Medicine and Health Sciences Commons^™

Genomic Loss Of Tumor Suppressor Mirna-204 Promotes Cancer Cell Migration And Invasion By Activating Akt/Mtor/Rac1 Signaling And Actin Reorganization, Saadi J. Imam, Jason R. Plyler, Hima Bansal, Suresh Prajapati, Sanjay Bansal, Jennifer Rebeles, Jeffrey S. Dome, +12 Additional Authors

Pediatrics Faculty Publications

Increasing evidence suggests that chromosomal regions containing microRNAs are functionally important in cancers. Here, we show that genomic loci encoding miR-204 are frequently lost in multiple cancers, including ovarian cancers, pediatric renal tumors, and breast cancers. MiR-204 shows drastically reduced expression in several cancers and acts as a potent tumor suppressor, inhibiting tumor metastasis in vivo when systemically delivered. We demonstrated that miR-204 exerts its function by targeting genes involved in tumorigenesis including brain-derived neurotrophic factor (BDNF), a neurotrophin family member which is known to promote tumor angiogenesis and invasiveness. Analysis of primary tumors shows that increased expression …

The Involvement Of Acidic Nucleoplasmic Dna-Binding Protein (And-1) In The Regulation Of Prereplicative Complex (Pre-Rc) Assembly In Human Cells, Yongming Li, Haijie Xiao, Christelle De Renty, Aimee Jaramillo-Lambert, Zhiyong Han, Melvin L. Depamphilis, Kristy J. Brown, Wenge Zhu

Pediatrics Faculty Publications

No abstract provided.

Household Food Access And Child Malnutrition: Results From The Eight-Country Mal-Ed Study, Zulfiqar Ahmed Bhutta, Maled Network Investigators, Anita K. M. Zaidi, Sajid Bashir Soofi, Ali Turab, Didar Alam, Shahida Qureshi, Aisha Khizar Yousafzai, Syed Asad Ali, Imran Ahmed, Sajad Memon, Muneera Rasheed

Woman and Child Health

Background: Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites.
Methods: We administered a socioeconomic survey to 800 households in research sites in eight countries, including a …

Post-Transfusion Purpura In An African-American Man Due To Human Platelet Antigen-5b Alloantibody: A Case Report, Filipa Lynce, Fang Yin, Kirsten Alcorn, Vera Malkovska

Pediatrics Faculty Publications

Introduction

Post-transfusion purpura is a rare immunohematological disorder characterized by severe thrombocytopenia following transfusion of blood components and induced by an alloantibody against a donor platelet antigen. It occurs primarily in women sensitized by pregnancy and is most commonly caused by anti-human platelet antigen-1a antibodies. Here, we describe what we believe to be the first documented case of an African-American man who developed post-transfusion purpura due to an anti-human platelet antigen-5b alloantibody after receiving multiple blood products.

Case presentation

A 68-year-old African-American man initially admitted with atrial flutter was started on anticoagulation treatment, which was complicated by severe hematemesis. On …

Pediatric Spasticity, Kavita Parikh, Olga Morozova, Melanie Anspacher, Neha Shah

E-Learning Modules

Children with special health care needs (CSHCN) are increasingly prevalent in US hospitals. The pediatric hospitalist is often the primary provider of inpatient care for these patients. However, exposure to this patient population during training varies from provider to provider. No published educational curricula are specific to the inpatient care of this population. The purpose of this project is to build a multi-modal educational curriculum for providers with the overall goal of improving inpatient care for this at-risk population.

This curriculum is primarily composed of a series of topic-specific learning modules. Asynchronous learning modules, utilized appropriately, can augment learning by …

Pediatric Spasticity, Kavita Parikh, Olga Morozova, Melanie Anspacher, Neha Shah

Pediatrics Posters and Presentations

No abstract provided.

