Medicine and Health Sciences Commons^™

Cost-Effectiveness And Outcomes Of Utilizing Tisagenlecleucel Therapy (Car T-Cell) In Pediatric Acute Lymphoblastic Leukemia In Comparison To Standard Of Care (Soc) Therapies: A Scoping Review, Andrew Atschinow, Evangeline Attota, Warren Chan, Pooja Kasarapu, Priyal Shah, Karina Vizzoni

Rowan-Virtua Research Day

Aims

This review aims to assess the correlations between outcomes and cost of treatment methods for pediatric acute lymphoblastic leukemia patients, specifically comparing CAR T-cell therapy and Standard-of-Care (SoC) therapy. The socioeconomic background of patients will also be taken into consideration to see if there are differences in their outcomes.

Methods

Peer-reviewed publications were collected from PubMed and Web of Science. The keyword strings used were “acute lymphoblastic leukemia,” “pediatric acute lymphoblastic leukemia,” “pediatric,” “CAR T-cell therapy,” and “cost-effectiveness.” 27 citations were obtained. Titles were screened by 6 authors. Articles met the inclusion criteria including potential Quality-Adjusted Life Year (QALY) …

Availability And Utilization Of Endoscopic Retrograde Cholangiopancreatography At Children's Hospitals., Sagar J. Pathak, Thomas M. Attard, Matthew Hall, Mustafa Arain, Melvin B. Heyman, Emily R. Perito

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: No study has explored whether availability of endoscopic retrograde cholangiopancreatography (ERCP) is adequate and equitable across US children's hospitals. We hypothesized that ERCP availability and utilization differs by geography and patient factors.

METHODS: Healthcare encounter data from 2009 to 2019 on children with pancreatic and biliary diseases from the Pediatric Health Information System were analyzed. ERCP availability was defined as treatment at a hospital that performed pediatric ERCP during the year of service.

RESULTS: From 2009 to 2019, 37,946 children (88,420 encounters) had a potential pancreatic or biliary indication for ERCP; 7066 ERCPs were performed. The commonest pancreatic diagnoses …

Investigating The Use Of Finerenone In Children With Chronic Kidney Disease And Proteinuria: Design Of The Fiona And Open-Label Extension Studies., Franz Schaefer, Giovanni Montini, Hee Gyung Kang, Johan Vande Walle, Joshua Zaritsky, Michiel F. Schreuder, Mieczyslaw Litwin, Andrea Scalise, Helen Scott, James Potts, Pablo Iveli, Stefanie Breitenstein, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Proteinuria is a modifiable risk factor for chronic kidney disease (CKD) progression in children. Finerenone, a selective, non-steroidal, mineralocorticoid receptor antagonist (MRA) has been approved to treat adults with CKD associated with type 2 diabetes mellitus (T2DM) following results from the phase III clinical trials FIDELIO-DKD (NCT02540993) and FIGARO-DKD (NCT02545049). In a pre-specified pooled analysis of both studies (N = 13,026), finerenone was shown to have an acceptable safety profile and was efficacious in decreasing the risk of adverse kidney and cardiovascular outcomes and of proteinuria.

OBJECTIVE: FIONA and the associated open-label extension (OLE) study aim to demonstrate that …

Infant Appendicitis: A Case Presentation Of Appendicitis In A Nine-Month-Old Infant With Respiratory Syncytial Virus (Rsv) And Otitis Media And Review Of Literature., Leslie Hueschen, April Mcneill-Johnson

