Digital Commons Network^™

Cow's Milk Protein-Induced Villous Atrophy And Elevated Celiac Autoimmunity In Children With Celiac Disease On A Glutten-Free Diet: A Report Of Three Cases, Kristin Capone, Naire Sansotta, Pankaj Vohra, Stefano Guandalini

Pediatrics Research and Scholarship

Objective: To describe the serologic and histologic response of three patients with celiac disease who had persistent autoimmunity and villous atrophy despite a strict gluten-free diet, to the elimination of cow's milk protein.

Noninfectious Manifestations And Complications Of Chronic Granulomatous Disease, S. E. Henrickson, A. M. Jongco, K. F. Thomsen, E. K. Garabedian, I. P. Thomsen

Journal Articles

© The Author(s) 2018. Chronic granulomatous disease (CGD), a primary immunodeficiency characterized by a deficient neutrophil oxidative burst and the inadequate killing of microbes, is well known to cause a significantly increased risk of invasive infection. However, infectious complications are not the sole manifestations of CGD; substantial additional morbidity is driven by noninfectious complications also. These complications can include, for example, a wide range of inflammatory diseases that affect the gastrointestinal tract, lung, skin, and genitourinary tract and overt autoimmune disease. These diseases can occur at any age and are especially problematic in adolescents and adults with CGD. Many of …

Racial And Ethnic Disparities In Diagnosis Of Chronic Medical Conditions In The Usa, E. J. Kim, T. Kim, J. Conigliaro, J. M. Liebschutz, M. K. Paasche-Orlow, A. D. Hanchate

Journal Articles

No abstract provided.

Gene Discovery And Polygenic Prediction From A Genome-Wide Association Study Of Educational Attainment In 1.1 Million Individuals, J. J. Lee, R. Wedow, A. Okbay, E. Kong, O. Maghzian, M. Zacher, A. N. Tuan, T. Lencz, A. K. Malhotra, D. Cesarini, +67 Additional Authors

Journal Articles

No abstract provided.

Aerobic Exercise Training And Inducible Inflammation: Results Of A Randomized Controlled Trial In Healthy, Young Adults., R. P. Sloan, P. A. Shapiro, P. S. Mckinley, M. Bartels, D. Shimbo, V. Lauriola, W. Karmally, M. Pavlicova, C. J. Choi, K. J. Tracey, +3 Additional Authors

Journal Articles

Background Consensus panels regularly recommend aerobic exercise for its health-promoting properties, due in part to presumed anti-inflammatory effects, but many studies show no such effect, possibly related to study differences in participants, interventions, inflammatory markers, and statistical approaches. This variability makes an unequivocal determination of the anti-inflammatory effects of aerobic training elusive. Methods and Results We conducted a randomized controlled trial of 12 weeks of aerobic exercise training or a wait list control condition followed by 4 weeks of sedentary deconditioning on lipopolysaccharide (0, 0.1, and 1.0 ng/mL)-inducible tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and on toll-like receptor 4 …

Enhanced Contribution Of Hla In Pediatric Onset Ulcerative Colitis, S. Venkateswaran, J. Prince, D. J. Cutler, U. M. Marigorta, D. T. Okou, S. Prahalad, D. Mack, B. Boyle, J. Markowitz, S. Kugathasan, +20 Additional Authors

Journal Articles

© 2018 Crohn's & Colitis Foundation. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. Background The genetic contributions to pediatric onset ulcerative colitis (UC), characterized by severe disease and extensive colonic involvement, are largely unknown. In adult onset UC, Genome Wide Association Study (GWAS) has identified numerous loci, most of which have a modest susceptibility risk (OR 0.84-1.14), with the exception of the human leukocyte antigen (HLA) region on Chromosome 6 (OR 3.59). Method To study the genetic contribution to exclusive pediatric onset UC, a GWAS was performed on 466 cases with 2099 healthy controls using …

Disparities In Utilization Of Social Determinants Of Health Referrals Among Children In Immigrant Families, O. T. Uwemedimo, H. May

Journal Articles

© 2018 Uwemedimo and May. Objective: Children in immigrant families (CIF) are at elevated risk of experiencing adverse social determinants of health (SDH), particularly material hardship, which contribute to disparate health outcomes. Previous studies have found that SDH screening programs integrated into pediatric practices have increased receipt of social service resources. Few studies have examined use of social services in these programs among ethnically-diverse patient populations and associations with caregiver immigrant status or limited English proficiency (LEP). Methods: Caregivers of children (<18 >years) were routinely screened in a practice-based, SDH screening program offering referral, assisted navigation and follow-up support. Information …

Extracorporeal Cellular Therapy (Elad) In Severe Alcoholic Hepatitis: A Multinational, Prospective, Controlled, Randomized Trial, J. Thompson, N. Jones, A. Al-Khafaji, S. Malik, D. Reich, S. Munoz, R. Macnicholas, T. Hassanein, A. Duddempudi, R. Subramanian, +33 Additional Authors

Journal Articles

No abstract provided.

