Medicine and Health Sciences Commons^™

Are Children Of A Diabetic Mother In Comparison To Children Of A Nondiabetic Mother At An Increased Risk For Developing Obesity In The First 10 Years Of Life?, Chhorn Pho

Theses and Graduate Projects

Body weight, glucose, insulin, and leptin were studied in children of mothers with gestational diabetes, type 1 or type 2 diabetes. Breast milk of diabetic mothers was also analyzed to study its relationship to childhood obesity. In the first 2 years of life, infants of mothers with gestational diabetes have no significant difference in weight gain but by the age of 10, most of the children birthed by any diabetic mothers were either overweight or obese. Children of mothers diagnosed with diabetes mellitus type 2 have higher resistance to insulin than children of mothers with other diabetes types. Leptin was …

Analysis Of The Effects Of Music Therapy On Pain And Anxiety Levels In Pediatric Burn Patients, Maria Cook

Theses and Graduate Projects

Burn injuries resulting in tissue damage are considered one of the most severe traumas that can be experienced. Pain and anxiety continue to be major problems for patients with burn injuries during all stages of the treatment. Proper pain management is essential during recovery because it reduces the chance of developing malnutrition and promotes a stronger immune system. A number of studies have explored the effects of music on pain levels before, during, and after medical procedures for burn patients. Few studies have examined the effects of music therapy in the population of pediatric burn patients. Many studies have shown …

Therapeutic Hypothermia For Neonatal Hypoxic Ischemic Encephalopathy: Effects On Neurodevelopmental Outcomes, Claire Rustad

Theses and Graduate Projects

Therapeutic hypothermia is a standardized protocol in the management of term- or near- term neonates who have suffered asphyxia in the perinatal period. Birth asphyxia, if sustained, may develop into a more serious condition known as hypoxic ischemic encephalopathy (HIE). Depending on severity, HIE is associated with adverse cognitive and neurodevelopmental outcomes, yet through various physiological mechanisms, hypothermia sustained for a 72-hour period has been shown to attenuate, or even prevent, permanent brain damage by decreasing cerebral energy demands. Unfortunately, cognitive and neurodevelopmental outcomes are difficult to prognosticate before or after completion of hypothermia protocol, but existing standards and technology …

The Impact Of Breastfeeding Interventions On Breastfeeding Behavior, Ryan D. Steele

Theses and Graduate Projects

Breast milk is the natural first food for all infants, and breastfeeding provides multiple benefits for both the mother and child. However, breastfeeding rates in the United States are far from optimal, despite these benefits. There are multiple complex and interrelated reasons for the suboptimal breastfeeding rates, and multiple interventions have been completed with the goal of obtaining optimal breastfeeding rates. This literature review examines the efficacy of these breastfeeding interventions, specifically examining whether antenatal breastfeeding education was associated with increased breastfeeding initiation and duration relative to individualized support. Results of the literature review suggest that a combination of antenatal …

Congenital Prepubic Sinus: An Aborted Dorsal Urethral Duplication Or A Cloacal Remnant?, Zafar Nazir, Muhammad Arif Mateen Khan, Javaria Qamar

Section of Paediatric Surgery

Background: Congenital Prepubic Sinus (CPS) is an uncommon urogenital anomaly characterized by a blind tract between the skin over the pubis to anterior of the urinary bladder, Urethra or umbilicus. We report four such cases to emphasize varied clinical presentation and embryological conundrum.
Methods: Following Ethical Review Committee (ERC) approval, medical records of pediatric patients (<16 >years) presenting with CPS (identified through operating room records and Hospital Information Management System (HIMS) between 1994 and 2018 were reviewed for demographics, clinical presentation, investigations including histopathology, management and outcome.
Results: Four cases of CPS, 3 females and 1 male, age range …

Adherence Mechanism Analysis: The Role Of Prsa Gene In Lactobacillus Acidophilus And Other Infectious Microorganisms, Nujuma Moussa

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

No abstract provided.

