Medical Specialties Commons^™

Improving Hpv Immunization By Age 13 In Over 20 Kansas City Pediatric Practices, Luke A. Harris, Douglas Blowey

Posters

No abstract provided.

Pressure Injury Prevention For Urology Surgical Procedures: A Qi Initiative, Azadeh Wickham, Pat Clay, Kate Gibbs

Posters

No abstract provided.

Resident Great Catches: Recognizing Resident Physicians Who Promote A Safe Environment For Patients, Kristin Streiler, Susamita Kesh

Posters

No abstract provided.

Impact Of Pre-Eclampsia On The Cardiovascular Health Of The Offspring: A Cohort Study Protocol, Zahra Hoodbhoy, Babar Hasan, Nuruddin Badruddin Mohammed, Devyani Chowdhury

Department of Paediatrics and Child Health

Introduction: Pre-eclampsia is a common disorder associated with serious maternal and fetal complications. It is associated with abnormal placentation, which significantly reduces flow, resulting in a relative hypoxic state. These pathophysiological changes lead to subtle macrovascular and cardiac structural and functional changes in the fetus. This can predispose the child with maternal history of pre-eclampsia to risk of premature cardiovascular disease.
Methods and analysis: The children will be identified from a cohort of women with pre-eclampsia. The study will be conducted at The Aga Khan University Hospital, Karachi. Inclusion criteria will be children who are between 2 and 5 years …

Hospital-Acquired Malnutrition In Children At A Tertiary Care Hospital, Del-Rossi Sean, Rose Kamenwa, Samuel Akech, William Macharia

Paediatrics and Child Health, East Africa

Objectives: This study sought to investigate the incidence and factors associated with hospital-acquired malnutrition in children.

Design: A hospital-based longitudinal survey carried out between December 2013 and February 2014.

Setting: Aga Khan University Hospital, Nairobi, Kenya, a tertiary care hospital.

Subjects: One hundred and seventy children who met the inclusion criteria were included in the study.

Outcome measures: Anthropometry was done at admission and discharge. Incidence of hospital-acquired malnutrition was estimated from the total number of children showing a decrease in weight-for-height/length (WFH) or Body Mass Index (BMI) z-scores from the time of admission to discharge. Logistic regression analysis was …

Children’S Oxygen Administration Strategies Trial (Coast): A Randomised Controlled Trial Of High Flow Versus Oxygen Versus Control In African Children With Severe Pneumonia, Kathryn Maitland, Sarah Kiguli, Robert Opoka, Peter Olupot-Olupot, Charles Engoru, Patricia Njuguna, Victor Bandika, Ayub Mpoya, Andrew Bush, Thomas Williams

Paediatrics and Child Health, East Africa

Background: In Africa, the clinical syndrome of pneumonia remains the leading cause of morbidity and mortality in children in the post-neonatal period. This represents a significant burden on in-patient services. The targeted use of oxygen and simple, non-invasive methods of respiratory support may be a highly cost-effective means of improving outcome, but the optimal oxygen saturation threshold that results in benefit and the best strategy for delivery are yet to be tested in adequately powered randomised controlled trials. There is, however, an accumulating literature about the harms of oxygen therapy across a range of acute and emergency situations that …

Mindfulness And Multiple Sclerosis, Mandakini Sadhir

Pediatrics Faculty Publications

Multiple sclerosis is a chronic, debilitating autoimmune condition with unknown etiology. It can have significant impact on quality of life and overall sense of wellbeing. It can be associated with poor sleep, fatigue, mental health disorders such as anxiety, depression and affect interpersonal relationships. Impact of mindfulness based interventions in mental health conditions, chronic illness as well as multiple sclerosis in adults has been widely studied. Several studies have concluded that mindfulness based intervention can be beneficial in improving quality of life, mental health and physical symptoms such as fatigue in adult patients with multiple sclerosis. Current literature suggest that …

Fmic Annual Report 2018 | Dari (دری), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2018 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Using International, Interprofessional Service Learning To Promote Transcultural Self-Efficacy And Interprofessional Attitudes In Health Science Students, Shana L. Cerny, Lana Svien, Julie Johnson, Bethany Hansmeier

