Medicine and Health Sciences Commons^™

Plan B Topic: Annotated Resource List, Payton Roberts

Undergraduate Research Award

No abstract provided.

Incidence Of Methicillin-Resistant Staphylococcus Aureus Infection In A Children's Hospital In The Washington Metropolitan Area Of The United States, 2003-2010, Xiaoyan Song, Joanthan Cogen, Nalini Singh

Pediatrics Faculty Publications

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major public health threat. In this retrospective cohort study, we included patients with laboratory-confirmed MRSA infections treated at Children’s National Medical Center in Washington, District of Columbia between July 2003 and December 2010. The secular trends in the incidence rates of skin/soft tissue and invasive MRSA infections were assessed. Molecular analyses were performed on a subset of patients with invasive infections whose MRSA isolates were available for genotyping. The study identified 3750 patients with MRSA infections. The incidence of MRSA infections peaked in 2007 (incidence rate: 5.34 per 1000 patient-visits) and subsequently …

National Trends In C. Difficileinfections In Hospitalized Children And Young Adults With Inflammatory Bowel Disease, 2001 –2010, Kelly C. Sandberg, Matthew M. Davis, Achamyeleh Gebremariam, Jeremy Adler, Child Health Evaluation And Research Unit, University Of Michigan, C.S. Mott Children's Hospital, Pediatric Gastroenterology, University Of Michigan

Pediatrics Faculty Publications

Clostridium difficile infection complicates inflammatory bowel disease in children and adults. Increased hospitalizations have been reported due to recent hypervirulent c. difficile strains. National trends of c. difficile infections in hospitalized children and young adults with inflammatory bowel disease (IBD) are currently incomplete.

Implantable Port Devices In Paediatric Oncology Patients: A Clinical Experience From A Tertiary Care Hospital, Sohail Asghar Dogar, Muhammad Arif Mateen Khan

Section of Paediatric Surgery

Objective: To assess the frequency of infection of portacath in children having malignant tumours and undergoing chemotherapy, and to assess the association of the infection with already known risk factors.
Methods: The retrospective review was conducted at Aga Khan University Hospital, Karachi, and involved patient data related to the period between January 2005 to December 2010. A questionnaire was designed to collect the required data. A total of 67 children were included having portacath inserted for chemotherapy. Children in which portacath was inserted under local anaesthesia in Radiology department, reinserted or inserted because of a reason other than childhood malignancy …

Risk Of Hearing Loss In Children Exposed To Gentamicin For The Treatment Of Sepsis In Young Infancy: A Community Based Cohort Study In Pakistan, Urooj Iftikhar, Syed Asad Ali, Shiyam Sunder Tikmani, Iqbal Azam, Sarah Saleem, Anita Kaniz Zaidi

Department of Paediatrics and Child Health

Objective: To determine the safety of gentamicin when used in a community setting to treat neonatal sepsis.
Methods: The study was conducted in peri-urban areas of Karachi from September 2009 to April 2010. The exposed group consisted of children 6 months to 3 years of age who were treated for sepsis during 0-2 months of age in the community, with a regimen that included gentamicin for at least five days.The control group included children from the same area who never received gentamicin. The outcome measure was hearing loss, which was assessed by Brainstem Evoked Response Audiometry.
Results: Of the 255 …

La Feminización De La Especialidad De Pediatría En La Ciudad De Buenos Aires, Argentina / The Feminization Of The Specialty Of Pediatrics In The City Of Buenos Aires, Argentina, Jessica Wilder

Independent Study Project (ISP) Collection

Background: In the context of feminization of pediatrics that is occurring rapidly worldwide, this investigation seeks to determine the underlying causes of the phenomenon in Argentina. It focuses on the field of pediatrics because pediatrics is one of the most feminized medical specialties. Through this narrowed focus, the investigation intends to suggest causes for the feminization occurring in all of medicine. It studies the pediatricians of the Autonomous City of Buenos Aires in order to illuminate the social, logistical, and personal motivations that attracted them to pediatrics. It is very important to discover these motivations and causes because they reflect …

