Medicine and Health Sciences Commons^™

Use Of Nasal Samples And Genom Amplification Methods For Detection Of Respiratory Viruses In Infants With Acute Lower Respiratory Tract Infection, Yasemi̇n Bulut, Yaşar Şen, Ahmet Gödekmerdan, Şükran Özdi̇ller, Zülal Aşçi Toraman

Turkish Journal of Medical Sciences

Aim: The aim of this study was to evaluate the use of genome amplification methods [polymerase chain reaction (PCR) and reverse transcription (RT)-PCR] for detection of common respiratory viruses (RSV: respiratory syncytial virus, PIV3: parainfluenza virus 3, IVA: influenza virus type A, IVB: influenza virus type B and adenovirus) in nasal wash specimens of infants with acute lower respiratory tract infection (ALRI). Materials and Methods: The nasal and serum samples taken from 90 infants with ALRI were analyzed by genome amplification methods and ELISA. Results: In ELISA, specific IgM to only one virus and to multiple viruses was present in …

Guidelines And Standards For Performance Of A Pediatric Echocardiogram: A Report From The Task Force Of The Pediatric Council Of The American Society Of Echocardiography., Wyman W. Lai, Tal Geva, Girish S. Shirali, Peter C. Frommelt, Richard A. Humes, Michael M. Brook, Ricardo H. Pignatelli, Jack Rychik, Pediatric Council Of The American Society Of Echocardiography

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Treatment Of Solid Organ Transplant Recipients With Autologous Epstein Barr Virus-Specific Cytotoxic T Lymphocytes (Ctls)., Barbara Savoldo, John A. Goss, Markus M. Hammer, Lan Zhang, Teresita Lopez, Adrian P. Gee, Yu-Feng Lin, Ruben E. Quiros-Tejeira, Petra Reinke, Stephan Schubert, Stephen Gottschalk, Milton J. Finegold, Malcolm K. Brenner, Cliona M. Rooney, Helen E. Heslop

Faculty Publications

We have investigated the in vivo safety, efficacy, and persistence of autologous Epstein Barr virus (EBV)-specific cytotoxic T lymphocytes (CTLs) for the treatment of solid organ transplant (SOT) recipients at high risk for EBV-associated posttransplantation lymphoproliferative disease (PTLD). EBV-CTLs generated from 35 patients expanded with normal kinetics contained both CD8 and CD4 lymphocytes and produced significant specific killing of autologous EBV-transformed B lymphoblastoid cell lines (LCLs). Twelve SOT recipients at high risk for PTLD, or with active disease, received autologous CTL infusions without toxicity. Real-time polymerase chain reaction (PCR) monitoring of EBV-DNA showed a transient increase in plasma EBV-DNA suggestive …

Treatment Evolution In High-Risk Congenital Diaphragmatic Hernia: Ten Years' Experience With Diaphragmatic Agenesis, Kevin P Lally, Pamela A Lally, Krisa P Van Meurs, Desmond J Bohn, Carl F Davis, Bradley Rodgers, Jatinder Bhatia, Golde Dudell

Journal Articles

OBJECTIVE: The objective of this study was to evaluate the impact of newer therapies on the highest risk patients with congenital diaphragmatic hernia (CDH), those with agenesis of the diaphragm.

SUMMARY BACKGROUND DATA: CDH remains a significant cause of neonatal mortality. Many novel therapeutic interventions have been used in these infants. Those children with large defects or agenesis of the diaphragm have the highest mortality and morbidity.

METHODS: Twenty centers from 5 countries collected data prospectively on all liveborn infants with CDH over a 10-year period. The treatment and outcomes in these patients were examined. Patients were followed until death …

Open Versus Laparoscopic Pyloromyotomy For Pyloric Stenosis: A Prospective, Randomized Trial., Shawn D. St Peter, G W. Holcomb Iii, Casey M. Calkins, J Patrick Murphy, Walter S. Andrews, Ronald J. Sharp, Charles L. Snyder, Daniel J. Ostlie

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pyloric stenosis, the most common surgical condition of infants, is treated by longitudinal myotomy of the pylorus. Comparative studies to date between open and laparoscopic pyloromyotomy have been retrospective and report conflicting results. To scientifically compare the 2 techniques, we conducted the first large prospective, randomized trial between the 2 approaches.

