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Improving Care for Adolescents and Young Women With Pelvic Pain: Highlights From New ACOG Guidelines
 Improving Care for Adolescents and Young Women With Pelvic Pain: Highlights From New ACOG Guidelines 1024 683 Geri Hewitt, MD
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Between 50 and 90 percent of adolescents and young women report dysmenorrhea- and endometriosis-related pelvic pain. Pediatricians and primary care doctors have many opportunities to recognize and treat these conditions, leading to enhanced quality of life and better long-term reproductive outcomes for these patients. The recently published guidance from the American College of Obstetrics and…

Should “Non-High Risk Patients” With Uncomplicated Influenza be Given Antivirals?
 Should “Non-High Risk Patients” With Uncomplicated Influenza be Given Antivirals? 150 150 Michael T. Brady, MD
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This question references a recommendation from the Centers for Disease Control and Prevention that is open to interpretation. For years, the CDC has recommended that all “hospitalized, severely ill and high-risk patients with suspected or confirmed influenza should be treated with antivirals.” Those at high risk include children younger than 2 years of age and…

The Joys and Challenges of Rural Pediatrics
 The Joys and Challenges of Rural Pediatrics 1024 575 Jill Neff, DO
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I often tell my medical students to choose not just a specialty but, first, a place where they want to live. Being happy with one’s life is more important than just being happy with one’s job. If a person prefers to live in a rural setting, then they probably should not become a neuro- or…

Bacteria Hiding Out Inside Epithelial Cells May Promote Recurring Ear Infections
 Bacteria Hiding Out Inside Epithelial Cells May Promote Recurring Ear Infections 1024 575 Rachael Hardison
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Middle ear infections, also known as otitis media (OM), remain a health care concern for children in the United States and across the world, despite recent therapeutic and technological advances. For the subset of children with chronic or recurring infections, OM becomes a significant socioeconomic burden for caregivers. Chronic or recurrent episodes of OM can…

Letting Go of The Screen (My 15-Year Journey With an EMR)
 Letting Go of The Screen (My 15-Year Journey With an EMR) 1024 683 William Long, MD
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Has the electronic medical record ruined medicine?  For those of us who trained pre-EMR, this conversion was a difficult change.  For ALL of us, regardless of age, the burden of charting and data entry is a significant reason for the alarming numbers of burned out and unhappy physicians.  There are many written opinions on this subject,…

Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed
 Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed 1024 575 Jeb Phillips
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Improved neonatal care and earlier diagnosis and management may instead be reason for a decrease in cerebral palsy severity. A large randomized controlled trial showed in 2008 that when pregnant women at imminent risk of preterm delivery were given magnesium sulfate, their children had reduced rates of moderate or severe cerebral palsy. As a result…

Primary Care for Refugee Children: What Providers Need to Know
 Primary Care for Refugee Children: What Providers Need to Know 1024 575 Aimee Swartz, MPH
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Toddler playing with toys

The growing number of refugee children across the United States means that more pediatricians need to be aware of the unique health needs of this population. The world’s estimated refugee population has surged to 24.5 million individuals – more than half of whom are children – at United Nations High Commissioner for Refugees (UNHCR) last count. Many…

The Impact of Opioids on Children
 The Impact of Opioids on Children 1024 575 Abbie Miller
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A black-and-white image of an adolescent White boy, a young Black girl, an adolescent White girl, a Black teen boy, and a young White mom and her infant, all in a row across the screen, all in white shirts, and all with solemn expressions.

The faces above represent the young lives affected by the opioid crisis. Children who are losing their parents to addiction and overdoses. Children who live in instability and uncertainty. Children who spend their earliest weeks in withdrawal. And children who are at risk of developing their own addictions. Here in Columbus, Ohio, we’ve had a…

Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families
 Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families 1024 575 Abbie Miller
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If there’s a success story to be told at this point in the history of the opioid crisis, it’s in the newborn intensive care unit. From changing attitudes to standardizing treatment, clinical care for infants with neonatal abstinence syndrome (NAS) and their families is markedly different than it was 10 years ago.   CHANGING ATTITUDES…

Primary Care Provider Guide to Neonatal Abstinence Syndrome Follow Up
 Primary Care Provider Guide to Neonatal Abstinence Syndrome Follow Up 150 150 Nationwide Children's
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Pediatricians have a unique challenge when it comes to caring for the broad spectrum of needs associated with opioid-exposed infants. Some babies who were treated with pharmacological methods in a hospital will be discharged home still on neuro-active medications. Other babies did not receive a neonatal abstinence syndrome (NAS) diagnosis or specific treatment after birth…

What Happens When Opioid-Exposed Babies Go Home?
 What Happens When Opioid-Exposed Babies Go Home? 1024 575 Abbie Miller
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Black and white image of an unsmiling White woman holding a young, awake infant in the right third of the frame

Follow-up for babies with NAS or prenatal opioid exposure is essential for understanding risks and outcomes.

