Medical Specialties Commons^™

Developing A Multidisciplinary Approach To Complex Pediatric Areodigestive Care- Where We've Been, Where We're Going, And What We've Learned Along The Way, Jason R. Brown

Grand Rounds

1. Enhance competence and expand expertise in pediatric surgical conditions prevalent in our geographical area and nationally.
2. Develop strategies to enhance communication and collaboration among interdisciplinary team members addressing pediatric surgical conditions.
3. List barriers to multidisciplinary care.

Embedding Interprofessional Education In Pediatric Clerkships: Lessons From Nebraska’S Tracking Infant Progress Statewide (Tips) Program, Grace E. Berentson, Liliana Bronner, Paige Hardy, Neil Kalsi, Brianna Brei, Kerry Miller

Posters and Presentations: Munroe-Meyer Institute

Background: NICU graduates experience disproportionate developmental and health challenges. Their families face barriers to equitable care including access to coordinated follow-up services. Traditional medical education rarely exposes students to authentic interprofessional models of care that address these inequities. The Tracking Infant Progress Statewide (TIPS) program provides developmental, social, and medical follow-up for NICU graduates across Nebraska, bringing together physicians, nurse practitioners, child developmental specialists, and nurses in a single family-centered visit. Embedding third-year medical students into this setting models collaborative practice, builds understanding of interprofessional competencies, and fosters awareness of systemic inequities affecting NICU families. This innovative curricular approach differs …

A Systematic Literature Review Of Cvid Reveals Pervasive Detrimental Noninfectious Manifestations, G Michelle Ducasa, Rebecca A Marsh, Ali Mojebi, Hsi-En Ho, Charlotte Cunningham-Rundles, Lisa Forbes Satter, Elena W Y Hsieh, Sinisa Savic, Marta Dafne Cabañero-Navalón, Hector Balastegui-Martin, Joud Hajjar, Gulbu Uzel, Kevin S Thorneloe, Jocelyn R Farmer

Faculty, Staff and Students Publications

Noninfectious manifestations of common variable immunodeficiency (CVID) are not formally summarized. We performed a systematic literature review to generate a comprehensive reference for the field. Splenomegaly was the most reported manifestation across 53 publications, occurring in a median of 35.2% of patients. Frequently reported digestive system manifestations included diarrhea (median 27.8%; 21 publications), hepato(spleno)megaly (median, 21.0%; 19 publications), portal hypertension (median 21.0%; 3 publications), nodular lymphoid hyperplasia (median, 17.0%; 9 publications), and enteropathy (median, 16.0%; 34 publications). Other notable manifestations included interstitial lung disease (median, 8.7%; 32 publications) and autoimmune cytopenias (median 18.0%; 21 publications). Steroids and rituximab were the …

Neurodevelopmental Outcomes Following Hematopoietic Cell Transplantation For Patients With Severe Combined Immunodeficiency (Scid): A Pidtc Study, Virdette L Brumm, Sharon A Kidd, Brent R Logan, Farheen Chunara, Jennifer Heimall, Linda M Griffith, Donald B Kohn, Lauren Sanchez, Jeffrey J Bednarski, Caridad Martinez, Mark Vander Lugt, Neena Kapoor, Nicola Wright, Barbara Spitzer, Joseph H Oved, Sharat Chandra, Deepak Chellapandian, Christen L Ebens, Aleks Petrovic, Ahmad Rayes, Hilary L Haines, Hannah Lust, Hannah-Lise Tirado Schofield, Lauren Christopher, Lynnette L Harris, Lisa Forbes Satter, Lauri Burroughs, Christopher C Dvorak, Elie Haddad, Jennifer W Leiding, Rebecca A Marsh, Luigi D Notarangelo, Sung Yun Pai, Michael A Pulsipher, Jennifer M Puck, Morton J Cowan, Ami J Shah

Faculty, Staff and Students Publications

Hematopoietic cell transplantation (HCT) is a potentially curative treatment for severe combined immunodeficiency (SCID). Since the initiation of newborn screening (NBS), survival rates have improved significantly, but the impact of HCT upon neurodevelopment for patients with SCID requires more investigation. We performed a cross-sectional study of subjects with SCID in North America to assess the impact of NBS, transplant conditioning regimen, and genotype on neurodevelopmental outcomes after HCT. 69 subjects with SCID from 17 PIDTC centers (excluding those with ADA deficiency), ages 6-16 years, received comprehensive standardized neurodevelopmental testing of cognitive, behavioral, and emotional function. Compared with the normative population, …

Isolated Clonidine Ingestions In Pediatric Patients, Spencer Greene, Caleb King, Sharan Campleman

Gulf Coast Division GME Research Day 2026

No abstract provided.