Trauma Treatment For Children In The Child Welfare System, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Children involved in the child welfare system almost universally have experienced trauma, and many have experienced complex trauma. Research has shown that early intervention, treatment, and positive caregiving can reduce damage to the brain caused by trauma. Children coming into care should be screened to determine their trauma histories and related symptoms. Based on the outcomes of screenings and assessments, trauma-specific, evidence-based treatments or interventions should be provided.

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

childrens.com/fostercare

Reducing Discard Blood Draw Volumes From Subcutaneously Implanted Ports (Port) In Patients With End Stage Renal Disease (Esrd), Uttam Garg, Tyson Moore, Renita Trujillo, Penny Monachino, Amy Wiebold, Angela Ferguson, Gabor Oroszi, Vimal Chadha

Posters

Background
•To monitor clinical status, dialysis and transplant patients with ESRD frequently require blood draws.
•To preserve their veins and to avoid frequent intravenous access, these patients, especially young children, require PORT placement.
•The PORT is flushed with saline and filled with heparinized saline to prevent blood clotting between blood draws.
•To avoid contamination from PORT fluids, a fixed amount of blood is withdrawn and discarded before the blood sample is drawn for laboratory analyses. Currently, the recommended discard blood volume is 5 mL (five times the reservoir volume of most PORTs and attached catheters.)
•The volume of discarded blood …

Pre-Albumin As A Marker For Predicting Weight Loss In Hospitalised Children, Del-Rossi Sean Quadros, Rose Kamenwa, Samuel Akech, William Macharia

Paediatrics and Child Health, East Africa

Objectives: This study sought to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children.

Design: A hospital-based longitudinal survey was carried out between December 2013 and February 2014.

Setting: Aga Khan University Hospital, Nairobi, Kenya, a tertiary care hospital.

Subjects: A total of 170 children aged 29 days to 15 years who met the inclusion criteria were included in the study.

Outcome measures: Serum pre-albumin levels and weight were measured at admission and repeated after 48–96 h. Sensitivity, specificity, and positive and negative predictive values were calculated to determine the diagnostic utility of serum pre-albumin …

Teaching Children Road Safety Through Storybooks: An Approach To Child Health Literacy In Pakistan, Haris Ahmad, Rubaba Naeem, Nukhba Zia, Asher Feroze, Amarah Shakoor, Uzma R. Khan, Asad Mian

Department of Emergency Medicine

Background: Road traffic injuries (RTIs) commonly affect the younger population in low- and-middle-income countries. School children may be educated about road safety using storybooks with colorful pictures, which tends to increase the child’s interest in the text. Therefore, this study assessed the use of bilingual pictorial storybooks to improve RTI prevention knowledge among school children.
Methods: This pretest-posttest study was conducted in eight public and nine private schools of Karachi, Pakistan, between February to May 2015. Children in grades four and five were enrolled at baseline (n = 410). The intervention was an interactive discussion about RTI prevention using a …

Impact Of Huddles On Provider’S Knowledge Of Medically Complex Patients, Irina G. Trifonova, Troy E. Richardson, Jessica L. Bettenhausen, Matthew B. Johnson

Posters

Background:
The increasing complexity of pediatric inpatients requires that all providers understand a comprehensive child’s medical and social needs. A survey administered to Children’s Mercy Hospital inpatient providers identified gaps in knowledge regarding the daily plan of care and discharge planning needs among Complex Chronic Care (CCC) patients. Multidisciplinary rounds (MDRs) create a shared decision model among all team members to ensure that all aspects of care for CCC patients are addressed.

Objectives:
To improve provider knowledge of the plan of care and discharge planning needs for CCC patients admitted to the Hospitalist service, from 40% to 75% of providers …

Congenital Ventricular Diverticulum Or Aneurysm: A Difficult Diagnosis To Make., Lloyd Halpern, Carl Garabedian, Neil K Worrall

Articles, Abstracts, and Reports

A pouch protruding from the free wall of the left ventricle may be either a congenital ventricular diverticulum (CVD) or aneurysm (CVA). Being aware of these rare congenital anomalies is critical in making the diagnosis. Differentiating the two is important for treatment decisions. We describe a patient with dextrocardia, Tetralogy of Fallot, and a congenital left ventricular apical diverticulum diagnosed following the induction of anesthesia. CVD and CVA may present in the antenatal period through late adulthood with differing morphology, location, and symptoms. Echocardiography is paramount in the diagnosis and characterization of these lesions. If this anomaly is encountered after …

