Medical Specialties Commons^™

Guidelines On Management Of Hereditary Polyposis Syndromes In Pediatric Patients: Agreement, Disagreement And Where It Matters, Taina Hudson, Claudia Phen, Isabel Rojas, Shlomi Cohen, Warren Hyer, Thomas M. Attard

Manuscripts, Articles, Book Chapters and Other Papers

Hereditary polyposis syndromes are rare but potentially devastating conditions which require multidisciplinary care from an early age. Societal guidelines, which ideally combine expert opinions and medical evidence, serve as the framework for disease diagnosis, surveillance and treatment. However, there is a significant underrepresentation of pediatric gastroenterology input in guideline formulation, and additionally, recommendations can vary significantly between societies, which can have a moderate-to-high clinical impact on patient care. This paper aims to summarize key differences in management based on societal guidelines and identify some of the factors which may contribute to divergence in care in hereditary polyposis syndromes in pediatric …

Common Liver Conditions, Robert W Steele, Ryan T. Fischer

Pediatrics in Practice: A CME Podcast

In this episode, Dr. Ryan Fischer shares his expertise on genetic liver diseases affecting children. Explore the latest advancements in diagnostic techniques and treatments, including genetic screening and their impact on transplant outcomes. Tune in to understand the relationship between genetics and pediatric liver conditions in 2024.

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Common Cases Of Diabetes, Robert W Steele, Ryan J. Mcdonough

Pediatrics in Practice: A CME Podcast

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Underutilization Of Influenza Antiviral Treatment Among Children And Adolescents At Higher Risk For Influenza-Associated Complications - United States, 2023-2024., Aaron M. Frutos, Haris M. Ahmad, Dawud Ujamaa, Alissa C. O'Halloran, Janet A. Englund, Eileen J. Klein, Danielle M. Zerr, Melanie Crossland, Holly Staten, Julie A. Boom, Leila C. Sahni, Natasha B. Halasa, Laura S. Stewart, Olla Hamdan, Tess Stopczynski, William Schaffner, H Keipp Talbot, Marian G. Michaels, John V. Williams, Melissa Sutton, M Andraya Hendrick, Mary A. Staat, Elizabeth P. Schlaudecker, Brenda L. Tesini, Christina B. Felsen, Geoffrey A. Weinberg, Peter G. Szilagyi, Bridget J. Anderson, Jemma V. Rowlands, Murtada Khalifa, Marc Martinez, Rangaraj Selvarangan, Jennifer E. Schuster, Ruth Lynfield, Melissa Mcmahon, Sue Kim, Val Tellez Nunez, Patricia A. Ryan, Maya L. Monroe, Yun F. Wang, Kyle P. Openo, James Meek, Kimberly Yousey-Hindes, Nisha B. Alden, Isaac Armistead, Suchitra Rao, Shua J. Chai, Pam Daily Kirley, Ariana P. Toepfer, Fatimah S. Dawood, Heidi L. Moline, Timothy M. Uyeki, Sascha Ellington, Shikha Garg, Catherine H. Bozio, Samantha M. Olson

Manuscripts, Articles, Book Chapters and Other Papers

Annually, tens of thousands of U.S. children and adolescents are hospitalized with seasonal influenza virus infection. Both influenza vaccination and early initiation of antiviral treatment can reduce complications of influenza. Using data from two U.S. influenza surveillance networks for children and adolescents agedattended, laboratory-confirmed influenza for whom antiviral treatment is recommended, the percentage who received treatment was calculated. Trends in antiviral treatment of children and adolescents hospitalized with influenza from the 2017-18 to the 2023-2024 influenza seasons were also examined. Since 2017-18, when 70%-86% of hospitalized children and adolescents with influenza received antiviral treatment, the proportion receiving treatment notably declined. …

Atypical Rash As A Presentation Of Pityriasis Rosea In A 23-Month-Old., Kedar Tilak, Erica Ray, Majo Joseph

Manuscripts, Articles, Book Chapters and Other Papers

Pityriasis rosea is a self-limiting skin disorder that can occur in pediatric patients. We report an atypical presentation of a 23-month-old male with a generalized rash similar in appearance to pityriasis rosea. We then review the literature on pityriasis rosea and its application to pediatrics. Our patient had the rash as the only presentation which was also atypical in appearance as opposed to the regular rashes seen with pityriasis rosea which makes this case further interesting. We only treated the case symptomatically and the patient had spontaneous resolution of symptoms.

