Medicine and Health Sciences Commons^™

Acute Kidney Injury In Hospitalized Children With Sickle Cell Anemia, Anthony Batte, Sahit Menon, John Ssenkusu, Sarah Kiguli, Robert Kalyesubula, Joseph Lubega, Edrisa Ibrahim Mutebi, Robert Opoka, Chandy John, Michelle Starr

Paediatrics and Child Health, East Africa

Background: Children with sickle cell anemia (SCA) are at increased risk of acute kidney injury (AKI) that may lead to death or chronic kidney disease. This study evaluated AKI prevalence and risk factors in children with SCA hospitalized with a vaso-occlusive crisis (VOC) in a low-resource setting. Further, we evaluated whether modifcations to the Kidney Disease: Improving Global Outcomes (KDIGO) defnition would infuence clinical outcomes of AKI in children with SCA hospitalized with a VOC.

Methods: We prospectively enrolled 185 children from 2 – 18 years of age with SCA (Hemoglobin SS) hospitalized with a VOC at a tertiary hospital …

Blackwater Fever And Acute Kidney Injury In Children Hospitalized With An Acute Febrile Illness: Pathophysiology And Prognostic Significance, Andrea Conroy, Michael Hawkes, Aleksandra Leligdowicz, Ivan Mufumba, Michelle Starr, Kathleen Zhong, Sophie Namasopo, Robert Opoka, Chandy John, Kevin C. Kain

Paediatrics and Child Health, East Africa

Background: Acute kidney injury (AKI) and blackwater fever (BWF) are related but distinct renal complications of acute febrile illness in East Africa. The pathogenesis and prognostic signifcance of BWF and AKI are not well understood.

Methods: A prospective observational cohort study was conducted to evaluate the association between BWF and AKI in children hospitalized with an acute febrile illness. Secondary objectives were to examine the association of AKI and BWF with (i) host response biomarkers and (ii) mortality. AKI was defned using the Kidney Disease: Improving Global Outcomes criteria and BWF was based on parental report of tea-colored urine. Host …

Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong

Student Scholarly Projects

Practice Problem: The experience of surgery for pediatric patients and their families can be dependent on multiple factors including adequate preparation, English language proficiency and realistic expectations. Anxiety can contribute to a negative experience that may result in poor outcomes and a damaging reflection of the healthcare team and organization.

PICOT: The PICOT question that guided this project was: In preoperative pediatric patients and their families, how do therapeutic communication style and the provision of information about the perioperative experience affect their healthcare experience over eight weeks?

Evidence: A multi-modal approach to providing tailored preoperative education for the child and …

Tip-Over Injuries Among Children: Data From An Urban Emergency Department Of Karachi, Pakistan, Rubaba Naeem, Asrar Ali, Ahmed Raheem Buksh, Ayesha Quddusi, Uzma Rahim Khan

Department of Emergency Medicine

Introduction: Most unintentional injuries among children occur in the home environment. Tip-overs, defined as incidents where heavy objects fall on children due to some type of interaction, are one of the reasons for injuries inside the home. This study aims to determine injury patterns and outcomes for child injuries resulting from tip-overs in the home environment as reported in the emergency department.
Methods: We performed a retrospective chart review of pediatric (under 18 years) tip-overs injuries occurred in years 2010 to 2015 at the Aga Khan University Hospital. Furthermore, parents of injured children participated in phone interviews to provide information …

The Enigma Of Primary Hypertension In Childhood, Bonita Falkner

Department of Medicine Faculty Papers

Beginning in the 1970s, hypertension in children and adolescents has been defined as systolic and/or diastolic blood pressure (BP) that is equal to or greater than the 95th percentile of the normal BP distribution in healthy children. The definition of hypertension in adults is based on longitudinal data that links a BP level with an increased risk for subsequent adverse outcomes related to hypertension including heart failure, kidney failure, stroke, or death. The statistical definition of hypertension continues to be used in childhood because there have been no data that link a BP level in childhood with a heightened risk …

The Childhood Acute Illness And Nutrition (Chain) Network Nested Case-Cohort Study Protocol: A Multi-Omics Approach To Understanding Mortality Among Children In Sub-Saharan Africa And South Asia, James M. Njunge, Kirkby Tickell, Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahi, Md Amran Gazi, Ali Faisal Saleem, Zaubina Kazi, Syed Ali, Caroline Tigoi, Ezekiel Mupere

