Medical Specialties Commons^™

Risk Factors For Strabismus Surgery After Pediatric Cataract Surgery In The United States, Bryce Hwang, Isdin Oke, Scott R. Lambert

Wills Eye Hospital Papers

Purpose: To determine the cumulative incidence of strabismus surgery after pediatric cataract surgery and identify the associated risk factors.

Design: US population-based insurance claims retrospective cohort study.

Participants: Patients ≤ 18 years old who underwent cataract surgery in 2 large databases: Optum Clinformatics Data Mart (2003e2021) and IBM MarketScan (2007e2016). Methods: Individuals with at least 6 months of prior enrollment were included, and those with a history of strabismus surgery were excluded. The primary outcome was strabismus surgery within 5 years of cataract surgery. The risk factors investigated included age, sex, persistent fetal vasculature (PFV), intraocular lens (IOL) placement, nystagmus …

Increasing Cefazolin Use For Surgical Prophylaxis In Penicillin-Allergy-Labeled Patients., Kathryn A. Vandervelde, Sarah Suppes, Kate Gibbs, Kevin Latz, Angela C. Vanderpool, Rana El Feghaly, Jennifer Goldman

Manuscripts, Articles, Book Chapters and Other Papers

Objective: Penicillin (PCN) allergy labels affect antimicrobial selection for surgical prophylaxis. We aimed to increase the percentage of cefazolin usage in patients with PCN allergy labels undergoing orthopedic surgery from 50% to 80%.

Design: Quality improvement initiative.

Setting: Children's Mercy Kansas City (CMKC), a freestanding children's hospital.

Patients: Children scheduled for an orthopedic surgery (excluding spinal surgery) at CMKC who had a PCN allergy label and received a perioperative antibiotic.

Methods: No standardized process existed to identify and clarify PCN-allergic-labeled patients preoperatively. We developed a process for patient identification combined with a pharmacist phone interview for PCN allergy clarification. In …

Efficacy Of Eltrombopag With Immunosuppressive Therapy For Children With Acquired Aplastic Anemia, Yufei Zhao, Wenrui Yang, Xin Zhao, Xiangrong Hu, Jing Hu, Xu Liu, Jianping Li, Lei Ye, Youzhen Xiong, Yang Yang, Baohang Zhang, Xiaoxia Li, Xiawan Yang, Yimeng Shi, Guangxin Peng, Yuan Li, Huihui Fan, Kang Zhou, Liping Jing, Li Zhang, Fengkui Zhang

Faculty, Staff and Student Publications

BACKGROUND: Eltrombopag (EPAG), an oral thrombopoietin receptor agonist (TPO-RA), has been proven to improve the hematologic response without increasing toxic effects as a first-line therapy combined with standard immunosuppressive treatment (IST) in adults with severe aplastic anemia (SAA). Nevertheless, the clinical evidence on the efficacy of EPAG in children with acquired aplastic anemia is limited and controversial.

METHODS: We performed a single-center, retrospective study to analyze the clinical outcomes of fifteen patients aged ≤18 years with newly diagnosed acquired SAA who received first-line IST and EPAG (EPAG group) compared with those of forty-five patients who received IST alone (IST group) …

Impact Of Enteropathogens On Faltering Growth In A Resource-Limited Setting, Furqan Kabir, Junaid Iqbal, Zehra Jamil, Najeeha Talat Iqbal, Fatima Aziz, Adil Kalam, Sahrish Muneer, Aneeta Hotwani, Sheraz Ahmed, Fayyaz Umrani, Sana Syed, Kamran Sadiq, Syed Asad Ali

Department of Paediatrics and Child Health

Introduction: Environmental enteropathy is an important contributor to childhood malnutrition in the developing world. Chronic exposure to fecal pathogens leads to alteration in intestinal structure and function, resulting in impaired gut immune function, malabsorption, and growth faltering leading to environmental enteropathy.
Methods: A community-based intervention study was carried out on children till 24 months of age in Matiari district, Pakistan. Blood and fecal specimens were collected from the enrolled children aged 3-6 and 9 months. A real-time PCR-based TaqMan array card (TAC) was used to detect enteropathogens.
Results: Giardia, Campylobacter spp., enteroaggregative Escherichia coli (EAEC), Enteropathogenic Escherichia coli (EPEC), …