Tips For Building Your Child's Emotional Piggy Bank, Maggie Mckay, Nicole Hogan, Allie Eudaly

Parent-ish Podcast

Adults are familiar with the concept of deposits and withdrawals to a bank account...but did you know the same principles apply to an emotional piggy bank? Experts discuss what an emotional piggy bank is, and how you can make deposits and avoid withdrawals to your child's piggy bank.

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Lactobacillus Rhamnosus Modulates Murine Neonatal Gut Microbiota And Inflammation Caused By Pathogenic Escherichia Coli., Hao Xuan, Shahid Umar, Cuncong Zhong, Wei Yu, Ishfaq Ahmed, Joshua Wheatley, Venkatesh Sampath, Susana Chavez-Bueno

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pathogenic Escherichia coli strains produce neonatal septicemia after colonizing the neonatal gut. While the probiotic Lactobacillus rhamnosus GG (LGG) effectively reduces neonatal sepsis, LGG's effects on the neonatal intestinal microbiota alterations and inflammation triggered by E. coli are incompletely understood. We hypothesized that LGG significantly modulates the specific neonatal gut microbial populations changes and the inflammatory response elicited by the enteral introduction of septicemia-producing E. coli. To test this hypothesis, newborn rats were pretreated orally with LGG or placebo prior to infection with the neonatal E. coli septicemia clinical isolate SCB34. Amplicon 16S rRNA gene sequencing was performed on …

Preventing Migration Of Esophageal Silicone Covered Self-Expanding Metal Stent Using Dental Floss In A Pediatric Patient, Sofia Colon Guzman, Nadia Ibrahimi, Amornluck Krasaelap

Presentations

Temporary esophageal stents are an important and effective treatment for benign esophageal strictures, such as those caused by caustic ingestions. Fully covered self-expanding metal stents (FCSEMS) provide the benefit of continuous dilation pressure over longer periods of time compared to bougie or balloon dilation. However, stent migration is the most common complication and can be observed in up to 40% of patients, especially with FCSEMS and in refractory strictures. Typically, the stent is secured by using clips or suturing devices. However, we present a case where traditional methods of securing a stent were not possible due to the location of …

A Unilateral Myopic Shift Secondary To Sturge-Weber Syndrome Results In Refractive Amblyopia Of The Fellow Eye In A Pediatric Patient, Mckenzie Stewart, Christina Twardowski

Posters

A 4-year-old patient with unilateral glaucoma secondary to Sturge-Weber Syndrome causes a myopic shift. The fellow healthy eye maintains high hyperopia resulting in anisometropic refractive amblyopia, requiring occlusion therapy. It is well documented that a glaucomatous high IOP causes an expansion of the globe due to excessive plasticity of collagen fibers in pediatric eyes. The elongated axial length induces myopic shifts. In this patient, the myopic shift in her glaucomatous eye resulted in a unilateral high hyperopic refractive error in the fellow eye with normal ocular health. This anisometropia is enough to cause amblyopia in the hyperopic eye. In past …

Terminal Ileal Intubation In Retroflexion In A Pediatric Patient, Lakshmi Kunam, Antonia Fernandez Ovalle, Thomas M. Attard

Posters

Background: Terminal ileum (TI) intubation is integral to complete diagnostic ileocolonoscopy in children. It is necessary to determine terminal ileal involvement in patients with a broad spectrum of pathologic processes. In some cases the standard method of intubation does not lead to success and retroflexion is needed. Here we describe the case of terminal ileal intubation in retroflexion on a 14 year old female. Case description: 14 year-old female patient with a past medical history of chronic abdominal pain, NAFLD, anxiety, vulvovaginitis, lichen sclerosus, depression, constipation, delayed menses, and GERD who was admitted for 2 weeks of escalating symptoms and …

But, It's Just A Uti, Gillian Long

Posters

IgA Vasculitis is a commonly seen presentation in the pediatric population. The constellation of symptoms typically includes purpuric rash, joint pain, abdominal pain and hematuria. This 12 year old female was seen by her pediatrician for rash on her legs, shortness of breath, cough and night sweats that all started around 2 months ago. Additionally, a 25 pound weight loss was noted over the past year. The rash appeared as nonblanching purpura on her lower extremities, lending suspicion to IgA Vasculitis. She was first treated for UTI with cefuroxime, and then treated with steroids. Urinalysis showed persistent hematuria and she …

Malignant Transformation And Tumour Recurrence In Sacrococcygeal Teratoma: A Global, Retrospective Cohort Study., Lieke J. Van Heurn, Joep P M Derikx, Nigel Hall, Jennifer H. Aldrink, Maria M. Bailez, Lohfa B. Chirdan, Shigehisa Fumino, Afua Hesse, Tuktu Soyer, Shawn D. St Peter, Jos Twisk, Tianyou Yang, Ernst L W Van Heurn, Sct-Study Consortium

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Sacrococcygeal teratoma (SCT) is a rare congenital tumour. The risk of malignancy and recurrence are not well defined. Previous studies are small and report differing conclusions about the timing of surgery and the duration of follow-up. We studied the risk of malignant transformation and SCT recurrence after surgery to address these gaps.

