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Articles 271 - 300 of 2695
Full-Text Articles in Medical Specialties
Concussions 101, Bob Underwood, Greg Canty
Concussions 101, Bob Underwood, Greg Canty
Pediatrics in Practice: A CME Podcast
In this episode, we’re joined by Dr. Greg Canty, Medical Director of the Sports Medicine Center at Children’s Mercy in Kansas City, to explore the latest in pediatric concussion care. From updated return-to-play protocols to the evolving science of rest and recovery, Dr. Canty shares practical insights every pediatrician can use. We’ll also discuss risk factors for prolonged recovery, the role of schools in concussion management, and how pediatricians can stay current in this rapidly changing field.
Click here to stream the podcast episode.
Successful Va Ecmo On An Adolescent Pre-B Cell Acute Lymphoblastic Leukemia Patient With Necrotizing Fasciitis From Clostridium Septicum, Jenna Miller, Johanna I. Orrick, Cara Holton, David Juang
Successful Va Ecmo On An Adolescent Pre-B Cell Acute Lymphoblastic Leukemia Patient With Necrotizing Fasciitis From Clostridium Septicum, Jenna Miller, Johanna I. Orrick, Cara Holton, David Juang
Manuscripts, Articles, Book Chapters and Other Papers
Extracorporeal membrane oxygenation (ECMO) has historically been avoided in oncological patients due to perceived risks. However, recent literature suggests improved survival rates for pediatric oncology patients. Additionally, necrotizing fasciitis from Clostridium septicum is associated with high morbidity and mortality, especially in patients with preexisting malignancies. Few studies have explored the outcomes of ECMO in patients with both necrotizing fasciitis and hematologic malignancies. We present a case of a 16-year-old male with pre-B cell acute lymphoblastic leukemia (ALL) and Clostridium septicum necrotizing fasciitis successfully supported with veno-arterial (VA) ECMO. The patient underwent induction chemotherapy for ALL but developed severe septic shock …
Diagnosing And Testing Gi Motility, Michael Smith, Sofia Colon Guzman
Diagnosing And Testing Gi Motility, Michael Smith, Sofia Colon Guzman
Pediatrics in Practice: A CME Podcast
We dive into the most common pediatric GI motility disorders, when to refer for testing, and how to navigate diagnostics like manometry and gastric emptying studies. Learn how to approach testing in non-verbal children, distinguish functional from structural issues, and stay updated on emerging tools in the field.
Click here to stream the podcast episode.
Bronchopulmonary Dysplasia Diagnosis And Screening, Bob Underwood, Winston Manimtim
Bronchopulmonary Dysplasia Diagnosis And Screening, Bob Underwood, Winston Manimtim
Pediatrics in Practice: A CME Podcast
Winston Manimtim, MD, discusses bronchopulmonary dysplasia including affects and complications, provides guidance to pediatricians working with patients with BDP and more in this episode.
Click here to stream the podcast episode.
Revisiting The Effect Of Udenafil On Exercise Performance In Patients With Fontan Circulation: Results Of A Post Hoc Analysis Of The Fuel Trial., David J. Goldberg, Victor Zak, Chenwei Hu, Adam M. Lubert, Rahul H. Rathod, Daniel J. Penny, Robert Whitehill, Kurt R. Schumacher, Salil Ginde, Michelle Ploutz, Gi Beom Kim, Todd T. Nowlen, Michael V. Dimaria, Benjamin P. Frischhertz, Jonathan B. Wagner, Kimberly E. Mchugh, Brian W. Mccrindle, Mark J. Cartoski, Jon Detterich, Anji T. Yetman, Anitha S. John, Marc E. Richmond, Matthew Files, R Mark Payne, Andrew S. Mackie, Christopher K. Davis, William B. Orr, Ruchira Garg, Kevin D. Hill, Jennifer S. Yauck, Michael G. Mcbride, James Yeager, Gail D. Pearson, Stephen M. Paridon, Bryan H. Goldstein
Revisiting The Effect Of Udenafil On Exercise Performance In Patients With Fontan Circulation: Results Of A Post Hoc Analysis Of The Fuel Trial., David J. Goldberg, Victor Zak, Chenwei Hu, Adam M. Lubert, Rahul H. Rathod, Daniel J. Penny, Robert Whitehill, Kurt R. Schumacher, Salil Ginde, Michelle Ploutz, Gi Beom Kim, Todd T. Nowlen, Michael V. Dimaria, Benjamin P. Frischhertz, Jonathan B. Wagner, Kimberly E. Mchugh, Brian W. Mccrindle, Mark J. Cartoski, Jon Detterich, Anji T. Yetman, Anitha S. John, Marc E. Richmond, Matthew Files, R Mark Payne, Andrew S. Mackie, Christopher K. Davis, William B. Orr, Ruchira Garg, Kevin D. Hill, Jennifer S. Yauck, Michael G. Mcbride, James Yeager, Gail D. Pearson, Stephen M. Paridon, Bryan H. Goldstein
Manuscripts, Articles, Book Chapters and Other Papers
BACKGROUND: In the FUEL (Fontan Udenafil Exercise Longitudinal) trial, a positive treatment effect was identified for outcomes at the ventilatory anaerobic threshold but not for the primary outcome, oxygen consumption (Vo2 in participants with near-normal baseline exercise performance.
