Medical Specialties Commons^™

Increased Risk For Aplastic Anemia And Myelodysplastic Syndrome In Individuals Lacking Glutathione S-Transferase Genes, Joanne F. Sutton, Michael Stacey, William G. Kearns, Thomas S. Roeg, Neal S. Young, Johnson M. Liu

Bioelectrics Publications

BACKGROUND: Aplastic anemia (AA) and myelodysplastic syndrome (MDS) are marrow failure states that may be associated with chromosomal instability. An absence of the glutathione S-transferase (GST) enzyme may genetically predispose individuals to AA or MDS. PROCEDURE AND RESULTS: To test this hypothesis, we determined the GSTM1 and GSTT1 genotypes in a total of 196 patients using multiplex PCR. The GSTT1 null genotype was found to be overrepresented in Caucasian, Asian, and Hispanic patients with either AA or MDS. We confirmed a difference in the expected frequency of the GSTM1 null genotype in Caucasian MDS patients. The double null GSTM1/GSTT1 …

Reversible Obstructive Sleep Apnea And Right Heart Failure Due To Massive Tonsillar Hypertrophy, Mehnaz Atiq, Fatima Masood, Mubasher Ikram, Raana Haqqee

Section of Otolaryngology, Head & Neck Surgery

Obstructive sleep apnea is a relatively common but under diagnosed clinical entity in children. Adenotonsillar hypertrophy is the most common cause for upper airway obstruction in pediatric patients. If the obstruction to upper airways is not relieved, then the child can develop obstructive sleep apnea and its consequences. Treatment is simply to remove the obstruction thereby restoring patency of upper airways

Neonatal Extra-Renal Wilm's Tumour, S Hussain, S Nizami, F Tareen

Section of Paediatric Surgery

No abstract provided.

Status Epilepticus In Children: A Five-Year Experience At Aga Khan University Hospital, S H. Ibrahim, M A. Yezdan, S Q. Nizami

Department of Paediatrics and Child Health

Objective: Status epilepticus is an under diagnosed entity in Pakistan. It is a potentially reversible condition but has a high mortality, if it is not recognized and managed on time. The purpose of this study was to determine the clinical profile and the relationship of mortality of status epilepticus with its known risk factors.
Methods: This was a retrospective study. Medical records of all the patients admitted in the last five years (1998-2002) with a diagnosis of status epilepticus (ICDcode 345.30, 345.31) were reviewed. Data was recorded on a Performa and analyzed by using the statistical programme SPSS, chi square …

Effect Of Low-Carbohydrate, Unlimited Calorie Diet On The Treatment Of Childhood Obesity: A Prospective Controlled Study, James R. Bailes Jr., Misty T. Strow, Joseph Werthammer, Richard A. Mcginnis, Yoram Elitsur

Pediatrics

Background: Childhood obesity has been recognized as the new epidemic in developed countries. Caloric restriction with physical activity is the main therapeutic treatment available for these children. We compared two different dietary protocols to assess treatment efficacy.

Methods: Obese children from the Pediatric Endocrinology clinic were prospectively recruited for the study. Children and their parents were allowed to choose one of two dietary protocols: (1) carbohydrate restricted diet (<30 g/day), with unlimited calories, protein, and fat (High protein, Low CHO Diet), and (2) calorie restricted diet (Low Cal Diet). Anthropometric data were measured at baseline and at the 2 month follow up appointment.

Results: Thirty-seven children completed the study of whom 27 chose High Protein, Low CHO Diet and 10 chose Low Cal diet. No differences in gender ratio, age, or …

Intensive Care Medical Procedure : Ptsd Symptoms In Children, Ludmila Zaytsev

Loma Linda University Electronic Theses, Dissertations & Projects

Studies indicate that medical procedures may cause post-traumatic stress (PTS) symptoms (fear, avoidance, sleep disturbances, irritability, concentration difficulties. hypervigilance). It has been suggested that administration of midazolam hydrochloride, a sedative/amnesic medication commonly used in the Pediatric Intensive Care Units (PICU), may help decrease if not prevent the development of PTS symptoms. This study examined if PTS symptoms were related to procedural invasiveness (PI) and whether midazolam had a moderating effect on the development and intensity of PTS symptoms in children. English-speaking children ages 8-16 (N=20) who had been in the PICU for at least 3 days were recruited at Loma …