The Pertinence Of Maternal Education On Child Immunization In Rural Uttarakhand: More Than Just Increased Rates, Sarah Banerji

Independent Study Project (ISP) Collection

Child immunization rates in India continue to remain low, despite the 1985 implementation of a Universal Immunization Program that provides free basic immunizations to all children. There are numerous logistical factors that contribute to the low rates of immunization, but rates are made further worse by a lack of parental awareness and education about immunization, especially in village communities. This study examines the maternal understanding of immunization in rural Uttarakhand, both in villages in which an NGO has been working to improve maternal immunization education and in villages with no NGO involvement. It finds a positive correlation between increased immunization …

The Perception Of Maternal Anemia And The Effect Of Nutritional Education: A Qualitative Analysis Among Village Mothers In Rural Kumaon, Uk, Kelsey Bash

Independent Study Project (ISP) Collection

Malnutrition is often associated with starving children in developing countries. However, while calorie and protein deficiencies—macronutrient deficiencies—are a cause for concern, micronutrient deficiencies can be equally detrimental and are even more pervasive. The most prevalent micronutrient deficiency is anemia, and the story of anemia in India is particularly grim. India has the largest number of anemic people in the world and severe anemia is the cause of death for an average of 22,000 Indians each year (The Micronutrient Initiative 2006). Anemia rates are exacerbated for women and even more so for pregnant women. According to the most recent National Family …

Factors Impacting Echocardiographic Imaging After The Fontan Procedure: A Report From The Pediatric Heart Network Fontan Cross-Sectional Study., Richard V. Williams, Renee Margossian, Minmin Lu, Andrew M. Atz, Timothy J. Bradley, Michael Jay Campbell, Steven D. Colan, Dianne Gallagher, Wyman W. Lai, Gail D. Pearson, Ashwin Prakash, Girish S. Shirali, Meryl S. Cohen, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Echocardiographic image quality in Fontan survivors may be limited by a variety of factors. We sought to describe echocardiographic quality and factors associated with study quality in subjects participating in the Pediatric Heart Network Fontan Cross-Sectional Study. Echocardiograms were obtained at 7 clinical sites using a standard protocol. Quality grading and analysis were performed by a core laboratory. Univariate and multivariable modeling were performed to assess factors associated with quality and ability to obtain images sufficient for prespecified quantitative analysis. A total of 543 echocardiograms were obtained. The quality of echocardiograms improved over the duration of the study. The great …

Adolescence, Violence, And Public Health, Joav Merrick, Isack Kandel, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Palliative Care For The Medically Complex Child, Melanie Anspacher, Neha H. Shah

E-Learning Modules

**From the AAMC website: Contains time-sensitive information that will likely be inaccurate, obsolete, or irrelevant by August 12, 2016**

Children with special health care needs are increasingly prevalent in US hospitals. The pediatric hospitalist is often the primary provider of inpatient care for these patients. The Complex Care Curriculum was developed to provide a multi-modal educational curriculum for providers with the overall goal of improving inpatient care for this population. The curriculum is composed primarily of a series of topic-specific learning modules. This particular resource was created to provide pediatricians with educational materials related to palliative care for the medically …

Development Of Uv/Hplc Methods For Quantitative Analysis Of Benznidazole In Human Plasma And Urine For Application In Pediatric Clinical Studies, María Elena Marsón, Diego Dante Dana, Jaime Altcheh, Facundo García-Bournissen, Guido Mastrantonio

Paediatrics Publications

Objective: Chagas disease constitutes a major public health problem in Latin America. Correctly designed pharmacokinetic, safety, and bioequivalence studies are desirable in order to fill the knowledge gaps that presently exist on available drugs. It is necessary to develop accurate, simple, reproducible, and sensitive high-performance liquid chromatography (HPLC)/UV methods for the quantization of benznidazole (BNZ) in human plasma and urine for clinical applications, specially in pediatric patients. Methods: Quantization of BNZ in human plasma involved freeze-drying and re-suspension in organic solvent followed by reverse phase HPLC with UV detection. Analysis of BNZ in urine involved liquid/liquid extraction followed by reverse …