Moving From Child Health Care to Child Health
 Moving From Child Health Care to Child Health 1024 575 Kelly Kelleher, MD, MPH
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As pediatricians, we want children to be healthier, even the ones who never come through our doors. At Nationwide Children’s Hospital, the board and leadership have aimed to do just that by setting the highest bar yet for our organization – we want central Ohio children to be the healthiest in the United States. But…

QI Project Increases Value of Asthma Care in a Large Primary Care Network
 QI Project Increases Value of Asthma Care in a Large Primary Care Network 1024 393 Kevin Mayhood
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Multiple steps lead to better control of disease, fewer emergency department visits and $5 million in savings. A quality improvement project helped kids achieve better control of their asthma, reduced emergency room visits and cut costs in a primary care network serving 10,000 children with the disease. Through multiple steps, including standardizing assessments and documentation,…

Opening the Door to Adult Medicine
 Opening the Door to Adult Medicine 1024 575 Katie Brind'Amour, PhD, MS, CHES
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Care transition plans aren’t just for kids with congenital conditions anymore. Could your practice benefit from a proactive transition plan for all patients? In the shift from pediatric to adult care, young patients have the responsibility to adjust to a new life of self-management. But health care providers also play an important role in this…

Managing Pain in an Era of Opioid Abuse
 Managing Pain in an Era of Opioid Abuse 1024 575 Abbie Miller
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A black-and-white image of an adolescent White boy, a young Black girl, an adolescent White girl, a Black teen boy, and a young White mom and her infant, all in a row across the screen, all in white shirts, and all with solemn expressions.

Managing pain is complicated. Not that long ago, perhaps 50 years or so, pain was understood to be a multidisciplinary issue requiring many different approaches. Doctors would recommend lifestyle changes, complementary therapies and medications to treat chronic pain. Then something changed. Opioids began being marketed as “nonaddictive.” Pain became the “5th vital sign,” and physicians…

What Can Bench Science Teach Us About Opioid Abuse?
 What Can Bench Science Teach Us About Opioid Abuse? 150 150 Abbie Miller
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In vitro models can help answer big questions about neonatal abstinence syndrome and fetal drug exposure.

Breaking the Cycle: Preventing and Treating Addiction in Youth
 Breaking the Cycle: Preventing and Treating Addiction in Youth 1024 575 Abbie Miller
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Virtually all addictions begin during adolescence. And nearly 4 million 12-25 year olds in the United States have a substance abuse problem, according to the U.S. Department of Health & Human Services. Substance abuse in adolescents is not restricted to opioids, but in the midst of this national crisis, too many young people are finding…

The Opioid Education Toolkit: For Providers and Parents
 The Opioid Education Toolkit: For Providers and Parents 1024 575 Nationwide Children's
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Do you know all the options for safe medication disposal? What are evidence-based methods for screening and assessing risk of opioid abuse? Find answers and resources in the Opioid Toolkit. Opioid Safety Protocol for the Home Four Points to Remember When Taking Opioids Monitor: Know where the medications are at all times. Keep a count of…

Generating the Genome: How Scientists Changed the Face of Cancer Research
 Generating the Genome: How Scientists Changed the Face of Cancer Research 1024 683 Katie Brind'Amour, PhD, MS, CHES
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Color photo; environmental portrait ofDrs. Elaine Mardis and Richard Wilson

Team science. Ongoing innovation. Brilliant minds. Here’s how The Cancer Genome Atlas spawned a revolution in cancer research and technology. The Cancer Genome Atlas is wrapping up. Its data now lives online in the Genomic Data Commons, freely available to the public. Reports of the primary findings for each studied tumor type have been published, and…

Are We Turning Away Too Many Pediatric Donor Hearts?
 Are We Turning Away Too Many Pediatric Donor Hearts? 150 150 Katie Brind'Amour, PhD, MS, CHES
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More than half of all pediatric donor hearts are declined for use each year, despite the fact that many children die waiting for a heart. But why? And what can be done about it?   As many as one in every four infants on the heart transplant list dies awaiting an organ. For older children,…

