Pediatrics Commons^™

Pharmacokinetic Profiles Of Sertraline In Pregnancy As A Predictor Of Postpartum Depressive Symptoms, Sílvia M. Illamola, Zachary N. Stowe, Marc L. Kalin, Michael D. Evans, Catherine M.T. Sherwin, Maged M. Costantine, D. Jeffrey Newport, James C. Ritchie, Angela K. Birnbaum

Pediatrics Faculty Publications

Aim: To characterize pharmacokinetic changes of sertraline and its metabolite during pregnancy and postpartum, and their relationship to maternal postpartum depressive symptoms. Methods: This was a prospective observational, longitudinal study of pregnant women with a major depressive disorder treated with sertraline (N = 185 women, 205 pregnancies). Women were enrolled at <16 weeks' gestation and followed at 4-8 week intervals throughout pregnancy and the first postpartum year. Baseline measures included structured clinical interviews and demographic information. Drug and metabolite concentrations and psychometric measures (study outcomes) (ie, Hamilton Rating Scale for depression - 17 item, Beck Depression Inventory, Edinburgh Postnatal Depression Scale [EPDS], Clinical Global Impression [CGI]) were measured at follow-up visits. Serum sertraline and N-desmethylsertraline exposure were reported asstandardized 24-h concentration-to-dose (C/D) and parent to metabolite (P/M) ratios. Linear mixed-effects and latent trajectory models were used to characterize longitudinal patterns in concentration measures across pregnancy and postpartum, and their association with study outcomes. Results: Mean 24-h C/D ratios showed high variability throughout pregnancy and postpartuM.T.hat were characterized by three trajectories for sertraline and five for N-desmethylsertraline and P/M ratio corresponding to different sertraline pharmacokinetic profiles. At postpartum, sertraline drug exposure was inversely associated with higher EPDS score (P < .05), while N-desmethylsertraline exposure was associated with higher scores for all measured depression scales (P < .001). Higher P/M ratios had higher CGI scores (P < .05) postpartum. Conclusion: Sertraline pharmacokinetic profiles varied across pregnant women and were associated with postpartum depressive symptoms. The use of therapeutic monitoring may provide clinical insight that can be useful for identifying patients with a potential toward depressive symptoms.

Infant Mortality In Ohio, Isabella Bacon, Alexis Jackson

Scholarship in Medicine - All Papers

Introduction: Infant mortality continues to occur at alarming rates that differ among various groups and states. Despite this, there has been a lack of intersectional examination of risk- and protective-factors. Methods: We examine how smoking status, education level, primary care to population ratio, teen birth rates, and urban vs rural status impact infant mortality rates in Ohio, Kentucky, Michigan, and Indiana using County Health Rankings data. Results: Ohio was shown to have no significant difference between urban and rural infant mortality rates; however,  risk-and-protective factors did differ. In urban counties, high school completion, teen birth rates, and primary care ratios …

A Novel Maturation Equation For Hepatic Clearance Across Preterm, Term Neonates, Children, And Adults: Application To Paracetamol And Its Metabolite, Yunjiao Wu, Swantje Völler, Sebastiaan C. Goulooze, Karel Allegaert, Catherine M.T. Sherwin, Anne Van Rongen, Daniëlla W. E. Roofthooft, Sinno H.P. Simons, Dick Tibboel, Robert B. Flint, John N. Van Den Anker, Catherijne A.J. Knibbe

Pediatrics Faculty Publications

A preterm and term neonate to adult (PTNA) maturation equation was introduced recently to describe the glomerular filtration rate maturation from birth to adulthood for neonates of varying gestational age. This study aims to evaluate the newly developed PTNA equation against common maturation approaches like allometric scaling (AS0.75), the AS0.75 plus postmenstrual age (PMA)-based Emax (AS0.75 + PMA) equation, and the bodyweight dependent exponent equation (BDE) for the maturation of three hepatic pathways of paracetamol (PCM) from preterm and term neonates up to adults. A population pharmacokinetic analysis was conducted with pooled plasma and urine data of PCM, PCM-glucuronide (PCM-GLU), …