Department of Paediatrics and Child Health

Introduction: Many acutely ill children in low- and middle-income settings have a high risk of mortality both during and after hospitalisation despite guideline-based care. Understanding the biological mechanisms underpinning mortality may suggest optimal pathways to target for interventions to further reduce mortality. The Childhood Acute Illness and Nutrition (CHAIN) Network ( www.chainnnetwork.org) Nested Case-Cohort Study (CNCC) aims to investigate biological mechanisms leading to inpatient and post-discharge mortality through an integrated multi-omic approach.
Methods and analysis; The CNCC comprises a subset of participants from the CHAIN cohort (1278/3101 hospitalised participants, including 350 children who died and 658 survivors, and …

Poliovirus Immunity Among Children Aged 6-11 And 36-48 Months In 14 Polio High-Risk Provinces Of Afghanistan: A Health-Facility-Based Study, Sajid Bashir Soofi, Maureen Martinez, Noha H. Farag, William S. Hendley, Derek Ehrhardt, Imran Ahmed, Imtiaz Hussain, William Weldon, Ahmed M. Kassem

Department of Paediatrics and Child Health

Afghanistan is one of two countries where wild poliovirus (WPV) type 1 remains endemic. We conducted a facility-based cross-sectional survey of antipoliovirus antibodies in children in 14 provinces of Afghanistan. The provinces were selected based on programmatic priorities for polio eradication. Children aged 6-11 and 36-48 months attending outpatient clinics were enrolled in the study. We collected venous blood, isolated serum, and conducted neutralization assays to detect poliovirus neutralizing antibodies. A total of 2086 children from the 14 provinces were enrolled. Among the enrolled children, 44.3% were girls; the median age in the 6-11-month group was 9.4 months, and in …

Frequency Of Bystander Exposure To Antibiotics For Enteropathogenic Bacteria Among Young Children In Low-Resource Settings, Elizabeth T. Rogawski Mcquade, Stephanie A. Brennhofer, Sarah E. Elwood, Timothy L. Mcmurry, Joseph A. Lewnard, Estomih R. Mduma, Sanjaya Shrestha, Najeeha Talat Iqbal, Pascal O. Bessong, Gagandeep Kang

Department of Paediatrics and Child Health

Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure). We quantified the frequency of bystander antibiotic exposures for enteric pathogens and estimated associations with resistance among children in eight low-resource settings. We analyzed 15,697 antibiotic courses from 1,715 children aged 0 to 2 y from the MAL-ED birth cohort. We calculated the incidence of bystander exposures and attributed exposures to respiratory and diarrheal illnesses. We associated bystander exposure with phenotypic susceptibility of E. coli isolates in …

Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan.
Method: We followed a group of children of age 6-8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the 'Aetiology of Neonatal Infection in South Asia (ANISA)' study. We standardised the research methods for the sites, trained field staff …

Optimal Dosing Of Enoxaparin In Overweight And Obese Children, Abdallah Derbalah, Stephen Duffull, Catherine M. Sherwin, Kathleen Job, Hesham Al‐Sallami

Pediatrics Faculty Publications

Aim:Current enoxaparin dosing guidelines in children are based on total bodyweight. This is potentially inappropriate in obese children as it may overestimate thedrug clearance. Current evidence suggests that obese children may require lower ini-tial doses of enoxaparin, therefore the aim of this work was to characterise the phar-macokinetics of enoxaparin in obese children and to propose a more appropriatedosing regimen.Methods:Data from 196 unique encounters of 160 children who received enoxa-parin treatment doses were analysed. Enoxaparin concentration was quantified usingthe chromogenic anti factor Xa (anti-Xa) assay. Patients provided a total of 552 anti-Xa samples. Existing published pharmacokinetic (PK) models were fitted …

Psychosocial Considerations For The Child With Rare Disease: A Review With Recommendations And Calls To Action., Leslee Belzer, Margaret Wright, Emily J. Goodwin, Mehar N. Singh, Brian S. Carter

Manuscripts, Articles, Book Chapters and Other Papers

Rare diseases (RD) affect children, adolescents, and their families infrequently, but with a significant impact. The diagnostic odyssey undertaken as part of having a child with RD is immense and carries with it practical, emotional, relational, and contextual issues that are not well understood. Children with RD often have chronic and complex medical conditions requiring a complicated milieu of care by numerous clinical caregivers. They may feel isolated and may feel stigmas in settings of education, employment, and the workplace, or a lack a social support or understanding. Some parents report facing similar loneliness amidst a veritable medicalization of their …

Burden, Clinical Characteristics, Risk Factors, And Seasonality Of Adenovirus 40/41 Diarrhea In Children In Eight Low-Resource Settings, Godfrey Guga, Sarah Elwood, Caroline Kimathi, Gagandeep Kang, Margaret N. Kosek, Aldo A M Lima, Pascal O. Bessong, Amidou Samie, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Biological & Biomedical Sciences