Technology Meets Tils: Deciphering T Cell Function In The -Omics Era, William H Hudson, Andreas Wieland

Faculty, Staff and Students Publications

T cells are at the centerstage of cancer immunology due to their ability to recognize mutations within tumor cells and directly mediate cancer cell killing. Immunotherapies to rejuvenate exhausted T cell responses have transformed the clinical management of several malignancies. In parallel, the development of novel multidimensional analysis platforms such as single-cell RNA-sequencing and high-dimensional flow cytometry has yielded unprecedented insights into immune cell biology. This convergence has revealed substantial heterogeneity of tumor-infiltrating immune cells, both within single tumors, across tumor types, and among cancer patients. Here, we discuss the opportunities and challenges of studying the complex tumor microenvironment with …

The Impact Of Covid-19 On Pediatric Cardiac Arrest Outcomes: A Systematic Review And Meta-Analysis, Alla Navolokina, Jacek Smereka, Bernd W Böttiger, Michal Pruc, Raúl Juárez-Vela, Mansur Rahnama-Hezavah, Zubaid Rafique, Frank W Peacock, Kamil Safiejko, Lukasz Szarpak

Faculty, Staff and Students Publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic, required the donning of personal protective equipment during clinical contact, and continues to be a significant worldwide public health concern. Pediatric cardiac arrest is a rare but critical condition with a high mortality rate, the outcomes of which may be negatively affected by donning personal protective equipment. The aim of this study is to perform a systematic review and meta-analysis of the impact of the COVID-19 pandemic on pediatric cardiac arrest outcomes. We conducted a systematic review with meta-analysis in the following databases: PubMed, EMBASE, Scopus, Web of Science, …

Echinococcus Multilocularis Calreticulin Interferes With C1q-Mediated Complement Activation, Siqi Xian, Lujuan Chen, Yan Yan, Jianfang Chen, Guixia Yu, Yuxiao Shao, Bin Zhan, Yanhai Wang, Limei Zhao

Faculty, Staff and Students Publications

As a zoonotic disease caused by Echinococcus multilocularis larvae, alveolar echinococcosis (AE) is one of the most severe forms of parasitic infection. Over a long evolutional process E. multilocularis has developed complex strategies to escape host immune attack and survive within a host. However, the mechanisms underlying immune evasion remain unclear. Here we investigated the binding activity of E. multilocularis calreticulin (EmCRT), a highly conserved Ca2+-binding protein, to human complement C1q and its ability to inhibit classical complement activation. ELISA, Far Western blotting and immunoprecipitation results demonstrated that both recombinant and natural EmCRTs bound to human C1q, …

Metabolomics Of A Neonatal Cohort From The Alliance For Maternal And Newborn Health Improvement Biorepository: Effect Of Preanalytical Variables On Reference Intervals, Lena Jafri, Aysha Habib Khan, Muhammad Ilyas, Muhammad Imran Nisar, Javairia Khalid, Hafsa Majid, Aneeta Hotwani, Fyezah Jehan

Department of Pathology and Laboratory Medicine

Background: The study was conducted to determine reference interval (RI) and evaluate the effect of preanalytical variables on Dried blood spot (DBS)-amino acids, acylcarnitines and succinylacetone of neonates.
Methodology: DBS samples were collected within 48-72 hours of life. Samples were analyzed for biochemical markers on tandem mass spectrometer at the University of Iowa. Comparison of RI across various categorical variables were performed.
Results: A total of 610 reference samples were selected based on exclusion criteria; 53.2% being females. Mean gestational age (GA) of mothers at the time of delivery was 38.7±1.6 weeks; 24.5% neonates were of low birth weight and …

Excretory/Secretory Proteome Of Females And Males Of The Hookworm Ancylostoma Ceylanicum, Samuel C Uzoechi, Bruce A Rosa, Kumar Sachin Singh, Young-Jun Choi, Bethany K Bracken, Paul J Brindley, R Reid Townsend, Robert Sprung, Bin Zhan, Maria-Elena Bottazzi, John M Hawdon, Yide Wong, Alex Loukas, Sergej Djuranovic, Makedonka Mitreva

