Pediatrics Commons^™

Absolute Reticulocyte Count Acts As A Surrogate For Fetal Hemoglobin In Infants And Children With Sickle Cell Anemia., Emily Riehm Meier, Colleen Byrnes, Maxine Weissman, Y Terry Lee, Jeffery L Miller

Pediatrics Faculty Publications

Hemoglobin switching is largely complete in humans by six months of age. Among infants with sickle cell anemia (HbSS, SCA), reticulocytosis begins early in life as fetal hemoglobin (HbF) is replaced by sickle hemoglobin (HbS). The objective of this study was to determine if absolute reticulocyte count (ARC) is related to HbF levels in a cohort of pediatric SCA patients. A convenience sample of 106 children with SCA between the ages of 1 month and 20 years who were not receiving hydroxyurea or monthly blood transfusions were enrolled in this observational study. Hematologic data, including ARC and HbF levels, were …

Characterizing The Propagation Of Uterine Electrophysiological Signals Recorded With A Multi-Sensor Abdominal Array In Term Pregnancies., Diana Escalona-Vargas, Rathinaswamy B. Govindan, Adrian Furdea, Pam Murphy, Curtis L Lowery, Hari Eswaran

Pediatrics Faculty Publications

The objective of this study was to quantify the number of segments that have contractile activity and determine the propagation speed from uterine electrophysiological signals recorded over the abdomen. The uterine magnetomyographic (MMG) signals were recorded with a 151 channel SARA (SQUID Array for Reproductive Assessment) system from 36 pregnant women between 37 and 40 weeks of gestational age. The MMG signals were scored and segments were classified based on presence of uterine contractile burst activity. The sensor space was then split into four quadrants and in each quadrant signal strength at each sample was calculated using center-of-gravity (COG). To …

Making The Leap From Research Laboratory To Clinic: Challenges And Opportunities For Next-Generation Sequencing In Infectious Disease Diagnostics., Brittany Goldberg, Heike Sichtig, Chelsie Geyer, Nathan Ledeboer, George M Weinstock

Pediatrics Faculty Publications

Next-generation DNA sequencing (NGS) has progressed enormously over the past decade, transforming genomic analysis and opening up many new opportunities for applications in clinical microbiology laboratories. The impact of NGS on microbiology has been revolutionary, with new microbial genomic sequences being generated daily, leading to the development of large databases of genomes and gene sequences. The ability to analyze microbial communities without culturing organisms has created the ever-growing field of metagenomics and microbiome analysis and has generated significant new insights into the relation between host and microbe. The medical literature contains many examples of how this new technology can be …

Graduate Medical Education 2014-2015 Annual Report, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

Nfkb1 Activation By The E26 Transformation-Specific Transcription Factors Pu.1 And Spi-B Promotes Toll-Like Receptor-Mediated Splenic B Cell Proliferation, Stephen K.H. Li, Ali K. Abbas, Lauren A. Solomon, Gaëlle M.N. Groux, Rodney P. Dekoter

Paediatrics Publications

Generation of antibodies against T-independent and T-dependent antigens requires Toll-like receptor (TLR) engagement on B cells for efficient responses. However, the regulation of TLR expression and responses in B cells is not well understood. PU.1 and Spi-B (encoded by Sfpi1 and Spib, respectively) are transcription factors of the E26 transformation-specific (ETS) family and are important for B cell development and function. It was found that B cells from mice knocked out for Spi-B and heterozygous for PU.1 (Sfpi1^+/- Spib^-/- [PUB] mice) proliferated poorly in response to TLR ligands compared to wild-type (WT) B cells. The NF-κB family member …

Estimation Of Gfr Using Β-Trace Protein In Children, Samantha H. Witzel, Shih Han S. Huang, Branko Braam, Guido Filler

Paediatrics Publications

Background and objectives Sexmay affect the performance of smallmolecularweight proteins as markers of GFR because of differences in fat mass between the two sexes. The hypothesis was that the diagnostic performance of b-trace protein, a novel marker of GFR, would be significantly better in boys than in girls. Design, setting, participants, & measurements GFR, height, weight, serum creatinine, and β-trace protein were measured in 755 children and adolescents (331 girls) undergoing 99technetium diethylenetriamine penta–acetic acid renal scans from July of 1999 to July of 2006. Boys and girls were separated into formula generation cohorts (284 boys and 220 girls) and …

Ventilator-Associated Pneumonia Or Bacterial Colonization Of The Airway, What Do Probiotics Decrease?, Saptharishi Lalgudi Ganesan, Sunit C. Singhi, M. Baalaaji

Data and Test Instruments

No abstract provided.