METHODS: Participants were divided into subgroups by baseline predicted peak Vo2 (< 80% versus ≥80%). Treatment effect was evaluated in those with a baseline peak Vo2 < 80% predicted and linear regression was performed to examine the interaction between subgroup and response to therapy for the primary and secondary outcomes.
RESULTS: Of the 379 participants with paired exercise data, 302 (80%) had a baseline peak Vo2 < 80% predicted. In this subgroup, the primary outcome of peak Vo2 improved significantly after 6 months of udenafil treatment, when compared with placebo (0.23±4.17 mL/kg per min versus -0.90±3.74 mL/kg per min; P=0.021). Secondary outcome measures, including Vo2 at …
Nurse-Initiated Improvement For Documentation Of Penicillin Adverse Drug Reactions In Pediatric Urgent Care Clinics., Elizabeth Monsees, Diane Petrie, Rana El Feghaly, Sarah Suppes, Brian R. Lee, Megan Whitt, Amanda Nedved
Nurse-Initiated Improvement For Documentation Of Penicillin Adverse Drug Reactions In Pediatric Urgent Care Clinics., Elizabeth Monsees, Diane Petrie, Rana El Feghaly, Sarah Suppes, Brian R. Lee, Megan Whitt, Amanda Nedved
Manuscripts, Articles, Book Chapters and Other Papers
Background/Objective: Penicillin allergy labels (PALs) contribute to broad-spectrum antibiotic use. Thorough documentation can help prescribers identify and remove unnecessary PALs. We aimed to improve documentation of PALs in three pediatric urgent care (PUC) clinics, using a nurse-initiated quality improvement (QI) approach. Methods: QI interventions included a survey to assess prescriber and nurse confidence, an online educational module, and an algorithm to aid in clarifying PALs. We measured the percentage of PALs with a clarified reaction severity as our primary outcome using annotated control charts. Descriptive and inferential statistics evaluated survey responses between nurses and prescribers. Results: Clarified PAL reaction severity …
School Safety And Health Policies, Bob Underwood, Erin Mccann
School Safety And Health Policies, Bob Underwood, Erin Mccann
Pediatrics in Practice: A CME Podcast
In this episode, we sit down with Dr. Erin McCann, MD, MPH, attending physician at the Children’s Mercy Primary Care Clinic, to explore the evolving landscape of school safety and health policies. From mental health support and chronic illness management to emergency preparedness and public health mandates, Dr. McCann shares practical insights on how pediatricians can partner with schools and families to create safer, healthier learning environments. Whether you're navigating new legislation or advocating for your patients, this conversation offers timely guidance and actionable takeaways.
Click here to stream the podcast episode.
Evaluation Of The Antimicrobial Management Of Intracranial Suppurative Infections In A Single Pediatric Institution., Cameron E. Bizal, Alaina N. Burns, Rana El Feghaly, Brian R. Lee, Ann L. Wirtz
Evaluation Of The Antimicrobial Management Of Intracranial Suppurative Infections In A Single Pediatric Institution., Cameron E. Bizal, Alaina N. Burns, Rana El Feghaly, Brian R. Lee, Ann L. Wirtz
Manuscripts, Articles, Book Chapters and Other Papers
OBJECTIVE: To describe the antimicrobial management of and examine the etiology of intracranial suppurative infections (ISIs) at a single pediatric institution.
DESIGN: Retrospective review.
