Medicine and Health Sciences Commons^™

Grading Of Improvement In Hypsarrhythmia With Standard Epileptic Spasms Treatment At A Large Pediatric Tertiary Care Center, Julie Grace Gianakon, Roha Khalid, Mohammed Ilyas

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Background Epileptic spasm is a peculiar type of epileptic seizure, entailing the clinical spasms and a characteristic electroencephalogram (EEG) abnormality often called hypsarrhythmia or its variants. The main goal of epileptic spasm treatment with standard therapy is to suppress clinical spasms and abolish the hypsarrhythmia and its variant EEG pattern. This interictal EEG pattern frequently heralds developmental regression. The elimination of hypsarrhythmia is a principal goal of therapy and a key outcome measure in clinical trials. There have been several studies in the interpretation or grading of hypsarrhythmia (Watanabe et al.1993 & Jeavons & Bower et al.1961). Still, there have …

Optimizing Oral Glucose Tolerance Test Completion At A Pediatric Cystic Fibrosis Care Center: A 10-Year Continuing Quality Improvement Effort, Christopher M. Oermann, Paula Capel, Jessica Haynes, Michelle Fischer, Jill Kohmetscher

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Background: Cystic fibrosis–related diabetes (CFRD) is a common comorbidity among people with CF (PwCF). It is associated with weight loss, protein catabolism, lung function decline, and increased mortality. Nutritional status and pulmonary function begin to decline in PwCF several years before the diagnosis of CFRD. Early CFRD detection and aggressive insulin therapy have been shown to reduce the mortality gap between PwCF who have CFRD and those who do not. The Clinical Care Guidelines for Cystic Fibrosis–Related Diabetes recommend annual screening for people with CF starting at age 10 [1]. Methods: In 2011, team members at Children’s Mercy Kansas City …

Delayed-Onset Anaphylactic Reaction With High Fever After Amoxicillin Oral Challenge And Negative Penicillin Skin Testing, Jordan Pitt, Paul J. Dowling, Christopher Miller, Aarti Pandya

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Introduction:  Immunologic adverse drug reactions can be categorized based on Gell and Coombs’s classification system. Anaphylaxis is generally considered a type I, immediate, IgE-mediated reaction and typically occurs independent of other immunologic reactions. However, the child presented here reacted after amoxicillin challenge with features of type I and type III or IV hypersensitivity reactions. Case Description:  A 12-year-old female presented for amoxicillin allergy evaluation after treatment for scarlet fever with amoxicillin. After the second dose she developed rash with varied features, fatigue, edema, and joint swelling. Labs included a persistently low C4 level, eosinophilia, normal inflammatory markers, and normal tryptase …

Impact Of Early Tracheostomy On Neurodevelopmental Outcome In Infants With Severe Bronchopulmonary Dysplasia Exposed To Postnatal Steroids, Amjad Taha, Gangaram Akangire, Janelle R. Noel-Macdonnell, Tiffany Willis, Winston Manimtim

Posters

No abstract provided.

Optic Disc Pit Maculopathy Leading To Vision Loss In A Pediatric Patient, Allyson Hall

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This case will review optic disc pit maculopathy in children and treatments available. An emphasis in vision rehabilitation will be discussed as any visual insult during this development period can lead to long-term visual consequences.

A Case Of An Elevated Tryptase, Sonya Parashar, Nikita Raje

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Hereditary Alpha Tryptasemia (HαT) is an autosomal dominant disorder characterized by an elevated baseline tryptase that occurs up to 3% of the population and clinically resembles mast cell activation syndrome.

