Pediatrics Commons^™

Utility Of 3-Dimensional Echocardiography In Patients With Complex Intracardiac Connections And Ventricular Septal Defects, Aura Andrea Sanchez Mejia, Tam T Doan, Christian Lilje, Minh B Nguyen, Ricardo H Pignatelli, Shagun Sachdeva, Anitha Parthiban

Faculty, Staff and Students Publications

The surgical management of patients with complex intracardiac connections, ventricular septal defect (VSD), and 2 adequately sized ventricles is challenging. Understanding the VSD anatomy and its spatial relationships with the outflow tracts is critical to determining the suitability for biventricular repair. Transthoracic 2-dimensional echocardiography (2D-echo) is the primary cardiac imaging tool in congenital heart disease. Transthoracic 3-dimensional echocardiography (3D-echo) has an additive role over 2D-echo in the definition of the potential baffle pathway from the VSD to the semilunar valves, the anatomical characteristics of the VSD, and any substrate for systemic outflow tract obstruction postrepair. In this paper, we describe …

Framework For Kidney Health Follow-Up Among Neonates With Critical Cardiac Disease: A Report From The Neonatal Kidney Health Consensus Workshop, Stephen M Gorga, Tara Beck, Paulomi Chaudhry, Marissa J Defreitas, Dana Y Fuhrman, Catherine Joseph, Catherine D Krawczeski, David M Kwiatkowski, Michelle C Starr, Matthew W Harer, Jennifer R Charlton, David J Askenazi, David T Selewski, Katja M Gist

Faculty, Staff and Students Publications

Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney-related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney disease is increasing. Thirty percent to 50% of adults with congenital heart disease have impaired kidney function, even in the absence of prior kidney injury episodes. This may be related to the current standardized acute kidney injury criteria, which may not fully capture clinically meaningful kidney injury and long-term kidney health risks. An improved understanding of which neonates with …

The Advanced Strategies Of Human And Donor Milk Fortification And Its Effect On Long-Term Outcome In Preterm Babies, Ashwini Lakra, Mahaveer Singh Lakra, Ishani Arora, Heena Bhandekar, Amar Taksande, Roshan Prasad, Mayur Wanjari

Chulalongkorn Medical Journal

Poor growth in intrauterine and extrauterine life and inadequate protein supplementation in babies during the first weeks of premature babies are linked to long-term growth failure and poor brain development. The calorie requirements of premature newborns cannot always be fulfilled, even with routine and traditional fortification. This is because traditional fortification procedures rely on the presumed well-known composition of human milk rather than the calculated one. The protein content of mothers' milk of preterm babies varies, decreases with breastfeeding duration, and differs with donor human milk being preserved in milk banks for a long duration. Newer fortification techniques are needed …

Effect Of Testosterone Treatment During Puberty In Boys With Klinefelter Syndrome (The Tipy Study): Protocol For A Nationwide Randomised, Double-Blinded, Placebo-Controlled Study, Ida Dyhr Caspersen, Andrés Felipe Østergaard Fritzbøger, Jørgen Holm Petersen, Niels Birkebæk, Ann-Margrethe Rønholt Christensen, Anders Jørgen Schou, Kurt Kristensen, Judith L. Ross, Shanlee Davis, Gary Butler, Sophie Van Rijn, Anders Juul, Lise Aksglaede

Department of Pediatrics Faculty Papers

INTRODUCTION: Klinefelter syndrome (KS) is a genetic condition characterised by the presence of an extra X chromosome in males (47,XXY). KS is associated with various phenotypic characteristics in adult life, including infertility, hypogonadism and increased risk of type II diabetes, cardiovascular disease and osteoporosis. Additionally, individuals with KS often experience mental health challenges and functional impairments that significantly impact their quality of life. Currently, testosterone replacement therapy (TRT) in adolescence is considered the first-line treatment by some physicians for patients with KS and biochemical signs of hypogonadism. However, comprehensive evidence on its effectiveness in preventing typical phenotypic traits associated with …