METHODS: After obtaining IRB approval, subjects with ultrasound-proven pyloric stenosis were randomized to either open or laparoscopic pyloromyotomy. Postoperative pain management, feeding schedule, and discharge criteria were identical for both groups. Operating time, postoperative emesis, analgesia requirements, time to full feeding, length of hospitalization after operation, and complications …

Incidence And Outcome Of Cardiopulmonary Resuscitation In Patients With Shunted Single Ventricle: Advantage Of Right Ventricle To Pulmonary Artery Shunt., Eric M. Graham, Geoffrey A. Forbus, Scott M. Bradley, Girish S. Shirali, Andrew M. Atz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Does The Choice Of Bottle Nipple Affect The Oral Feeding Performance Of Very-Low-Birthweight (Vlbw) Infants?, C E. Scheel, Richard J. Schanler, Chantal Lau

Faculty Publications

BACKGROUND: There is a continuous debate regarding the best bottle nipple to be used to enhance the bottle-feeding performance of a preterm infant. Aim: To verify that feeding performance can be improved by using the bottle nipple with the physical characteristics that enhance infants' sucking skills. METHODS: Ten "healthy" VLBW infants (941+/-273 g) were recruited. Feeding performance was monitored at two time periods, when taking 1-2 and 6-8 oral feedings/d. At each time and within 24 h, performance was monitored using three different bottle nipples offered in a randomized order. Rate of milk transfer (ml/min) was the primary outcome measure. …

Investigating The Causes Of Low Birth Weight In Contrasting Ovine Paradigms., J M Wallace, Timothy Regnault, S W Limesand, W W Hay, R V Anthony

Paediatrics Publications

Intrauterine growth restriction (IUGR) still accounts for a large incidence of infant mortality and morbidity worldwide. Many of the circulatory and transport properties of the sheep placenta are similar to those of the human placenta and as such, the pregnant sheep offers an excellent model in which to study the development of IUGR. Two natural models of ovine IUGR are those of hyperthermic exposure during pregnancy, and adolescent overfeeding, also during pregnancy. Both models yield significantly reduced placental weights and an asymmetrically growth-restricted fetus, and display altered maternal hormone concentrations, indicative of an impaired trophoblast capacity. Additionally, impaired placental angiogenesis …

Developing And Deploying A New Member Of The Dental Team: A Pediatric Oral Health Therapist, David A. Nash

Oral Health Science Faculty Publications

There are inadequate numbers of dentists able and willing to treat America's children, specifically children from low income and minority populations. This has led to the well-publicized disparities in oral health among children. In the early part of the 20^th century New Zealand faced a significant problem with oral disease among its children and introduced a School Dental Service, staffed by allied dental professionals with two years' training in caring for the teeth of children, "school dental nurses." A significant number of countries have adopted the model. This article reviews the history of attempts to develop such an approach …

Infant Oral Health: A Survey Of General Dentists, Pediatric Dentists, And Pediatricians In Virginia, Rhea Delcastillo Davis

Theses and Dissertations

Purpose: The purpose of this study was to examine the knowledge, attitudes, and experiences related to infant oral health for both dental and medical providers.Methods: A survey of infant oral health care was sent to 300 randomly selected general dentists, 300 randomly selected pediatricians, and all pediatric dentists in Virginia. The survey contained questions regarding the providers' routine infant oral health care regimen. In addition demographic data from the provider was collected. Responses to the questionnaire were tabulated and percent frequency distributions for responses to each item computed. Percents for all items were based on the total number of respondents …

Oncolog, Volume 49, Number 11, November 2004, Rachel Williams, Steve C. Stuyck Mph

OncoLog MD Anderson's Report to Physicians (All issues)

• The Youngest Cancer Patients
• Meeting the Rising Demand for Outpatient Care
• House Call: Going Beyond the Headlines: Tips to help you evaluate cancer stories in the news media
• DiaLog: Cancer Information in the Media, by Stephen C. Stuyck, MPH, Vice President for Public Affairs