Manuscripts, Articles, Book Chapters and Other Papers

Appendicitis in children < 5 years old is uncommon and even less common in children < 1 year old. Symptoms of appendicitis can be non-specific and mimic other common pediatric diseases, causing delays in diagnosis. Without a timely diagnosis, young children with appendicitis are at risk of developing worsening disease, intra-abdominal abscess, perforation, and bacteremia. We submit a case of a nine-month-old male infant presenting with fever, vomiting, and irritability seen the day prior and treated for otitis media, who was ultimately diagnosed with appendicitis with concomitant viral infection (respiratory syncytial virus and human rhinovirus/enterovirus) and treated with intravenous antibiotics and laparoscopic appendectomy. This case illustrates how easy it is to misdiagnose infant appendicitis due to factors including normal developmental speech barriers, nonspecific presentations, and overlap of symptoms with many other common childhood illnesses, along with a challenging abdominal examination. Delay in diagnosis leads to increased rates of perforation and complications. Providers should trust abnormal physical examination findings, especially abdominal guarding against palpation, and keep a wide differential diagnosis in order to diagnose appendicitis in young children.

Primary Lung And Pleural Malignancies In Children: Imaging Of A Case Series, Teerasak Phewplung, Tanitha Phruksahirun

Chulalongkorn Medical Journal

Early diagnosis of primary lung and pleural malignancies is a challenge because it is extremely rare in children. The patient often presents with metastatic disease and non-neoplastic lesions. Clinical detection and imaging studies are nonspecific findings and may be indistinguishable from other lung malformations, resulting in a delay in diagnosis and treatment and an increase in tumor morbidity and mortality.

We present four cases of children whose clinical presentation and initial imaging had suspicious abnormalities and were eventually revealed to be primary lung and pleural malignancies. The literature on primary lung and pleural malignancies is also reviewed.

Changes In Real-World Dispensing Of Adhd Stimulants In Youth From 2019 To 2021 In California, Anika Patel, Rishikesh Chavan, Cyril Rakovski, Richard C. Beuttler, Sun Yang

Mathematics, Physics, and Computer Science Faculty Articles and Research

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric neurobehavioral disorders in the U.S. Stimulants, classified as controlled substances, are commonly used for ADHD management. We conducted an analysis of real-world stimulants dispensing data to evaluate the pandemic’s impact on young patients (≤ 26 years) in California.

Methods: Annual prevalence of patients on stimulants per capita across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient …

Exploring Referral And Service Utilization Patterns Within An Outpatient Interdisciplinary Pediatric Chronic Pain Program, Aimee Hildenbrand, Christina M Amaro, Benjamin Bear, Catherine Soprano, Katherine S Salamon

Department of Medicine Faculty Papers

PURPOSE: We examine referral sources and clinical characteristics for youth presenting to an outpatient interdisciplinary pediatric chronic pain program.

PATIENTS AND METHODS: Referral data were extracted from the electronic health record. PROMIS Pediatric Anxiety and Pain Interference Scales were administered at an initial evaluation visit.

RESULTS: The program received 1488 referrals between 2016 and 2019, representing 1338 patients, with increasing volume of referrals over time. Referrals were primarily from orthopedics (19.6%), physical medicine and rehabilitation (18.8%), neurology (14.4%), and rheumatology (12.6%). Patients referred were primarily female (75.4%), White (80.1%), English-speaking (98.4%) adolescents (median=15.0 years). Of those referred, 732 (54.7%) attended …

Pediatric Dentists’ Considerations Concerning Obesity-Related Education For Parents Of Young Children: Who Should Educate About What, How And When?, Arianne Swanson Dds, Ms, James R. Boynton Dds, Ms, Larry B. Salzmann Dds, Yu-Ju Yang Dds, Marita R. Inglehart Dipl. Psych., Dr. Phil., Dr. Phil. Habil

The Journal of the Michigan Dental Association

This study aimed to explore pediatric dentists' perspectives on obesity-related interventions for parents of young children. A web-based survey was administered to 210 American Academy of Pediatric Dentistry members. Findings revealed that respondents considered it important for various healthcare professionals, especially pediatricians and nurse practitioners, to engage in obesity-related parent education. Strong consensus existed on educating parents about the link between early childhood caries and diet, soft drink and fruit juice consumption, and healthy snacking. The study also found positive attitudes correlated with increased engagement in objective weight determination, data collection, and diet/nutrition counseling.

