Medicine and Health Sciences Commons^™

Development Of Maine Ongoing Outreach Simulation Education (Moose), A Novel Telesimulation Program, To Improve Neonatal Resuscitation In A Rural Community Hospital, Allison Zanno, Misty Melendi, Micheline Chipman, Jeffrey Holmes, Alexa Craig, Samantha Piro, Anna Gilbert, Sarah Gabrielson, Leah Mallory, Anya Culter, Mary Ottolini

Costas T. Lambrew Research Retreat 2021

Objective- To implement monthly neonatal resuscitation telesimulation team training sessions in a rural community hospital delivery room that is feasible, sustainable, and replicable at other sites.

Plasma Concentrations Of Per- And Polyfluoroalkyl Substances And Body Composition From Mid-Childhood To Early Adolescence, Jaclyn Janis, Sheryl Rifas-Shiman, Shravanthi M. Seshasayee, Clifford J Rosen, Abby F Fleisch, Sharon Sagiv, Emily Oken

Costas T. Lambrew Research Retreat 2021

BACKGROUND

• Per- and polyfluoroalkyl substances (PFAS) may alter body composition by lowering anabolic hormones and increasing inflammation.

Prior studies have found positive, inverse, and null associations of PFAS concentrations with adiposity among children and adolescents.

Few studies have examined associations of PFAS concentrations with changes in body composition longitudinally.

No study has examined the association of PFAS plasma concentrations with lean mass.

Simulation-Based Training In The Paediatric Surgery Population: A Review Of Current Trends And Future Direction, Areej Saleem, Zorays Moazzam, Sohail Asghar Dogar, Saqib Hamid Qazi

Section of Paediatric Surgery

In recent years, simulation-based training in surgery has emerged as a viable accompaniment to traditional teaching methods. Multiple studies have highlighted the benefits of simulation-based training in both learning and teaching aspects of surgical training, with a particular emphasis on the honing of technical skills. However, multiple issues still exist in widespread implementation of simulation-based training, especially in the developing countries. Furthermore, the existing literature needs to be expanded upon in both quantity and quality domains to ensure a more evidence-based transition to simulation-based training in surgery. The current review article was planned to take a look at the existing …

Transitioning From Foster Care To Adulthood: Supporting Adolescents And Young Adults, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Children involved in foster care have significant trauma histories and have often experienced substantial neglect and/or abuse. Such adverse childhood experiences can lead to cumulative toxic stress, which if not buffered by support and a consistent adult caregiver, can negatively impact physical, mental and socio-emotional development. Such experiences can also result in a lack of trust in adults and systems of care, which can further reduce sources of support for children in foster care.

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

childrens.com/fostercare

Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand

Paediatrics and Child Health, East Africa

With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a felt need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of …

The Influence Of Coronavirus Disease-2019 (Covid-19) On Parkinson’S Disease: An Updated Systematic Review, Vikash Jaiswal, Danah Alquraish, Zouina Sarfraz, Azza Sarfraz, Shavy Nagpal, Prakriti Singh Shrestha, Dattatreya Mukherjee, Prathima Guntipalli, Diana F. Sánchez Velazco, Arushee Bhatnagar

Department of Paediatrics and Child Health

Background: COVID-19 has affected global communities with multiple neurological complications in addition to other critical medical issues. COVID-19 binds to the host's angiotensin-converting enzyme 2 (ACE2) receptors, which are expressed in the neurons and glial cells, acting as an entry port to the central nervous system (CNS). ACE2 receptors are abundantly expressed on dopamine neurons, which may worsen the prognosis of motor symptoms in Parkinson's disease (PD). SARS-CoV-2 may lead to an indirect response via immune-mediated cytokine storms and propagate through the CNS leading to damage. In this systematic review, we aim to provide thorough analyses of associations between COVID-19 …

The Effects Of Combined Transcranial Brain Stimulation And A 4-Week Visuomotor Stepping Training On Voluntary Step Initiation In Persons With Chronic Stroke-A Pilot Study, Ira H Gewolb, Babatunde T Sobowale, Frank L Vice, Abhijit Patwardhan, Nino Solomonia, Eric W Reynolds

Faculty, Staff and Student Publications

Background: Suck-swallow rhythmicity and the integration of breathing into infant feeding are developmentally regulated. Neurological injury and breathing abnormalities can both impact feeding in preterm infants.

Objective: To determine the effects of neurologic injury independent of effects of disordered breathing on feeding biorhythms in premature infants.