Parent Feedback On The Reducing Emotional Distress For Childhood Hypoglycemia In Parents (Redchip) Intervention: A Qualitative Analysis., Nicole A. Kahhan, Maryjane S. Campbell, Mark A. Clements, Kimberly A. Driscoll, Amy I. Milkes, Holly K. O'Donnell, Susana R. Patton

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Severe hypoglycemia is more common among young children with type 1 diabetes mellitus (T1DM) than older youth, and parents report significant hypoglycemia fear (HF). Parents experiencing HF describe constant and extreme worry about the occurrence of hypoglycemia and may engage in potentially risky behaviors to avoid hypoglycemia. Our team developed and tested a behavioral intervention, Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP), to decrease HF in parents of young children with T1DM. Here, we qualitatively analyzed parent feedback to refine and optimize future intervention iterations.

METHODS: The randomized pilot study included parents (n = 73) of …

A Scoping Review Of Sleep Disturbances In Children And Adolescents With Abdominal Pain Disorders., Hunter J. Friesen, Neha Singh, Jennifer Verrill Schurman, Amanda D. Deacy, Craig A. Friesen, Jennifer Colombo

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE/PURPOSE/AIM: Sleep disturbances have been implicated as contributors to chronic pain. We undertook this review to assess the current literature regarding sleep disturbances in youth with chronic abdominal pain. We assessed studies evaluating prevalence, pathophysiology, and/or outcomes to identify gaps in knowledge and to determine whether there is an evidential basis for sleep interventions in this population.

MATERIALS AND METHODS: Utilizing Google Scholar, Pub Med, SCOPUS, and Embase, we searched using the terms "sleep disturbances" AND ("abdominal pain"/exp OR "abdominal pain") AND ([adolescent]/lim OR [school]/lim). Articles were included if they contained data regarding sleep disturbance prevalence, pathophysiology, or relationships to …

The Dnase Trex1 Is A Substrate Of The Intramembrane Protease Spp With Implications For Disease Pathogenesis, Onur Kerem Tever, Torben Mentrup, Ivan Kingyue Chinn, Hitoshi Ishikuma, Regina Fluhrer, Marc Schmitz, Rebekka Wehner, Rayk Behrendt, Javier Chinen, Bernd Schröder

Faculty, Staff and Students Publications

Signal peptide peptidase (SPP) is an ER-resident aspartyl intramembrane protease cleaving proteins within type II-oriented transmembrane segments. Here, we identified the tail-anchored protein Three prime repair exonuclease 1 (TREX1) as a novel substrate of SPP. Based on its DNase activity, TREX1 removes cytosolic DNA acting as a negative regulator of the DNA-sensing cGAS/STING pathway. TREX1 loss-of-function variants cause Aicardi-Goutières syndrome (AGS), a type I interferonopathy. Cleavage of ER-bound TREX1 by SPP releases a cleavage product into the cytosol. Proteolysis depends on sequence determinants within the transmembrane segment and is modulated by different disease-associated TREX1 variants. The AGS-causing T303P variant greatly …

Impact Of A Three-Week Full Leg Cast Immobilization On Infant Crawling Kinetics And Spatiotemporal Parameters, Mark Daniel Geil

Faculty Articles

Despite its importance in the development of mobility in infants, there is a general lack of quantified data on infant crawling, and a specific lack of understanding of crawling kinetics, which includes the relative weightbearing and force generation among the four limbs. Moreover, because of the difficulty of measurement and study design, there is no longitudinal quantification of the impact of a perturbation to typical development, such as limb immobilization. This study measured kinetic and spatiotemporal outcomes in a typically developing infant prior to a fracture that necessitated a long-leg cast that immobilized the left knee and ankle, while crawling …