Children's Mercy Hospital Annual Report 2014, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Optical Measurement Of Skin Temperature In Mr-Hifu, Daniel Yang, Haydar Celik, Doug Wackerle, David Kinnaird, Avinash Eranki, Matthew E. Oetgen, Aerang Kim, Karun Sharma, Harry Kim, Peter Kim, Pavel Yarmolenko

Pediatrics Posters and Presentations

No abstract provided.

Impact Of Prenatal Environmental Stress On Cortical Development, Seiji Ishii, Kazue Hashimoto-Torii

Pediatrics Faculty Publications

Prenatal exposure of the developing brain to various types of environmental stress increases susceptibility to neuropsychiatric disorders such as autism, attention deficit hyperactivity disorder and schizophrenia. Given that even subtle perturbations by prenatal environmental stress in the cerebral cortex impair the cognitive and memory functions, this review focuses on underlying molecular mechanisms of pathological cortical development. We especially highlight recent works that utilized animal exposure models, human specimens or/and induced Pluripotent Stem (iPS) cells to demonstrate: 1. molecular mechanisms shared by various types of environmental stressors, 2. the mechanisms by which the affected extracortical tissues indirectly impact the cortical development …

Dual Transcriptomic Profiling Of Host And Microbiota During Health And Disease In Pediatric Asthma., Marcos Pérez-Losada, Eduardo Castro-Nallar, Matthew L. Bendall, Robert J. Freishtat, Keith A. Crandall

Pediatrics Faculty Publications

BACKGROUND: High-throughput sequencing (HTS) analysis of microbial communities from the respiratory airways has heavily relied on the 16S rRNA gene. Given the intrinsic limitations of this approach, airway microbiome research has focused on assessing bacterial composition during health and disease, and its variation in relation to clinical and environmental factors, or other microbiomes. Consequently, very little effort has been dedicated to describing the functional characteristics of the airway microbiota and even less to explore the microbe-host interactions. Here we present a simultaneous assessment of microbiome and host functional diversity and host-microbe interactions from the same RNA-seq experiment, while accounting for …

Integrating Microbial And Host Transcriptomics To Characterize Asthma-Associated Microbial Communities., Eduardo Castro-Nallar, Ying Shen, Robert J. Freishtat, Marcos Pérez-Losada, Solaiappan Manimaran, Et Al.

Pediatrics Faculty Publications

BACKGROUND: The relationships between infections in early life and asthma are not completely understood. Likewise, the clinical relevance of microbial communities present in the respiratory tract is only partially known. A number of microbiome studies analyzing respiratory tract samples have found increased proportions of gamma-Proteobacteria including Haemophilus influenzae, Moraxella catarrhalis, and Firmicutes such as Streptococcus pneumoniae. The aim of this study was to present a new approach that combines RNA microbial identification with host gene expression to characterize and validate metagenomic taxonomic profiling in individuals with asthma.

METHODS: Using whole metagenomic shotgun RNA sequencing, we characterized and compared the microbial …

Pharmacologically-Induced Mitotic Synchrony In Airway Epithelial Cells As A Mechanism Of Action Of Anti-Inflammatory Drugs, Robert J. Freishtat, Gustavo Nino, Y. Tsegaye, Sarah E. Alcala, Angela S. Benton, Alan M. Watson, E.K.M. Reeves, S. K. Haider, Jesse M. Damsker

Pediatrics Faculty Publications

Background

Mitotic synchrony is the synchronous progression of a population of cells through the cell cycle and is characteristic of non-diseased airway epithelial cells. However, we previously showed that asthmatic airway epithelial cells are characterized by mitotic asynchrony and are pro-inflammatory as a result. Glucocorticoids can induce mitotic synchrony that in turn suppresses the pro-inflammatory state of diseased cells, suggesting a novel anti-inflammatory mechanism of action. Herein, we benchmarked traditional glucocorticoids against the ability of a new clinical-stage dissociative steroidal drug, VBP15, for mitotic resynchronization and associated anti-inflammatory activity in asthmatic airway epithelial cells.