Hydroxyurea Pharmacokinetics In Children With Sickle Cell Anemia Across Different Global Populations, Alexandra Power-Hays, Kathryn Mcelhinney, Thomas Williams, George Mochamah, Peter Olupot-Olupot, George Paasi, Marvin Reid, Angela Rankine-Mullings, Robert Opoka, John Chandy

Paediatrics and Child Health, East Africa

Hydroxyurea provides effective disease-modifying treatment for people with sickle cell anemia (SCA), especially when escalated to maximum tolerated dose (MTD), but has wide interpatient dosing variability due to pharmacokinetic (PK) differences. Whether hydroxyurea PK parameters differ among children with SCA in different global regions is unknown. We compared hydroxyurea PK parameters among children with SCA from five clinical trials: HUSTLE (USA, NCT00305175), TREAT (USA, NCT02286154), NOHARM (Uganda, NCT01976416), REACH (Uganda and Kenya, NCT01966731), and EXTEND (Jamaica, NCT02556099). Key hydroxyurea PK parameters were determined using HdxSim™, a validated hydroxyurea PK-software program. The results were compared across regions by one way analysis …

Investigating Neonatal Sepsis: Anti-Infectives, Diagnostics And Guidelines Used In Health Systems Across Sub-Saharan Africa – The Insights Study, Jack Louis Stanley, David Hettle, Rachel Poffley, Larisse Bolton, Emelyne Gres, Isabel Coelho, Raana Hussain, Gildas Boris Hedible, Gwendoline Lilly Chimhini, Valeriane Leroy

Paediatrics and Child Health, East Africa

Background Sepsis is a leading cause of neonatal mortality in sub-Saharan Africa (SSA), where microbiological diagnostic capacity and antibiotic access are limited. High antimicrobial resistance (AMR) rates limit the effectiveness of current treatment guidelines, with concern that available antibiotics are rarely adequate treatment for neonatal sepsis in the region.

Methods A cross-sectional online survey was electronically distributed in English, French and Portuguese to neonatal clinicians across SSA between April and June 2025. Questions focused on the management of neonatal sepsis including diagnostic, antibiotic and guideline use. Responses were analysed descriptively and presented as percentages of the total number of responses. …

Quantification Of Illicit And Prescription Drug Residues In Pasteurized Donor Human Milk: A Comprehensive Analytical Approach, Michelle Brenner, Kaytlin Krutsch, Ashlynn Baker, Dhavalkumar Patel, Palika Datta

Department of Pediatrics Faculty Publications

Objective

To assess the risk of infant exposure to illicit and prescription drug residues, from infant-ready, pooled, pasteurized donor human milk (PDHM) provided by healthy, screened, voluntary non-remunerated donors to a not-for-profit milk bank.

Study Design

A total of 150 pooled samples, representing 742 donor contributions, were analyzed for 15 illicit and prescription drug analytes using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Detected concentrations were evaluated for clinical significance.

Result

All 150 PDHM samples tested negative for residues of marijuana, amphetamines, benzodiazepines, fentanyl, hydrocodone, and morphine. Three samples (2%) contained trace amounts of oxycodone (< 0.6 parts per billion), yielding exposures over 455 times lower than established standards for infant safety (Relative Infant Dose: < 0.022%; standard safety threshold 10%).

Conclusion

Comprehensive analysis detected no clinically …

Causal Effect Estimates Of Online E-Cigarette Marketing Exposure On Future E-Cigarette Harm Perception And Use, Paul T. Harrell, Nicholas T. Williams, Kara E. Rudolph, Rachel Ayala Guzman, Ateeqa Ijaz, Nicole Rychagov, Aaron Null, Silvia S. Martins

Department of Pediatrics Faculty Publications

Background

Globally, over 10 million youth use e-cigarettes; United States use, in particular, dramatically rose in the late 2010's, exceeding year-over-year increases from any other substance in over four decades. This rise has been partially attributed to youth online e-cigarette marketing exposure, but has not been appropriately studied.