Cohesion: A Core Outcome Set For The Treatment Of Neonatal Encephalopathy, Fiona A. Quirke, Shabina Ariff, Malcolm R. Battin, Caitlin Bernard, Linda Biesty, Frank H. Bloomfield, Mandy Daly, Elaine Finucane, Maira Niaz, Farhana Tabassum

Department of Paediatrics and Child Health

Background: Heterogeneity in outcomes reported in trials of interventions for the treatment of neonatal encephalopathy (NE) makes evaluating the effectiveness of treatments difficult. Developing a core outcome set for NE treatment would enable researchers to measure and report the same outcomes in future trials. This would minimise waste, ensure relevant outcomes are measured and enable evidence synthesis. Therefore, we aimed to develop a core outcome set for treating NE.
Methods: Outcomes identified from a systematic review of the literature and interviews with parents were prioritised by stakeholders (n = 99 parents/caregivers, n = 101 healthcare providers, and n = 22 …

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.

Post-Acute Sequelae Of Covid-19 (Pasc) In Pediatrics: Factors That Impact Symptom Severity And Referral To Treatment., Catherine Soprano, Ryan Ngo, Casey A Konys, Ashley Bazier, Katherine Salamon

Department of Medicine Faculty Papers

The post-acute sequelae of COVID-19 (PASC) is a complex condition. While there are emerging studies on its effects in adults, there is scarce research regarding the long-term effects of COVID-19 infection among youth. Several researchers have likened long-haul COVID-19 to chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and postural orthostatic tachycardia syndrome (POTS). In adults, the prognosis for these diagnoses is less promising than that in youth; however, there is currently very little information available on the presentation of youth with PASC. A better understanding of the specific symptom presentation for youth diagnosed with PASC is necessary. Retrospective chart reviews were conducted …

Identification Of Post-Cardiac Arrest Blood Pressure Thresholds Associated With Outcomes In Children: An Icu-Resuscitation Study, Monique M Gardner, David A Hehir, Ron W Reeder, Tageldin Ahmed, Michael J Bell, Robert A Berg, Robert Bishop, Matthew Bochkoris, Candice Burns, Joseph A Carcillo, Todd C Carpenter, J Michael Dean, J Wesley Diddle, Myke Federman, Richard Fernandez, Ericka L Fink, Deborah Franzon, Aisha H Frazier, Stuart H Friess, Kathryn Graham, Mark Hall, Monica L Harding, Christopher M Horvat, Leanna L Huard, Tensing Maa, Arushi Manga, Patrick S Mcquillen, Kathleen L Meert, Ryan W Morgan, Peter M Mourani, Vinay M Nadkarni, Maryam Y Naim, Daniel Notterman, Murray M Pollack, Anil Sapru, Carleen Schneiter, Matthew P Sharron, Neeraj Srivastava, Bradley Tilford, Shirley D. Viteri, David Wessel, Heather A Wolfe, Andrew R Yates, Athena F Zuppa, Robert M Sutton, Alexis A Topjian

Department of Medicine Faculty Papers

INTRODUCTION: Though early hypotension after pediatric in-hospital cardiac arrest (IHCA) is associated with inferior outcomes, ideal post-arrest blood pressure (BP) targets have not been established. We aimed to leverage prospectively collected BP data to explore the association of post-arrest BP thresholds with outcomes. We hypothesized that post-arrest systolic and diastolic BP thresholds would be higher than the currently recommended post-cardiopulmonary resuscitation BP targets and would be associated with higher rates of survival to hospital discharge.