Neonatal Neurobehavioral Abnormalities And Mri Brain Injury In Encephalopathic Newborns Treated With Hypothermia, Maya B. Coleman, Penny Glass, Judy Brown, Nadja Kadom, Tammy Tsuchida, Joseph Scafidi, Taeun Chang, Gilbert Vezina, An Nguyen Massaro

Pediatrics Faculty Publications

Background

Neonatal Encephalopathy (NE) is a prominent cause of infant mortality and neurodevelopmental disability. Hypothermia is an effective neuroprotective therapy for newborns with encephalopathy. Post-hypothermia functional–anatomical correlation between neonatal neurobehavioral abnormalities and brain injury findings on MRI in encephalopathic newborns has not been previously described.

Aim

To evaluate the relationship between neonatal neurobehavioral abnormalities and brain injury on magnetic resonance imaging (MRI) in encephalopathic newborns treated with therapeutic hypothermia.

Study design

Neonates with hypoxic ischemic encephalopathy (HIE) referred for therapeutic hypothermia were prospectively enrolled in this observational study. Neurobehavioral functioning was assessed with the NICU network neurobehavioral scale (NNNS) performed …

Pulmonary Arteriovenous Malformation In Cryptogenic Liver Cirrhosis, Noureen Afzal, Saleem Akhtar, Shakeel Ahmed, Mehnaz Atiq

Department of Paediatrics and Child Health

The cause in 10 - 20% cases of liver cirrhosis (LC) cannot be elucidated, and are thus termed cryptogenic. Pulmonary arteriovenous malformations (PAVMs) are relatively rare, but the most common anomaly involving the pulmonary tree. Although the rare correlation between LC and PAVM is well-known, there have been no reports of PAVMs occurring in cryptogenic LC. We report a case of PAVM that occurred in cryptogenic liver cirrhosis in a 3 years old male child. The child presented with complaints of malena, hematemesis and variceal bleed. The examination revealed a child with respiratory distress, irritability, tachycardia, clubbing and abdominal distention. …

Strengthening Paediatric Emergency Medicine In Pakistan Is Our Need To Reach Millennium Development Goal 4., Emaduddin Siddiqui, Kiran Ejaz

Department of Emergency Medicine

No abstract provided.

Reproducibility Of Cine Displacement Encoding With Stimulated Echoes (Dense) Cardiovascular Magnetic Resonance For Measuring Left Ventricular Strains, Torsion, And Synchrony In Mice, Christopher M. Haggerty, Sage P. Kramer, Cassi M. Binkley, David K. Powell, Andrea C. Mattingly, Richard Charnigo, Frederick H. Epstein, Brandon K. Fornwalt

Pediatrics Faculty Publications

BACKGROUND: Advanced measures of cardiac function are increasingly important to clinical assessment due to their superior diagnostic and predictive capabilities. Cine DENSE cardiovascular magnetic resonance (CMR) is ideal for quantifying advanced measures of cardiac function based on its high spatial resolution and streamlined post-processing. While many studies have utilized cine DENSE in both humans and small-animal models, the inter-test and inter-observer reproducibility for quantification of advanced cardiac function in mice has not been evaluated. This represents a critical knowledge gap for both understanding the capabilities of this technique and for the design of future experiments. We hypothesized that cine DENSE …

Positive Youth Development, Life Satisfaction, And Problem Behaviors Of Adolescents In Intact And Non-Intact Families In Hong Kong, Daniel T. L. Shek, Hildie Leung

Pediatrics Faculty Publications

This study investigated whether Chinese adolescents living in intact and non-intact families differed in their positive development, life satisfaction, and risk behavior. A total of 3,328 Secondary 1 students responded to measures of positive youth development (such as resilience and psychosocial competencies), life satisfaction, and risk behavior (substance abuse, delinquency, Internet addiction, consumption of pornographic materials, self-harm, and behavioral intention to engage in problem behavior). Findings revealed that adolescents growing up in intact families reported higher levels of positive developmental outcomes and life satisfaction as compared with adolescents from non-intact families. Adolescents in non-intact families also reported higher levels of …

