Pediatrics Commons^™

Is My Child's Heart Murmur Dangerous?, Bob Underwood, Mahmoud Jaara, Pezad Doctor

Pediatrics in Practice: A CME Podcast

Is my child's heart murmur dangerous or just harmless? Heart murmurs and when they matter — Pezad Doctor, MD, Pediatric Cardiology at Children's Mercy - Pediatrics in Practice - CME, and Mahmoud Jaara, MD, pediatric cardiology fellow at Children's Mercy - Pediatrics in Practice - CME, explain how to tell innocent murmurs (soft, systolic, short, position‑dependent) from concerning ones, which symptoms and family history raise concern, and what to expect at a cardiology visit (exam, oxygen saturation, pulses).

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Strengthening Health System-Community Partnerships To Address Pediatric Social Needs: A Qualitative Study, Joy Friedman, Melissa A. Alderfer, Kelsey Higgins, Aaron Carpenter, Jennifer Sciolla, Sarah E. Wawrzynski

Department of Pediatrics Faculty Papers

IntroductionStructural and social conditions influence pediatric health outcomes. Successful implementation of social needs screening and referral programs depends on community-based organizations (CBOs) to provide resources that address health-related social needs (HRSN). We explored current practices and perspectives of health care workers and CBO representatives on improving health system-CBO partnerships.MethodsParticipants were purposively recruited from a variety of health care settings involved in HRSN screening and CBOs delivering resources in the community. Participants completed semi-structured interviews. Qualitative thematic analysis was used to summarize data.ResultsTen key informants participated (six health care workers and four CBO representatives). Four themes were identified: 1) mismatches in …

Blinatumomab Care Delivery For Pediatric B-Cell Acute Lymphoblastic Leukemia, Daniel Zheng, Katelyn Oranges, Subhash Ramakrishnan, Lingyun Ji, Melissa Beauchemin, Sarah Alexander, Allison Leahy, Kira Bona, Emi Caywood, Sharon Castellino, Sumit Gupta, Douglas Hawkins, Olga Militano, Kathleen Montgomery, Haley Newman, Rachel Rau, Susan Rheingold, Joanna Robles, Michael Roth, David Teachey, Sarah Vargas, Sue Zupanec, Susan Parsons

Department of Pediatrics Faculty Papers

IMPORTANCE: Blinatumomab, a novel immunotherapy administered as a 28-day continuous infusion, has fundamentally shifted the treatment paradigm for pediatric B-cell acute lymphoblastic leukemia (B-ALL) and is now considered a component of standard therapy for the most common childhood cancer. However, the care delivery challenges in transitioning from an experimental agent on a clinical trial to widespread clinical implementation are unknown.

OBJECTIVE: To characterize the clinical landscape of pediatric blinatumomab care-delivery practice and challenges in the US from the perspective of treating centers.

DESIGN, SETTING, AND PARTICIPANTS: This survey study was conducted from February to March 2025 among US member institutions …

Is My Child's Pink Eye Contagious?, Sarah Gubara, Jennifer N. Qayum

Pediatrics in Practice: A CME Podcast

Is my child's pink eye contagious and how long will it last? Jennifer Qayum, OD, FAAO, Optometrist at Children's Mercy - Pediatrics in Practice - CME, explains how viral, bacterial, and allergic conjunctivitis spread and how long contagion can persist. She discusses unilateral vs bilateral onset, discharge types (yellow/green versus watery), typical contagious periods for viral cases, and practical prevention steps like hand hygiene and laundering linens to reduce household spread.