Could Antimicrobial Peptides Be Biomarkers for Obstructive Uropathy?
 Could Antimicrobial Peptides Be Biomarkers for Obstructive Uropathy? 1024 683 Katie Brind'Amour, PhD, MS, CHES
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New research reveals the expression of antimicrobial peptides — long associated only with infections — in children with obstructive uropathy, creating the potential for a wide range of clinical applications. Previously only studied in the context of urinary tract and other infections, antimicrobial peptides (AMPs) — naturally occurring antibiotic molecules that our bodies may use…

Quality Improvement Study Shifts HPV Vaccine Initiation to Earlier Age
 Quality Improvement Study Shifts HPV Vaccine Initiation to Earlier Age 150 150 Aimee Swartz, MPH
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A QI project shows that it is feasible, and possibly beneficial, to routinely administer HPV vaccine at age 9. It is feasible, and possibly beneficial, to routinely administer the human papillomavirus (HPV) vaccine beginning at age 9 — two to three years earlier than currently recommended — according to findings from a recent study conducted…

A Better Way to Administer Probiotics?
 A Better Way to Administer Probiotics? 150 150 Abbie Miller
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Researchers have designed a delivery system to treat premature infants with necrotizing enterocolitis that may have applications beyond the NICU. Most of the time, we think biofilms are bad news. And when pathogenic microbes form biofilms, they are. The biofilms created by pathogenic microbes create fortresses that make them resistant to attack by the immune…

Cannabis-Derived Treatment Can Significantly Reduce Seizures in Hard-To-Treat Childhood Epilepsy
 Cannabis-Derived Treatment Can Significantly Reduce Seizures in Hard-To-Treat Childhood Epilepsy 150 150 Jeb Phillips
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A new study shows that cannabidiol is effective in children with Lennox-Gastaut syndrome. Children with Lennox-Gastaut syndrome can have hundreds of brief seizures every day. This complex form of epilepsy often does not respond to conventional epilepsy medication, leaving children at serious risk of injury from their seizures, or confined to wheelchairs and beds. An international…

How Primary Care Providers Can Help Justice-Involved Youth
 How Primary Care Providers Can Help Justice-Involved Youth 1024 683 Deena Chisolm, PhD
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Deena Chisolm, PhD, shares how primary care physicians can support youth who may experience behavioral health issues related to justice involvement. For most people in the United States, the law enforcement and criminal justice systems support a sense of safety and security.  However, for some populations, particularly people of color, perceptions of and interactions with…

The Pediatrician’s Role in Health and Hope after Trauma
 The Pediatrician’s Role in Health and Hope after Trauma 150 150 Anna Kerlek, MD
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A primary care provider’s ability to identify and treat symptoms associated with trauma can increase positive outcomes for patients and families. Almost two-thirds of the children and their caretakers in your office have experienced at least one trauma. Many have experienced more. As a primary care provider, you can provide early intervention and support for…

Mapping the World of Pediatric Severe Sepsis
 Mapping the World of Pediatric Severe Sepsis 1024 576 Katie Brind'Amour, PhD, MS, CHES
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Blood cells

Researchers work to reveal the many subtypes of pediatric sepsis — and what to do about them. Once upon a time, sepsis was just sepsis. Children experiencing septic shock and its aftermath — any resulting organ failure — were viewed as a fairly homogenous group of patients. But now, thanks in a large part to…

How to Identify and Treat Blood Clots in Pediatric Patients With Cancer
 How to Identify and Treat Blood Clots in Pediatric Patients With Cancer 1024 575 Mary Bates, PhD
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Black and white photo of a young patient with cancer wearing a mask and gown and holding an IV poll smiling and giving a thumbs up in the hospital

New guidelines will help doctors recognize and treat children at risk of venous thromboembolism. Prevention of blood clots is well described in adult cancer patients, but data on the problem in pediatric cancer patients is limited. In a new publication initiated at the request of the International Society of Thrombosis and Hemostasis, researchers provide guidance for…

The PDA Conundrum
 The PDA Conundrum 150 150 Jeb Phillips
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A patent ductus arteriosus is associated with increased morbidity and mortality, but common treatments are associated with poor outcomes as well. What is a neonatologist to do? Until the mid-2000s, most neonatologists were pretty sure they knew how to handle a patent ductus arteriosus (PDA) in an infant born preterm – it needed to be…

Can Gene Therapy Treat Dominantly Inherited Disorders?
 Can Gene Therapy Treat Dominantly Inherited Disorders? 1024 575 Abbie Miller
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Colorful illustration of gene therapy in action

Recent applications of adeno-associated virus (AAV) mediated gene therapy have focused mainly on correcting recessively inherited diseases. But what about dominantly inherited disorders? It looks like AAV could be a delivery mechanism for treating those genetic disorders, too. Most applications of AAV-mediated gene therapy research are in recessively inherited rare diseases. The affected individuals have…

