Medical Specialties Commons^™

Assessing The Relationship Between Planter Fascia And Planter Calcaneonavicular Ligament Thickness In Individuals Suffering From Planter Fasciitis Using Musculoskeletal Ultrasonography, Wessam Eissa Hamed Attia

Journal of Medicine in Scientific Research

Abstract Objective: There is uncertainty regarding how thick spring ligament is in persons with plantar fasciitis complaints, despite the fact that they exhibit laxity of this ligament. The purpose of this study was to use an ultrasonic imaging system (US) to clarify the anatomical features of spring ligament in individuals who suffer from plantar fasciitis. Methods: The study was conducted on 30 feet of thirty patients suffering from plantar fasciitis representing the painful group and 30 feet of thirty healthy individuals that have no planter pain representing the healthy group that were chosen from Mataria Teaching Hospital's rheumatology and rehabilitation …

Molecular Characterization And Predictors Of Relapse In Patients With Ph + All After Frontline Ponatinib And Blinatumomab, Nicholas J Short, Hagop Kantarjian, Ken Furudate, Nitin Jain, Farhad Ravandi, Omer Karrar, Sanam Loghavi, Lewis Nasr, Fadi G Haddad, Jayastu Senapati, Rebecca Garris, Koichi Takahashi, Elias Jabbour

Faculty, Staff and Student Publications

Background: Several studies have suggested that chemotherapy-free regimens consisting of blinatumomab and a BCR::ABL1 tyrosine kinase inhibitor are highly effective in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL). However, the clinical and molecular characteristics that predict for relapse with these chemotherapy-free regimens are largely unknown.

Methods: We conducted a prospective phase II clinical trial of the combination of blinatumomab and ponatinib in 76 patients with newly diagnosed Ph + ALL. Patients received 12-15 doses of intrathecal chemotherapy as central nervous systemic (CNS) prophylaxis. The patterns of relapse and the clinical and molecular predictors of relapse were analyzed.

Results: With …

Immunotherapy With Nebulized Pattern Recognition Receptor Agonists Restores Severe Immune Paralysis And Improves Outcomes In Mice With Influenza-Associated Pulmonary Aspergillosis, Jezreel Pantaleón García, Sebastian Wurster, Nathaniel D Albert, Uddalak Bharadwaj, Keerthi Bhoda, Vikram K Kulkarni, Mbaya Ntita, Paris Rodríguez Carstens, Madeleine Burch-Eapen, Daniela Covarrubias López, Jania Foncerrada Lizaola, Katherine E Larsen, Lauren M Matula, Seyed J Moghaddam, Yongxing Wang, Dimitrios P Kontoyiannis, Scott E Evans

Faculty, Staff and Student Publications

Influenza-associated pulmonary aspergillosis (IAPA) is a potentially deadly superinfection in patients with influenza pneumonia, especially those with severe disease, underlying immunosuppression, corticosteroid therapy, or requiring intensive care support. Given the high mortality of IAPA, adjunct immunomodulatory strategies remain a critical unmet need. Previously, the desensitization of pattern recognition pathways has been described as a hallmark of IAPA pathogenesis and a predictor of mortality in IAPA patients. Therefore, we studied the impact of nebulized Toll-like receptor 2/6/9 agonists Pam2 CSK4 (Pam2) and CpG oligodeoxynucleotides (ODNs) on infection outcomes and pulmonary immunopathology in a corticosteroid-immunosuppressed murine IAPA model. Mice with IAPA receiving …

Forward Genetic Screen In Zebrafish Identifies New Fungal Regulators That Limit Host-Protective Candida-Innate Immune Interaction, Bailey A Blair, Emma Bragdon, Gursimran Dhillon, Nnamdi Baker, Lena Stasiak, Mya Muthig, Pedro Miramon, Michael C Lorenz, Robert T Wheeler

Faculty, Staff and Student Publications

Candida is one of the most frequent causes of bloodstream infections, and our first line of defense against these invasive infections is the innate immune system. The early immune response is critical in controlling Candida albicans infection, but C. albicans has several strategies to evade host immune attack. Phagocytosis of C. albicans blocks hyphal growth, limiting host damage and virulence, but how C. albicans limits early recruitment and phagocytosis in vertebrate infection is poorly understood. To study innate immune evasion by intravital imaging, we utilized the transparent larval zebrafish infection model to screen 131 C. albicans mutants for altered …