Methods: Low-risk preterm infants (LRP), infants with Grade 3–4 Intraventricular Hemorrhage (IVH), those with bronchopulmonary dysplasia (BPD), and those with both BPD and IVH (BPD+IVH) were identified. Forty-seven infants, 32–42 weeks Postmenstrual Age (PMA) were evaluated on one or more occasions (131 studies). Of these, 39 infants (81 studies) were performed at >35 weeks …

Time Trends Of Overweight And Obesity Among Schoolchildren In Kuwait Over A 13-Year Period (2007-2019): Repeated Cross-Sectional Study, Abdullah Al-Taiar, Nawal Alqaoud, Ali H. Ziyab, Faheema Alanezi, Monica Subhakaran, Reem Sharaf Alddin, Hueiwang Anna Jeng, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Objectives: This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions.

Design: Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period.

Setting: Public primary, middle, and high schools in all provinces of Kuwait.

Participants: Schoolchildren aged 5-19 …

Association Of In‐Line Digestive Enzyme Cartridge With Enteral Feeds On Improvement In Anthropometrics Among Pediatric Patients With Cystic Fibrosis, Karyn Shaw, Stacie Hunter, Minjae Lee, Meghana Sathe

2021

No abstract provided.

Dietary Management Of A 7-Year-Old Boy With S-Adenosylhomocysteine Hydrolase (Sah) Deficiency, Page Meachum, Garrett Gotway

2021

No abstract provided.

Orthostatic Headaches Associated With Spontaneous Intracranial Hypotension And Autonomic Dysfunction-A Case Series In Young Patients, Ankita Ghosh, Yen X Tran, Leon Grant, Mohammed T Numan, Rajan Patel, Ian J Butler

Faculty, Staff and Student Publications

Background: Orthostatic headaches can be noted in spontaneous intracranial hypotension and orthostatic intolerance. We present a case series of young patients diagnosed with spontaneous intracranial hypotension and were treated for the same but subsequently developed orthostatic intolerance. Methods: We retrospectively reviewed charts for seven young patients with orthostatic headaches related to spontaneous intracranial hypotension and orthostatic intolerance. Results: Patients were diagnosed with spontaneous intracranial hypotension. Diagnosis was confirmed by identifying epidural contrast leakage and three of seven patients were noted to have early renal contrast excretion on computerized tomography myelography. Patients were treated with epidural blood patches. All patients showed …

Development Of An Integrated Medical And Behavioral Health Care Model For Children In Foster Care: The Rees-Jones Center For Foster Care Excellence, Kimberly Stone, Sara Moore, Sara Pollard

Integrated, Trauma-Informed Care

Children in foster care are classified as a population with special health care needs. They face multiple adverse childhood experiences and disrupted relationships, yet face barriers accessing consistent, high-quality health care. The American Academy of Pediatrics recommends integrated physical and behavioral health care for children in foster care, but little is known about the implementation of integrated care for this population. As a pediatrician, doctor of nursing practice, and psychologist in an academic medical setting, we describe the development and implementation of the Rees-Jones Center for Foster Care Excellence, emphasizing the role of medical and behavioral health providers in promoting …

Unusual Teenage Growing Pains: If The Genes Fit, Kourtney Rudzinski Do, Rebecca Sharim Md

Department of Pediatrics

No abstract provided.

Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand

Department of Paediatrics and Child Health

With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of pediatric …

Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.
Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords "COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication." We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, …

The Safe Environment For Every Kid Model: Analyzing Demographics Related To Higher Risks Of Child Maltreatment In High-Risk Pediatric Population, Hannah Redding

Scholarship in Medicine - All Papers

Background: The Safe Environment for Every Kid (SEEK) screener was developed by Dr. Howard Dubowitz for primary care clinicians to identify and address risk factors for child maltreatment. The instrument queries parents/guardians regarding their families' needs (e.g. food insecurity) and screens for depressive symptoms in the parent/guardian.

Objective: To examine the frequency of social determinants of health (e.g., food insecurity) and its correlates using the SEEK screener during pediatric visits at a Federally Qualified Health Center in south central Ohio.

Design/Methods: The SEEK screener was distributed to parents/guardians (PG) at Rocking Horse Community Health Center, a Federally Qualified Health Center …

A Simulation-Based Outreach Program Improves Delivery Room Team Confidence In Neonatal Resuscitation At Rural Community Hospitals, Allison Zanno, Misty Melendi, Micheline Chipman, Jeffrey Holmes, Alexa Craig, Samantha Piro, Anna Gilbert, Sarah Gabrielson, Leah Mallory, Anya Culter, Mary Ottolini

Costas T. Lambrew Research Retreat 2021

Objective- Our goal is to pilot the use of an onsite Neonatal Community Outreach Education Program to improve provider confidence with procedural skills and neonatal resuscitation in the delivery room.

Optimizing A Pediatric Dka Protocol In A Tertiary Care Hospital System In Northern West Virginia, Jennifer L. Burky

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body compensates for insufficient insulin, producing dangerously high levels of ketones. Without proper treatment, DKA can be fatal. For that reason, staff in the pediatric intensive care unit (PICU) at a tertiary care hospital in northern West Virginia expressed concerns about the complexity of and lack of adherence to a poorly referenced and dated DKA treatment protocol.