Vancomycin Auc Monitoring In Individuals With Cystic Fibrosis At A Pediatric Institution, Christopher M. Oermann, Stephanie Duehlmeyer, Ellen Meier, Claire Elson

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Vancomycin AUC monitoring in individuals with cystic fibrosis at a pediatric institution S. Duehlmeyer1, C. Oermann1, E. Meier1, E. Elson1. 1Pulmonology, Children’s Mercy Kansas City, Kansas City, USA Background: Antibiotic therapy is essential for the treatment of cystic fibrosis (CF) lung infections. Methicillin-resistant Staphylococcus aureus (MRSA) infects 20% to 25% of people with CF (PwCF) and is associated with increased morbidity. Treatment of pulmonary exacerbations (PEs) often requires hospitalization including respiratory treatments and intravenous (IV) antimicrobials. IV vancomycin, which is commonly used for MRSA infections, requires serum concentration monitoring to ensure efficacy and minimize toxicity. Previous guidelines recommended trough concentrations …

Severe Diastolic Dysfunction Following Prolonged Extracorporeal Membrane Oxygenation In A Pediatric Burn Patient., Cara Holton, Johanna I. Orrick, Igor Areinamo, Jenna Miller

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A previously healthy 3-year-old female was admitted following a 22% TBSA scald burn. She was initially hemodynamically stable on room air. However, one week into hospitalization she developed ARDS with catecholamine-refractory shock requiring VA-ECMO. She was enterovirus positive, grew MRSA in respiratory cultures and was treated with prolonged antibiotics. The patient spent 26 days on VA-ECMO followed by 61 days on VV- ECMO after failing decannulation due to refractory hypoxia. She developed anuric renal failure requiring CRRT during her second ECMO course. Following VV-ECMO decannulation, she required mechanical ventilation with high settings and had severe recurrent pulmonary hemorrhage requiring FFP, …

A Proposal For Developing Academic Partnerships Between American Clinical Institutions And Ngos, Anik Patel, Nahreen Ahmed, Alfredo Mena Lora, Riley Jones

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"Humanitarian and health-focused non-governmental organizations, such as MedGlobal, and American clinical institutions can mutually benefit from the formation of academic partnerships. MedGlobal has a longitudinal presence in ongoing humanitarian disasters that can provide rich clinical experiences for academic institutions looking to provide more diverse and equity-driven training for its residents and fellows. American institutions can provide resources, personnel with special skills and knowledge, as well as research assistance to MedGlobal and its partner sites as it continues to promote evidence-based clinical care for refugees. We propose an innovative model that addresses 3 areas of opportunities: education, research/QI, and clinical care. …

Pharmacogenetic Testing In Patients With Autism Spectrum Disorder Evaluated In A Pediatric Precision Medicine Clinic, Rachel Goodson, Cy Nadler, Jennifer A. Wagner, Sarah Soden, Sarah Nyp, Tracy L. Sandritter

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Pharmacogenetic Testing In Patients with Autism Spectrum Disorder Evaluated in a Pediatric Precision Medicine Clinic Purpose The purpose of this study is to investigate the demographic and presentation profiles of children with autism spectrum disorder (ASD) who present for evaluation in a pediatric precision medicine clinic. Methods: This retrospective, observational cohort study utilized data extracted from a pediatric precision medicine clinic database between 2010 and 2021 with recorded ICD9/10 codes of Autism Spectrum Disorder, Autistic Disorder, Pervasive Developmental Disorder, or Asperger’s Syndrome. Extracted variables included demographic data, presenting medication regimens and concerns to be addressed by precision medicine. Results: A …

Short And Long Term Outcomes Of Using Cryoablation For Post-Operative Pain Control In Patients After Pectus Excavatum Repair, James Fraser, Kayla B. Briggs, Wendy Jo Svetanoff, David Juang, Pablo Aguayo, Jason D. Fraser, Charles L. Snyder, Tolulope A. Oyetunji, Shawn D. St. Peter Md

Posters

Background: Previous prospective trials have demonstrated that intercostal cryoablation reduces length of stay and postoperative opioid consumption compared with thoracic epidural and patient controlled analgesia (PCA) modalities. We report the findings of a 3-year prospective, observational study to elucidate long-term pain control, symptoms, and complications with attention to postoperative short and long-term pain control associated with the cryoablation technique.

