Pediatrics Commons^™

Exploring Adolescent Hearing Aid Usage And Appearance Of Psychiatric Symptoms In Adolescents Using Hearql-28 Surveys, Courtney J. Austin, Dylan Chan

MEDI 9331 Scholarly Activities Clinical Years

Approximately 2% of DHH people in need of mental health services actually receive these services. Among pediatric hearing loss populations, co-occurring cognitive and physical impairments are risk factors for poor mental health status. Due to language barriers and isolation, more children with hearing loss do not have access to mental health services. Cochlear implants have been shown to improve mental health status among the DHH population. Current literature focuses on the mental health status of children with cochlear implants, with little focus on hearing aid users. Using HEAR28 data and surveys, we can quantify the incidence of psychiatric symptoms among …

Prior Head Circumference Measurements In Infants With Older Subdural Hematomas: Did We Miss It?, Maryann Alvarez Griffis, Nancy D. Kellogg, Wouter Koek

School of Medicine Publications

Objective: To establish whether infants with macrocephaly and non-acute subdural hematomas (SDHs) had missed opportunities for measuring fronto-occipital circumference (FOC) and obtaining neuroimaging prior to diagnosis. Macrocephaly due to SDH in infancy is initially detected by FOC measurements and/or neuroimaging, as neurologic symptoms may be subtle or missed.

Methods: Retrospective chart review of infants with macrocephaly and non-acute SDHs referred to child abuse pediatricians for suspected abusive head trauma (AHT) over an 8-year period. A study sample of 35 infants met inclusion criteria and had complete prior medical records which were reviewed for missed opportunities for earlier SDH diagnosis. Four …

Atypical High-Burden Breakthrough Varicella: A Diagnostic Pitfall In The Two-Dose Vaccine Era, Smaran Marupudi, Jared Hensley, Robert Vezzetti

School of Medicine Publications

We present the case of a seven-year-old fully immunized male who developed an intensely pruritic, generalized maculopapular rash that progressed to vesicles. The patient’s rash was initially diagnosed by his primary care provider as possible scabies and treated with topical permethrin. Our examination revealed a diffuse maculopapular and vesicular exanthem with lesions at various stages of evolution, eventually progressing to secondary cellulitis. The patient’s presentation, consistent with varicella (chickenpox), highlights the diagnostic challenges of breakthrough varicella infection and potential complications in fully vaccinated children. Thus, we highlight the importance of having a high clinical index of suspicion for varicella, even …

Emergent Bedside Re-Sternotomy: An Innovative Simulation Model For Training Pediatric Cardiac Intensive Care Teams, Toluwani Akinpelu, Nikhil R. Shah, Mohammed Alhendy, Malarvizhi Thangavelu, Karen Weaver, Nicole Muller, James Mcelroy, Utpal Bhalala

School of Medicine Publications

Introduction: Cardiac tamponade after cardiac surgery is a life-threatening event that requires simultaneous resuscitation and emergent re-sternotomy by the intensive care team. A simulated scenario using an innovative mannequin with sternotomy wound has the capability of reproducing cardiac arrest associated with postoperative tamponade. We evaluated the validity of this mannequin to investigate the confidence level and crisis resource management skills of the team during bedside re-sternotomy to manage postoperative cardiac tamponade.

Methods: The simulation scenario was developed using the sternotomy mannequin for a pediatric cardiac intensive care unit (CICU) team. The case involved a 3-year-old male, intubated, mechanically ventilated after …

Improving Outcomes In Pediatric Congenital Heart Disease: The Integration Of Wearable Technology And Ai-Driven Analysis, Sophia Moon, Melissa Cruz, Pad Renga

Research Colloquium

Background: Wearable devices such as biosensors and smartwatches have demonstrated clinical utility in arrhythmia detection in adult populations, but their integration into pediatric congenital heart disease (CHD) care remains limited. Despite advances in CHD management, challenges persist in the timely identification of arrhythmias in children. The use of wearables in pediatrics is constrained by research gaps, adherence issues, and complex data interpretation. Traditional tools like Holter monitors and event recorders face limitations in detecting intermittent arrhythmias and ensuring compliance. These devices cannot leverage artificial intelligence (AI) and machine learning (ML) to enhance ECG interpretation. This study analysis evaluates the potential …

Educational Services And Language Congruency In Low-Income Children Who Are Deaf Of Hard-Of-Hearing, Courtney J. Austin, Dylan Chan, Jihyun Stephans

Research Colloquium

Background: Children who are deaf or hard-of-hearing (DHH) are required by United States law to have access to educational services through the Individuals with Disabilities in Education Act (IDEA). However, access to language-congruent providers, as well as supplemental services, varies considerably. Household income is associated with poorer hearing care access and outcomes in DHH children. We predict that access to supplemental, language-congruent DHH services is poorer in DHH children from lower-income homes.

