Medical Specialties Commons^™

Trajectories Of Attention Problems In Preschoolers Born Very Preterm., Marie Camerota, Francisco Xavier Castellanos, Brian S. Carter, Jennifer Check, Jennifer Helderman, Julie A. Hofheimer, Elisabeth C. Mcgowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Thomas Michael O'Shea, Carmen J. Marsit, Barry M. Lester

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born(GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention-deficit/hyperactivity disorder (ADHD) diagnosis.

METHODS: We studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of …

Changes In Adequacy Of Splanchnic Oxygen Delivery And Splanchnic Artery Doppler After Bolus Feedings In Infants: A Systematic Review And Meta-Analysis., Rohit S. Loomba, Saloni P. Sheth, Joshua Wong, Megan Davis, Juan S. Farias, Enrique G. Villarreal, Saul Flores

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Current practice regarding timing of feed initiation and feed tolerance largely relies on anecdotal practice and protocols. This study aims to provide an objective measure to guide clinical practice by analyzing changes in splanchnic regional oxygen saturation and Doppler patterns with feeds.

METHODS: A systematic review was performed. Inclusion criteria were: 1) patients under 1 year of age; 2) splanchnic regional oxygen saturation with near infrared spectroscopy before and after feeds or mesenteric Doppler findings before and after feeds; and 3) clinical parameters must have been presented as either mean and standard deviation or median and range. Endpoints of …

A Scoping Review Of Sexual And Reproductive Health Interventions With Youth In U.S. Juvenile Facilities., April Mcneill-Johnson, Jason Glenn, Nekia Ivory Daniel, Mira Menon, Basil H. Aboul-Enein, Patricia J. Kelly, Megha Ramaswamy

Manuscripts, Articles, Book Chapters and Other Papers

Youth placed in U.S. juvenile detention facilities face multilevel barriers that contribute to disparate sexual and reproductive health (SRH) outcomes when compared to their peers in the general adolescent population. Minimal information is available about evidence-based interventions that have been effective in changing these outcomes. The aim of this scoping review was to focus on the current state of SRH and identify recommendations for SRH care. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews guidelines, we searched electronic databases for publications published through March 2024. The search terms were designed to find intervention studies focusing …

Accuracy Of Race And Ethnicity Data In The Pediatric Electronic Health Record: A Concordance And System Adequacy Study, John Cowden, Rachel Drake, Jessi Johnson, Kataina Kelty, Mehwish Ahmed

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Conventional race and ethnicity categories and analysis are reductive and prone to inaccuracy. Because race and ethnicity data validity is essential to health equity efforts, we measured the accuracy of race and ethnicity data in a pediatric electronic health record (EHR) to identify areas for improvement in data collection and use. Methods: Patients and their caregivers reported patient race and ethnicity via in-person survey in four pediatric settings (inpatient, emergency room, urgent care, and primary care). Race and ethnicity data from the EHR were compared with survey data to calculate four measures of EHR data accuracy. The U.S. Census …

The Role Of Responsive Feeding In Childhood Development And Clinical Implications: A Comprehensive Literature Review, Alexander Burbach

Capstone Experience: Master of Public Health

Responsive feeding refers to caregiver-infant feeding interactions that encourage healthy eating behaviors and support the child’s autonomy by responding to their hunger and satiety cues. Responsive feeding supports healthy early childhood development, influencing self-regulation in eating behaviors and long-term health outcomes, particularly in obesity prevention. A comprehensive literature review was conducted to examine the impact of responsive feeding practices on childhood development in the United States and its clinical implications. The objectives were to explore the role of parental feeding practices in shaping childhood eating behaviors, understand the relationship between responsive feeding and obesity, and determine literature daps. Articles for …

