Medicine and Health Sciences Commons^™

Factors Affecting Pregnancy Outcome In Refugee Mothers In Lebanon, Hesham Elshal, Mohammad Chour, Sirine Abdel Halim, Sadika Kharpoutli, Hind Raad, Sami Abou Alfa, Rida Maaliki, Zeina Makki

BAU Journal - Health and Wellbeing

In recent years, Lebanon has been a destination for less privileged refugees who seek better living conditions and shelter from regional wars, conflicts and instabilities. Recently, it is estimated that more than 20% of residents in Lebanon are Syrian refugees who live under questionable conditions regarding quality of life. Pregnant women, among their population, are considered more vulnerable to the effect of such living conditions. This study aimed at assessment of pregnancy outcome (birth weight, infant complications…) in a sample of women in refugees areas who have recently given birth and relate this outcome to multiple factors including socioeconomic status …

Disparities In Health Care Utilization And The Effect Of Family Resilience And Neighborhood Support, Temitope Omoladun, Nora L. Vish

Medical Student Research Symposium Abstracts and Posters

Resilience, the ability to recover from adversity and turn obstacles into strengths and successes, can mitigate negative health outcomes associated with external drivers of health. Poverty, low educational attainment, insurance status and marginalized communities along with adverse childhood events are all known to be associated with poor health outcomes. Resilience is increasingly understood as a potent mitigating factor of negative health outcomes associated with toxic stress and social determinants of health. Individual resilience itself is impacted by external drivers such as family resilience and community cohesion.

Medical homes seek to promote patient well-being by establishing a partnership of trust and …

Overcoming Obesity: Provider Reminders And Education In Pediatrics, Michelle Warren

Evidence-Based Practice Project Reports

The prevalence of pediatric overweight and obesity is rising globally (Di Cesare et al., 2019) and results in lifelong chronic health problems and an estimated annual healthcare cost of $14.1 billion (Trasande & Chatterjee, 2009). The purpose of this evidence-based practice project was to address overweight and obesity in patients between the ages of five and 12 years through the provision of provider reminders, education, and guidelines. Primary outcomes included frequency of diagnosis, frequency of patient referrals, return to see times, and frequency of patient nutrition and activity education while secondary outcomes included patient weight, body mass index (BMI), and …

Cross-Sectional Exploration Of Plasma Biomarkers Of Alzheimer's Disease In Down Syndrome: Early Data From The Longitudinal Investigation For Enhancing Down Syndrome Research (Life-Dsr) Study, James A. Hendrix, David C. Airey, Angela Britton, Anna D. Burke, George T. Capone, Ronelyn Chavez, Jacqueline Chen, Brian Chicoine, Alberto C. S. Costa, Jeffrey L. Dage, Eric Doran, Anna Esbensen, Casey L. Evans, Kelley M. Faber, Tatiana M. Foroud, Sarah Hart, Kelsey Haugen, Elizabeth Head, Suzanne Hendrix, Hampus Hillerstrom, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

With improved healthcare, the Down syndrome (DS) population is both growing and aging rapidly. However, with longevity comes a very high risk of Alzheimer’s disease (AD). The LIFE-DSR study (NCT04149197) is a longitudinal natural history study recruiting 270 adults with DS over the age of 25. The study is designed to characterize trajectories of change in DS-associated AD (DS-AD). The current study reports its cross-sectional analysis of the first 90 subjects enrolled. Plasma biomarkers phosphorylated tau protein (p-tau), neurofilament light chain (NfL), amyloid β peptides (Aβ_1-40, Aβ_1-42), and glial fibrillary acidic protein (GFAP) were undertaken with …

Determinants Of Short Birth Intervals Among Married Women: A Cross-Sectional Study In Karachi, Pakistan, Sidrah Nausheen, Maria Asif Bhura, Kristy Hackett, Imtiaz Hussain, Zainab Shaikh, Arjumand Rizvi, Uzair Ansari, David Canning, Iqbal Shah, Sajid Bashir Soofi

