Pediatrics Commons^™

Parental Perception Of Improvement In Prelinguistic Skills In Kids With Autism In Two Months Of Goal Directed Cognitive Approach, Ratnapriya Chowdhry, Santosh Kondekar, Surbhi Rathi, Abhinaya V, Tasneem Motiwala

Digital Journal of Clinical Medicine

The study aimed to assess the parental perception of improvement in prelinguistic skills in children with Autism Spectrum disorder [ASD] after 1 and 2 months of Goal Directed Cognitive Approach. This was assessed by a questionnaire filled by parents of 26 consecutive ASD kids at a neurodevelopmental center. Parents were asked to rate these skills on a Likert scale of 1-5 before and after 1 month and 2 months of GDCA to check for any improvement. 69% of ASD kids were boys. Mean age at presentation was 2.6 years. The children were subjected to GDCA for an average duration of …

– Foreign Body Ingestion In Children(<12 Years) At A Tertiary Care Hospital: A Retrospective Cohort Study Studying Role Of Socioeconomic Status And Parental Supervision., Khyati Gupta, Gargi Rekhawar, Anisha Jain, Vishal D. Sawant, Sushma Save

Digital Journal of Clinical Medicine

Background- Foreign body ingestion is a long-standing problem concerning pediatric population. We aim to evaluate the correlation between the median time interval between ingestion of foreign body and arrival to the hospital with socioeconomic factors, effect of parental supervision and number of children in the family. We also aim to find out the deciding factors for proper selection of method of removal of ingested foreign bodies.

Methods- The data was collected from patient’s admission files, medical and endoscopic records. Chi-square test was used to calculate the corelation of time since ingestion with the socioeconomic status of family, method of removal …

Pediatric Dentists’ Considerations Concerning Obesity-Related Education For Parents Of Young Children: Who Should Educate About What, How And When?, Arianne Swanson Dds, Ms, James R. Boynton Dds, Ms, Larry B. Salzmann Dds, Yu-Ju Yang Dds, Marita R. Inglehart Dipl. Psych., Dr. Phil., Dr. Phil. Habil

The Journal of the Michigan Dental Association

This study aimed to explore pediatric dentists' perspectives on obesity-related interventions for parents of young children. A web-based survey was administered to 210 American Academy of Pediatric Dentistry members. Findings revealed that respondents considered it important for various healthcare professionals, especially pediatricians and nurse practitioners, to engage in obesity-related parent education. Strong consensus existed on educating parents about the link between early childhood caries and diet, soft drink and fruit juice consumption, and healthy snacking. The study also found positive attitudes correlated with increased engagement in objective weight determination, data collection, and diet/nutrition counseling.

Evaluating Causes Of Sinus Tachycardia In The Pediatrics Population And Managing In A Primary Care Setting, Guillemette Calderwood

Capstone Showcase

This article’s goal is to fill a gap in research that compares causes of tachycardia in children by appropriately addressing epidemiology, what is physiologically happening with tachycardia, symptoms that may be associated with it, as well as a differential diagnosis. This review specifically discusses positional orthostatic tachycardia syndrome, anxiety, hyperthyroidism, as well as infection. This is important and needed in order to help providers in diagnosing the cause for this common arrhythmia.

Diagnostic Utility Of Chest Radiographs In Children With Clinically Diagnosed Pneumonia As Per The Kenya Basic Paediatric Protocol, Ivy Waruguru Wakahora

Master of Medicine in Imaging and Diagnostic Radiology

Introduction; Pneumonia causes significant morbidity and mortality in children globally, emphasizing the need for accurate diagnosis. While chest radiographs have traditionally been the gold standard for diagnosis, recent international guidelines discourage their routine use in paediatric community acquired pneumonia (pCAP). Despite this, chest radiographs are still regularly acquired for pneumonia diagnosis, resulting in practice variations and imaging overutilization. This study aims to evaluate the diagnostic utility of chest radiographs in children with clinically diagnosed pneumonia as per the Kenya Basic Paediatric Protocol (KBPP).