Twice-Daily Application Of Hiv Microbicides Alters The Vaginal Microbiota, Jacques Ravel, Pawel Gajer, Li Fu, Christine K. Mauck, Sara S.K. Koenig, Joyce Sakamoto, Alison A. Motsinger-Reif, Gustavo F. Doncel, Steven L. Zeichner

Pediatrics Faculty Publications

Vaginal HIV microbicides offer great promise in preventing HIV transmission, but failures of phase 3 clinical trials, in which microbicide-treated subjects had an increased risk of HIV transmission, raised concerns about endpoints used to evaluate microbicide safety. A possible explanation for the increased transmission risk is that the agents shifted the vaginal bacterial community, resulting in loss of natural protection and enhanced HIV transmission susceptibility. We characterized vaginal microbiota, using pyrosequencing of bar-coded 16S rRNA gene fragments, in samples from 35 healthy, sexually abstinent female volunteer subjects (ages 18 to 50 years) with regular menses in a repeat phase 1 …

Prevalence Of Obesity Among Young Asian-American Children, Anjali Jain, Stephanie Mitchell, Radha Chirumamilla, Jin Zhang, Ivor B. Horn, Amy Lewin, Z. Jennifer Huang

Pediatrics Faculty Publications

BACKGROUND:

Asian-American children are considered to be at low risk of obesity, but previous estimates have not distinguished between children from different Asian countries. We estimate the prevalence of obesity among Asian-American children by mother's country of origin, generational status, and family socioeconomic factors using a secondary analysis of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) wave III (children ∼4 years old) dataset.

METHODS:

The ECLS-B is a nationally representative study of children born in 2001 that oversampled births to Asian mothers. Asian ethnic categories included Chinese, Japanese, Filipino, Asian Indian, Korean, Vietnamese, and Other Asian/Pacific Islander. The primary outcome …

Fiberoptic Intubation In A Paediatric Patient With Severe Temporomandibular Joint (Tmj) Ankylosis, Ali Asghar, Faisal Shamim, Asiyah Aman

Department of Anaesthesia

Craniofacial abnormalities are associated with mandibular hypoplasia, reduced mandibular space with overcrowding of soft tissues and maxillary hypoplasia. Decreased mouth opening and limitation in jaw protrusion are independent predictors of difficult airway in such patients. The relative difficult problem becomes even graver in the paediatric age group because of their small mouth opening and un-cooperativeness. A child with severe temporomandibular joint (TMJ) ankylosis presented with negligible mouth opening and required surgical correction under general anaesthesia. Successful intubation was performed with endotracheal tube size 5.5 mm using an adult 4.3 mm fiberoptic bronchoscope under inhalational as well as topical anaesthesia.

Omphalocoele, Ten Years Experience At A Tertiary Care Hospital, Anila Haroon, Akhtar Amin Memon, Rehan Ali

Department of Paediatrics and Child Health

Omphalocoele is a rare congenital anterior abdominal wall defect. We present 12 cases of Omphalocoele seen in our hospital. Further, we have discussed the clinical presentation, antenatal diagnosis, associated abnormalities and final outcome of the cases.

Village Of Cuba St. Francis Of Assisi Park Improvement Plan Community Input Report, Healthy Kids, Healthy Cuba, Step Into Cuba

Reports & Documents

At the request of the Village of Cuba Council, Healthy Kids, Healthy Cuba and Step into Cuba have gathered additional community input regarding the proposed improvements to the Village of Cuba St Francis of Assisi Park. Previously, we had obtained community input through a series of meetings held in Cuba. Chance Munns, a landscape architect working with the University of New Mexico Prevention Research Center, developed the community ideas into three maps with descriptions of the proposed improvements. At the request of the Village Council last fall, we obtained additional input from the Cuba community on the Park improvement plan …

Enteric Feeding Tubes, Rebekah Conroy, Melanie Anspacher, Priti Bhansali, Neha Shah

Pediatrics Posters and Presentations

No abstract provided.

Male Gender Promotes An Increased Inflammatory Response To Lipopolysaccharide In Umbilical Vein Blood., Shunaha Kim-Fine, Timothy Regnault, James S Lee, Sarah A Gimbel, Jill A Greenspoon, Jonathan Fairbairn, Kelly Summers, Barbra De Vrijer

Paediatrics Publications

OBJECTIVES: To establish gender-specific differences in maternal and fetal immune response in healthy human fetuses at term.

METHODS: Forty-five women with elective caesarean sections for uncomplicated singleton pregnancies were recruited for two studies. Using a multiplex biomarker immunoassay system, unstimulated maternal and fetal plasma concentrations of interleukin (IL)-1β, IL-1ra, IL-6, IL-8, macrophage inflammatory protein (MIP)-1α, and tumor necrosis factor (TNF)-α were measured from one study population. Lipopolysaccharide (LPS)-stimulated cytokine response was measured in a second study.

