Medical Specialties Commons^™

Evaluation For Association Between Maternal Microbiota And Development Of Necrotizing Enterocolitis Or Gram-Negative Bacteremia In Preterm Infants, Mei Chi Quek

Master of Medicine in Paediatrics and Child Health

Background: Preterm birth is the leading cause of perinatal morbidity and mortality worldwide. There is a need for a better understanding of the correlation of vaginal microbiota with adverse preterm outcomes. Our study aimed to explore how the vaginal microbiota influences the outcome of the preterm infants, determine whether fecal microbiota in premature infants differs from that in term infants, and explore the microbiota pattern in preterm neonates who received multiple antibiotics. Method: A prospective cohort design was used to enroll 33 women admitted in spontaneous labor between 25 to 36 weeks, and 33 controls matched for age and parity …

Creating A Noise-Reducing, Wearable Intervention For Newborns In The Nicu, Mohammad Rasool, Alexandra A. Mccullough, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Excessive auditory stimulation can have negative effects on the growth and development of newborn babies. The American Academy of Pediatrics states that newborns should not be exposed to sounds in excess of 45dB while they are in the hospital, however noise levels in NICUs across the country are often between 50-100dB. A design project was conducted to develop an intervention that could reduce infant exposure to excessive noise.

Methods: Neonatologists, nurses, audiologists, music therapists, sound designers, soft materials experts, and medical device designers were interviewed and consulted throughout the design process. A 24-hour sound recording using a REED-SD-4023 meter …

Caring For Children In Child Welfare Systems: A Trauma-Informed Model Of Integrated Primary Care, Jill Mcleigh, Laura Lamminen, Heidi Roman

Integrated, Trauma-Informed Care

Children involved with the child welfare system have high rates of behavioral health concerns, chronic health conditions, and developmental disabilities. Further, as a result of the complicated relationships among the court system, child protective services, and caregivers (i.e., biological, kinship, and/or foster caregivers) and the high volume of health-, behavior-, and development-related services children in care need, the services they receive tend to be fragmented and problem driven. On top of these challenges, children involved with the child welfare system have been exposed to trauma, and often more than one form of trauma. Taken together, these factors point to the …

Fit Clinical Decision-Making: Brain Abscess In A Nonfenestrated Fontan Patient, Bethany Runkel, Natalie Shwaish, Geetha Raghuveer, William Drake

Posters

No abstract provided.

Fit Clinical Decision-Making: Isolated Polymorphic Ventricular Tachycardia In A Pediatric Patient: An Unusual Presentation Of Acute Mycocarditis, Natalie S. Shwaish, Bethany Runkel, Lindsey Malloy-Walton

Posters

No abstract provided.

Sound Dampening Headband For Infants, Alexandra A. Mccullough, Mohammad Rasool, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Noise in the Intensive Care Nursery (ICN) has been linked to sleep disruption, vital sign destabilization, abnormal development, and stress response induction in infants. Specifically, a sound level ≥60 decibels (dB) was linked to sleep disruption in infants, and the American Academy of Pediatrics (AAP) set a maximum recommended sound level of 45dB in ICNs. The present work was conducted to confirm that the Jefferson ICN exceeds the 60dB and 45dB levels, like most hospitals do, and to conduct preliminary testing on materials for a wearable intervention to reduce infants’ exposure to noise.

Methods: A group of …

Serum 25-Hydroxyvitamin D Levels In Children With Mild And Severe Atopic Asthma, Rhoda Ndinda Masaku

Master of Medicine in Paediatrics and Child Health

Background: Asthma is a chronic respiratory illness affecting an estimated 334 million people worldwide, including 14% of the total pediatric population. It results in significant morbidity, and therefore the etiologies and risk factors associated with asthma are of great interest. Serum 25- hydroxyvitamin D (25(OH)D) has substantial immunomodulatory effects on the innate immune system. It reduces the probability of viral respiratory infections and asthma exacerbations by potentiating the anti-inflammatory action of corticosteroids. Objectives: This study was conducted to determine if there was a difference in serum 25-hydroxyvitamin D levels between children with mild and severe atopic asthma and explored the …

Fmic Annual Report 2020 | Pashto (پشتو), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2020 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2020 | Dari (دری), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Development Of Vaccine Preferences In Parents Of Newborns, Ramon Ruiz, Neera Goyal

Phase 1

Introduction: The resurgence in cases of vaccine-preventable childhood diseases in the U.S. may be associated with increasing rates of vaccine hesitancy. Although previous research has sought to identify attributes of non-vaccinating parents, the timing in which parents make such vaccination decisions has yet to be explored. Our goal is to identify when first-time parents develop their vaccination preferences: before, after, or during pregnancy.