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Sports Injuries You May Overlook, Sarah Gubara, Greg Canty

Pediatrics in Practice: A CME Podcast

Could this recurring pain or sudden limp mean something more than a sprain? Greg Canty, MD, Medical Director, Sports Medicine Center at Children's Mercy, walks through how to recognize concerning pediatric sports injuries that are often missed. This episode covers X‑ray‑negative knee injuries (patella dislocation, ACL tear, meniscus), pelvic avulsion and transitional ankle growth plate fractures, and overuse conditions such as gymnast wrist, spondylolysis, Little League elbow, and shoulder impingement. Dr. Canty outlines practical red flags—swelling, inability to weight‑bear, point tenderness, pain persisting beyond two weeks in single‑sport athletes, and declines in participation—and explains how assessing training load, sleep, nutrition, …

Association Between Estimated Time With Low Glomerular Filtration Rate And Access To Transplant Among Youth With Advanced Chronic Kidney Disease., Elaine Ku, Timothy Copeland, Charles E. Mcculloch, Jonathan D. Savant, Bradley A. Warady, Susan L. Furth, Sarah Kizilbash, Daniel I. Feig, Roshan P. George, Joseph T. Flynn, Judith Jerry-Fluker, Matthew B. Matheson, Sandra Amaral, Ckid Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Slower chronic kidney disease (CKD) progression allows more time for transplant preparation. Whether differences in CKD progression by race/ethnicity associate with preemptive or living donor transplantation in youth has not been well studied.

METHODS: We examined the association between time spent with low eGFR (between 10-30 mL/min/1.73 m²) and odds of preemptive or living donor transplantation among youth with CKD. eGFR was estimated using the bedside Schwartz (if < 18 years) and CKD-EPI 2021 equations (if ≥ 18 years) and the CKiD U25 equation in sensitivity analysis. Time spent with low eGFR was compared by race/ethnicity.

RESULTS: Among 333 youth with CKD (median age 11 years [IQR 7,14]), median time spent with low eGFR was 28.8 months. 77% were preemptively waitlisted, and 45% received preemptive …

Prediction Model For Children With Anaphylaxis Who May Not Require Emergency Department Care: A Multicenter Retrospective Cohort Study., Timothy E. Dribin, David Schnadower, Hugh A. Sampson, Yin Zhang, Nanhua Zhang, Stephen B. Freedman, Mark I. Neuman, David C. Brousseau, Rakesh D. Mistry, Stephanie Boyd, Yonatan Wolnerman, Patrick S. Walsh, Craig Vander Wyst, Vandana Thapar, Jonathan Strutt, Geetanjali Srivastava, Nidhi V. Singh, Christopher J. Russo, Christian D. Pulcini, Thuy L. Ngo, Jo-Ann O. Nesiama, Matthew M. Moake, Ashley M. Metcalf, Tamar R. Lubell, Juhee Lee, Chari D. Larsen, Karen Y. Kwan, Curtis L. Knoles, Kajal Khanna, Julia F. Freeman, Justin R. Davis, Alicia Daggett, Joanna S. Cohen, Ari R. Cohen, Wee-Jhong Chua, Sri S. Chinta, Brittany Boswell, Kelly R. Bergmann, Paul L. Aronson, Kenneth A. Michelson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The 2023 US Anaphylaxis Practice Parameter indicated that some patients receiving epinephrine in the community might avoid emergency department (ED) visits; however, the criteria and safety of this approach remain unproven.

OBJECTIVE: To derive and validate a clinical prediction model for identifying children at risk of receiving epinephrine after arriving at the ED.

METHODS: We conducted a 31-center retrospective cohort study of children aged 6 months to less than 18 years who received 1 prehospital dose of epinephrine for allergic reactions between 2016 and 2019. The outcome was receipt of epinephrine after ED arrival. We used least absolute shrinkage …

Maternal Violent Injury And Child Exposure To Violence-A Call For Trauma-Informed And Structural Responses., Gunjan Tiyyagura, M Katherine Henry, Kimberly Randell

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

More Than A Free Snack: Benefits Of Mobilized Resources And Socialization For Pediatric Healthcare Workers., Thomas Ayres, Kristin Ray, Aimee M. Hoflander, Angela Myers

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Addressing the burnout epidemic in the healthcare workforce is a primary concern of the modern healthcare organization and recognized across researchers and leaders of nations. This study aims to test whether a mobilized micro-break intervention, the Wellbeing on Wheels (WOW) Cart, improved health care worker (HCW) energy perceived organizational support and work engagement.