Materials and methods: Data was retrospectively reviewed of 159 paediatric patients at Aga Khan University Hospital, Nairobi …

Biomechanical Evaluation And Intraoperative Strategies For Addressing Suture Anchor Failure In Osteoporotic Bone, Richard Marchese, Samir Baig, Sofia P. Hidalgo, Jaclyn Brunner, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: When aiming to enhance the strength of a suture anchor construct, typically in osteoporotic bone, it is often suggested to employ a method referred to as "under-tapping" (UT). A comprehensive assessment of tapping protocols for anchor placement was conducted to ascertain if this contributes to the prevention of anchor failure. Further, supplementary fixation techniques were examined to offer methods for secure fixation in the event of unanticipated failure.

Hypothesis: Under-tapping can increase load to failure compared to standard tapping (ST). If the initial fixation fails, using larger diameter anchors or bioabsorbable Trim-IT pins (TIP) via cross-pinning can provide stable …

Incidence Of Cardiovascular Surgery Following Pediatric Posterior Sternoclavicular Dislocation: Evaluating The Necessity Of Cardiothoracic Surgeon Standby During Operative Treatment, Ryan Lebens, Christian Leonardo, Rigel Hall, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Posterior sternoclavicular (PSC) dislocations are rare events, most commonly occurring after high energy injury such as motor vehicle accident or contact sports. While rare, PSC dislocations can be life threatening due to risk of posterior displacement of the medial clavicle impinging the great vessels leading to the heart. As such, patients with sternoclavicular dislocation are at risk for intimal tears and hemorrhage. Traditional orthopedic surgery teachings state closed reductions for PSC dislocation should have cardiothoracic (CT) surgeons on standby in the event intimal tears need repair. Despite this, there lacks conclusive evidence and literature about whether CT surgeon standby …

Perioperative Continuous Glucose Monitoring In Diabetic Patients Undergoing Primary Total Joint Arthroplasty, Dorian Cohen, Mei Lin Chan, Abdullah Y. Hassan, Anna Lei, Joseph F. Lacomb, Igor Kravetz, James Nicholson

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Postoperative Recovery Following Ankle Fracture Surgery With And Without At Home Physical Therapy System: A Prospective Randomized Control Study, John Kennedy, Amos Dai, Michelle Regan, Kaitlyn Compitello, David E. Komatsu, Megan Paulus

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

The Prevalence Of Dupuytren’S Disease In Patients With Epilepsy, Sandhya Ganesan, Kaitlyn N. Compitello, Benjamin N. Blond, David E. Komatsu, Lawrence C. Hurst

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Dupuytren’s disease (DD) is a fibroproliferative disorder characterized by progressively worsening contractures of the fingers, first web, and thumb. This condition has been associated with various risk factors, one of which includes epilepsy and recurrent seizures. Antiseizure medications (ASMs) especially phenobarbital, have been implicated in the connection between the two conditions; however, their association remains unclear.

Purpose: This study evaluated data from a TriNetX network of 132,152,597 total patients, 1,492,227 patients with epilepsy, 141,237 patients with DD, and 4,244 patients with both epilepsy and DD, to assess the correlation between DD and epilepsy and factors that may …

Utility Of Intraoperative Ultrasound In Localizing Retracted Flexor Tendon Injuries: A Cadaveric Study, Cris Min, Emil Vutescu S. Vutescu, Kenny Ling, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Flexor tendon injuries are common injuries typically seen in the working-age (20 to 45 years) young male population1. These injuries can be debilitating and lead to significant morbidity, as most flexor tendon lacerations require surgical treatment for proper healing. There is increasing use of both preoperative and postoperative ultrasound to aid in evaluation of flexor tendon injuries.