Methods

Primary airway epithelial cells differentiated …

Are Immune Modulating Single Nucleotide Polymorphisms Associated With Necrotizing Enterocolitis?, Ashanti L Franklin, Mariam Said, Clint D Cappiello, Heather Gordish-Dressman, Zohreh Tatari-Calderone, Stanislav Vukmanovic, Khodayar Rais-Bahrami, Naomi L.C. Luban, Joseph M. Devaney, Anthony D. Sandler

Pediatrics Faculty Publications

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal emergency. The purpose of this study is to determine if functional single nucleotide polymorphisms (SNPs) in immune-modulating genes pre-dispose infants to NEC. After Institutional Review Board approval and parental consent, buccal swabs were collected for DNA extraction. TaqMan allelic discrimination assays and BglII endonuclease digestion were used to genotype specific inflammatory cytokines and TRIM21. Statistical analysis was completed using logistic regression. 184 neonates were analyzed in the study. Caucasian neonates with IL-6 (rs1800795) were over 6 times more likely to have NEC (p = 0.013; OR = 6.61, 95% CI 1.48-29.39), and over …

St Segment Depression After Norwood/Systemic-Pulmonary Artery Shunt, Ashraf Harahsheh, Craig A. Sable, Pranava Sinha, Richard A. Jonas

Pediatrics Faculty Publications

A three-month-old girl with double inlet left ventricle (S;D;D), hypoplastic outlet ventricle, restrictive bulboventricular foramen, d-transposition of great arteries and interrupted aortic arch underwent Norwood stage 1 operation, systemic to pulmonary artery (PA) shunt and atrial septectomy, and developed ectopic atrial tachycardia that responded to digoxin therapy. She developed fussiness lasting two hours, not associated with cyanosis, and not relieved by feeding. Her pulse oximetry was 88% while breathing room air, and she had no differential blood pressure gradient.

Prevalence Of Vitamin D Deficiency In Exclusively Breastfed Infants At The Aga Khan University Hospital, Nairobi, Nusrat. A. Said

Master of Medicine in Paediatrics and Child Health

Introduction: Vitamin D deficiency in infants is a recognized cause of rickets. In the last few years, evidence has emerged of its association with lower respiratory tract infections, food allergy, type 1 diabetes, schizophrenia and various other extra skeletal health effects. Exclusively breastfed infants are especially vulnerable to vitamin D deficiency due to their dependence on previous trans-placental transfer of vitamin D from the mother, dietary vitamin D from breast milk and cutaneous synthesis of vitamin D on exposure to sunlight. The worldwide epidemic of Vitamin D deficiency in pregnancy and the low content of vitamin D in breast milk …

Parental Understanding Of Tuberous Sclerosis Complex, Pauline Samia, Kirsten A. Donald, Birgit Schlegel, Jo M. Wilmshurst

Paediatrics and Child Health, East Africa

Tuberous sclerosis complex is a genetic disorder with multisystem involvement that poses significant challenges to the affected child and family. Caregiver knowledge in the South African population has not previously been reported. A prospective study of the parents of 21 children with tuberous sclerosis complex was undertaken. Median parental age was 38 (interquartile range 34.5-45) years. Parents were randomly allocated to receive written information about the condition, or to receive verbal counselling already established in clinic. A significant difference (P ¼ .001) was observed in the change in the mean knowledge scores for the parent group that received written information …

Cross-Sectional Survey On Prevalence Of Attention Deficit Hyperactivity Disorder Symptoms At A Tertiary Care Health Facility In Nairobi, Susan Wamithi, Roseline Ochieng, Frank Njenga, Samuel Akech, William Macharia

Paediatrics and Child Health, East Africa

Background:Attention deficit hyperactivity disorder is the most common childhood neurobehavioral disorder with well documented adverse consequences in adolescence and adulthood, yet 60-80% of cases go undiagnosed. Routine screening is not practiced in most pediatric outpatient services and little information exists on factors associated with the condition in developing countries.

