Pediatrics Commons^™

Risk Factors For Unplanned Readmissions In Paediatric Neurosurgery: A Systematic Review Protocol, Lance Vincent Caburian Sese, Ma Celina Legaspi Guillermo

Ateneo School of Medicine and Public Health Publications

Introduction Unplanned hospital readmission (UHR) following surgical procedures reflects patient outcomes. While adult readmission studies are abundant, limited research exists in paediatric populations, especially in the context of neurosurgery. Methods and analysis This protocol outlines a systematic review aimed at identifying reasons for unplanned readmissions (30-day and 90-day readmissions) and risk factors following paediatric neurosurgical procedures. Narrative synthesis, sensitivity analyses, subgroup analyses, and meta-analysis, when appropriate, will be done. Ethics and dissemination There are no primary data involved and no access to confidential patient information. The findings aim to contribute to refining clinical practice, enhance patient counselling, and optimise healthcare …

Iron Oxide-Coupled Crispr-Ncas9-Based Genome Editing Assessment In Mucopolysaccharidosis Iva Mice, Andrés Leal, Betul Celik, Nidhi Fnu, Shaukat Khan, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis (MPS) IVA is a lysosomal storage disorder caused by mutations in the GALNS gene that leads to the lysosomal accumulation of keratan sulfate (KS) and chondroitin 6-sulfate, causing skeletal dysplasia and cardiopulmonary complications. Current enzyme replacement therapy does not impact the bone manifestation of the disease, supporting that new therapeutic alternatives are required. We previously demonstrated the suitability of the CRISPR-nCas9 system to rescue the phenotype of human MPS IVA fibroblasts using iron oxide nanoparticles (IONPs) as non-viral vectors. Here, we have extended this strategy to an MPS IVA mouse model by inserting the human GALNS cDNA into the …

Postmortem Minimally Invasive Tissue Sampling In Communities: Exploring Perceptions Of Families, Funeral Workers, Religious And Community Leaders And Healthcare Providers From Pakistan, Nazia Ahsan, Fauzia Aman Malik, Waliyah Mughis, Rawshan Jabeen, Shaheen Mehboob, Raheel Allana, Syeda Quratulain, Saima Jamal Saima Jamal, Christina R. Paganelli, Abdul Momin Kazi

Department of Paediatrics and Child Health

Background: Minimally invasive tissue sampling (MITS) has increasingly been used to improve the diagnosis of disease and identification of the cause of death, particularly in underserved areas. However, there are multiple barriers to accessing those who die within the community, our study aimed to explore the perceptions and insights of community members and healthcare providers regarding the feasibility of implementing MITS in community settings.
Methods: A qualitative exploratory study was conducted. A total of twenty one in-depth interviews were conducted with deceased infants' parents, elders of the family, religious leaders, community leaders, and funeral workers. Focus group discussions were conducted …

Ablation Of Accessory Pathway From Right Atrial Appendage To Anatomic Left Ventricle In L-Transposition Of The Great Arteries, Shree Lata Radhakrishnan, Robert O. Drutel, Cody M. Williams, Raman Danrad, Kelly K. Gajewski, Paul A. Lelorier

School of Medicine Faculty Publications

No abstract provided.

Lessons Learnt In The First Year Of An Australian Pediatric Cardio Oncology Clinic., Claudia Toro, Ben Felmingham, Mangesh Jhadav, David S. Celermajer, Andre La Gerche, John O'Sullivan, Sanjeev Kumar, Marion K. Mateos, Joy M. Fulbright, Dinisha Govender, Lane Collier, Michael Cheung, David D. Eisenstat, Peter W. Lange, Julian Ayer, David A. Elliott, Rachel Conyers

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Modern oncological therapies together with chemotherapy and radiotherapy have broadened the agents that can cause cardiac sequelae, which can manifest for pediatric oncology patients while on active treatment. Recommendations for high-risk patients who should be monitored in a pediatric cardio-oncology clinic have previously been developed by expert Delphi consensus by our group. In 2022 we opened our first multidisciplinary pediatric cardio-oncology clinic adhering to these recommendations in surveillance and management.

OBJECTIVES: Our pediatric cardio-oncology clinic aimed to: (i) Document cardiovascular toxicities observed within a pediatric cardio-oncology clinic and. (ii) Evaluate the applicability of the Australian and New Zealand Pediatric …

Applying Occupation-Centered Coaching For Caregivers Of Children With Disabilities, Ali S. Gregory, Mary A. Smith Phd, Otr/L, Mary E. Godman Otd, Ms

Fall 2023 Virtual OTD Capstone Symposium

Statement of the problem: Caregivers of children with disabilities (CWD) experience stress, mental health conditions, sleep disruption, and fatigue leading to decreased occupational engagement and family community participation.

Purpose Statement: This project applied Occupation-Centered Coaching with a family-centered approach to promote caregiver empowerment, advocacy for mental health services, and family community participation.