Direct Parieto-Occipital Connectivity Of The Amygdala Via The Parahippocampal Segment Of The Cingulum Bundle, Arash Kamali, Kamand Khalaj, Atif Ali, Farbod Khalaj, Diana Kokash, Andres R Gonzalez, Michael A Jacobs, Alireza Akhbardeh, Paul E Schulz, Khader M Hasan

Faculty, Staff and Student Publications

Background

The amygdala is a key structure involved in memory, emotional processing, and sensory integration. While the cortical connectivity of the amygdala with the frontal and temporal lobes has been extensively studied, its direct connections with the parieto-occipital cortices remain underexplored. This study aims to delineate the direct connectivity between the amygdala and the parietal and occipital cortices via the parahippocampal segment of the cingulum bundle.

Methods

High-resolution diffusion-weighted imaging (DWI) tractography was performed on 30 healthy adult brains. Fiber tracking was conducted using three regions of interest (ROIs) placed in the parietal, occipital, and medial temporal lobes. A fractional …

Clinical And Fundamental Research Progressions On Tumor-Infiltrating Lymphocytes Therapy In Cancer, Jiandong Hu, Mengli Jin, Weihong Feng, Barbara Nassif-Rausseo, Alexandre Reuben, Chunhua Ma, Gregory Lizee, Fenge Li

Faculty, Staff and Student Publications

Malignant tumors represent a significant threat to human health. Among the various therapeutic strategies available, cancer immunotherapy-encompassing adoptive cell transfer (ACT) and immune checkpoint blockade therapy-has emerged as a particularly promising approach following surgical resection, radiotherapy, chemotherapy, and molecular targeted therapies. This form of treatment elicits substantial antigen-specific immune responses, enhances or restores anti-tumor immunity, thereby facilitating the control and destruction of tumor cells, and yielding durable responses across a range of cancers, which can lead to the eradication of tumor lesions and the prevention of recurrence. Tumor-infiltrating lymphocytes (TILs), a subset of ACT, are characterized by their heterogeneity and …

Theta Oscillons In Behaving Rats, M S Zobaer, Nastaran Lotfi, Carli M Domenico, Clarissa Hoffman, Luca Perotti, Daoyun Ji, Yuri Dabaghian

Faculty, Staff and Students Publications

Recently discovered constituents of the brain waves—the oscillons—provide a high-resolution representation of the extracellular field dynamics. Here, we study the most robust, highest-amplitude oscillons recorded in actively behaving male rats, which underlie the traditional θ-waves. The resemblances between θ-oscillons and the conventional θ-waves are manifested primarily at the ballpark level—mean frequencies, mean amplitudes, and bandwidths. In addition, both hippocampal and cortical oscillons exhibit a number of intricate, behavior-attuned, transient properties that suggest a new vantage point for understanding the θ-rhythms’ structure, origins and functions. In particular, we demonstrate that oscillons are frequency-modulated waves, with speed-controlled …

The Genestar Manual For Biospecimen Collection Biobanking And Omics Data Generation From Commercial Space Missions, Aparna Krishnavajhala, Marie-Claude Gingras, Emmanuel Urquieta, Hsu Chao, Dilrukshi Bandaranaike, Yi Chen, Sravya Bhamidipati, Viktoriya Korchina, S Michelle Griffin, Michal M Masternak, Hannah Moreno, Javid Mohammed, Mullai Murugan, Jennifer E Posey, Jimmy H Wu, Donna Muzny, Richard A Gibbs, Harsha Doddapaneni

Faculty, Staff and Students Publications

The surge in commercial and civilian spaceflight enables the systematic and longitudinal, large-scale biospecimen collection to understand the prospective effects of space travel on human health. The Genomics and Space Medicine (Space Omics) project at BCM-HGSC involves a comprehensive biospecimen collection plan from commercial/private space flight participants. The manuscript addresses the critical gaps in the biospecimen collection process including details of the informed consent process, a provision for subjects to obtain custom CLIA-WGS reports, a data dictionary and a LIMS enabled biobank. The manuscript also discusses the biospecimens collection, processing methodologies and nucleic acid suitability for Omics data generation. Results …

Role Of Systemic Therapy In Localized Renal Cell Carcinoma: Where Do We Stand And Where Are We Heading?, Deepa Raghavan, Viktoriya Gibatova, Nikhil Vojjala, Nagaishwarya Moka, Aihua Edward Yen

