Medical Specialties Commons^™

Regional Variation Of Underlying Kidney Diseases In Children Undergoing Chronic Kidney Replacement Therapy Around The Globe., Dagmara Borzych-Dużałka, Marjolein Bonthuis, Uma Ali, Yok-Chin Yap, Michael Manno, Yihui Zhai, Reyner Loza, Seema Hashmi, Naye Choi, Kenza Soulami, Judith Exantus, Mohamed S. Al Riyami, Sameh Mabrouk, Marbella Ma Angeles, Cristina Zelaya-Camacho, Henny Adriani Puspitasari, Syed Saimul Huque, Francisco Cano, Kar Hui Ng, Sevcan A. Bakkaloğlu, Jerome Harambat, Kitty J. Jager, Bradley A. Warady, Franz Schaefer

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: There is a scarcity of information regarding the distribution of the diseases leading to kidney failure (KF) in children living in the emerging world. We used registry data to provide a global overview of the underlying disease spectrum in children commencing kidney replacement therapy (KRT).

METHODS: We analyzed KF causes among 23,620 children and adolescents commencing maintenance KRT in 80 countries, using data from the IPNA Global KRT Registry (including ESPN/ERA Registry), the International Pediatric Dialysis Network (IPDN), the United States Renal Data System (USRDS), and the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). The analysis considered …

Ai-Powered Insights In Pediatric Nephrology: Current Applications And Future Opportunities., Arwa Nada, Yamen Ahmed, Jieji Hu, Darcy K. Weidemann, Gregory H. Gorman, Eva Glenn Lecea, Ibrahim A. Sandokji, Stephen Cha, Stella Shin, Salar Bani-Hani, Sai Sudha Mannemuddhu, Rebecca L. Ruebner, Aadil Kakajiwala, Rupesh Raina, Roshan George, Rim Elchaki, Michael L. Moritz, The American Society Of Pediatric Nephrology Quality Improvement And Artificial Intelligence (Aspn Qi/Ai) Interest Group

Manuscripts, Articles, Book Chapters and Other Papers

Artificial intelligence (AI) is rapidly emerging as a transformative force in pediatric nephrology, enabling improvements in diagnostic accuracy, therapeutic precision, and operational workflows. By integrating diverse datasets-including patient histories, genomics, imaging, and longitudinal clinical records-AI-driven tools can detect subtle kidney anomalies, predict acute kidney injury, and forecast disease progression. Deep learning models, for instance, have demonstrated the potential to enhance ultrasound interpretations, refine kidney biopsy assessments, and streamline pathology evaluations. Coupled with robust decision support systems, these innovations also optimize medication dosing and dialysis regimens, ultimately improving patient outcomes. AI-powered chatbots hold promise for improving patient engagement and adherence, while …

Clinical Characteristics, Antibiotic Resistance Trends, And Associated Molecular Epidemiology Traits In Escherichia Coli Isolates Producing Neonatal Bacteremia, Keerti Ivaturi, Christine Symes, Mina Farahbakhsh, Sanjula Bhuri, Joshua L Wheatley, Rangaraj Selvarangan, Daniel P. Heruth, Susana Chavez-Bueno

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Escherichia coli is a leading cause of neonatal sepsis. This study's objective was to investigate the clinical characteristics of newborns with E. coli bacteremia, and recent antibiotic resistance trends and molecular epidemiologic features of these invasive strains.

METHODS: Clinical data and blood E. coli isolates collected from 54 neonates with bacteremia were studied. E. coli antibiotic susceptibility trends over time, and whole-genome sequencing data relevant to the genomic relatedness and capsule genotype of the isolates were analyzed.

