Medicine and Health Sciences Commons^™

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Olu Oyesanmi, Heather Schramm, Michael King

HCA Healthcare Journal of Medicine

Objective

Hepatitis B is an infectious deoxyribonucleic acid virus which can cause significant morbidity and mortality. There is no current definitive treatment, however in the United States immunization is widely available. A paper published by the Advisory Committee on Immunization Practices/Centers for Disease Control (ACIP/CDC) in 2018 made updated recommendations regarding vaccination practices in the United States. The most notable change made was that all healthy newborns weighing ≥2000 g with a negative hepatitis B-status mother should receive hepatitis B immunization within 24 hours of birth. This quality improvement project studied the effect of the electronic medical record newborn admission …

Biomechanical Analysis Of Stroke Patterns And Functional Outcomes In Pediatric Manual Wheelchair Users, Paige Louise Aschenbrener

Theses and Dissertations

Approximately 88,0000 manual wheelchair (MWC) users are under the age of 21 in the United States (Kaye, LaPlante, & Kang, 2000). More than half of pediatric MWC users with spinal cord injury (SCI) report shoulder pain later in life and are at higher risk for developing upper extremity (UE) overuse injuries (Vogel & Zebracki, 2015). During MWC propulsion, a stroke pattern is the path the hand follows with respect to the pushrim (Boninger et al., 2002). Current clinical guidelines for adults recommend sole use of the semicircular stroke pattern as best practices because a MWC user is able to spend …

A Patient-Centered Asthma Management Communication Intervention For Rural Latino Children: Protocol For A Waiting-List Randomized Controlled Trial, Robin Dawson, Sue P. Heiney, De Anne Hilfinger Messias, Dennis Ownby

Faculty Publications

Background: Rural Latino children with asthma suffer high rates of uncontrolled asthma symptoms, emergency department visits, and repeat hospitalizations. This vulnerable population must negotiate micro- and macrolevel challenges that impact asthma management, including language barriers, primary care access, parental time off from work, insurance coverage, distance from specialty sites, and documentation status. There are few proven interventions that address asthma management embedded within this unique context. Objective: Using a bio-ecological approach, we will determine the feasibility of a patient-centered collaborative program between rural Latino children with asthma and their families, school-based nursing programs, and primary care providers, facilitated by the …

Upper Extremity Kinematics And Pain Outcomes During Activities Of Daily Living In Pediatric Hypermobile Ehlers-Danlos Syndrome, Olivia Yanez Wilwert

Theses and Dissertations

Ehlers-Danlos syndrome (EDS) is a group of heritable connective tissue disorders, consisting of thirteen different subtypes. Among the thirteen, Hypermobile Ehlers Danlos Syndrome (hEDS) is the most common. Individuals with this condition present with frequent joint instability that results in ongoing subluxations and dislocations. Secondary diagnoses of this condition include chronic pain, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Major Depressive Disorder (MDD), and Generalized Anxiety Disorder (GAD). The diagnostic process of hEDS is convoluted by the lack of a genetic identifier (Malfait et al., 2017). Individuals with hEDS are often not diagnosed until later in adulthood, leaving their adolescent life full …

Severe Acute Respiratory Syndrome Coronavirus 2 Infections In Children: Multicenter Surveillance, United States, January-March 2020., Brian Rha, Joana Y. Lively, Janet A. Englund, Mary A. Staat, Geoffrey A. Weinberg, Rangaraj Selvarangan, Natasha B. Halasa, John V. Williams, Julie A. Boom, Leila C. Sahni, Marian G. Michaels, Laura S. Stewart, Christopher J. Harrison, Peter G. Szilagyi, Monica M. Mcneal, Eileen J. Klein, Bonnie Strelitz, Kirsten Lacombe, Elizabeth Schlaudecker, Mary Moffatt, Jennifer E. Schuster, Barbara A. Pahud, Gina Weddle, Robert W. Hickey, Vasanthi Avadhanula, Mary E. Wikswo, Aron J. Hall, Aaron T. Curns, Susan I. Gerber, Gayle Langley

Manuscripts, Articles, Book Chapters and Other Papers

Previous reports of coronavirus disease 2019 among children in the United States have been based on health jurisdiction reporting. We performed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing on children enrolled in active, prospective, multicenter surveillance during January-March 2020. Among 3187 children, only 4 (0.1%) SARS-CoV-2-positive cases were identified March 20-31 despite evidence of rising community circulation.