Faculty, Staff and Students Publications

The effectiveness of immunotherapy and targeted therapy has been well established in metastatic renal cell cancer (mRCC). These therapies demonstrated higher overall response rates and led to prolonged survival. In contrast, in localized RCC, conventional treatment is either partial or complete nephrectomy. While surgery is a curative option in early stages, high recurrence rates remain a concern, with survival rates ranging from 53% to 85%, depending on the initial stage at the time of diagnosis. Given favorable outcomes with systemic therapies in the metastatic setting, there has also been an increased interest in utilizing these therapies for the localized stage …

Genome-Wide Allele-Specific Expression In Multi-Tissue Samples From Healthy Male Baboons Reveals The Transcriptional Complexity Of Mammals, Ramesh Ramasamy, Muthuswamy Raveendran, R Alan Harris, Hiep D Le, Ludovic S Mure, Giorgia Benegiamo, Ouria Dkhissi-Benyahya, Howard Cooper, Jeffrey Rogers, Satchidananda Panda

Faculty, Staff and Students Publications

Allele-specific expression (ASE) is pivotal in understanding the genetic underpinnings of phenotypic variation within species, differences in disease susceptibility, and responses to environmental factors. We processed 11 different tissue types collected from 12 age-matched healthy olive baboons (Papio anubis) for genome-wide ASE analysis. By sequencing their genomes at a minimum depth of 30×, we identified over 16 million single-nucleotide variants (SNVs). We also generated long-read sequencing data, enabling the phasing of all variants present within the coding regions of 96.5% of assayable protein-coding genes as a single haplotype block. Given the extensive heterozygosity of baboons relative to humans, we could …

Characteristics Of Pediatric Patients With Sports-Related Concussions: A Single Site Retrospective Review, Jose A. Cruz Ayala, Shahrukh Khan, Holly Monk, Emma Cole, Alison Smith, Scott Schultz, Lindsay Elliott, Jessica Zagory

School of Medicine Faculty Publications

PURPOSE: Sports-related concussion (SRC) cases have increased among children in the last decade. Differences in concussion symptoms, presentation, and follow-up care exist when comparing demographics. The aim of this study was to explore SRC within the pediatric population. METHODS: A retrospective chart review of patients ≤ 18 years old diagnosed with SRC at a New Orleans stand-alone children's hospital from January 2007 to December 2021 was performed. T-test and Fisher's exact test were used for relationship between outcomes and sports, demographics, setting, insurance, and follow-up care. RESULTS: Children who sustained SRC at practice were more likely to be male (p …

"Bridging Research, Outreach, And Care: Advancing Community-Driven Cancer Solutions", Rachel M. Ceballos Phd​, Angie Fausett Agnp-C, Dnp​, Allison Foust Mha, Mches​

Utah Conference on Community Engagement

"This panel will provide an overview of Huntsman Cancer Institute’s (HCI) collaborative efforts to enhance cancer care through innovative community outreach and local treatment programs, with a specific focus on rural outreach and care. Panelists will discuss HCI’s approach to fostering partnerships with community champions, integrating regional outreach through initiatives like the Mountain West Cancer Collaborative (MWCC), and expanding local treatment options to increase accessibility and equity in care, especially in rural areas. By highlighting how these initiatives align with HCI’s mission to reduce cancer disparities, the panel will emphasize strategies for improving cancer prevention, treatment, and survivorship in underserved …

The Impact Of Race-Corrected Spirometry Results On Eligibility Into An Asthma Clinical Trial, Carina H. Perdew, Bridgette L. Jones, Wumi V. Akinjole

Research Days

BACKGROUND: Spirometry is a widely used pulmonary function test that assesses lung function by examining airflow and capacity. Spirometry measurements assist in the diagnosis, severity classification, and management of asthma, and can affect one’s eligibility into various events (e.g., clinical trials, high-risk jobs, sports). Reference equations are used to establish predicted values to account for biological variables such as age, sex, and height; however past clinical guidelines recommended utilizing race-correction. The incorporation of race may negatively impact people of color due to misrepresentation of one's lung function, consequently impacting future medical management. OBJECTIVES: To characterize differences in spirometry values across …