Metabolic Signatures In Adipose Tissue Linking Lipophilic Persistent Organic Pollutant Mixtures To Blood Pressure Five Years After Bariatric Surgery Among Adolescents, Shudi Pan, Zhenjiang Li, Douglas I Walker, Brittney O Baumert, Hongxu Wang, Jesse A Goodrich, Sarah Rock, Thomas H Inge, Todd M Jenkins, Stephanie Sisley, Scott M Bartell, Stavra Xanthakos, Xiangping Lin, Brooklynn Mcneil, Anna R Robuck, Catherine E Mullins, Michele A La Merill, Erika Garcia, Max T Aung, Sandrah P Eckel, Rob Mcconnell, David V Conti, Justin R Ryder, Lida Chatzi

Faculty, Staff and Students Publications

Persistent organic pollutants (POPs) are lipophilic environmental contaminants accumulated in the adipose tissue. Weight loss interventions, such as bariatric surgery, can mobilize POPs from adipose tissue into the bloodstream. We hypothesized that this mobilization could contribute to increases in blood pressure among 57 adolescents with severe obesity undergoing bariatric surgery. POPs and metabolic features were measured from visceral adipose tissue collected during surgery using gas and liquid chromatography, coupled with high-resolution mass spectrometry. Blood pressure was assessed at baseline, 6 months, and 5 years post-surgery. We used quantile g-computation to estimate associations of POP mixtures with blood pressure changes. With …

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 …

Skin-To-Skin Care To Decrease Length Of Stay For Late Preterm Newborns, Theresa Bowden, Colleen Applegate, Susan Stauffer, Alex Schmidt, Lisa Mcgill-Vargas, Barbara Bennett-Wolcott

Providence Nursing Research Conference 2023 – Present

No abstract provided.

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 …

Association Of Inflammatory Biomarkers With New Functional Morbidity At Hospital Discharge In Children Who Survive Severe Sepsis, Mallory Perry-Eaddy, Walter Faig, Martha Curley, Scott Weiss

Department of Pediatrics Faculty Papers

OBJECTIVE: New functional morbidity is common in critically ill children who survive sepsis; yet, the underlying biological mechanisms, particularly the impact of inflammation, remain unknown. We sought to test the hypothesis that increased levels of inflammatory biomarkers during the acute phase of pediatric sepsis are associated with new functional morbidity at hospital discharge.

METHODS: We conducted a post hoc secondary analysis of the MitoPSe clinical study, including N = 119 critically ill children who survived sepsis. Data collected included demographic and clinical variables and 31 inflammatory biomarkers collected at three distinct timepoints (within days 1-2 of PICU admission, days 3-5, …

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 …

Factors Driving Adolescent Tuberculosis Incidence By Age And Sex In 30 High-Tuberculosis Burden Countries: A Mathematical Modelling Study, Silvia S Chiang, Megan B Murray, Alexander W Kay, Peter J Dodd

Faculty, Staff and Students Publications

INTRODUCTION: During adolescence, tuberculosis incidence rises, with a greater increase in males compared with females. Tuberculosis notifications and estimates infrequently disaggregate adolescent age groups. Moreover, the factors that drive the increases in overall incidence and the male-to-female (MF) ratio remain unclear.

METHODS: We constructed a mechanistic model to estimate cumulative Mycobacterium tuberculosis infection and tuberculosis disease incidence in the WHO’s 30 high-tuberculosis burden countries (HBCs), which represent 86%–90% of global tuberculosis incidence. We derived infection risk from tuberculosis prevalence and assortative social mixing based on sex and age (10–14 years vs 15–19 years old). We adjusted age subgroup-specific risks of …

Neonatal Outcomes In Periviable Births Weighing ≤ 500 Grams, Bijan Morshedi, Diego Maurente, Ursula Griffiths-Randolph, Elisabeth Kamano, Katharine Hopkins, Dana Baraki, Juliana Martins, Steven Warsof

Eastern Virginia Medical Journal

Background: The average rate of preterm birth in the US in 2021 was 10.1%. Although the rate of mortality from preterm birth has been decreasing, complications remain the leading cause of death in infants under the age of 5 years worldwide. Gestational age (GA) and birth weight (BW) remain the 2 most important variables for predicting survivability in preterm births, and lower GA and BW are both correlated with lower survivability.