Journal of Occupational Therapy Education

Interprofessional teams of occupational therapy, physical therapy, physician assistant, and dental hygiene students from the University of South Dakota participated in a service-learning experience in Guatemala. Student perceptions were measured using the Interprofessional Attitudes Scale and the Transcultural Self-Efficacy Tool. Qualitative data were obtained through written reflections and discussions during the immersion component of the service-learning experience. Students reported statistically significant improvements in transcultural self-efficacy as defined by their confidence in interviewing individuals from different cultures; their values, attitudes, and beliefs regarding cultural awareness, acceptance, appreciation, recognition, and advocacy; and their knowledge on how cultural factors influence care. Slightly different …

Dexa Use For Early Detection Of Pediatric Cystic Fibrosis-Related Bone Disease, Christina Baldwin, Renallie Arcinas, Melissa Ham, Stacie Hunter, Megha Mehta, Preeti Sharma, Prigi Anu Varghese, Kelli Williams, David M. Troendle, Meghana Sathe

2018

No abstract provided.

Improving Weight For Length In Infants With Cystic Fibrosis, Christina Baldwin, Lauren Lazar, Stacie Hunter, Meghana Sathe

2018

No abstract provided.

The Global Impact Of The Dracma Guidelines Cow’S Milk Allergy Clinical Practice, Alessandro Fiocchi, Holger Schunemann, Ignacio Ansotegui, Amal Assa’Ad, Sami Bahna, Roberto Berni Canani, Martin Bozzola, Lamia Dahdah, Christophe Dupont, Motohiro Ebisawa, Elena Galli, Haiqi Li, Rose Kamenwa, Gideon Lack, Alberto Martelli, Ruby Pawankar, Maria Said, Mario Sánchez-Borges, Hugh Sampson, Raanan Shamir, Jonathan Spergel, Luigi Terracciano, Yvan Vandenplas, Carina Venter, Susan Waserman, Gary Wong, Jan Brozek

Paediatrics and Child Health, East Africa

Background: The 2010 Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) guidelines are the only Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines for cow’s milk allergy (CMA). They indicate oral food challenge (OFC) as the reference test for diagnosis, and suggest the choice of specific alternative formula in different clinical conditions. Their recommendations are flexible, both in diagnosis and in treatment.

Objectives & methods: Using the Scopus citation records, we evaluated the influence of the DRACMA guidelines on milk allergy literature. We also reviewed their impact on successive food allergy and CMA guidelines at national and …

Changes In The 2017 Pediatric Hypertension Clinical Guidelines., Bonita Falkner

Department of Medicine Faculty Papers

The clinical practice guidelines on diagnosis and management of high blood pressure in children and adolescents have been periodically modified and updated since the original publication in 1977.1 Since the last pediatric blood pressure guideline was published in 2004, known as the Fourth Report,2 the literature on child BP and hypertension has expanded considerably. There has been a recognized need to update the Fourth Report for several years. However, the National Heart, Lung, and Blood Institute (NHLBI) who sponsored previous pediatric BP guidelines announced that NHLBI would no longer sponsor development of new clinical guidelines.3 Subsequently, in 2014 the American …

The Relationship Between Iron Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md

Posters

Background

•Iron status is an important aspect of the evaluation of children with excessive limb movements during sleep. •While there is clear data in adults to support this relationship, the data in children is less well established. •We evaluated the association between iron status and limb movements during sleep in a large pediatric sample. Methods •This is a retrospective analysis of a single institution sleep program looking at all patients who underwent overnight polysomnogram and ferritin test within 24 hours of doing the sleep study between January 2015 and October 2017. •Those with sleep apnea (Central Apnea Index >5/hr or …

Outcome Of Traumatic Brain Injury In Children By Using Rotterdam Score On Computed Tomography, Anwarul Haque, Zehra Dhanani, Amin Ali, Basit Salam, Qalab Abbas, Gohar Javed, Humaira Jurair