Faculty, Staff and Students Publications

The dynamic host-parasite mechanisms underlying hookworm infection establishment and maintenance in mammalian hosts remain poorly understood but are primarily mediated by hookworm’s excretory/secretory products (ESPs), which have a wide spectrum of biological functions. We used ultra-high performance mass spectrometry to comprehensively profile and compare female and male ESPs from the zoonotic human hookworm Ancylostoma ceylanicum, which is a natural parasite of dogs, cats, and humans. We improved the genome annotation, decreasing the number of protein-coding genes by 49% while improving completeness from 92 to 96%. Compared to the previous genome annotation, we detected 11% and 10% more spectra in …

Utility Of Computed Tomography In Diagnosis Of A Patent Ductus Arteriosus In Pulmonary Artery Endarteritis, Anneliese J Grewing, Betul Yilmaz Furtun, Melissa K Webb

Faculty, Staff and Students Publications

A 15-year-old patient with infective endarteritis had a pulmonary artery vegetation but no ductus arteriosus on echocardiogram. Computed tomography scan revealed a closed ductus that became patent after antibiotics and anticoagulation. Infective endarteritis should be considered in patients with a pulmonary artery vegetation even if no ductus is seen on echocardiogram. (Level of Difficulty: Intermediate.)

Single-Cell Multi-Omics Integration For Unpaired Data By A Siamese Network With Graph-Based Contrastive Loss, Chaozhong Liu, Linhua Wang, Zhandong Liu

Faculty, Staff and Students Publications

BACKGROUND: Single-cell omics technology is rapidly developing to measure the epigenome, genome, and transcriptome across a range of cell types. However, it is still challenging to integrate omics data from different modalities. Here, we propose a variation of the Siamese neural network framework called MinNet, which is trained to integrate multi-omics data on the single-cell resolution by using graph-based contrastive loss.

RESULTS: By training the model and testing it on several benchmark datasets, we showed its accuracy and generalizability in integrating scRNA-seq with scATAC-seq, and scRNA-seq with epitope data. Further evaluation demonstrated our model's unique ability to remove the batch …

Challenges In Management Of Refractory Pain And Sedation In Infants., Alexandra Oschman, Karishma Rao

Manuscripts, Articles, Book Chapters and Other Papers

The survival of preterm infants continues to improve, along with an increased in neonatal intensive care unit (NICU) management of chronic infants who are medically complex infants who have prolonged hospital stays, sometimes up until 2 years of age. Despite advances in neonatal and infant care, the management of pain and sedation in chronic NICU patients continues to be a challenge. Challenges such as development of appropriate pain, sedation, and withdrawal scales along with unfamiliarity of the NICU care team with pediatric disease states and pharmacotherapy complicate management of these patients. Opioid induced hyperalgesia (OIH) and delirium may play a …

Longitudinal Developmental Outcomes Of Infants And Toddlers With Traumatic Brain Injury, Heather T Keenan, Amy Clark, Rich Holubkov, Linda Ewing-Cobbs

Faculty, Staff and Student Publications

IMPORTANCE: Among children, infants and toddlers have some of the highest rates of traumatic brain injury (TBI), but longitudinal information on their developmental outcomes to guide postinjury surveillance is sparse.

OBJECTIVE: To evaluate infants' and toddlers' development over 3 years following TBI compared with those with orthopedic injury (OI).

DESIGN, SETTING, AND PARTICIPANTS: A longitudinal observational cohort study was conducted at 2 level 1 pediatric trauma centers from January 20, 2013, to September 30, 2015; data analysis was performed from May 12 to October 20, 2021. Participants included children injured when younger than 31 months with TBI or OI who …

Increased Camkk2 Expression Is An Adaptive Response That Maintains The Fitness Of Tumor-Infiltrating Natural Killer Cells, Patrick K Juras, Luigi Racioppi, Debarati Mukherjee, Sandeep Artham, Xia Gao, Laura Akullian D'Agostino, Ching-Yi Chang, Donald P Mcdonnell

Faculty, Staff and Students Publications

Calcium/calmodulin-dependent protein kinase kinase 2 (CaMKK2) is a key regulator of energy homeostasis in several cell types. Expression of this enzyme in tumor cells promotes proliferation and migration, and expression in tumor-associated immune cells facilitates M2 macrophage polarization and the development of myeloid-derived suppressor cells. Thus, there has been interest in developing CaMKK2 inhibitors as potential anticancer therapeutics. One impediment to clinical development of these agents is that the roles of CaMKK2 in other cellular compartments within the tumor immune microenvironment remain to be established. We report herein that CaMKK2 is expressed at low basal levels in natural killer (NK) …

