Pediatrics Commons^™

Blaschko-Linear Lupus Erythematosus In A Pediatric Patient, Marshall Hall, Olivia Mayer, Henry Lim, Dustin V. Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

The lines of Blaschko represent epithelial cell migration during embryonic development. Rare forms of cutaneous lupus erythematosus may manifest along these lines, and lesions are termed Blaschko-linear lupus erythematosus (BLE). The purpose of this case study is to present a rare manifestation of linear cutaneous lupus erythematosus following the lines of Blaschko in a pediatric patient. To date, there are very few reports of BLE. We present a 17-year-old female with a 2-month history of a mildly tender growing lesion along the right nasofacial sulcus. The patient denied lesions elsewhere and any systemic, joint, or mucosal symptoms. A biopsy of …

Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide

HCA Healthcare Journal of Medicine

More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered …

An Unusual Case Of Bilateral Upper And Lower Oral Cavity Cysts In A Newborn, Frances Rodriguez Lara, Jillian L. Chen, Jennifer N. Shehan, Jessica R. Levi

HCA Healthcare Journal of Medicine

Background

Oral mucosal lesions in newborns have a broad differential diagnosis, ranging from benign, transient conditions to potential early signs of systemic disease. Most of these lesions are resolved without intervention, but delayed recognition can lead to complications, such as airway obstruction. Early identification is crucial for appropriate management. This case report discusses an unusual presentation of multiple oral mucosal cysts in a newborn, emphasizing the challenges of diagnosis and management.

Case Presentation

A 1-day-old male was evaluated at Boston Medical Center for cystic oral lesions identified during newborn screening. The infant was born at 36 weeks and 2 days’ …

Building A Better Clinical Competency Committee: A Multi-Institutional Approach To Improving The Quality Of Resident Feedback Through Appreciative Inquiry, Nikita Khetan, Emma Omoruyi, Elizabeth Hanson

HCA Healthcare Journal of Medicine

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.

Methods

This project was conducted with pediatric residents and faculty during the 2019–20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center …

Isolated Clonidine Ingestions In Pediatric Patients, Spencer Greene, Caleb King, Sharan Campleman

Gulf Coast Division GME Research Day 2026

No abstract provided.

Reducing Respiratory Viral Testing In A Pediatric Emergency Department: A Quality Improvement Initiative, Anna Suessman

North Texas GME Research Forum 2026

Background: Respiratory viral testing in pediatric emergency departments (EDs) is frequently performed despite limited impact on clinical management for many low-risk presentations. Unnecessary testing increases cost and operational burden may delay patient throughput and can provide false reassurance to caregivers. Additionally, pediatric emergency department nurses agreed with overburden and impact to throughput based on overuse of viral testing (qualitative nursing survey conducted on September 4, 2024 showed >98% felt testing was unnecessary). We hypothesized that reducing testing through standardized team education and discharge processes would not negatively affect patient experience. This initiative aimed to decrease unnecessary respiratory viral testing during …

Nitrous Oxide Vs. Ketamine: Impacts On Pediatric Emergency Department Length Of Stay, Tabitha Brock, Anna Suessman

North Texas GME Research Forum 2026

Background Nitrous oxide (N₂O) is a well-established analgesic and anxiolytic agent, widely used for procedural sedation in pediatric dentistry. Despite its demonstrated safety and efficacy, its use in Pediatric Emergency Departments (PEDs) remains limited and underexplored. To address this gap, we implemented a comprehensive training program for PED providers and introduced N₂O as an alternative sedation agent.

Objective We hypothesized that using N₂O for procedural sedation would significantly reduce patient length of stay (LOS) without compromising safety or outcomes.

Methods We conducted a retrospective chart review of pediatric patients who underwent painful procedures in a tertiary children’s hospital emergency department. …

Stronger Together: A Resident-Led Initiative Advancing School Nurse Readiness In Pediatric Seizures And Pediatric Cardiology, Shana-Kay Lambert-Johnson, Amy Nguyen-Pham, Tony Do, Devika Adusumilli, Jorim Parmar, Dimitar Semerdzhiev, Elizabeth White, Joanna John, Myrna Garcia, Nicholas Gerden, Tasaduq Mir, Michele Mccarroll

North Texas GME Research Forum 2026

BACKGROUND: School nurses play a vital role in safeguarding the health and safety of children by serving as frontline providers within the school setting. Timely recognition and appropriate management of acute medical conditions can reduce morbidity, prevent unnecessary emergency department utilization, and improve long-term outcomes. Needs assessment surveys identified knowledge and confidence gaps among school nurses related to pediatric seizure management and pediatric cardiology.