Possible Involvement Of Keratinocyte-Derived Microvesicle Particles In Human Photosensitivity Disorders, Risha Annamraju, Madison S. Owens, Anita Thyagarajan, Danielle A. Corbin, Catherine M.T. Sherwin, Jade Bryant, Garrett W. Fisher, Winston R. Owens, Alycia Ketter, Craig A. Rohan, Michael G. Kemp, Robyn K. Crow, Jeffrey B. Travers

Pediatrics Faculty Publications

BACKGROUND: Previous murine studies have implicated acid sphingomyelinase-(aSMase) generated subcellular microvesicle particles (MVP) in photosensitivity. Objective: The current double-blinded placebo-controlled studies examined if a single localized ultraviolet B radiation (UVB) treatment generated more MVP in human subjects with self-identified photosensitivity versus normal controls. A topical 4% formulation of the aSMase inhibitor imipramine applied immediately after UVB blocked the MVP release and erythema responses. Erythema responses at 24 and 72 h in response to multiple UVB fluences and minimal erythema doses (MED) at 24 h and effects of imipramine were also tested.

RESULTS: Small cohorts of 10 adult self-identified photosensitive subjects …

Emerging Therapeutic Potential Of Fisetin For Nephrotoxicity, Kidney Injury, And Nephropathy: A Systematic Review, Saeed Mohajeri, Alizamen Salehifard Jouneghani, Saeid Heidari-Soureshjani, Catherine M.T. Sherwin, Faramarz Beigi

Pediatrics Faculty Publications

INTRODUCTION/OBJECTIVE: Kidney diseases cause high morbidity and mortality worldwide. This study investigated the mechanistic effects of Fisetin (FIS) on nephrotoxicity, kidney injury, and nephropathy induced by drugs, toxic chemicals, diabetes, lupus, diet, ureteral obstruction, and ischemic situations.

METHODS: To identify pertinent articles published before Oct 1, 2024, a comprehensive electronic search was performed across several databases, including MEDLINE/PubMed, Embase, Cochrane Library, Web of Science, and Scopus. After establishing clear inclusion and exclusion criteria, studies that met the research objectives were selected. Data were extracted and analyzed, documenting study characteristics, methodologies, and biological mechanisms.

RESULTS: Antioxidant benefits were evident with increased …

Prediction Of Lacosamide Concentrations To Support Dose Optimization During Pregnancy, Jessica M. Barry, Sílvia M. Illamola, Page B. Pennell, Catherine M.T. Sherwin, Kimford J. Meador, Angela K. Birnbaum

Pediatrics Faculty Publications

Objective: We aimed to quantify and predict lacosamide exposure during pregnancy by developing a pregnancy physiologically-based pharmacokinetic model, allowing the prediction of potential dose increases to support maintaining a patient's preconception lacosamide concentrations. Methods: Models for nonpregnant adults and pregnant female patients were constructed using physiochemical and pharmacological parameters identified from literature review. Evaluation of plasma concentration data from human males was digitized froM.T.he literature. Concentration data in nonpregnant and pregnant human females were available froM.T.he Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study, a longitudinal observational study which followed 11 nonpregnant and 16 pregnant women receiving lacosamide. …

Pharmacokinetic Effect Of Disease Severity And Use Of Extracorporeal Membrane Oxygenation In Critically Ill Asian Patients Receiving Vancomycin, Charul Avachat, Pi Lien Hung, Angela K. Birnbaum, Daniel P. Healy, Catherine M.T. Sherwin, Alex C. Lin

Pediatrics Faculty Publications

Purpose: Vancomycin is an essential antibiotic for the treatment of severe gram-positive bacterial infections, including methicillin-resistant Staphylococcus aureus (MRSA). In critically ill patients, particularly children, attaining the appropriate dosage is crucial to avert drug resistance and ensure therapeutic efficacy. This study sought to investigate the pharmacokinetics of vancomycin in critically ill Asian pediatric patients and evaluate the influence of extracorporeal membrane oxygenation (ECMO) and disease severity on vancomycin clearance. Methods: This retrospective analysis examined data from 90 critically ill Asian patients residing in Kaohsiung, Taiwan, encompassing 263 data points gathered over 2 years. A one-compartment pharmacokinetic model with first-order elimination …