RESULTS: Thirty percent of bacteremic newborns were preterm. Mortality was 19% in preterm versus 5% in term infants. Cerebrospinal fluid was collected …

Accelerated Weaning Of Opioids To Reduce Pharmacologic Exposure For Neonatal Opioid Withdrawal Syndrome: A Randomized Clinical Trial., Abbot R. Laptook, Adam Czynski, Rouba Chahine, Rachel G. Greenberg, P Brian Smith, Erica Oliveira, Jenna Gabrio, Barry Eggleston, Abhik Das, Jeannette Lee, Barry Lester, Dave Clark, Michele Walsh, Helen Ko, Clare Campbell Asher, Hayley Friedman, Samuel Gentle, Karishma Rao, Anup Katheria, Kristen Benninger, Sanket Jani, Mark Cody Smith, Akram Khan, Ajay Talati, Shaina Lodhi, Fernando Mena, Amanda England, Prabhu Parimi, Ranjit Kylat, Heidi Harmon, Javed Mannan, Meghan P. Howell, Tanner Wright, Jessica Snowden, Act Now Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To determine if newborns receiving morphine or methadone as the primary pharmacologic treatment for neonatal opioid withdrawal syndrome (NOWS) tolerate and receive fewer days of opioid using an accelerated wean protocol (15% decrements) compared with using a slower wean protocol (10% decrements).

STUDY DESIGN: Newborns ≥36 weeks of gestation receiving morphine or methadone for NOWS were enrolled in a pragmatic blinded, randomized multicenter trial. Newborns underwent protocol-driven weaning with decreasing opioid doses of either 15% or 10% decrements. Weaning was encouraged every 24 hours, and if signs of NOWS worsened, the preceding dose was resumed. To maintain blinding, the …

American Epilepsy Society Clinical Practice Guideline: Infantile Epilepsy., Daniel Freedman, Ifeoluwa Babatunde, Rebecca L. Morgan, Renad Abu-Sawwa, Dara Albert, Mandana Behbahani, Kevin Chapman, Erin Day Fecske, William Davis Gaillard, Monika Jones, Mary Anne Meskis, Leah Schust Myers, Kim Nye, Chima Oluigbo, Heidi H. Pfeifer, Reneé A. Shellhaas, Lindsey Thompson, Howard L. Weiner, Courtney J. Wusthoff, Elissa Yozawitz

Manuscripts, Articles, Book Chapters and Other Papers

This practice guideline from the American Epilepsy Society provides evidence-based recommendations for pharmacological, dietary, and surgical therapies for epilepsy for infants and children from 1 month of age to < 36 months. The multidisciplinary panel updated an existing systematic review, which was funded by the Patient-Centered Outcomes Research Institute and conducted by ECRI (formerly the Emergency Care Research Institute) on behalf of the Agency for Healthcare Research and Quality. The updated review used the same search strategy, inclusion/exclusion criteria, and Grading of Recommendations Assessment, Development and Education methodology, and added studies from August 2021 through September 2025 that were not in the original systematic review. As with the previous review, West syndrome and infantile spasms were excluded from this guideline, as existing treatment guidance is already available for infantile epileptic spasms. While many of the recommendations are conditional due to low certainty of evidence, the panel made two strong recommendations: (1) hemispherectomy/hemispherotomy surgery is recommended for infants and children < 36 months of age with drug resistant epilepsy secondary to select underlying lesional pathologies, including but not limited to hemimegaloencephaly, Rasmussen's encephalitis, Sturge-Weber syndrome, perinatal stroke, and hemispheric cortical dysplasia; and (2) intralobar, multilobar, or focal resections or posterior disconnections for drug-resistant focal or lesional epilepsy in this same age range. A treatment algorithm was developed based on evidence and expert opinion as part of the guideline to help place pharmacological, dietary, and surgical recommendations in a clinical context. The limited number of studies and low certainty of evidence in this population underscores the need for higher-quality data and etiology-specific treatments. More research is needed to evaluate effective therapies for infants with epilepsy, as well as the impact these therapies have on long-term developmental and mortality outcomes.