Purpose: The purpose of this study was to determine if ultrasound was a modality that could be useful intraoperatively in the localization of Zone II retracted flexor tendon injuries, as well as to determine how accurate ultrasound is in measuring the defect. …

Empowering And Educating Parents To Implement A Home Intervention: Effects On Preschool Children's Engagement In Hands-On Constructive Play, Michelle Boulanger Thompson, Yaoying Xu, Chin-Chih Chen, Kathleen Rudasill

Rehabilitation Sciences Faculty Publications

Constructive play is a creative process-oriented activity that promotes children’s engaged learning through building and designing with materials. This study investigated a parent-implemented intervention to promote active engagement in constructive play for preschool-aged children at risk for developmental delay. This study utilized a single-subject multiple-baseline across-participants design with four participants. Visual analysis of the data identified a functional relation between the temporal, physical, and social–emotional environmental support provided by the parents and the children’s active engagement in constructive play. Parents reported the intervention as meaningful to their lives, indicating strong social validity. These findings highlight the importance of centering and …

Models Of Video Feedback For Youth Athletes Performing An American Football Tackle, Eric Schussler, Richard J. Jagacinski, Ajit Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Video feedback is an expeditious method for improving athlete safety when performing activities with an inherent risk of injury. Providing appropriate and validated feedback during tackling training in American football may be a mechanism for athletes to learn safe tackling performance.

Objective: To determine the effect of video feedback in the instruction of tackling form.

Design: Controlled laboratory study.

Setting: Laboratory.

Patients or Other Participants: A total of 32 youth football athletes (28 boys, 4 girls; age ¼ 11.8 6 0.8 years) participated in 1 day of training. Of those, 14 participants completed 2 additional days of training and …

Abnormalities In Pharyngeal Arch-Derived Structures In Satb2-Associated Syndrome, Yuri A. Zarate, Katherine Bosanko, Nada Derar, Jennifer L. Fish

Pediatrics Faculty Publications

SATB2-associated syndrome (SAS, glass syndrome, OMIM#612313) is a neurodevelopmental autosomal dominant disorder with frequent craniofacial abnormalities including palatal and dental anomalies. To assess the role of Satb2 in craniofacial development, we analyzed mutant mice at different stages of development. Here, we show that Satb2 is broadly expressed in early embryonic mouse development including the mesenchyme of the second and third arches. Satb2-/- mutant mice exhibit microglossia, a shortened lower jaw, smaller trigeminal ganglia, and larger thyroids. We correlate these findings with the detailed clinical phenotype of four individuals with SAS and remarkable craniofacial phenotypes with one requiring mandibular distraction in …

Importance Of Tropical Medicine, Chia-Chi Angela Fu, A Clinton White, Miguel Cabada, Ryan Northup

Posters

Overviews the importance of tropical medicine to society and global health.

Self-Efficacy And Parental Miscarried Helping In Adherence And Transition Readiness Among Adolescents And Young Adults With Epilepsy, Kirby-Estar G. Laguerre

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Given the complex regimen associated with epilepsy, ensuring that adolescents and young adults (AYAs) adhere to their medications, and are ready to transition from pediatric to adult care, is crucial to optimizing their health outcomes. Several social and ecological factors such as self-efficacy and parental miscarried helping can strengthen or weaken an adolescent’s medication adherence and readiness to shift from pediatric to adult care. Intending to contribute to informing and improving clinical care, this study sought to understand the relationships between self-efficacy, parental miscarried helping, medication adherence, and transition readiness. Methods: Using a cross-sectional observational design, 46 AYAs with …

The Impact Of Iron Supplementation On The Preterm Neonatal Gut Microbiome: A Pilot Study, Matthew Van Ormer, Maranda Thompson, Melissa Thoene, Jean-Jack Riethoven, Sathish Kumar Natarajan, Corrine K. Hanson, Ann Anderson-Berry