Catecholaminergic Polymorphic Ventricular Tachycardia Patients With Multiple Genetic Variants In The Paces Cpvt Registry., Thomas M Roston, Omid Haji-Ghassemi, Martin J Lapage, Anjan S Batra, Yaniv Bar-Cohen, Chris Anderson, Yung R Lau, Kathleen Maginot, Roman A Gebauer, Susan P Etheridge, James E Potts, Filip Van Petegem, Shubhayan Sanatani

Articles, Abstracts, and Reports

BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is often a life-threatening arrhythmia disorder with variable penetrance and expressivity. Little is known about the incidence or outcomes of CPVT patients with ≥2 variants.

METHODS: The phenotypes, genotypes and outcomes of patients in the Pediatric and Congenital Electrophysiology Society CPVT Registry with ≥2 variants in genes linked to CPVT were ascertained. The American College of Medical Genetics & Genomics (ACMG) criteria and structural mapping were used to predict the pathogenicity of variants (3D model of pig RyR2 in open-state).

RESULTS: Among 237 CPVT subjects, 193 (81%) had genetic testing. Fifteen patients (8%) with …

The Effectiveness Of Interventions And Bundles For Central Line-Associated Bloodstream Infections In The Neonatal Intensive Care Unit, Mohamad Alhamwi

Honors Undergraduate Theses

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs.

Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple …

D-Cycloserine-Augmented One-Session Treatment Of Specific Phobias In Children And Adolescents, Lara J. Farrell, Allison M. Waters, Ella L. Oar, Evelin Tiralongo, Vinay Garbharran, Clair Alston-Knox, Harry Mcconnell, Nigel Collings, Melanie Zimmer-Gembeck, Caroline L. Donovan, Chris Testa, Eric A. Storch, Thomas H. Ollendick

Pediatrics Faculty Publications

Background: D-Cycloserine has potential to enhance exposure therapy outcomes. The current study presents a preliminary randomized, placebo-controlled double-blind pilot trial of DCS-augmented one-session treatment (OST) for youth (7–14 years) with specific phobia. A secondary aim of this pilot study was to explore the effects of youth age and within-session fear reduction as potential moderators of DCS outcomes in order to generate hypotheses for a larger trial. It was hypothesized that DCS would be associated with greater improvements than placebo, that children (7–10 years) would have greater benefits than adolescents (11–14 years), and that DCS effects would be stronger for participants …

Two Unrelated Patients With Autosomal Dominant Omodysplasia And Frizzled2 Mutations, Hannah E. Warren, Raymond J. Louie, Michael J. Friez, Jaime L. Frías, Jules G. Leroy, Jürgen W. Spranger, Steven A. Skinner, Neena L. Champaigne

Pediatrics Faculty Publications

No abstract provided.

Preclinical Pharmacokinetic Evaluation To Facilitate Repurposing Of Tyrosine Kinase Inhibitors Nilotinib And Imatinib As Antiviral Agents, Hari Krishna Ananthula, Scott Parker, Erin Touchette, R. Mark Buller, Gopi Patel, Daniel Kalman, Johanna S. Salzer, Nadia Gallardo-Romero, Victoria Olson, Inger K. Damon, Tessa Moir-Savitz, Larry Sallans, Milton H. Werner, Catherine M.T. Sherwin, Pankaj B. Dasai

Pediatrics Faculty Publications

Background

Several tyrosine kinase inhibitors (TKIs) developed as anti-cancer drugs, also have anti-viral activity due to their ability to disrupt productive replication and dissemination in infected cells. Consequently, such drugs are attractive candidates for “repurposing” as anti-viral agents. However, clinical evaluation of therapeutics against infectious agents associated with high mortality, but low or infrequent incidence, is often unfeasible. The United States Food and Drug Administration formulated the “Animal Rule” to facilitate use of validated animal models for conducting anti-viral efficacy studies.

