Pediatrics Commons^™

Infective Endocarditis And Meningitis In A Healthy Newborn Without Underlying Heart Disease, Due To Streptococcus Agalactiae - A Case Report., Dalal Siddig Idris, Muath Mohammed Al Ghamdi, Maria Laura Bellovalls, Mohammed Fararjeh

Journal of the Saudi Heart Association

Streptococcus Agalactiae endocarditis is a rare clinical entity in newborns with a normal structured heart. It is generally characterized by acute onset, the presence of large vegetations, rapid valvular destruction and frequent complications, particularly embolization. Mortality is high with medical therapy alone. We are reporting a rare case of infective endocarditis (IE) with mitral valve vegetation in a 9-day old healthy newborn following Streptococcus Agalactiae sepsis, complicated by meningitis and micro-abscesses. Mitral valve (MV) vegetation was removed surgically; the patient received intravenous antibiotics for six weeks. Transthoracic echocardiography after surgery showed severe MV regurgitation and severe pulmonary hypertension which was …

New Avenues In Childhood Vasculitis, Hulya Ercan Emreol, Cagri Yildirim-Toruner, Marija Jelusic, Marinka Twilt, Seza Ozen

Faculty, Staff and Students Publications

Childhood vasculitis encompasses a group of rare and heterogeneous diseases with systemic inflammation affecting various vessel sizes. This comprehensive review highlights recent advances in the pathogenesis, biomarkers, diagnosis, and treatment strategies for major pediatric vasculitides including IgA vasculitis, Kawasaki Disease, ANCA-associated vasculitis, Takayasu arteritis, and Polyarteritis Nodosa. Novel insights from genetic, immunologic, and imaging studies have paved the way for early diagnosis and individualized therapeutic approaches. Future directions emphasize the role of artificial intelligence, precision medicine, and international collaborative trials to optimize long-term outcomes and quality of life in affected children.

Cerebral Resistive Indices And Intraventricular Hemorrhage In Premature Neonates < 29 Weeks' Gestation: A Pilot Prospective Cohort Study., Abhinav Pal, Dan Stewart, Kshama Ojha, Vesna Kriss, Craig Ziegler, Hannah Fischer

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: In extremely preterm newborns, intraventricular hemorrhage (IVH) greatly influences neurodevelopmental outcomes. Preterm newborns who later develop IVH might have altered cerebral blood flow (CBF) as measured by resistive index (RI) on Doppler ultrasound. Knowledge regarding RI in extremely premature infants remains limited.

OBJECTIVE: This pilot prospective cohort study aimed to evaluate the association between early cerebral RI (within the first 36 h of life) and the occurrence of IVH in preterm infants born at <  29 weeks’ gestation.

METHODS: Prospective cohort study in which cranial Doppler was performed in preterm infants <  29 weeks at <  36 h of age and between 5 and 7 days of age. CBF velocities and RI were measured. Clinical and demographic factors were also assessed. Statistical analyses included Pearson’s chi-square exact test, independent

RESULTS: Of the 30 enrolled infants, 27% developed an IVH. RI and …

Vaccine Value Profile For Schistosomiasis, Gavin Yamey, Kaci Kennedy Mcdade, Roy M Anderson, Sarah M Bartsch, Maria Elena Bottazzi, David Diemert, Peter J Hotez, Bruce Y Lee, Donald Mcmanus, Adebayo J Molehin, Meta Roestenberg, David Rollinson, Afzal A Siddiqui, Miriam Tendler, Joanne P Webster, Hong You, Raphaël M Zellweger, Caroline Marshall

Faculty, Staff and Students Publications

Schistosomiasis is caused by parasitic flatworms (Schistosoma). The disease in humans can be caused by seven different species of Schistosoma: S. mansoni, S. japonicum, S. haematobium, S. malayensis, S. mekongi, S. guineensis and S. intercalatum, as well as by hybrids between species, including livestock schistosome species. People are infected when exposed to infested water and the parasite larvae penetrate the skin. Poor and rural communities are typically the most affected, and the general population who lives in affected areas and is exposed to contaminated water is at risk. Areas with poor access to safe water and adequate sanitation are also …

Monitoring The Laboratory Frequency For Musculoskeletal Infections At A Tertiary Care Children's Hospital: A Diagnostic Stewardship Qi Project, Kedar Tilak, Douglas Swanson, Christine Symes, Alaina N. Burns, Ann L. Wirtz, Rana El Feghaly