Methods: Following IRB approval, we prospectively collected data on patients who underwent bar placement for pectus excavatum with thoracoscopic intercostal cryoablation by six surgeons at our institution from 2017 to 2021. Patients and their parents completed surveys regarding pain scores, narcotic …

Racial Disparities In Testicular Torsion, Kayla B. Briggs, Obiyo O. Osuchukwu, Chris E. Roberts, James Fraser, Wendy Jo Svetanoff, Tolulope A. Oyetunji, Hanna Alemayehu

Posters

Racial Disparities in Testicular Torsion Introduction: Testicular torsion (TT) is a surgical emergency requiring prompt intervention to preserve testicular function. Race and insurance status are thought to be associated with higher rates of gonadal loss; however, reports in the literature are conflicting. We sought to determine the effect of race on the treatment and outcomes of testicular torsion. Methods: Following IRB approval, a retrospective review was conducted of patients <18 years of age who presented to 2 institutions (hereby referred to as H1 and H2) with acute scrotal pain between December 2017 and September 2019. Demographic data, clinical history, imaging results, diagnosis, and surgical outcomes were recorded. Social vulnerability index (SVI), as determined by zip code, was obtained from the Centers for Disease Control and dichotomized using the 75th percentile. Higher SVI denotes increased social vulnerability. Primary outcome was diagnosis of TT. Secondary outcomes included orchiectomy rates. A p-value <0.05 was considered significant. Results: A total of 515 patients (H1 85%, H2 15%) were included in the final analysis. There were no difference in median age, BMI, TT diagnosis and orchiectomy rate between the two institutions. H2 treated more black patients (43% vs. 14%, p=<0.01) and patients with public insurance (57% vs. 41%, p=0.03) compared to H1. In multivariate analysis, older age was associated with TT (median age TT 14.12 years [12.13,15.69]) vs. no TT 9.86 years [5,13.05], OR 1.35, 95% CI 1.18-1.55, p=<0.01). Black patients were ~4 times more likely (OR 4.05, 95% CI 2.13-7.69, p=<0.01) than white patients to be diagnosed with TT when controlled for dichotomized SVI, insurance, and age. In the same model, Hispanic patients were ~2 times more likely (OR 2.20, 95% CI 1.10-4.40, p=0.03) to be diagnosed with TT when compared to white patients. Despite more black and Hispanic patients having dichotomized SVI >75th percentile than white patients (70% and 82%, respectively vs. 16%, p=<0.01), dichotomized SVI was not found to be associated with higher rates of TT or orchiectomy, respectively. Conclusion: At the two centers, more black and Hispanic children had SVI >75th percentile, however, when controlling for this in multivariate analysis, they were significant more likely to be diagnosed with …

Descriptive Study Of The Safety Behaviors And Attitudes Of Portable Pool Owners, Kristyn Jeffries, Kathy W. Monroe, Alicia Webb, Kristin L. Chancellor, Justina C. Goldman, David C. Schwebel

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Background Drowning is the leading cause of injury death for children 1-4 years old and the second leading cause for children 5-9 years old. Most prior epidemiology work has focused on submersions in below-ground swimming pools and natural bodies of water. Portable pools pose a new and emerging risk for drowning due to their affordability, convenience, and easy assembly. Successful drowning prevention consumer products, such as 4-sided fencing, may prove more difficult to implement with portable pools, and currently are not marketed for such use. Furthermore, parental perceptions and knowledge of drowning risks associated with portable pools has not yet …

Reconsidering Perioperative Antibiotic Use In Elective Laparoscopic Cholecystectomy, Kayla B. Briggs, James Fraser, Wendy Jo Svetanoff, Charles L. Snyder, Pablo Aguayo, David Juang, Rebecca M. Rentea, Jason D. Fraser, Shawn D. St. Peter Md, Tolulope A. Oyetunji