Methods

We examined youth data from the Population Assessment of Tobacco and Health (PATH) spanning the dramatic increase period (Waves 4, 4.5, and 5; 2016-2019). We estimated average risk differences (RD) for Wave 5 e-cigarette harmfulness perception and use comparing all youth versus no youth reporting past-month online e-cigarette marketing exposure in …

Posterior Subperiosteal Abscess Of The Distal Femur In A Pediatric Patient: A Rare Surgical Presentation Of Acute Hematogenous Osteomyelitis, Michael Dearman, Corey Bindner

School of Medicine Student Publications and Presentations

Introduction: Pediatric osteomyelitis commonly arises from acute hematogenous spread and remains diagnostically challenging due to limited radiographic findings and difficulty obtaining MRI in young children. Subperiosteal abscess formation is an uncommon but serious complication, with posterior distal femoral involvement reported only once previously.

Case Report: A 19-month-old male presented with fever and refusal to bear weight. Initial radiographs were unremarkable. Worsening symptoms prompted admission with rising inflammatory markers and blood cultures positive for gram positive cocci. MRI demonstrated distal femoral metaphyseal osteomyelitis with a posterior subperiosteal abscess. Through an anterior arthrotomy and metaphyseal drilling, osteomyelitis and joint involvement were addressed. …

Transition From High School (Spanish), Children's Health School Services

School Guides

Parent guide about the transition from high school. Translated into Spanish.

Transverse Myelitis, Children's Health School Services

School Guides

Educator guide about how to support students with transverse myelitis.

Traumatic Brain Injury, Children's Health School Services

School Guides

Educator guide about how to support students with traumatic brain injury.

Neuromyelitis Optica, Children's Health School Services

School Guides

Educator guide about how to support students with neuromyelitis optica.

Optic Neuritis, Children's Health School Services

School Guides

Educator guide about how to support students with optic neuritis.

Generalized Anxiety Disorder, Children's Health School Services

School Guides

Educator guide about how to support students with generalized anxiety disorder.

Limbic Encephalitis, Children's Health School Services

School Guides

Educator guide about how to support students with limbic encephalitis.

Leukemia, Children's Health School Services

School Guides

Educator guide about how to support students with leukemia.

Lupus, Children's Health School Services

School Guides

Educator guide about how to support students with lupus.

Lymphoma, Children's Health School Services

School Guides

Educator guide about how to support students with lymphoma.

Major Depressive Disorder, Children's Health School Services

School Guides

Educator guide about how to support students with major depressive disorder.

Inflammatory Bowel Disease, Children's Health School Services

School Guides

Educator guide about how to support students with inflammatory bowel disease.

Functional Neurological Disorder, Children's Health School Services

School Guides

Educator guide about how to support students with functional neurological disorder.

A Cost-Consequence Analysis Of The Children’S Administration Oxygenation Strategies Trial (Coast) In Severe Pneumonia, Orlagh U. Carroll, Richard Grieve, Sarah Kiguli, Peter Olupot-Olupot, Robert Opoka, Charles Engoru, Florence Alaroker, Abner Tagoola, Mainga Hamaluba, Eva Nabawanuka

Paediatrics and Child Health, East Africa

Oxygen supplementation is a recommended treatment for children with severe pneumonia or hypoxaemia. The open, fractional-factorial Children’s Oxygen Administration Strategies Trial (COAST) recruited Kenyan and Ugandan children with severe pneumonia and hypoxaemia. Participants in the severe hypoxaemia stratum (SpO₂ <  80%) were randomised to high-flow nasal therapy (HFNT) or low-flow oxygen (LFO), and in the hypoxaemia stratum (SpO₂ 80–91%) to HFNT, LFO or permissive hypoxaemia (ratio 1:1:2). The trial stopped early and there is ongoing uncertainty about the clinical benefits of the alternative strategies. There is a lack of evidence about the relative costs, of alternative oxygen delivery for critically-ill children in low- and middle- income countries. We used data from COAST to conduct a cost-consequence analysis …

