Pediatrics Commons^™

Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone

Medical Student Research Symposium

Vaccine hesitancy among youth with human immunodeficiency virus (HIV) was evaluated to determine if the pandemic affected vaccine acceptance. A retrospective chart review was conducted to analyze vaccine rates over a five-year (pre-post COVID) in one university-based clinic. Results indicated a variation in acceptance rates between vaccines, with the MenACWY, MenB, tetanus, and HPV having the highest acceptance rates and COVID-19 and annual flu vaccine having the lowest acceptance rates. Vaccine hesitancy did not correlate with HIV treatment hesitancy nor with aversion to needles. Negative messaging around vaccines from a variety of sources appeared to be the primary factor in …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

Comparison Of Data On Preterm Neonatal Growth Measures In The Neonatal Intensive Care Unit, Madison Baty, Emily Faerber, Cayenne Sirois

Providence Nursing Research Conference 2023 – Present

Background:

Extrauterine Growth Restriction (EUGR) has been defined as infant weight-for-age z-score (WAZ) of less than -1.28 standard deviations (SD), at discharge or 36–40 weeks (about 9 months) postmenstrual age. In 2018, the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition published indicators of neonatal malnutrition, including a decline in WAZ over time. Mild, moderate, and severe neonatal malnutrition is defined as a WAZ decline of 0.8-1.2 SD; >1.2-2 SD; >2 SD, respectively, and it is unclear how widely revised neonatal malnutrition indicators are being used.

Purpose/aim:

To investigate the sensitivity and specificity …

Effective Non-Pharmacological Pain Relief Interventions Among Neonates: An Integrative Research Review, Staci Shaw

Providence Nursing Research Conference 2023 – Present

Background:

Newborns encounter many painful events, including heel sticks, venous blood sampling, peripheral intravenous insertions, and more. Newborns cannot verbally express pain, and caregivers rely on changes in vital signs (increased heart rate, decreased oxygen saturations) behavior (long periods of inconsolable crying), and facial expressions to grade newborn pain. Pain management in neonates is critical to preserve neurodevelopment. Due to adverse effects of pharmacological pain management interventions in neonatal populations, non-pharmacological pain management interventions are often utilized in newborns, such as swaddling, non-nutritive sucking, kangaroo care, oral sucrose, holding, touching, music, and breastfeeding. However, the most effective pain management intervention, …

Special Considerations For The Adolescent With Obesity: An Obesity Medicine Association (Oma) Clinical Practice Statement (Cps) 2024., Suzanne Cuda, Valerie O'Hara, Marisa Censani, Rushika Conroy, Brooke Sweeney, Jennifer Paisley, Cristina Fernandez Md, Meredith Dreyer, Allen Browne, Nancy T. Browne

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details special considerations for the management of the adolescent with obesity. The information in this CPS is based on scientific evidence, supported by medical literature, and derived from the clinical experiences of members of the OMA.

METHODS: The scientific information and clinical guidance in this CPS are based on scientific evidence, supported by the medical literature, and derived from the clinical perspectives of the authors.

RESULTS: This OMA Clinical Practice Statement addresses special considerations in the management and treatment of adolescents with overweight and obesity.

CONCLUSIONS: This OMA Clinical Practice …

Associations Between Anemia And Fgf23 In The Ckid Study., Elizabeth Thomas, Alexandra M. Klomhaus, Marciana L. Laster, Susan L. Furth, Bradley A. Warady, Isidro B. Salusky, Mark R. Hanudel

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that plays a central role in chronic kidney disease-mineral bone disorder and is associated with CKD progression and cardiovascular morbidity. Factors related to CKD-associated anemia, including iron deficiency, can increase FGF23 production. This study aimed to assess whether anemia and/or iron deficiency are associated with increased circulating concentrations of FGF23 in the large, well-characterized Chronic Kidney Disease in Children (CKiD) study cohort.

METHODS: Hemoglobin concentrations, iron parameters, C-terminal (total) FGF23, intact FGF23, and relevant covariables were measured in cross-sectional analysis of CKiD study subjects.