Play's Continuum Of Needs: Building Blocks For Deepening Play Opportunities In Medical Environments, Deborah Brewster Vilas

Graduate School of Education

Optimal healing for children in hospitals occurs when their developmental needs are considered as part of their overall treatment plan. One of the most pressing developmental needs for all children is the need to play, and this remains so even when they are confined to a hospital bed or face developmental delays or disabilities. This chapter examines the most basic components of implementing play programs in hospitals, such as the intentional creation of space for play, determining the best times for children to play, and exploring what types of play are therapeutic and possible in a hospital environment. The author …

Benefits Of Rooming-In On Infants With Neonatal Opioid Withdrawal Syndrome, Emma Ricioli

Nursing | Senior Theses

Neonatal opioid withdrawal syndrome (NOWS) is a significant public health concern, affecting infants born to mothers who use opioids during pregnancy. Those exposed in-utero exhibit numerous signs of withdrawal after delivery including tremors, gastrointestinal distress, inconsolability, and poor feeding. Typical treatment for infants suffering from NOWS included direct admission to the neonatal intensive care unit (NICU) for close observation and pharmacological interventions. However, NICU stays can interfere with bonding and breastfeeding. They can also lead to increased lengths of stay, higher costs, and more invasive pharmacological treatments. These infants typically do not have any other concerning health issues besides NOWS …

Quality Improvement: Implementation Of Rapid Mri Protocol At Gsmc For Further Evaluation Of Suspected Pediatric Appendicitis, Colin W. Woolard, Christian Salinas, Allison Hudak, Jeffery Durbin

South Atlantic Division GME Research Day 2023

No abstract provided.

Concussion, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Emergency Contraception, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Gastric Sleeve Enhanced Recovery After Surgery, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Genital Ulcers (Painful, Aphthous) In Females, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Pectus Excavatum With Bar Placement Eras, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Perforated Congenital Sigmoid Diverticula Of A Pediatric Patient, Tamir Bresler, Ryan Meyer, Kevin Palmer, Philip Frykman

Far West Division GME Research Day 2023

No abstract provided.

Urinary Ascites In A Newborn Male, Amanda Stragnell, Querube Santana-Holcombe, Annette Santiago

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Neonatal ascites is a condition characterized by abdominal distention resulting from the accumulation of fluid within the peritoneal cavity and is life-threatening if not treated appropriately. Genitourinary abnormalities and urinary ascites are important to consider as part of the differential for newborns presenting with abdominal distention and ascites. In male infants with urinary ascites, presence of a posterior ureteral valve is a common etiology, accounting for up to 70% of cases. In this setting, early identification and management of urinary outlet obstruction is essential to prevent progression to autodialysis and uremia. …

Patient Experience Study: Healthy Birth Initiatives & Providence, Monique Gill, Ritu Ghosal, Maggie M Hodges, Lindsay Dickey, Roberta Hunte

View All

No abstract provided.

An App-Based Ecological Momentary Assessment Of Undergraduate Mental Health During The Covid-19 Pandemic In Canada (Smart Healthy Campus Version 2.0): Longitudinal Study, Kelly Anderson, Chris Brogly, Daniel Lizotte, Marc Mitchell, Mark Speechley, Arlene Macdougall, Erin Huner, Michael Bauer

Data and Test Instruments

No abstract provided.

Comparing Youth With Vs Without Outpatient Mental Health Services On Subsequent Acute Mental Health Care Visits, Kelly Anderson, Jordan Edwards, Li Wang, Anne Fuller, Katholiki Georgiades

Data and Test Instruments

No abstract provided.

Neighbourhood-Level Social Capital, Marginalisation, And The Incidence Of Schizophrenia And Schizoaffective Disorder In Toronto, Canada: A Retrospective Population-Based Cohort Study, Kelly Anderson, Martin Rotenberg, Kwame Mckenzie, Andrew Tuck

Data and Test Instruments

No abstract provided.

Return On Investment From Service Transformation For Young People Experiencing Mental Health Problems: Approach To Economic Evaluations In Access Open Minds (Esprits Ouverts), A Multi-Site Pan-Canadian Youth Mental Health Project, Kelly Anderson

Data and Test Instruments

No abstract provided.

Sexually Transmitted Infection (Sti), Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.