RESULTS: There were no significant gender differences in either maternal or fetal unstimulated plasma cytokine concentrations, but concentrations of the proinflammatory cytokines IL-1β and …

A Review Comparing The Most Beneficial Regimens Of Cleansing An Umbilical Cord Before Detachment, Caitlyn Seegers, Mary Burkholder, Ellen Moore

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

This review was conducted because an umbilical cord infection is one of the leading causes of death in neonates. “Newborn cord care practices may directly contribute to infections, which account for a large proportion of the four million annual global neonatal deaths (Alam).” Previous studies have shown that there are multiple ways to care for an umbilical cord stub before detachment. Chemical and natural regimens have been proven to be significant in decreasing omphalitis in neonates. One of the most susceptible areas to bacterial colonization for a neonate is the umbilicus. The purpose of this study is to determine the …

The Effectiveness Of Music Therapy In The Pediatric Population, Megan Brewer, Jaclyn Lewis

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Music therapy (MT) is defined as, “the systematic use of music or musical elements-along with the resulting interpersonal relationship with a trained music therapist to achieve optimal health outcomes…” (The Effectiveness, 2010). Nurses are able to implement music therapy in care. Decreasing fear, anxiety, and ultimately pain will enhance the patient’s experience at the hospital and will lessen the burden of performing care on the patient, decrease stress on caregivers, and ease the provision of care on health professionals.

Kangaroo Mother Care For Premature And Low Birthweight Infants, Emma Rahn, Bethany Hotchkiss

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Due to an overwhelming number of babies born prematurely each year, new Interventions are being Introduced and studied. Kangaroo Mother Care (KMC), the prolonged skin-to-skin contact between mother/father and the infant, has been studied and has been shown to be a more beneficial alternative to care for both the infant and the parents. The purpose of this paper Is to compare the holistic outcome of KMC to that of conventional care (incubators and radiators). The research team consisted of two Cedarville nursing students, Emma Rahn and Bethany Hotchkiss. For our paper, the Iowa model was used to guide our research. …

Skin-To-Skin Care Related To Thermoregulation, Becky Wunderlich, Hannah Elwell

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Skin-to-skin contact can reduce neonatal mortality or morbidity by 18-42%. After birth temperature regulation is essential in newborn babies. Skin-to-skin benefits include: regulating heart rate, temperature, and respirations; greater weight gain. The purpose of this study is to determine if skin-to-skin care is more efficient in stabilizing the temperature of a full-term infant than using a radiant warmer. If so, why are radiant warmers still used on health full-term infants if skin-to-skin has more benefits?

Neonate Abstinence Syndrome And Therapeutic Interventions, Erica Danner

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

The impact of drug use by mothers to fetus’ in utero is critical not only to their growth and development but also has huge implications for sudden withdrawal at birth. Medication is used for neonates along with many other therapeutic techniques. With drug use for pregnant mothers rising, the incidence for NAS is significant. Hospitals are faced with lengthy hospital stays for neonates as well as providing environments appropriate for these newborns. Neonatal Abstinence Syndrome has risen in opioid dependency alone from 26.4% in 2000 to 41.7% in 2008. As national drug use is increasing, Neonatal Abstinence Syndrome (NAS) congruently …

Adherence To Clean Intermittent Catheterization Treatment In Pediatric Patients: A Comprehensive Review Of Literature, Amanda Miller, Ashley Thompson

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Clean Intermittent Catheterization (CIC) was first introduced by Lapides, et al, in 1972 and has revolutionized management of voiding dysfunction through decreasing urological complications. CIC is an invasive procedure where a clean catheter is introduced into the bladder in order to empty it. The procedure can be done by the patient or caregiver and is usually performed 4-5 times a day. The World Health Organization defines adherence as the extent to which a person’s behavior corresponds with agreed recommendations from a health care professional. Non-adherence to CIC causes many urological complications, including UTIs, epididymitis, and decreasing renal function. The purpose …

Pulse Oximetry Testing For Screening For Congenital Heart Defects In Newborns: A Literature Review Of The Effectiveness And Accuracy, Amanda Custer, Bethany Teixeira