Department of Paediatrics and Child Health

Background: The Rotterdam Score (RS) on CT head is a new evolving clinical tool as a predictor of mortality in Traumatic Brain Injury (TBI). The objective of this study is to assess the outcome of children with TBI admitted in paediatric intensive care unit (PICU) of a tertiary-care, university hospital by using RS.
Methods: This was a prospective observational study conducted on children (age: 1mo -16yr) with TBI admitted in PICU of Aga Khan University Hospital from 2013 to 2016. RS on CT was calculated by a radiologist. All patients were managed according to according to Paediatric Brain Trauma Foundation …

Hemimegalencephaly: Seizure Outcome In An Infant After Hemispherectomy, Prem Chand, Pooja Manglani, Qalab Abbas

Department of Paediatrics and Child Health

Isolated hemimegalencephaly (iHME) is a rare form of congenital malformation of cortical development characterized by enlargement of all or part of one cerebral hemisphere. It typically presents with intractable seizures, developmental delay, contralateral hemiparesis, and hemianopia. We report a case of an 18-month-old girl who presented first with focal seizures at tenth day of life, with no other physical or behavioral abnormality. Initial EEG showed excessive sharp EEG transients more over the right hemisphere; repeated EEG showed spikes, polyspikes, sharps, and slow wave discharges predominately over the right hemisphere. MRI of the brain showed asymmetric enlargement of the right cerebral …

What’S Coming For Health Science And Policy In 2018? Global Experts Look Ahead In Their Field, Soumya Swaminathan, Robin S. Room, Louise C. Ivers, Graham Hillis, Rebecca F. Grais, Zulfiqar Ahmed Bhutta, Peter Byass

Department of Paediatrics and Child Health

No abstract provided.

Factors Influencing Choice Of Skilled Birth Attendance At Anc: Evidence From The Kenya Demographic Health Survey, Caroline Nyongesa, Xiaoyue Xu, John J. Hall, William Macharia, Faith Yego, Brigid Hall

Paediatrics and Child Health, East Africa

Background: In Kenya, skilled attendance at delivery is well below the international target of 90% and the maternal mortality ratio is high at 362 (CI 254–471) per 100,000 live births despite various interventions. The preventative role of skilled attendance at delivery makes it a benchmark indicator for safe motherhood.

Methods: Maternal health data from the Service Provision Assessment Survey, a subset of the 2010 Kenya Demographic Health Survey was analyzed. Logistic regression models were employed using likelihood ratio test to explore association between choice of skilled attendance and predictor variables.

Results: Overall, 94.8% of women are likely to seek …

Partnering With Inpatient Situation Awareness Screening To Improve Early Sepsis Recognition, Leslie Hueschen, Stephanie Burrus, Andrea Raymond, Charity Thompson, Lisa Carney, Jay Rilinger

Posters

Background

Early recognition of sepsis and designing a huddle process are key drivers of the Improving Pediatric Sepsis Outcomes (IPSO) collaborative. Our tertiary care, free-standing, pediatric hospital joined the IPSO collaboration in 2016. Our hospital began piloting Situation Awareness (SA) Escalation Huddles in 2016, to improve recognition of patients with clinical deterioration. The tool triggers if a patient has a high PEWS(> 5), requires initiation of hi-flow nasal cannula, or for staff/parental concern. The SA paper tool guides the communication process and steps of the huddle. Huddles include a nurse, provider, and respiratory therapist. One of the goals of the …

Significant Loss Of Blood Amino Acids And Free Carnitine In Newborns Receiving Continuous Renal Replacement Therapy (Crrt), Uttam Garg, Marita Thompson, Bradley A. Warady, Vimal Chadha

Posters

Background

•Newborns with acute kidney injury (AKI) or end-stage kidney disease (ESKD) often receive prolonged CRRT when the early initiation of peritoneal dialysis is either contraindicated or unable to be performed. •These patients often receive total parenteral nutrition (TPN) to meet their nutritional goals. •Little to no information exists on the loss of blood amino acids (AA) and carnitine during CRRT in these patients. •The objective of this study was to determine the amino acids and carnitine losses in newborns receiving prolonged CRRT and TPN. Material and Methods

•Three newborns who received prolonged (> 2 weeks) CRRT and TPN were …

Intermittent Hypoxemia In Preterm Infants, Elie G. Abu Jawdeh

Theses and Dissertations--Clinical and Translational Science

Intermittent hypoxemia (IH) is defined as episodic drops in oxygen saturation (SpO₂). Virtually all preterm infants have IH events. Extremely preterm infants have hundreds of IH events per day. The extent of IH is not apparent clinically as accurately documenting cardiorespiratory events for day-to-day patient care management is challenging. High resolution pulse oximeters with 2 second averaging time are currently the ideal methods to measure IH. We have developed novel methods and processes to accurately and efficiently calculate an IH profile that reflects to spectrum of the problem.