PATIENTS: We included children hospitalized at a 367-bed freestanding pediatric institution for treatment of an ISI (epidural or subdural empyema, brain abscess) between January 1, 2015, and September 30, 2023. ISIs were identified using international classification of diseases 9/10 discharge diagnosis codes.
METHODS: We collected data regarding patient characteristics, infection etiology and complications, antimicrobial choice and route (empiric, definitive, and outpatient), microbiology results, treatment duration, and treatment-related outcomes from the electronic health record.
RESULTS: A total …
Prenatal Diagnosis Of An Uncommon Form Of A Hypoplastic Left Heart Syndrome Variant., Anmol Goyal, Abigail Phillips, Kelsey Brattrud, Rita France, Maria Kiaffas
Prenatal Diagnosis Of An Uncommon Form Of A Hypoplastic Left Heart Syndrome Variant., Anmol Goyal, Abigail Phillips, Kelsey Brattrud, Rita France, Maria Kiaffas
Manuscripts, Articles, Book Chapters and Other Papers
BACKGROUND: Mitral valve dysplasia syndrome (MVDS) is a rare cardiac defect requiring accurate prenatal identification and appropriate counseling, delivery planning, and postnatal management.
CASE SUMMARY: A 39-year-old woman underwent fetal echocardiography at 34 weeks' gestation owing to cardiomegaly and hydrops. Biatrial enlargement, mild to moderate atrioventricular valve insufficiency, dysplastic mitral valve apparatus, biventricular dilation with systolic dysfunction, endocardial fibroelastosis, hypoplastic aortic outflow, and severely restrictive atrial septum were attributed to MVDS. The plan for critical (class IV) delivery was modified with premature onset of labor at 36 weeks' gestation, leading to urgent cesarean section. Emergent balloon atrial septostomy was performed …
Extracorporeal Membrane Oxygenation (Ecmo) Neuromonitoring And Acute Brain Injury, Children's Mercy Kansas City
Extracorporeal Membrane Oxygenation (Ecmo) Neuromonitoring And Acute Brain Injury, Children's Mercy Kansas City
Clinical Pathways
No abstract provided.
Serum Syndecan-1 Is Associated With Kidney And Cardiovascular Outcomes In Idiopathic Nephrotic Syndrome., Colin Bauer, Arshia Anand, Christine Sethna, Jonathan Troost, Tarak Srivastava, Imtiazul Islam, Audrey Fetsko, Julie A. Dougherty, William E. Smoyer, Richard J. Johnson, Gabriel Cara-Fuentes
Serum Syndecan-1 Is Associated With Kidney And Cardiovascular Outcomes In Idiopathic Nephrotic Syndrome., Colin Bauer, Arshia Anand, Christine Sethna, Jonathan Troost, Tarak Srivastava, Imtiazul Islam, Audrey Fetsko, Julie A. Dougherty, William E. Smoyer, Richard J. Johnson, Gabriel Cara-Fuentes
Manuscripts, Articles, Book Chapters and Other Papers
INTRODUCTION: Idiopathic nephrotic syndrome (INS) is associated with important kidney and cardiovascular morbidities. We tested the hypothesis that serum syndecan-1, a marker of endothelial glycocalyx injury, can help identify patients at risk for unfavorable kidney and cardiovascular outcomes.
METHODS: We included 348 children and adults with INS (n = 35 unbiopsied, n = 141 minimal change disease [MCD] and n = 172 focal segmental glomerulosclerosis [FSGS]) from the Nephrotic Syndrome Study Network (NEPTUNE) cohort and 34 healthy participants (n = 22 adults, n = 12 children). We measured baseline serum syndecan-1 levels using an enzyme-linked immunosorbent assay and …
American College Of Rheumatology Guidance Statements For Addressing Mental Health Concerns In Youth With Pediatric Rheumatologic Diseases., Natoshia R. Cunningham, Ashley N. Danguecan, Samantha L. Ely, Yaa Amponsah, Alaina Davis, Suzanne Edison, Julia G. Harris, Jordan T. Jones, Alana Goldstein-Leever, Alison Manning, Anne Mchugh, Crystal Mui, Ekemini Ogbu, Nikki Reitz, Martha Rodriguez, Natalie Rosenwasser, Alyse Tankanow, Erin Treemarcki, Katherine Winner, Tamar B. Rubinstein, Andrea M. Knight, Carra Mental Health Workgroup
American College Of Rheumatology Guidance Statements For Addressing Mental Health Concerns In Youth With Pediatric Rheumatologic Diseases., Natoshia R. Cunningham, Ashley N. Danguecan, Samantha L. Ely, Yaa Amponsah, Alaina Davis, Suzanne Edison, Julia G. Harris, Jordan T. Jones, Alana Goldstein-Leever, Alison Manning, Anne Mchugh, Crystal Mui, Ekemini Ogbu, Nikki Reitz, Martha Rodriguez, Natalie Rosenwasser, Alyse Tankanow, Erin Treemarcki, Katherine Winner, Tamar B. Rubinstein, Andrea M. Knight, Carra Mental Health Workgroup
Manuscripts, Articles, Book Chapters and Other Papers
OBJECTIVE: Pediatric rheumatologic diseases (PRDs) are characterized by high rates of anxiety and depression known to impact health-related outcomes. We present guidance statements to assess and manage mental health concerns for youth with PRDs in pediatric rheumatology practice.