Promises, Pitfalls, And Paths Forward For The Pediatric Research Equity Act., Alexa L. Pagano, Danielle J. Green, Jennifer Goldman, Anjali Deshmukh

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Since its enactment in 2003, the Pediatric Research Equity Act (PREA) has significantly increased the number of pediatric drug studies performed and expanded pediatric drug labeling. Despite these advancements, many drugs used in children still lack pediatric-specific US Food and Drug Administration (FDA) labeling, even when pediatric studies are required by law. Recent legislative changes strengthened the FDA's enforcement authority over PREA. As these changes are implemented, persistent gaps in pediatric drug development warrant examination. Addressing these gaps may help ensure that children are systematically included in clinical research and that medications used in children are supported by rigorous …

Building A Better Clinical Competency Committee: A Multi-Institutional Approach To Improving The Quality Of Resident Feedback Through Appreciative Inquiry, Nikita Khetan, Emma Omoruyi, Elizabeth Hanson

HCA Healthcare Journal of Medicine

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.

Methods

This project was conducted with pediatric residents and faculty during the 2019–20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center …

Mislabeling And Inappropriate Analysis Render Interpretations From “The Effect Of The Participatory Heat Education And Awareness Tools (Heat) Intervention On Agricultural Worker Physiological Heat Strain: Results From A Parallel, Comparison, Group Randomized Study” Unreliable, Chelsi M Webster, Yasaman Jamshidi-Naeini, Lilian Golzarri-Arroyo, Colby J Vorland, Zachary J Schlader, Blair D Johnson, David B Allison

Faculty, Staff and Students Publications

No abstract provided.

Indicators Of Fontan Circulatory Failure In Pediatric Patients: A Scoping Review Of Early Clinical And Hemodynamic Factors, Marina Mcmahon

Student Works

Structured Summary

a. Background/Introduction:

For patients with single ventricle congenital heart disease, the Fontan procedure is the definitive palliative procedure. Although advancements have been made in the surgical technique and management, the Fontan circulation is inefficient and prone to progressive dysfunction. Elevated central venous pressure, non-pulsatile pulmonary blood flow, and reduced cardiac output can lead to many complications, and eventual failure. These conditions can lead to protein losing enteropathy, plastic bronchitis, and hepatic fibrosis which often indicate advanced decline. Though a known problem, there is a lack of standardized criteria to guide optimal intervention timing of Fontan revision prior to …

Early Neurologic Red Flags In Pediatrics: What Primary Care Providers Need To Know, Bob Underwood, Justin Coogle

Pediatrics in Practice: A CME Podcast

Subtle neurologic symptoms can be easy to miss in primary care. Pediatric neurologist Justin Coogle, MD, reviews early red flags, age‑specific warning signs and referral considerations to help pediatricians identify neurologic disorders earlier and optimize care.

Click here to stream the podcast episode.

High-Precision Automated Bone Age: A Clinically Useful Tool In Monitoring Of Treatment Effects In Children And Adolescents, Hans Henrik Thodberg, Lise Aksglaede, Anders Juul, Shanlee M. Davis, Judith L. Ross

Department of Pediatrics Faculty Papers

The clinical value of serial bone age (BA) determinations in children during growth is limited by the manual rater variability (precision 0.63 years). The objective of this work was to determine the precision of automated bone age and bone health index (BHI) measurements by BoneXpert and to establish the time interval at which the automated method can detect a significant treatment effect. The data were from a case-control trial (oxandrolone/placebo) following 90 boys with Klinefelter syndrome (KS) with five visits over 2 years, recording X-rays of both hands. The precision of BA was 0.08 years [0.07; 0.09] 95% CI, leading …

Speed Of Intravenous Fluid On Glycocalyx Integrity And Central Blood Volume In A Porcine Septic Shock Model, Yosef Levenbrown, Md Jobayer Hossain, Paul T. Fawcett, Marjorie Postell, Anne M. Hesek, Lynell S. Jones, James P. Keith, Thomas H. Shaffer