Background: The application of molecular diagnostics has identified enteric group adenovirus serotypes 40 and 41 as important causes of diarrhea in children. However, many aspects of the epidemiology of adenovirus 40/41 diarrhea have not been described.
Methods: We used data from the 8-site Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project birth cohort study to describe site- and age-specific incidence, risk factors, clinical characteristics, and seasonality.
Results: The incidence of adenovirus 40/41 diarrhea was substantially higher by quantitative polymerase chain reaction than enzyme immunoassay and peaked at ∼30 episodes …

Decreased Physical Activity Among Youth Resulting From Covid-19 Pandemic-Related School Closures: Natural Experimental Study., Amanda Grimes, Joseph S. Lightner, Katlyn Eighmy, Chelsea Steel, Robin P. Shook, Jordan A. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The COVID-19 pandemic has resulted in the closure of schools and may have inadvertently resulted in decreased physical activity for youth. Emerging evidence suggests that school closures due to the COVID-19 pandemic could have hastened the inactivity of youth, possibly due to a lack of structure outside of school and increased access to sedentary activities.

OBJECTIVE: The purpose of this study was to assess changes in physical activity from pre-school closure (before the pandemic) to post-school closure (during the pandemic) among youth in spring 2020.

METHODS: This study used a natural experimental design; youth were enrolled in a physical …

Effects Of Covid-19 In The Status Of Childhood Obesity In The United States: A Literature Review, Ana Cruz

The Graduate School Posters

Introduction: The main hypothesis is that COVID-19 affects the prevalence of childhood obesity in the United States due the precautions needed to contain the pandemic.

Methods: The methods used in this semi-systematic literature review includes web-based research from the following sources: Centers for Disease Control and Prevention, Google Scholar, ResearchGate, and EBSCOhost. The search was limited to children ages 5 to 19 years old with diagnosed obesity.

Results: The review found that COVID-19 pandemic has greatly increased the rate of childhood obesity in the United States due to changes in diet, increased screen time, and less physical activity.

Discussion: There …

Paediatric Physical Activity And Health: Moving Towards A Measure Of Quality, Cain C.T. Clark, Claire M. Barnes

Baltic Journal of Health and Physical Activity

It is clear that physical activity, holistically, is linked with several positive factors through the life course. There exists a large evidence base for physical activity quantity, yet there has been little integration of physical activity qualities, and whilst qualityis a nebulous term, recent developments in literature suggest it may be a viable measure in the characterisation of physical activity. The purpose of the study was to comprehensively review the development towards a measure of physical activity quality.‪A review of literature was conducted using online databases: Web of Science, PubMed and Google Scholar. A narrative review was subsequently prepared on …

Changes In Body Composition Of Children Aged Of 9 To 12 Years With Excess Body Weight Under The Influenceof Eight-Week Workout, Tomasz Dudziak, Zbigniew Czubek, Mirosław Grabowski, Robert Urbanski

Baltic Journal of Health and Physical Activity

Background:‪The increasing problem of overweight and obesity in children is the reason for taking further actions leading to mass reduction, because, in contrast to adults, the consequences of this pathology in young people are still not well known. The intervention actions that can lead to reduction in mass are not easy to find in literature, and their long-term effects are unknown. The aim of this research was to define the changes in body composition of children with excess body mass after eight-week high intensity workout.Material and methods:‪The study was conducted on 47 children aged 9‒12 years who were overweight or …

Assessment Of The Impact Of One-Year Training In Acrobatic Rock’N’Roll On Overall Motor Coordination In Eight-Year-Old Children, Robert Walaszek, Tomasz Nosal

Baltic Journal of Health and Physical Activity

Background: The purpose of the research was to assess the level of overall motor coordination in children practising sport dance – namely, acrobatic rock’n’roll – against the background of their peers who did not dance. The evaluation also included the lateral differentiation of overall motor coordination and skills of kinaesthetic movement differentiation. Material/Methods: The research was conducted in a group of 64 persons aged eight. The research group consisted of thirty children who had practised acrobatic rock’n’roll for a year. The clinical control group was formed by nineteen schoolgirls and fifteen schoolboys who did not practise any sport dance. The …

Functional Conditions Of Three-Dimensional Correction Of Side Curvatures Of The Spine, Andrzej Suchanowski, Andrzej Stolarz