Methods: This is a secondary, ad hoc exploratory study of DHH children aged 0-27 months enrolled in a randomized clinical trial (CT.gov: NCT04928209). Children were enrolled across all …

Long-Term Neurocognitive And Behavioral Outcomes In Survivors Of Pediatric Brain Tumors: A Systematic Review, Tori Sayers, Megan W. Szobody, Nina Mourao, Blake C. Martin, Sriya Gullapalli, Kory Punch, Tirath Patel, Murali Yallapu, Bharathi Shrikanth Gadad

Research Symposium

Background: Pediatric populations have an increased susceptibility for brain tumors and suffer from neurocognitive impairment due to the neoplasm itself, and side effect of subsequent treatments. This causes many patients to experience a subpar quality of life (QoL), affecting academic endeavors, social interaction and mental well-being. Increasing our understanding of the long-term effects associated with brain tumors and the side effects from our current treatment methodology will help us formulate better treatment protocols and improve survivors’ QoL. This review aims to investigate different long-term neurocognitive and behavioral outcomes in pediatric brain tumor survivors, as well as evaluate how various treatment …

Maternal Health And Congenital Heart Defects: Investigating Ventricular Septal Defects In South Texas Region 11, Miguel A. Lopez, Sophia Moon, Jonathan M. Hebert, Padmanabhan Rengasamy

Research Symposium

Congenital heart defects are a known risk factor for early childhood mortality and can be traced to poor maternal health, a crisis plaguing the South Texas region. This perspective research project utilizes previously computed data on the prevalence of ventricular septal defects (VSD) in South Texas region 11 combined with a comprehensive literature review to investigate the correlation between both maternal obesity and diabetes with VSD. Current literature supports a significant association between maternal diabetes and VSD, with one Russian study reporting an eight to nine fold increased risk in VSD in children born to diabetic mothers. By contrast, the …

Clinical Relapse Versus Treatment Failure: The Case For Surveillance For Re-Appearance Of Minimal Measurable Disease In Pediatric Patients With Higher Risk B-All, Paul S. Gaynon, Linwei Li

Research Symposium

Background: Despite significant advancements in the treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL), chemotherapy has reached its end of “intensification” stage despite improvements in supportive care. Moreover, relapse remains a major challenge, particularly in high-risk populations such as adolescents and young adults (AYAs). The definition of threshold for clinical relapse as 25% presence of marrow lymphoblasts was established decades ago, which may be incoherent with current therapeutic strategies and delay the window for timely treatment for relapsed patients. Emerging data suggest that early detection of minimal residual disease (MRD) may offer an opportunity to intervene before clinical relapse, improving …

Utilidad De La Combinación De Los Biomarcadores: Procalcitonina, Proteína C Reactiva Y Volumen Plaquetario Medio En El Diagnóstico Temprano De Sepsis Neonatal [Usefulness Of The Combination Of Biomarkers: Procalcitonin, C-Reactive Protein And Mean Platelet Volume In The Early Diagnosis Of Neonatal Sepsis], Oscar Manuel Berlanga Bolado Jr, Patricia Rivera Vazquez, Arely Socorro Hernández García, Angelica Lizbeth Martinez Ortiz

Research Symposium

Introducción: La sepsis neonatal es una causa frecuente de morbilidad y mortalidad infantil. Se le ha definido como un síndrome clínico caracterizado por signos sistémicos de infección, acompañado de bacteriemia en el primer mes de vida. Por lo tanto, el diagnóstico temprano es fundamental.

Objetivo: Conocer la sensibilidad y especificidad de la combinación de biomarcadores séricos como procalcitonina, proteína C reactiva y volumen plaquetario medio en el diagnóstico temprano de sepsis neonatal.

Material y métodos: Estudio clínico, de tipo prospectivo, predictivo, observacional, analítico, longitudinal y conveniencia. Se analizaron los biomarcadores como PCT, PCR, VPM para diagnosticar sepsis neonatal. Se incluyeron …

Clinical Relapse Versus Treatment Failure: The Case For Surveillance For Re-Appearance Of Minimal Measurable Disease In Pediatric Patients With Higher Risk B-All, Paul S. Gaynon, Linwei Li

School of Medicine Publications

No abstract provided.