Objective: The purpose of this project was to assess the feasibility and sustainability of optimizing the DKA protocol in the PICU. The primary objective was to implement an updated, …

Intraventricular Septation In The Context Of Dilated Cardiomyopathy Associated With Ttn Mutation, Karl R. Khandalavala, Jean A. Ballweg, Stanley J. Radio, Jeffrey A. Robinson

Journal Articles: Pediatrics

A 6-month-old infant boy presented with symptomatic heart failure. Dilated cardiomyopathy was found in association with a mutation in TTN. Structural heart disease included novel septation of the left ventricle with a fenestrated membrane resulting from aberrant congenital mitral valve apparatus formation. (Level of Difficulty: Advanced.).

Symptomatic Combined Thumb Cmc Arthritis And Slac Wrist: Incidence & Treatment Options, Frank Lalezar, Lawrence C. Hurst

Stony Brook Orthopaedic and Musculoskeletal Journal

Thumb basal joint osteoarthritis and scapholunate advanced collapse are common degenerative wrist disorders. Surprisingly, literature describing the incidence and treatment of these two disorders in the same wrist is limited. This study sought to determine how often these disorders present concurrently, as well as report on outcomes from a new surgical technique devised to treat these cases.

Are Radiographs Over-Utilized In Pediatric Orthopaedic Emergency Room Care?, Brian Lynch, Stephen Bowen, David E. Komatsu, Wesley Carrion

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: There is an estimated $760 to $935 billion in annual cost of waste in the United States healthcare system. $12.8 to $28.6 billion is attributed to wasteful studies/treatments. In an effort to examine current waste in our institution, we examined the use of radiographs in orthopedic patients evaluated in our pediatric emergency department (ED). The pediatric population is largely unable to make decisions for themselves and thus are susceptible to unneeded studies.

Hypothesis/Purpose: We propose that there is a significant amount of waste, in regard to: time, cost, and resources in the ED. Additionally, we believe that unnecessary studies …

Hip Fractures Before And During The Covid-19 Pandemic: Comparative Demographics And Outcomes, Alireza K. Nazemi, Samer M. Al-Humadi, Ryan Tantone, Thomas R. Hays, Stephen N. Bowen, David E. Komatsu, Nicholas Divaris

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: During the height of the COVID-19 pandemic in NY, hip fractures requiring operative management continued to present to Stony Brook University Hospital. Given the novelty of SARS-CoV-2, there is recent interest in the pandemic and its relationship to orthopaedic operative outcomes.

Purpose: This retrospective cohort study compared outcomes for operative hip fractures in patients prior to and during the COVID-19 pandemic at a Level 1 academic center.

Methods: Data were collected from patients age18 years or older who underwent operative management for hip fractures performed from January 21, 2019 to July 1, 2019 (pre-pandemic) and from January 21, 2020 …

Psychosocial Preoperative Preparation In A Non-Children's Hospital Without Child Life Supports, Haley M. Fricke

EWU Masters Thesis Collection

On average, 6 million children undergo general anesthesia for surgery annually in the United States (Shah et al., 2021).Anesthesia can be one of the most stress provoking experiences, with 40% to 60% of children displaying emotional and behavior stress before surgery (Boles, 2016). Psychosocial preoperative preparation in pediatrics has been seen to lower children’s stress levels, enhance understanding, increase compliance, decrease length of time in recovery, and decrease analgesic use (Aranha et al., 2017; Al-Yateem et al., 2016; Dolidze et al., 2013; Tunney & Boore 2013; Wenstrom et al., 2011). The purpose of this exploratory case study was to better …

Tisagenlecleucel Infusion In Patients With Relapsed/Refractory All And Concurrent Serious Infection., Erin Hall, Dwight E. Yin, Rakesh K. Goyal, Atif Ahmed, Grace S. Mitchell, Shawn D. St Peter, Terrie Flatt, Ibrahim A. Ahmed, Weijie Li, Richard J. Hendrickson, Keith August, Douglas Myers

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Tisagenlecleucel, an anti-CD19 chimeric antigen receptor T (CAR-T) cell therapy, has demonstrated durable efficacy and a manageable safety profile in pediatric and young adult patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) in the ELIANA pivotal trial and real-world experience. Experience from investigator-led studies prior to ELIANA suggests that infections and inflammatory conditions may exacerbate the severity of cytokine release syndrome (CRS) associated with CAR-T cell therapy, leading to extreme caution and strong restrictions for on-study and commercial infusion of tisagenlecleucel in patients with active infection. CRS intervention with interleukin (IL)-6 blockade and/or steroid therapy was introduced late in …