Baltic Journal of Health and Physical Activity

Background: This paper sets out to present theoretical and methodological premises for the therapeutic mode of conduct which utilizes FED and PNF improvement methods complemented by introduction of correctional re-education basing on the biofeedback mechanism. Material/Methods: Authors develop and present an original mode of treatment of children with the SCS, which can be divided into the following stages and targets: 1. Elimination of biomechanical pathologies of the passive stabilizing. 2. Restoration of the structure and function of local muscles and balance among muscles from the first and second reference arrangement and structures around the spine, both on the concave and …

The Somatic Physique Versus The Sports Result Of Tennis Players Of The Pupils’ Sports Club “Return” Lomza, Poland, Kazimierz Kochanowicz, Tomasz Waldzinski

Baltic Journal of Health and Physical Activity

Background: Individuals who take up professional sport must comply with requirements dependent on the character of the discipline. The requirements refer to motor skills, mental state and somatic physique. A lot of authors claim that somatic physique in tennis is a factor which helps to achieve the highest sports results. Superiority of arms range in the attacking zone makes a game easier for tall players who are more effective in offensive actions as well. The purpose of the research was to estimate the somatic physique of children and youth who play tennis in the Pupils’ Sports Club “Return” Lomza. Material/Methods: …

Methods To Encourage Healthy Eating In Children: Review Of Current Findings, Reda Moceviciene, Apolinaras Zaborskis

Baltic Journal of Health and Physical Activity

Background: Healthy eating, especially fruit and vegetable consumption, is a major contributor to the prevention of chronic non-communicable diseases. The multiple benefits of healthy food and nutrition in childhood and adolescence reinforce the need for studies encouraging young people to healthy nutrition. The present review increases understanding of what methods (interventions) should be performed to encourage healthy eating in children and adolescents. Material/Methods: A scientific literature review of Medline (Pubmed) database was performed, a total of 615 publications were found. Of these, only 15 papers were selected for the analysis. Results: The multi-component interventions (encouraging of fruit and vegetable consumption …

Physical Activity, Academic Performance And Cognition In Children And Adolescents. A Systematic Review, Eero Hapala

Baltic Journal of Health and Physical Activity

A literature review was conducted to investigate the effect of physical exercise and physical training on cognition and academic performance in children and adolescents. Nine randomized or quasi-randomized controlled trials with 2,013 participants were identified by employing the following data sources: the Cochrane Register of Controlled Trials, Medline, Eric, CINAHL, PsychINFO, and ISI Web of Knowledge. Five studies indicated positive effects of physical exercise on attention, concentration, and working memory, and three studies reported positive effects of 14 to 64 week physical training on language and arithmetic skills. Thus, there is some evidence that physical exercise may facilitate cognitive functions …

Obesity And Overweight Among Children And Adolescents In The Light Of Health Education Principles, Adam Wiek, Katarzyna Tkacz, Waclaw Mozolewski, Malgorzata E. Kusmierczyk, Sylwester Rybaczek

Baltic Journal of Health and Physical Activity

Pedagogical and educational institutions play an important role in health education. The proposed systemic principles should account for biological, environmental and cultural factors that determine the health of children and adolescents. Young people’s individual needs should constitute the framework of educational policy in the prevention of obesity and overweight. An analysis of health education practice in the Polish educational system indicates that the adopted measures, their practical applications and educational goals are adequate. Despite the above, the proposed systemic solutions are not always deployed or correctly implemented by the responsible institutions at various levels of local or social governance. The …

The Positive Role Of Kinesio Taping In Adjunctive Therapy Of Static Plano-Valgusfeet In Children Between The Ages Of 5 And 7, Agnieszka Straczynska, Jacek Kruczynski, Agnieszka Radziminska, Magdalena Weber-Rajek, Ewelina Lulinska-Kuklik, Aleksander Goch

Baltic Journal of Health and Physical Activity

Kinesio taping (KT) might be of substantial value as far as adjunctive therapy of flat foot correction in children is concerned. The study’s prime aim is to evaluate the role of KT in terms of static plano-valgus foot therapy in children. The study involved 120 children aged 5 to 7. Parameter calculations determining the shape of foot were performed on the electronic podoscope before and after the therapy, and after the subsequent 4 months in order to evaluate the permanence of the therapy result. Statistical analysis revealed that the study period considerably influenced the change of parameters which determine the …

Muscle Bloodflow As An Indicator Of Anaerobic Threshold In Young Athletes – A Near Infrared Spectroscopy Study, Maciej Chroboczek, Magdalena Jakubowska, Sylwester Kujach, Marcin Luszczyk, Radoslaw Laskowski