Pediatric Predictive Artificial Intelligence Implemented In Clinical Practice From 2010 To 2021: A Systematic Review, Swaminathan Kandaswamy, Lindsey A Knake, Adam C Dziorny, Sean M Hernandez, Allison B Mccoy, Lauren M Hess, Evan Orenstein, Mia S White, Eric S Kirkendall, Matthew J Molloy, Philip A Hagedorn, Naveen Muthu, Avinash Murugan, Jonathan M Beus, Mark Mai, Brooke Luo, Juan D Chaparro

Faculty, Staff and Students Publications

To review pediatric artificial intelligence (AI) implementation studies from 2010 to 2021 and analyze reported performance measures.We searched PubMed/Medline, Embase CINHAL, Cochrane Library CENTRAL, IEEE, and Web of Science with controlled vocabulary. Inclusion criteria: AI intervention in a pediatric clinical setting that learns from data (i.e., data-driven, as opposed to rule-based) and takes actions to make patient-specific recommendations; published between 01/2010 and 10/2021; must have agency (AI must provide guidance that affects clinical care, not merely running in the background). We extracted study characteristics, target users, implementation setting, time span, and performance measures.Of 126 articles reviewed as full text, 17 …

Evaluating The Test-Negative Design For Covid-19 Vaccine Effectiveness Using Randomized Trial Data: A Secondary Cross-Protocol Analysis Of 5 Randomized Clinical Trials, Leah I B Andrews, M Elizabeth Halloran, Kathleen M Neuzil, Lars Van Der Laan, Yunda Huang, Jessica Andriesen, Mayur Patel, Leigh H Fisher, Holly Janes, Nadine Rouphael, Stephen R Walsh, Deborah A Theodore, Hong-Van Tieu, Magdalena Sobieszczyk, Hana M El Sahly, Lindsey R Baden, Ann R Falsey, Thomas B Campbell, Colleen F Kelley, Catherine Mary Healy, Lilly Immergluck, Benjamin Luft, Ian Hirsch, Guy De Bruyn, Carla Truyers, Frances Priddy, Kelsey M Sumner, Brendan Flannery, Dean Follmann, Peter B Gilbert, Covid-19 Prevention Network (Covpn)

Faculty, Staff and Students Publications

Importance: The test-negative design (TND) has been widely used to assess postmarketing COVID-19 vaccine effectiveness but requires further evaluation for this application.

Objective: To determine whether the TND reliably evaluates vaccine effectiveness against symptomatic COVID-19 using placebo-controlled vaccine efficacy randomized clinical trials (RCTs).

Design, setting, and participants: This secondary cross-protocol analysis constructed TND study datasets from study sites in 16 countries across 5 continents using the blinded phase cohorts of 5 harmonized phase 3 COVID-19 Prevention Network RCTs: COVE (Coronavirus Vaccine Efficacy and Safety), AZD1222, ENSEMBLE, PREVENT-19 (Prefusion Protein Subunit Vaccine Efficacy Novavax Trial COVID-19), and VAT00008. Participants included adults …

Technology Dependence Among Hospitalized Us Children., Emily J. Goodwin, Isabella Zaniletti, Margaret Wright, Matt Hall, Jeffrey D. Colvin

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Enterovirus D68-Associated Respiratory Illness In Children., Benjamin R. Clopper, Adriana S. Lopez, Leah A. Goldstein, Terry Fei Fan Ng, Ariana P. Toepfer, Mary A. Staat, Elizabeth P. Schlaudecker, Leila C. Sahni, Julie A. Boom, Jennifer E. Schuster, Rangaraj Selvarangan, Natasha B. Halasa, Laura S. Stewart, John V. Williams, Marian G. Michaels, Geoffrey A. Weinberg, Peter G. Szilagyi, Eileen J. Klein, Janet A. Englund, Meredith L. Mcmorrow, Heidi L. Moline, Claire M. Midgley

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Enterovirus D68 (EV-D68) typically causes mild to severe acute respiratory illness (ARI). Testing and surveillance for EV-D68 in the US are limited, and important epidemiologic gaps remain.