RESULTS: In 493 pediatric patients with …

Real-World Evidence On The Dosing And Safety Of C.E.R.A. In Pediatric Dialysis Patients: Findings From The International Pediatric Dialysis Network Registries., Laura Kohlhas, Milena Studer, Loes Rutten-Jacobs, Sylvie Meyer Reigner, Anja Sander, Hui-Kim Yap, Karel Vondrak, Paula A. Coccia, Francisco Cano, Claus Peter Schmitt, Bradley A. Warady, Franz Schaefer, Ipdn Collaborators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: This retrospective real-world study used data from two registries, International Pediatric Peritoneal Dialysis Network (IPPN) and International Pediatric Hemodialysis Network (IPHN), to characterize the efficacy and safety of continuous erythropoietin receptor activator (C.E.R.A.) in pediatric patients with chronic kidney disease (CKD) on peritoneal dialysis (PD) or hemodialysis (HD).

METHODS: IPPN and IPHN collect prospective data (baseline and every 6 months) from pediatric PD and HD centers worldwide. Demographics, clinical characteristics, dialysis information, treatment, laboratory parameters, number and causes of hospitalization events, and deaths were extracted for patients on C.E.R.A. treatment (IPPN: 2007-2021; IPHN: 2013-2021).

RESULTS: We analyzed 177 patients …

Epigenome-Wide Association Study Identifies Neonatal Dna Methylation Associated With Two-Year Attention Problems In Children Born Very Preterm., Marie Camerota, Barry M. Lester, Francisco Xavier Castellanos, Brian S. Carter, Jennifer Check, Jennifer Helderman, Julie A. Hofheimer, Elisabeth C. Mcgowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Thomas Michael O'Shea, Carmen J. Marsit, Todd M. Everson

Manuscripts, Articles, Book Chapters and Other Papers

Prior research has identified epigenetic predictors of attention problems in school-aged children but has not yet investigated these in young children, or children at elevated risk of attention problems due to preterm birth. The current study evaluated epigenome-wide associations between neonatal DNA methylation and attention problems at age 2 years in children born very preterm. Participants included 441 children from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a multi-site study of infants born < 30 weeks gestational age. DNA methylation was measured from buccal swabs collected at NICU discharge using the Illumina MethylationEPIC Bead Array. Attention problems were assessed at 2 years of adjusted age using the attention problems subscale of the Child Behavior Checklist (CBCL). After adjustment for multiple testing, DNA methylation at 33 CpG sites was associated with child attention problems. Differentially methylated CpG sites were located in genes previously linked to physical and mental health, including several genes associated with ADHD in prior epigenome-wide and genome-wide association studies. Several CpG sites were located in genes previously linked to exposure to prenatal risk factors in the NOVI sample. Neonatal epigenetics measured at NICU discharge could be useful in identifying preterm children at risk for long-term attention problems and related psychiatric disorders, who could benefit from early prevention and intervention efforts.

A Case Of Streptococcus Constellatus Bacteremia Secondary To Respiratory Syncytial Virus Bronchiolitis In A Neonate, Ronald G. Lott Iii, Samantha M. Lavertue, Xavier Zonna, Samuel Wlasowicz, Roland Zhang, Ravi Kavuda

Advances in Clinical Medical Research and Healthcare Delivery

Common causes of bacteremia in the neonatal period include group B streptococcus, listeria, and E. coli. We report a rare case of neonatal bacteremia with culture-positive Streptococcus constellatus. Streptococcus constellatus is part of the normal flora of the orogenital regions of the body; when found elsewhere, it causes pyogenic abscesses in the brain and digestive tract. In this case, the Streptococcus constellatus bacteremia was secondary to prolonged hospitalization in a patient with respiratory syncytial virus (RSV) bronchiolitis. This report serves to make physicians aware of and to define treatment options for Streptococcus constellatus as a rarely isolated organism that …

Pediatric Spinal Ependymoma With Chromothripsis Of Chromosome 6: A Case Report And Review Of The Literature., Keela R. Scott, Melissa Gener, Elena Repnikova

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Ependymomas are the third most common central nervous system tumor in the pediatric population; however, spinal ependymomas in children are rare. Ependymomas affecting the spinal cord most frequently occur in adults of 20-40 years of age. The current World Health Organization classification system for ependymomas is now composed of ten different entities based on histopathology, location, and molecular studies, with evidence that the new classification system more accurately predicts clinical outcomes.