Methods

To enable such efficacy studies of two clinically approved TKIs, nilotinib, and imatinib, we first conducted comprehensive pharmacokinetic …

Implementing Lean Daily Management System To Improve Cvor First Case On-Time Starts, Haley Borchers, Kelly Fehlhafer, Barbara Mueller, Jessica Nichols, Sarah Talken, Mary Hunter, Kenneth Sam

Posters

No abstract provided.

Venous Thromboembolism Risk Stratification Via Electronic Medical Record Classification, Shannon L. Carpenter, Laura Miller-Smith, Brittney Hunter, Ashley Duty, Justin Sheets, Yuri Tupa, Kate Gibbs

Posters

No abstract provided.

A Ninja Initiative At Children's Mercy, Richard Ogden, Bradley A. Warady, Vimal Chadha, Wendy Hoebing

Posters

No abstract provided.

Increasing The Use Of Waveform Capnography In Neonatal And Pediatric Patients, Sherry Mccool, Lisa Pruitt, Olivia Kaullen

Posters

No abstract provided.

Quality Improvement: Implementing A Foot Exam To Improve Care For Patients With Diabetes Mellitus, Emily Paprocki, Ryan Mcdonough, Tiffany Musick, Joseph Cernich

Posters

No abstract provided.

Customizing A Pressure Injury Bundle Based On Unit-Specific Data, Kathlyn Baharaeen, Kimberly Palmer, Jamie Leroy, Julia Crouch, Bryan Limer, Gianna Swift, Kate Gibbs

Posters

No abstract provided.

Sustainability And Outcomes Of A Standardized Aminoglycoside Induced Ototoxicity Monitoring Algorithm, Claire Elson, Christopher M. Oermann, Michelle Weltman, Ellen Meier

Posters

No abstract provided.

Improving Hpv Immunization By Age 13 In Over 20 Kansas City Pediatric Practices, Luke A. Harris, Douglas Blowey

Posters

No abstract provided.

Pressure Injury Prevention For Urology Surgical Procedures: A Qi Initiative, Azadeh Wickham, Pat Clay, Kate Gibbs

Posters

No abstract provided.

Resident Great Catches: Recognizing Resident Physicians Who Promote A Safe Environment For Patients, Kristin Streiler, Susamita Kesh

Posters

No abstract provided.

What’S Coming For Health Science And Policy In 2018? Global Experts Look Ahead In Their Field, Soumya Swaminathan, Robin S. Room, Louise C. Ivers, Graham Hillis, Rebecca F. Grais, Zulfiqar Ahmed Bhutta, Peter Byass

Department of Paediatrics and Child Health

No abstract provided.

Hemimegalencephaly: Seizure Outcome In An Infant After Hemispherectomy, Prem Chand, Pooja Manglani, Qalab Abbas

Department of Paediatrics and Child Health

Isolated hemimegalencephaly (iHME) is a rare form of congenital malformation of cortical development characterized by enlargement of all or part of one cerebral hemisphere. It typically presents with intractable seizures, developmental delay, contralateral hemiparesis, and hemianopia. We report a case of an 18-month-old girl who presented first with focal seizures at tenth day of life, with no other physical or behavioral abnormality. Initial EEG showed excessive sharp EEG transients more over the right hemisphere; repeated EEG showed spikes, polyspikes, sharps, and slow wave discharges predominately over the right hemisphere. MRI of the brain showed asymmetric enlargement of the right cerebral …

Impact Of Pre-Eclampsia On The Cardiovascular Health Of The Offspring: A Cohort Study Protocol, Zahra Hoodbhoy, Babar Hasan, Nuruddin Badruddin Mohammed, Devyani Chowdhury

Department of Paediatrics and Child Health

Introduction: Pre-eclampsia is a common disorder associated with serious maternal and fetal complications. It is associated with abnormal placentation, which significantly reduces flow, resulting in a relative hypoxic state. These pathophysiological changes lead to subtle macrovascular and cardiac structural and functional changes in the fetus. This can predispose the child with maternal history of pre-eclampsia to risk of premature cardiovascular disease.
Methods and analysis: The children will be identified from a cohort of women with pre-eclampsia. The study will be conducted at The Aga Khan University Hospital, Karachi. Inclusion criteria will be children who are between 2 and 5 years …