METHODS: Development of the guidance statements was initiated in 2019 and concluded in November 2023. It included (1) the formation of a task force (including pediatric rheumatologists, pediatric behavioral health providers, patients, and parents) led by two licensed pediatric psychologists and two board-certified pediatric rheumatologists, (2) iterative drafting of statements and rating of evidence based on the Oxford Centre for Evidence-Based Medicine …
Indoor Air Quality Conditions And Respiratory Virus Detections In Elementary Schools—Kansas City, Missouri, February–March 2023, Olivia M. Almendares, Jasmine D. Ruffin, Luke Gard, Rangaraj Selvarangan, Anjana Sasidharan, Dithi Banerjee, Nibha Sagar, Amanda Hayes, Sydnie Petty, Brian R. Lee, Chris T. Young, Janelle Potter, Shannon Tilsworth, Jennifer Goldman, Jennifer E. Schuster, Hannah L. Kirking
Indoor Air Quality Conditions And Respiratory Virus Detections In Elementary Schools—Kansas City, Missouri, February–March 2023, Olivia M. Almendares, Jasmine D. Ruffin, Luke Gard, Rangaraj Selvarangan, Anjana Sasidharan, Dithi Banerjee, Nibha Sagar, Amanda Hayes, Sydnie Petty, Brian R. Lee, Chris T. Young, Janelle Potter, Shannon Tilsworth, Jennifer Goldman, Jennifer E. Schuster, Hannah L. Kirking
Manuscripts, Articles, Book Chapters and Other Papers
Background/Objectives: Respiratory viruses circulate year-round and can spread indoors via inhalation of airborne particles. Effective ventilation and filtration may reduce transmission, particularly in school settings where children and staff spend significant time. This study examines the impact of indoor air quality (IAQ) and ventilation in schools on respiratory virus detection.
Methods: During February 27 to March 30, 2023, we assessed the relationship between IAQ and respiratory viruses in two Kansas City, Missouri, elementary schools by collecting bioaerosol samples, student and staff nasal swabs, and monitoring IAQ across 10 rooms (six classrooms, two common spaces, and two nurses’ offices). We calculated …
Antithrombotic Strategies And Outcomes In Neonates And Infants With Cardiac Shunts: A Systematic Review And Meta-Analysis., Amy L. Kiskaddon, Neil A. Goldenberg, Marisol Betensky, Joshua W. Branstetter, Dina Ashour, Pamela Williams, Arabela C. Stock, Michael Silvey, Therese M. Giglia, Nhue L. Do, Cardiac Disease Thrombosis And Hemostasis Working Party Of The Isth Ssc Subcommittee On Pediatric And Neonatal Thrombosis And Hemostasis
Antithrombotic Strategies And Outcomes In Neonates And Infants With Cardiac Shunts: A Systematic Review And Meta-Analysis., Amy L. Kiskaddon, Neil A. Goldenberg, Marisol Betensky, Joshua W. Branstetter, Dina Ashour, Pamela Williams, Arabela C. Stock, Michael Silvey, Therese M. Giglia, Nhue L. Do, Cardiac Disease Thrombosis And Hemostasis Working Party Of The Isth Ssc Subcommittee On Pediatric And Neonatal Thrombosis And Hemostasis
Manuscripts, Articles, Book Chapters and Other Papers
BACKGROUND: Cardiac shunt thrombosis in neonates and infants remains a concern for shunt failure and mortality. The optimal strategy for thromboprophylaxis remains unknown.
OBJECTIVES: This systematic review aims to characterize antithrombotic strategies and outcomes in neonates and infants with a cardiac shunt.