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Introduction: Prophylactic preoperative antibiotics (PPA) are questionable in cases with a low rate of surgical site infection (SSI). We report institutional PPA usage and SSI rates after elective laparoscopic cholecystectomy in a children’s hospital. Methods: Children <18 years old who underwent outpatient laparoscopic cholecystectomy between 7/2010 and 8/2020 were included. SSI was defined as clinical signs of infection, requiring antibiotics, within 30 days of surgery. Results: 502 patients met inclusion criteria; 50% were pre-operatively diagnosed with symptomatic cholelithiasis, 47% biliary dyskinesia, 2% hyperkinetic gallbladder, and 1% gallbladder polyp(s). The majority were female (78%) and Caucasian (80%). 60% (n=301) of patients received PPA while 40% (n=201) did not; 1.3% (n=4) of those who received PPA developed SSI compared to 5.5% (n=11) of those who did not (p=0.01). Though PPA use was associated with an 84% reduction in risk of SSI on multivariate analysis (p=0.01), all SSIs were superficial. One child required readmission for intravenous antibiotics while the remainder were treated with outpatient antibiotics. Gender, age, BMI, ethnicity, and preoperative diagnosis did not influence the likelihood of receiving PPA (Table 1). Conclusion: Given the relatively low morbidity of the superficial SSI, conservative use of PPA should be carefully considered in outpatient laparoscopic cholecystectomy to avoid contributing to antibiotic-related complications.

Improving Skin And Soft Tissue Antibiotic Duration Concordance With National Guidelines In Pediatric Urgent Care Clinics, Megan Hamner, Amanda Nedved, Holly Austin, Donna Wyly, Alaina N. Burns, Diana King, Brian Lee, Rana El Feghaly

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Introduction: Skin and soft tissue infections (SSTIs) are the second most common diagnosis leading to pediatric antibiotic prescriptions in the outpatient setting after respiratory diagnoses. Children with SSTIs often receive >7 days of antibiotics, although current guidelines recommend 5-7 days for most diagnoses. At CMH urgent care clinics (UCCs), only 58% patients received the recommended 5-7 days of antibiotics. We aimed to increase the percentage of patients receiving 5-7 days of oral antibiotics for SSTIs from 58% to 75% by December 31st, 2021. Methods: We formed a multidisciplinary team in April 2020. A provider survey assessed factors influencing prescribing habits. …

Correlation Between Strain And Weight Status In Infants With A Univentricular Hear, Amulya Buddhavarapu, Mathew Warren, Lori Erickson, Christopher Mathis, Whitney Haas, Daniel Forsha

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Background

Infants with univentricular physiology are at risk of poor weight gain and reduced ventricular function, both of which have been independently associated with worse outcomes. Since nutritional status has been correlated to ventricular function in other populations, we evaluated the relationship between nutritional status and ventricular function including speckle-tracking strain during this period.

Methods

Thirty term infants (median age 55 days, 13 females) with univentricular physiology prior to stage II palliation were included with data obtained at the time of their initial hospital discharge. Ventricular function was quantified using 2D global longitudinal strain (GLS) and strain rate, analyzed from …

Transient Tricuspid Valvulitis: Another Brief Casualty Of Covid-19 In Children, Amulya Buddhavarapu, Girish S. Shirali, Stephen Kaine, Doaa Aly

Posters

Clinical Presentation:

We discuss 3 patients, 8-10 years old, with significant tricuspid valve dysfunction during initial days of admission for multi-system inflammatory syndrome in children (MIS-C) associated with coronavirus 2019 (COVID-19) infection.

All 3 patients had COVID antibodies and presented in uncompensated shock needing aggressive fluid resuscitation and vasoactive support. Elevated acute inflammatory markers, acute kidney injury (2/3 patients), troponin leak and repolarization abnormality on ECG were present on admission and resolved by discharge. All were treated with intravenous immunoglobulin (IVIG) infusion, high-dose steroids and prophylactic low molecular weight heparin. They were discharged home on aspirin and steroid taper.