METHODS: This was a global retrospective cohort study. Data of consecutive SCT patients was obtained from 145 institutes in 62 countries. Malignant transformation, defined as malignancy at initial resection, malignant recurrence or death due to malignancy, and its risk factors were analysed.

RESULTS: Of the 3612 included …

Seasons Of Kawasaki Disease During The Covid-19 Pandemic., Todd T. Nowlen, Ashraf S. Harahsheh, Geetha Raghuveer, Simon Lee, Anji T. Yetman, Nagib Dahdah, Michael A. Portman, Supriya S. Jain, Michael Khoury, Selemet Tierney, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle

Manuscripts, Articles, Book Chapters and Other Papers

The incidence of Kawasaki Disease has a peak in the winter months with a trough in late summer/early fall. Environmental/exposure factors have been associated with a time-varying incidence. These factors were altered during the COVID-19 pandemic. The study was performed through the International Kawasaki Disease Registry. Data from patients diagnosed with acute Kawasaki Disease and Multiple Inflammatory Syndrome-Children were obtained. Guideline case definitions were used to confirm site diagnosis. Enrollment was from 1/2020 to 7/2023. The number of patients was plotted over time. The patients/month were tabulated for the anticipated peak Kawasaki Disease season (December-April) and non-peak season (May-November). Data …

Addressing Weight Bias Among Pediatric Healthcare Clinical Staff., Kathyrn Kyler, Codi Cutburth, Gayla Goleman, Sarah Hampl, Amy R. Beck

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children with obesity may experience weight-based discrimination as a result of weight bias and stigma, which can have deleterious effects on their health and wellbeing, including increased risk of dysregulated, maladaptive, and disordered eating such as restriction, purging, and binging. Prior work has shown that weight bias occurs from healthcare workers caring for adults, but less is known about the prevalence of weight bias in the pediatric healthcare setting.

METHODS: We aimed to determine what proportion of pediatric healthcare professionals had attitudes of weight bias at our own institution by constructing a survey with questions from validated weight bias …

Decentralized Clinical Trials (Dcts): Facilitators & Barriers For A Pediatric Research Site, Abby Kietzman

Presentations

In 2020, the COVID-19 pandemic drastically altered the way clinical research is conducted through a widespread adoption of telemedicine practices. Using telehealth/telemedicine services allowed researchers to conduct “decentralized clinical trials”, or DCTs, for all or portions of study protocol procedures while maintaining safety measures implemented for pandemic control. However, current review of available literature details the explosion in use of decentralized clinical trials, resulting in gaps in evidence-based outcomes and lack of standardization across research entities. While sponsors and contract research organizations (CROs) tend to lead the charge around adoption of DCTs, research sites are hesitant to make the transition …

Key Data Elements For A Successful Pediatric Rheumatology Virtual Visit: A Survey Within The Pr-Coin Network., Y Ingrid Goh, Meghan E. Ryan, Shoghik Akoghlanian, Rajdeep Pooni, Julia G. Harris, Danielle R. Bullock, Sheetal S. Vora, Tzielan C. Lee, Shirley M L Tse, Fatima Barbar-Smiley

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease which is commonly monitored by a combination of history, physical examination, bloodwork, and imaging. The COVID-19 pandemic prompted a rapid shift to telemedicine to ensure that patients continued to receive healthcare. The shift to telemedicine changed the methodology and ability of healthcare providers to monitor their patients' progress, as they were unable to perform direct hands-on assessments. The following survey sought to understand the impact of switching pediatric rheumatology healthcare delivery from in-person to telemedicine modality. Specifically, it sought to examine the rate of collection of critical data …

Neighborhood Effects On Acute Pediatric Asthma: Race, Greenspace, And Pm2.5, Elizabeth Wesley, Nathaniel A. Brunsell, David R. Rahn, Jarron M. Saint Onge, Natalie J. Kane, Kevin F. Kennedy