The Special Issue “The 20th Anniversary Of Pharmaceuticals—Multi-Targeted Natural Products As Therapeutics” Editorial—Multi-Targeted Therapeutics From Natural Sources: What Do We Know?, Elena Y. Enioutina, Katheleen M. Job, Catherine M.T. Sherwin

Pediatrics Faculty Publications

Herbal and marine products in the form of extracts, infusions, and decoctions have been used for centuries in folk and traditional medicine. Preparations typically contain multiple biologically active compounds. The World Health Organization (WHO) estimated that about 65% of consumers worldwide use natural remedies containing bioactive molecules to treat various diseases [1]. Most single-molecule drugs of natural origin were developed in the middle of the 20th century through the active screening of natural products for bioactive molecules [2]. Examples include artemisinin, cyclosporine, taxol, doxorubicin, and many others. However, at the beginning of the 21st century, we saw a decline in …

Low-Acuity Pediatric Emergency Department Utilization, Lisa Ziemnik, Noah Parker, Kyra Bufi, Kristen Waters, Jacob Almeda, Adrienne Stolfi

Medical Education Faculty Publications

Objectives: Proper emergency department (ED) utilization is a hallmark of population health. Emergency department overcrowding due to nonurgent visits causes increased stress to healthcare staff, higher costs, and longer wait times for more urgent cases. This study sought to better understand post pandemic reasons caregivers have when bringing in their children for nonurgent visits and devise effective interventions to improve caregiver choice for non-ED care for nonurgent conditions.

Methods: Surveys were conducted at an urban pediatric hospital for Emergency Severity Index (ESI) level 3 to 5 visits. A total of 602 surveys were completed with 8 being excluded from analysis. …

Competency-Based Medical Education And The Education Continuum: Establishing A Framework For Lifelong Learning, Ann E. Burke, Daniel J. Sklansky, Hilary M. Haftel, Andrew Mitchell, Keith J. Mann

Pediatrics Faculty Publications

Competency Based Medical Education (CBME) is built on the concept that the competencies of learners, both graduates and practicing physicians, should ensure they are ready to meet the ever-changing healthcare needs of patients.1, 2, 3 Education outcomes in a CBME system are defined based on the needs of patients, and in healthy CBME systems, there is a paradigm shift from a focus on process and teachers to outcomes and learners.2,4 CBME should occur across the continuum of one's career, from undergraduate medical education through retirement. Furthermore, learners must be accustomed to driving their own educational processes.4,5 This learner-centered perspective requires …

A Physiological Approach To Renal Clearance: From Premature Neonates To Adults, Nick Holford, Conor J. O'Hanlon, Karel Allegaert, Brian Anderson, Amilcar Falcão, Nicolas Simon, Yoke Lin Lo, Alison H. Thomson, Catherine M.T. Sherwin, Evelyne Jacqz-Aigrain, Carolina Llanos-Paez, Stefanie Hennig, Linas Mockus, Carl Kirkpatrick

Pediatrics Faculty Publications

Aims: We propose using glomerular filtration rate (GFR) as the physiological basis for distinguishing components of renal clearance. Methods: Gentamicin, amikacin and vancomycin are thought to be predominantly excreted by the kidneys. A mixed-effects joint model of the pharmacokinetics of these drugs was developed, with a wide dispersion of weight, age and serum creatinine. A dataset created from 18 sources resulted in 27,338 drug concentrations from 9,901 patients. Body size and composition, maturation and renal function were used to describe differences in drug clearance and volume of distribution. Results: This study demonstrates that GFR is a predictor of two distinct …

When Will The Glomerular Filtration Rate In Former Preterm Neonates Catch Up With Their Term Peers?, Yunjiao Wu, Karel Allegaert, Robert B. Flint, Sebastiaan C. Goulooze, Pyry A.J. Välitalo, Matthijs De Hoog, Hussain Mulla, Catherine M.T. Sherwin, Sinno H.P. Simons, Elke H.J. Krekels, Catherijne A.J. Knibbe, Swantje Völler