Journal Articles: Pediatrics

OBJECTIVE: The gastrointestinal microbiome in preterm infants exhibits significant influence on optimal outcomes-with dysbiosis shown to substantially increase the risk of the life-threatening necrotizing enterocolitis. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurodevelopment. However, excess colonic iron exhibits potent oxidation capacity and alters the gut microbiome-potentially facilitating the proliferation of pathological bacterial strains. Breastfed preterm infants routinely receive iron supplementation starting 14 days after delivery and are highly vulnerable to morbidities associated with gastrointestinal dysbiosis. Therefore, we set out to determine if routine iron supplementation alters the preterm gut …

Hour Of Life At Enteral Feeding Initiation And Associated Clinical Morbidity In Extremely Low-Birth-Weight Infants, Melissa Thoene, Lauren Ridgway, Elizabeth Lyden, Ann Anderson-Berry

Journal Articles: Pediatrics

BACKGROUND/OBJECTIVES: Identifying nutritional interventions in extremely low-birth-weight (ELBW) infants (<1000 >g) that are associated with favorable clinical outcomes is important. Delayed enteral feeding initiation (>3 days) has been associated with increased odds of developing morbidity. Therefore, the aim of this study is to evaluate the relationship between hour of life at enteral feeding initiation and associated clinical outcomes.

METHODS: An IRB-approved retrospective chart review evaluated ELBW infants. Birth acuity was evaluated using CRIB II scoring and incidence of various morbidities (bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), and spontaneous intestinal perforation (SIP)) and mortality was assessed …

Bioactive Metabolites Of Omega-6 And Omega-3 Fatty Acids Are Associated With Inflammatory Cytokine Concentrations In Maternal And Infant Plasma At The Time Of Delivery, Rebecca Slotkowski, Matthew Van Ormer, Anum Akbar, Taija Hahka, Maranda Thompson, Rebekah Rapoza, Arzu Ulu, Melissa Thoene, Elizabeth Lyden, Maheswari Mukherjee, Ana G. Yuil-Valdes, Sathish Kumar Natarajan, Tara Nordgren, Corrine K. Hanson, Ann Anderson-Berry

Journal Articles: Pediatrics

Background & aims

Inflammation is necessary for a healthy pregnancy. However, unregulated or excessive inflammation during pregnancy is associated with severe maternal and infant morbidities, such as pre-eclampsia, abnormal infant neurodevelopment, or preterm birth. Inflammation is regulated in part by the bioactive metabolites of omega-6 (n-6) and omega-3 (n-3) fatty acids (FAs). N-6 FAs have been shown to promote pro-inflammatory cytokine environments in adults, while n-3 FAs have been shown to contribute to the resolution of inflammation; however, how these metabolites affect maternal and infant inflammation is still uncertain. The objective of this study was to predict the influence of …

Social Determinants Of Health: Evaluation Using Rates Of Vision Screening And Follow-Up Examinations, Madeline Dyer

Williams Honors College, Honors Research Projects

Vision care is essential to the quality of life of young children, impacting them over the course of their lives. Social Determinants of Health (SDOH) affect the likelihood of a child having access to appropriate care specified by the Bright Futures. The aim of this study was to assess the impact of SDOH on the completion of vision screening and the rate of follow-up with an eye care provider when applicable. In addition, rates of instrument-based vision screening and recommended ophthalmology follow-up were compared with COI, a metric assessing the quality of resources available and the conditions that matter for …

Understanding Guardian Perceptions Of Whole-Foods Plant-Based Diets As Interventions In Pediatric Medicine, Vijay R. Luthra

Honors Undergraduate Theses

The obesity epidemic is widespread in American society, often affecting children who bear its consequences innocently. Due to a lack of nutrition knowledge, children rely on caregivers to meet their nutritional needs and instill healthy habits. This study examines parents' attitudes, knowledge, and behaviors, as well as perceived barriers to adopting a whole-foods plant-based diet (WFPD) for their children. Using a modified survey instrument by Morton et al., this study focused on parents and children regarding dietary choices. Participants were recruited from the waiting area of a pediatric clinic at the Medical College of Georgia between April and May 2023. …