Functional Variants In The Lrrk2 Gene Confer Shared Effects On Risk For Crohn's Disease And Parkinson's Disease, K. Y. Hui, H. Fernandez-Hernandez, J. Hu, A. Schaffner, N. Pankratz, N. Hsu, L. Chuang, S. Katz, T. Lencz, I. Peter, +41 Additional Authors

Journal Articles

No abstract provided.

Insulin-Like Growth Factor 2: A Poor Prognostic Biomarker Linked To Racial Disparity In Women With Uterine Carcinosarcoma, A. R. Van Arsdale, R. C. Arend, M. J. Cossio, B. K. Erickson, Y. Wang, D. W. Doo, C. A. Leath, G. L. Goldberg, G. S. Huang

Journal Articles

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. The objective of this study was to investigate the relationship of insulin-like growth factor 2 (IGF2) expression and survival in women with uterine carcinosarcoma (UCS). Insulin-like growth factor 2 protein expression was determined by immunohistochemical staining of tumor tissues from 103 patients with UCS. The H-score (product of staining intensity and percentage positive cells) was quantified for the epithelial cytoplasmic (EC), epithelial nuclear (EN), and malignant stromal compartments. Multivariable Cox proportional hazard regression models were used to examine the relationship of IGF2 levels with progression-free survival (PFS) …

Future Implications Of Using Registered Dietitians In Multidisciplinary Polycystic Ovary Syndrome Treatment, Wendy M. Wolf, Rachel A. Wattick, Pamela J. Murray, Melanie Clemmer, Melissa D. Olfert

Faculty & Staff Scholarship

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in females with insulin resistance playing a key role in pathogenesis. The objective of this study was to investigate current trends and future implications of multidisciplinary PCOS clinics with inclusion of dietitians. A two-phase, formative investigation on practitioners was conducted through an anonymous survey followed by focus groups. Survey respondents included 261 health care providers from around the world; the majority (59%) representing multidisciplinary teams. Focus group participants included four dietitians, three physicians, a health psychologist and a licensed nutritionist. Primary barriers for future multidisciplinary clinics included: money/resources, insurance …

Use Of A 4-Week Up-Titration Regimen Of Roflumilast In Patients With Severe Copd, Henrik Watz, Nitin Bagul, Klaus F. Rabe, Stephen I. Rennard, Vijay Kt Alagappan, Jonas Román, Axel Facius, Peter Ma Calverley

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: The oral selective phosphodiesterase-4 inhibitor roflumilast (ROF) reduces exacerbations in patients with severe COPD. Adverse events (AEs) can cause early ROF discontinuation. Alternative dosing strategies may help patients continue their therapy.

METHODS: In this multicenter, double-blind trial, 1,321 patients with severe COPD were randomized 1:1:1 to 4 weeks' treatment with ROF 250 µg once daily (OD), 500 µg every other day (EOD), or 500 µg OD, each followed by ROF 500 µg OD for 8 weeks, plus standard therapy. The primary end point was the percentage of patients prematurely discontinuing study treatment.

RESULTS: Patients in the 250 µg OD/500 …

An Exploration Into The Psychotic Symptoms Associated With Schizophrenia And Major Depressive Disorder, Kyndester I. Michael-Samaroo

Honors Undergraduate Theses

This research focuses on examining the neurological similarities between schizophrenia and major depressive disorder with psychotic features in order to compare the manifestations of psychosis in each disorder. Both disorders often involve symptoms of psychosis, although the overall disorders are very different from each other. The hypothesis for this research is that the neurological similarities between schizophrenia and major depressive disorder with psychotic features will provide researchers with the strategies needed to develop a treatment for psychotic symptoms. In order to test this hypothesis, five related studies were gathered for each disorder, and three studies were gathered for psychosis. These …

Exploring The Regulatory Mechanism Of The Notch Ligand Receptor Jagged1 Via The Aryl Hydrocarbon Receptor In Breast Cancer, Sean Alan Piwarski

Theses, Dissertations and Capstones

The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor that binds pollutants, therapeutic drugs and endogenous ligands. AHR is of particular interest in cancer and has been shown to play roles in both tumor progression and tumor suppression. As a result, it has received growing attention as a possible chemotherapeutic target. AHR is expressed in all breast cancer subtypes and can promote or inhibit breast cancer depending on the ligand it binds. The Notch signaling pathway is a highly conserved evolutionary pathway that plays extremely vital roles during development by regulating cell fate and differentiation. Notch signaling has increasingly …

Pre-Licensure Nursing Student Attitudes Toward Physician-Assisted Suicide, Stephanie K. Cox

Honors Undergraduate Theses

Physician assisted suicide (PAS) has been a legalized presence in the United States since Oregon first passed the Death with Dignity Act in 1994. Now PAS is legalized in six states and it is realistic that nurses may encounter PAS during their career. This project explores pre-licensure nursing student attitudes toward PAS.