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Pulse oximetry detects the level of oxygen in the blood. A deficiency of oxygen can indicate the presence of CHD. Congenital Heart Defects (CHD) are the number one birth defect in newborns • CHD contributes to 3% of infant mortality and 46% of deaths from congenital malformations in the first year of life

Breastfeeding Among Infants With Neonatal Abstinence Syndrome And Mothers Addicted To Narcotics, Landon Bundenthal

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

50,000 infants born in the U.S yearly receive medical treatment for maternal drug use while pregnant. Breastfeeding is associated with decreased maternal use of drugs or alcohol. Breast milk lessens side effects of drug withdrawal for infant. Breastfeeding is associated with decreased cases of necrotizing enter colitis and a significant decrease in hospitalization time. Drug dependent mothers have very low rate of breastfeeding. The purpose of this study is to determine if mothers who are using opioids or methadone should be encouraged to breastfeed.

Overexpression Of Pyruvate Dehydrogenase Kinase 1 And Lactate Dehydrogenase A In Nerve Cells Confers Resistance To Amyloid Β And Other Toxins By Decreasing Mitochondrial Respiration And Reactive Oxygen Species Production, Jordan T. Newington, Tim Rappon, Shawn Albers, Daisy Y. Wong, R. Jane Rylett, Robert C. Cumming

Paediatrics Publications

Background: Aerobic glycolysis promotes resistance against Aβ toxicity. Results: Increased LDHA and PDK1 expression attenuates mitochondrial activity and confers resistance to Aβ. These proteins are down-regulated in a transgenic Alzheimer disease (AD) mouse model, and PDK1 is decreased in AD brain. Conclusion: PDK and LDHA are central mediators of Aβ resistance. Significance: Drugs that augment aerobic glycolysis may enhance brain cell survival in AD patients. © 2012 by The American Society for Biochemistry and Molecular Biology, Inc.

Genetic And Environmental Vulnerabilities In Children With Neurodevelopmental Disorders, Annette Karmiloff-Smith, Dean D'Souza, Tessa M. Dekker, Jo Van Herwegen, Fei Xu, Maja Rodic, Daniel Ansari

Paediatrics Publications

One might expect that children with varying genetic mutations or children raised in low socioeconomic status environments would display different deficits. Although this expectation may hold for phenotypic outcomes in older children and adults, cross-syndrome comparisons in infancy reveal many common neural and sociocognitive deficits. The challenge is to track dynamic trajectories over developmental time rather than focus on end states like in adult neuropsychological studies. We contrast the developmental and adult approaches with examples from the cognitive and social domains, and we conclude that static models of adult brain lesions cannot be used to account for the dynamics of …

Gender Differences In The Developmental Outcomes Of Children With Congenital Cardiac Defects, Annette Majnemer, Catherine Limperopoulos, Michael Shevell, Charles Rohlicek, Bernard Rosenblatt, Chirsto Tchervenkov

Pediatrics Faculty Publications

Objective: This study compares the developmental and functional outcomes at school entry between boys and girls born with a congenital cardiac defect who required early surgical correction.

Study design: A prospective cohort of 94 children, including 49 percent boys, were followed up to 5 years of age and assessed for developmental progress. Developmental measures included Wechsler Preschool and Primary Scale of Intelligence – cognitive; Peabody Picture Vocabulary Test – receptive language; Peabody Developmental Motor Scale – motor; and Child Behaviour Checklist – behaviour. Measures of function included the Vineland Adaptive Behavior Scale and Functional Independence Measure for Children (WeeFIM).

Results: …

Achieving Consensus On Measure-Driven Child Health Quality: Maine’S Improving Health Outcomes For Children Initiative, Martha Elbaum Williamson Mpa, Nargiza Fuzailova Md, Mph, Kimberley S. Fox Mpa

Population Health & Health Policy

This brief describes Maine’s process for selecting child health quality measures, including identified strengths and limitations of the CHIPRA core measures that led to the inclusion of additional state-specific measures and the factors considered for selection. Subsequent articles will describe how measures have been implemented and used to improve child health quality and how they have been integrated into systems of care (e.g. health information technology systems, policy changes).