Manuscripts, Articles, Book Chapters and Other Papers

Urbanization produces spatially variable landscapes where climatic, environmental, and social systems interact in complex ways that affect public health. Environmental exposure along with the associated health risks are unevenly distributed and communities of color are often disproportionately affected by poor health outcomes. Acute pediatric asthma is the most common chronic condition of childhood in developed nations and is especially prevalent in minority and low-income children. In this study, we analyze the spatial variability of neighborhood-level acute pediatric asthma emergency department (ED) visits across the Kansas City Metro Area. Using Bayesian negative binomial regression, we describe the relationships and interactions between …

Clean Intermittent Catheterisation Determinants And Caregiver Adherence In Paediatric Patients With Spinal Dysraphism And Spinal Cord Injury In A Paediatric Spinal Differences Clinic: A Mixed Methods Study Protocol., Azadeh Wickham, Cynthia L. Russell, John Gatti

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Clean intermittent catheterisation (CIC) is the standard of care for treating neurogenic lower urinary tract dysfunction (NLUTD), the most common bladder dysfunction in children diagnosed with spinal dysraphism (SD) and spinal cord injury (SCI). Failure to follow the prescribed CIC regimen results in urinary tract infections, incontinence and renal insufficiency. Adherence to CIC is suboptimal, with reported non-adherence rates of 18%-66%. Despite the efficacy of CIC, the research on CIC adherence is not well defined in the literature and even less for caregivers of children on CIC protocols.

METHODS: This proposed study aims to identify caregiver CIC adherence and …

Cardiovascular, Autonomic Symptoms And Quality Of Life In Children With Hypermobile Ehlers-Danlos Syndrome., Amanda K. Hertel, William R. Black, Ashley Lytch, Emily Cramer, Lindsey Malloy-Walton, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Hypermobile Ehlers-Danlos syndrome is a connective tissue disorder characterized by joint hypermobility and other systemic manifestations. Cardiovascular, autonomic symptoms and dysautonomia are frequently reported in adults with hypermobile Ehlers-Danlos syndrome and have been shown to have a negative impact on quality of life. However, there is scant literature on autonomic symptoms in pediatric patients with hypermobile Ehlers-Danlos syndrome. This study aims to characterize cardiovascular symptoms and diagnoses in pediatric patients with hypermobile Ehlers-Danlos syndrome and evaluate the impact of autonomic symptoms on quality of life.

METHODS: As part of a longitudinal study, a consecutive sample of 70 patients with …

A Feasibility Study Of A Music Enrichment Program On Relative Reinforcing Value Of Food And Home Environmental Enrichment Among Families Of Low Socioeconomic Status., Kai Ling Kong, Amy R. Smith, Brenda Salley, Deanna Hanson-Abromeit, Hideko Engel, Catherine Serwatka

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Emerging evidence suggests that low socioeconomic status (SES) home environments may play a role by promoting excess energy intake through a lack of access to non-food reinforcers. Because of the deleterious effects of SES-related disparities on child health and development, feasible and culturally acceptable interventions are urgently needed. Community-based music enrichment programs may be an ideal intervention strategy.

METHODS: In collaboration with a local non-profit organization and music studio, we conducted a pilot randomized controlled trial to assess the effects of a music enrichment program versus a play date control in a group of 9-24-month-old healthy infants (N = …

Pandemic Perspectives From Detained Youth During Covid-19: Bridging The Knowledge Gap For Future Safeguards., April Mcneill-Johnson, Zuri Hudson, Brittany Moore, Dumebi Okocha, Megha Ramaswamy, Kimberly Randell

Manuscripts, Articles, Book Chapters and Other Papers

Despite the worsening health disparities among youth in detention during the COVID-19 pandemic, there has been minimal exploration into the pandemic experiences of detained youth and opportunities for pandemic mitigation. This paper analyzes the perspectives of youth in detention on the pandemic, including the effect of the pandemic on their detention experience and their perceptions about COVID-19 vaccination. The study used purposive sampling to recruit 16 participants (aged 14-17 years) from two juvenile detention centers in the urban Midwest. We conducted semi-structured interviews and analyzed verbatim transcripts using a hybrid deductive-inductive approach and thematic analysis. Four themes emerged: 1) personal …

Monte Carlo Simulations Of Cefepime In Children Receiving Continuous Kidney Replacement Therapy Support Continuous Infusions For Target Attainment., H Rhodes Hambrick, Nieko Punt, Kathryn Pavia, Tomoyuki Mizuno, Stuart L. Goldstein, Sonya Tang Girdwood

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Sepsis is a leading cause of acute kidney injury requiring continuous kidney replacement therapy (CKRT) and CKRT can alter drug pharmacokinetics (PK). Cefepime is used commonly in critically ill children and is cleared by CKRT, yet data regarding cefepime PK and pharmacodynamic (PD) target attainment in children receiving CKRT are scarce, so we performed Monte Carlo simulations (MCS) of cefepime dosing strategies in children receiving CKRT.