The natural progression of IH is dynamic. There is low …

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Decreasing Cardiac Arrests In The Pediatric Intensive Care Unit, Jeremy Affolter, Kathlyn Baharaeen, Mari Hanson, Lisa Laddish, Amy Bohm, Lindsey Bradbury, Megan Mcghee, Anne Leroy, Hannah Cunningham, Michelle Waddell, Tiffany Mullen, Kimberly Lucas, William Douglas, Angel Pope, Marita Thompson, Paul N. Bauer, Erica Molitor-Kirsch, Tara Benton, Laura Miller-Smith

Posters

No abstract provided.

Financial Stewardship Through Appropriate Critical Care Documentation, Shobhit Jain, Nirav Shastri, Gregory P. Conners, Irene Walsh

Posters

No abstract provided.

Atrioventricular Junctional Tachycardia With Exit Block In An Adolescent, Nicholas M. Cundiff, Jeffrey A. Robinson, Bryan C. Cannon, Christopher S. Snyder

Journal Articles: Pediatrics

No abstract provided.

Depressed Left And Right Ventricular Cardiac Output In Fetuses Of Diabetic Mothers, Jennifer Winter, Aparna Kulkarni, Mary Craft, Ling Li, Lisa K. Hornberger, David A. Danford, Shelby Kutty

Journal Articles: Pediatrics

INTRODUCTION: We compared right and left ventricular cardiac output (RVCO and LVCO) in fetuses of diabetic mothers (FDM) to a large normal cohort.

METHODS: We prospectively enrolled 264 normal fetuses and 30 FDM. Fetal CO parameters: semilunar valve velocity time integrals (AVVTI, PVVTI), ventricular outflow diameters (LVOTD, RVOTD), stroke volumes (AVSV, PVSV) were measured, and LVCO and RVCO calculated. These were normalized using nonlinear regression to estimated fetal weight (EFW) to provide means and standard deviations. Among FDMs, mean Z-scores and 95% confidence limits (CL) were calculated, and compared to zero.

RESULTS: LVCO, RVCO, and parameters they were calculated from, …

Atrioventricular Junctional Tachycardia With Exit Block In An Adolescent, Nicholas M. Cundiff, Jeffrey A. Robinson, Bryan C. Cannon, Christopher S. Snyder

Journal Articles: Pediatrics

No abstract provided.

The Relationship Between Vitamin D Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md

Posters

Background

•Vitamin D deficiency has recently been posited as an important factor in the pathogenesis of restless leg syndrome.

•We evaluated the association between vitamin D deficiency and limb movements and sleep architecture in a pediatric sample.

Methods

•This is a retrospective analysis of a single institution sleep program looking at all patients who underwent overnight polysomnogram and 25-OH vitamin D within 60 days of doing the sleep study between January 2015 and October 2017. •Those with sleep apnea (Central Apnea Index >5/hr or Obstructive Apnea Hypopnea Index >2/ hr) were excluded. Results •There were a total of 83 children …

A "Passport" To Urgent Care: Medical Student Education In The Pediatric Urgent Care Setting, Emily Montgomery, David Skoglund, Tiffany Addington, Robert Riss, Amanda Montalbano

Posters

Background
Pediatric Urgent Care (PUC) serves as a rich environment to teach outpatient pediatric acute care. 96% of PUCs host trainees, but only 4% host medical students.1 Constraints on clinical teaching slots2 necessitate the utilization of novel settings.

Fall 2017, the University of Kansas (KU) School of Medicine approached the Division of Urgent Care at Children’s Mercy Hospital (CMH) in Kansas City, Missouri to host 3rd year medical students as part of their pediatric clerkship.

The PUC became a new site for medical student education, necessitating the development of a new curriculum.

Objective
Create a curriculum for pediatric clerkship students …