Cyclosporine Shows Benefit As Compared To Methotrexate For Treatment Of Pediatric Atopic Dermatitis Refractory To Topical Medications When Rapidity Of Clinical Response Is Of Key Importance To The Patient, Connor R. Buechler, Steven Daveluy Md

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. European Journal of Pediatrics. 2012;172(3):351-356. https://doi.org10.1007/s00431-012-1893-3 for a pediatric patient with severe atopic dermatitis.

An Unexpected Outcome Of A Pediatric Simulation Encounter For Occupational Therapy Students., Anne H. Zachry, K. Booker, S. B. Lancaster

Faculty Presentations

This presentation reviewed how to plan and implement a pediatric simulated educational experience to align with the targeted course learning objective(s). Participants learned how to incorporate best practices into simulation education in order to advance occupational therapy education.

Recognizing Delirium In The Picu: An Evidence-Based Practice Improvement Project, Abigail Begovich, Tracy L. Brewer, Jennifer G. Tourville Dnp

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Introduction: Pediatric delirium is underrecognized in the pediatric population and can lead to increased length of stay, hospital costs, and post-traumatic stress disorder (PTSD). Using a standardized screening tool to assess for delirium is an easy way for bedside nurses to evaluate patients and intervene as necessary. This quality improvement project aimed to implement the Cornell Assessment of Pediatric Delirium (CAPD) and complete a delirium screening on applicable patients once a shift > 85% over four months.

Methods: Between January 2020 to May 2020, bedside nurses completed a delirium screening assessment on applicable patients, first on paper and then …

Telehealth Care And Its Role In Undergraduate Medical Education In The Covid-19 Era., Peter J. Gonzalez, Dustin J. Paul

MEDI 9331 Scholarly Activities Clinical Years

Background

On March 17, 2020, the American Association of Medical Colleges issued a statement which “strongly supports medical schools pausing all student clinical rotations, effective immediately, until at least March 31.” The University of Texas Rio Grande Valley School of Medicine immediately withdrew third- and fourth-year students from clinical rotation sites, and developed alternative, online-based clerkship curricula to complete for the remainder of the academic year. The COVID-19 pandemic has brought about many challenges to Undergraduate Medical Education, and has deprived upper-level students of foundational, in-person, clinical experiences. The UTRGV School of Medicine Department of Neurology is among the first …

An Exploration Of Pediatricians’ Personal Value On Mental Health: Experience With Integrated Healthcare And Its Impact On Physicians’ Lives, Bridget Anton, Jason D. Reynolds 4858637

The Qualitative Report

An integrated healthcare model incorporates behavioral health services into a medical setting to address patients’ physical, emotional, and behavioral healthcare concerns. The integrated healthcare model has been associated with positive patient satisfaction and health outcomes, yet limited studies have examined, using qualitative methods, physicians’ experiences of working alongside behavioral health consultants (BHCs) in integrated healthcare settings. Data was gathered through semi-structured interviews with pediatricians (N=4) working in an integrated healthcare model. Participants shared that as pediatricians they received personal, educational, and organizational benefits from an integrated healthcare model. Pediatricians also reported increased knowledge in effectively addressing mental health concerns for …

Balloon Atrial Septostomy As Initial Therapy In Pediatric Pulmonary Hypertension, Paul J. Critser, Patrick D. Evers, Eimear Mcgovern, Michelle Cash, Russel Hirsch

Pediatrics Faculty Publications

Balloon atrial septostomy is a palliative procedure currently used to bridge medically refractory pulmonary hypertension patients to lung transplantation. In the current report, we present balloon atrial septostomy as an initial therapy for high-risk pediatric pulmonary hypertension patients at our institution. Nineteen patients with median age of 4.3 years (range 0.1-14.3 years) underwent balloon atrial septostomy during initial admission for pulmonary hypertension. There were no procedural complications or deaths within 24 h of balloon atrial septostomy. Patients were followed for a median of 2.6 years (interquartile range 1.0-4.8 years). Three (16%) patients died, 3 (16%) underwent lung transplantation, and 1 …

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed for use …

Ultrasound-Guided Peripheral Vascular Catheterization In Pediatric Patients: A Narrative Review, Yoshinobu Nakayama, Jun Takeshita, Yasufumi Nakajima, Nobuaki Shime

Publications and Research

Peripheral vascular catheterization (PVC) in pediatric patients is technically challenging. Ultrasound guidance has gained the most interest in perioperative and intensive care fields because it visualizes the exact location of small target vessels and is less invasive than other techniques. There have been a growing number of studies related to ultrasound guidance for PVC with or without difficult access in pediatric patients, and most findings have demonstrated its superiority to other techniques. There are various ultrasound guidance approaches, and a comprehensive understanding of the basics, operator experience, and selection of appropriate techniques is required for the successful utilization of this …