CASE PRESENTATION: We present the case of a 16-year-old Caucasian female patient with a history of type 2 neurofibromatosis with multiple schwannomas, meningioma, and spinal ependymoma. Chromosome analysis …

Economic Impacts Of The Covid-19 Pandemic On Families Of Children With Autism And Other Developmental Disabilities., Olivia M. Pokoski, Hayley Crain, Carolyn Diguiseppi, Sarah M. Furnier, Eric J. Moody, Cy Nadler, Karen Pazol, Jessica Sanders, Lisa D. Wiggins, Maureen S. Durkin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: To control the spread of the coronavirus disease (COVID-19), many jurisdictions throughout the world enacted public health measures that had vast socio-economic implications. In emergency situations, families of children with developmental disabilities (DDs), including autism, may experience increased difficulty accessing therapies, economic hardship, and caregiver stress, with the potential to exacerbate autism symptoms. Yet, limited research exists on the economic impacts of the COVID-19 pandemic on families of children with autism or another DD compared to families of children from the general population.

OBJECTIVES: To assess impact of the COVID-19 pandemic related to parental employment and economic difficulties in …

A Case Report And Review On The Anesthetic Considerations Of Anterior Mediastinal Masses, Carter A. Schulz, Joshua D. Mohs, Andrew M. Reuter

Aesculapius Journal (Health Sciences & Medicine)

Case summary: A 15-year-old female presented with chest pain, dyspnea, and weight loss. A chest X-ray and subsequent CT scan revealed a large anterior mediastinal mass with cervical lymphadenopathy and pericardial effusion. Two biopsies under general anesthesia were performed, with the latter confirming classic Hodgkin lymphoma, nodular sclerosis subtype.

Discussion: This case underscores the significant clinical challenges posed by anterior mediastinal masses due to their proximity to vital cardiovascular and respiratory structures. Physiologic changes during general anesthesia can exacerbate these challenges. Preoperative assessment, including imaging and symptom evaluation, is crucial to guide operative planning. It is key to individualize the …

Measures Of Function In Physical Therapy Assessment Of Children With Cerebral Palsy: A Clinical Audit, Marvin D. Zotomayor

Philippine Journal of Physical Therapy

Introduction: The assessment of outcomes in children with cerebral palsy (CP) is important for monitoring their progress, evaluating interventions, and guiding health policies. This study aimed to (1) identify the most common outcome measures used in the clinics to assess function in children with CP, and (2) determine whether the outcome measures used in the clinics meet the current standards of assessment for the purpose of improving patient care decisions, research, and quality assurance.

Methodology: A retrospective record audit study design was used to determine if the current practice in the clinics on the assessment of function in children with …

Molecular-Guided Therapy For The Treatment Of Patients With Relapsed And Refractory Childhood Cancers: A Beat Childhood Cancer Research Consortium Trial., Giselle L Saulnier Sholler, Genevieve Bergendahl, Elizabeth C. Lewis, Jacqueline Kraveka, William Ferguson, Abhinav B. Nagulapally, Karl Dykema, Valerie I Brown, Michael S. Isakoff, Joseph Junewick, Deanna Mitchell, Jawhar Rawwas, William Roberts, Don Eslin, Javier Oesterheld, Randal K. Wada, Devang Pastakia, Virginia Harrod, Kevin Ginn, Raya Saab, Kevin Bielamowicz, Jason Glover, Eugenia Chang, Gina K. Hanna, Daniel Enriquez, Tyler Izatt, Rebecca F Halperin, Abigail Moore, Sara A. Byron, William P D Hendricks, Jeffrey M. Trent

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children with relapsed central nervous system (CNS tumors), neuroblastoma, sarcomas, and other rare solid tumors face poor outcomes. This prospective clinical trial examined the feasibility of combining genomic and transcriptomic profiling of tumor samples with a molecular tumor board (MTB) approach to make real‑time treatment decisions for children with relapsed/refractory solid tumors.