OBJECTIVE: To characterize the epidemiology and clinical severity of EV-D68 among US children seeking care for ARI from 2017 to 2022, using a multisite, active, systematic surveillance network.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study collected data from the New Vaccine Surveillance Network, an active, prospective, population-based surveillance system of emergency departments (EDs) and hospitals at 7 US academic medical centers. Children with ARI and EV-D68-positive results were enrolled during platform-wide EV-D68 …

Us Infant Formulas Contain Primarily Added Sugars: An Analysis Of Infant Formulas On The Us Market, Audrey R. Rips-Goodwin, Daiil Jun, Adrianne Griebel-Thompson, Kai Ling Kong, Tera L. Fazzino

Manuscripts, Articles, Book Chapters and Other Papers

Added sugar consumption is contraindicated for infants <  2 years old; however added sugars are present in many US infant formulas. We examined whether US formulas contain primarily added sugars, or whether formulas contain primarily naturally occurring lactose (the sugar in human milk). Data were obtained from the Nutrition Data System for Research and included formulas available on the US market in 2022 (N = 73). Formulas were categorized as: standard (n = 31), gentle (n = 27), and lactose-free (n = 15). Differences across formulas were examined using Bayesian modeling. The median percent added sugars were high in standard (M=59.7 %; IQR=22.0), gentle (M=85.0 %; IQR=39.5), and lactose-free formulas (M=90.0 %; IQR=54.3). Gentle formulas had significantly lower proportional lactose (OR=0.22, 95 % HDI=[0.11,0.44], pd=99.3 %) and > 2 fold higher proportional added sugars compared to standard formulas (ORs=2.11–2.57, HDI>0, pd=99.1–99.99 …

Discharge Practice Variability In Pediatric Chronic Home Invasive Ventilation, Guillermo Beltran-Ale, Ryne Simpson, Terri Magruder, Ajay S Kasi, Amit Agarwal, Jake A Kaslow

Faculty, Staff and Students Publications

Introduction: The Pediatric Mechanical Ventilation Society is a collaboration of pediatric pulmonologists with a focus on pediatric chronic home invasive ventilation (PCHIV). Since the initial discharge on PCHIV is not always directed by pediatric pulmonologists, we sought to understand how this variability between centers impact adherence to American Thoracic Society (ATS) guidelines for PCHIV.

Methods: A survey was distributed to pediatric pulmonologists across multiple platforms inquiring about discharging practices for PCHIV and adherence to six of the nine ATS recommendations for PCHIV. Two subgroups were created based on common practices - discharge by pediatric pulmonologists from a non-ICU unit (pulmonary …

Addressing Structural Violence In School Policies: A Call To Protect Children's Safety And Well-Being., Daniela Brissett, Jacquelin Rankine, Lisa Mihaly, Romina Barral, Maria Veronica Svetaz, Alison Culyba, Marissa Raymond-Flesch

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Digital Interventions For Suicide Prevention, Sean K Burr, Miao Yu, Danny Clark, Dana Alonzo, Robin E Gearing

Faculty, Staff and Students Publications

Background: Digital-based mobile interventions hold significant promise in preventing suicide. Although mixed, some evidence suggests these interventions are effective and capable of overcoming barriers such as cost and stigma. Aim(s): This review aimed to determine the effectiveness of digital interventions designed to address suicidal ideation and behaviors and the impacts of age, gender, and control group type on these outcomes.

Methods: Databases were searched for randomized controlled trials (RCTs) on digital suicide interventions (apps/online programs) published before January 1, 2022. Data were analyzed using a random-effects model in Stata 17.

Results: The search identified 4,317 articles, and 16 were included. …

Early Prediction Of Mortality And Morbidities In Vlbw Preterm Neonates Using Machine Learning, Chi-Hung Shu, Rema Zebda, Camilo Espinosa, Jonathan Reiss, Anne Debuyserie, Kristina Reber, Nima Aghaeepour, Mohan Pammi

Faculty, Staff and Students Publications

Background: Predicting mortality and specific morbidities before they occur may allow for interventions that may improve health trajectories.