Lipid Profile In Cases Of Lichen Planus, Eman M. H Abd El Hamid El Khateeb, Mustafa A. Hammam, Ola A. Bakry, Shaimaa El Shafey Soliman

Menoufia Medical Journal

Objective The aim of this work is to measure serum lipid profile in lichen planus) LP (cases for assessment of possible myocardial ischemia in these cases. Background LP is a chronic inflammatory disease that affects the skin and mucous membranes. It occurs mostly in individuals older than 45 years, and it is more common among women. Lipids are a broad group of naturally occurring molecules. High levels of triglycerides in the blood stream have been linked to atherosclerosis and, by extension, the risk of heart disease and stroke. Atherogenic lipid profile leads to atherosclerosis, which may be complicated by cerebral …

Serum Granulysin As A Possible Key Marker Of Activity Of Alopecia Areata, Alaa H. Maraee, Doaa M. A. El-Wareth Tolba, Enas A. M. Mahrous, Sally M. El-Hefnawy

Menoufia Medical Journal

Objective To study whether granulysin (GNLY) level, which is known to reflect the activity of cytotoxic immune response, is related to the disease activity of alopecia areata (AA). Background AA is a common type of hair loss or alopecia in humans. GNLY is an important mediator of damage in a variety of skin diseases. Patients and methods A case–control study was carried out on 72 individuals. A total of 36 patients experiencing AA circumscripta, selected from the Dermatology Outpatient Clinic, Menoufia University Hospital, and 36 healthy individuals as a control group were recruited during the period from October 2017 to …

Studies On Inherited Platelet Disorder: A Systematic Review, Alaa E. A. El-Hameed, Bassam H. Ramadan Alemam, Mohammed A. Abdelhafez, Sabry A. Shoieb

Menoufia Medical Journal

Objective The aim was to review the studies on clinical presentation, diagnosis, and management of inherited platelet disorder (IPD). Materials and methods A systematic search of MEDLINE (PubMed, Medscape, Science Direct, EMF-Portal) and internet was conducted on all articles published from 1997 to 2016. English language reports of perianal fistula were assessed. The initial search presented 150 articles where 26 satisfied the inclusion criteria. Articles not reporting on IPD in the title or abstract were not included. A total of 11 independent investigators extracted data on methods. Comparisons were made by structured review, with the results tabulated. Eight authors emphasized …

Neutrophil Extracellular Traps In Systemic Lupus Erythematosus, Alaa H. Elghotmy, Emad M. El-Shebini, Sabry A. Shoeib

Menoufia Medical Journal

Objectives To study the role of neutrophil extracellular traps (NETs) in the pathogenesis, clinical manifestations, and treatment of systemic lupus erythematosus (SLE). Materials and methods All medical databases including PubMed, Google Scholar, ScienceDirect, and Springer were searched for relevant data and the studies were published according to specific criteria and all materials available on the internet from 2011 to 2018. Search methodology All medical databases including PubMed, Google Scholar, ScienceDirect, and Springer were searched for relevant data. Data sources All medical databases including PubMed, Google Scholar, ScienceDirect, and Springer were searched for relevant data and all materials available on the …

Pathobiology And Management Of Essential Thrombocythemia: A Systematic Review, Ahmed A. Fathallah, Alaa E. Abd El Hamid, Mohamed A. Abdel-Hafez, Sabry A. Shoeib

Menoufia Medical Journal

Objective The objective of this study was to review the pathobiology and management of essential thrombocythemia (ET). Materials and methods A systematic search of MEDLINE (PubMed, Medscape, Science Direct, EMF-Portal) and Internet was conducted on all articles published from 1996 to 2017. English language reports of the pathobiology and management of ET were included. The initial search presented 155 articles; of which, 27 satisfied the inclusion criteria. Articles not reporting on the pathobiology and management of ET in the title or abstract were not included. Eleven independent investigators extracted data on methods. Comparisons were made by structured review with the …

Thyroid Dysgenesis As A Risk Factor For Patients With Poorly Controlled Congenital Hypothyroidism, Essam S. Khattab, Naglaa F. Barseem, Rehab K. A. Beddah, Sohier S. Abu El-Liaa