Methods: A cross sectional survey was conducted using a convenience sample of 73 first time parents at Thomas Jefferson University Hospital. Survey questions addressed timing of vaccination decisions and projected compliance with vaccine schedules. Eligibility for …

Glycogen Storage Diseases-Time To Flip The Outdated Diagnostic Approach Centered On Liver Biopsy With The Molecular Testing, Sibtain Ahmed, Bushra Afroze

Department of Pathology and Laboratory Medicine

The glycogen storage diseases (GSDs) are a group of inherited metabolic disorders that result from a defect in any one of several enzymes required for either glycogen synthesis or glycogen degradation. The traditional diagnostic approach is based on the invasive hepatic or muscle biopsies, which are neither cost effective nor convenient. Molecular (gene testing) has emerged over the course of past few years as a robust alternative diagnostic tool, which not only confirms the diagnosis of GSDs but also clearly differentiates the types of GSDs allowing the initiation of the type-specific appropriate treatment for the particular type of GSDs. The …

A Qualitative Study On Adequate Sleep In Preschool Children – Can We Sleep On It?, Seema Zainulabdin Lasi, Noreen Afzal, Somal Kayani

Human Development Programme

Sleep is a significant marker of physical and psychological health. The present research was undertaken to explore perceptions of parents, teachers and pediatricians about preschool children’s sleep patterns, habits, and problems from urban Karachi, Pakistan. A qualitative research approach was employed; data collection methods were Focus Group Discussion (FGDs) and Key Informant Interviews (KIIs). The themes identified were children’s sleep patterns, sleep environment, sleep rituals, distractions, sleep problems, the impact of inadequate sleep, and recommendations to improve. Emergent themes were inconsistency of rules from parents, lack of opportunities for outdoor physical activity, different kinds of stresses, social and cultural events …

Impact Of Nicu Design On Feeding-Related Outcomes In Preterm Infants, Emma Kate Calvert

Theses and Dissertations--Communication Sciences and Disorders

Many NICUs around the country are moving away from traditional open-bay designs in favor of single-family rooms (SFRs) as more is understood about the impact of the sensory environment on neurodevelopment in preterm infants. SFRs house one infant and their family for the length of the infant’s stay and are associated with improvements in numerous outcomes, including increased milk intake and weight gain and earlier transition to enteral feeding. Oral feeding remains a critical requirement for NICU discharge; however, the impact of NICU design on feeding outcomes remains unknown.

The purpose of this study was to compare feeding outcomes between …

Two Months Of Global Health In Maseru, Lesotho, Rachel Hildebrand

Posters

Describes her experience working with infants and children at the Center of Excellence and Adolescents at Queen Mamohato Memorial Hospital in Maseru, Lesotho.

Global Health Immersive Elective In The Philippines, Lisa Godfrey

Posters

Describes her experiences working at Fabella Memorial NICU and the Philippines General Hospital.

Assessing The Temporality Of Adverse Effects Of Vaccines In The Nicu, Julia Tonnessen, Pedro Urday, Md

Phase 1

Introduction: Premature infants have an increased risk of contracting vaccine-preventable diseases and experience worse outcomes. Evidence supports keeping them on a regular vaccination schedule, but it is often delayed, partly because preterm infants have an increased incidence of cardiorespiratory events compared to term infants. The aim of our study was to determine if immunizations in the NICU contribute to an increased number of adverse events.

Methods: This was a retrospective, single-center, observational study with the target population infants born at less than 32 weeks gestation at Thomas Jefferson University Hospital who received the two-month vaccination series in the NICU. The …

Effect Of Sustained Attention On Early Start Denver Model Outcomes, Katherine Mcleod, Giacomo Vivanti, Phd

Phase 1

Introduction: There is very little research on the use of sustained attention as an outcome predictor for the Early Start Denver Model (ESDM). We hypothesized that a child’s level of sustained attention prior to therapy will correlate with positive ESDM outcomes.