Delaying Infant Inguinal Hernia Repair Does Not Increase Incarceration Rate, Seth Saylors, Cory Nonnemacher, Charles Snyder, Pablo Aguayo, Richard Hendrickson, Bhargava Mullapudi, Irene Lim-Beutel, Rebecca Rentea, Shawn St. Peter, David Juang, Tolulope Oyetunji

Research Days

Introduction: Inguinal hernia repair is one of the most common pediatric surgical procedures performed with an estimated incidence of 1-5% in children. Patients can present with or without symptoms, with symptomatic hernias (incarcerated or strangulated) that may require emergent or urgent operative intervention. During the Covid-19 pandemic, restrictions, and shutdowns of elective surgeries at our institution resulted in delaying elective inguinal hernia repair unless presenting with more emergent symptoms, with no apparent increase in complication. In our institution, this practice was continued even after COVID restrictions were lifted, with elective repairs delayed until patients were older before completing elective inguinal …

Single-Incision Laparoscopic Ileocecectomy In Pediatric Crohn’S Disease: A 15-Year Experience, Seth Saylors, Cory Nonnemacher, Meredith Elman, Shawn St. Peter

Research Days

Purpose: In refractory Crohn’s disease, the terminal ileum is a common site requiring excision. Laparoscopic ileocecectomy is the procedure of choice and we use a single-incision laparoscopic technique (SILS). We have previously reported our experience with SILS ileocecectomy with a sizeable cohort compared to other series. This project aims to expand on our single institutional experience with SILS ileocecectomy and evaluate the impact of experience.

Methods: We completed a retrospective review of patients who underwent single-incision laparoscopic (SILS) ileocecectomy for Crohn’s disease from 1/1/2009-3/31/2024 at a single institution by a single surgeon. Operative and inpatient characteristics were collected to determine …

Asking About Gender Identity In Pediatric And Adolescent Gynecology Clinic: Patient, Family And Provider Perspectives (The Reflective Study), Madeline Ross, Hariye Sema Baghaki, Hannah Suffian, Lauren Roth, Jeanette Higgins, Tazim Dowlut-Mcelroy

Research Days

Background

The provision of medical and psychosocial support requires the identification of gender diverse individuals in health care settings. However, in primary care settings, some adolescents and parents expressed that gender identity screening (GIS) was offensive and clinicians expressed that GIS negatively affected their workflow. We sought to assess the acceptability and feasibility of GIS in Pediatric and Adolescent Gynecology (PAG) clinics of a large tertiary care children’s hospital in the United States (US) Midwest.

Methods

A GIS survey developed in the US West Coast was modified with permission. After IRB approval, the anonymous single-site cross-sectional survey was administered to …

Emergency Department Utilization For Educational Prioritization For Children By Levels Of Community Advantage, Katherine Randolph, Chris Kennedy, Jennifer Watts, Matt Hall

Research Days

Background: Children with higher social deprivation have higher emergency department (ED) utilization. The Childhood Opportunity Index (COI) is a validated multidimensional measure of community advantage which includes access to resources and healthy neighborhood factors. Educational priorities are frequently not tied to risk data.

Objective: This study aimed to identify zip codes with higher-than-expected ED utilization by diagnoses to prioritize the development of educational initiatives for hospitals, emergency medical services, pediatrician offices, and the community.

Methods: We performed a population-based study of children aged 0-17 years who presented to an ED in Kansas or Missouri in 2023 using census data via …

Variables Affecting Neurodevelopmental Outcome In Infants With Critical Congenital Heart Disease, Elizabeth Loughman, Julie Weiner Do, Marcie Files Md

Research Days

Background: The mortality of cardiac conditions in infancy is improving with advances in surgical planning and medical management. Neurologic morbidity remains significant. Clinically correlating an infant with their neurologic exam, MRI/EEG, and subsequent developmental testing remains a challenge. Counseling regarding neurologic outcomes after cardiac intervention is difficult due to the wide range of findings that can sometimes be clinically irrelevant.

Purpose: The goal of this study is to identify factors associated with poor neurodevelopmental outcomes in infants with critical congenital heart defects (CCHD) as assessed by the Bayley Scales of Infant and Toddler Development Edition IV (Bayley).