Pediatrics Faculty Publications

Aims: Whether and when glomerular filtration rate (GFR) in preterms catches up with term peers is unknown. This study aims to develop a GFR maturation model for (pre)term-born individuals from birth to 18 years of age. Secondarily, the function is applied to data of different renally excreted drugs. Methods: We combined published inulin clearance values and serum creatinine (Scr) concentrations in (pre)term born individuals throughout childhood. Inulin clearance was assumed to be equal to GFR, and Scr to reflect creatinine synthesis rate/GFR. We developed a GFR function consisting of GFRbirth (GFR at birth), and an Emax model dependent on PNA …

Multi-Dose Enteral L-Citrulline Administration In Premature Infants At Risk Of Developing Pulmonary Hypertension Associated With Bronchopulmonary Dysplasia, Candice D. Fike, Judy L. Aschner, Charul Avachat, Angela K. Birnbaum, Catherine M.T. Sherwin

Pediatrics Faculty Publications

Objective: Information is needed to guide the design of randomized controlled trials (RCTs) evaluating L-citrulline therapy for premature infants with pulmonary hypertension associated with bronchopulmonary dysplasia (BPD-PH). Based on our single-dose pharmacokinetic study, we evaluated the ability of a multi-dose enteral L-citrulline strategy to achieve a target trough steady-state L-citrulline plasma concentration and its tolerability in premature infants. Study design: Plasma L-citrulline concentrations were measured in six premature infants receiving 60 mg/kg L-citrulline every 6 h for 72 h before the first and last L-citrulline doses. L-citrulline concentrations were compared to concentration-time profiles from our previous study. Results: Target trough …

Association Between Gallstone Disease And Kidney Stone Disease: A Systematic Review And Meta-Analysis, Faramarz Beigi, Alizamen Salehifard Jouneghani, Sae Heari-Soureshjani, Catherine M.T. Sherwin, Ghorbanali Rahimian

Pediatrics Faculty Publications

Background and aims: Gallstone disease (GSD) and kidney stone disease (KSD) have increased due to lifestyle in recent decades. This systematic review and meta-analysis aimed to investigate the association between these two diseases. Methods: A comprehensive electronic database search was conducted before August 25, 2024. This systematic review and meta-analysis included observational studies. The meta-analysis employed a random-effects model to compute the overall summary estimates of the association between GSD and KSD using risk ratios with 95% confidence intervals (CIs) as the primary measure of the effect size. Heterogeneity was evaluated using chi-square tests, the I² statistic, and forest plots. …

Immunomodulatory Effects Of Modified Colostrum, Whey, And Their Combination With Other Natural Products: Effects On Natural Killer Cells, Xuesheng Han, David Vollmer, Xuefei Yan, Yahong Zhang, Mingfa Zang, Chenfei Zhang, Catherine M.T. Sherwin, Elena Y. Enioutina

Pediatrics Faculty Publications

Objectives Natural killer (NK) cells are important immune system effector cells providing innate defenses against intracellular infections, including viral infections, immune surveillance, and cancer immunoediting. The primary purpose of this study was to investigate whether modified ultra-filtrated colostrum (UC) and hydrolyzed whey (W) products or their combinations with other natural products with reported immunomodulatory properties will stimulate NK cell cytotoxic activity by activation of granzyme B and IFN-γ production. Methods The ability of study products to stimulate the cytotoxic activity of human-purified CD56+ NK cells and the production of granzyme B and IFN-γ by activated NK cells was evaluated in …

A Perspective On In Vitro Developmental Neurotoxicity Test Assay Results: An Expert Panel Review, D. R. Juberg, D. A. Fox, P. A. Forcelli, S. Kacew, J. C. Lipscomb, S. A. Saghir, Catherine M. Sherwin, C. M. Koenig, S. M. Hays, C. R. Kirman

Pediatrics Faculty Publications

For decades, there has been increasing concern about the potential developmental neurotoxicity (DNT) associated with chemicals. Regulatory agencies have historically utilized standardized in vivo testing to evaluate DNT. Owing to considerations including higher-throughput screening for DNT, reduction in animal use, and potential cost efficiencies, the development of alternative new approach methods (NAMs) occurred; specifically, the advent of the DNT in vitro test battery (DNT IVB). SciPinion convened an expert panel to address specific questions related to the interpretation of in vitro DNT test data. The consensus of the expert panel was that the DNT IVB might be used during initial …