The Psychological Characteristics Of Obese Children, Thomas Taylor Mitchell

Loma Linda University Electronic Theses, Dissertations & Projects

Several studies along with the surgeon general of the United States have identified obesity as a national health issue. Research indicates that adult obesity treatment has relatively poor long-term effects. Consequently increased attention has been given to addressing obesity in children. This focus is particularly vital due to the fact that children are one of the populations showing the most rapid increase in overweight and obesity. The purpose of this study was to identify the some of the unique psychological characteristics of obese children by analyzing the intake data of children and adolescents attending the Loma Linda University Growing Fit …

Risk Factors For Cardiovascular Disease In School Children--A Pilot Study., A. K. Khuwaja, Zafar Fatmi, W. B. Soomro, N. K. Khuwaja

Community Health Sciences

OBJECTIVE:

To assess the frequencies of risk factors for cardiovascular disease in school children. The information may help in designing interventions aimed at modifying unhealthy lifestyle in children, which may reduce the later incidence of cardiovascular disease in adults.

METHODS:

A cross-sectional study was conducted on 206 students (ages 14-18 years), enrolled in higher secondary school. Students were interviewed about their lifestyles, family history of cardiovascular disease and its risk factors. Moreover, they were assessed for height, weight and blood pressure.

RESULTS:

Twenty nine percent of the children were physically inactive, 31% were taking unhealthy diet daily, 21% were overweight …

Prevalence Of Overweight In Preschool Children And The Association With Dietary And Lifestyle Factors, Anthony H. Ng

All-Inclusive List of Electronic Theses and Dissertations

For the past several decades, there has been a steady increase in obesity in the United States. National surveys indicate that 64% of American adults are overweight or obese and more than 1 0% of preschool children are overweight. This study determined the prevalence of overweight in a group of preschool children aged between three and five years at a Head Start Center and evaluated the relationship of specific lifestyle factors between caregivers and their children and the relationship of these patterns to the development of overweight. The caregivers were asked to complete a questionnaire, which assessed specific dietary and …

Adolescent Violence Prevention: A Case Presentation, Hatim A. Omar, Joan Griffith

Pediatrics Faculty Publications

Violence in adolescence has seen an increase since the 1990s with dramatic statistics on violent death and risk behaviors. School violence has been focused upon by a huge media coverage of especially violent cases that could have had some endemic consequences worldwide. We present a case of a 14 year old white male with change in school behavior, strategies for the case investigation, its results, and long term prevention. Other research has shown that preventive measures during pregnancy, infancy and childhood can prevent adolescent and adult delinquency.

Exploring The Physician’S Processes: Diagnosing Autism, Gwennyth Li Sze Palafox

Loma Linda University Electronic Theses, Dissertations & Projects

Physicians are customarily the first point of contact for parents who are concerned about a child’s development. Thus, it is important for physicians to be current and educated about childhood disorders and subsequent treatment for those disorders. Recently, empirical evidence has led to the proposal of early indicators of autism supporting that autism may be diagnosed accurately in children less than three years old. Furthermore, formal screening and assessment parameters developed by medical organizations have been proposed in order to identify autism as early as possible (American Academy of Neurology, 2000). While the proposed parameters and empirical evidence support early …

Residency Program At Michael E Debakey Department Of Surgery, Baylor College Of Medicine, F Charles Brunicardi

Faculty, Staff and Students Publications

No abstract provided.

Hdl-Associated Estradiol Stimulates Endothelial No Synthase And Vasodilation In An Sr-Bi–Dependent Manner, Ming Gong, Melinda E. Wilson, Thomas Kelly, Wen Su, James Dressman, Jeanie Kincer, Sergey V. Matveev, Ling Guo, Theresa Guerin, Xiang-An Li, Weifei Zhu, Annette M. Uittenbogaard, Eric J. Smart

Pediatrics Faculty Publications

Cardiovascular diseases remain the leading cause of death in the United States. Two factors associated with a decreased risk of developing cardiovascular disease are elevated HDL levels and sex — specifically, a decreased risk is found in premenopausal women. HDL and estrogen stimulate eNOS and the production of nitric oxide, which has numerous protective effects in the vascular system including vasodilation, antiadhesion, and anti-inflammatory effects. We tested the hypothesis that HDL binds to its receptor, scavenger receptor class B type I (SR-BI), and delivers estrogen to eNOS, thereby stimulating the enzyme. HDL isolated from women stimulated eNOS, whereas HDL isolated …