Department of Obstetrics & Gynaecology

Introduction: Birth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan.
Methods: We used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were …

Maternal And Neonatal Morbidity And Mortality Among Pregnant Women With And Without Covid-19 Infection: The Intercovid Multinational Cohort Study, José Villar, Shabina Ariff, Robert B. Gunier, Ramachandran Thiruvengadam, Stephen Rauch, Alexey Kholin, Paola Roggero, Federico Prefumo, Marynéa Silva Do Vale, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance: Detailed information about the association of COVID-19 with outcomes in pregnant individuals compared with not-infected pregnant individuals is much needed.
Objective: To evaluate the risks associated with COVID-19 in pregnancy on maternal and neonatal outcomes compared with not-infected, concomitant pregnant individuals.
Design, setting, and participants: In this cohort study that took place from March to October 2020, involving 43 institutions in 18 countries, 2 unmatched, consecutive, not-infected women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were …

“Not So ‘Sweet’” – Case Of Sweet Syndrome In Patient With Mds With Excessive Blasts, Janet Digber-Williams Md, Neysa Perez Crespo Md, Taylor Jarvill Ms, Leia Derosato Do, Kirsten S. Bellucci Md, Daniel Zinn Md

Department of Pediatrics

No abstract provided.

A Decade Of Induction Chemotherapy Practices At A Small Children’S Cancer Center, Julia Vandenheuvel Md, Felipe Bautista Otanez Md

Department of Pediatrics

No abstract provided.

Ewing Sarcoma Of The 9th Rib Subsequent To Pediatric Leukemia: A Case Series, Julia Vandenheuvel Md, Leighton Elliott Md, Daniel Zinn Md, Michal Miller Md, Jacob Troutman Do

Department of Pediatrics

No abstract provided.

Is Biventricular Vascular Coupling A Better Indicator Of Ventriculo-Ventricular Interaction In Congenital Heart Disease?, Emily L. Yang, Shelby Kutty, Brian D. Soriano, Sathish Mallenahalli, Mark R. Ferguson, Mark B. Lewin, Sujatha Buddhe

Journal Articles: Pediatrics

BACKGROUND: Ventriculo-ventricular interactions are known to exist, though not well quantified. We hypothesised that the ventricular-vascular coupling ratio assessed by cardiovascular MRI would provide insight into this relationship. We also sought to compare MRI-derived ventricular-vascular coupling ratio to echocardiography and patient outcomes.

METHODS: Children with cardiac disease and biventricular physiology were included. Sanz's and Bullet methods were used to calculate ventricular-vascular coupling ratio by MRI and echocardiography, respectively. Subgroup analysis was performed for right and left heart diseases. Univariate and multivariate regressions were performed to determine associations with outcomes.

RESULTS: A total of 55 patients (age 14.3 ± 2.5 years) …

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial, Melissa S. Bauserman, Carla M. Bann, K Michael Hambidge, Ana L. Garces, Lester Figueroa, Jamie L. Westcott, Jackie K. Patterson, Elizabeth M. Mcclure, Sumera Ali Aziz, Sarah Saleem

Community Health Sciences

Background: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.
Objective: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.
Methods: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Correlation Of Severity Of Covid-19 Disease With Gastrointestinal Manifestations And Liver Injury - A North Brooklyn Community Hospital Experience: A Retrospective Cohort Study, Kitson Deane, Ajay Singh, Azza Sarfraz, Zouina Sarfraz, Lyam Ciccone, Beishi Zheng, Arslan Afzal, Gulam Khan, Giovanna Rodriguez, Gul Bahtiyar