Objective: To explore outcomes of neonates born in the periviable period (20 weeks and 0 days to 25 weeks and 6 days) with BW ≤ 500 g and to …

A Bland–Altman Comparison Of The Lead Care® System And Inductively Coupled Plasma Mass Spectrometry For Detecting Low-Level Lead In Child Whole Blood Samples, Christina Sobin, Tanner Schaub, Natali Parisi, Eva De La Riva

Departmental Papers (PH)

Chronic childhood lead exposure, yielding blood lead levels consistently below 10 μg/dL, remains a major public health concern. Low neurotoxic effect thresholds have not yet been established. Progress requires accurate, efficient, and cost-effective methods for testing large numbers of children. The LeadCare® System (LCS) may provide one ready option. The comparability of this system to the “gold standard” method of inductively coupled plasma mass spectrometry (ICP-MS) for the purpose of detecting blood lead levels below 10 μg/dL has not yet been examined. Paired blood samples from 177 children ages 5.2–12.8 years were tested with LCS and ICP-MS. Triplicate repeat tests …

Developing And Implementing Pediatric Nephrology Milestones 2.0 As An Efficient Tool For Trainee Evaluation And Just-In-Time Feedback., Caroline V. Jackson, Rebecca Hjorten, Laura Edgar, Beatrice Goilav, Roshan P. George, Darcy K. Weidemann

Manuscripts, Articles, Book Chapters and Other Papers

In 2013, the Accreditation Council for Graduate Medical Education (ACGME) implemented Milestones 1.0 as a tool to assess trainee progress towards readiness for independent practice. Critiques of Milestones 1.0 suggested its complexity made the tool difficult to quickly understand and implement in a standardized fashion. This was particularly challenging among subspecialties due to inherent differences in clinical practice settings and make-up of procedural and patient care needs. In response, ACGME launched Milestones 2.0 in 2016 to harmonize competencies applicable to all subspecialties and develop new subspecialty specific competencies to facilitate precise feedback on subspecialty specific content domains. We describe how …

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 …

Markers Of Growth And Nutrition In Children With Acquired Chylothorax Post Chd Surgery, Kevin N. Marzotto, Karin R. Videlefsky, Meghan P. Howell, Thomas R. Kimball, Frank A. Pigula, Kurt D. Piggott

School of Medicine Faculty Publications

Background: Acquired chylothorax is an established complication of CHD surgery, affecting 2-9% of patients. CHD places a child at risk for failure to thrive, with subsequent chylothorax imposing additional risk. Objective: We conducted a retrospective chart review to ascertain quantitative markers of nutrition and growth in children affected by chylothorax following CHD surgery between 2018 and 2022 compared to controls. Methods: We utilised electronic medical record system, EPIC, at Children's Hospital, New Orleans, targeting subjects < 18 years old who underwent CHD surgery between 2018 and 2022 and developed a subsequent chylothorax. Study subjects were identified using the 10th revision of the International Classification of Diseases codes (ICD-10 codes: J94.0, I89.8, and J90.0). Each chylothorax case (n = 20) was matched by procedure type and age to a control with no chylothorax (n = 20). Data were recorded in REDCap and analysed using SPSS. Results: After removal of outliers, we analysed 19 total matched pairs. There was no statistical difference in growth velocity (p = 0.12), weight change (operation to discharge) (p = 0.95), weight change (admission to discharge) (p = 0.35), Z-score change (operation to discharge) (p = 0.90), Z-score change (admission to discharge) (p = 0.21), serum protein (p = 0.88), or serum albumin (p = 0.82). Among cases, linear regression demonstrated no significant association between maximum chylous output and growth velocity (p = 0.91), weight change (operation to discharge) (p = 0.15), or weight change (admission to discharge) (p = 0.98). Conclusions: We did not observe statistically significant markers of growth or nutrition in children with chylothorax post-CHD surgery compared to those without chylothorax. Multisite data collection and analysis is required to better ascertain clinical impact and guide clinical practice.