METHODS: We performed a secondary analysis of prospectively collected BP data from the first 24 h following return of circulation from index IHCA events enrolled …

Mobile Health As A Potential Tool To Treat Children In Obesity, Olivia Carey

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

Introduction

• Pediatric obesity prevalence is estimated to be 22% in 2020 of all children in the US³
• Obesity is defined as greater or equal to the 95th percentile for age and sex⁴
• Childhood obesity leads to adulthood hypertension, hyperlipidemia, respiratory complications, and reduced quality of life⁴⁴
• The AAP released new 2023 guidelines that define the standard of care as a multi-modal, chronic-care treatment plan that prescribes healthy eating choices, an increase in physical activity, and mental health support.⁵
• Mobile health is the use of mobile phones and wireless technology in healthcare³
• A meta analysis of …

Is Mixed Chimerism Post Allogeneic Hematopoietic Stem Cell Transplantation In Pediatric Acute Lymphoid Leukemia A Prognostic Factor For Relapse ?, Saadiya Khan, Zainab Alsaif, Khawar Siddiqui, Hawazen Alsaedi, Ali Al-Ahmari, Abdullah Al-Jefri, Ibrahim Ghemlas, Awatif Alanazi, Mouhab Ayas

Hematology/Oncology and Stem Cell Therapy

Hematopoietic Stem Cell Transplantation (HSCT) has been considered curative for children with high-risk acute leukemia (ALL) offering better survival. Short tandem repeat (STR) has been used as a marker of chimerism status after HSCT. The appearance of recipient cells >1% post allogenic stem cell transplant was defined as mixed chimerism (MC). Chimeric studies post HSCT are dynamic. The aim of this study was to study the significance of recipients cells in post-HSCT pediatric ALL patients as a predictor of relapse of their primary disease. Rate of MC was 51.4% (19 out of 37 recipients). It was 48.6% (n=18) during Day+100 …

The Effects Of Covid-19 On Cognition In The Pediatric Population, Mia Ramirez, Hope Mccarroll, Lisa Griggs-Stapleton

Summer 2023 Virtual OTD Capstone Symposium

Coronavirus disease or COVID-19, is an infectious disease caused by the SARS-CoV-2 virus. COVID-19 can affect adults and children by causing long-term symptoms such as difficulty concentrating, anxiety, depression, long-term breathing problems, and even heart complications. Children represent about 19% of all reported COVID-19 cases since the pandemic first began. Children also can have trouble concentrating, which can impact their ability to attend school and do their daily activities that require concentration, such as dressing, showering, and social participation. Cognitive deficits due to COVID-19 can impact the pediatric population as they may have decreased occupational performance in desired occupations, such …

Program Development In Pediatric Prosthetic Training For Occupational Therapists, Paulina Alas, Monica Watford, Grace Evasco

Summer 2023 Virtual OTD Capstone Symposium

This project delves into the necessity for professional tools designed to assist occupational therapists (OTs) in readying themselves for the treatment of pediatric patients requiring upper limb prosthetics. The endeavor encompasses an examination of various diagnoses that warrant prosthetic intervention, an exploration of diverse prosthetic variants, and a comprehensive manual detailing pre-prosthetic and prosthetic functional training.

Screening For Food Insecurity In A Suburban Pediatric Urgent Care, Rachel Foutz

Dissertations

Problem: Screening for Social Determinants of Health (SDOH), including food insecurity (FI) should be done on a regular basis at a child’s pediatrician. Many children in the state of Missouri do not have a pediatrician or do not regularly see their pediatrician and are therefore never being screened for FI.

Methods: This observational descriptive quality improvement (QI) project utilized a prospective observational analysis to implement a voluntary FI screening tool in a pediatric only urgent care. The project sampled pediatric patients aged two days to 21 years of life. All participants were given local resources after completing the screening. The …

Persistent Increase In Serum Ferritin Levels Despite Converting To Permanent Vascular Access In Pediatric Hemodialysis Patients: Pediatric Nephrology Research Consortium Study., Ali Mirza Onder, Md Abu Yusuf Ansari, Fang Deng, Matthew M. Grinsell, Larry Patterson, Jennifer Jetton, Sahar Fathallah-Shaykh, Daniel Ranch, Diego Aviles, Lawrence Copelovitch, Eileen Ellis, Vimal Chadha, Ayah Elmaghrabi, Jen-Jar Lin, Lavjay Butani, Maha Haddad, Olivera Marsenic, Paul Brakeman, Raymond Quigley, H Stella Shin, Rouba Garro, Rupesh Raina, Craig B. Langman