A Cohort Study Assessing The Impact Of Anki As A Spaced Repetition Tool On Academic Performance In Medical School, Michael M. Gilbert, Timothy C. Frommeyer, Garrett V. Brittain, Nickolas A. Stewart, Todd M. Turner, Adrienne Stolfi, Dean Parmelee

Pediatrics Faculty Publications

Introduction

Anki is an application that capitalizes upon the techniques of spaced repetition and is increasingly utilized by medical students for examination preparation. This study examines the impact of Anki usage in a medical school curriculum on academic performance. Secondary objectives analyzed individual Anki utilization and a qualitative assessment of Anki use.

Methods

A cohort-control study was conducted at Boonshoft School of Medicine. One hundred thirty first-year medical students were enrolled in an Anki utilization training program from July 2021 to September 2021. Training included educational Anki courses and subsequent survey data collection over Anki usage. Data variables included all …

Effects Of Pubertal Growth Variation On Knee Mechanics During Walking In Female And Male Adolescents, Andrew W. Froehle, Brian A. Edwards, Matthew Peterson, Brian Meyerson, Dana Duren

School of Health and Exercise Sciences Faculty Publications

Introduction: Puberty substantially alters the body's mechanical properties, neuromuscular control, and sex differences therein, likely contributing to increased, sex-biased knee injury risk during adolescence. Female adolescents have higher risk for knee injuries than male adolescents of similar age engaging in similar physical activities, and much research has investigated sex differences in mechanical risk factors. However, few studies address the considerable variation in pubertal growth (timing, pace), knee mechanics, and injury susceptibility within sexes, or the impact of such growth variation on mechanical injury risk.

Objectives: The present study tested for effects of variation in pubertal growth on established mechanical …

Using Multiple Imputation Of Real-World Data To Estimate Clinical Remission In Pediatric Inflammatory Bowel Disease, Nanhua Zhang, Chunyan Liu, Steven J. Steiner, Richard B. Colletti, Robert Baldassano, Shiran Chen, Stanley Cohen, Michael D. Kappelman, Shehzad Saeed, Laurie S. Conklin, Richard Strauss, Sheri Volger, Eileen King, Kim Hung Lo

Pediatrics Faculty Publications

Aim: To evaluate the performance of the multiple imputation (MI) method for estimating clinical effectiveness in pediatric Crohn's disease in the ImproveCareNow registry; to address the analytical challenge of missing data. Materials & methods: Simulation studies were performed by creating missing datasets based on fully observed data from patients with moderate-to-severe Crohn's disease treated with non-ustekinumab biologics. MI was used to impute sPCDAI remission statuses in each simulated dataset. Results: The true remission rate (75.1% [95% CI: 72.6%, 77.5%]) was underestimated without imputation (72.6% [71.8%, 73.3%]). With MI, the estimate was 74.8% (74.4%, 75.2%). Conclusion: MI reduced nonresponse bias and …

Optimal Dosing Of Enoxaparin In Overweight And Obese Children, Abdallah Derbalah, Stephen Duffull, Catherine M. Sherwin, Kathleen Job, Hesham Al‐Sallami

Pediatrics Faculty Publications

Aim:Current enoxaparin dosing guidelines in children are based on total bodyweight. This is potentially inappropriate in obese children as it may overestimate thedrug clearance. Current evidence suggests that obese children may require lower ini-tial doses of enoxaparin, therefore the aim of this work was to characterise the phar-macokinetics of enoxaparin in obese children and to propose a more appropriatedosing regimen.Methods:Data from 196 unique encounters of 160 children who received enoxa-parin treatment doses were analysed. Enoxaparin concentration was quantified usingthe chromogenic anti factor Xa (anti-Xa) assay. Patients provided a total of 552 anti-Xa samples. Existing published pharmacokinetic (PK) models were fitted …

Hypothesis: Hypermobile Ehlers Danlos Syndrome Is A Determinant Of Fetal And Young Infant Bone Strength, Marvin E. Miller