A mixed method design incorporating descriptive correlation and thematic analysis of an open-ended question was used. Surveys were sent to 550 nursing students enrolled in the UCF nursing program asking participants to complete the 34-question survey. This survey included a 12 item “Domino scale” on student nursing opinions …

Graduate Medical Education Annual Report 2017-2018, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

All Ttg Positive Patient Do Not Have Celiac Disease, Pankaj Vohra, Kalyan Ray Parashette, Rajmohan Dharmaraj, Angela Deubel, Richardo Castillo, Jacqueline Fridge

Pediatrics Research and Scholarship

Tissue transglutaminase antibody IgA level (tTG) is an excellent screening test for celiac disease in the presence of adequate IgA levels. Most labs while screening for Celiac disease (CD) will do the IgA levels automatically. However the serological test is not a diagnostic test.

An Investigation Into The Relationship Between Fundamental Movement Skill Proficiency And Markers Of Health Among A Cohort Of Irish Primary School Children, Linda Bolger

PhDs

Background: Fundamental movement skills (FMS) are basic observable patterns of movement. Although FMS are positively associated with health, FMS levels among children worldwide are low. Interventions to improve FMS and markers of health among children are warranted. Thus, the purpose of this research was to firstly evaluate the FMS proficiency and markers of health of Irish primary school children, and to design and implement a programme of interventions to improve both.

Methods: Two interventions (1 Physical Activity [PA] and 1 FMS) were implemented and evaluated using children from 3 primary schools in Cork. Children (N=217, mean age: 7.98±2.00 years) …

Pediatric Rheumatology: Addressing The Transition To Adult-Orientated Health Care., Sara Sabbagh, Tova Ronis, Patience H White

Medicine Faculty Publications

The transition from pediatric to adult health care is often a challenging process due to multiple interwoven complexities, especially for children with chronic medical conditions. Health care transition (HCT) is a process of moving from a pediatric to an adult model of health care with or without a transfer to a new clinician. This paper focuses on what is known about HCT for youth and young adults (Y/YA) with rheumatic diseases within a larger context of HCT recommendations. HCT barriers for youth, families, and providers and current evidence for a structured HCT processes are reviewed. Practical advice is offered on …

Gut Microbiota And Cardiovascular Uremic Toxicities, Manuel T. Velasquez, Patricia Centron, Ian Barrows, Rama Dwivedi, Dominic S. Raj

Medicine Faculty Publications

Cardiovascular disease (CVD) remains a major cause of high morbidity and mortality in patients with chronic kidney disease (CKD). Numerous CVD risk factors in CKD patients have been described, but these do not fully explain the high pervasiveness of CVD or increased mortality rates in CKD patients. In CKD the loss of urinary excretory function results in the retention of various substances referred to as “uremic retention solutes”. Many of these molecules have been found to exert toxicity on virtually all organ systems of the human body, leading to the clinical syndrome of uremia. In recent years, an increasing body …

The Neurodevelopmental Perspective Of Surgical Necrotizing Enterocolitis: The Role Of The Gut-Brain Axis., Chariton Moschopoulos, Panagiotis Kratimenos, Ioannis Koutroulis, Bhairav V Shah, Anja Mowes, Vineet Bhandari

Pediatrics Faculty Publications

This state-of-the-art review article aims to highlight the most recent evidence about the therapeutic options of surgical necrotizing enterocolitis, focusing on the molecular basis of the gut-brain axis in relevance to the neurodevelopmental outcomes of primary peritoneal drainage and primary laparotomy. Current evidence favors primary laparotomy over primary peritoneal drainage as regards neurodevelopment in the surgical treatment of necrotizing enterocolitis. The added exposure to inhalational anesthesia in infants undergoing primary laparotomy is an additional confounding variable but requires further study. The concept of the gut-brain axis suggests that bowel injury initiates systemic inflammation potentially affecting the developing central nervous system. …

Project Anacostia, Lapoldeon Williams, Abenezer Lemma, Janae Thomas, Kafoued Ouedraogo

DC Health and Academic Prep Program (DC HAPP)

Objectives Project Anacostia aims to [1] help meet the Healthy People 2020 goal of reducing the disease burden of diabetes mellitus (DM) and improving the quality of life for all persons who have, or are at risk for, DM as outlined by the U.S. Department of Health and Human Services. [2] To increase community awareness of the social determinants of health related to obesity and diabetes. [3] Increase access to recreational facilities and healthy food options in Wards 7 &8 and [4] promote healthy lifestyle choices among youth in the Anacostia community.