Microglia In Post-Mortem Hippocampal Brain Tissue Of Male And Female Neonates After Hie, Kassandra M. Pulido, Angela N. Viaene, Amelia J. Eisch, Danielle G. Barber

Research Colloquium

Background: Hypoxic-ischemic encephalopathy (HIE) is the second-leading cause of neonatal morbidity and mortality worldwide. There are sex differences in the pathophysiology of HIE, particularly in microglia, which are critical in the immune response. Prior work highlights microglial aggregation in the hippocampus of human infants as a marker for HIE, but it is unknown whether this differs by sex.

Aim: We compare the microglial response in post-mortem hippocampal tissue from male and female neonates diagnosed with HIE vs. Controls who expired from other causes.

Methods: Using a retrospective cohort design, we reviewed medical records of neonates with hippocampal tissue in the …

Can We Predict Dominant Compensatory Curves In Congenital Scoliosis?, Myung-Jin Cha, William Elnemer, Paul D. Sponseller

Research Colloquium

Background: A complication in the natural evolution of congenital scoliosis is the development of a compensatory curve. Congenital curves are often focal and rigid, causing patients to develop a compensatory curve cranial and/or caudal to the congenital anomaly to achieve coronal balance. Therefore, surgeons are faced with the difficult choice of waiting for the patient to reach an appropriate age for surgery or correcting the congenital curve before a compensatory curve develops.

Methods: By searching the Pediatric Spine Study Group database, we identified 307 pediatric patients (age <18) with congenital scoliosis who had preoperative radiographs taken during at least 2 years of natural growth (without bracing or surgery). Of these patients, 17 (5.5%) had a dominant compensatory curve, and 290 had no compensatory curve or one that was smaller than the congenital curve. Of those 290 patients, we randomly selected 100 to serve as a control group, referred to as the nondominant curve cohort. We extracted data on the type of congenital anomaly and its vertebral level, as well as the Cobb angles of the congenital and compensatory curves at initial and latest follow-up. We compared vertebral level and type of congenital anomaly via chi-squared test between the dominant and nondominant curve group.

Results: The congenital anomaly was located at L4 or more caudal in 18% …

Rates Of Bronchopulmonary Dysplasia In Very Low Birth Weight Neonates: A Systematic Review And Meta-Analysis, Alvaro Moreira, Michelle Noronha, Jooby Joy, Noah Bierwirth, Aina Tarriela, Aliha Naqvi, Sarah Zoretic, Maxwell Jones, Ali Marotta, Taylor Valarie

MEDI 9331 Scholarly Activities Clinical Years

Importance: Large-scale estimates of bronchopulmonary dysplasia (BPD) are warranted for adequate prevention and treatment. However, systematic approaches to ascertain rates of BPD are lacking.

Objective: To conduct a systematic review and meta-analysis to assess the prevalence of BPD in very low birth weight (≤ 1,500 g) or very low gestational age (< 32 weeks) neonates.

Data sources: A search of MEDLINE from January 1990 until September 2019 using search terms related to BPD and prevalence was performed.

Study selection: Randomized controlled trials and observational studies evaluating rates of BPD in very low birth weight or very low gestational age infants were eligible. Included …

Building Equitable Mental Health Care For Latino Children: Perspectives From Providers And Communities, Francisco Banda, Greeshma James, Karina Vasudeva, Michelle Franklin, Andrea Thoumi, Rushina Cholera

Psychological Science Faculty Publications

Background: The current pediatric mental health crisis has disproportionately impacted Latino youth in the United States (US), as demonstrated by their elevated risks of depression, substance use disorder, and anxiety. Despite this, research suggests Latino youth receive inequitable mental health services.

Objective: To understand best practices, challenges, and priorities in providing accessible and equitable mental health care for Latino youth from the perspectives of front-line mental health providers and Latino community members.

Methods: A bicultural, bilingual researcher conducted semi-structured interviews with 20 participants with expertise in Latino mental health. Topics included barriers and facilitators to mental health care access and …

Multisystem Inflammatory Syndrome In Children (Mis-C): Is There A Relationship To Typhus?, Sravani Mannuru, Juliana Hager, Jacob Smith

Research Colloquium

The United Kingdom first reported in April 2020 a group of eight previously healthy children with a link to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that presented with systemic inflammation and multi-organ involvement, now named multisystem inflammatory syndrome in children (MIS-C). The Centers of Disease Control and Prevention (CDC) have reported over 1000 cases since the primary discovery as of October 2020 with 20 total deaths. [1] The clinical features of MIS-C have been previously compared to inflammatory syndromes including Kawasaki disease (KD) and toxic shock syndrome (TSS). We describe the clinical presentation and management for 3 pediatric cases with …

Rotator Cuff Injury In The Pediatric Population: A Systematic Review Of Patient Characteristics, Treatment, And Outcomes, Kevin J. Orellana, Kathleen L. Harwood, John G. Horneff 3rd, Joseph J. King, Brendan A. Williams

Research Colloquium

Background: Rotator cuff injuries (RCIs), traditionally thought to be an adult-type pathology, have been reported in the pediatric population, but there remains limited evidence regarding this injury pattern in pediatric patients. The purpose of this study was to systematically review the literature to characterize the epidemiology, injury patterns, treatment modalities, and outcomes for pediatric patients with RCIs.

Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines reviewing Pubmed, Embase, Cochrane, and CINAHL databases. Studies reporting imaging confirmed RCIs and treatment outcomes in patientsdemographics, mechanism, injury type and injury location were …

Trauma Center Designation Effects On Clinical Outcomes In Pediatric Dog Bites: A Retrospective Study, Jessy Feng, Sabrina Orta, Alejandro Aquino, Lori Berry, Demba Fofana, Paul Berry

Research Colloquium

Introduction: Clinical outcomes associated with the American College of Surgeons (ACS) trauma center designation have been examined for many conditions. However, we sought to analyze the association between ACS pediatric trauma center designation and outcomes following pediatric dog bite trauma cases, which has rarely been studied.

Methods: The National Trauma Data Bank was queried to identify pediatric (0-19y) dog bite trauma patients admitted to ACS pediatric level I or II trauma centers from 2007-2016. Chi-Squared and Odds Ratio statistical analyses were used to compare the outcomes.

Results:We identified 6,196 pediatric dog bite trauma patients treated at ACS level …

Autoimmune Encephalitis Of Unknown Etiology, Elizabeth Cook, Giselle Ricoy

Research Colloquium

Encephalitis is the inflammation of the brain which can come about through various etiologies. Autoimmune encephalitis is a rare form that is most common among women and children. The clinical presentation can vary between patients with a constellation of symptoms including deficits in memory, cognition, seizures, abnormal movement, psychosis, and coma. Because of the variation in clinical presentation and the lack of specificity in imaging and laboratory findings, diagnosis and intervention are often delayed for months to years. These delays in diagnosis can have long term ramifications on patients especially pediatric patients whose neural pathways are still developing. In pediatric …

Pediatric Covid-19 Encephalitis, Nelson D. Gonzalez, Dustin Paul, Ana Almeda, Samuel Serna, Linette Linsangan

Research Symposium

Background: Neurologic complications of COVID-19 in the pediatric population have been reported in a limited number of reports. There have been reports of COVID-19-associated encephalitis in pediatric cases along with neuroimaging findings revealing involvement of some parts of the nervous system. We present the first case of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - associated encephalitis targeting the parietal lobes.

Case: A 14-year-old morbidly obese Hispanic male with no past medical history presented to the hospital for new onset seizures. Family reported exposure to his COVID-19 positive mother, a one-week history of fever, and a three-month history of …

Vitamin D Deficiency Among Children And Adolescents Living In Sunny South Texas, Yoscelina E. Martinez-Lopez, Margarita Faz, Beatriz Tapia, Juan C. Lopez-Alvarenga, Francisco J. Cervantes

Research Symposium

Background: Exposure to sunlight is essential to produce Vitamin D (ViD). Recent studies suggest obesity is associated with low ViD concentration. Living in South Texas with 220 sunny days a year should be enough to maintain adequate ViD levels. We aimed to analyze ViD levels and obesity in children and adolescents.

Methods: We included 1239 pediatric (1.5 to 18.8 years old) participants (primary care clinic from Laredo) with registered CDC percentiles of BMI (pBMI) and serum concentrations of ViD (Atellica™). Data are described as median (p25, p75), Loess correlation between pBMI and ViD, ANCOVA to adjust by age, sex, and …

Cardiac Tamponade: Innovative Sternotomy Simulation Model For Training Pediatric Cardiac Intensive Care Team, Tolu Akinpelu, Mohammed Alhendy, Malarvizhi Thangavelu, Karen Weaver, Nicole Muller, James Mcelroy, Daniel Nento, Utpal Bhalala

Research Symposium

Introduction: Cardiac tamponade occurring after cardiac surgery is rare but life threatening and requires simultaneous resuscitation and emergent sternotomy by the intensive care team. A simulated scenario using innovative mannequin with sternotomy wound has the capability of reproducing cardiac arrest associated with postoperative tamponade. We evaluated the face validity of this innovative mannequin, the confidence level and crisis resource management skills of the team during sternotomy to manage postoperative cardiac tamponade.