Accessing Genomic Data for Research and Clinical Diagnostics – Meeting the Challenge
 Accessing Genomic Data for Research and Clinical Diagnostics – Meeting the Challenge 1024 575 Rajeswari Swaminathan, MS
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Rajeswari Swaminathan smiling and posing for photo in front of windows

What good is genomic data if it can’t be shared efficiently? The genesis of DNA sequencing technology in the 1970s was a turning point in science, giving birth to a modern era in biology. Further, with the unfolding of the relationship between nucleic acid order and uniqueness across species, improvement in strategies to sequence this…

FDA APPROVAL: Gene Therapy Comes of Age
 FDA APPROVAL: Gene Therapy Comes of Age 1024 575 Abbie Miller
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Colorful illustration of gene therapy in action

UPDATED: May 2019 On May 24, 2019, the FDA approved Zolgensma (formerly AVXS-101), a first-of-its-kind gene therapy for spinal muscular atrophy. In the 13 months that have passed since this article first posted, the long-term outcomes of gene therapy for spinal muscular atrophy (SMA) have continued to bolster the community’s hope for the treatments. Now,…

Weaving an Antimicrobial Safety Net
 Weaving an Antimicrobial Safety Net 150 150 Kevin Mayhood
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Stewards thread together monitoring programs and new protocols while trimming unwarranted tests and diagnostic speed. This story also appeared in the Spring/Summer 2018 print issue. Download a PDF of the print issue. Studies estimate that 30 to 50 percent of antimicrobials prescribed in hospitals and up to 50 percent prescribed in outpatient settings are either unnecessary…

A Heart in Three Dimensions
 A Heart in Three Dimensions 1024 575 Abbie Miller
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The 3D Printing Lab at Nationwide Children’s Hospital provides comprehensive patient-specific treatment planning and device development services from a pediatric perspective. The tiny heart pictured above is just one of the many 3D printed models created by the 3D Printing Team at Nationwide Children’s. It represents one of the many helped by the technology and…

Can We Prevent Future Language Delays in the NICU?
 Can We Prevent Future Language Delays in the NICU? 150 150 Abbie Miller
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Researchers investigate the use of event related potentials to measure the effects of mother’s voice exposure on speech sound differentiation. Preterm infants are at high risk for neurosensory impairments and developmental delays, including hearing loss, which may have lasting consequences. Compared to babies born at term, preterm infants are twice as likely to have a…

Solving the Puzzle of Transfusion-Related Immune Reactions
 Solving the Puzzle of Transfusion-Related Immune Reactions 576 367 Katie Brind'Amour, PhD, MS, CHES
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Now that physicians have the “how” of blood transfusions mastered, they are starting to explore the “what” — and they’re learning that the effects of sharing human blood may be even more far-reaching and complex than previously imagined. With the initial safety challenges addressed and the technical barriers of donor blood storage and cleaning improved,…

The Challenge of Studying Supplementation: Omega Fatty Acids to Prevent Preterm Birth and Associated Complications
 The Challenge of Studying Supplementation: Omega Fatty Acids to Prevent Preterm Birth and Associated Complications 1024 575 Abbie Miller
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Dietary supplements: it seems that medical professionals either love them or hate them. And while much research shows that the average healthy adult with a good diet probably doesn’t need them, studies of specific supplements in specific patient populations may show efficacy. For example, studies show that omega-3 fatty acid supplements can reduce inflammation and…

Conquering the Biological Politics of Cancer: Corruption, Coercion and Collusion
 Conquering the Biological Politics of Cancer: Corruption, Coercion and Collusion 150 150 Timothy Cripe, MD, PhD
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Understanding the “Three C’s” may provide the insights need to move the needle on the cancers with the bleakest prognoses. Broadly speaking, cancers fall into three categories: leukemias, brain tumors and other solid tumors. Since the dawn of chemotherapy in the 1940s, we’ve converted the most common type of leukemia, acute lymphoblastic leukemia, from incurable…

To Test or Not to Test: The Inherited Thrombophilia Question
 To Test or Not to Test: The Inherited Thrombophilia Question 150 150 Abbie Miller
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When a result provides questionable or limited clinical utility, physicians and genetic counselors must educate patients and providers on the pros and cons of genetic testing. Between the increased ease of clinical genetic testing and the direct-to-consumer genetic testing kits now available, physicians and genetic counselors face education challenges that simply did not exist a…

Considerations for Integrating Behavioral Health and Primary Care
 Considerations for Integrating Behavioral Health and Primary Care 150 150 Cody Hostutler, PhD
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As increasing numbers of pediatric patients require behavioral health care, primary care providers look to integrate behavioral health providers in their practice. You know the story. It’s the middle of a busy Friday afternoon, you just finished up an adolescent well-visit, your hand is on the door and you hear, “Doc, one more question?” The…