METHODS: MEDLINE, Embase, and Cochrane CENTRAL were searched from inception through July 2024 for studies reporting shunt thrombosis prevalence among infants who received a cardiac shunt. We estimated the pooled prevalence of shunt thrombosis using random-effects meta-analysis. In the subgroup analysis, we evaluated the effects of shunt type and antithrombotic strategies on shunt thrombosis prevalence.
RESULTS: A total …
Biomechanical Analysis Of 3d Correction And Bone-Screw Forces As A Function Of Rod Insertion Sequence And Orientation Relative To The Sagittal Plane In Adolescent Idiopathic Scoliosis Instrumentation., Camille Pillot, Xiaoyu Wang, Alexandria Mallinos, Todd Ritzman, Lorena Floccari, Richard M. Schwend, Carl-Eric Aubin
Biomechanical Analysis Of 3d Correction And Bone-Screw Forces As A Function Of Rod Insertion Sequence And Orientation Relative To The Sagittal Plane In Adolescent Idiopathic Scoliosis Instrumentation., Camille Pillot, Xiaoyu Wang, Alexandria Mallinos, Todd Ritzman, Lorena Floccari, Richard M. Schwend, Carl-Eric Aubin
Manuscripts, Articles, Book Chapters and Other Papers
BACKGROUND: In adolescent idiopathic scoliosis instrumentation, rods are typically aligned with the sagittal plane during the initial translation maneuver. Surgeons often empirically orient the rod slightly opposite to the scoliotic curve, but the optimal orientation and insertion sequence, as well as their influence on 3D correction and forces, remain unclear. This study investigates the biomechanical influence of these rod parameters on scoliosis correction.
METHODS: Patient-specific multi-body biomechanical models were developed for 30 adolescent idiopathic scoliosis patients (11 hypo-, 12 normo-, 7 hyper-kyphotic thoracic curves) to simulate posterior instrumentation with a primary segmental translation correction maneuver. Rod insertion was tested in …
Epigenomic Diagnosis And Prognosis Of Acute Myeloid Leukemia., Francisco Marchi, Vivek M. Shastri, Richard J. Marrero, Nam H K Nguyen, Antonella Öttl, Ann-Kathrin Schade, Marieke Landwehr, Olga Krali, Jessica Nordlund, Matin Ghavami, Fernando Sckaff, Vikash K. Mansinghka, Xueyuan Cao, William Slayton, Petr Starostik, Christopher R. Cogle, Raul C. Ribeiro, Jeffrey E. Rubnitz, Jeffery Klco, Abdelrahman Elsayed, Alan S. Gamis, Timothy J. Triche, Rhonda Ries, E Anders Kolb, Richard Aplenc, Todd Alonzo, Stanley Pounds, Soheil Meshinchi, Jatinder K. Lamba
Epigenomic Diagnosis And Prognosis Of Acute Myeloid Leukemia., Francisco Marchi, Vivek M. Shastri, Richard J. Marrero, Nam H K Nguyen, Antonella Öttl, Ann-Kathrin Schade, Marieke Landwehr, Olga Krali, Jessica Nordlund, Matin Ghavami, Fernando Sckaff, Vikash K. Mansinghka, Xueyuan Cao, William Slayton, Petr Starostik, Christopher R. Cogle, Raul C. Ribeiro, Jeffrey E. Rubnitz, Jeffery Klco, Abdelrahman Elsayed, Alan S. Gamis, Timothy J. Triche, Rhonda Ries, E Anders Kolb, Richard Aplenc, Todd Alonzo, Stanley Pounds, Soheil Meshinchi, Jatinder K. Lamba
Manuscripts, Articles, Book Chapters and Other Papers
Despite the critical role of DNA methylation, clinical implementations harnessing its promise have not been described in acute myeloid leukemia. Utilizing DNA methylation from 3314 leukemia patient samples across 11 harmonized cohorts, we describe the Acute Leukemia Methylome Atlas, which includes robust models capable of accurately predicting AML subtypes. A genome-wide prognostic model as well as a targeted panel of 38 CpGs significantly predict five-year survival in our pediatric and adult test cohorts. To accelerate rapid clinical utility, we develop a specimen-to-result protocol that uses long-read nanopore sequencing and machine learning to characterize patients' whole genomes and epigenomes. Clinical validation …