Manuscripts, Articles, Book Chapters and Other Papers

Our objective was to examine serum ferritin trends after conversion to permanent vascular access (PVA) among children who started hemodialysis (HD) using tunneled cuffed catheters (TCC). Retrospective chart reviews were completed on 98 subjects from 20 pediatric HD centers. Serum ferritin levels were collected at the creation of PVA and for two years thereafter. There were 11 (11%) arteriovenous grafts (AVG) and 87 (89%) arteriovenous fistulae (AVF). Their mean TCC use was 10.4 ± 17.3 months. Serum ferritin at PVA creation was elevated at 562.64 ± 492.34 ng/mL, increased to 753.84 ± 561.54 ng/mL (p = < 0.001) in the first year and remained at 759.60 ± 528.11 ng/mL in the second year (p = 0.004). …

Persistent Increase In Serum Ferritin Levels Despite Converting To Permanent Vascular Access In Pediatric Hemodialysis Patients: Pediatric Nephrology Research Consortium Study, Ali Mirza Onder, Md Abu Yusuf Ansari, Fang Deng, Matthew M. Grinsell, Larry Patterson, Jennifer Jetton, Sahar Fathallah-Shaykh, Daniel Ranch, Diego Aviles, Lawrence Copelovitch, Eileen Ellis, Vimal Chadha, Ayah Elmaghrabi, Jen-Jar Lin, Lavjay Butani, Maha Haddad, Olivera Marsenic, Paul Brakeman, Raymond Quigley, H Stella Shin, Rouba Garro, Rupesh Raina, Craig B. Langman

School of Medicine Faculty Publications

Our objective was to examine serum ferritin trends after conversion to permanent vascular access (PVA) among children who started hemodialysis (HD) using tunneled cuffed catheters (TCC). Retrospective chart reviews were completed on 98 subjects from 20 pediatric HD centers. Serum ferritin levels were collected at the creation of PVA and for two years thereafter. There were 11 (11%) arteriovenous grafts (AVG) and 87 (89%) arteriovenous fistulae (AVF). Their mean TCC use was 10.4 ± 17.3 months. Serum ferritin at PVA creation was elevated at 562.64 ± 492.34 ng/mL, increased to 753.84 ± 561.54 ng/mL (p = < 0.001) in the first year and remained at 759.60 ± 528.11 ng/mL in the second year (p = 0.004). The serum ferritin levels did not show a statistically significant linear association with respective serum hematocrit values. In a multiple linear regression model, there were three predictors of serum ferritin during the first year of follow-up: steroid-resistant nephrotic syndrome as primary etiology (p = 0.035), being from a center that enrolled >10 cases (p = …

Effect Of Everolimus On The Liver Function Of Children Receiving Liver Transplant With Chronic Rejection: An Evidence–Based Case Report, Adi Nd Puruboyo, Tri H. Rahayatri, Marini Stephanie

The New Ropanasuri Journal of Surgery

Introduction. Chronic rejection, a complication after pediatric living donor liver transplantation (LDLT), is challenging to treat as management generally requires retransplantation. However, retransplantation is avoided because of rejection risks, longer operating time, higher mortality, and lower survival rates. Immunosuppressant therapy has potential as an option for nonsurgical treatment. Everolimus, a mammalian target of rapamycin inhibitors (mTOR inhibitors), is a well-known immunosuppressant in treating chronic rejection of LDLT. However, studies in the pediatric field remain minimum.

Method. The discussion was based on evidence found from studies found through a systematic literature search. These three studies showed permanent liver function improvement after …

Seroma As A Biological Tissue Expander On Post-Mastectomy Reconstruction: A Case Report, Ahmad Kurnia, Fatahillah Muazdhani

The New Ropanasuri Journal of Surgery

Introduction. Previous studies have reported that patient satisfaction with breast cancer management is related to the success of breast reconstruction. The tissue expander used in breast reconstruction today has several disadvantages: the high cost, the nature of the foreign body, and the risk of failure. Seroma has the potential as a natural tissue developer in post-mastectomy reconstruction. This case report aims to describe the technique, results, advantages, and limitations of post-mastectomy breast reconstruction using a seroma as a natural tissue expander that has never been done before.