Hypothesis: Integrating key maternal and postnatal infant variables in the first 2 weeks of age into machine learning (ML) algorithms will reliably predict survival and specific morbidities in VLBW preterm infants.

Methods: ML algorithms were developed to integrate 47 features for predicting mortality, bronchopulmonary dysplasia (BPD), neonatal sepsis, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), cystic periventricular leukomalacia (PVL), and retinopathy of prematurity (ROP). A retrospective cohort (n = 3341) was used to train and validate the models with a repeated 10-fold cross-validation …

Changes In Adequacy Of Splanchnic Oxygen Delivery And Splanchnic Artery Doppler After Bolus Feedings In Infants: A Systematic Review And Meta-Analysis, Rohit S Loomba, Saloni P Sheth, Joshua Wong, Megan Davis, Juan S Farias, Enrique G Villarreal, Saul Flores

Faculty, Staff and Students Publications

Background: Current practice regarding timing of feed initiation and feed tolerance largely relies on anecdotal practice and protocols. This study aims to provide an objective measure to guide clinical practice by analyzing changes in splanchnic regional oxygen saturation and Doppler patterns with feeds.

Methods: A systematic review was performed. Inclusion criteria were: 1) patients under 1 year of age; 2) splanchnic regional oxygen saturation with near infrared spectroscopy before and after feeds or mesenteric Doppler findings before and after feeds; and 3) clinical parameters must have been presented as either mean and standard deviation or median and range. Endpoints of …

Multicenter Food Protein-Induced Enterocolitis Syndrome (Fpies) Data Collection: Leveraging A Redcap Fpies Registry For Improved Clinical Outcomes, Ankona Banerjee, J Andrew Bird, Amy M Scurlock, Pooja Varshney, Elizabeth Brunner, Ankur Bhagwath, Benjamin Daines, Malika Gupta, Tevon Hood, Maria Lee, Michelle Lee, Emily Seminara, Rachel Smith, Gail Tan, Marion Jose Valladares, Hiral Waghela, Duc T Nguyen, Sara Anvari

Faculty, Staff and Students Publications

Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy typically presenting in infancy but has also been recognized in adults. FPIES is an allergic emergency due to severe vomiting occurring 1 to 4 hours after ingesting the causative food protein. Since the 2017 FPIES guidelines, no prospective data exist on the prevalence, incidence, and clinical characteristics of FPIES.

Objective: We established a multicenter FPIES registry to systematically collect clinical data and biospecimens on FPIES patients.

Methods: The FPIES registry is a US multicenter REDCap database collecting epidemiologic data to support the evolving FPIES landscape in relation to age …

Editorial: The Journal Of Pediatric Psychology Remains Committed To Advancing Pediatric Psychology Science, Avani C Modi, Kurt A Freeman, Cecelia Valrie, Marisa E Hilliard, Eleanor R Mackey, Katie A Devine, Susan Wood

Faculty, Staff and Students Publications

No abstract provided.

Testing For Bleeding Disorders In Child Abuse: Aap Recommendation Adherence And Testing Results, Lyndsey Hultman, Angela Doswell, Henry T Puls, Shannon L Carpenter, Angela Bachim, Caitlin R Mcnamara, Farah W Brink, Lori D Frasier, Nancy S Harper, Natalie Laub, Kristine A Campbell, Daniel M Lindberg, Joanne N Wood, James Anderst

Faculty, Staff and Students Publications

Objectives: Using a multicenter child abuse pediatrics research network (CAPNET), the study objectives were to characterize the adherence to American Academy of Pediatrics (AAP) recommendations for bleeding disorder testing and the frequency of bleeding disorder identification.