Department of Paediatrics and Child Health

Introduction: The primary receptor for SARS-CoV-2 infection, angiotensin-converting enzyme-2 (ACE-2), is expressed in the gastrointestinal tract and liver parenchyma. The involvement of the gastrointestinal tract with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has remained unclear. The following study retrospectively reviews gastrointestinal symptoms and liver function tests at the time of hospital admission to identify patient outcomes including prolonged hospital stay, the requirement for intensive care, and all-cause in-hospital 30-day mortality.
Methods: A retrospective review of patient charts at the Woodhull Medical and Mental Health Center (WMC) was conducted at the time of hospital admission, using a pre-determined selection criterion. …

Health-Related Quality Of Life Across Recent Pediatric Obesity Classification Recommendations., William R. Black, Kelsey B. Borner, Marshall T. Beauchamp, Ann M. Davis, Meredith Dreyer, Brooke Sweeney, Sarah Hampl

Manuscripts, Articles, Book Chapters and Other Papers

Extreme body mass index (BMI) values (i.e., above the 97th and below the 3rd percentiles) are inaccurately represented on the Centers for Disease Control and Prevention's growth curves, which may limit the utility of BMI percentile and BMI z-score for capturing changes in clinical outcomes for patients at extreme weights. Modeling child obesity severity based upon the percentage of BMI in excess of the 95th percentile (BMI95pct) has been proposed as an improved metric to better capture variability in weight at extreme ends of growth curves, which may improve our understanding of relationships between weight status and changes in clinical …

The Prevalence Of Hyperpalatable Baby Foods And Exposure During Infancy: A Preliminary Investigation., Kai Ling Kong, Tera L. Fazzino, Kaitlyn M. Rohde, Katherine S. Morris

Manuscripts, Articles, Book Chapters and Other Papers

Objective: To characterize the prevalence of hyperpalatable foods (HPF) among baby foods in the U.S. and examine the prevalence of HPF exposure and consumption from both baby food and adult food sources among infants aged 9-15 months.

Methods: A U.S. baby food database as well as baby foods from three 24-h dietary recalls of 147 infants were used to identify baby foods as HPF per previous publication. HPF exposure was defined as intake of any HPF during the 3-day measurement period. To determine the extent of HFP consumption, % kilocalorie (kcal) intake from HPF was characterized.

Results: Only 12% of …

Efficacy Of Weight Reduction On Pediatric Nonalcoholic Fatty Liver Disease: Opportunities To Improve Treatment Outcomes Through Pharmacotherapy., Chance S. Friesen, Chelsea Hosey-Cojocari, Sherwin S. Chan, Iván L. Csanaky, Jonathan B. Wagner, Brooke Sweeney, Alec Friesen, Jason D. Fraser, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

Obesity is the single greatest risk factor for nonalcoholic fatty liver disease (NAFLD). Without intervention, most pediatric patients with NAFLD continue to gain excessive weight, making early, effective weight loss intervention key for disease treatment and prevention of NAFLD progression. Unfortunately, outside of a closely monitored research setting, which is not representative of the real world, lifestyle modification success for weight loss in children is low. Bariatric surgery, though effective, is invasive and can worsen NAFLD postoperatively. Thus, there is an evolving and underutilized role for pharmacotherapy in children, both for weight reduction and NAFLD management. In this perspective article, …

Hydronephrosis Classifications: Has Utd Overtaken Apd And Sfu? A Worldwide Survey., Santiago Vallasciani, Anna Bujons Tur, John Gatti, Marcos Machado, Christopher S. Cooper, Marie Klaire Farrugia, Huixia Zhou, Mohammed El Anbari, Pedro-José Lopez

Manuscripts, Articles, Book Chapters and Other Papers

Objective: To collect baseline information on the ultrasonographic reporting preferences.

Method: A 13-multiple choice questionnaire was designed and distributed worldwide among pediatric urologists, pediatric surgeons, and urologists. The statistical analysis of the survey data consisted of 3 steps: a univariate analysis, a bivariate and a multivariate analysis.