Menoufia Medical Journal

Objective Our aim was to search for the risk factors of cases with poor controlled congenital hypothyroidism (CH) in correspondence to their clinical aspect. Background CH is largely caused by thyroid gland dysgenesis, and there is lack of a standardized approach for diagnosis, follow-up, education, and genetic counseling of patients with CH. Patients and methods Genetic counseling and thyroid ultrasonography (US) were done. Blood samples were collected from 56 children (30 girls and 26 boys) with CH, diagnosed on the basis of neonatal screening program done by Egyptian Ministry of Health and Population, Central Health Laboratories, Hormones and Tumour Marker …

The Role Of Chemokine Cxc-Motif Receptor 3 In Vitiligo: A Clinical And Immunohistochemical Study, Azza G. Farag, Dalia R. Al-Sharaky, Eman N. Elshafey, Noura N. N. Shehata, Reem A. Hassan

Menoufia Medical Journal

Objectives The present study aimed at evaluating the immunohistochemical expression of CXCR3 in the involved skin in vitiligo patients and to correlate its evaluated expression with the available clinicopathological parameters in those patients. Background Vitiligo is an autoimmune skin disorder in which the loss of melanocytes is mainly attributed to defective autoimmune mechanisms, cytotoxic mechanisms, an intrinsic defect of melanocytes, oxidant–antioxidant mechanisms, and neural mechanisms. The assessment of maintenance of vitiligo could be related to CXCR3 expression. The treatment of vitiligo remains a challenge. Patients and methods This case–control study was carried out on 35 patients with variable degrees of …

Tissue Expression Of Endothelial Selectin In Patients With Atopic Dermatitis, Azza G. A. Farag, Dalia R. A. Sharaky, Eman N. El-Shafey, Sawsan S. Allam

Menoufia Medical Journal

Objective To investigate the role of endothelial selectin (E-selectin) in atopic dermatitis (AD) through evaluation of the immunohistochemical expressions in lesional skin biopsies. Background AD is a chronic, pruritic inflammatory skin disease that occurs most frequently in children. In AD, the inflammatory cascade is initiated by the release of proinflammatory cytokines from atopic keratinocytes. Patients and methods A total of 50 patients with AD and 10 healthy control participants were included in this case–control study. From all participants, skin biopsies were taken, and immunohistochemical staining by E-selectin monoclonal antibodies was done. Results There were significant elevations in E-selectin cellular localization …

Evaluate The Efficacy Of Carboxytherapy For Localized Lipolysis In A Sample Of Egyptian Patients, Alaa H. Maraee, Ashraf A. Zytoon, Azza G. A. Farag, Shahlaa A. E. R. Essa

Menoufia Medical Journal

Objective To evaluate the efficacy of injection of carbon dioxide (CO₂) in the treatment of localized fat deposits. Background Obesity is a serious medical problem resulting in significant morbidity and mortality. CO₂ therapy or carboxytherapy is the transcutaneous administration of CO₂ for therapeutic purposes. Patients and methods A prospective, cross-sectional study was carried out on 15 men having localized fat deposits in the abdomen, who attended the Dermatology Outpatient Clinic, Faculty of Medicine, Menoufia University Hospitals, during the period from July 2017 to January 2018. Detailed history, clinical examination, digital photographic registration, and ultrasound measurements of …

Matrix Metalloproteinase-9 In The Blood Of Acne Patients: The Possible Use Of Matrix Metalloproteinase-9 As A Biomarker Of Acne Severity, Mostafa A. Hammam, Nesreen G. Alhelbawy, Sarah N. Hanafy Mahmoud

Menoufia Medical Journal

Objectives The aim of this study was to study the blood level of matrix metalloproteinase-9 (MMP-9) in acne patients and its relation to disease severity. Background The possible use of MMP-9 as a biomarker of acne severity. Patients and methods This case–control study was conducted on 45 patients with acne vulgaris collected from the Dermatology Outpatient Clinic in Menoufia University Hospital with age ranging from 18 to 25 years. The study was done during the period from June 2018 to January 2019. Acne grading was performed according to the Global Acne Grading System. Twenty normal controls matched for …

8-Hydroxy-2-Deoxyguanosine As A New Biomarker Of Oxidative Stress In Patients With Acne Vulgaris, Eman F. Abd Elfadil Albarqi, Magda M. Hagag, Nesreen G. Elhelbawy