Sars Surveillance During Emergency Public Health Response, United States, March-July 2003, Stephanie J. Schrag, John T. Brooks, Chris Van Beneden, Umesh D. Parashar, Patricia M. Griffin, Larry J. Anderson, William J. Bellini, Robert F. Benson, Dean D. Erdman, Alexander Klimov, Thomas G. Ksiazek, Teresa C. T. Peret, Deborah F. Talkington, W. Lanier Thacker, Maria L. Tondella, Jacquelyn S. Sampson, Allen W. Hightower, Dale F. Nordenberg, Brian D. Plikaytis, Ali S. Khan, Nancy E. Rosenstein, Tracee A. Treadwell, Cynthia G. Whitney, Anthony E. Fiore, Tonji M. Durant, Joseph F. Perz, Annemarie Wasley, Daniel Feikin, Joy L. Herndon, William A. Bower, Barbara W. Klibourn, Deborah A. Levy, Victor G. Coronado, Joanna Buffington, Clare A. Dykewicz, Rima F. Khabbaz, Mary E. Chamberland

Journal Articles: Epidemiology

In response to the emergence of severe acute respiratory syndrome (SARS), the United States established national surveillance using a sensitive case definition incorporating clinical, epidemiologic, and laboratory criteria. Of 1,460 unexplained respiratory illnesses reported by state and local health departments to the Centers for Disease Control and Prevention from March 17 to July 30, 2003, a total of 398 (27%) met clinical and epidemiologic SARS case criteria. Of these, 72 (18%) were probable cases with radiographic evidence of pneumonia. Eight (2%) were laboratory-confirmed SARS-coronavirus (SARS-CoV) infections, 206 (52%) were SARS-CoV negative, and 184 (46%) had undetermined SARS-CoV status because of …

Epidemiologic And Environmental Investigation Of A Recreational Water Outbreak Caused By Two Genotypes Of Cryptosporidium Parvum In Ohio In 2000, Els Mathieu, Deborah A. Levy, Fran Veverka, Mary-Kay Parrish, John Sarisky, Nancy Shapiro, Stephanie Johnston, Thomas Handzel, Allen Hightower, Lihua Xiao, Yeuk-Mui Lee, Steve York, Michael Arrowood, Robin Lee, Jeffrey L. Jones

Journal Articles: Epidemiology

In August 2000, the Ohio Department of Health requested assistance to investigate a cryptosporidiosis outbreak with more than 700 clinical case-patients. An epidemiologic and environmental investigation was conducted. Stool specimens, pool water, and sand filter samples were analyzed. A community-based case-control study showed that the main risk factor was swimming in pool A (odds ratio [OR] = 42, 95% confidence interval [CI] = 12.3-144.9). This was supported by results of polymerase chain reaction (PCR) analysis, which showed the presence of both the human and bovine genotypes of Cryptosporidium parvum in case-patients and samples from the filter of pool A. A …

Occupational Therapy Sensory Integration Protocol For Early Intervention: Birth To Three Years, Reagan Boyson

Occupational Therapy Capstones

No abstract provided.

Association Of Viral Genome With Graft Loss In Children After Cardiac Transplantation., Girish S. Shirali, J Ni, R E. Chinnock, J K. Johnston, G L. Rosenthal, N E. Bowles, J A. Towbin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The survival of recipients of cardiac allografts is limited by rejection, lymphoproliferative disease, and coronary vasculopathy. The purpose of this study in children who had received heart transplants was to evaluate the cardiac allografts for myocardial viral infections and to determine whether the presence of viral genome in the myocardium correlates with rejection, coronary vasculopathy, or graft loss.

METHODS: We enrolled heart-transplant recipients 1 day to 18 years old who were undergoing evaluation for possible rejection and coronary vasculopathy. Endomyocardial-biopsy specimens were evaluated for evidence of rejection with the use of standard criteria and were analyzed for the presence …

Physical Activity: Essential Component In Primary And Secondary Curricula For Lifelong Health, Maril Mccord

Physical Therapy Scholarly Projects

Chronic disease, preventable illness and injury, and growing trends of sedentary behaviors have currently been associated with the American population. It is estimated that 70% of all deaths in America are attributable to chronic disease of a preventable nature. Childhood disease has declined only to be replaced by new waves of social, environmental, and behavioral factors which manifest as health risks. At least 68 million Americans suffer from some form of heart disease while nearly 60% of adults lead sedentary lifestyles. The challenge in the nation is to counter these trends by implementation of policy and programs for healthier habits …

The Use Of Neuromuscular Electrical Stimulation In The Gait Training Of Children With Cerebral Palsy: A Literature Review, Rachel Rolfson

Physical Therapy Scholarly Projects

Cerebral palsy is a common developmental disorder that causes a wide array of problems in the population. The manifestations of cerebral palsy commonly interfere with the child's activities of daily living, including the important function of gait. It is therefore important that physical therapists be knowledgeable about the various treatment options used in gait training of children with cerebral palsy, as well as their effectiveness.

