectional survey, the Behavioral Risk Factor Surveillance System …

An Epidemiological Study Of Pediatric Sports And Recreational Injuries Reporting To The Emergency Room In Grand Forks, Nd, Carly Bertsch, Lucas Dolan

Physical Therapy Scholarly Projects

PROBLEM: The purpose of this research study is to evaluate the emergency room records from Altru Health System in Grand Forks, ND from 2011-2015 to find trends in pediatric injuries from the ages of 0-19. The justification for the study is to provide Grand Forks with information about the frequency and distribution of pediatric sports and recreational injuries. No injury surveillance system has been implemented to monitor youth injuries, but his study is a continuation of a previous 10-year study and the combining of the two time frames would result in a 15-year compilation of data. By using descriptive data …

Generationactive: Creating Healthier Communities Two Generations At A Time, Jerrica Thiel, Mallory Manecke

Occupational Therapy Capstones

Obesity has become an epidemic across all ages, as the prevalence of obesity has nearly tripled over the last 40 years (World Health Organization, 2017-a). Obesity can have a detrimental impact on the health and future of Americans, as many diseases are correlated with obesity. Diabetes, which often occurs secondary to obesity and is the 7th leading cause of death in America, is similarly on the rise (CDC, 2012). To combat these issues, there is a great need for a health promotion initiative that provides individuals of all ages an opportunity to learn about health and wellness, to take steps …

Vitamin E Status Is Inversely Associated With Risk Of Incident Tuberculosis Disease Among Household Contacts, Omowunmi Aibana, Molly F Franke, Chuan-Chin Huang, Jerome T Galea, Roger Calderon, Zibiao Zhang, Mercedes C Becerra, Emily R Smith, Carmen Contreras, Rosa Yataco, Leonid Lecca, Megan B Murray

Journal Articles

BACKGROUND: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression.

OBJECTIVE: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk.

METHODS: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on …

Practice Survey: Adherence Monitoring And Intervention In Pediatric Gastroenterology And Hepatology., Michele H. Maddux, Shawna Ricks, Julie A. Bass, James F. Daniel, Ellen Carpenter, Kimberely Radford

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.

Participants and methods: One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.

Results: Practices varied greatly in terms of when and how …

Clinical Features Of Guillain-Barré Syndrome With Vs Without Zika Virus Infection, Puerto Rico, 2016, Emilio Dirlikov, Chelsea G. Major, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge L. Muñoz-Jordan, Candimar Colon-Sanchez, Myriam Garcia, Marangely Olivero-Segarra, Graciela Malave, Gloria M. Rodríguez-Vega, Dana L. Thomas, Stephen H. Waterman, James J. Sejvar, Carlos A. Luciano, Tyler M. Sharp, Brenda Rivera-García

Journal Articles: Epidemiology

Importance: The pathophysiologic mechanisms of Guillain-Barré syndrome (GBS) associated with Zika virus (ZIKV) infection may be indicated by differences in clinical features.

Objective: To identify specific clinical features of GBS associated with ZIKV infection.

Design, Setting, and Participants: During the ZIKV epidemic in Puerto Rico, prospective and retrospective strategies were used to identify patients with GBS who had neurologic illness onset in 2016 and were hospitalized at all 57 nonspecialized hospitals and 2 rehabilitation centers in Puerto Rico. Guillain-Barré syndrome diagnosis was confirmed via medical record review using the Brighton Collaboration criteria. Specimens (serum, urine, cerebrospinal fluid, and saliva) from …