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Pupillometric Assessment Of Small Doses Of Opioid In A Pediatric Population, David Strum, Elizabeth Malphrus, Kevin Jackson, Julia Finkel Apr 2018

Pupillometric Assessment Of Small Doses Of Opioid In A Pediatric Population, David Strum, Elizabeth Malphrus, Kevin Jackson, Julia Finkel

GW Research Days 2016 - 2020

According to the CDC, opioid prescriptions in the United States have more than tripled from 1999-2014, which has correlated with the staggering increase in opioid-involved drug overdose deaths. This pattern of prescription is thought to be a major contributory factor to the increase in drug overdose in America, as four out of five new heroin users started by misusing prescription painkillers. Providers need the means to objectively monitor analgesic efficacy of treatment in patients with pain to mitigate unnecessary analgesic prescribing.

It is well established that mu opioid agonists like morphine cause miosis, an effect to which tolerance does not …


Parental Compliance For Two Stage Fowler-Stephens Laparoscopic Orchiopexy: Is Everyone Following Up For The Second Stage And, If Not, Who Is At Risk?, Campbell Grant, H. Gil Rushton, Tanya D. Davis Apr 2018

Parental Compliance For Two Stage Fowler-Stephens Laparoscopic Orchiopexy: Is Everyone Following Up For The Second Stage And, If Not, Who Is At Risk?, Campbell Grant, H. Gil Rushton, Tanya D. Davis

GW Research Days 2016 - 2020

Purpose: Patients undergoing a two-stage Fowler-Stephens laparoscopic orchiopexy for intra-abdominal testes are typically recommended to undergo the second stage 4-6 months after the first stage. . As part of a quality care initiative, our studied examined if patients were in fact following up within this window and, if not, why patients were lost to follow up.

Materials and Methods: We retrospectively reviewed a cohort of 105 patients who underwent the first stage of a 2-stage Fowler-Stephens orchidopexy at our institution between 1/2005 to 1/2015. Bivariate and multivariate analyses were performed to compare clinical, surgical, and socioeconomic factors. Patients identified as …


Characteristics Of Correctly Identified Pediatric Obesity And Overweight Status And Management In An Academic General Pediatric Clinic, Ana Morais, Joseph Kelly, James E. Bost, Susma Vaidya Apr 2018

Characteristics Of Correctly Identified Pediatric Obesity And Overweight Status And Management In An Academic General Pediatric Clinic, Ana Morais, Joseph Kelly, James E. Bost, Susma Vaidya

GW Research Days 2016 - 2020

Objective: The goals of this study were to identify and characterize the rates of documentation and guideline-based management of overweight and obese children within an academic pediatric clinic.

Population/Methods: Overweight, obese, and severely obese children were identified from 7,422 well child visits in 2016 within a primary care clinic that cares for a primarily urban, minority (80% African American), and Medicaid (85%) population until the age of 12. During this 1-year study, there were 79 pediatric residents, 19 attending pediatricians, and 5 nurse practitioners who treated patients. Through a retrospective electronic medical record review, diagnosis and treatment including counseling, …


Resilience Of Children With Chronic Health Conditions: The Impact Of Neuropsychiatric Comorbidities, Sarah Bernstein, Sandra Cushner-Weinstein Apr 2018

Resilience Of Children With Chronic Health Conditions: The Impact Of Neuropsychiatric Comorbidities, Sarah Bernstein, Sandra Cushner-Weinstein

GW Research Days 2016 - 2020

BACKGROUND: Resilience, the ability to overcome adversity and effectively recover from stressful experiences, is a complex theory with many contributing factors. Previous studies have shown that condition-specific summer camps for children with chronic health conditions increase resilience and adaptive coping skills, change attitudes toward the illness, and improve quality of life. The aim of this study was to determine how neuropsychiatric comorbid diagnoses such as attention deficit hyperactivity disorder (ADHD), learning disability, and anxiety disorder influence the resilience of children with chronic health conditions.

METHODS: Children with chronic health conditions including autism, epilepsy, cerebral palsy, Tourette’s syndrome, sickle cell anemia, …


A Review Of Pain Control In Pediatric Cardiac Bypass Surgery, Pranathi Ari, Andrew T. Waberski, Nina Deutsch Apr 2017

A Review Of Pain Control In Pediatric Cardiac Bypass Surgery, Pranathi Ari, Andrew T. Waberski, Nina Deutsch

GW Research Days 2016 - 2020

Background: Children undergoing cardiac surgery with cardiopulmonary bypass receive high dose opioids for analgesia and to reduce the neurohormonal stress response. While opioids have excellent pharmacodynamics profiles adverse effects include: respiratory depression, bradycardia, nausea, vomiting, and tolerance. Additionally, opioids with short half-lives like fentanyl require several boluses to be administered during surgery causing fluctuating levels analgesia. Several strategies to advance pain control incorporate regional and neuraxial anesthetic techniques, however anticoagulation preclude its routine use. Alternatively using opioids with longer half-lives for analgesia may improve pain control and reduce adverse effects.

Objective: The objective of this study is to quantify postoperative …


Needs Assessment Of Pediatric Radiological Equipment And Cross-Cultural Investigation Into Parental Empowerment In Pediatric Radiology Program Development In The Kingdom Of Bhutan, Danielle Canter Apr 2017

Needs Assessment Of Pediatric Radiological Equipment And Cross-Cultural Investigation Into Parental Empowerment In Pediatric Radiology Program Development In The Kingdom Of Bhutan, Danielle Canter

GW Research Days 2016 - 2020

Background:

Bhutan is a magnificent mountainous country hugged by India to the east and west and by China to the North and South. This peaceful nestled country faces challenges in combating non-communicable diseases due to the lack of radiological equipment necessary for early diagnosis. Prior to implementation of these medical devices, it is imperative to investigate the cultural attitudes, beliefs, and infrastructure, to ensure successful integration. Bhutan is beginning to implement a pediatric radiology program for the nation with the assistance of ABAH Foundation and RAD-AID International, both of whom partnered with graduate students at George Washington University School of …


Perioperative Aspirin Recommendations In Children With Fenestrated Fontan Undergoing Adenotonsillectomy, Mariam Ashraf, Pamela A. Mudd, Jamie Mcelrath Schwartz, Karen Thompson Mar 2016

Perioperative Aspirin Recommendations In Children With Fenestrated Fontan Undergoing Adenotonsillectomy, Mariam Ashraf, Pamela A. Mudd, Jamie Mcelrath Schwartz, Karen Thompson

GW Research Days 2016 - 2020

Objective: Pediatric patients who have undergone the Fontan procedure are often on a long term aspirin regimen which can complicate perioperative management. In high risk procedures such as adenotonsillectomy, hemorrhage can be a significant complication and aspirin use may increase the risk. There is a need for evidence-based protocol on how to manage aspirin intake in the perioperative period for Fontan patients. We report the case of a patient with Fontan palliation who underwent adenotonsillectomy and presented with postoperative hemorrhage.

Methods: PubMed was searched for guidelines, case reports, and reviews on pediatric Fontan patients, adenotonsillectomy, and perioperative aspirin …