Results: Three hundred eighty participants responded from all the continents. The bivariate analysis showed the significant differences in the geographical area, the years of experience and the volume of cases. Most of the physicians prefer the SFU and APD systems because of familiarity and simplicity (37 and 34%, respectively). Respondents noted that their …

Dosing Recommendations For Vancomycin In Children And Adolescents With Varying Levels Of Obesity And Renal Dysfunction: A Population Pharmacokinetic Study In 1892 Children Aged 1–18 Years, Cornelis Smit, Sebastiaan C. Goulooze, Roger J. M. Brüggemann, Catherine M. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Vancomycin is an effective but potentially nephrotoxic antibiotic commonly used for severe infections. Dosing guidelines for vancomycin in obese children and adolescents with or without renal impairment are currently lacking. This study describes the pharmacokinetics of vancomycin in a large pediatric cohort with varying degrees of obesity and renal function to design practical dosing guidelines for this population. A multi-center retrospective population pharmacokinetic study was conducted using data from patients aged 1−18 years who received >1 dose of vancomycin and had ≥1 vancomycin concentration measured between January 2006 and December 2012. Besides pharmacokinetic data, age, gender, body weight, creatinine clearance …

Safety And Improved Efficacy Signals Following Gene Therapy In Childhood Blindness Caused By Gucy2d Mutations, Samuel G. Jacobson, Artur V. Cideciyan, Allen Ho, Igor V. Peshenko, Alexandra V. Garafalo, Alejandro J. Roman, Alexander Sumaroka, Vivian Wu, Arun Krishnan, Rebecca Sheplock, Sanford Boye, Alexander Dizhoor, Shannon Boye

Wills Eye Hospital Papers

A first-in-human clinical trial of gene therapy in Leber congenital amaurosis due to mutations in the GUCY2D gene is underway, and early results are summarized. A recombinant adeno-associated virus serotype 5 (rAAV5) vector carrying the human GUCY2D gene was delivered by subretinal injection to one eye in three adult patients with severe visual loss, nystagmus, but preserved retinal structure. Safety and efficacy parameters were monitored for 9 months post-operatively. No systemic toxicity was detected; there were no serious adverse events, and ocular adverse events resolved. P1 and P2 showed statistically significant rod photoreceptor vision improvement by full-field stimulus testing in …

A Pedunculated Esophageal Chondromatous Hamartoma In A Child, Dan-Alexandru Iozsa, Maria Puscasu, Catalin Gabriel Cirstoveanu, Vlad Denis Constantin, Anca Silvia Dumitriu, Stana Paunica, Nicolae Sebastian Ionescu

Journal of Mind and Medical Sciences

Esophageal tumors are uncommon in pediatric population and most of them are benign. Esophageal hamartomas have been reported extremely rare in children. These can present as intramural tumors of the esophageal wall or as polyps. Dysphagia is the main symptom described in their case, but other specific symptoms are also reported. Such symptoms encountered in clinical practice are represented by obstructive apnea episodes and bradycardia, poor weight gain, epigastric or retrosternal pain, hematemesis or melena, dysphonia or tracheal sounds. Diagnosis can be delayed due to the insidious onset and non-specific symptoms, therefore patient’s compliance to follow-up and broad, careful evaluation …

Postoperative Complicated Appendectomy Revealing Crohn’S Disease In A Pediatric Patient, Augustina Enculescu, Mircea Denis Lupusoru, Catalin Cirstoveanu, Andra-Iulia Suceveanu, Liliana Florina Andronache, Adrian-Paul Suceveanu, Felix Voinea, Maria Puscasu

Journal of Mind and Medical Sciences

Granulomatous appendicitis is a very rare entity in children. It is related to Crohn’s disease in only 5-10% of the cases. The diagnosis of Crohn’s disease is a real challenge in the pediatric population, especially when its initial manifestation is acute appendicitis. Herein, we present a 13-year-old boy admitted for acute appendicitis. The histopathological examination was conclusive for acute granulomatous appendicitis. The development of an entero-cutaneous fistula has complicated the postoperative evolution. The failure of the conservative management required ileocecal resection. The pathological examination revealed Crohn’s disease. The one-year follow-up on the patient din not reveal any complications. We strongly …