Progression Of Mild Sleep-Disordered Breathing In Children Managed With Watchful Waiting, Erin M. Kirkham, Stacey Ishman, Susan Garetz, Cristina M. Baldassari, Ron B. Mitchell, Christopher Liu, Ignacio E. Tapia, Lisa M. Elden, Fauziya Hassan, Sally Ibrahim, Kristie Ross, Mengqi Cen, Rui Wang, Susan Redline, Ronald D. Chervin

Department of Otolaryngology (ENT) Faculty Publications

Purpose

To identify clinical characteristics that may be associated with persistence or progression of mild sleep-disordered breathing (SDB) in children who are observed without surgery.

Methods

This is a secondary analysis of the control arm of the Pediatric Adenotonsillectomy Trial for Snoring (PATS), which randomized 458 children aged 3.0 to 12.9 years with mild SDB (snoring with obstructive apnea-hypopnea index [oAHI] <  3 events/hour) to early adenotonsillectomy (eAT) versus watchful waiting with supportive care (WWSC). Participants were assessed at baseline and 12 months with the Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder (PSQ-SRBD) scale and polysomnography (PSG). We tested for factors predictive of either (1) PSG progression defined by a 12-month oAHI ≥ 3 or (2) symptom persistence or progression defined by a 12-month PSQ-SRBD score ≥ 0.33.

Results

A total of 234 participants were observed (mean age 6.2 years, 111 [47%] female, 65 [28%] Black or African American, 37 [16%] Hispanic). Overall, only 13% (n = 20/150) progressed to an oAHI ≥ 3 on repeat PSG, …

Differences Of Sex Development (Dsd), Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

An Analysis Of Pediatric Retinoblastoma Medical Malpractice Litigation, Victoria Miller, Alyssa D. Reese, Katherine Foote, Alejandro Navarro, Andrew Galfano, Christian Hietanen

Department Surgery Faculty Publications

BACKGROUND: Retinoblastoma is a cancer of the retina that is most commonly diagnosed in the pediatric population. Unfortunately, this cancer can spread, leading to poor outcomes such as enucleation. The purpose of this study was to determine the characteristics of medical malpractice litigation associated with a diagnosis of retinoblastoma in the pediatric population.

METHODS: A search for all available cases associated with "retinoblastoma" in the Westlaw Campus Research Legal Database was conducted. This spanned from database inception to August 2023. Cases were included if there was a complaint of medical malpractice related to retinoblastoma present in a pediatric patient. Demographic …

Infantile Epileptic Spasms Syndrome: Clinical Profile And Outcomes At A Tertiary Hospital In Kenya, Peninah Mwangi, Katherine Oyieke, Sam Gwer, Pauline Samia

Paediatrics and Child Health, East Africa

Background: Infantile epileptic spasms syndrome (IESS) is characterised by onset of epileptic spasms between 3 and 12 months, with or without typical hypsarrhythmia, and developmental stagnation or regression. There are limited data on the clinical profile and treatment outcomes of IESS in sub-Saharan Africa.

Objective: To describe the clinical profile and treatment outcomes of infants diagnosed with and managed for IESS at Aga Khan University Hospital, Nairobi.

Methods: Records of children aged 3–24 months diagnosed with IESS between January 2012 and December 2021 were identified from the hospital information system using the terms “infantile spasm”, “epileptic spasms”, …

Child Exploitation Through Online Sharing: “Sharenting” And The Role Of The Pediatric Provider, Stacey Steinberg, Cameron Rosenthal

UF Law Faculty Publications

The alarming trend of “sharenting” highlights the need for increased vigilance in protecting children from online exploitation. When parents share intimate details about children’s lives on social media, they may inadvertently expose them to danger. Pediatricians are equipped to safeguard children from parental abuse and neglect; however, they are less prepared to protect children from harm caused by parents online.

When parents exploit children on social media, pediatricians face challenges in protecting patients while also following laws that maintain parental autonomy. Using a child welfare framework, this article defines these online harms and proposes strategies for protecting children from exploitative …

Intra-Amniotic Infection (Iai) Prevention, Shelbie Clement, Deanna Conley

Articles, Abstracts, and Reports

No abstract provided.