Methods: 10 pre-preschool age children with a diagnosis of autism spectrum disorder received one year of ESDM therapy. A novel coding scheme was developed to evaluate each child’s pre-treatment level of sustained attention. Mullen Scales of Early Learning were evaluated prior to and after one year of ESDM. Pre-treatment levels of sustained attention were compared to pre-and post-treatment Mullen …

Obesity And Cardiovascular Health Differences Between Urban And Suburban Philadelphia High School Athletes, Peri Levey, Kyle Prochno, Prashant Rao, Md, David Shipon, Md, Facc, Facp, Jeremy Close, Md

Phase 1

Introduction: The strongest risk factor for primary hypertension in children is obesity, and concern for pediatric hypertension rises with the rising prevalence of obesity in American children. Specifically, in urban Philadelphia schools from 2009 to 2012, preparticipation physical evaluations (PPEs) demonstrated a positive correlation between blood pressure measurements demonstrating stage 1 or 2 hypertension and elevated body mass index (P < 0.00001).

Objective: The purpose was to identify potential differences in cardiovascular health and prevalence of obesity between adolescents in the urban and suburban Philadelphia areas.

Methods: Data from PPEs administered to urban Philadelphia high school athletes in 2018 by the Athlete …

Quality Improvement Study Of Behavioral Health Resources Access In 19121 And 19132, Courtney Kaye, Rickie Brawer, Mph, Phd, Mches, Jeanne Felter, Phd, Lpc

Phase 1

Introduction: Children who have experienced four or more ACES (adverse childhood events) are shown to have negative mental health outcomes. Adolescents living in the Philadelphia zip codes 19121 and 19132 have higher ACE scores. This makes it necessary for adolescent providers to screen for behavioral health issues in their patients and refer out to appropriate resources.

Objective: The purpose of this quality improvement study is to see what current barriers exist relating to physician referral and access to behavioral health resources for their patients.

Methods: A guide of behavioral health resources available to adolescents in 19121 and 19132 was …

Advocating For Protective Measures Against Childhood Lead-Poisoning In Philadelphia Rental Homes, Claire Miller, Colleen Mccauley

Phase 1

Introduction: Lead exposure has been linked to delays in development and behavioral problems in children. Over 1,500 children are poisoned by lead each year in Philadelphia; the majority (62%) in rental homes.

Objective: The purpose of this project was to understand the impact of lead poisoning on children in Philadelphia, the current policies in place to protect children and the ways in which various stakeholders can advocate for policy changes that will better protect children.

Methods: A mixed-methods approach was utilized including meetings with councilmembers, stakeholder interviews and data analysis, visualization and presentation. This information was used to gain councilmembers’ …

Comorbidities And Treatments In United States Youth With Chronic Musculoskeletal Pain, Matthew T. Taylor, Sabrina Gmuca, Alexis Boneparth, L. Nandini Moorthy, Daniel B. Horton

Phase 1

Introduction: Chronic musculoskeletal (MSK) pain has been associated with chronic illnesses and high rates of pain medication use, often in referral centers, European populations, or studies focused on single drug classes. We aimed to characterize patterns of comorbidities and treatments associated with chronic MSK pain in a nationally-representative sample of US youth.

Methods: We used the National Ambulatory Medical Care Survey (2002-2015) and National Hospital Ambulatory Medical Care Survey (2002-2011), which contain cross-sectional data for US outpatient visits. The study included all visits for youth age 8-24, excluding those with malignancy or sickle cell disease. We compared comorbidities and drugs …

Obesity And Cardiovascular Health Differences Between Urban And Suburban Philadelphia High School Athletes, Kyle W. Prochno, Peri Levey, Prashant Rao, Md, David M. Shipon, Md, Facc, Facp, Jeremy D. Close, Md

Phase 1

Introduction: Limited data exist regarding hypertension and obesity levels of Philadelphia-area high school student-athletes. We aim to assess their prevalence in an urban population, investigate whether they are correlated with demographic factors, and determine whether urban student-athletes differ in these outcomes compared to their suburban/non-urban counterparts.

Methods: Demographic and physical data were extracted from Athlete Health Organization (AHO) 2018 pre-participation physical exams. Adiposity classifications were made from body mass index (BMI) calculations applied to appropriate Centers for Disease Control and Prevention (CDC) growth charts, while systolic/diastolic measurements were used to classify students’ blood pressure according to current American Academy of …

Gastroschisis, Rebecca M. Rentea, Vikas Gupta

Manuscripts, Articles, Book Chapters and Other Papers

Gastroschisis is a paraumbilical, full-thickness abdominal wall defect associated with protrusion of the bowel through the defect. It is rarely associated with genetic conditions. A membrane does not cover the bowel exposed in utero and, as a result, may be matted, dilated, and covered with a fibrinous inflammatory rind. Infants have a high proportion of intrauterine growth restriction. Diagnosis is often made on the 20-week ultrasound with free-floating bowel loops in the uterine cavity. Maternal serum alpha-fetoprotein (AFP) is elevated in pregnancies with gastroschisis. Compared with other abdominal wall defects diagnosed prenatally such as omphalocele, only 10 percent of cases …