Delta-Like 4 Is Required For Pulmonary Vascular Arborization And Alveolarization In The Developing Lung., Sheng Xia, Heather Menden, Nick Townley, Sherry M. Mabry, Jeffrey J. Johnston, Michael F. Nyp, Daniel P. Heruth, Thomas Korfhagen, Venkatesh Sampath

Manuscripts, Articles, Book Chapters and Other Papers

The molecular mechanisms by which endothelial cells (ECs) regulate pulmonary vascularization and contribute to alveolar epithelial cell development during lung morphogenesis remain unknown. We tested the hypothesis that delta-like 4 (DLL4), an EC Notch ligand, is critical for alveolarization by combining lung mapping and functional studies in human tissue and DLL4-haploinsufficient mice (Dll4+/lacz). DLL4 expressed in a PECAM-restricted manner in capillaries, arteries, and the alveolar septum from the canalicular to alveolar stage in mice and humans. Dll4 haploinsufficiency resulted in exuberant, nondirectional vascular patterning at E17.5 and P6, followed by smaller capillaries and fewer intermediate blood vessels at P14. Vascular …

Leveraging Institutional Support To Build An Integrated Multidisciplinary Care Model In Pediatric Inflammatory Bowel Disease., Jennifer Verrill Schurman, Craig A. Friesen

Manuscripts, Articles, Book Chapters and Other Papers

While the biopsychosocial nature of inflammatory bowel disease (IBD) is now well accepted by clinicians, the need for integrated multidisciplinary care is not always clear to institutional administrators who serve as decision makers regarding resources provided to clinical programs. In this commentary, we draw on our own experience in building successful integrated care models within a division of pediatric gastroenterology (GI) to highlight key considerations in garnering initial approval, as well as methods to maintain institutional support over time. Specifically, we discuss the importance of making a strong case for the inclusion of a psychologist in pediatric IBD care, justifying …

A Career Of Honor And Humility: Interview With A Pioneer In Ophthalmology, Eli Cehelyk

inSIGHT

Imagine being a first-time parent in your early 30s, and you have just learned that your three-month old infant has retinoblastoma. Thanksgiving is right around the corner and you have no idea what the future holds. How would you feel? What thoughts would be racing through your head? With both hope and anxiety, you make an appointment at Wills Eye to see Dr. Carol Shields, a world-renowned expert on ocular oncology. With confidence and compassion, she walks into the room with her entire team and says, “Don’t worry, we will get everything under control for you. We will take your …

Heartburn In Children And Adolescents In The Presence Of Functional Dyspepsia And/Or Irritable Bowel Syndrome Correlates With The Presence Of Sleep Disturbances, Anxiety, And Depression., Jennifer Colombo, Amanda D. Deacy, Jennifer Verrill Schurman, Craig A. Friesen

Manuscripts, Articles, Book Chapters and Other Papers

ABSTRACT: The aim of this study was to assess the relationship of heartburn in pediatric patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS) with gastrointestinal symptoms, sleep disturbances, and psychologic distress.The overlap in symptoms of FD, IBS, and gastroesophageal reflux disease (GERD) predicts greater symptom severity and decreased quality of life and presents opportunities for improved diagnostic classification and personalized therapeutics.A cross-sectional observational study of 260 pediatric patients with abdominal pain was conducted. Patients completed standardized questionnaires assessing clinical symptoms, sleep quality, and psychologic symptoms during routine clinical care. Questionnaire data were compared for patients reporting heartburn and …

Hyperglycemia During The First Three Days Of Life Increases The Risk Of Retinopathy Of Prematurity In Extremely Low Birth Weight Infants, Jihan M. Esmail, Ramasubbareddy Dhanireddy Md

Longitudinal Scholar's Project

Background: The association between hyperglycemia and ROP has been inconsistent in previous studies. Extremely low birth weight (ELBW) infants are at high risk for ROP. They also experience hypoglycemia initially and hyperglycemia while receiving IV glucose infusion. The effect of initial hypoglycemia on hyperglycemia associated ROP risk is unknown.