Effects Of A Preventive Mental Health Curriculum Embedded Into A Scholarly Gaming Course On Adolescent Self-Esteem: Prospective Matched Pairs Experiment., Christopher Jenson, Sharon Fitzgerald Wolff, Libby Milkovich

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Positive self-esteem predicts happiness and well-being and serves as a protective factor for favorable mental health. Scholarly gaming within the school setting may serve as a channel to deliver a mental health curriculum designed to improve self-esteem.

OBJECTIVE: This study aims to evaluate the impact of a scholarly gaming curriculum with and without an embedded preventive mental health curriculum, Mental Health Moments (MHM), on adolescents' self-esteem.

METHODS: The scholarly gaming curriculum and MHM were developed by 3 educators and a school-based health intervention expert. The scholarly gaming curriculum aligned with academic guidelines from the International Society for Technology Education, …

Feasibility Of Electronic Medication Monitoring Among Adolescents And Emerging Adults With Sickle Cell Disease, Aimee Hildenbrand, Katherine Kidwell, Meghan Mcgrady, Constance Mara, Charles Quinn, Lori Crosby

Department of Pediatrics Faculty Papers

Purpose: To examine the feasibility of using MEMS® bottles to assess adherence among adolescents and emerging adults with sickle cell disease.

Patients and Methods: Eighteen non-Hispanic Black participants with HbSS (M = 17.8 years; 61% male) were given a MEMS® bottle to store hydroxyurea (n = 14) or deferasirox (n = 4).

Results: One hundred percent initiated MEMS® use and 61% sustained use through the 18-week study; at follow-up, only 11% returned their bottle on time. Barriers to MEMS® use included medication changes and transition to adult care; facilitators included tip sheets and reminders.

Conclusion: While MEMS® is acceptable to …

Association Between Remote Monitoring And Interstage Morbidity And Death In Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups., Bianca Cherestal, Lori A. Erickson, Janelle R. Noel-Macdonnell Phd, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Matthew Files, Sarah Clauss, Natalie Jayaram

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES.

METHODS AND RESULTS: Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the …

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Atrial Appendage Accessory Pathway Ablation: Tips For Recognition And Approach To Ablation, Nikola Dragisic, Emily R. Backes, Lindsey Malloy-Walton, Philip M. Chang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Rare Tumors: Opportunities And Challenges From The Children's Oncology Group Perspective., Kris Ann P. Schultz, Murali Chintagumpala, Jin Piao, Kenneth S. Chen, Rachana Shah, Robyn D. Gartrell, Emily Christison-Lagay, Farzana Pashnakar, Jesse L. Berry, Allison F. O'Neill, Lauren M. Vasta, Ashley Flynn, Sarah G. Mitchell, Brittani Kn Seynnaeve, Jeremy Rosenblum, Samara L. Potter, Junne Kamihara, Carlos Rodriguez-Galindo, Douglas S. Hawkins, Theodore W. Laetsch

Manuscripts, Articles, Book Chapters and Other Papers

While all childhood cancers are rare, tumors that are particularly infrequent or underrepresented within pediatrics are studied under the umbrella of the Children's Oncology Group Rare Tumor committee, divided into the Retinoblastoma and Infrequent Tumor subcommittees. The Infrequent Tumor subcommittee has traditionally included an emphasis on globally rare tumors such as adrenocortical carcinoma, nasopharyngeal carcinoma, or those tumors that are rare in young children, despite being common in adolescents and young adults, such as colorectal carcinoma, thyroid carcinoma, and melanoma. Pleuropulmonary blastoma, gonadal stromal tumors, pancreatic tumors including pancreatoblastoma, gastrointestinal stromal tumor, nonmelanoma skin cancers, neuroendocrine tumors, and desmoplastic small …

Community Acquired Pneumonia Antibiotic Duration, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Obesity And Outcomes Of Kawasaki Disease And Covid-19-Related Multisystem Inflammatory Syndrome In Children., Michael Khoury, Ashraf S. Harahsheh, Geetha Raghuveer, Nagib Dahdah, Simon Lee, Marianna Fabi, Elif Seda Selamet Tierney, Michael A. Portman, Nadine F. Choueiter, Matthew Elias, Deepika Thacker, Frédéric Dallaire, William B. Orr, Tyler H. Harris, Kambiz Norozi, Dongngan T. Truong, Manaswitha Khare, Jacqueline R. Szmuszkovicz, Joseph J. Pagano, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle, International Kawasaki Disease Registry

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Obesity may affect the clinical course of Kawasaki disease (KD) in children and multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19.

OBJECTIVE: To compare the prevalence of obesity and associations with clinical outcomes in patients with KD or MIS-C.

DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, analysis of International Kawasaki Disease Registry (IKDR) data on contemporaneous patients was conducted between January 1, 2020, and July 31, 2022 (42 sites, 8 countries). Patients with MIS-C (defined by Centers for Disease Control and Prevention criteria) and patients with KD (defined by American Heart Association criteria) were included. Patients with …

The Modified Clinical Progression Scale For Pediatric Patients: Evaluation As A Severity Metric And Outcome Measure In Severe Acute Viral Respiratory Illness., Shannon B. Leland, Steven J. Staffa, Margaret M. Newhams, Robinder G. Khemani, John C. Marshall, Cameron C. Young, Aline B. Maddux, Mark W. Hall, Scott L. Weiss, Adam J. Schwarz, Bria M. Coates, Ronald C. Sanders, Michele Kong, Neal J. Thomas, Ryan A. Nofziger, Melissa L. Cullimore, Natasha B. Halasa, Laura L. Loftis, Natalie Z. Cvijanovich, Jennifer E. Schuster, Heidi Flori, Shira J. Gertz, Janet R. Hume, Samantha M. Olson, Manish M. Patel, David Zurakowski, Adrienne G. Randolph, Pediatric Acute Lung And Sepsis Investigator’S Network Pediatric Intensive Care Influenza Study Group (Palisi Picflu) Investigators And Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To develop, evaluate, and explore the use of a pediatric ordinal score as a potential clinical trial outcome metric in children hospitalized with acute hypoxic respiratory failure caused by viral respiratory infections.

DESIGN: We modified the World Health Organization Clinical Progression Scale for pediatric patients (CPS-Ped) and assigned CPS-Ped at admission, days 2-4, 7, and 14. We identified predictors of clinical improvement (day 14 CPS-Ped ≤ 2 or a three-point decrease) using competing risks regression and compared clinical improvement to hospital length of stay (LOS) and ventilator-free days. We estimated sample sizes (80% power) to detect a 15% clinical …

Temporal Artery Pseudoaneurysm In A Pediatric Patient, Gowri Gowda, Donald Mendoza, Amanda Tullos, Jessica Zagory, Malachi Sheahan

School of Medicine Faculty Publications

Superficial temporal artery pseudoaneurysms are an uncommon vascular pathology that can present after head or facial trauma. Furthermore, they are rarely reported in the pediatric population. Ultrasound can be a useful tool in the diagnosis because it is easily accessible and can be rapidly acquired. We report a case that demonstrates the utility of ultrasound in the diagnosis of a superficial temporal artery pseudoaneurysm.

Bridging Gaps: A Qualitative Inquiry On Improving Paediatric Rheumatology Care Among Healthcare Workers In Kenya, Angela Migowa, Sasha Bernatsky, Anthony Ngugi, Helen Foster, Peterrock Muriuki, Roselyter Riang’A, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Due to the paucity of paediatric rheumatologists in Kenya, it is paramount that we explore strategies to bridge clinical care gaps for paediatric rheumatology patients in order to promote early diagnosis, prompt referral, and optimal management.

Purpose: To identify proposed interventions which can improve the ability of non-specialist healthcare workers to care for paediatric rheumatology patients across Kenya.

Methods: We conducted 12 focus group discussions with clinical officers (community physician assistants), nurses, general practitioners and paediatricians across six regions in Kenya. Interviews were conducted, audio-recorded, transcribed verbatim, and analysed using MAXQDA 2022.2 software.

Results: A total of 68 individuals …

Measuring Effects Of Screen Time On The Development Of Children In The Philippines: A Cross-Sectional Study, Angel Belle C. Dy, Alane Blythe C. Dy, Samantha Katrina Santos

Ateneo School of Medicine and Public Health Publications

Background

Screen time in young children is discouraged because of its negative effects on their development. However, excessive screen media use has been rising, particularly during the global pandemic when stay-at-home mandates were placed on young children in several countries. This study documents potential developmental effects of excessive screen media use.

Method

This is a cross-sectional study. Participants were 24 to 36 month old Filipino children recruited through non-probable convenience sampling from August to October 2021. Regression analyses were performed to test the association between screen time and changes in scaled scores for skills and behaviors determined from the Adaptive …

Epigenetic Age Acceleration, Neonatal Morbidities, And Neurobehavioral Profiles In Infants Born Very Preterm., Uriel Paniagua, Barry M. Lester, Carmen J Marsit, Marie Camerota, Brian S. Carter, Jennifer F. Check, Jennifer Helderman, Julie A. Hofheimer, Elisabeth C. Mcgowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Sheri A. Dellagrotta, Lynne M. Dansereau, T Michael O'Shea, Todd M. Everson

Manuscripts, Articles, Book Chapters and Other Papers

Epigenetic age acceleration is a risk factor for chronic diseases of ageing and may reflect aspects of biological ageing. However, few studies have examined epigenetic ageing during the early neonatal period in preterm infants, who are at heightened risk of developmental problems. We examined relationships between neonatal age acceleration, neonatal morbidities, and neurobehavioral domains among very preterm (gestation) infants to characterize whether infants with early morbidities or different neurobehavioral characteristics had accelerated or decelerated epigenetic ageing. This study uses data from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) study, restricted to infants with data on variables assessed …