All …

Challenges In Echocardiographic Diagnosis Of Corrected Malposition Of Great Arteries: The Segmental Approach Coming Handy, Amulya Buddhavarapu, Anmol Goyal, Sanket Shah, Nitin Madan, Hayley S. Hancock, Maria Kiaffas

Posters

Clinical Presentation

Two cases of {S,D,L} anatomically corrected malposition of great arteries (ACMGA) are presented with differences in conal anatomy. Case 1: A fetal echocardiogram (echo) performed at 28 weeks gestation due to multiple anomalies revealed atrial situs solitus, D-loop ventricles, a large conoventricular septal defect (VSD) and an overriding, anterior and leftward aorta. The diagnosis of double outlet right ventricle (DORV) vs ACGMA was entertained. Postnatal echo revealed {S,D,L} segmental anatomy with ventriculoarterial concordance consistent with ACGMA and a muscular VSD. Case 2: A 3-week-old boy presented to clinic for a murmur evaluation with no associated cardiac symptoms. Transthoracic …

Virtual Child Neurology Education During Covid-19 And Beyond, Jennifer J. Dilts, Rose N. Gelineau-Morel

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Background: Even prior to the Coronavirus Disease 2019 (COVID-19) pandemic, Children’s Mercy Kansas City’s large neurology division struggled to engage learners in educational conferences. With 113 division members across 5 locations, attending conferences was challenging. While some conferences were live-streamed, we offered no recorded lectures, and most conferences were attended solely by trainees and 3-4 select faculty. COVID-19 eliminated in-person group learning opportunities.


Objective: We aimed to rapidly develop and implement a comprehensive and inclusive virtual child neurology curriculum and assess its impact.


Design/Methods: We created a neurology education “team” using Microsoft® Teams. Within 1 week of beginning social distancing, …

Evaluation Of The Hypothesis That Viral Meningitis Is A Mimic Of Abusive Head Trauma, Danielle Horton, Tanya Burrell, James Anderst, Lyndsey Hultman, Mary Moffatt, Henry T. Puls, Rangaraj Selvarangan

Posters

Background: Viral meningitis (VM) has been proposed as an alternative cause of subdural hemorrhage (SDH) in young children diagnosed with abusive head trauma (AHT). It has been proposed that VM may mimic symptoms and clinical features of AHT, resulting in an incorrect diagnosis of abuse.


Objective: We aim to evaluate the hypothesis that VM is a mimic of AHT by comparing the history of present illness (HPI) and initial clinical presentation of young children with proven VM to those with subdural hemorrhage and concomitant suspicious injuries (SDH + CSIs) and to those with SDH and no CSIs (SDH only). We …

Gender Dysphoria, General Well-Being, Bmi, And Weight-Related Behaviors Among Adolescent Transgender Males, Timothy A. Roberts, Anna Egan, Mirae J. Fornander, Christine Moser, Michaela Voss

Posters

Background: Gender dysphoria is associated body-dissatisfaction, abnormal weight and weight-related behaviors.


Objective: Describe the association of gender dysphoria severity and general well-being with Body Mass Index (BMI) and weight related behaviors among transgender males.


Design/Methods: Retrospective review of 118 transgender male patients presenting to initiate gender-affirming medical care in 2017-2020. Gender dysphoria confirmed by an experienced mental health provider. We measured parent and patient reports of patient general well-being [Pediatric Quality of Life Inventory (PedsQL) 4.0 General Well-Being Scale], severity of gender dysphoria [Transgender Congruence Scale (TCS) [n=47 for TCS] and Gender Identity/Gender Dysphoria Questionnaire (GIDYQ-AA)], weight related intentions, and …

Improving The Rate Of Emergency Department Physician Pre-Procedure Time-Out Documentation For Deep Sedation And Cutaneous Abscess Incision And Drainage, Arjun Sarin, Nikita Sharma, Shobhit Jain

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Background: The pre-procedure time-out, an important safety measure to verify patient identity and accuracy of a planned procedure, and Joint Commission requirement, is not documented consistently by physicians in our emergency department (ED). Deep sedation and cutaneous abscess incision and drainage (I&D) are two high-risk procedures performed in the ED, supporting the use of a time-out in this setting. Between June 2018 and May 2019, a pre-procedure time-out was documented in the physician procedure note of the electronic medical record (EMR) for 75% of deep sedations, and 94% of I&Ds.