Methods:This was a questionnaire based cross-sectional survey whose primary objective was to determine prevalence of attention deficit hyperactivity disorder (ADHD) symptoms in children aged 6-12 years attending a tertiary care hospital Accidents and Emergency unit. Secondary objectives were to: (i) ascertain if physical injury and poor academic performance were …

Prevalence And Immediate Outcome Of Candida Colonized Preterm Neonates Admitted To Special Care Unit Of Mulago Hospital, Kampala Uganda, Yaser Abdallah, Deogratias Kaddu -Mulindwa, Jolly Nankunda, Philippa M. Musoke

Paediatrics and Child Health, East Africa

Background: Candida species is the third commonest cause of sepsis among neonates. Colonization by Candida is a predictor for candidemia among preterm neonates.

Objectives: To determine prevalence of early Candida colonization and early outcome among colonized preterm neonates admitted to Mulago hospital Special Care Unit.

Methods: A prospective observational cohort was conducted between December 2008 and April 2009. Preterm neonates aged >72 hours and less than one week were screened for Candida colonization of the groin, oral pharynx and rectum using CHROMagar. Colonized neonates were followed up for 14 days. Blood cultures were done for those with signs of …

Final Thoughts, Hatim A. Omar

Pediatrics Faculty Publications

The work to establish the "Stop Youth Suicide Campaign (SYS)" has resulted in contact with many young adults. We realized that the most important thing for the kids was finding a caring person they can trust and talk to. This project has been a learning process for all involved. I learned that I can help and so can everyone else. This community and grassroots approach showed tangible results. It needs caring and dedication and most importantly desire to make a difference. It is hard work, but well worth it. Many people, including myself, are afraid of failure. I suffered every …

Urine Neutrophil Gelatinase-Associated Lipocalin In Asphyxiated Neonates: A Prospective Cohort Study, Farida Essajee, Fred Were, Bashir Admani

Paediatrics and Child Health, East Africa

Background: Acute kidney injury (AKI) is the most common complication of perinatal asphyxia. Recent research indicates that urine neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI; yet, there is a paucity of data about its use in term neonates with perinatal asphyxia.

Methods: A prospective cohort study was conducted on 108 term babies in the new-born unit of Pumwani Maternity Hospital and Kenyatta National Hospital. Urine NGAL and serum creatinine were measured in 108 term asphyxiated neonates on days 1 and 3 of life.

Results: One-hundred and eight patients were recruited (male:female 1.4:1). At a cut-off of 250 …

Parenting Skills And Emotional Availability: An Rct, Aisha K. Yousafzai, Muneera A. Rasheed, Arjumand Rizvi, Robert Armstrong, Zulfiqar A. Bhutta

Paediatrics and Child Health, East Africa

Objective: To investigate whether a responsive stimulation intervention delivered to caregivers of young children either alone or integrated with nutrition interventions would benefit parenting skills and emotional availability to promote children’s development and growth compared with either a nutrition intervention alone or the usual standard of care.

Methods: A cluster randomized factorial effectiveness trial was implemented in an impoverished community in Pakistan. The 4 trial arms were control (usual standard of care), responsive stimulation (responsive care and stimulation), enhanced nutrition (education and multiple micronutrients), and a combination of both enriched interventions. The 4 intervention packages were delivered by community health …

World Allergy Organization-Mcmaster University Guidelines For Allergic Disease Prevention (Glad-P): Probiotics, Alessandro Fiocchi, Ruby Pawankar, Carlos Cuello-Garcia, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Shreyas Gandhi, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny Rosenwasser, Hugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda-Ortiz, Susan Waserman, Juan José Yepes-Nuñez, Jan L. Brożek, Holger J. Schünemann

Paediatrics and Child Health, East Africa

Background: Prevalence of allergic diseases in infants, whose parents and siblings do not have allergy, is approximately 10% and reaches 20–30% in those with an allergic first-degree relative. Intestinal microbiota may modulate immunologic and inflammatory systemic responses and, thus, influence development of sensitization and allergy. Probiotics have been reported to modulate immune responses and their supplementation has been proposed as a preventive intervention.

Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations about the use of probiotics in the prevention of allergy.

Methods: We identified the most relevant clinical questions and performed a systematic review …

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 …

Impact Of Service Provision Platforms On Maternal And Newborn Health In Conflict Areas And Their Acceptability In Pakistan: A Systematic Review, Zohra S. Lassi, Wafa Aftab, Shabina Ariff, Rohail Kumar, Imtiaz Hussain, Nabiha Musavi, Zahid Memon, Sajid B. Soofi, Zulfiqar A. Bhutta

Woman and Child Health

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas.

The literature search revealed ten studies that …

Fmic Annual Report 2015 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Pfapa: A Periodic Febrile Syndrome Afflicting Children, Jessica Lahti

Physician Assistant Scholarly Project Posters

• Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA).

• Auto-inflammatory disorder occurring in affected children every 3-8 weeks.

• Onset around age 2; lasting into second decade of life.

• A current pathophysiologic theory is PFAPA is a disorder of the innate immune system involving interleukins, chemoattractants, and cytokines that stimulating the inflammatory response causing symptoms associated with PFAPA.

• Early diagnosis of PFAPA may help prevent the unnecessary use of antibiotics.

• Biomarker CD64, galectin-3 and the MPV may be useful in the diagnosis of PFAPA along with other laboratory values during the febrile attack period …

Adolescent Idiopathic Scoliosis: Comparing And Contrasting Operative Versus Non-Operative Treatment Abstract, Ethan Morris

Physician Assistant Scholarly Project Posters

• Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. It affects 2-4 percent of adolescents aged 10-16 years. Although most adolescents diagnosed with scoliosis will not develop clinical symptoms, ten percent will progress and require medical intervention due to the potential for rib deformity and respiratory compromise as well as significant emotional distress due to aesthetic changes in appearance. Primary care providers should be prepared to evaluate and recommend treatment when idiopathic scoliosis is discovered or addressed by the patient. Three major factors that determine whether scoliosis will progress are patient gender, magnitude of curve on presentation, …

Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection Antibiotic Prophylaxis Treatment Compared With Alternative Treatment Options, Heather Watkins

Physician Assistant Scholarly Project Posters

• Pediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal Infection, known as PANDAS, is a clinical diagnosis made after a child develops Obsessive Compulsive Disorder and/or ticks after a Streptococcal Pharyngitis. Pediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal Infection is diagnosed in children 3 years of age until 14 years of age. The purpose of this study is to determine if antibiotics versus selective serotonin reuptake inhibitor with cognitive behavior therapy versus prophylaxis with antibiotics should be used in the treatment of children who develops PANDAS. The review of literature will explore studies that compare current treatment options with new research …

Joint Attention Intervention With Assisting Parent­ Mediated Techniques To Increase A Toddler With Autism Spectrum Disorders' Use Of Joint Attention: A Single Case Study, Rebecca Schulz

All Graduate Theses, Dissertations, and Other Capstone Projects

Attention Intervention (JAI) conducted by graduate researcher, parent, and caregiver, would change the use of joint attention (JA) by a three-year-old suspected of having Autism Spectrum Disorder (ASD). The participant was a three-­year-­old child suspected of having ASD. Intervention was conducted twice per week for 30-45 minute duration by the student graduate researcher at a university clinic under the supervisor of Dr. Bonnie Berg, CCC­SLP. The parent and child's caregiver were trained in JAI and implemented the intervention daily in the home environment. The author's research question was, "Will the use of a JAI parent­mediated intervention model increase the JA …