Department of Pediatrics Faculty Papers

BACKGROUND: It is unclear whether the rate of intravenous fluid (IVF) administration in sepsis influences glycocalyx breakdown. This study aimed to measure the effect of rapid versus slow fluid bolus in a septic pig model on the integrity of the glycocalyx by measuring the serum levels of heparan sulfate and syndecan-1, breakdown products of the glycocalyx. Because endothelial glycocalyx is composed of apical cell membrane-bound proteoglycans such as syndecan-1, covalently bound with long linear glycosaminoglycans such as heparan sulfate, shedding of these different glycocalyx components is closely related. Additionally, we measured central blood volume (blood volume in the heart and …

Seeing Surgery Differently: The Role Of Virtual Reality In Pediatric Care, Bob Underwood, Mark Ryan

Pediatrics in Practice: A CME Podcast

Virtual reality is changing how pediatric surgeons plan procedures, educate care teams and help children and families better understand what to expect. In this episode, Mark Ryan, MD, pediatric surgeon, discusses how virtual reality is being used in pediatric surgery today, its impact on patient experience and surgical planning and what pediatricians should know as this technology continues to evolve.

Click here to stream the podcast episode.

Genetic Predispositions To Cancer: What Pediatricians Need To Know, Sarah Gubara, Nicole Wood

Pediatrics in Practice: A CME Podcast

Pediatric hematology/oncology physician Nikki Wood, DO, explains how pediatricians can recognize genetic cancer risk, refer to genetics appropriately, and support families through long‑term surveillance.

Click here to stream the podcast episode.

Cardiovascular Disease And Dyslipidemia In Pediatric Type 1 Diabetes, Grace K Kim, Preneet Cheema Brar, Nidhi Bansal

Faculty, Staff and Students Publications

Purpose of review

Despite advances in type 1 diabetes (T1D) management, mortality is still increased, with cardiovascular disease (CVD) as the leading cause. Dyslipidemia is a highly prevalent modifiable CVD risk factor. We reviewed the existing literature on CVD mortality in T1D to highlight CVD risk in pediatric patients with T1D.

Recent findings

Pathophysiology of T1D and premature CVD risk is still not fully understood. Dyslipidemia remains a highly prevalent and undertreated CV risk factor in T1D. Statins have been shown to be safe and effective to improve CVD risk in adults with T1D, and in children with familial hypercholesterolemia, …

Groove ‘N’ Grow: Promoting Social Participation Through Dance And Movement, Juliana N. Ward, Karen Park

Spring 2026 OTD Capstone Symposium

Groove ‘n’ Grow is a structured pediatric occupational therapy group program designed to improve social participation, engagement, and sensory regulation in children with developmental and sensory processing differences through dance and movement-based activities. The program was developed as part of an occupational therapy doctoral capstone project and implemented within a pediatric outpatient therapy clinic. The purpose of the program is to provide children with developmental and sensory processing differences opportunities to practice peer engagement, cooperative participation, emotional regulation, and emotional awareness in a supportive small-group environment.

First, Do No Trend: Aligning Parenteral Lipid Therapy With Physiology And Evidence In Neonates, Parvesh Mohan Garg, Srinivas Bolisetty, Camilia R Martin, Muralidhar H Premkumar

Faculty, Staff and Students Publications

Lipid injectable emulsions (ILE) are essential components of parenteral nutrition in neonatal intensive care units. Over the past two decades, the expanded availability of ILE has led to rapid changes in clinical practice, largely driven by concerns about intestinal failure–associated liver disease. Despite these evolving trends, the evidence supporting one ILE over another remains limited and nuanced. Importantly, no currently available ILE replicates the intrauterine supply of critical long-chain polyunsaturated fatty acids, particularly arachidonic acid and docosahexaenoic acid, both of which decline postnatally regardless of emulsion type. Neonates requiring ILE represent a heterogeneous population of preterm and term infants, with …