Objective: We aimed to improve ED physician pre-procedure time-out documentation …

Human Lactoferrin And The Siderophore Aerobactin Independently Impact Intestinal Invasion By Neonatal Escherichia Coli Bacteremia Isolates, Susana Chavez-Bueno, Joshua Wheatley, Jennifer Tabakh

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Background: E. coli is a major cause of neonatal sepsis. After ingestion, E. coli translocates the neonatal gut causing bacteremia. E. coli virulence depends on iron acquisition mechanisms, including siderophore systems. Lactoferrin (LF) protects against neonatal sepsis through immunomodulatory and antimicrobial effects which include iron chelation. However, it is not known whether siderophores in neonatal E. coli strains have an impact on LF’s effects on bacterial invasion and survival in intestinal epithelium.


Objective: To investigate the effects of human LF and the siderophore aerobactin on intestinal invasion and survival of septicemia-producing neonatal E. coli.


Design/Methods: Neonatal E. coli septicemia isolates …

Recurrent Neonatal Herpes Simplex Virus Infection Associated With Irf7 And Unc93b1 Variants, Venkatesh Sampath, Megan H. Tucker, Heather Menden, Sheng Xia, Wei Yu, Nikita Raje

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Background: Neonatal herpes simplex virus (HSV) is a devastating disease with high mortality. In adults and children, genetic variants in the toll-like receptor 3 (TLR3) pathway increase susceptibility to herpes simplex encephalitis (HSE), but the genetic basis of susceptibility to neonatal HSV is unknown. We hypothesized that deleterious variants in the TLR3 pathway increased vulnerability to HSE in neonates. We investigated immunogenetic studies in an infant with neonatal skin, eye, mouth (SEM) HSV followed by HSE.


Objective: To combine exome sequencing with in vivo and in vitro immune functional analysis to discover the immunogenetic basis of HSV vulnerability in proband. …

Parental Health Literacy And Acute Care Utilization In Children With Medical Complexity, Emily J. Goodwin, Joy L. Solano, Jessica L. Bettenhausen, Ryan Coller, Adrienne G. Deporre, Rupal Gupta, Kayla R. Heller, Lauren Jones, Leah Jones, Kathyrn Kyler, Ingrid Larson, Laura Plencner, Margaret Queen, Timothy Ryan Smith, Tyler Smith, Jacqueline M. Walker, Margaret Wright, Isabella Zaniletti, Jeffrey D. Colvin

Posters

Background: Inadequate health literacy, defined as inadequate ability to find, understand and use health information is associated with poor health outcomes and high health care costs. Children with medical complexity (CMC) have high rates of acute care utilization. Understanding parental health literacy in CMC and its relationship to acute care utilization may inform interventions designed to lower utilization.


Objective: To examine parental health literacy for CMC and determine its association with acute care utilization.


Design/Methods: In this single-site cross-sectional study, 250 parents of CMC completed a self-administered survey (response rate of 66.1%). CMC were included if they had a complex …

Impact Of Early Tracheostomy On Neurodevelopmental Outcome Of Infants With Severe Bronchopulmonary Dysplasia Exposed To Postnatal Steroids, Amjad Taha, Gangaram Akangire, Janelle R. Noel-Macdonnell Phd, Tiffany Willis, Winston M. Manimtim

Posters

Background: BPD is associated with neurodevelopmental impairment. Tracheostomy is performed in 5-12% of severe BPD for prolonged ventilation. There is evidence that chronic ventilation with tracheostomy in severe BPD may facilitate neurodevelopment and lead to improved outcome. However, there is no consensus on the optimal timing of tracheostomy. A large multicenter study of infants with tracheostomy performed at <120 days of life had better neurodevelopmental outcomes at 18-22 months of age. Use of steroids postnatally to ameliorate the severity of BPD had been controversial due to its negative effect on neurodevelopment. To date, no data has specifically evaluated the impact of early tracheostomy on neurodevelopmental outcome of infants with severe BPD who are exposed to postnatal steroids.


Objective: To compare cognitive, language and motor scores among 3 groups of severe BPD infants who received early vs late vs no tracheostomy. Secondly, evaluate if postnatal steroids had an additive negative effect on neurodevelopmental outcomes.