METHODS: Subjects were divided into three strata: stratum 1-relapsed/refractory neuroblastoma; stratum 2-relapsed/refractory CNS tumors; and stratum 3-relapsed/refractory rare solid tumors. Tumor samples were sent for tumor/normal whole-exome (WES) and tumor whole-transcriptome (WTS) sequencing, and the genomic data were used in a multi-institutional MTB to make real‑time treatment …

Revolutionizing Esophageal Atresia Treatment: Newly Approved Technique To Bypass Surgery, Gabriella Llorente

Mako: NSU Undergraduate Student Journal

Esophageal atresia (EA) is a rare congenital defect where the esophagus, during the early stages of development, does not fully form. This causes there to be no connection between the oral cavity and the stomach. Complications with EA treatment come into play when there is a long gap between the two segments of the esophagus, meaning they cannot simply be sewed together using anastomosis. A new device called Flourish has recently been approved by the FDA and may be a new and more humanitarian approach to solving long gap esophageal atresia in infants.

Relationship Between Obesity And Global Longitudinal Strain In The Pediatric Single Ventricle Fontan Population Across Ventricular Morphologies., Nitin Madan, Doaa Aly, Melanie Kathol, Amulya Buddhavarapu, Thomas Rieth, Ashley K. Sherman, Daniel Forsha

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Obesity is associated with diminished myocardial function as measured by strain echocardiography in children and young adults with normal cardiac anatomy. Data are lacking about the effect of obesity on myocardial strain in patients with a single ventricle. In this study, the relationship between body mass index (BMI) and single ventricle myocardial strain in the Fontan population was assessed.

METHODS AND RESULTS: Thirty-eight abnormal BMI Fontan cases (21 overweight and 17 obese) and 30 normal BMI Fontan controls matched based on single ventricular morphology, age, and sex were included in the study. Ventricular morphology was categorized as single right …

Opportunities For Pharmacogenetic Testing To Guide Dosing Of Medications In Youths With Medicaid., Sonya Tang Girdwood, Matthew Hall, James W. Antoon, Kathryn Kyler, Derek J. Williams, Samir S. Shah, Lucas E. Orth, Jennifer Goldman, James A. Feinstein, Laura B. Ramsey

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: There are an increasing number of medications with a high level of evidence for pharmacogenetic-guided dosing (PGx drugs). Knowledge of the prevalence of dispensings of PGx drugs and their associated genes may allow hospitals and clinical laboratories to determine which pharmacogenetic tests to implement.

OBJECTIVES: To investigate the prevalence of outpatient dispensings of PGx drugs among Medicaid-insured youths, determine genes most frequently associated with PGx drug dispenses, and describe characteristics of youths who were dispensed at least 1 PGx drug.

DESIGN, SETTING, AND PARTICIPANTS: This serial cross-sectional study includes data from 2011 to 2019 among youths aged 0 to …

Prenatal Diagnosis Of A Ductal-Dependent Branch Pulmonary Artery: Extra Vessels In The 3-Vessel And Trachea View., Anmol Goyal, Maria Kiaffas, Tara Swanson, Melanie Kathol, Sanket Shah, Nitin Madan

Manuscripts, Articles, Book Chapters and Other Papers

Obtaining a three-vessel (3V) and three-vessel and trachea (3VT) view from the fetal upper mediastinum is now considered to be part of standard imaging protocol for routine obstetric cardiac screening examinations. We report two fetal cases of an anomalous pulmonary artery origin, utilizing the standard 3V and 3VT views. Further imaging led to a rare diagnosis of bilateral ductus arteriosus with discontinuous branch pulmonary arteries in the absence of any other congenital heart defect. We briefly discuss the imaging features, differential diagnoses, and management of this rare entity.

Exploring Referral And Service Utilization Patterns Within An Outpatient Interdisciplinary Pediatric Chronic Pain Program, Aimee Hildenbrand, Christina M Amaro, Benjamin Bear, Catherine Soprano, Katherine S Salamon

Department of Medicine Faculty Papers

PURPOSE: We examine referral sources and clinical characteristics for youth presenting to an outpatient interdisciplinary pediatric chronic pain program.

PATIENTS AND METHODS: Referral data were extracted from the electronic health record. PROMIS Pediatric Anxiety and Pain Interference Scales were administered at an initial evaluation visit.

RESULTS: The program received 1488 referrals between 2016 and 2019, representing 1338 patients, with increasing volume of referrals over time. Referrals were primarily from orthopedics (19.6%), physical medicine and rehabilitation (18.8%), neurology (14.4%), and rheumatology (12.6%). Patients referred were primarily female (75.4%), White (80.1%), English-speaking (98.4%) adolescents (median=15.0 years). Of those referred, 732 (54.7%) attended …

Pharyngitis, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.