Outcome And Clinical Characteristics Of Diaphragm Dysfunction After Pediatric Cardiac Surgery: From Detection To Plication, Muhammad Shahzad, Muhammad Bokir, Haifa Almuhanna, Abdulaziz Alanazi, Zehra Alabbas, Reem Beheri, Yasser Abdulrhman Alheraish, Khaled Alarwan

Journal of the Saudi Heart Association

Background:

Diaphragm paralysis (DP) due to phrenic nerve injury is a rare but serious complication of pediatric cardiac surgery (0.3–5% of cases). It presents as an extubation failure or difficulty weaning from ventilation. Early recognition and management are essential.

Objectives:

This study aimed to evaluate the incidence, clinical characteristic and outcome of diaphragm paralysis after heart surgery in children.

Methods:

A retrospective single-center review (2019–2024) was conducted of ultrasound-confirmed DP case. Demographics, surgical details, ventilatory course, interventions, and outcomes were analyzed. Partial and complete DP were compared using multivariate logistic regression to identify predictors.

Results:

Out of 2,280 surgeries, 108 …

Understanding How Nurses Could Utilize Child Life Specialists, Paige Perkins

Honors Projects

Do pediatric nurses notice improvement in patient education levels when they use the resources of Child Life Specialists, understand their role, and utilize their resources to educate their patients, compared to hospitals without Child Life Specialists?

Developing Pediatric Educational Resources For Occupational Therapy Fieldwork Students And New Employees, Alyssa Gottheiner

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

For occupational therapy students, the fieldwork education portion of their curriculum allows them to apply theory and principles learned in their academic program into practice with actual clients (Occupational therapy fieldwork education, 2022). Research indicates the benefit of access to resources and adapting to different learning styles in occupational therapy fieldwork education (Grenier, 2015). Research also indicates that training programs for new healthcare employees can positively impact knowledge, skills, and performance (Patel et al., 2023).  However, there is a lack of research on the availability and benefit of supplemental educational resources for students to access during fieldwork education in pediatric …

Quick! Which Scanner Should The Patient Go To?, Nicholas Johnson, Farnaz Norozian

School of Medicine Research Poster Showcase

Introduction Rarely does a pediatric patient have a stroke, but when they do what imaging modality is best suited? EMS tele comes in activating a stroke alert. An 11 year old otherwise healthy male presented with 10 hours of left sided sensation changes, waking up with dense left hemiparesis.14 days prior he had been on amusement park rides resulting in headache with vomiting since resolved. On arrival, slight hypertension for age otherwise hemodynamically stable, glucose normal, EKG demonstrated sinus rhythm. No history of genetic blood or clotting disorder. PICU and ER attendings discussion resulted in MRI as the initial imaging …

A Mild Case Of Pseudoachondroplasia In A Child: Lessons For Long-Term Primary Care, Alec J. Pupo D.O., Connor J. Stinson D.O., Autumn Dye D.O.

The Journal of Integrated Primary Care

Background: Pseudoachondroplasia (PSACH) is a rare autosomal dominant skeletal dysplasia caused by pathogenic variants in the cartilage oligomeric matrix protein (COMP) gene. It is classically characterized by early-onset growth failure, disproportionate short stature, progressive epiphyseal dysplasia, and premature degenerative joint disease. Although phenotypic variability has been reported, PSACH is often regarded as a uniformly severe condition with predictable orthopedic morbidity.

Case Presentation: We report an eleven-year-old female with genetically confirmed PSACH who demonstrates an unexpectedly mild clinical phenotype, despite a maternal history of severe disease requiring bilateral total hip replacement during adolescence. The patient exhibited mild hip dysplasia, evolving genu …

Acute Musculoskeletal Injuries In Kids—Assessment, Imaging & Return-To-Play, Mike Smith, Kevin Latz Md

Pediatrics in Practice: A CME Podcast

How should pediatricians triage an acute sports injury—what to check first, what imaging to order, and when to escalate urgently? In this Pediatrics in Practice CME episode, Kevin Latz, MD, MBA shares a practical framework for assessment, red flags, return-to-play counseling, and prevention strategies for active kids.