Who Benefits From Active Music Engagement During Cancer Treatment? Associations Of Sociodemographic Characteristics And Risk Factors With Moderators Of Intervention Effects., Steven J. Holochwost, Elizabeth Harman, Kristin Stegenga, Seethal A. Jacob, Sheri L. Robb
Who Benefits From Active Music Engagement During Cancer Treatment? Associations Of Sociodemographic Characteristics And Risk Factors With Moderators Of Intervention Effects., Steven J. Holochwost, Elizabeth Harman, Kristin Stegenga, Seethal A. Jacob, Sheri L. Robb
Manuscripts, Articles, Book Chapters and Other Papers
Young children and their parents experience frequent and repeated exposure to potentially traumatic events during treatment for cancer. Active Music Engagement (AME) is a dyadic music therapy intervention that has been found to mitigate traumatic stress symptoms among parents who screened high for traumatic stress symptoms (TSS) and reported higher levels of child distress with cancer-related hospitalizations/treatment (child distress). The current study examined sociodemographic characteristics and risk factors that were associated with higher levels of parent TSS and child distress as a means to identify families that may benefit most from AME in the future. Data were collected from the …
Kids Exploring The World With Chatbots, Maggie Mckay, Mark Connelly
Kids Exploring The World With Chatbots, Maggie Mckay, Mark Connelly
Parent-ish Podcast
Are your kids chatting away with AI? In this episode, we provide parents with the tools they need to understand the implications of children's interactions with chatbots. Find out what signs to look for and how to set healthy boundaries to protect your child from potential pitfalls of digital companionship.
Click here to stream the podcast episode.
Supporting Children In Managing Extracurricular Activities, Maggie Mckay, Simone Moody
Supporting Children In Managing Extracurricular Activities, Maggie Mckay, Simone Moody
Parent-ish Podcast
As the school year nears, so do busy schedules and the "extras" that kiddos do outside of school. While children love their sports, clubs and other extracurriculars, it can be hard to balance them with school and other important activities. Simone Moody, PhD, Clinical Psychologist at Children's Mercy in Kansas City, discusses signs your child might be overextended, how to find balance and more in this podcast.
Click here to stream the podcast episode.
Adolescents' Use Of Music For Pain Management., Rebecca J. Lepping, Lora L. Black, Kymberly A. Kline, Deanna Hanson-Abromeit, Andrea L. Chadwick, Dustin Wallace, William R. Black
Adolescents' Use Of Music For Pain Management., Rebecca J. Lepping, Lora L. Black, Kymberly A. Kline, Deanna Hanson-Abromeit, Andrea L. Chadwick, Dustin Wallace, William R. Black
Manuscripts, Articles, Book Chapters and Other Papers
To investigate the experiences of adolescents with chronic pain who participated in an intensive interdisciplinary pain treatment program, this secondary study analyzes the themes that emerged regarding the spontaneous utilization of music in coping strategies for chronic pain. During research interviews focused on coping skills and treatment engagement, participants spontaneously reported using music as an effective coping strategy for managing pain. A deductive thematic analysis revealed key themes related to their usage, including using music as a distractor, motivator and in other ways as coping strategies. Since participants indicated that music is essential to their experiences of coping with pain, …
Measles Assessment And Treatment, Bob Underwood, Edward Lyon
Measles Assessment And Treatment, Bob Underwood, Edward Lyon
Pediatrics in Practice: A CME Podcast
Eddie Lyon, MD, discusses concerns related to an uptick in measles cases, and how community providers can assess, limit exposure and guide patients to remain healthy.
Click here to stream the podcast episode.