Assessing Discharge Knowledge For Caregivers Of Newborn (Using Video Discharge Instructions As An Adjunct To Standard Written Instructions) In Covid Period – A Randomized Controlled Trial, Jayesh Yadav, Khyati Gupta, Vishal D. Sawant

Digital Journal of Clinical Medicine

Background: Studies have demonstrated that caregivers of newborn frequently face challenges in comprehending the instructions provided to them upon discharge. Video discharge instructions provide a clear and concise message and can potentially alleviate factors which have an impact on comprehension of caregivers like illiteracy, communication barriers and limited physician time. We aim to assess the impact of incorporating video-based discharge instructions on caregivers' comprehension of newborn care and post-discharge follow-up, specifically in the context of the COVID-19 pandemic.

Methods: Caregivers of newborn in the COVID times were randomized into written only and written with video discharge instruction groups; …

Improving Nutritional Delivery To Pediatric Patients On Continuous Renal Replacement Therapy, Jennifer Ruiz-Boada, Sarah Brunner, Tara Benton, Vimal Chadha

Presentations

INTRODUCTION: Continuous renal replacement therapy (CRRT) is used in critically ill children with acute renal failure. CRRT can lead to malnutrition by removing essential proteins and micronutrients. Malnutrition is associated with worse outcomes, including increased length of stay and mortality. CRRT guidelines suggest the importance of early nutrition and ensuring high protein intake. After evaluating our CRRT patients, we found sub-optimal adherence to the guidelines. This Quality Improvement project aimed to increase the percentage of patients achieving 75% of their goal protein and caloric intake by day 5 of CRRT initiation by 15% by August 2023. METHODS: A multidisciplinary group …

Practical Quality Improvement Changes For A Low-Resourced Pediatric Unit, Phoebe H Yager, Kevin Mary Callans, Aubrey Samost-Williams, Jose A Bonilla, Luis J G Flores, Susana C A Hasbun, Angel E A Rodríguez, Alejandra B A Cárdenas, Alexia M L Núñez, Asitha D L Jayawardena, Evelyn J Zablah, Christopher J Hartnick

Faculty, Staff and Student Publications

Background: This work describes a sustainable and replicable initiative to optimize multi-disciplinary care and uptake of clinical best practices for patients in a pediatric intensive care unit in Low/Middle Income Countries and to understand the various factors that may play a role in the reduction in child mortality seen after implementation of the Quality Improvement Initiative.

Methods: This was a longitudinal assessment of a quality improvement program with the primary outcome of intubated pediatric patient mortality. The program was assessed 36 months following implementation of the quality improvement intervention using a t-test with linear regression to control for co-variates. …

The Lawnmower And The Pediatric Lower Extremity: A Catastrophic Combination, Sairandri Sathyanarayanan, Chioma G Obinero, Jackson C Green, Kasra N Fallah, Matthew R Greives, Wendy Chen, Phuong D Nguyen

Faculty, Staff and Student Publications

BACKGROUND: Lower extremity (LE) trauma within the pediatric population may be debilitating and have different implications and etiologies than in adults. Specifically, lawnmower injuries can cause catastrophic sequelae to the lower extremities, often requiring complex reconstruction or resulting in amputation. This study aims to present our experience with pediatric LE lawnmower injuries at one of the busiest level 1 trauma centers in the United States.

METHODS: An IRB-approved retrospective analysis was performed studying pediatric patients (age < 18 >years) who experienced LE trauma due to a lawnmower injury over a 5-year period (2012-2017). Patient demographics, perioperative data, and types of reconstruction were …

Pregnancy-Related Factors Responsible For Delivering Low Birth Weight Babies: An Institutional-Based Cross-Sectional Study, Jamnagar, Gujarat, Harsh K Patel, Jitesh P Mehta, Bela A Patel, Rohitkumar Ram, Dipesh V Parmar

Faculty, Staff and Student Publications

BACKGROUND: The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood.