Methods: We performed a descriptive study of bleeding disorder evaluations among children younger than 10 years of age who presented with bruising and/or intracranial hemorrhage (ICH) concerning for abuse from February 2021-May 2022 utilizing CAPNET. Cases were classified as bruising without ICH or ICH with or without bruising. Based on AAP guidance, testing was not recommended in cases with concomitant suspicious injuries, inflicted injury …

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

Nutrition Provision In Pediatric Extracorporeal Membrane Oxygenation: Evidence, Challenges, And Clinical Considerations, Marwa Mansour, Nicole Knebusch, Andrea Ontaneda, Stephanie Vazquez, Jennifer Daughtry, Katri Typpo, Jorge A Coss-Bu

Faculty, Staff and Students Publications

Background/objectives: Nutritional support is a critical yet challenging aspect of care for pediatric patients requiring extracorporeal membrane oxygenation (ECMO). Malnutrition is prevalent in this population and is associated with worse clinical outcomes. This review synthesizes current evidence on nutritional strategies for pediatric ECMO patients, emphasizing assessment methods, feeding routes, challenges, and clinical outcomes.

Methods: A literature review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies published between January 2010 and 2025. Keywords included "pediatric ECMO", "nutrition", "enteral feeding", and "parenteral nutrition". Studies addressing nutritional assessment, enteral and parenteral feeding practices, and their impact on clinical …

Evaluation Of Depression Screening Tools For Utilization In Adolescents: A Scoping Review, Helen Whitaker Bsn, Rn, Jade Bray Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Anxiety and depression are prevalent mood disorders among the adolescent population with significant impacts on academic performance, social interactions, and mental well-being. With depression rates continuing to rise and suicide among the leading causes of death in adolescents, there is an urgent need for effective screening and intervention. While depression screening is recommended in the primary care setting, many adolescents do not have regular access to healthcare, complicating early identification and treatment. The purpose of this scoping review is to compare the effectiveness of two depression screening tools, the Patient Health Questionnaire (PHQ-9) and the Beck Depression Inventory (BDI), …

Utility And Safety Of Romiplostim As An Alternative To Platelet Transfusion For Neonates, Rachel N. Zeno, Sara Awad, Harry Lesmana

Student Scholarship

Thrombocytopenia is a common challenge in the neonatal intensive care unit, traditionally managed with platelet transfusions. However, transfusions are associated with significant risks, including increased mortality and neurodevelopmental impairment. This case series highlights the use of romiplostim, a thrombopoietin receptor agonist, in three neonates with thrombocytopenia. Each case demonstrated notable improvements in platelet counts without adverse events, reducing dependency on transfusions. These findings underscore romiplostim's potential as a safer alternative for managing neonatal thrombocytopenia. This report advocates for further research to explore romiplostim's efficacy and safety in this vulnerable population, emphasizing its promise in improving neonatal outcomes.

Evaluating The Efficacy Of Discharge Education On Readmission Rates In Pediatric Patients With Chronic Conditions: A Scoping Review, Camden Shaw Bsn, Rn, Cpn, Ashely St. Julien Bsn, Rn, Claire Avant Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn

Doctor of Nursing Practice Projects

Abstract Assignment

Purpose/Background

Children with multiple chronic health conditions account for a significant portion of hospital readmission and healthcare expenses. A scoping review was completed to analyze and summarize the available research regarding the effectiveness of discharge education on readmission rates and associated outcomes in children with chronic conditions. The following PICOT question was created: In pediatric patients with chronic disease, how does a discharge education bundle compared to no discharge education bundle affect readmission rates within 30 days of discharge?