Case Presentation. A 37-year-old woman was diagnosed with stage IIIA non-special type (NST) …

Diagnostic Role Of Fractional Exhaled Nitric Oxide In Pediatric Eosinophilic Esophagitis, Relationship With Gastric And Duodenal Eosinophils., Panamdeep Kaur, Rachel Chevalier, Craig A. Friesen, Jamie Ryan, Ashley K. Sherman, Stephanie Page

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Eosinophilic esophagitis (EoE) is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies. A non-invasive and cost-effective alternative for management of EoE is being researched. Previous studies assessing utility of fractional exhaled nitric oxide (FeNO) in EoE were low powered. None investigated the contribution of eosinophilic inflammation of the stomach and duodenum to FeNO.

AIM: To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease activity.

METHODS: Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational study. Patients on steroids …

Rare First Rib Pseudoarthrosis With Thoracic Outlet Syndrome In Pediatric Gymnast: A Case Report, Jessica M. Kraft, Ann L. Contrucci, Gary E. Freed

Research Day

Background: This case study evaluates the diagnosis and treatment of a 12 year old Caucasian male gymnast who had several diagnoses including an isolated first rib fracture, resultant pseudoarthrosis of the first rib, and the development of symptomatic thoracic outlet syndrome. We discuss the causes, prevalence, and suggestions for prompt diagnosis and treatment of these conditions in pediatric patients. Although all three conditions are rare in a child, this case highlights the importance of having a high clinical index of suspicion in recurrent pain in pre-pubertal athletes.

Case presentation: A 10 year old Caucasian male presented with a two to …

Contributions To Auditory System Conduction Velocity: Insights With Multi-Modal Neuroimaging And Machine Learning In Children With Asd And Xyy Syndrome, Jeffrey I. Berman, Luke Bloy, Lisa Blaskey, Carissa R. Jackel, Judith S. Miller, Judith Ross, J. Christopher Edgar, Thimothy P.L. Roberts

Department of Pediatrics Faculty Papers

Introduction: The M50 electrophysiological auditory evoked response time can be measured at the superior temporal gyrus with magnetoencephalography (MEG) and its latency is related to the conduction velocity of auditory input passing from ear to auditory cortex. In children with autism spectrum disorder (ASD) and certain genetic disorders such as XYY syndrome, the auditory M50 latency has been observed to be elongated (slowed).

Methods: The goal of this study is to use neuroimaging (diffusion MR and GABA MRS) measures to predict auditory conduction velocity in typically developing (TD) children and children with autism ASD and XYY syndrome.

Results: Non-linear TD …

Targeting Metabolic Alterations Associated With Smooth Muscle Α-Actin Pathogenic Variant Attenuates Moyamoya-Like Cerebrovascular Disease, Anita Kaw

Dissertations & Theses (Open Access)

Heterozygous pathogenic variants in ACTA2, encoding smooth muscle α-actin (α-SMA), predispose to thoracic aortic aneurysms and dissections. De novo missense variants disrupting ACTA2 arginine 179 (p.Arg179) cause a multisystemic disease termed smooth muscle dysfunction syndrome (SMDS), which is characterized by early onset thoracic aortic disease and moyamoya disease-like (MMD) cerebrovascular disease. The MMD-like cerebrovascular disease in SMDS patients is marked by bilateral steno-occlusive lesions in the distal internal carotid arteries (ICAs) and their branches. To study the molecular mechanisms that underlie the ACTA2 p.Arg179 variants, a smooth muscle-specific Cre-lox knock-in mouse model of the heterozygous Acta2 R179C variant, termed …