Neurodevelopmental techniques (NDT), neurosurgical interventions, and orthotics are just a few of the numerous treatment options available for the gait training of children with cerebral palsy. Neuromuscular Electrical Stimulation (NMES) has recently become a popular …

Global Cns Gene Transfer For A Childhood Neurogenetic Enzyme Deficiency: Canavan Disease., Paola Leone, Christopher G Janson, Scott J Mcphee, Matthew J During

Department of Neurosurgery Faculty Papers

The neurogenetic prototypic disease on which we chose to test our gene therapy strategy is Canavan disease (CD). CD is an autosomal recessive leukodystrophy associated with spongiform degeneration of the brain. At present the disease is uniformly fatal in affected probands. CD is characterized by mutations in the aspartoacylase (ASPA) gene, resulting in loss of enzyme activity. In this review, recent evidence is summarized on the etiology and possible treatments for CD. In particular, we discuss two gene delivery systems representing recent advances in both viral and liposome technology: a novel cationic liposome-polymer-DNA (LPD) complex, DCChol/DOPE-protamine, as well as recombinant …

A Comparison Of The Use Of Tympanic, Axillary, And Rectal Thermometers In Infants, Russell Wilshaw, Renea L. Beckstrand, Dawn Waid, Bruce Schaallje

Faculty Publications

This study examined the relationship between three instruments used in measuring tympanic, axillary, and rectal temperatures in infants less than 1 year of age. Temperatures were measured by Oto-temp Pedi Q tympanic thermometers, Becton Dickinson axillary thermometer, and rectal thermometers. A convience sample of 5 infants less than 90 day and 54 greater than 90 days with fever, as well as 34 infants less than 90 days and 27 infants greater than 90 days without fever were studied. Correlations of infants less than 90 days and greater 90 days of age, as well as differences between infant temperature with and …

Nebulized Nitroglycerin In Children With Pulmonary Hypertension Secondary To Congenital Heart Disease, Hatim Omar, Fangqi Gong, Mei Y. Sun, Stanley Einzig

Pediatrics Faculty Publications

Pulmonary hypertension continues to be a major cause of morbidity and mortality, despite new treatments. Since inhaled nitric oxide has been reported to be effective in some cases, we investigated using nebulized nitroglycerine to treat pulmonary hypertension in children with congenital heart disease. Four children (ages 6-72 months) with severe pulmonary hypertension secondary to congenital heart disease (all with membranous ventricular septal defect, undergoing cardiac catheterization) were given 3 cc of nebulized normal saline over 10 min as placebo control, followed by nebulized nitroglycerine (20 micrograms/Kg in 3 cc normal saline). Normal saline administration did not elicit any change, but …

Home Observation For Asymptomatic Coin Ingestion: Acceptance And Outcomes. The New York State Poison Control Center Coin Ingestion Study Group., Gregory P. Conners, D J. Cobaugh, R Feinberg, R Lucanie, T Caraccio, C M. Stork

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To obtain preliminary estimates of the acceptance rate and the frequency of adverse outcomes, and to identify issues related to acceptance, associated with management of asymptomatic pediatric coin ingestion by home observation, in preparation for a large-scale prospective study.

METHODS: Scripted telephone follow-up of callers who had reported asymptomatic pediatric coin ingestions to one of five poison control centers six to 36 months previously, which had been managed by home observation.

RESULTS: Of the 67 callers enrolled, 41 (67%) reported contacting a physician regarding the coin ingestion, despite home observation instruction by poison control center personnel. Those who did …

Cutaneous Malignant Melanoma, S. Sitawarin, N. Voravud, J. Vipakool

Chulalongkorn Medical Journal

No abstract provided.

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

Isolation Of Lautropia Mirabilis From Oral Cavities Of Human Immunodeficiency Virus-Infected Children, S. N. Rossmann, P. H. Wilson, J. Hicks, B. Carter, S. G. Cron, C. Simon, C. M. Flaitz, G. J. Demmler, W. T. Shearer, M. W. Kline

Journal Articles

Lautropia mirabilis, a pleomorphic, motile, gram-negative coccus, has been isolated from the oral cavities of 32 of 60 (53.3%) children infected with human immunodeficiency virus (HIV) and 3 of 25 (12.0%) HIV-uninfected controls; the association of L. mirabilis isolation with HIV infection is significant (P < 0.001). All children in the study, both HIV-infected children and controls, were born to HIV-infected mothers. The presence of this bacterium was not associated with clinical disease in these children. The HIV-infected children with L. mirabilis did not differ from the HIV-infected children without L. mirabilis in immunological status, clinical status, or systemic medications. The role of HIV infection itself or concomitant factors in the establishment of L. mirabilis in the oral cavity remains to be elucidated.