METHODS: This prospective educational quality improvement initiative was conducted across the Dallas–Fort Worth (DFW) region during the 2025-2026 academic year. Over 25 residents served as curriculum developers and educators, creating and delivering evidence- and case-based education …

Ed Presentation Of Pediatric Suprasellar Mass Presenting As Headache With New-Onset Seizure, Pranav Bommineni, Arjavon Talebzadeh, Michael Beck

South Atlantic Division GME Research Days 2026

No abstract provided.

Changing Practice: Optimizing Head Ct-Imaging In Pediatric Trauma Patients At A Community Level Ii Pediatric Trauma Center - A Quality Improvement Initiative, Matthew Daniel, Aaron Worthley, Sarah Johnson, Daniel Saad, Antonio Pepe, Eleah Porter

South Atlantic Division GME Research Days 2026

No abstract provided.

Staphylococcal Scalded Skin Syndrome In Melanated Skin: A Pediatric Case Report, Aleah Lafrancis-Ream, Scott Gutovitz, Hannah Chotiner

HCA Healthcare Journal of Medicine

Background

Staphylococcal scalded skin syndrome (SSSS) is a dermatologic emergency that most commonly affects young children, requiring prompt recognition and treatment to avoid severe symptoms and fatal sequelae. It is characterized by a desquamation of the skin caused by exotoxins produced by the Staphylococcus aureus species and may present differently in melanated skin.

Case Presentation

Our case describes a 6-month-old Black infant girl who presented to the emergency department with SSSS that was unrecognized on 2 prior encounters. This delay in diagnosis and the misapplication of topical antibacterial agents and steroids may have contributed to the worsening of her symptoms …

Can The Combination Of White Blood Cell Count And C-Reactive Protein Rule Out Pediatric Appendicitis, A Retrospective Analysis?, Scott Gutovitz, Samantha Stoner, Jarrett Koper, Sarah Kleist

HCA Healthcare Journal of Medicine

Background

Pediatric appendicitis (PA) is the most frequent cause of pediatric emergency surgery. Standard PA scoring systems incorporate inflammatory biomarkers (white blood cell count [WBC] or C-reactive protein [CRP]); however, the individual biomarker sensitivities have not been reported beyond single-center sites. We aimed to measure the individual and combined sensitivities of WBC and CRP to rule out PA in a large multicenter hospital system.

Methods

We did a retrospective study of pediatric emergency department patients (age <18) with abdominal pain, using a deidentified electronic health database from a 175-hospital system in the United States, comparing PA versus non-PA patients. Pediatric appendicitis patients were identified by ICD-10 diagnosis codes and had advanced imaging, whereas non-PA patients had advanced imaging and were discharged home with the ICD-10 code for abdominal pain. Using matched propensity matching, we calculated receiver operator characteristics and Youden’s index to find the optimal cutpoints. Sensitivity was calculated at the optimal and traditional cutpoints for each biomarker, also combined in parallel fashion.

Results

We identified 7414 subjects (3707 PA matched to 3707 controls). The WBC in PA patients was 14.99 ± 5.00 k/mm³ versus 9.63 …

Using Dexcom G7 In Critically Ill Infant With Hyperinsulinemia On High Frequency Oscillatory Ventilation Support, Chad E. Ward, Timothy Clark, Eric Velezquez

HCA Healthcare Journal of Medicine

Introduction

Life threatening hypoglycemia can occur during critical illness in infants with underlying hyperinsulinemia or metabolic conditions, such as glycogen storage diseases. Using a continuous glucose monitor (CGM) can provide insight into glycemic trends with this high-risk patient population in the intensive care setting. Barriers to usage of CGMs in the intensive care unit include familiarity with CGMs devices among staff, safety, and cost.

Case Presentation

We describe the first reported case of safely utilizing the newest Dexcom G7 continuous glucose monitor in an infant with hyperinsulinemia undergoing high frequency oscillatory ventilator (HFOV) support for acute respiratory distress syndrome (ARDS) …

Skin Manifestations And Related Clinical Characteristics Of Multisystem Inflammatory Syndrome In Children: A Descriptive Retrospective Cohor Study At Texas Children's Hospital, Matthew Penna, Lauren Pupa, Grace Lee, Soo Jung Kim

Gulf Coast Division GME Research Day 2025

No abstract provided.