Methods: This is …

Implementation Of A Weaning Protocol For Inhaled Nitric Oxide In A Level Iv Neonatal Intensive Care Unit, Elizabeth Loughman, Julie Weiner Do, Maryam El Tawil, Chris Nitkin Md

Research Days

Background: Decrease time to begin iNO weaning from 13 hours to 9.75 hours by 31 December 2024 in patients with persistent pulmonary hypertension of the newborn (PPHN).

Methods: Countermeasures include (1) provider education at each disciplinary level, (2) badge reminder cards and laminated copies of the protocol available at the bedside, (3) order set modifications, (4) abnormality tracking at huddles. Data collection will be automated through weekly Business Objects report. The main outcome measure will be time to first wean of iNO after meeting protocol criteria. Feedback regarding the ease of weaning will be generated via Gemba Rounds.

Results: These …

Preferred And Actual Place Of Death To Assess Goal Concordant End Of Life Care For Children With Cancer, Amy Johnson Md, Mba, Lisa Tarbell Msn, Rn, Fnp-C, Brooke Fridley Phd, Terrie Flatt Do

Research Days

This study examines disparities in pediatric end-of-life (EOL) cancer care, highlighting socioeconomic and racial inequities in concordance between preferred and actual death locations, ICU deaths, and intensive interventions, with findings emphasizing the need for earlier palliative care integration, proactive preference documentation, and tailored approaches to improve equity and family-centered care.

Effect Of Social Determinants Of Health On Clinic Visit Attendance In Patients With Hemophilia, Shailly Gaur Md, Brian Lee Phd, Mph, James Anderst Md, Msci, Katie Foote Lscsw, Lcsw, Osw-C, Andrea Bradley-Ewing Mpa, Ma, Shannon Carpenter Md

Research Days

Background

Social determinants of health (SDOH) create barriers to seeking care regularly, especially for patients with chronic disease. Patients with moderate-severe hemophilia A and B (factor 8 and 9 deficiencies respectively) have a life-long higher risk of bleeding and require chronic therapies. Specialized care is offered through hemophilia treatment centers (HTCs); however, these can be difficult to access for some individuals. Previous SDOH research in this patient population has been limited; therefore, it can be difficult to identify the barriers to care that exist. There is a need to examine SDOH more thoroughly to create patient-directed interventions to improve access …

Intraspinal Anomalies In Presumed Ais Does Not Increase The Risk Of Intraoperative Neuromonitoring Changes During Posterior Spinal Fusion, Connor Mathes, Bill Woodhams, Aaron Shaw, John Anderson, Michael Benvenuti, Richard Schwend

Research Days

This study aims to identify the association between intraoperative neuromonitoring changes during posterior spinal fusion surgery among patients with adolescent idiopathic scoliosis and those found to have intraspinal anomalies on standard preoperative imaging.

Teen And Young Adult Experiences With Intrauterine Device Placement Under Procedural Sedation: A Pilot Study, Ellen Bryant, Stephani L. Stancil, Anne-Marie Priebe, Andrea Nos, Ashli A. Lawson

Research Days

Intrauterine devices (IUDs) are a reliable method of contraception and menstrual management, but uptake of them, especially in the adolescent population, can be limited by concerns for pain and anxiety during the placement procedure. Pain management plans for IUD insertion are recommended prior to placement, but data regarding multiple modes of analgesia and anxiolysis have shown mixed results. This study is designed as a pilot study to analyze adolescent experiences with IUD placement with sedation, as well as to identify patient characteristics that may be associated with a favorable or unfavorable experience.

Implementation Of An Enhanced Recovery After Surgery Pathway In Adolescent Patients Undergoing Laparoscopic Evaluation Of Endometriosis, Lauren Roth Md, Madeline Ross Md, Todd Glenski Md, Emily Weisberg Md, Ashli Lawson

Research Days

This study evaluates the implementation of an Enhanced Recovery After Surgery (ERAS) pathway for adolescent patients undergoing diagnostic laparoscopy for endometriosis at a tertiary children's hospital. The retrospective reviewed included 53 patients (20 pre-ERAS, 33 post-ERAS) aged 12-20 years old, comparing preoperative compliance, intraoperative adherence, and postoperative outcomes. Findings showed 81% compliance with preoperative medication, 76% received appropriate preoperative medications, and 39% had recommended carbohydrate loading. Intraoperative compliance was 87%, with 61% adherence to postoperative medications. Post-anesthesia care unit (PACU) stay time increased (44 vs 53 minutes, p=0.21), but pain scores, postoperative prescriptions, and hospital readmissions remained unchanged. This study …