Posters

Patients with musculoskeletal infections (MSKI) undergo several laboratory tests. To promote laboratory stewardship, our Infectious diseases (ID) division recommended the following frequencies for labs: 1) C-reactive protein (CRP) every 2-3 days until >50% reduction while >3mg/dL, otherwise weekly until normal, 2) Sedimentation rate (ESR) at the start of therapy and end if > 20mm/hr initially, 3) Complete blood cell count (CBC) at the start of therapy and when transitioning to oral therapy if WBC is initially elevated. Baseline data showed that of 42 children evaluated between July 2023-May 2024, only 15 (35.7%) had a CBC and 13 (30.95%) had a CRP …

Perspective: Restoring Rest-The Critical Role Of Sleep In Foster Care Well-Being, Jill Mcleigh, Anna Wani, Likhita Shaik

Health Status, Outcomes, and Literacy and Healthcare Utilization

In 2023, approximately 400,000 children were in foster care in the United States, a population disproportionately affected by trauma, instability, and systemic inequities.1 These children face chronic disruptions in sleep—an essential physiological process that underpins physical development, learning, emotional regulation, and overall health.²⁻⁴ Adverse Childhood Experiences (ACEs), including abuse, neglect, and household dysfunction, are prevalent in this group and contribute to significant sleep disturbances through pathways of hyperarousal, stress dysregulation, and recurrent nightmares. 3,4 Understanding the interplay between foster care, social determinants of health (SDOH), and sleep health disparities highlights opportunities for targeted interventions to improve outcomes.

For questions about …

Combined Multichannel Intraluminal Impedance And Ph Testing In Infants And Young Children-A Narrative Review, Rochelle Sequeira Gomes, Sheeja Abraham, Michael Favara, Amy J. Sloane, Zubair H. Aghai

Department of Medicine Faculty Papers

Gastroesophageal reflux disease (GERD) is common in infants and young children, and thediagnosis and characterization of the disease continues to evolve in recent times. The typicalsymptoms thought to be related to GERD in young children are often nonspecific andubiquitous, underscoring the need for diagnostic testing in patients who have severe symptomsor complications related to GERD. Combined multichannel intraluminal impedance and pHtesting (MII-pH) is a diagnostic tool that can be used to study the frequency andseverity of gastroesophageal reflux. Compared to other diagnostic devices, MII-pH hasthe advantage of detecting both acidic and alkaline reflux events, as well as allows the study …

Growth Measurements In Ugandan Children With Sickle Cell Anaemia From A Hydroxyurea (Hydroxycarbamide) Treatment Trial Relative To Unaffected Sibling Controls, Dennis Kalibbala, Vincent Mboizi, Grace Nambatya, Susan Murungi, Joan Ashaba, Catherine Nabaggala, Lynnth Turyagyenda, Deogratias Munube, Phillip Kasirye, Robert Opoka

Paediatrics and Child Health, East Africa

No abstract provided.

Circulation Of Respiratory Viruses From Air And Human Specimens In A Pre-Kindergarten-12th Grade School District In Kansas City, Mo, Nicole Neeley, Brian Lee, Brittney Fritschmann, Luke Gard, Nibha Sagar, Dithi Banerjee, Anjana Sasidharan, Rangaraj Selvarangan, Olivia Almendares, Hannah L. Kirking, Jennifer Goldman, Jennifer E. Schuster

Posters

Background: Air sampling with respiratory virus testing in community settings may be a potential non-invasive, scalable method to monitor respiratory viruses. We performed an ecological analysis to describe the correlation between respiratory virus detections in air and human samples across all schools to evaluate the potential for air sampling as a tool for community-level surveillance. Methods: Knowledge of Infectious Diseases in Schools (School KIDS) is a voluntary respiratory virus surveillance program in a pre-kindergarten-12th grade public school district in Kansas City, MO. In 10 schools, students and staff collected anterior nasal swabs while at school, with optional on-demand swabbing when …

Objectively Monitored Sleep In School-Age Children With Cystic Fibrosis And Their Parents., Andrea L. Fidler, Casey Lawless, James Peugh, Dean W. Beebe, Silvia Delgado, Robin S. Everhart, David A. Fedele

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Recapitulating The Immune Microenvironment In Pediatric Brain Cancer: Preclinical Modeling Strategies., Adip G. Bhargav, Joseph S. Domino, David Akhavan, Jo Ling Goh