Patent Urachus, Kayla B. Briggs, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

atent urachus refers to one condition in a rare spectrum of disorders referred to as urachal anomalies. These conditions result from the failure of the involution of normal embryologic tissues that serve to empty the fetal bladder. The location and amount of persistent tissue dictate the presenting symptoms. Some of these urachal anomalies are obvious at birth, while others are more subtle and not diagnosed until adulthood or only incidentally discovered after imaging is obtained for other reasons. Historically, surgical resection of urachal anomalies was routinely undertaken, given the potential for malignancy in retained ectopic tissue. Early surgical resection has …

Ileal Atresia, Obiyo O. Osuchukwu, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Ileal and jejunal atresias are usually described together as jejunoileal atresia (JIA). JIA is a common cause of intestinal obstruction in neonates. It is seen in 1 in 5000 to 1 in 14000 live births. Intestinal atresia can occur in any location on the small bowel as a solitary or even multiple lesions. Distally located atresia usually presents with delayed symptoms compared to proximal ones. Occasionally, JIA is associated with other malformations such as cardiac anomalies, gastroschisis, and cystic fibrosis. Evaluation can be initiated before birth with prenatal diagnosis using ultrasound findings of evidence of intestinal obstruction reported in 29% …

Pentalogy Of Cantrell, Muhammad Khawar Sana, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Pentalogy of Cantrell (POC) is a collection of five congenital midline birth anomalies that present a distinctive challenge for clinicians and surgeons. Those five defects are of the heart, pericardium, diaphragm, sternum, and abdominal wall. This condition has been divided into two categories, complete or partial. Complete, as the name indicates, refers to the presence of all five defects, while others may present with only partial defects. It is also referred to as thoracoabdominal ectopia cordis, a condition where the heart is covered by an omphalocele-like membrane. Ectopia cordis (EC) is often found in fetuses with POC. Infants usually have …

Morgagni Hernia, Wendy Jo Svetanoff, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

A Morgagni hernia is one of four types of diaphragmatic hernias; the other types include a Bochdalek hernia, where the defect is posterolateral, a hiatal hernia, where the defect is at the esophageal hiatus, and a paraesophageal hernia, where the defect is located adjacent to the esophageal hiatus. The Morgagni hernia, in which the defect is found in an anterior and retrosternal location, was first described by Morgagni in 1769. It is rarer than the other type of congenital diaphragmatic hernia (Bochdalek hernia) and comprises only 2% to 5% of all congenital diaphragmatic hernias. Morgagni hernias tend to be less …

Ambiguous Genitalia And Disorders Of Sexual Differentiation, Khawar T. Mehmood, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

The birth of an infant with ambiguous genitalia generates difficult multiple medical, surgical, ethical, psychosocial, and physical issues for patients and their parents. Phenotypic sex results from the differentiation of internal ducts and external genitalia under the influence of hormones and other additional factors. When discordance occurs among three process es (chromosomal, gonadal, phenotypic sex determination), a DSD is the result. Terminology such as hermaphrodite, pseudo-hermaphrodite, and intersex, are considered to be pejorative and dated. These terms have been replaced by the term disorders of sexual development (DSD) by the consensus statement on management of intersex disorders. Disorders of sexual …

Torsion Of An Accessory Spleen In A Child With Biliary Atresia Splenic Malformation Syndrome., David A. Simon, Nathan R. Fleishman Md, Pamala Choi, Jason D. Fraser, Ryan T. Fischer

Manuscripts, Articles, Book Chapters and Other Papers

Torsion of an accessory spleen is an exceedingly rare cause of abdominal pain in pediatric patients. The diagnosis is frequently challenging as presentation is variable and diagnostic imaging can be aspecific. The current case describes an unusual presentation of a torted accessory spleen in a 5-year-old girl with biliary atresia splenic malformation syndrome who initially presented with non-specific abdominal symptoms and fever. The diagnosis was made following fine-needle aspiration of a suspected intraabdominal abscess. The case highlights the diagnostic challenge of accessory splenic torsion and stresses the importance of its inclusion on the differential diagnosis of pediatric patients, especially those …