Adhd: What Educators And Parents Should Know, Jessica J. Foust

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

Cell-Cycle Regulatory Proteins In Podocyte Cell In Idiopathic Nephrotic Syndrome Of Childhood., Tarak Srivastava, Robert E. Garola, J M. Whiting, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The podocyte cell is believed to play an important role in idiopathic nephrotic syndrome (INS) of childhood. In adults with cellular and collapsing focal segmental glomerulosclerosis (FSGS), the expression of cell-cycle regulatory proteins such as p27, p57, and cyclin D is decreased and expression of cyclin A, Ki-67, and p21 is observed in podocyte cells suggestive of a dysregulated podocyte phenotype. We investigated for alterations in the expression of cyclin kinase inhibitors, p27, p57, p21, and cyclins D and A in the podocyte cell of children with INS.

METHODS: Forty-two kidney biopsies were investigated; 14 with minimal-change disease (MCD), …

Association Of Iron Deficiency Anaemia In Children Of 1-2 Years Of Age With Low Birth Weight, Recurrent Diarrhoea Or Recurrent Respiratory Tract Infection - A Myth Or Fact?, Niloufer Sultan Ali, Rukhsana Wamiq Zuberi

Department for Educational Development

No abstract provided.

Attitudes Of Developing World Physicians To Where Medical Research Is Performed And Reported, John Page, Richard F. Heller, Scott Kinlay, Lynette Lim, Wang Qian, Zheng Suping, Supornchai Kongpatanakul, Murtaza Akhtar, Salah Khedr, William Macharia

Paediatrics and Child Health, East Africa

Background: Little is known about the influence of the site of research or publication on the impact of the research findings on clinical practice, particularly in developing countries. The International Clinical Epidemiology Network (INCLEN) is dedicated to improving the quality of health research in the Developing World through institutional capacity building for evidence based medicine, and provided the opportunity to examine the likely impact of research location and journal location on physicians' practice in a number of the participating countries.

Methods: Physicians from secondary and tertiary hospitals in six cities located in China, Thailand, India, Egypt and Kenya were enrolled …

Clinical Issues Surrounding Once-Daily Aminoglycoside Dosing In Children, Chad A. Knoderer, Julie A. Everett, William F. Buss

Scholarship and Professional Work – COPHS

Aminoglycoside antibiotics are first-line treatment for many infectious diseases in the pediatric population and are effective in adults. The traditional dosing interval in children is every 8–12 hours. Studies in adults reported equivalent efficacy and equal or less toxicity with once-daily regimens. Despite many studies in the adult population, this approach has yet to become standard practice in most pediatric hospitals. Reasons for lack of acceptance of this strategy in children include rapid aminoglycoside clearance, unknown duration of postantibiotic effect, safety concerns, and limited clinical and efficacy data.

Research Annual Report 2002, Children's Mercy Hospital

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Educating Adolescents About Puberty: What Are We Missing?, Hatim A. Omar, Darby H. Mcelderry, Rana M. Zakharia

Pediatrics Faculty Publications

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (Median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of …

Febrile Seizures: Factors Affecting Risk Of Recurrence In Pakistani Children Presenting At The Aga Khan University Hospital, Z Habib, S Akram, S Ibrahim, B Hasan

Department of Paediatrics and Child Health

Objectives: To (a) describe the effect of temperature rise on seizure recurrence in the ER (b) investigate the effect of age, gender, family and developmental history, type, duration and multiple seizures, past history and number of seizures and treatment given (either late or early) on seizure recurrence in the ER and (c) explore prognostic indicators for seizure recurrence.
Methods: Data from 352 children [ages 3-84 months; 220 males (62.5%) 132 females (37.5%)] was taken using chart reviews for the years January 1998-August 2000 inclusive, from the Pediatric department of the Aga Khan University Hospital. Descriptive statistics, Chi-square, and Discriminant …

Our Adolescents--Our Future, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Sex Education In The Schools: What Role Does It Play?, Darby H. Mcelderry, Hatim A. Omar

Pediatrics Faculty Publications

Information regarding pubertal development, sex, pregnancy, and contraception should be provided to children and adolescents in an age-appropriate manner from parents, health care providers, and schools. This article reviews the medical literature on school sex education programs, adolescents' perception of these programs, and the role played by the media, parents, and health care professionals in sexual education of teens.