Manuscripts, Articles, Book Chapters and Other Papers

Primary brain and CNS tumors comprise the most common tumors in children and are the most common cause of cancer deaths in this population. Pediatric primary malignant brain tumors including high-grade glioma and medulloblastoma account for a significant proportion of these cancer deaths. Advances in the surgical management and adjuvant treatment paradigms have improved the prognosis of many patients with these tumors, but there remains a subset of treatment-resistant tumors or tumors with unique genetics aberrations and aggressive phenotypes that confer a poor prognosis. Immunotherapeutic strategies have demonstrated promise in pre-clinical studies and early clinical trials. However, high-fidelity evaluation of …

Changes In Antiviral Prescribing For Children With Influenza In Us Emergency Departments., Tess Stopczynski, Olla Hamdan, Justin Z. Amarin, James W. Antoon, Laura S. Stewart, Haya Hayek, James Chappell, Andrew J. Spieker, Eileen J. Klein, Janet A. Englund, Geoffrey A. Weinberg, Peter G. Szilagyi, John V. Williams, Marian G. Michaels, Julie A. Boom, Leila C. Sahni, Mary Allen Staat, Elizabeth P. Schlaudecker, Jennifer E. Schuster, Rangaraj Selvarangan, Ayzsa Tannis, Heidi L. Moline, Samantha M. Olson, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Despite national recommendations, antiviral prescribing in emergency departments (EDs) for children at higher risk of severe influenza, such as those younger than 5 years and those with specific underlying conditions, remains low.

OBJECTIVE: To assess whether there were changes in antiviral prescribing for children at higher risk of severe influenza in academic pediatric EDs before the COVID-19 pandemic (2016-2020) vs the late pandemic period (2021-2023).

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, cross-sectional study included influenza-positive children younger than 18 years presenting to the ED at 1 of 7 US pediatric academic hospitals participating in the Centers for Disease Control …

Assessment And Management Of Magnesium And Trace Element Status In Children With Ckd Stages 2-5, On Dialysis And Post-Transplantation: Clinical Practice Points From The Pediatric Renal Nutrition Taskforce., Jetta Tuokkola, Caroline E. Anderson, Sheridan Collins, Pearl Pugh, Molly R Wong Vega, Matthew Harmer, Lyndsay A. Harshman, Christina L. Nelms, Barry Toole, An Desloovere, Fabio Paglialonga, Nonnie Polderman, José Renken-Terhaerdt, Rukshana Shroff, Evelien Snauwaert, Stella Stabouli, Johan Vande Walle, Bradley A. Warady, Vanessa Shaw, Larry A. Greenbaum

Manuscripts, Articles, Book Chapters and Other Papers

Children and young people with chronic kidney disease (CKD) are at risk for deficiency or excess of magnesium and trace elements. Kidney function, dialysis, medication, and dietary and supplemental intake can affect their biochemical status. There is much uncertainty about the requirements of magnesium and trace elements in CKD, which leads to variation in practice. The Pediatric Renal Nutrition Taskforce is an international team of pediatric kidney dietitians and pediatric nephrologists, formed to develop evidence-based clinical practice points to improve the nutritional care of children with CKD. PICO (patient, intervention, comparator, and outcomes) questions led the literature searches, which were …

Metabolic Acidosis And Cardiovascular Disease Risk In Children With Ckd., Denver D. Brown, Jennifer Roem, Kimberly Reidy, Susan Furth, Bradley A. Warady, Michal Melamed, Tammy Brady, Ckid Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

KEY POINTS: Metabolic acidosis may be associated with adverse cardiovascular disease risk. Prospective studies of the benefit of alkali therapy on cardiovascular disease risk are needed.

BACKGROUND: The link between metabolic acidosis (MA) and cardiovascular disease (CVD) outcomes has been studied in adults but not in children with CKD where MA is a common and early finding. Using longitudinal BP and cardiac measurement data, we evaluated whether low serum bicarbonate (a surrogate for MA) is associated with adverse CVD risk.

METHODS: This study used data from children age 1 year and older with eGFRs between 30 and 90 ml/min per …

The Home Visiting Referral Quality Improvement Initiative (Thrive) Change Package, Elizabeth Yakes Jimenez, Theresa Cruz, Rebecca Craig, Ivan De La Rosa

Population Health Research and Scholarship

Early childhood home visiting programs improve maternal and child health outcomes but remain underutilized. Healthcare providers are well-positioned to connect families to home visiting services; however, structural barriers in clinical settings limit consistent and effective referral practices. The Home Visiting Referral Quality Improvement Initiative (THRIVE) change package was developed to provide a starting point for addressing these challenges. The THRIVE change package outlines actionable improvement strategies to test, such as standardizing referral workflows, training clinical teams, and establishing relationships and feedback loops with home visiting programs. It offers a scalable approach to strengthening clinical–community linkages and improving family engagement with …

Neonatal Early-Onset Sepsis: It’S Not Always What You Think, Gabriela M. Henriquez, Kedar Tilak, Douglas Swanson, Susana Chavez-Bueno

Posters

No abstract provided.

