Pediatrics Commons^™

Growing Up With Chronic Kidney Disease: What Parents And Children Really Want To Know, Uptal D. Patel, Debbie S. Gipson, Abiodun Aderogba Omoloja, Caitlin Wise Carter

Pediatrics Faculty Publications

Adolescents with chronic kidney disease have specific questions about how their disease will affect their quality of life, but they may not always bring this up with their nephrologist. This session is designed to provide pediatricians and pediatric nephrologists with practical information to provide to adolescents with chronic kidney disease and their families. All providers who care for adolescents with renal disease need to be equipped to educate this high risk population and help them navigate through this vulnerable period. This session is designed to explore issues related to athletic participation, academic performance, substance use and abuse and sexual and …

Neonatal Magnesium Levels Correlate With Motor Outcomes In Premature Infants: A Long-Term Retrospective Cohort Study, Elizabeth Doll, Jacob Wilkes, Lawrence J. Cook, E. Kent Korgenski, Roger G. Faix, Bradley A. Yoder, Rajendu Srivastava, Catherine M.T. Sherwin, Michael G. Spigarelli, Erin A.S. Clark, Joshua L. Bonkowsky

Pediatrics Faculty Publications

OBJECTIVE:

Chronic neurological deficits are a significant complication of preterm birth. Magnesium supplementation has been suggested to have neuroprotective function in the developing brain. Our objective was to determine whether higher neonatal serum magnesium levels were associated with better long-term neurodevelopmental outcomes in very-low birth weight infants.

STUDY DESIGN:

A retrospective cohort of 75 preterm infants (<1500 g, gestational age <27 weeks) had follow-up for the outcomes of abnormal motor exam and for epilepsy. Average total serum magnesium level in the neonate during the period of prematurity was the main independent variable assessed, tested using a Wilcoxon rank-sum test.

RESULTS:

Higher average serum magnesium level was associated with a statistically significant decreased risk for abnormal motor exam (p = 0.037). A lower risk for epilepsy in the group with higher magnesium level did not reach statistical significance (p = 0.06).

CONCLUSION:

This …

Medical Education Practice-Based Research Networks: Facilitating Collaborative Research, Alan Schwartz, Robin Young, Patricia J. Hicks, Ann Burke, Hilary M. Haftel, R. Mcgregor, L. Degnon, Carol Carraccio

Pediatrics Faculty Publications

Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging.Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research …

Pharmacokinetics And Pharmacodynamics Of Antifungals In Children And Their Clinical Implications, Chris Stockmann, Jonathan E. Constance, Jessica K. Roberts, Jared Olson, Elizabeth H. Doby, Krow Ampofo, Justin Stiers, Michael G. Spigarelli, Catherine Mt Sherwin

Pediatrics Faculty Publications

Invasive fungal infections are a significant cause of morbidity and mortality in children. Successful management of these systemic infections requires identification of the causative pathogen, appropriate antifungal selection, and optimisation of its pharmacokinetic and pharmacodynamic properties to maximise its antifungal activity and minimise toxicity and the emergence of resistance. This review highlights salient scientific advancements in paediatric antifungal pharmacotherapies and focuses on pharmacokinetic and pharmacodynamic studies that underpin current clinical decision making. Four classes of drugs are widely used in the treatment of invasive fungal infections in children, including the polyenes, triazoles, pyrimidine analogues and echinocandins. Several lipidic formulations of …

Fish Odor Syndrome: A Case Report Of Trimethylaminuria, Catherine A. Ulman, Julian J. Trevino, Marvin E. Miller, Rishi K. Gandhi

Pediatrics Faculty Publications

Trimethylaminuria is a rare, autosomal recessive, metabolic disorder that results in accumulation of trimethylamine (TMA), which smells like rotten fish. The chemical is excreted in sweat and urine owing to a deficiency in the enzyme flavin monooxygenase 3 (FMO3). We report a case of trimethylaminuria in a 12-year-old girl. The patient failed treatment with diet and hygiene modification, but achieved symptomatic improvement after a four-month course of metronidazole.

Factors For Recurrent Injuries In Victims Of Suspected Non-Accidental Trauma: A Retrospective Cohort Study, Katherine Deans, Jonathan D. Thackeray, Johnathan I. Groner, Jennifer N. Cooper, Peter Minneci

Pediatrics Faculty Publications

Background

Many children who are victims of non-accidental trauma (NAT) may be repeatedly evaluated for injuries related to maltreatment. The purpose of this study was to identify risk factors for repeated injuries in children with suspected NAT.