Neurally Adjusted Ventilatory Assist: Summation Of The Safety Proofs And Benefits, Landry Carneal

Williams Honors College, Honors Research Projects

Neurally Adjusted Ventilatory Assist (NAVA) is a mode of ventilation that is triggered by neither flow nor pressure but by the electrical activity of the diaphragm (Stein & Firestone, 2018, p. 227). NAVA puts ventilatory control into the hands of the patient and is often used in neonates who are more challenging to ventilate. Medical practitioners, however, are skeptical to put this mode of ventilation into practice with fear that neonates are neither strong enough nor capable to manage their own respiratory efforts without hypoventilation or damage to the lungs (Lubarsky et al., 2020, p. 3). Research shows that despite …

Is There A Role For Ct Pan-Scans In The Initial Work-Up Of Fragility Fracture Patients?, Eric Lepkowsky, Trevor Simcox, Hunter Rogoff, Shahidul Islam, Omid Barzideh

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: CT pan-scans have become increasingly commonplace as part of the initial diagnostic work-up for patients sustaining traumatic injuries. They have proven effective in improving diagnostic accuracy in those with high energy mechanisms of injury. However, the utility of pan-scans in the geriatric population sustaining low energy traumatic injuries remains unproven. There is no study that assesses the usefulness of CT pan-scans in patients who sustain injuries related to osteoporosis, also known as fragility fractures.

Methods: A retrospective review was conducted of patients who sustained a fragility fracture at a Level 1 trauma center over a 15-month period. Patients underwent …

Identification Of Infant Feeding Practices In Eastern Kentucky And Southern West Virginia That Correlate With High Weight-For-Length, Havilah R. Adkins

DNP Projects

Background: Approximately 20% of children in the United States are obese. West Virginia and Kentucky rank in the top 10 for obesity rates in children as young as 2-4 years old. Obesity increases the risk for numerous short-term health problems and impacts long-term health, development, quality of life, and life expectancy. Research indicates that obesogenic behaviors can be addressed prior to the development of obesity or significant health problems to prevent, rather than treat. Interventions targeting caregivers of infants younger than 2-years can promote early development of healthy feeding habits that persist through the developmental stages of nutrition. Before a …

Effects Of Alcohol Use On Total Knee Arthroplasty Patient Osteoarthritis Severity, Preoperative Pain Scores, And Postoperative Range Of Motion: A Retrospective Study, Christopher Ruland, Samir Baig, Zach Warheit, David E. Komatsu, James Nicholson

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Despite the prevalence of significant alcohol use, the effect of alcohol consumption on patients undergoing total knee arthroplasty (TKA) is poorly understood. Other forms of substance abuse, such as narcotic dependence, decrease patient pain tolerance and increase self-reported pain scores, while excessive alcohol consumption has been associated with adverse outcomes following other elective surgical procedures. In the context of TKA, perception of pain is also likely linked to the ability to achieve functional postoperative range of motion (ROM), one of the most important predictive indicators of patient satisfaction. It is not well understood whether heavy alcohol users who are …

Biomechanical Comparison Of Krackow Open Repair And Percutaneous Achilles Repair System For Achilles Tendon Rupture: A Cadaveric And Finite Element Model Study, David R. Swanson, Alireza Nazemi, Bonnie Macaluso, Chaudhry R. Hassan, Megan Paulus, Yi-Xian Qin, David E. Komatsu

Stony Brook Orthopaedic and Musculoskeletal Journal

Achilles tendon ruptures are one of the most common tendon injuries. Numerous surgical procedures have been developed to repair these injuries, but there is no consensus as to which technique is superior. This combined cadaveric and finite element model study was performed to compare directly initial biomechanical integrity between two operative techniques and use these resulting data to validate a finite element model.

Multicenter Studies In Orthopaedic Trauma: Importance, Challenges, And Stony Brook’S Contributions, Amanda C. Pawlak, Nathan Olszewski, Maxwell Alley, Thomas Seaver, Diana Lee, Michael Doany, Paul Tornetta Iii, Stephen A. Kottmeier, Orthopaedic Trauma Research Consortium

Stony Brook Orthopaedic and Musculoskeletal Journal

Historically, research within the field of orthopaedic surgery has largely consisted of small cohort studies or case series, typically produced out of one single center.1 Multicenter studies, however, allow for larger sample sizes and analyses with greater power and improved generalizability.2 Though these collaborative studies present challenges, including time, cost, communication and authorship issues, the value of these types of studies cannot be overstated.2,3 The Orthopaedic Trauma Research Consortium (OTRC) is one of several multi-institution research groups dedicated to furthering the field of orthopaedic trauma research. This manuscript reviews four recent OTRC studies that Stony Brook provided significant contributions to: …