Menoufia Medical Journal

Objectives To evaluate the serum level of 8-hydroxy-2-deoxyguanosine (8-OHdG) in patients with acne vulgaris and also to detect relation between serum level of 8-OHdG and acne vulgaris severity. Background Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, characterized mainly by comedones. The precise mechanisms of acne are not known. Oxidative stress within the pilosebaceous unit are considered an important initiating step in the pathogenesis of acne. 8-OHdG is considered to be one of the main biomarkers of oxidative stress. Patients and methods This cross-sectional study was carried out on 75 patients with mild, moderate, and severe acne …

Seroprevalence Of Helicobacter Pylori Infection Among School Children In Al Qulubia Governorate, Mahmood D. Al-Mendalawi

Menoufia Medical Journal

In their interesting study, Deeb et al. estimated the seroprevalence of Helicobacter pylori infection and assessed its correlation with certain epidemiological and demographic variables among school children in Al Qulubia governorate, Egypt. The authors found that the overall H. pylori seroprevalence was 44%, and the frequency of seropositive cases increased highly significantly with advance in age. They also found a highly significant difference between seropositive and seronegative cases considering the family income, socioeconomic status, occupational status of the parents, and educational status of the parents (P = 0.001). However, no significant differences between seropositive and seronegative cases were found considering …

Investigation Of A Peculiar Case Of Childhood Lymphadenopathy, Chade Aribo, Alonso Al, Allison Woodall, Tommy Y. Kim

HCA Healthcare Journal of Medicine

Introduction: Lymphadenopathy is a common physical finding often associated with an infectious etiology. We present a case of a patient with generalized cervical and supraclavicular lymphadenopathy diagnosed with a rare malignancy. Health care providers should be aware of some uncommon historical or physical examination findings that warrant further investigation.

Clinical Findings: A 16-year-old female presented to the emergency department with 3 days of a fever, congestion and sore throat with swelling around the jaw. Her physical examination findings included bilateral mandibular swelling and generalized cervical lymphadenopathy with palpable supraclavicular lymph nodes.

Outcomes: Complete blood count showed pancytopenia with a white …

Post Traumatic Stress In Families With Pediatric Illness, Olivia Seecof, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline

• Behavioral Science Topic
• Introduce post traumatic stress in parents and children
• Talk specifically about post traumatic stress in families with pediatric (Cancer diagnoses, Type 1 diabetes diagnoses, Traffic accidents)
• Discuss relationship of PTSS in parents, children and siblings
• Apply what we’ve learned (Trauma-informed care)

Stress And Negative Affect As Mediators In The Association Between Parental Social Support And Lung Function In Adolescents With Asthma, Amber Osorno, Eric Sternlicht, Pornchai Tirakitsoontorn, Azucena Talamantes, Anchalee Yuengsrigul, Zeev N. Kain, Brooke Jenkins

SURF Posters and Papers

Asthma is the leading chronic condition amongst children in the United States as 7.5% of children are diagnosed with asthma. Studies have shown that positive social support is associated with positive asthma management. A strong social support system predicts good management of asthma symptoms; however, current literature has not yet examined how social support impacts lung function as opposed to merely symptom management. Stress and negative affect have been revealed to be associated with worse asthma control, as well as exacerbation of symptoms. Stressful situations, such as the death of a family member, unemployment, and familial tensions lead to worsening …

The Rapid Increase In Telemedicine Visits During Covid-19, Chelsea Johnson, Kathryn Taff, Brian R. Lee, Amanda Montalbano

Patient Experience Journal

Prior to the COVID-19 pandemic, facilitated telemedicine encounters were available at outreach locations; however, our tertiary children’s hospital had not invested widely in direct to patient telemedicine. Our daily pediatric subspecialty visits dropped from an average of 2066 visits a day prior to COVID-19 in our community to 1000 patients a day during the study period. Over the four-week period from April 15 to May 12, 2020, patient and family experience ratings of percentage of positive responses (9 or 10) on the provider rating 0-10 scale between telemedicine and in-person visits were compared for our pediatric subspecialty clinics using a …

Patient Experience In A Pediatric Emergency Department During Covid-19, Beth L. Emerson Md, Erika Setzer

Patient Experience Journal

The COVID-19 pandemic has changed many dynamics in healthcare in the United States. This study explores an increase in patient experience (PE) scores in a pediatric emergency department. Visits were analyzed before and after March 8, 2020, corresponding with the first local case of COVID-19. Changes in the patient population and characteristics of survey responders were analyzed. Overall, the number of daily visits decreased (113 vs 36/day) and survey response rate decreased (3.7 vs 2.8%, p = 0.03), but PE scores increased (87.21 to 93.73, p = 0.002). Comparatively, an increase in patients with higher acuity levels by Emergency Severity …