Pediatrics Faculty Publications

Several studies have demonstrated that young infants who present with unexplained fractures have a higher frequency of joint hypermobility, either in themselves or their parents, compared to the general population. The joint hypermobility is often associated with the autosomal dominant hypermobile form of Ehlers Danlos Syndrome (h-EDS) in which the mother is far more likely the affected parent. Most of these infants have metabolic bone disease as their radiographs often show poor bone mineralization. Some have alleged these infants were abused, while others have stated infants who have h-EDS or a parent with h-EDS are at increased risk to fracture …

Comparison Of Unmet Health Care Needs In Children With Intellectual Disability, Autism Spectrum Disorder And Both Disorders Combined, K. Haller, Adrienne Stolfi, John Duby

Medical Education Faculty Publications

Background: The purpose of this study was to assess the unmet health care needs of children with intellectual disability (ID) compared with children with autism spectrum disorder (ASD) and whether access to health insurance coverage is a contributing factor. Children with ID may be masked in the health care system due to increased diagnosis and awareness of ASD. The needs, unmet needs and insurance coverage of children with ID alone, ASD alone, and co-occurring ID and ASD were assessed in this study.

Methods: The 2016 to 2019 United States' Census Bureau National Survey of Children's Health was used to determine …

Use Of Physiologically-Based Pharmacokinetic Modeling To Inform Dosing Of The Opioid Analgesics Fentanyl And Methadone In Children With Obesity, Jacqueline G. Gerhart, Fernando O. Carreño, Jennifer L. Ford, Andrea N. Edginton, Eliana M. Perrin, Kevin M. Watt, William J. Muller, Andrew M. Atz, Amira Al-Uzri, Paula Delmore, Daniel Gonzalez, Catherine Sherwin

Pediatrics Faculty Publications

Obesity is an increasingly alarming public health threat, with nearly 20% of children classified as obese in the United States today. Children with obesity are commonly prescribed the opioids fentanyl and methadone, and accurate dosing is critical to reducing the risk of serious adverse events associated with overexposure. However, pharmacokinetic studies in children with obesity are challenging to conduct, so there is limited information to guide fentanyl and methadone dosing in these children. To address this clinical knowledge gap, physiologically-based pharmacokinetic models of fentanyl and methadone were developed in adults and scaled to children with and without obesity to explore …

Oral Drug Dosing Following Bariatric Surgery: General Concepts And Specific Dosing Advice, Jurjen S. Kingma, Desirée M. T. Burgers, Valerie M. Monpellier, Marinus J. Wiezer, Heleen J. Blussé Van Oud‐Alblas, Janelle D. Vaughns, Catherine M. T. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Bariatric or weight-loss surgery is a popular option for weight reduction. Depending on the surgical procedure, gastric changes like decreased transit time and volume and increased pH, decreased absorption surface in the small intestine, decreased exposure to bile acids and enterohepatic circulation, and decreased gastrointestinal transit time may be expected. In the years after bariatric surgery, patients will also substantially lose weight. As a result of these changes, the absorption, distribution, metabolism and/or elimination of drugs may be altered. The purpose of this article is to report the general influence of bariatric surgery on oral drug absorption, and to provide …

Metabolic Bone Disease Of Infancy In The Offspring Of Mothers With Bariatric Surgery: A Series Of 5 Infants In Contested Cases Of Child Abuse, Marvin E. Miller, David Ayoub

Pediatrics Faculty Publications

Background and aims: Metabolic Bone Disease of Infancy is a multifactorial disorder of bone fragility in infants who typically present under 6 months of age with multiple unexplained fractures. Major risk factors for this disorder relate to the fetal time period and include decreased provision of the essential nutrients for bone formation during pregnancy (calcium, phosphate, vitamin D, and protein), prema- turity, and decreased fetal bone loading. Methods: This study presents 5 infants with multiple unexplained fractures born to women who had prior bariatric surgery in which child abuse was alleged, and the alleged perpetrator denied wrong doing. Results: The …

Toward An Ontology Of Collaborative Learning Healthcaresystems, Alexandra H. Vinson, Michael Seid, Breck Gamel, Shehzad Ahmed Saeed, Brandy Fureman, Susan C. Cronin, Katherine Bates, David Hartley