OBJECTIVE: To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight.

METHODS: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child …

Patient-Reported Outcomes Following Severe Abdominal Trauma: A Secondary Analysis Of The Damage Control Laparotomy Trial, Shah-Jahan M Dodwad, Kayla D Isbell, Krislynn M Mueck, James M Klugh, David E Meyer, Charles E Wade, Lillian S Kao, John A Harvin

Faculty, Staff and Student Publications

Introduction: Little is known about patient-reported outcomes (PROs) following abdominal trauma. We hypothesized that patients undergoing definitive laparotomy (DEF) would have better PROs compared to those treated with damage control laparotomy (DCL).

Methods: The DCL Trial randomized DEF versus DCL in abdominal trauma. PROs were measured using the European Quality of Life-5 Dimensions-5 Levels (EQ-5D) questionnaire at discharge and six months postdischarge (1 = perfect health, 0 = death, and < 0 = worse than death) and Posttraumatic Stress Disorder (PTSD) Checklist-Civilian. Unadjusted Bayesian analysis with a neutral prior was used to assess the posterior probability of achieving minimal clinically important difference.

Results: Of 39 randomized patients (21 DEF versus 18 DCL), 8 patients died (7 DEF versus 1 DCL). Of those who survived, 28 completed the EQ-5D at discharge (12 DEF …

Development And Validation Of A Scale To Measure Person-Centered Care In Fetal Care Centers, Abigail Wilpers, Marney White, Mary T Austin, Mert Ozan Bahtiyar, Katie Francis, Stephen P Emery, Diane Wall, Lonnie Somers, Charlotte Wool

Faculty, Staff and Student Publications

Introduction: Fetal care centers (FCCs) in the USA lack a standardized instrument to measure person-centered care. This study aimed to develop and validate the Person-Centered Care in Fetal Care Centers (PCC-FCC) Scale.

Methods: Initial items were developed based on literature and input from clinicians and former patients. A Delphi study involving 16 experts was conducted to validate the content and construct. Through three rounds of online questionnaires using open-ended questions and Likert scales, consensus on item clarity and relevancy was established. The resulting items were then piloted with former fetal care center patients via a web-based survey. The instrument's reliability …

Improving Health Outcomes In Children And Adolescents With Asthma, Elizabeth Kate Coffey Moore

Theses and Dissertations (ETD)

Asthma is among the most prevalent chronic illnesses found in the United States, affecting millions of people under the age of 18 each year. The disease burden for affected children, adolescents, their families, and the healthcare system is immense. Finding ways to mitigate its impact is critical to improving the lives of affected children, adolescents, and their families. The three chapters included in this dissertation aimed to document the asthma triggers that children and adolescents are exposed to and strategies for reducing them and to demonstrate using Imogene King’s conceptual framework to guide nursing practice to care for and nursing …

The Validity And Reliability Of Ultrasound As A Tool For Assessing Skeletal Muscle Characteristics In The Pediatric Population, Elizabeth Seewer

Theses and Dissertations (ETD)

Annually, around 5 million people in the U.S. are admitted to Intensive Care Units (ICU) due to critical conditions, with pediatric patients comprising 21% of these admissions. Approximately 40% of pediatric ICU (PICU) patients require mechanical ventilation and extended stays, and about 6% result in death. Survivors often face long-term disabilities, including loss of skeletal muscle mass (SMM), a risk factor for morbidity and mortality. Abdominal computed tomography (CT) scans, often performed during PICU admissions, can assess muscle mass but pose risks of increased cost and radiation exposure. While CT and Magnetic Resonance Imaging (MRI) are gold standards for muscle …