METHODOLOGY: This study was conducted at an independent children's hospital in the midwestern United States. Between August and September 2024. A total of 367 pediatric HCWs completed our survey. IBM's SPSS was used to analyze the data using t-tests, ANOVAs, linear regression, and polynomial regression …

Micrognathia, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Emergency Contraception, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Using Early And Periodic Screening, Diagnostic, And Treatment (Epsdt) To Improve Access To Obesity Pharmacotherapy: A Practical Guide For Clinicians Caring For Youth With Obesity Across United States Medicaid Programs:, Jaime M. Moore, Valerie M. O'Hara, Cassie Totman, Brooke Sweeney, Sarah Hampl, Alaina P. Vidmar

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Coverage of obesity pharmacotherapy for youth varies substantially across state Medicaid programs. This variability limits access to evidence-based treatment for pediatric obesity. The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit is a federally mandated Medicaid provision requiring coverage of medically necessary services for individuals under age 21, even when such services are not included in standard state Medicaid benefits. Despite its broad scope, EPSDT remains underutilized due to limited awareness and operational complexity.

METHODS: We developed a clinician-facing, practice-oriented framework to operationalize EPSDT for pediatric obesity treatment. This approach integrates (1) review of federal EPSDT policy and …

Vomica And Respiratory Distress: A Complicated Lung Hydatid Cyst In A Child., Riccardo Guanà, Antonella Peduto, Maria Grazia Sacco Casamassima, Marco Denina, Marco Petraz, Cristina Giuliano, Giuseppe Farruggio, Lucia Gerbaudo, Fabrizio Gennari

Manuscripts, Articles, Book Chapters and Other Papers

Hydatid cyst, caused by Echinococcus infection, is the most common parasitic lung infection in children. Giant cysts are generally the result of a late diagnosis and are associated with a high risk of spontaneous rupture and life-threatening complications, including anaphylactic shock. We present the complex management of a large, complicated hydatid cyst of the lung in an 11-year-old boy in a nonendemic area. This case highlighted the specific work-up and surgical treatment of lung cysts as well as the differential diagnosis to consider when treating pulmonary masses or pneumonia.

Patient-Specific Computational Fluid Dynamics Modeling Of Airway Collapse In Infants With Robin Sequence., Gautam Jalori, Michael Barbour, Michael Bindschadler, Kelly Evans, John P. Dahl, Alberto Aliseda

Manuscripts, Articles, Book Chapters and Other Papers

Robin Sequence (RS) is a congenital condition in which patients experience dynamic, periodic obstruction or collapse of the upper airway due to an underdeveloped jaw and a posteriorly displaced tongue. Current clinical techniques for evaluating airway obstruction do not provide quantifiable data and fail to account for the dynamic nature of obstruction or collapse. There is no standardized criterion to characterize obstruction or collapse severity. This study presents the first method that extracts airway motion from 4-dimensional computed tomography and performs a patient-specific, moving-mesh computational fluid dynamics (CFD) analysis of RS patients with complete airway collapse or obstruction. To quantify …

Pharmacogenetics In Pediatric Cardiology., Adenike Adenikinju, Jonathan B. Wagner, Mollie Walton

Manuscripts, Articles, Book Chapters and Other Papers

Children with congenital and acquired heart disease frequently require complex and prolonged pharmacotherapy, often involving off-label cardiovascular medications with narrow therapeutic ranges. Consequently, variability in drug response and medication-related adverse events remains a significant clinical challenge in pediatric cardiology. Pharmacogenetics provides a framework to individualize drug selection and dosing by incorporating genetic variability alongside established clinical and developmental factors. This review outlines the current clinical utility and emerging role of pharmacogenetics in pediatric cardiology, emphasizing applications most relevant to day-to-day patient care. Established pharmacogenetic associations with direct implications for pediatric cardiac practice include gene-drug pairs involving tacrolimus (CYP3A5), …