Methods: The simulation case scenario was developed using innovative sternotomy mannequin for children’s hospital cardiac intensive care unit (CICU) teams. The case involved a 3-year old male, intubated, mechanically …

Heart Rate Variability (Hrv) Loss And Other Ekg Changes Prior To A Cardiopulmonary Event In Children Admitted To The Icu At A Tertiary Care Children’S Hospital, Sabrina R. Orta, Shreya Chandran, Utpal Bhalala

MEDI 9331 Scholarly Activities Clinical Years

Introduction: HRV and EKG changes prior to cardiopulmonary events (CPEs) occurring in children in intensive care unit (ICU) settings is not well documented. We assess if substantial losses of HRV and/or other EKG changes, if any, may be detectable prior to a CPE occurring in children admitted to the ICU.

Methods: A prospective observational cohort study was conducted in the ICU from January to February of 2023 at Driscoll Children’s Hospital. A “CPE” was defined as a change in the clinical status of a child warranting a cardiopulmonary intervention. Demographic and clinical data from each patient was collected, …

Primary Middle Meningeal Artery Embolization For A Chronic Subdural Hematoma After Non-Accidental Trauma In A Child: A Case Report, Saisree Ravi, Sohum Desai, Ameer E. Hassan, Wondwossen G. Tekle

School of Medicine Publications

Chronic subdural hematoma in children can be pathognomonic of abusive head trauma. Treatment options for these range from observation to surgical evacuation depending on clinical circumstance and presenting features, which can include mental status changes, headaches, focal neurologic deficits, or asymptomatic presentation. Standalone endovascular treatments represent an area of growing interest in the adult population as an effective treatment modality. However, embolization as a singular treatment approach has not been reported in the pediatric population. We report the first case of stand-alone middle meningeal artery (MMA) embolization of a chronic subdural hematoma as a sequela of abusive head trauma in …

Complex Chromosomal Rearrangement Involving 15q11‐Q13 Interstitial Triplication And Duplication: A New Case Report Of Dysmorphic And Neuropsychiatric Features, Lekha Chilakamarri, Lizbeth Mellin

MEDI 9331 Scholarly Activities Clinical Years

Our patient is the first to encompass the full spectrum of reported features related to tetrasomy of the Prader–Willi Angelman Critical Region. She has a complex chromosomal rearrangement including an interstitial triplication reported in twelve cases till date and a rare interstitial duplication reported in only four cases till date.

Complex Chromosomal Rearrangement Involving 15q11-Q13 Interstitial Triplication And Duplication: A New Case Report Of Dysmorphic And Neuropsychiatric Features, Lekha Chilakamarri, Estrella Lizbeth Mellin-Sanchez

School of Medicine Publications

Our patient is the first to encompass the full spectrum of reported features related to tetrasomy of the Prader–Willi Angelman Critical Region. She has a complex chromosomal rearrangement including an interstitial triplication reported in twelve cases till date and a rare interstitial duplication reported in only four cases till date.

Primary Hyperhidrosis In Children: A Review Of Therapeutics, Courtney Remington, Jennifer Ruth, Adelaide A. Hebert

School of Medicine Publications

Primary hyperhidrosis, an idiopathic disease that commonly affects the palms, soles, axillae, or craniofacial region, is characterized by perspiration in excess of what is required for physiologic cooling. This disease begins in childhood or adolescence and negatively impacts emotional, physical, and psychologic well‐being. This review explores current therapeutic options for primary hyperhidrosis in the pediatric population, including topical therapies, oral therapies, non‐surgical and procedural interventions, and adjunctive therapies. In addition, this review identifies new and emerging treatments and highlights the need for further research and therapeutic options for this impactful disease.

Telehealth Care And Its Role In Undergraduate Medical Education In The Covid-19 Era., Peter J. Gonzalez, Dustin J. Paul

MEDI 9331 Scholarly Activities Clinical Years

Background

On March 17, 2020, the American Association of Medical Colleges issued a statement which “strongly supports medical schools pausing all student clinical rotations, effective immediately, until at least March 31.” The University of Texas Rio Grande Valley School of Medicine immediately withdrew third- and fourth-year students from clinical rotation sites, and developed alternative, online-based clerkship curricula to complete for the remainder of the academic year. The COVID-19 pandemic has brought about many challenges to Undergraduate Medical Education, and has deprived upper-level students of foundational, in-person, clinical experiences. The UTRGV School of Medicine Department of Neurology is among the first …