Methods Our intervention is comprised of three progressive …

Are Children Of A Diabetic Mother In Comparison To Children Of A Nondiabetic Mother At An Increased Risk For Developing Obesity In The First 10 Years Of Life?, Chhorn Pho

Theses and Graduate Projects

Body weight, glucose, insulin, and leptin were studied in children of mothers with gestational diabetes, type 1 or type 2 diabetes. Breast milk of diabetic mothers was also analyzed to study its relationship to childhood obesity. In the first 2 years of life, infants of mothers with gestational diabetes have no significant difference in weight gain but by the age of 10, most of the children birthed by any diabetic mothers were either overweight or obese. Children of mothers diagnosed with diabetes mellitus type 2 have higher resistance to insulin than children of mothers with other diabetes types. Leptin was …

Acute Post-Operative Pain Management: Preventing Overuse Of Opioids, Alison Hirsch

Theses and Graduate Projects

Background: Surgical pain management with opioids is common. The use of multimodal analgesia has been proposed in order to provide opioid-sparing regimens and improve pain control post-operatively. Inadequate control of surgical pain can lead to development of chronic pain. Furthermore, studies have linked acute surgical opioid use to increased risk of long-term use. Long-term opioid use has undesirable, life-altering consequences, including physical dependence and addiction which may lead to overdose or death. Use of a variety of medications in the operative setting can lead to synergistic or additive effects on pain control, thus decreasing post-operative opioid consumption.

Methods: A literature …

The Impact Of Breastfeeding Interventions On Breastfeeding Behavior, Ryan D. Steele

Theses and Graduate Projects

Breast milk is the natural first food for all infants, and breastfeeding provides multiple benefits for both the mother and child. However, breastfeeding rates in the United States are far from optimal, despite these benefits. There are multiple complex and interrelated reasons for the suboptimal breastfeeding rates, and multiple interventions have been completed with the goal of obtaining optimal breastfeeding rates. This literature review examines the efficacy of these breastfeeding interventions, specifically examining whether antenatal breastfeeding education was associated with increased breastfeeding initiation and duration relative to individualized support. Results of the literature review suggest that a combination of antenatal …

Adherence Mechanism Analysis: The Role Of Prsa Gene In Lactobacillus Acidophilus And Other Infectious Microorganisms, Nujuma Moussa

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

No abstract provided.

Pre-Albumin As A Marker For Predicting Weight Loss In Hospitalised Children, Del-Rossi Sean Quadros, Rose Kamenwa, Samuel Akech, William Macharia

Paediatrics and Child Health, East Africa

Objectives: This study sought to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children.

Design: A hospital-based longitudinal survey was carried out between December 2013 and February 2014.

Setting: Aga Khan University Hospital, Nairobi, Kenya, a tertiary care hospital.

Subjects: A total of 170 children aged 29 days to 15 years who met the inclusion criteria were included in the study.

Outcome measures: Serum pre-albumin levels and weight were measured at admission and repeated after 48–96 h. Sensitivity, specificity, and positive and negative predictive values were calculated to determine the diagnostic utility of serum pre-albumin …

The Effects Of Emerging Technology On Healthcare And The Difficulties Of Integration, Skyler J. Pavlish-Carpenter

Honors Undergraduate Theses

Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all.

Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare.

Methods: …

Impact Of Huddles On Provider’S Knowledge Of Medically Complex Patients, Irina G. Trifonova, Troy E. Richardson, Jessica L. Bettenhausen, Matthew B. Johnson

Posters

Background:
The increasing complexity of pediatric inpatients requires that all providers understand a comprehensive child’s medical and social needs. A survey administered to Children’s Mercy Hospital inpatient providers identified gaps in knowledge regarding the daily plan of care and discharge planning needs among Complex Chronic Care (CCC) patients. Multidisciplinary rounds (MDRs) create a shared decision model among all team members to ensure that all aspects of care for CCC patients are addressed.

Objectives:
To improve provider knowledge of the plan of care and discharge planning needs for CCC patients admitted to the Hospitalist service, from 40% to 75% of providers …

The Western Diet: A Smoking Gun For Chronic Obstructive Pulmonary Disease And Asthma?, Conor Kerley

Other resources

No abstract provided.