Posaconazole Target Attainment In Critically Ill Children: A 15-Year Single-Center Retrospective Analysis., Kathryn Pavia, Addison M. Pritchett Ms, Jennifer Goldman

Manuscripts, Articles, Book Chapters and Other Papers

Posaconazole is a triazole antifungal agent used for prophylaxis and treatment of invasive fungal diseases. Posaconazole has high inter-individual variability in dose-exposure relationship and benefits from therapeutic drug monitoring (TDM). Adult studies report particularly high rates of subtherapeutic exposure among intensive care unit (ICU) patients related to changes in physiology during critical illness. The rates of subtherapeutic posaconazole exposure among critically ill children in ICU's are unknown. This single-center retrospective analysis at a large freestanding children's hospital used TDM results from 2010 to 2025 obtained while patients were undergoing care in a pediatric ICU. Therapeutic targets were ≥ 1.0 mg/L …

Hla-Dr Expression At Diagnosis Is Not Predictive Of Relapse Risk Post Allogeneic Hematopoietic Stem Cell Transplantation For Pediatric Acute Myeloid Leukemia: A Report From The Children's Oncology Group., Vasant Chinnabhandar, Michael R. Verneris, Kirk R. Schultz, Alan S. Gamis, Richard Aplenc, Chad A. Hudson, Todd A. Alonzo, Robert B. Gerbing, John T. Horan, Joseph H. Chewning

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Blaschko-Linear Lupus Erythematosus In A Pediatric Patient, Marshall Hall, Olivia Mayer, Henry Lim, Dustin V. Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

The lines of Blaschko represent epithelial cell migration during embryonic development. Rare forms of cutaneous lupus erythematosus may manifest along these lines, and lesions are termed Blaschko-linear lupus erythematosus (BLE). The purpose of this case study is to present a rare manifestation of linear cutaneous lupus erythematosus following the lines of Blaschko in a pediatric patient. To date, there are very few reports of BLE. We present a 17-year-old female with a 2-month history of a mildly tender growing lesion along the right nasofacial sulcus. The patient denied lesions elsewhere and any systemic, joint, or mucosal symptoms. A biopsy of …

Measuring Family Involvement In Early Intervention Services For Children Who Are Dhh: A Scoping Review, Marie Martinez, Blair Richlin, Kristina Blaiser

Journal of Early Hearing Detection and Intervention

Background: Family involvement after a child has been identified as deaf or hard of hearing (DHH) is often recommended as “best practice” for Family Centered Early Intervention (FCEI; Szarkowski et al., 2024) and a catalyst for improved outcomes. Defining actions of a family will inform high-quality family support programs. This scoping review aims to explore and document family involvement as well as the current systems of measurement used in early intervention DHH family-centered services.

Purpose: The specific aim of this scoping review was to identify the operational definitions of family involvement and metrics used with families of children who are …

Mean Platelet Volume As A Marker Of Disease Severity In Hospitalized Children With Acute Bronchiolitis., Kedar Tilak, Trisha Sunderajan, Lewis Krata

Manuscripts, Articles, Book Chapters and Other Papers

Bronchiolitis is one of the most common lower respiratory tract infections affecting children less than two years of age and is a leading cause of hospitalization. Mean platelet volume (MPV), a readily available component of the complete blood count, has been investigated as an inflammatory biomarker in various conditions. Our present study evaluated the association between MPV values and the severity of acute bronchiolitis in hospitalized children.    Objective: The aim of this study was to determine the association between MPV, severity of respiratory distress, and need for oxygen support in hospitalized children under two years of age with acute bronchiolitis. …