Tonsillectomy/Adenoidectomy Post-Operative Management At Children’S Mercy Kansas, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Spinal Cord Injury, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Building Access To Care For Women And Girls+ With Bleeding Disorders: The Wgbd Clinic Of Excellence Model, Ming Y. Lim, Katherine C. Anguiano, Shannon L. Carpenter, Kerry B. Funkhouser

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Undifferentiated Embryonal Sarcoma Of Liver In A Child : A Case Report, Neha Devendra Bhongale, Sumeet Baheti, Poonam Wade, Omkar Khandkar, Meenakshi Balasbramanian

Digital Journal of Clinical Medicine

Background: Undifferentiated Embryonal Sarcoma of liver (UESL) is a rare malignancy of liver originating from primary mesenchymal tissue with overall poor prognosis. Around 220 pediatric cases of UESL have been reported in the literature. The lack of characteristic clinical manifestations, laboratory tests and imaging studies pose a diagnostic challenge and the preoperative misdiagnosis rate is high. Historically, treatment was limited to surgical resection with poor survival rate. In recent times, combination of chemotherapy and surgical resection has improved survival.

Case Presentation: We report a case of undifferentiated embryonal sarcoma of liver in a 6 years old boy who presented …

Three-Dimensional Human Mucopolysaccharidosis Iva Chondrocyte Culture Reveals Significant Impairments In The Lysosomal-Mitochondrial Crosstalk, Andrés Felipe Leal, Sampurna Saikia, Shaukat A. Khan, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis IVA (MPS IVA) is a lysosomal storage disorder (LSD) caused by a deficiency of N-acetylgalactosamine-6-sulfate sulfatase enzyme. MPS IVA patients suffer from skeletal dysplasia due to the abnormal function of chondrocytes. Given the interactions of lysosomes with various intracellular organelles, it is not surprising that lysosomal dysfunction can lead to improper functioning of lysosome-interacting organelles such as mitochondria. Mitochondrial alterations have been evaluated in several LSDs; nevertheless, they have not been fully addressed in MPS IVA. In this study, we assessed the mitochondrial alterations in MPS IVA chondrocytes using a three-dimensional culture approach. Our findings revealed that MPS IVA …

Gender Trends In Professional Advancement Among Academic Pediatric Neurologists., Juliet K. Knowles, Angela L. Hewitt, Prathyusha Teeyagura, Bren Botzheim, Derek Boothroyd, Ria Pal, Chrisoula Cheronis, Shermila Pia, Rebecca Macrae, Christine Shrock, Taelor Hancock, Rayann Solidum, Jaclyn Peraino, Amy Hill, Laura Owlett, Sara N. Moss, Catherine Tran, Daniel A. Castillo, Mark S. Wainwright, Renée A. Shellhaas, Nomazulu Dlamini, Mustafa Sahin, Rose N. Gelineau-Morel, Joshua L. Bonkowsky

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Germline Cancer Predisposition Results From The National Cancer Institute-Children's Oncology Group Pediatric Match Trial, Sarah Scollon, Sharon E Plon, Steven Joffe, Jaclyn A Biegel, Shashikant Kulkarni, George Miles, David R Patton, Brent Coffey, Cynthia L Winter, Gregory J Tsongalis, Mark J Routbort, Nilsa C Ramirez, Lauren Saguilig, Jin Piao, Todd A Alonzo, Stacey L Berg, Elizabeth Fox, Brenda Weigel, Douglas S Hawkins, Jeffrey S Abrams, Margaret Mooney, Naoko Takebe, James V Tricoli, Katherine A Janeway, Nita L Seibel, D Williams Parsons

Faculty, Staff and Students Publications

Purpose: Precision oncology trials have generally focused on tumor testing to identify actionable alterations. The National Cancer Institute-Children's Oncology Group Pediatric MATCH trial incorporated return of germline results to assess feasibility of reporting in a cooperative group setting and characterize germline cancer predisposition in patients with refractory cancers.