Objective: To study the effect of initial hypoglycemia and subsequent hyperglycemia during the first three days of life on the incidence of ROP and severe ROP in ELBW (birth weight ≤1000g) infants.

Methods: Clinical and demographic data were collected from 227 ELBW infants born during the years 2017-2019 at the Regional …

Attention Deficit Hyperactivity Disorder: Treatment, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Risk Factors For Re-Hospitalization Following Neonatal Discharge Of Extremely Preterm Infants In Canada, Zakariya Bambala Puthattayil, Thuy Mai Luu, Marc Beltempo, Shannon Cross, Thevanisha Pillay, Marilyn Ballantyne, Anne Synnes, Prakesh Shah, Thierry Daboval

Paediatrics Publications

Objective: Survivors of extremely preterm birth are at risk of re-hospitalization but risk factors in the Canadian population are unknown. Our objective is to identify neonatal, sociodemographic, and geographic characteristics that predict re-hospitalization in Canadian extremely preterm neonates. Methods: This is a retrospective analysis of a prospective observational cohort study that included preterm infants born 22 to 28 weeks’ gestational age from April 1, 2009 to September 30, 2011 and seen at 18 to 24 months corrected gestational age in a Canadian Neonatal Follow-Up Network clinic. Characteristics of infants re-hospitalized versus not re-hospitalized are compared. The potential neonatal, sociodemographic, and …

Observing Pediatric Residents' Communication Skills During Sick Visits: Do They Determine Concern And Their Reasons For Concern And Are Caregivers Satisfied?, Carter Guice, Kristine Schmitz, Annette Aldous, Larrie Greenberg

Pediatrics Faculty Publications

Fifty years ago, Dr. Barbara Korsch published her seminal work on pediatric resident communication skills, demonstrating that residents did not always ascertain the caregivers’ main concern for the visit was and specifically, why those caregivers were concerned.

Repeating her study using a direct observation methodology, the authors evaluated 103 pediatric sick visits at a large children’s hospital primary care clinic to determine 1) if residents elicited the caregiver’s main concern about their child’s acute illness, 2) why they were concerned, and 3) whether asking these questions was statistically associated with caregiver satisfaction, which was determined by an exit survey.

Results …

Implementation Of An Infant Male Circumcision Programme, Pakistan, Shazia Moosa, Ammar Ali Muhammad, Sohail Asghar Dogar, Sundus Iftikhar, Walter Johnson, Asad Latif, Lubna Samad

Section of Paediatric Surgery

Objective: To retrospectively review outcomes of a health provider-led infant circumcision programme in Pakistan.
Methods: Based on World Health Organization guidelines, we trained surgical technicians and midwives to perform circumcisions using the Plastibell device at two Indus Health Network facilities. Programme tools include a training manual for health providers, information brochures for families, an enrolment form and standardized forms for documenting details of the procedure and outcomes. Infants aged 1-92 days were eligible for the study. Health workers contacted families on days 1 and 7 after the procedure to record any adverse events. We compared the characteristics of infants experiencing …

Research Participation Of Minor Adolescents In Foster Care, Jenny Francis, Jane Andresen, Heidi Kloster, Jill Mcleigh, Alexis Guzman, Susan Rosenthal

Health Status, Outcomes, and Literacy and Healthcare Utilization

In this study we evaluated published studies about foster care to: (1) determine the types of data used; (2) describe the degree to which a sexual/reproductive health topic was addressed; and (3) describe the consent process.

For questions about this study or others, please email [email protected]

childrens.com/fostercare