Click here to stream the podcast episode.

A Digital Diabetes Prevention Program For Hispanic Adolescents (Fit24+): Protocol For A Feasibility Randomized Controlled Trial, Erica G Soltero, Marbelly Partida, Sandra Mihail, Lizette Villanueva, Callie Lopez, Salma M Musaad, Teresia M O'Connor, Maria J Redondo, Matthew Buman, Debbe Thompson

Faculty, Staff and Students Publications

Background: Hispanic youth are disproportionately impacted by obesity and subsequent type 2 diabetes (T2D) yet remain underrepresented in diabetes prevention research. Digital health interventions hold promise for increasing the accessibility to and engagement in disease prevention programming, particularly among high-risk populations. However, there is a significant gap in the literature regarding digital T2D prevention programs for adolescents or Hispanic youth.

Objective: The objective of this article is to describe the protocol for examining the feasibility of a 12-week digital diabetes prevention program among Hispanic adolescents with obesity.

Methods: Participants (N=40; aged 12-16 years) will be randomized (1:1) to a 12-week …

International Consensus On The Evaluation And Management Of Hypothalamic Hamartomas: Results From A Modified Delphi Survey, Nathan T Cohen, Xiaotong Li, Madison M Berl, Chima O Oluigbo, Hiroshi Shirozu, Samuel F Berkovic, Margaret Zacharin, Wirginia Maixner, Andreas Schulze-Bonhage, Kerstin Klotz, Nicola Specchio, Sarah Ferrand-Sorbets, Christine Bulteau, Alexis A Arzimanoglou, Jean Regis, J Helen Cross, Martin M Tisdall, Hanna Richardson, Arthur Cukiert, Cristine Cukiert, Julia Jacobs, Elizabeth J Donner, Phillip L Pearl, John F Kerrigan, Angus A Wilfong, Kevin C J Yuen, Dennis J Dlugos, Daniel Curry, Irfan Ali, John Ragheb, Lisa Soeby, Erica Webster, William D Gaillard

Faculty, Staff and Students Publications

Background and objectives: Hypothalamic hamartomas (HH) are rare brain lesions associated with epilepsy and numerous comorbidities. Worldwide treatment is varied. There is a paucity of high-quality evidence to guide treatment. This study aimed to establish expert consensus on the evaluation and management of HH.

Methods: A modified Delphi survey was designed by the Medical Advisory Board of Hope for Hypothalamic Hamartomas and was conducted among 17 International League Against Epilepsy level II epilepsy surgery centers. The survey included 257 questions in round 1 and 81 refined questions in round 2, covering domains of diagnosis, imaging, medical and surgical treatment, neuropsychological …

Holding Hope: Empowering Parents Through Perinatal And Nicu Palliative Care, Huntington N. Cotten

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Families receiving perinatal and neonatal Palliative Care (PC) services can experience significant emotional and practical challenges while caring for a child with medical complexities. The Care Companion, a family centered, educational resource, was created in response to survey findings indicating that rehabilitation therapists (OT, PT, and SLP) encountered challenges in providing PC services, followed by site‑specific insights that highlighted additional gaps in family support, education, and parent–infant bonding. This Occupational Therapy (OT) Capstone project was completed within a large academic pediatric medical center providing interdisciplinary PC services to families whose infants have been diagnosed with serious, life‑limiting conditions. The purpose …

Contributing Factors Of Contralateral Breast Cancer In Patients With Brca Mutation (On-Brca Ii Study, Korea-Bsg 11), Seon-Hi Shin, Sung Gwe Ahn, Jai Min Ryu, Sae Byul Lee, Hyung Seok Park, Eun-Shin Lee, Janghee Lee, Byeongju Kang, Sanghwa Kim, Eun Young Kim, Young-Joon Kang, Sun Young Min, Moohyun Lee, Se-Kang Kim, Hong-Kyu Kim, Chihwan David Cha

Faculty, Staff and Students Publications

Background: The cumulative risk of contralateral breast cancer (CBC) in BRCA1/2 carriers is remarkably higher than in non-carriers. This study aimed to investigate the clinicopathological predictors associated with the risk of metachronous CBC among breast cancer patients with BRCA1/2 mutations using correspondence analysis.