Phase 1 Study Shows Promise of Gene Replacement Therapy for Spinal Muscular Atrophy Type 1
 Phase 1 Study Shows Promise of Gene Replacement Therapy for Spinal Muscular Atrophy Type 1 1024 575 Abbie Miller
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The phase 1 clinical study shows that gene therapy extends survival of patients and supports achievement of milestones previously unseen in the natural course of the disease. A one-time intravenous infusion of the high dose of gene therapy extended the survival of patients with spinal muscular atrophy type 1 (SMA1), according to a study published in…

On the Road to Eliminating RSV
 On the Road to Eliminating RSV 150 150 Abbie Miller
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With the recent publication of two papers, researchers shed light on factors that influence disease severity and immune response to respiratory syncytial virus infection in infants and young children. “RSV is a very common infection in infants and young children – almost everyone will be infected by age 2. In the United States, 2-3 percent…

8 Ways You Can Support Families in Need of Behavioral Health Services
 8 Ways You Can Support Families in Need of Behavioral Health Services 150 150 Nancy Cunningham, PsyD
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Long wait times and difficulties accessing behavioral health services cause stress for many patients and families. As awareness grows about the prevalence of behavioral health challenges for children and adolescents, more patients and families are seeking specialized care. However, due to a shortage of behavioral health specialists, wait times can seem daunting. As the pediatrician,…

6 Strategies for Incorporating Behavioral Economics in Your Practice
 6 Strategies for Incorporating Behavioral Economics in Your Practice 150 150 Kevin Mayhood
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Behavioral economics combines insights from psychology, economics and marketing to improve or direct decision-making. It can be used to “nudge” patients, their families and practitioners in the direction of better health if used by health care providers. While the use of behavioral economics strategies has limited study in pediatrics, the existing research indicates a number of…

Bouncing Back: Overcoming Physician Burnout With Resilience
 Bouncing Back: Overcoming Physician Burnout With Resilience 1024 575 Suzanne Reed, MD and John Mahan, MD
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Physician burnout is becoming increasingly recognized as an extensive and debilitating reality. Present in specialties across the spectrum of medicine, most disciplines report burnout rates of 50 to 60 percent or more, and these rates have been increasing over the last several years. Pediatrics alone demonstrated a more than 16 percent increase in burnout, up…

Can Behavioral Economics Help People Adopt Better Health Habits?
 Can Behavioral Economics Help People Adopt Better Health Habits? 150 150 Kevin Mayhood
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Simple incentives may nudge patients, caregivers and clinicians to make more healthful choices. Behavioral economics has helped electricity customers cut down on usage, new employees to start setting aside money for retirement from day one and, more recently, to change health care provider and patient behaviors. The practice combines insights from psychology, economics and marketing…

Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease
 Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease 1024 575 Abbie Miller
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From bioengineers to interventional cardiologists, molecular biologists to cardiothoracic surgeons, experts with diverse backgrounds are focusing on the problem of heart valve disease in children. Heart valve disease affects more than 5 million Americans. And while acquired disease in the adult population certainly accounts for much of this, children with heart valve disease face multiple…

Creative Reality: Using a New Platform Technology to Improve Patient Experience
 Creative Reality: Using a New Platform Technology to Improve Patient Experience 1024 575 Abbie Miller
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Amy Dunn, MD, had a problem. Some of her patients in the hematology clinic at Nationwide Children’s Hospital receive hundreds of needle sticks each year. “Needle phobia is very real for these patients and their families,” says Dr. Dunn, director of Pediatric Hematology at Nationwide Children’s. “In some cases, ports need to be implanted so that these…

Mapping the Journey to Optimal Health for NICU Graduates
 Mapping the Journey to Optimal Health for NICU Graduates 1024 683 Jeb Phillips
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Babies born preterm need ongoing, specialized care to help them thrive after discharge from the hospital. Innovative programs are being designed to ensure that they get that care. In the early 1980s, only 10 percent of infants born before 28 weeks of gestational age survived to be discharged from the hospital. By 2015, 65 percent…

Integrating Research Into the “Journeys”
 Integrating Research Into the “Journeys” 1024 683 Jeb Phillips
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Along with their work to build an innovative follow-up program, Nationwide Children’s faculty and staff members are international leaders in NICU follow-up research. A number of foundation and National Institutes of Health-funded follow-up studies are housed entirely or in part at the hospital, and The Research Institute at Nationwide Children’s is one of 17 member…