Trends In Respiratory Pathogen Testing At Us Children's Hospitals., Matthew J. Molloy, Matthew Hall, Jessica L. Markham, Jillian M. Cotter, Elisha Mccoy, Michael J. Tchou, Megan E. Collins, Michael J. Steiner, John R. Stephens, Andrew G. Yu, Irma T. Ugalde, Rustin B. Morse, Monika K. Goyal, Samantha A. House

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Respiratory pathogen testing has been a common deimplementation focus. The COVID-19 pandemic brought new considerations for respiratory testing; recent trends in testing rates are not well understood.

OBJECTIVE: To measure trends in respiratory testing among encounters for acute respiratory infections among children and adolescents (agedyears) from 2016 to 2023, assess the association of COVID-19 with these trends, and describe associated cost trends.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective serial cross-sectional study included emergency department (ED) encounters and hospitalizations in US children's hospitals among children and adolescents with a primary acute infectious respiratory illness diagnosis. Data were ascertained from the …

Recovery Potential In Patients After Cardiac Arrest Who Die After Limitations Or Withdrawal Of Life Support, Jonathan Elmer, Patrick J Coppler, Cecelia Ratay, Alexis Steinberg, Sara Difiore-Sprouse, Nicholas Case, Baruch Fischhoff, Maria De-Arteaga, Alain Cariou, Alejandro A Rabinstein, Andrea O Rossetti, Ankur A Doshi, Bradley J Molyneaux, Cameron Dezfulian, Carolina B Maciel, Christoph Leithner, Cindy H Hsu, Claudio Sandroni, David M Greer, David B Seder, Francis X Guyette, Fabio Silvio Taccone, Hiromichi Naito, Jasmeet Soar, Jean-Baptiste Lascarrou, Jerry P Nolan, Karen G Hirsch, Katherine M Berg, Marion Moseby-Knappe, Markus B Skrifvars, Michael C Kurz, Min Jung Kathy Chae, Mypinder S Sekhon, Nicholas J Johnson, Pedro Kurtz, Romergryko G Geocadin, Sachin Agarwal, Teresa L May, Theresa M Olasveengen, Clifton W Callaway, Optimizing Recovery Prediction After Cardiac Arrest (Orca) Study Group

Faculty, Staff and Students Publications

Importance: Understanding the relationship between patients' clinical characteristics and outcomes is fundamental to medicine. When critically ill patients die after withdrawal of life-sustaining therapy (WLST), the inability to observe the potential for recovery with continued aggressive care could bias future clinical decisions and research.

Objective: To quantify the frequency with which experts consider patients who died after WLST following resuscitated cardiac arrest to have had recovery potential if life-sustaining therapy had been continued.

Design, setting, and participants: This prospective cohort study included comatose adult patients (aged ≥18 years) treated following resuscitation from cardiac arrest at a single academic medical center …

Comparative Analysis Of Oxygenators And Anticoagulation Strategies In Neonatal And Pediatric Ecmo Patients, Debra E. Newton, Johanna I. Orrick

Presentations

Background: Due to supply chain challenges, our institution transitioned from Pediatric Quadrox oxygenators to Nautilus oxygenators for neonatal and pediatric extracorporeal membrane oxygenation (ECMO) patients. During this transition, variations in anticoagulation results were observed with bivalirudin, the first-line anticoagulant, in patients weighing less than 8 kg. This study aimed to evaluate heparin as an alternative anticoagulant in this patient population utilizing Nautilus oxygenators. Methods: A retrospective analysis was conducted on 29 neonatal and pediatric ECMO patients (weight range: 2.3–6.1 kg). Patients were divided into three groups based on oxygenator and anticoagulant type: · Group 1: Quadrox with bivalirudin (n=11) · …