Video Of Adapted Techniques To Overcome The Physical Deficits Of Children With Visual Impairments, Amy Skalsky

Physical Therapy Scholarly Projects

Blindness is a disability with far reaching effects. Many of these effects are physical and can be seen clinically in children who have been blind for much, or all, of their lives. As physical therapists, we have the technical skills to assist in reducing the effects of the functional deficits that are associated with blindness. However, we are often unaware of these deficits, or have trouble adapting our treatment techniques to fit the needs of children who are blind or have visual impairments.

The purpose of this study is to provide a video that will demonstrate techniques that are specially …

Predicting Red Blood Cell Transfusions In Very Low Birth Weight Infants Based On Clinical Risk Factors., David A. Paul, Stephen A. Pearlman, Kathleen H. Leef, John L. Stefano

Department of Pediatrics Faculty Papers

OBJECTIVE: To describe the clinical factors most predictive of red blood cell transfusion in very low birth weight (VLBW) infants.

STUDY DESIGN: Retrospective review of VLBW infants cared for at a single level III NICU during a two year period, n = 199.

RESULTS: Overall transfusion requirement was 4.6 +/- 6.2 transfusions/infant/hospital course. Length of hospital stay, days of mechanical ventilation, requirement for dopamine support, birth weight, initial hematocrit, periventricular leukomalacia and necrotizing enterocolitis all independently correlated with number of transfusions and donors. Bronchopulmonary dysplasia and patent ductus arteriosus were associated with donor but not transfusion number.

CONCLUSIONS: Our data …

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …

A Literature Review And Introductory Pediatric Aquatic Therapy Manual, Dena Wright

Physical Therapy Scholarly Projects

Aquatic therapy continues to grow as an acceptable and often times preferable means of achieving therapeutic goals across a variety of patient populations: pediatric to geriatric, orthopedic to neurologic. The unique properties of water allow people to exercise and to recover in a safe and relaxing environment that promotes similar goals to those on land. However, land exercises can not simply be performed in water due to the water's unique properties. Similarly, exercises for adults do not work as effectively for children. Many physical therapy programs across the nation provide only minimal instruction on aquatic or pediatric therapy as a …

Dietary Influences And Exposure To Cigarette Smoke On Myringotomy Rates Of Infants, Melanie Eller Thompson

MSN Research Projects

Breastfeeding has been identified as a protective measure to defend against infection, while cigarette smoking is linked with increasing the risk of infection. The purpose of this research was to determine if there is a relationship between dietary influences and exposure to cigarette smoke on myringotomy rates of infants. The Betty Neuman Systems Model was the theoretical framework which guided the study. The researcher, using a correlational ex post facto study design, sought an answer to the question: Is there a relationship between dietary influences and exposure to cigarette smoke on myringotomy rates of infants? A convenience sampling of 128 …

Ventricular Remodeling Following Infant-Pediatric Cardiac Transplantation. Does Age At Transplantation Or Size Disparity Matter?, Girish S. Shirali, F Lombano, W L. Beeson, D A. Dyar, N F. Mulla, A Khan, J K. Johnston, R E. Chinnock, S R. Gundry, A J. Razzouk

Manuscripts, Articles, Book Chapters and Other Papers

Early left ventricular (LV) remodeling following pediatric cardiac transplantation has not been described. To identify patterns and determinants of change in left ventricular mass and volume posttransplant, we studied 125 consecutive children who underwent cardiac transplantation between January 1, 1989 and July 31, 1993. Two-dimensional imaging-directed M-mode echocardiograms were studied weekly until 26 weeks post-transplant. LV mass and volume (indexed to BSA1.5) were measured. LV mass index increased until 3 weeks post-transplant, and then decreased. The mean decrement in LV mass index after 8 weeks post-transplant (relative to baseline) was significantly larger in patients with donor-recipient weight ratio > 1.5 compared …