Environmental Exposures Increase Health Risks In Childhood Cancer Survivors., Omar Shakeel, Nicole Wood, Hannah M. Thompson, Michael E. Scheurer, Mark D. Miller
Environmental Exposures Increase Health Risks In Childhood Cancer Survivors., Omar Shakeel, Nicole Wood, Hannah M. Thompson, Michael E. Scheurer, Mark D. Miller
Manuscripts, Articles, Book Chapters and Other Papers
Childhood cancer survivors (CCSs) are at increased risk for chronic health issues due to late effects of cancer and its treatment. We address the impact of environmental exposures, such as air pollution, tobacco smoke, extreme weather events, and pesticides, on the health and survival of CCSs. These environmental hazards have been associated with worsening health outcomes and decreased survival among CCSs on a global scale. We also highlight that providers at a major pediatric cancer center in the United States have limited knowledge and practical skills about environmental risk factors and how to reduce exposures. Our survey results show that …
Current Landscape Of Preclinical Models For Pediatric Gliomas: Clinical Implications And Future Directions., Syed M. Faisal, Monika Yadav, Garrett R. Gibson, Adora T. Klinestiver, Ryan M. Sorenson, Evan Cantor, Maria Ghishan, John R. Prensner, Andrea T. Franson, Kevin Ginn, Carl Koschmann, Viveka Nand Yadav
Current Landscape Of Preclinical Models For Pediatric Gliomas: Clinical Implications And Future Directions., Syed M. Faisal, Monika Yadav, Garrett R. Gibson, Adora T. Klinestiver, Ryan M. Sorenson, Evan Cantor, Maria Ghishan, John R. Prensner, Andrea T. Franson, Kevin Ginn, Carl Koschmann, Viveka Nand Yadav
Manuscripts, Articles, Book Chapters and Other Papers
Pediatric high-grade gliomas (pHGGs), particularly diffuse midline gliomas (DMGs), are among the most lethal brain tumors due to poor survival and resistance to therapies. DMGs possess a distinct genetic profile, primarily driven by hallmark mutations such as H3K27M, ACVR1, and PDGFRA mutations/amplifications and TP53 inactivation, all of which contribute to tumor biology and therapeutic resistance. Developing physiologically relevant preclinical models that replicate both tumor biology and the tumor microenvironment (TME) is critical for advancing effective treatments. This review highlights recent progress in in vitro, ex vivo, and in vivo models, including patient-derived brain organoids, genetically engineered mouse models (GEMMs), and …
2025-2026 Pediatric Subspecialty Trainees, Children's Mercy Kansas City
2025-2026 Pediatric Subspecialty Trainees, Children's Mercy Kansas City
Residents and Fellows Portraits
Photo composites of the graduate pediatric trainees in advanced non-invasive imaging,, allergy/immunology, Pediatric EM/child abuse, child abuse pediatrics, child neurology, clinical neuro-psychology, clinical child psychology, clinical child psychology internship, congenital cardiac surgery, developmental-behavioral, epilepsy, hospice & palliative care, laboratory genetics & genomics, pediatric anesthesiology, pediatric bioethics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pathology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, sleep medicine, pharmacy, …
Sickle Cell: Acute Chest Syndrome, Children's Mercy Kansas City
Sickle Cell: Acute Chest Syndrome, Children's Mercy Kansas City
Clinical Pathways (Formally Known As Care Process Models)
No abstract provided.
Musculoskeletal Infection, Children's Mercy Kansas City
Musculoskeletal Infection, Children's Mercy Kansas City
Clinical Pathways (Formally Known As Care Process Models)
No abstract provided.
Appendicitis, Children's Mercy Kansas City
Appendicitis, Children's Mercy Kansas City
Clinical Pathways (Formally Known As Care Process Models)
No abstract provided.
A Risk Score To Predict Recurrent High Intensity Inpatient Resource Utilization For Children With Medical Complexity., Charles Maloy, Jessica L. Bettenhausen, Y Raymond Chan, Leah Jones, Kathryn Kyler, Laura Plencner, Jessica Markham, Jacqueline Walker, Smit Shah, Sian Best, Jonathan Ermer, Shelby Chesbro, Maria Newmaster M.D., Henry T. Puls
A Risk Score To Predict Recurrent High Intensity Inpatient Resource Utilization For Children With Medical Complexity., Charles Maloy, Jessica L. Bettenhausen, Y Raymond Chan, Leah Jones, Kathryn Kyler, Laura Plencner, Jessica Markham, Jacqueline Walker, Smit Shah, Sian Best, Jonathan Ermer, Shelby Chesbro, Maria Newmaster M.D., Henry T. Puls
Posters