Increased Reticulocytosis During Infancy Is Associated With Increased Hospitalizations In Sickle Cell Anemia Patients During The First Three Years Of Life, Emily Riehm Meier, Colleen Byrnes, Y. Terry Lee, Elizabeth C. Wright, Alan N. Schechter, Naomi L. Luban, Jeffrey L. Miller

Pediatrics Faculty Publications

Objective

Among older children with sickle cell anemia, leukocyte counts, hemoglobin, and reticulocytosis have previously been suggested as disease severity markers. Here we explored whether these blood parameters may be useful to predict early childhood disease severity when tested in early infancy, defined as postnatal ages 60–180 days.

Study Design

Data from fifty-nine subjects who were followed at Children’s National Medical Center’s Sickle Cell Program for at least three years was retrospectively analyzed. Comparisons were made between white blood cell counts, hemoglobin and reticulocyte levels measured at ages 60–180 days and the clinical course of sickle cell anemia during infancy …

Ereply. Re: Balancing The Pulmonary Circulation In Tricuspid Atresia With An Aortopulmonary Window, Pranava Sinha, Syed Murfad Peer, Mary T. Donofrio

Pediatrics Faculty Publications

No abstract provided.

Appendicitis Is Like A Box Of Chocolates, Clint D. Cappiello, Phillip C. Guzzetta, Faisal G. Qureshi

Pediatrics Faculty Publications

Appendicitis is the most commonly encountered abdominal emergency in pediatric surgery. However, the presentation of acute appendicitis is as diverse as the patient population. We present here a case of appendicitis presenting as an intra-abdominal mass consistent with lymphoma. Our patient is a 3 year old male with an atypical presentation of acute appendicitis. Additionally, he was found to have malrotation at the time of surgery. A delayed presentation, coupled with anomalous laboratory findings and aberrant anatomy made for a difficult diagnosis and overall interesting case of appendicitis.

The Relationship Between Prenatal Stress, Depression, Cortisol And Preterm Birth: A Review, Kiran Shaikh, Shahirose Premji, Khurshid Khowaja, Suzanne Tough, Ambreen Kazi, Shaneela Khowaj

School of Nursing & Midwifery

Preterm birth is one of the most common adverse pregnancy outcomes. Maternal risk factors such as stress and depression have been associated with preterm birth. Preterm infants are at a higher risk of poor growth and neuro developmental outcomes. The objective of this paper is to examine the relationship between maternal stress, depression, cortisol level, and preterm birth. Preterm birth is one of the most common adverse pregnancy outcomes with a global prevalence of 9.6% and one of the major contributors to infant mortality and morbidity. The association between psychosocial stress and preterm birth, although examined for more than 25 …

Early Echocardiographic Changes After Percutaneous Implantation Of The Edwards Sapien Transcatheter Heart Valve In The Pulmonary Position., Shahryar M. Chowdhury, Ziyad M. Hijazi, John Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Lydia King, Jodi Akin, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To evaluate echocardiographic changes after SAPIEN valve implantation in the pulmonary position.

BACKGROUND: The feasibility of the SAPIEN transcatheter pulmonary valve (TPV) has recently been demonstrated. We evaluated changes in pulmonary valve function and the right ventricle after SAPIEN TPV placement.

METHODS: We evaluated echocardiograms at baseline, discharge, 1 and 6 months after TPV placement in 33 patients from 4 centers. Pulmonary insufficiency severity was graded 0-4. TPV peak and mean gradients were measured. Right ventricular (RV) size and function were quantified using routine measures derived from color, spectral, and tissue Doppler indices and two-dimensional echocardiography.

RESULTS: At baseline, …

A Case Of Worsening Stridor In A Neonate, Richard J. Mazzaccaro Md

Department of Pediatrics

No abstract provided.