Symptom Management Care Pathway Adaptation Process And Specific Adaptation Decisions, Emily Vettese, Farha Sherani, Allison A. King, Lolie Yu, Catherine Aftandilian, Christina Baggott, Vibhuti Agarwal, Ramamoorthy Nagasubramanian, Kara M. Kelly, David R. Freyer, Etan Orgel, Scott M. Bradfield, Wade Kyono, Michael Roth, Lisa M. Klesges, Melissa Beauchemin, Allison Grimes, George Tomlinson, L. Lee Dupuis, Lillian Sung

School of Medicine Faculty Publications

BACKGROUND: There is substantial heterogeneity in symptom management provided to pediatric patients with cancer. The primary objective was to describe the adaptation process and specific adaptation decisions related to symptom management care pathways based on clinical practice guidelines. The secondary objective evaluated if institutional factors were associated with adaptation decisions. METHODS: Fourteen previously developed symptom management care pathway templates were reviewed by an institutional adaptation team composed of two clinicians at each of 10 institutions. They worked through each statement for all care pathway templates sequentially. The institutional adaptation team made the decision to adopt, adapt or reject each statement, …

Use Of Integrative, Complementary, And Alternative Medicine In Children With Epilepsy: A Global Scoping Review, Zahra Zhu, Daniela Dluzynski, Nouran Hammad, Deepika Pugalenthi, Sarah A. Walser, Rea Mittal, Debopam Samanta, Melanie L. Brown, Ali A. Asadi-Pooya, Angelina Kakooza-Mwesige, Alberto Spalice, Martina Capponi, Alain Lekoubou, Ashutosh Kumar, Sita Paudel, Paul R. Carney, Gayatra Mainali, Sunil Naik

Department of Neurology Faculty Papers

(1) Background: Epilepsy is one of the most common chronic neurological disorders in childhood. Complementary and alternative medicine (CAM) use is highly prevalent in patients with epilepsy. Despite CAM’s widespread and increasing popularity, its prevalence, forms, perceived benefits, and potential risks in pediatric epilepsy are rarely explored. (2) Methods: We performed a scoping review of the available literature on the use of CAM in pediatric epilepsy. (3) Results: Overall, global cross-sectional studies showed a variable degree of CAM usage among children with epilepsy, ranging from 13 to 44% in prevalence. Popular types of CAMs reported were supplements, cannabis products, aromatherapy, …

International Consensus Statement On Allergy And Rhinology: Allergic Rhinitis – 2023, Sarah K. Wise, Cecelia C. Damask, Lauren T. Roland, Charles Ebert, Joshua M. Levy, Sandra Lin, Amber Luong, Kenneth Rodriguez, Ahmad R. Sedaghat, Helene J. Krouse

School of Medicine Publications and Presentations

Background

In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document.

Methods

ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus …

International Consensus Statement On Allergy And Rhinology: Allergic Rhinitis – 2023, Sarah K. Wise, Cecelia C. Damask, Lauren T. Roland, Charles Ebert, Joshua M. Levy, Sandra Lin, Amber Luong, Kenneth Rodriguez, Ahmad R. Sedaghat, Helene J. Krouse

School of Medicine Publications and Presentations

Background

In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document.

Methods

ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus …

A Comparison Of Chief Complaints, Specific Diagnoses, And Demographics Of Pediatric Urgent Care Visits Before And During The Covid-19 Pandemic: A Retrospective Study, Zaharoula A. Viennas, Julie Martin, Benjamin Klick, Tammy Speerhas, Turaj Vazifedan, Danielle Millspaugh, Jennifer Ferris, Margret Bedle, Lauren Paluch, Theresa Guins

Nursing Faculty Publications

There was an increased incidence of pediatric patients who presented with injuries caused by falls not related to sports or other recreational activities, as well as for animal bites, during the early pandemic period of April 2020. Education of parents and caregivers of young children is warranted to raise awareness of the even greater potential for falls and animal bites when children are confined at home for longer than typical periods of time, as occurred with the stay-at-home government orders during the initial period of the COVID-19 pandemic.