Background Children with medical complexity (CMC) use a greater amount of inpatient resources and stand to benefit from unique care models and coordination. However, hospital resources can be limited, and a better understanding of which CMC are high resource users could improve hospital and staff planning. Objective: To develop a risk score predictive of recurrent high intensity inpatient utilization among CMC. Methods: We conducted a retrospective cohort study of children < 18 years old with ≥3 complex chronic conditions (CCC) discharged from one of 48 children’s hospitals in the Pediatric Health Information System during 2021 and 2022. To reflect CMC typically cared for by a general medical service, children with cardiac procedures, dialysis, oncology, or transplant CCCs, and index hospitalization mortality were excluded. We used multivariable logistic regression to determine factors present on the index hospitalization associated with ≥5 hospitalizations or ≥3 hospitalizations with one lasting ≥25 days within any 365-day period (high inpatient utilization) in 2021-2023. We developed risk scoring system using model coefficients and defined the optimal risk score cutoff to maximize sensitivity and specificity. We then applied the risk score cutoff to children discharged to determine (a) ratio of predicted:actual CMC with recurrent high resource use and (b) the total predicted daily volume on 50th, 75th, and 90th percentile days for each hospital. Results: Of 44,432 included children , 9,596 (21.6%) had high inpatient utilization (Table). Children under 1 year of age had the highest odds of high inpatient utilization (OR 2.26 [95% CI: 2.16, 2.37]) and all CCC and technology groups (except metabolic) met statistical significance (Figure 1). The optimal risk score cutoff was 29 and predicted 17,411 (39.2%) CMC as high inpatient resource utilizers; the predicted:actual ratio of CMC with high inpatient utilization was 1.81. The mean daily census of the 50th, 75th, and 90th percentiles across hospitals was 28 CMC with recurrent high utilization (± 17), 34 (±18), and 39 (±19; Figure2). Conclusions: It is feasible to develop a risk score predictive of recurrent high inpatient utilization among CMC. There is substantial variability in volume of CMC with high utilization between pediatric hospitals. The risk score cutoff values can be modified to suit different applications and institution-specific objectives. These applications could include a dedicated service line or staffing. Alternatively, this could identify patients who would benefit from more formal handoff from inpatient to outpatient providers.
Variation A Blood Culture Testing For Three Common Infections, Smit Shah, Jennifer Goldman, Matt Hall, Jillian Cotter, Samantha A. House, Matthew J. Molloy, Michelle Polich, Michael J. Steiner, John R. Stephens, Michael J. Tchou, Ronald J. Teufel Ii, Irma Ugalde, Andrew Yu, Jessica Markham
Variation A Blood Culture Testing For Three Common Infections, Smit Shah, Jennifer Goldman, Matt Hall, Jillian Cotter, Samantha A. House, Matthew J. Molloy, Michelle Polich, Michael J. Steiner, John R. Stephens, Michael J. Tchou, Ronald J. Teufel Ii, Irma Ugalde, Andrew Yu, Jessica Markham
Presentations
Background: Routine blood culture (BC) testing in uncomplicated community-acquired pneumonia (CAP), skin and soft tissue infections (SSTI), and urinary tract infections (UTI) has demonstrated low clinical utility. Objectives: To evaluate hospital-level BC testing trends and their association with clinical outcome differences for children hospitalized with CAP, SSTI, and UTI. Methods: This retrospective cohort study used the Pediatric Health Information System database to identify hospitalizations of children aged 3 months-18 years admitted with CAP, SSTI, or UTI from 2016-2023. We excluded patients with complicated infections, medical complexity, ICU admission, or length of stay (LOS) >7 days. Hospital-level BC testing rates were …
The Pediatric Experience Collaborative: Paving The Way In Pediatric Experience., Lauren Hamilton, Trenton House, Taylor B. Sewell, Harris Baden, Brianna Combs, Sara L. Toomey, Shehzad Saeed, Jana Rojas, Molly Warneke, Maureen Hoff, Andréa Aken'ova, Lisa Rubino, Dana Ileana Williams, Samuel P. Hanke
The Pediatric Experience Collaborative: Paving The Way In Pediatric Experience., Lauren Hamilton, Trenton House, Taylor B. Sewell, Harris Baden, Brianna Combs, Sara L. Toomey, Shehzad Saeed, Jana Rojas, Molly Warneke, Maureen Hoff, Andréa Aken'ova, Lisa Rubino, Dana Ileana Williams, Samuel P. Hanke
Manuscripts, Articles, Book Chapters and Other Papers
Positive patient experience is associated with improved patient outcomes, but efforts to improve patient experience are often underprioritized, especially with respect to pediatric care. To address this challenge, leaders at several US children's hospitals established the Pediatric Experience Collaborative (PEC) in 2016 to leverage their collaboration and scale to optimize patient, family, and provider experiences. Since then, the PEC has steadfastly incorporated the patient and family perspective in all its endeavors (e.g., installing a family member as one of the organization's co-chairs); has created both structured opportunities and unstructured opportunities for learning and connection; and has embarked on multi-institutional research …