Methods

We conducted a retrospective cohort study using claims data from a pediatric Medicaid accountable care organization. Children with birth claims and at least one non-birth related claim indicating a diagnosis of NAT or skeletal survey in 2007–2011 were included. Recurrent events were defined as independent episodes of care involving an urgent/emergent care setting that included a diagnosis code specific for child abuse, …

National Trends In C. Difficileinfections In Hospitalized Children And Young Adults With Inflammatory Bowel Disease, 2001 –2010, Kelly C. Sandberg, Matthew M. Davis, Achamyeleh Gebremariam, Jeremy Adler, Child Health Evaluation And Research Unit, University Of Michigan, C.S. Mott Children's Hospital, Pediatric Gastroenterology, University Of Michigan

Pediatrics Faculty Publications

Clostridium difficile infection complicates inflammatory bowel disease in children and adults. Increased hospitalizations have been reported due to recent hypervirulent c. difficile strains. National trends of c. difficile infections in hospitalized children and young adults with inflammatory bowel disease (IBD) are currently incomplete.

Infliximab Dose Rounding Pratices In Pediatric Inflammatory Bowel Disease, Kelly C. Sandberg, Benjamin H. Shpeen, Sally J. Eder, Muhammad Dhanani, Sarah J. Clark, Gary L. Freed, Jeremy Adler

Pediatrics Faculty Publications

Infliximab (IFX) is commonly used to treat Inflammatory Bowel Disease (IBD). IFX is supplied in 100mg vials and remains expensive. Dosing usually starts at 5mg/kg, and is commonly rounded up or down. The scope of dosing practices is unknown. Under-dosing may place patients at risk for exacerbation of IBD. Over-treatment potentially carries increased risk of infectious and malignant complications. We aimed to characterize IFX dosing practices among pediatric IBD practitioners participating in the ImproveCareNow Network.

Population Pharmacokinetic (Pk) And Pharmacodynamic (Pd) Modeling Of Ticarcillin‐Clavulanate In Pediatric Cf Patients, Jeffery T. Zobell, Chris Stockmann, D. C. Young, Jared Cash, Catherine M.T. Sherwin, Michael G. Spigarelli, Barbara A. Chatfield, Krow Ampofo

Pediatrics Faculty Publications

No abstract provided.

Pediatric Primary Intramedullary Spinal Cord Glioblastoma, Robert M. Lober, Robert M. Lober, Suash Sharma, Beverly Bell, Alan Free, Ramon Figueroa, Chris W. Sheils, Mark Lee, John Kenneth Cowell

Pediatrics Faculty Publications

Spinal cord tumors in pediatric patients are rare, representing less than 1% of all central nervous system tumors. Two cases of pediatric primary intramedullary spinal cord glioblastoma at ages 14 and 8 years are reported. Both patients presented with rapid onset paraparesis and quadraparesis. Magnetic resonance imaging in both showed heterogeneously enhancing solitary mass lesions localized to lower cervical and upper thoracic spinal cord parenchyma. Histopathologic diagnosis was glioblastoma. Case #1 had a small cell component (primitive neuroectodermal tumor-like areas), higher Ki67, and p53 labeling indices, and a relatively stable karyotype with only minimal single copy losses involving regions: Chr8;pter-30480019, …

Individualized Learning Plans: Faculty As Facilitators, Ann Burke

Pediatrics Faculty Publications

Introduction: Individualized learning plans (ILPs) are documented personal learning objectives developed by a learner with the help of a facilitator. The Pediatric Residency Review Committee requires residents to accomplish one ILP per year. Faculty members, including program directors, who are newly responsible for facilitating development of resident ILPs may feel unprepared for the task. They are likely unfamiliar with the concepts of ILPs, and most have not created an ILP of their own. Methods: This paper-based faculty development curriculum is designed to educate faculty members on ILPs. The materials include a didactic introduction regarding ILPs and an overview of adult …

Smoking And Second Hand Smoking In Adolescents With Chronic Kidney Disease: A Report From The Chronic Kidney Disease In Children (Ckid) Cohort Study, Abiodun Aderogba Omoloja, J. Jerry-Fluker, Alison Abraham, S. Furth, B. Warady, M. Mitsnefes

Pediatrics Faculty Publications

The goal of this study was to determine the prevalence of smoking and second hand smoking [SHS] in adolescents with CKD and their relationship to baseline parameters at enrollment in the CKiD, observational cohort study of 600 children (aged 1-16 yrs) with Schwartz estimated GFR of 30-90 ml/min/1.73m2. 239 adolescents had self-report survey data on smoking and SHS exposure: 21 [9%] subjects had “ever” smoked a cigarette. Among them, 4 were current and 17 were former smokers. Hypertension was more prevalent in those that had “ever” smoked a cigarette (42%) compared to non-smokers (9%), p

Pediatric Window Falls: Not Just A Problem For Kids In High Rises, Nora L. Vish, E C. Powell, D Wiltsek, K M. Sheehan

Pediatrics Faculty Publications

Abstract

Background: Window falls are a frequent cause of injury (15/100 000) among Chicago preschool children. In Boston and New York, public health efforts have successfully decreased window fall injuries. Local data are needed to develop appropriate interventions for Chicago.

Objective: To describe the housing characteristics and types of injuries among children who fell from windows treated in a Chicago pediatric trauma center.

Methods: Children treated in a pediatric trauma center for injuries related to window falls between 1995 and 2002 were identified retrospectively. We reviewed family demographics, the circumstances of the fall, and types of injuries. Site visits were …