METHODS: We developed a CKRT "module" in the precision dosing software Edsim++. The module was added into a pediatric cefepime PK model. 1000-fold MCS were performed using six dosing strategies in patients aged …

Adhd Update, Robert W. Steele, Simone Moody

Pediatrics in Practice: A CME Podcast

In this episode, Dr. Simone Moody leads a discussion focusing on ADHD, and the recent advancements in diagnosing, as well as management and treatment options.

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General Surgery Overview For Pediatricians, Robert W Steele, Tolulope A. Oyetunji

Pediatrics in Practice: A CME Podcast

In this episode, Dr. Tolu Oyetunji leads a discussion focusing on a general overview of surgery practices for pediatricians.

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Supporting Patients Transitioning To Adult Care, Robert W. Steele, Stephanie Pratt

Pediatrics in Practice: A CME Podcast

In this episode, transition program manager Stephanie Pratt leads a discussion focusing on ways to support patients as they transition from pediatric to adult care.

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Back To School Illnesses, Robert W Steele, Edward Lyon

Pediatrics in Practice: A CME Podcast

In this episode, Dr. Eddie Lyon will lead a discussion focusing on back to school illnesses, and the preventative methods, including vaccinations, parents can take during this school year.

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Implementation Study Of The Carra Uveitis Consensus Treatment Plans: Feasibility For Clinical Practice And Applicability For Research., Margaret H. Chang, Fatima Barbar-Smiley, Shoghik Akoghlanian, Joanne Drew, Sheila T. Angeles-Han, Megan Quinlan-Waters, John F. Bohnsack, Ashley M. Cooper, Barbara Edelheit, Jennifer Twachtman-Bassett, Melissa A. Lerman, Kabita Nanda, C Egla Rabinovich, Mindy S. Lo, Carra Uveitis Workgroup And The Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Chronic anterior uveitis (CAU) carries a significant risk for eye complications and vision loss. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) introduced consensus treatment plans (CTPs) to standardize treatment for CAU and facilitate future comparative effectiveness studies. Two CTPs were developed to address: 1) initiation of methotrexate (MTX) in patients with CAU naïve to steroid-sparing therapy, and 2) initiation of a TNF inhibitor (TNFi) in patients with severe uveitis or uveitis refractory to MTX. We evaluated implementation of the uveitis CTPs using existing CARRA Registry infrastructure and assessed feasibility of the CTPs for comparative effectiveness research.

METHODS: This …

Microfluidic Affinity Selection Of B-Lineage Cells From Peripheral Blood For Minimal Residual Disease Monitoring In Pediatric B-Type Acute Lymphoblastic Leukemia Patients., Malgorzata A. Witek, Nicholas E. Larkey, Alena Bartakova, Mateusz L. Hupert, Shalee Mog, Jami K. Cronin, Judy Vun, Keith August, Steven A. Soper

Manuscripts, Articles, Book Chapters and Other Papers

Assessment of minimal residual disease (MRD) is the most powerful predictor of outcome in B-type acute lymphoblastic leukemia (B-ALL). MRD, defined as the presence of leukemic cells in the blood or bone marrow, is used for the evaluation of therapy efficacy. We report on a microfluidic-based MRD (MF-MRD) assay that allows for frequent evaluation of blood for the presence of circulating leukemia cells (CLCs). The microfluidic chip affinity selects B-lineage cells, including CLCs using anti-CD19 antibodies poised on the wall of the microfluidic chip. Affinity-selected cells are released from the capture surface and can be subjected to immunophenotyping to enumerate …

Early Versus Staged Repair Of Pulmonary Atresia With Ventricular Septal Defect Without Mapcas: A Phis Analysis, Mohamed Aashiq Abdul Ghayum, Brian R. Lee, James O'Brien, Edo Bedzra

Presentations

Objective: The management of Pulmonary Atresia and Ventricular Septal Defect (PA/VSD) without Major Aortopulmonary Collaterals (MAPCAs) is variable. This study aims to describe the practice patterns, choice of interventions, and outcomes of patients treated using various surgical strategies. Methods: Data from the Public Health Information System (PHIS) database was analyzed for patients with a diagnosis of PA/VSD without MAPCAs who followed a two-ventricle strategy between 2003 and 2023. Patients were categorized based on the initial surgical approach into four groups: single-stage early repair, ductal stent, systemic to pulmonary artery shunt, and right ventricle to pulmonary artery (RV-PA) connection. Outcomes, including …

Sinusitis: Acute Bacterial, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.