Design/Methods: IRB approved retrospective cohort of …

Where Are They Now? Spanish Utilization And Career Direction Of Graduates Of A Pediatric Bilingual Continuity Clinic, Jodi Dickmeyer, Katie Mcanany, Sarah Stone, John Cowden

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Background: The Clínica Hispana de Cuidados de Salud (CHiCoS) Program was created in 2009 to prepare bilingual (English-Spanish) pediatric residents to independently give safe, effective care to Spanish-speaking families. By providing 1:1 support from a culture and language coach over three years of residency, CHiCoS has improved residents’ cultural and linguistic skills and families' perceptions of care. The effects of such training on residents’ future careers have not been formally studied.


Objective: To describe the careers of former CHiCoS residents, the impact of culture and language training on their practice, and opportunities for post-CHiCoS cultural and language training.


Design/Methods: In …

Perinatal Exposure To Interleukin-6 (Il-6): A Model To Study Influence Of Developmental Insult On Susceptibility To Chronic Kidney Disease (Ckd), Tarak Srivastava, Robert E. Garola, Varun Chandra Boinpelly, Jianping Zhou, Daniel P. Heruth, Mohammad Rezaiekhaligh, M. Farhan Ali, Lakshmi Priya, Uri Alon, Trupti Joshi, Yuexu Jiang, Ellen T. Mccarthy, Ram Sharma, Madhulika Sharma, Gregory Vanden Heuvel, Virginia J. Savin, Pramod B. Mahajan, Mukut Sharma

Posters

Background: CKD and obesity are marked by elevated pro-inflammatory cytokines, including IL-6. Pregnant obese women are associated with 1.5- to 2-fold increase in serum IL-6, newborns with smaller kidney/body weight ratio, kidney anomalies and increased susceptibility to CKD. Maternal IL-6, but not TNFα or IL-1β, can cross the placental barrier and enter fetal compartment.


Objective: We examined the role of (a) maternal injection of IL-6 during mid-gestation, similar to levels observed in pregnant obese women, on kidney development as a specific molecular surrogate of gestational inflammation and (b) IL-6 on glomerular filtration barrier.


Design/Methods: Pregnant mice received IL-6 (10 pg/g …

Peripartum Antibiotics Induce Dysbiosis And Predispose The Neonatal Gut Towards Inflammation, Alain Cuna, Marianne N. Nsumu, Venkatesh Sampath

Posters

Background: Broad-spectrum antibiotics in preterm infants have been associated with necrotizing enterocolitis (NEC), but the exact mechanisms that explain this association remain poorly defined.


Objective: To examine the impact of peripartum antibiotics on gut microbiota and intestinal inflammation in the developing gut.


Design/Methods: C57BL6 dams were administered broad spectrum antibiotics mixed with sterile drinking water from E15 to postnatal day (P)14 (Fig 1). Gut microbiota were analyzed by targeted 16S PCR for total bacterial density and relative abundance of major bacterial phyla. Effects of antibiotics on inflammatory TLR-signaling and injury in the neonatal gut were evaluated with PCR and histology. …

Educating Providers: Timely Post-Operative Pain Management In A Level Iv Neonatal Intensive Care Unit (Nicu), Jamesia Donato, Darian Younger, Rebecca Palmer, Denise Smith, Alexandra Oschman, Meredith Kopp, Daphne Reavey, Eugenia K. Pallotto

Posters

Background: NICU patients often encounter painful procedures and can have significant short and long-term consequences from inadequately treated pain. Ensuring adequate pharmacological and non-pharmacological pain management while minimizing associated risks is paramount. Our NICU is part of the Children’s Hospitals Neonatal Consortium “Erase Pain” collaborative to improve management of postop pain in neonates.


Objective: SMART

Aim: Increase the percentage of patients receiving acetaminophen within one hour after surgery to greater than 70% by July 2020.


Design/Methods: A multidisciplinary team developed pain treatment algorithms and postop order plans to standardize the approach to postop pain management. Providers were educated about their …