Disease Patterns And Outcomes Of Neonatal Admissions At A Secondary Care Hospital In Pakistan, Syed R. Ali, Shakeel Ahmed, Heeramani Lohana

Department of Paediatrics and Child Health

Objectives: This study aimed to determine the disease patterns and outcome of patients admitted to the neonatal unit of a secondary care hospital in Pakistan from January to December 2009.
Methods: Retrospective data from the medical records of all neonates admitted during the study period were reviewed and analysed for age, weight, sex, reason for admission, duration of hospital stay, diagnosis and final outcome. Trends were examined to identify the indicators of inpatient neonatal deaths.
Results: The total number of neonates admitted during the study period was 1,554; 979 were male (63%), and 575 were female (37%). A total of …

Mothers’S Education And Working Status; Do They Contribute To Corrosive Poisoning Among Paediatric Patients Of Karachi, Pakistan?, Emaduddin Siddiqui, Kiran Ejaz, Sayyeda Ghazala Irfan Kazi, Saif Siddiqui, Syed Jamal Raza

Department of Emergency Medicine

Objectives: To determine the causative factors behind corrosive poisoning in children like effect of working mothers, their educational status, financial background, family size and number of siblings.

Methods: The multi-centre, prospective, case series of all paediatric patients presenting to the Emergency Department of the National Institute of Child Health and the Aga Khan University Hospital, Karachi from August 2008 to July 2009 is presented. It comprised all paediatric patients with a history of corrosive poisoning at the two hospitals. SPSS 20 was used for statistical analysis.

Results: Out of 105 cases, 56(53%) related to the private-sector Aga Khan University Hospital, …

Nutrition Political Economy, Pakistan. Province Report:Sindh, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Rozina Mistry, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Nutrition Political Economy, Pakistan. Province Report: Khyber Pakhtunkhwa, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Abdul Wajid, Gul Nawaz, Kashif Nazeer, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Nutrition Political Economy, Pakistan. Provincial Report: Balochistan., Shehla Zaidi, Zulfiqar Ahmed Bhutta, Suleman Qazi, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Pediatric Palliative Care For Youth With Hiv/Aids: Systematic Review Of The Literature, Megan L. Wilkins, Ronald H. Dallas, Kathleen E. Fanone, Maureen E. Lyon

Pediatrics Faculty Publications

Improvement in treatment has led to decreased death in youth with human immunodeficiency virus (HIV) in developed countries. Despite this, youth with HIV are still at risk for increased mortality and morbidity compared with their uninfected counterparts. In developing countries, high numbers of youth die from acquired immune deficiency syndrome (AIDS)-related illnesses due to lack of access to consistent antiretroviral treatment. As a result, pediatric palliative care is a relevant topic for those providing care to youth with HIV. A systematic review was conducted to gather information regarding the status of the literature related to pediatric palliative care and medical …

Crystal Structure Of The N-Acetyltransferase Domain Of Human N-Acetyl-L-Glutamate Synthase In Complex With N-Acetyl-L-Glutamate Provides Insights Into Its Catalytic And Regulatory Mechanisms, Gengxiang Zhao, Zhongmin Jin, Norma M. Allewell, Mendel Tuchman, Dashuang Shi

Pediatrics Faculty Publications

N-acetylglutamate synthase (NAGS) catalyzes the conversion of AcCoA and L-glutamate to CoA and N-acetyl-L-glutamate (NAG), an obligate cofactor for carbamyl phosphate synthetase I (CPSI) in the urea cycle. NAGS deficiency results in elevated levels of plasma ammonia which is neurotoxic. We report herein the first crystal structure of human NAGS, that of the catalyticN-acetyltransferase (hNAT) domain with N-acetyl-L-glutamate bound at 2.1 Å resolution. Functional studies indicate that the hNAT domain retains catalytic activity in the absence of the amino acid kinase (AAK) domain. Instead, the major functions of the AAK domain appear to be providing …