Infliximab Dose Rounding Pratices In Pediatric Inflammatory Bowel Disease, Kelly C. Sandberg, Benjamin H. Shpeen, Sally J. Eder, Muhammad Dhanani, Sarah J. Clark, Gary L. Freed, Jeremy Adler

Pediatrics Faculty Publications

Infliximab (IFX) is commonly used to treat Inflammatory Bowel Disease (IBD). IFX is supplied in 100mg vials and remains expensive. Dosing usually starts at 5mg/kg, and is commonly rounded up or down. The scope of dosing practices is unknown. Under-dosing may place patients at risk for exacerbation of IBD. Over-treatment potentially carries increased risk of infectious and malignant complications. We aimed to characterize IFX dosing practices among pediatric IBD practitioners participating in the ImproveCareNow Network.

Interstage Mortality After The Norwood Procedure: Results Of The Multicenter Single Ventricle Reconstruction Trial., Nancy S. Ghanayem, Kerstin R. Allen, Sarah Tabbutt, Andrew M. Atz, Martha L. Clabby, David S. Cooper, Pirooz Eghtesady, Peter C. Frommelt, Peter J. Gruber, Kevin D. Hill, Jonathan R. Kaltman, Peter C. Laussen, Alan B. Lewis, Karen J. Lurito, L Luann Minich, Richard G. Ohye, Julie V. Schonbeck, Steven M. Schwartz, Rakesh K. Singh, Caren S. Goldberg, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: For infants with single ventricle malformations undergoing staged repair, interstage mortality is reported at 2% to 20%. The Single Ventricle Reconstruction trial randomized subjects with a single morphologic right ventricle undergoing a Norwood procedure to a modified Blalock-Taussig shunt (MBTS) or a right ventricle-to-pulmonary artery shunt (RVPAS). The aim of this analysis was to explore the associations of interstage mortality and shunt type, and demographic, anatomic, and perioperative factors.

METHODS: Participants in the Single Ventricle Reconstruction trial who survived to discharge after the Norwood procedure were included (n = 426). Interstage mortality was defined as death postdischarge after the …

Pediatric Pharmacogenomics: A Systematic Assessment Of Ontogeny And Genetic Variation To Guide The Design Of Statin Studies In Children., Jonathan B. Wagner, J Steven Leeder

Manuscripts, Articles, Book Chapters and Other Papers

The dose-exposure-response relationship for drugs may differ in pediatric patients compared with adults. Many clinical studies have established drug dose-exposure relationships across the pediatric age spectrum; however, genetic variation was seldom included. This article applies a systematic approach to determine the relative contribution of development and genetic variation on drug disposition and response using HMG-CoA reductase inhibitors as a model. Application of the approach drives the collection of information relevant to understanding the potential contribution of ontogeny and genetic variation to statin dose-exposure-response in children, and identifies important knowledge deficits to be addressed through the design of future studies.

Situation Analysis Of Child Labour In Karachi, Pakistan: A Qualitative Study, Asaad Ahmed Nafees, Kausar S. Khan, Zafar Fatmi, Mubashir Aslam

Community Health Sciences

In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal …

Variation In Perioperative Care Across Centers For Infants Undergoing The Norwood Procedure., Sara K. Pasquali, Richard G. Ohye, Minmin Lu, Jonathan Kaltman, Christopher A. Caldarone, Christian Pizarro, Carolyn Dunbar-Masterson, J William Gaynor, Jeffrey P. Jacobs, Aditya K. Kaza, Jane Newburger, John F. Rhodes, Mark Scheurer, Eric Silver, Lynn A. Sleeper, Sarah Tabbutt, James Tweddell, Karen Uzark, Winfield Wells, William T. Mahle, Gail D. Pearson, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: In the Single Ventricle Reconstruction trial, infants undergoing the Norwood procedure were randomly allocated to undergo a right ventricle-to-pulmonary artery shunt or a modified Blalock-Taussig shunt. Apart from shunt type, subjects received the local standard of care. We evaluated variation in perioperative care during the Norwood hospitalization across 14 trial sites.

METHODS: Data on preoperative, operative, and postoperative variables for 546 enrolled subjects who underwent the Norwood procedure were collected prospectively on standardized case report forms, and variation across the centers was described.

RESULTS: Gestational age, birth weight, and proportion with hypoplastic left heart syndrome were similar across sites. …