Autism Prevalence And Appropriate Care Analytics, Brittany Bare, Final Patel, Peyton Dekle, Jessica Donaldson

South Atlantic Division GME Research Day 2025

No abstract provided.

Distinguishing Narcolepsy Hallucinations From Drug-Induced Hallucinations In An Adolescent With Comorbidities, Avidor Gerstenfeld, Biwy Emmanuella Cadet, Salma Alkhatib, Annette Santiago

East Florida Division GME Research Day 2025

No abstract provided.

Closing The Communication Gap: A Quality Improvement Approach To Safer Shift Changes And Transfers, Stephanie O'Kresik Jewette, Annette Santiago

East Florida Division GME Research Day 2025

No abstract provided.

Seizure Action Plan, Ian Holt, Sy Jama

East Florida Division GME Research Day 2025

No abstract provided.

Breaking The Blockade: A Retrospective Analysis Of Pediatricconstipation In Hospitalized Patients, Yenamala Reddy, Jaicy Pottokaran, Eric K. Shaw, Aimee Behnke, Jean B. Wiggins, Lauren Hebert, Norman Taylor Parks

South Atlantic Division GME Research Day 2025

No abstract provided.

Incontinentia Pigmenti Diagnosed In Newborn Nursery, Virginia Ramsey Aldrich, Andrea Heuser

South Atlantic Division GME Research Day 2025

No abstract provided.

Atypical Hemolytic Uremic Syndrome Following Influenza B: A Case Report, Kathryn E. Mcgraw, Amanda P. Porter, Alyssa M. Moffitt, Marina E M Golden, Heather Stewart

HCA Healthcare Journal of Medicine

Background

Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy that presents with a triad of hemolytic anemia, thrombocytopenia, and acute kidney impairment. It can be attributed to mutations in an array of different complement proteins leading to the overactivation of the complement system, the most impacted being the alternative pathway. Though rare, influenza B has been documented as a potential trigger to the development of aHUS.

Case Presentation

We discuss a 10-year-old girl with a history of aHUS who was found to have a repeat episode of aHUS following an influenza B infection. There have only been a few …

Osteopathic Manipulative Techniques (Omt) In Concussion Management: A Literature Review, Sushil Talreja, Annette Santiago

East Florida Division GME Research Day 2024

No abstract provided.

Reactive Infectious Mucocutaneous Eruption Secondary To Mycoplasma Pneumoniae, Final Patel, Michael Bossak, Natalie Hogan

South Atlantic Division GME Research Day 2024

No abstract provided.

Devastating Cerebral Injury Prior To Dka Therapy -Case Report, Brittany Bare, Chandler Sapp, Evelyn Fagan, Sunil Keshwah

South Atlantic Division GME Research Day 2024

No abstract provided.

Decreasing Blood Culture Contamination At A Children’S Hospital, Taylor Pearl, Brittany Bare, Ricardo Zegarra-Linares, Jessica Lee

South Atlantic Division GME Research Day 2024

No abstract provided.

Eikenella Corrodens Orbital Cellulitis On A 2 Year Old Boy: A Case Report, Juan F. Bedoya, Ricardo Zegarra-Linares, Meena Dhir

South Atlantic Division GME Research Day 2024

No abstract provided.

Cerebral Sinus Venous Thrombosis In A 5-Year-Old Male With Relapsed Nephrotic Syndrome, Amanda L. Stragnell, Andrea Horbey, Annette Santiago

East Florida Division GME Research Day 2024

No abstract provided.

Pediatric Quick Reference Dosing Guide, Alexander E. Teshon, Caleb Marcy, Himanshu Gupta, Urvashi Barua-Nath

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

A Nicu Quality Initiative To Decrease Unsatisfactory Newborn Screen Samples, Karina Patel, Emily Ward, Eric Shaw, Palmer Johnston

South Atlantic Division GME Research Day 2024

No abstract provided.

Beyond The Bruise/Swelling And Ear-Resistible Issues: Exploring The Etiology, Management, And Complications Of Auricular Hematoma, Jenny Tran, Annette Santiago

East Florida Division GME Research Day 2024

No abstract provided.