African Guidelines For Diagnosis And Management Of Polyarticular Juvenile Idiopathic Arthritis: Paflar Initiative, Mohammed Hassan Abu-Zaid, Angela Migowa, Hanna Lishan Kassa, Wassila Messadi, Yassmine Taha, Yaninga Halwani Fuseini, Madeleine Ngandeu, Yasser El Miedany, Michael Hofer, Wafa Hamdi

Paediatrics and Child Health, East Africa

Background Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disease of childhood. The Existing guidelines for polyarticular JIA are typically based on data from non-African populations and may not fully address the unique challenges faced in African settings. We aimed to produce updated African guidelines for the diagnosis and treatment of children and adolescents with polyarticular juvenile idiopathic arthritis (poly-JIA).

Methods This study was conducted with the aim of reaching a consensus among African experts on the diagnosis and treatment of poly-JIA using the Delphi technique. The frst scientifc committee identifed a total of 15 key clinical questions according …

Neurocognitive Gains Among Ugandan Children With Sickle Cell Anemia On Hydroxyurea: 18-Month Trial Interim Results, Shubaya Kasule Naggayi, Dennis Kalibbala, Vincent Mboizi, John M. Ssenkusu, Zhezhen Jin, Caterina Rosano, Deogratias Munube, Bill Wambaka, Ruth Namazzi, Robert Opoka

Paediatrics and Child Health, East Africa

Children with sickle cell anemia (SCA) frequently develop progressive neurocognitive impairment. We aimed to determine effects of hydroxyurea therapy on neurocognitive function in Ugandan children with SCA by comparing levels at enrollment to a planned 18-month interim assessment. Ugandan children (N=264) ages 3-9 years were enrolled from a SCA clinic and treated in a 30-month singlearm open-label trial with escalation to maximum tolerated dose (MTD). Primary outcome was the effects of hydroxyurea on cognition, attention and executive function, along with transcranial doppler ultrasound (TCD) blood flow velocity. Sibling controls (N=110) without SCA underwent neurocognitive testing in parallel to establish age-normalized …

Effect Of Social Determinants Of Health On Clinic Visit Attendance In Patients With Hemophilia, Shailly Gaur, Brian Lee Phd, Mph, James Anderst Md, Msci, Katie Foote Lscsw, Lcsw, Osw-C, Andrea Bradley-Ewing Mpa, Ma, Shannon L. Carpenter

Posters

Background Social determinants of health (SDOH) create barriers to seeking care regularly, especially for patients with chronic disease. Patients with moderate-severe hemophilia A and B (factor 8 and 9 deficiencies respectively) have a life-long higher risk of bleeding and require chronic therapies. Specialized care is offered through hemophilia treatment centers (HTCs); however, these can be difficult to access for some individuals. Previous SDOH research in this patient population has been limited; therefore, it can be difficult to identify the barriers to care that exist. There is a need to examine SDOH more thoroughly to create patient-directed interventions to improve access …

The Pediatric Ecmo Diary: Strengthening Communication, Family Coping, And Staff Engagement, Sarah P. Jimenez, Johanna I. Orrick, Kari L. Davidson

Posters

Bedside diaries have been used in Adult Intensive Care Units (ICUs) in Europe since the 1970s. These journals encourage clinicians to record a patient’s progress, illness narrative, and daily occurrences. Adult ICUs in America are beginning to implement and study the benefits of ICU journals. Bedside journals have been shown to increase staff engagement and aid in psychological recovery for patients and families following their illness. These diaries improve communication between the healthcare team and families, and help patients make sense of ICU stays by filling in memory gaps. Studies on ICU diaries have shown that a bedside diary kept …

Covid-19, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Status Epilepticus: Refractory Management, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Sickle Cell Disease: Stroke, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.