Parenting Adolescents, Sandra L. D'Angelo, Hatim A. Omar

Pediatrics Faculty Publications

The period of adolescence is often thought to be one of intense stress and turmoil. Yet many parents and teens negotiate this developmental stage without extreme family conflict and without sacrificing close relationships. This review summarizes a portion of the literature on parent-adolescent relationships, focusing on monitoring and control of adolescent behavior and parenting style. Basic principles to emphasize when working with adolescents and parents are also included.

L’Observation Du Comportement Du Nouveau-Ne: Une Source Pertinente D’Informations Medicales, N. Ratynski, G. Cioni, L. Franck, Yvette Blanchard, J. Sizun

All PTHMS Faculty Publications

L’observation du comportement du nouveau-né est une source importante d’informations d’ordre médical. Trois domaines bénéficient des données de l’observation : 1) l’analyse du développement grâce à l’utilisation de l’Assessment of Preterm Infant Behavior (évaluation du comportement de l’enfant prématuré) ; 2) l’évaluation de la douleur dominée par l’analyse de l’expression faciale grâce à des échelles validées, telle que le Neonatal Facial Coding System (système néonatal de codage facial) ; 3) la recherche de lésions cérébrales par le Quality Assessment of General Movements (évaluation de la qualité des mouvements généraux). L’observation comportementale fondée sur des outils validés par la recherche …

Divorce: A Teacher's Perspective On How It Affects Primary Age Children And Their Behavior In An Elementary School Setting, Reina Moriah Beere-Kuklinski

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

Morbidity And Outcome Of Low Birthweight Babies Of Adolescent Mothers At Kenyatta National Hospital, Nairobi, A. Wasunna, K. Mohammed

Paediatrics and Child Health, East Africa

Objective: To compare the morbidity and outcome of low birthweight babies (birthweight < 2000gm) of adolescent (age < 20 years) and older mothers.

Design: Cross sectional descriptive study.

Setting: The newborn Unit of the Kenyatta National Hospital. Main outcome measures: All babies weighing less than 2000gm at birth whose mothers consented to the study had their gestational age verified using the Dubowitz scoring system. They were then followed up by daily clinical assessment untill discharge, death or up to one month in the ward. The babies were divided into two groups according to their mother's age and then compared with respect to episodes of illness, duration of hospital stay, and overall …

Low Birthweight Babies: Socio-Demographic And Obstetric Characteristics Of Adolescent Mothers At Kenyatta National Hospital, Nairobi, A. Wasunna, K. Mohammed

Paediatrics and Child Health, East Africa

Objective: To compare some socio-demographic and obstetric factors between adolescent mothers (aged below 20 years) and older mothers of low birthweight (birthweight <2000gm) babies.

Design: Cross sectional descriptive study.

Setting: The Newborn Unit of the Kenyatta National Hospital.

Results: Sixty nine adolescent mothers and 73 older mothers were studied. Adolescent mothers were more likely to be unmarried (p 0.0001) have less formal education (p

Justification For The Continuance Of A Pediatric Physician's Office Laboratory, Veronica C. Santilli

Seton Hall University Dissertations and Theses (ETDs)

The continued viability of the Physician's Office Laboratory (POL) has been questioned because of barriers imposed by managed care organizations, oversight by regulatory agencies and competition for professionally trained laboratory staff. Pediatricians view the POL as an important adjunct to quality healthcare services for children and do not consider the POL as a "profit center", whose priority is generation of revenues for the The practice. parents of pediatric patients consider an on-site laboratory a convenience and valuable service. Through an analysis of patients' satisfaction, physicians' perceptions of enhancement to quality care, managed care reimbursement data and costs associated with maintenance …

Effectiveness Of Current Therapy Of Bacterial Vaginosis, Petya M Andreeva, Hatim A. Omar

Pediatrics Faculty Publications

The study was conducted in order to evaluate effectiveness of the treatment of bacterial vaginosis (BV) with different therapeutic regimes according to recommendations of the World Health Organization (WHO). During a one-year period (February 2000-February 2001) the Sexually Transmitted Diseases (STD) Center was visited by 482 women aged 14-51. The diagnosis of BV was established by standard methods: Amsel's clinical criteria and Gram stain of vaginal discharge. The first-line treatment was oral Metronidazole 2 g single dose. Second line was Metronidazole 500 mg twice daily orally for 7 days or oral Clindamycin 300 mg twice daily for seven days. BV …