Patients and methods: Tumor and blood DNA from patients 1-21 years of age with treatment-refractory solid tumors, non-Hodgkin lymphomas, or histiocytic disorders underwent cancer gene panel sequencing. Clinical germline reports returned to 151 study sites included pathogenic/likely pathogenic (P/LP) germline variants found in 38 cancer predisposition genes (CPGs). European Society of Medical …

Clinical Profiles And Outcomes Of Adult Congenital Heart Disease Patients In The Cardiac Intensive Care Unit, Luke J Burchill, Viral K Desai, Maan Jokhadar, Cameron Dezfulian, Heidi M Connolly, Alexander C Egbe, William R Miranda, C Charles Jain, Jacob C Jentzer

Faculty, Staff and Students Publications

Background: There is limited evidence to guide care and improve outcomes among critically ill adult congenital heart disease (ACHD) patients.

Objectives: The purpose of this study was to examine the clinical profile and outcomes of ACHD patients admitted to an academic cardiac intensive care unit (CICU).

Methods: Retrospective cohort study of Mayo Clinic CICU admissions (2007-2018), including those who had been evaluated in our ACHD clinic. Critical care diagnoses (CCD) at the time of admission and critical care therapies (CCT) during the CICU stay were examined. Logistic regression and Cox proportional hazards regression were used to evaluate in-hospital and 1-year …

Pfas Exposure And Postoperative Weight Regain In Adolescents After Bariatric Surgery: Findings From The Teen-Labs Study, Brittney O Baumert, Elizabeth Costello, Zhenjiang Li, Justin R Ryder, Thomas Inge, Todd Jenkins, Stephanie Sisley, Stavra A Xanthakos, Douglas I Walker, Nikos Stratakis, Damaskini Valvi, Scott M Bartell, Angela L Slitt, Rohit Kohli, Sarah Rock, Michele A La Merrill, Sandrah P Eckel, Max T Aung, Rob Mcconnell, David V Conti, Lida Chatzi

Faculty, Staff and Students Publications

Objective: Weight regain following bariatric surgery remains a clinical challenge, with limited understanding of contributing environmental factors. Per- and polyfluoroalkyl substances (PFAS), persistent chemicals linked to metabolic dysfunction, may influence long-term weight trajectories. This study aimed to evaluate associations between PFAS exposure and changes in BMI, percent weight loss, and waist circumference among adolescents after bariatric surgery.

Methods: We included 186 adolescents (mean age: 17.1 years; 76.3% female; 72.0% White) from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort who underwent surgery between 2007 and 2012. Anthropometric measurements were collected at baseline and 6, 12, 36, and 60 months post …

A Narrative Review Of The Ileal Pouch In Pediatric Inflammatory Bowel Disease And Familial Adenomatous Polyposis, Anitta Philip, Allyson Wyatt, Jose R Rodriguez, Brad Pasternak, Lisa Mcmahon, Kalyani Patel, Richard Kellermayer

Faculty, Staff and Students Publications

Ileal pouch-anal anastomosis is a surgical intervention in patients with medically refractory inflammatory bowel disease and familial adenomatous polyposis syndrome. Reported outcomes in children have been limited by both the retrospective nature and sample size of the investigations. In addition, there is a lack of consensus on surveillance guidelines in this patient population. Delay or lack of surveillance may increase the risk of complications (pouchitis, Crohn's disease-like inflammation, dysplasia, etc.). This narrative review aims to summarize the most recent literature (2013-2023) on short-term, long-term, and quality of life (QoL) outcomes in pediatric ileal pouch (J-pouch) patients. A proposed surveillance guidance …

Functional Importance Of Bile Acid-Fxr Signaling In Neonatal Immunity And Disease, Douglas G Burrin, Greg Guthrie, Caitlin Vonderohe

Faculty, Staff and Students Publications

No abstract provided.

Effective Enforcement Of Laws Prohibiting Underage Tobacco Product Sale Is Needed, Harold J Farber

Faculty, Staff and Students Publications

No abstract provided.

Does Every Person With Asthma Need An Inhaled Corticosteroid?, Harold J Farber

Faculty, Staff and Students Publications

No abstract provided.

Complexity And Health Care Utilization In Infant Eskd, Ashna R Pudupakkam, Michael C Braun, Catherine Joseph, Poyyapakkam R Srivaths, Sarah J Swartz, Shweta S Shah

Faculty, Staff and Students Publications

Key Points:

1. Infant ESKD is associated with significant health care utilization including hospitalizations, subspecialty care, and financial expenditures.

2. Further investigation of health care utilization in infant ESKD can help guide the appropriate allocation of resources to support care delivery.

Background: Dialysis in neonates with ESKD is often associated with multiple comorbidities and the need for more intensified dialysis regimens. With recent advances in prenatal interventions and infant-specific KRT, survival of neonates with ESKD has improved over the past decade. Little is known, however, about the impact on the health care system of improved survival in this population. Our primary aim …