Pediatrics Faculty Publications

Objective:To establish a basis for a domain ontology - a formal, explicit specificationof a shared conceptualization - of collaborative learning healthcare systems (CLHSs)in order to facilitate measurement, explanation, and improvement.Methods:We adapted the“Methontology”approach to begin building an ontologyof CLHSs. We specified the purpose of an ontology, acquired domain knowledge vialiterature review, conceptualized a common framework of CLHSs using a groundedapproach, refined these concepts based on expert panel input, and illustrated con-cept application via four cases.Results:The set of concepts identified as important to include in an ontologyincludes goals, values, structure, actors, environment, and products. To establish thisset of concepts, we gathered input …

Technology-Enabled Health Care Collaboration In Pediatric Chronic Illness: Pre-Post Interventional Study For Feasibility, Acceptability, And Clinical Impact Of An Electronic Health Record–Linked Platform For Patient-Clinician Partnership, Shehzad Ahmed Saeed, Lisa Opipari-Arrigan, Dana M. H. Dykes, Sunny Thakkar, Lisa Burns, Barbara A. Chini, Gary L. Mcphail, Ian Eslick, Peter A. Margolis, Heather C. Kaplan

Pediatrics Faculty Publications

Background: Mobile health (mHealth) technology has the potential to support the Chronic Care Model's vision of closed feedback loops and patient-clinician partnerships. Objective: This study aims to evaluate the feasibility, acceptability, and short-term impact of an electronic health record-linked mHealth platform (Orchestra) supporting patient and clinician collaboration through real-time, bidirectional data sharing. Methods: We conducted a 6-month prospective, pre-post, proof-of-concept study of Orchestra among patients and parents in the Cincinnati Children's Hospital inflammatory bowel disease (IBD) and cystic fibrosis (CF) clinics. Participants and clinicians used Orchestra during and between visits to complete and view patient-reported outcome (PRO) measures …

Trauma-Informed Care, Heather Forkey, Moira Szilagyi, Erin T. Kelly, James Duffee, Sarah H. Springer, Moira Szilagyi, Heather Forkey, Kristine Fortin, Mary Booth Vaden Greiner, Todd J. Ochs, Anu N. Partap, Linda Davidson Sagor, Deborah L. Shropshire, Jonathan D. Thackeray, Douglas Waite, Lisa Weber Zetley

Pediatrics Faculty Publications

No abstract provided.

Disparities In Health Care Utilization And The Effect Of Family Resilience And Neighborhood Support, Temitope Omoladun, Nora L. Vish

Medical Student Research Symposium Abstracts and Posters

Resilience, the ability to recover from adversity and turn obstacles into strengths and successes, can mitigate negative health outcomes associated with external drivers of health. Poverty, low educational attainment, insurance status and marginalized communities along with adverse childhood events are all known to be associated with poor health outcomes. Resilience is increasingly understood as a potent mitigating factor of negative health outcomes associated with toxic stress and social determinants of health. Individual resilience itself is impacted by external drivers such as family resilience and community cohesion.

Medical homes seek to promote patient well-being by establishing a partnership of trust and …

Dosing Recommendations For Vancomycin In Children And Adolescents With Varying Levels Of Obesity And Renal Dysfunction: A Population Pharmacokinetic Study In 1892 Children Aged 1–18 Years, Cornelis Smit, Sebastiaan C. Goulooze, Roger J. M. Brüggemann, Catherine M. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Vancomycin is an effective but potentially nephrotoxic antibiotic commonly used for severe infections. Dosing guidelines for vancomycin in obese children and adolescents with or without renal impairment are currently lacking. This study describes the pharmacokinetics of vancomycin in a large pediatric cohort with varying degrees of obesity and renal function to design practical dosing guidelines for this population. A multi-center retrospective population pharmacokinetic study was conducted using data from patients aged 1−18 years who received >1 dose of vancomycin and had ≥1 vancomycin concentration measured between January 2006 and December 2012. Besides pharmacokinetic data, age, gender, body weight, creatinine clearance …