Methods: This retrospective study included patients who underwent BRCA testing between January 2008 and December 2018. The inclusion criterion was patients being between 20 and 80-years-old with invasive breast cancer (pT1-3, N0-3). We performed univariate and multivariate survival analyses to assess the risks associated with BRCA mutations, and conducted correspondence analysis to identify contributing factors for CBC …

Choice-Aya: Adapting An Evidence-Based Contraceptive Counseling Intervention For Adolescents And Young Adults Experiencing Homelessness., Mariah E. Brewe, Anna Burns, Nikolaus Schuetz, Taylor Stephens, Emma Francis, Haylie Yost, Stephani L. Stancil

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Adolescents and young adults (AYA) experiencing homelessness face an increased risk of reproductive violence, unintended pregnancy, and barriers accessing healthcare. While interventions focused on efficacy-first contraceptive counseling are successful at increasing rates of long-acting reversible contraceptive (LARC) use, little is known about how an efficacy-first approach is received by AYA experiencing homelessness given unique factors associated with their reproductive health care. We aimed to adapt the evidence-based CHOICE contraceptive counseling approach for AYA experiencing homelessness.

METHODS: Focus groups discussion with AYA experiencing homelessness were conducted to understand prior reproductive health care experiences and contraception counseling preferences, comparing efficacy first …

Multi-Organ Physiologic Deficits During Exercise Identify Clinical And Molecular Predisposition To Heart Failure With Preserved Ejection Fraction, Isabela Landsteiner, Lindsey K Stolze, Tess E Peterson, Andrew Perry, Phillip Lin, Quanhu Sheng, Shilin Zhao, Kaushik Amancherla, Michael Y Mi, Takenori Ikoma, Laura P Cohen, Ilya Giverts, Joseph Campain, Joao A C Lima, Wendy S Post, Kent D Taylor, Robert Gerszten, Stephen S Rich, Russell Tracy, Peter Durda, Alexis C Wood, Rajeev Malhotra, Jerome I Rotter, Clary Clish, Matthew Nayor, Eric R Gamazon, Ravi V Shah, Gregory D Lewis

Faculty, Staff and Students Publications

Background: Exercise unmasks limitations in multi-organ system reserve capacity characteristic of heart failure with preserved ejection fraction (HFpEF). However, the metabolic and genetic underpinnings of exercise deficits, and their cumulative contribution to HFpEF severity and prognosis, remain incompletely understood.

Methods: We used invasive cardiopulmonary exercise testing (iCPET), metabolite profiling, and genomics to simultaneously characterize seven exercise physiologic deficits in HFpEF patients: reduced exercise stroke volume and heart rate, steep pulmonary capillary wedge pressure/cardiac output (PCWP/CO) slope, elevated pulmonary vascular resistance, pulmonary mechanical limitation to exercise, impaired peripheral oxygen extraction, and obesity-related exaggerated metabolic cost of initiating exercise. We first mapped …

Cardiomyopathy In Children: What Pediatricians Need To Know, Michael Smith, Brian Birnbaum

Pediatrics in Practice: A CME Podcast

Cardiomyopathy in children can present with subtle signs but serious consequences if missed. In this episode, Brian Birnbaum, MD, Interim Co-Director of the Ward Family Heart Center at Children’s Mercy, shares practical insights for pediatricians on recognizing early red flags, knowing when to refer, and understanding how diagnosis and management of pediatric cardiomyopathy are evolving.

Click here to stream the podcast episode.