Methods

A systematic approach was utilized for analysis to determine article eligibility. The initial search yielded 30 articles; however, …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

Association Between Maternal Hematologic Parameters And Risk Of Pregnancy Loss In Pregnancies Treated For Iron Deficiency Anemia, Simal Thind, Mbchb, Mph, Rupsa Boelig, Md, Mrutyunjaya B. Bellad, Md, Manjunath S. Sommannavar, Md, S. Yogeshkumar, Md, Benjamin Leidy, Phd, Rebecca Hartman, Mph, Zubair H. Aghai, Md, Praveen Patil, Phd, Chander Shekhar, Md, Umesh Y. Ramadurg, Md, Michael K. Georgieff, Md, Richard Derman, Md, Mph

Global Health Posters

Background

• Maternal iron deficiency anemia (IDA) is associated with an increased risk of infant complications including stillbirth, pregnancy loss, and low birthweight (LBW).
• It is unclear how treatment of maternal IDA can mitigate the infant related complications.

How Long Must We Wait? A Review Of Adherence To Established Npo Guidelines, Ellen C. Bouaziai, Anthony S. Hernandez, Shashi Sahai, Kerry Peters Mychaliska

Conference Presentation Abstracts

Background: Patients undergoing a procedure with anesthesia are required to be nil per os (NPO) for a defined period to reduce the risk of aspiration of gastric contents. In 2017, the American Society of Anesthesiologists (ASA) published guidelines for preoperative fasting, which allow for consumption of a full meal 8 hours before a procedure; non-human milk, light meal, and infant formulas 6 hours prior; breastmilk 4 hours prior; and clear liquids 2 hours prior to procedure. It is well known that these NPO guidelines are inconsistently applied to pediatric patients. The purpose of this study is to determine the percentage …

Historical Perspectives On Bloodletting In The Management Of Asthma In Children And Adults, Joudeh B. Freij, Bishara J. Freij

Conference Presentation Abstracts

Background: Current asthma management consists of a combination of drugs with different mechanisms of action. Ancient asthma care, by contrast, focused on loosening the humours using remedies such as drinking animal blood, eating rabbit fat and fox lungs, inhaling or consuming certain herbs and plants, bloodletting (including wet cupping), diet (eating raisins, dried figs, vegetables, barley, capers, bread, cake), steaming, baths, wet compresses, and moderate helpings of wine with dinner. Bloodletting was believed to purge the body of noxious humours that caused human disease and thereby reduce inflammation. Here we address the use of bloodletting in asthma management over the …

Low Serum Alkaline Phosphatase Concentrations At Hospital Admission As Markers For Severe Pediatric Sars-Cov-2-Related Acute Illnesses, Sneha Jayadeep, Julie A. George, Bishara J. Freij

Conference Presentation Abstracts

Background: Alkaline phosphatase (ALP) is composed of several isoenzymes. The measured serum (total) ALP is mostly of bone and liver origin. ALP activity changes with growth and puberty, and its level is affected by age and sex. Abnormal ALP levels have been noted in COVID19 patients but its use as a marker of severity has not been assessed to our knowledge.

Objective: Assess if low serum ALP is a marker of disease severity in acute Pediatric SARS-CoV-2-related illnesses.

Design/Methods: Retrospective observational study of children 0-18 years of age hospitalized at Beaumont Children’s Hospital from 3/1/2020-3/31/2022 with positive PCR for SARS-CoV-2 …

Reducing Antibiotic Duration For Pneumonia And Sinusitis In The Emergency Department: A Quality Improvement Approach, Joshua Saucedo, Leslie Hueschen, Amanda Nedved, Marsha Dannenburg, Patricia Phillips, Jennifer Floyd, Alaina N. Burns, Rana El Feghaly

Presentations

Background: Limiting antibiotic duration is one of the pillars of antimicrobial stewardship programs (ASP) as it reduces unnecessary antibiotic exposure. In our emergency department (ED), >90% of respiratory infections are treated with first-line guideline-recommended antibiotics; however, duration continues to be prolonged especially for community acquired pneumonia (CAP) and acute bacterial rhinosinusitis (ABRS). Institutional guidance recommends shortening antibiotic durations to 3-5 days for CAP and 5-7 days for ABRS, however only 13% of discharged ED patients receive the recommended duration. Objective: Our aim is to increase the percentage of children discharged home from the ED with a diagnosis of CAP or …