Baltic Journal of Health and Physical Activity

Background: In this study we evaluated the effect of exercise with increasing intensity until exhaustion on muscle tissue oxygenation in children. Furthermore, we tested the hypothesis that a decrease in muscle indirect blood flow (O2Hb) predicts the anaerobic threshold determined by analysis of ventilation parameters. Material/Methods: Five, young, school-aged tennis players were engaged in this study (age 16.2 ±1.63 years, VO2max 56.7 ±2.00 ml · kg-1 · min-1). Changes in oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (HHB), blood volume (tHb = HbO2 + HHB) and muscle tissue oxygenation (TOI%) in the right vastus lateralis muscle, using a near-infrared spectrometer were recorded. …

Changes In The Prevalence Of Excessive And Deficient Body Weight Among Pomeranian Youth In The Years 1979, 1989, And 1999, Anna Lysak, Janusz Dobosz, Jozef Drabik

Baltic Journal of Health and Physical Activity

Background: The analysis presented in this paper aimed to identify trends in the prevalence of the two extremes of body fat disorders over a period of 20 years (1979–1999) and to form a comparative basis for further studies of physical development of the youth of the Pomerania region. Material/Methods: The study population consisted of 23,854 boys and girls aged 7 to 18 years attending schools in rural and urban areas in the Pomerania administrative region. An overweight and underweight population was identified based on the body mass index (BMI) according to WHO, CDC and the Mother and Child Institute recommendations. …

The Examination Of Some Anthropometric And Motoric Characteristics Of Students Aged Eight Years According To Their Maturation Level, Erdal Ari, Gökhan Deliceoglu

Baltic Journal of Health and Physical Activity

Background: Maturation is an important factor for exercise. The maturation effect on some anthropometric and motoric characteristics of students aged eight years was examined in this study. Material and methods: 535 primary education students voluntarily participated in this study. Anthropometric measurements (weight, height, sitting height, stroke length, stroke rate, leg length and body mass index), flexibility, handgrip strength, vertical jump (squat and countermovement jump), tapping (skipping) test parameters (step frequency, flight times and contact times to ground of right and left foot, step/speed ratio), postural sway (anterior-posterior, medial lateral and total postural sway), visual reaction and reaction time, 20 meters …

Epigenetic Impact Of The Parents' Physical Activity On The Health Of Their Children, Agnieszka Boron

Baltic Journal of Health and Physical Activity

All parents’ dream is to have healthy children. The question whether the parents' lifestyle affects the quality of their progeny's health has been bothering scientists and society for many years. Based on epidemiological studies, it has been shown that physical activity during pregnancy is beneficial both for the health of the mother and the newborn. A significant number of studies conducted so far have shown that exercises performed by fathers modulate future generations by affecting the sperm epigenome. Epigenetics plays a key role in transmitting the response of the parents' environment and their lifestyle onto the characteristics and health of …

School Injuries And Their Prevention From The Present Perspective, Václav Beranek, Petr Stastny, Vit Novacek

Baltic Journal of Health and Physical Activity

Background: ‪Injuries are considered worldwide to be the most significant health problem, especially in childhood. In the Czech Republic, injuries are the most common cause of death among children and young adults. The aim of the study was to provide more insight in school accidents in the Czech Republic from 2008 to 2018 and to estimate future trends. Material and methods: ‪Annual reports of the Czech School Inspectorate (CSI) from 2007 to 2017 were the main sources of data. Results: ‪A high number of injuries occur in the school environment, especially at the primary level. In the Czech Republic, there …

Knowledge And Practices On The Prevention And Management Of Diarrhea In Children Under-2 Years Among Women Dwelling In Urban Slums Of Karachi, Pakistan, Asif Khaliq, Amreen 1, Nazia Jameel, Stefanie J. Krauth

Department of Paediatrics and Child Health

Background: Diarrhea is the second leading cause of death especially among children. The age-proportionate mortality of diarrheal disease in infants under 2 years is 72%, among children under 5 years of age. Children living in urban slums are more prone to develop diarrhea. Although the disease can be prevented by many simple cost-effective interventions, i.e. proper sanitation and hygiene, appropriate feeding, and timely vaccination, poverty and lack of basic life amenities often potentiate diarrhea mortality. Gadap town is the largest town of Karachi with a deprived health system. This study aims to assess pediatric diarrhea prevalence and related knowledge-practice gaps …

Cervicofacial Actinomycosis In The Pediatric Population: Presentation And Management, Karan Gandhi, Benjamin D. Van Der Woerd, M. Elise Graham, Michelle Barton, Julie E. Strychowsky

Paediatrics Publications

Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and …