Impact Of A Multidisciplinary Clinic On Hormone Replacement Therapy In Adolescents With Turner Syndrome, Madeline Ross, Trisha Patel, Ashli A. Lawson, Joseph Cernich, Tazim Dowlut-Mcelroy

Research Days

Background

Turner Syndrome (TS) is associated with primary ovarian insufficiency (POI). Most adolescents with TS require hormone replacement therapy (HRT).1 International guidelines recommend transdermal estradiol (TDE) as first-line estrogen replacement therapy.1 Care within a multidisciplinary clinic (MDC) has been associated with higher adherence to screening guidelines for metabolic and auditory disorders in TS.2 It is unknown if adherence to guidelines for postpubertal HRT differ for adolescents with TS managed in a MDC compared to those managed outside of a MDC. Our study aimed to compare 1) postpubertal HRT regimen prescribed, and 2) compliance to HRT and menstrual bleeding patterns for …

Analytical Verification Of The Fda Cleared Xpert® Xpress Cov-2 Plus Test For Sars-Cov-2 Detection In Respiratory Specimens, Gabriela M. Henriquez, Neena Kanwar, Rangaraj Selvarangan

Research Days

Introduction

The COVID-19 pandemic, caused by SARS-CoV-2, highlighted severe gaps in broad testing and prompt diagnosis. Rapid real-time RT-PCR assay Xpert® Xpress CoV-2 Plus was developed to enhance SARSCoV-2 detection in respiratory specimens. Using ZeptoMetrix's inactivated organisms, this study seeks to assess its analytical performance and compare its accuracy with current standard of care diagnostic assay.

Methods

The accuracy of the Xpert® Xpress CoV-2 Plus test was evaluated using ZeptoMetrix NATtrol inactivated SARS-CoV-2 organisms diluted with pooled negative nasopharyngeal (NP) swabs. Ten positive and ten negative NP swabs were tested over five days at two sites, with >90% agreement required. …

A Novel Approach To The Management Of Extreme Hypernatremia Using Continuous Kidney Replacement Therapy And Hypertonic Saline, Bahar Barani, Xuexin Lu, Darcy Weidemann, Jenna Miller, Nathan Beins, Judith Vansickle, Vimal Chadha

Research Days

Case series about two patients with severe hypernatremia and kidney failure who were treated with a novel mechanism using continuous dialysis and customized fluids with good outcomes.

Bivalirudin Versus Heparin In Patients With Congenital Diaphragmatic Hernias Requiring Extracorporeal Life Support, Cory Nonnemacher, Seth Saylors, Vatche Melkonian, Richard Hendrickson, Inna Lobeck

Research Days

Introduction

Congenital Diaphragmatic Hernia (CDH) is a rare congenital anomaly. The pulmonary hypoplasia, pulmonary hypertension and altered cardiac function associated with CDH may result in early cardiorespiratory failure requiring life-saving extracorporeal life support (ECLS). Early repair of CDH on ECLS has shown to improve survival, but poses an increased bleeding risk due to anticoagulation. Heparin has traditionally been the anticoagulant of choice for ECLS. Recent data has suggested that the use of bivalirudin may result in lower bleeding rates and transfusion requirements. This study aims to stratify complications for patients with CDH repaired on heparin versus bivalirudin, hypothesizing that complications …

Spinal Deformity Characteristics Associated With Intraspinal Anomalies In A Population Of Presumed Ais, Connor Mathes, Aaron Shaw, Bill Woodhams, John Anderson, Michael Benvenuti, Richard Schwend

Research Days

This study aims to identify an association between pre-operative radiographic criterion and the presence of an underlying intraspinal anomaly in patients presenting with presumed adolescent idiopathic scoliosis undergoing posterior spinal fusion.

Adherence To Oral Iron In Adolescent Females With Iron Deficiency Secondary To Heavy Menstrual Bleeding, Kennedy Sheedy, Lauren Amos Md, Ms

Research Days

Iron deficiency is an important, but often minimized issue among adolescent females. While treat with oral iron is generally first-line treatment, IV iron has been shown to be safe and effective. Our study looks at adherence and barriers to oral iron treatment and assesses current use of IV iron for iron deficiency at Children's Mercy, in hopes of helping move towards utilizing the most beneficial treatment for each individual patient.