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Abbie Miller

Grandparents Raising Grandchildren: “They Get the Job Done”
 Grandparents Raising Grandchildren: “They Get the Job Done” 1024 575 Abbie Miller
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Research presented at the American Academy of Pediatrics 2018 National Conference finds that the growing number of grandparents serving as sole caregivers for their grandchildren are coping well. In the United States, millions of children are being raised solely by their grandparents. As the opioid crisis and other factors continue to disrupt families, experts expect the number…

Using Quality Improvement to Customize Opioid Reduction Strategies
 Using Quality Improvement to Customize Opioid Reduction Strategies 1024 681 Abbie Miller
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Different specialties across pediatrics have different uses, indications and practices when it comes to opioids. Many primary care pediatricians do not routinely prescribe them. Pediatric surgical specialties, however, may use opioid medications more frequently depending on the patient and procedure performed. While broad restrictions, such as those enacted on the federal and state levels, aimed…

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…

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.

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…

Is Your Patient Really Allergic to Penicillin?
 Is Your Patient Really Allergic to Penicillin? 150 150 Abbie Miller
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Cumulative Subconcussive Impacts in a Single Season of Youth Football Not Associated With Declines in Neurocognitive Measures
 Cumulative Subconcussive Impacts in a Single Season of Youth Football Not Associated With Declines in Neurocognitive Measures 1024 575 Abbie Miller
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In an investigation of head impact burden and change in neurocognitive function during a season of youth football, researchers find that sub-concussive impacts are not correlated with worsening performance in neurocognitive function. Each year, more than 3 million children in primary and high school play tackle football in the United States. Growing concern about the…

Housing for Health: An Early Look at What Can Happen When a Pediatric Health System Begins to Treat a Neighborhood as a Patient
 Housing for Health: An Early Look at What Can Happen When a Pediatric Health System Begins to Treat a Neighborhood as a Patient 150 150 Abbie Miller
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In a recent publication in the journal Pediatrics, researchers from Nationwide Children’s Hospital present a case study for treating a neighborhood as a patient. Neighborhood effect syndrome, characterized by symptoms of extreme poverty including blight, housing insecurity, racial segregation, trauma, violence, poorly performing schools, low social cohesion and support and environmental toxins, has debilitating consequences…

QI Project Improves Response Time to Nurse Triage Phone Calls in Busy ENT Practice
 QI Project Improves Response Time to Nurse Triage Phone Calls in Busy ENT Practice 1024 683 Abbie Miller
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A high-volume pediatric otolaryngology practice receives a lot of phone calls from patients and families. The practice at Nationwide Children’s Hospital, which sees 32,000 clinic visits and 9,000 surgical patients each year, averaged more than 200 triage calls per week over the last 5 years. The response times to those calls needing clinician input ranged…

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…

How to Make a Viral Vector
 How to Make a Viral Vector 150 150 Abbie Miller
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The Research Institute at Nationwide Children’s Hospital is the home to a current Good Manufacturing Practices (cGMP) Clinical Manufacturing Facility (CMF) that operates according to FDA cGMP Guidelines to ensure the safety of manufactured biologic products. The Space The CMF is a 9000-sq-ft space, including a 7500-sq-ft clean room suite with ISO Class 5/7/8 spaces…

Bridging the Gap Between the Genomics Lab and the Cardiology Clinic: CardioGX for Phenotype-Driven Variant Analysis
 Bridging the Gap Between the Genomics Lab and the Cardiology Clinic: CardioGX for Phenotype-Driven Variant Analysis 150 150 Abbie Miller
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The cloud-based platform is a free tool that empowers clinicians and fosters collaboration to find new genetic mutations that cause heart disease. Finding ways to support clinicians and researchers in accessing and utilizing genomic data is paramount to incorporating genomics into clinical care. CardioGX (CardioGenomics eXchange commons) is an interactive web application designed to help clinicians and…

Age-Related Racial Disparities in Suicide Rates Among Youth Ages 5 to 17 Years
 Age-Related Racial Disparities in Suicide Rates Among Youth Ages 5 to 17 Years 150 150 Abbie Miller
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Under the age of 13, suicide rates are roughly double for black children compared with white children. Suicide rates in the United States have traditionally been higher among whites than blacks across all age groups. However, a new study from researchers at Nationwide Children’s Hospital and collaborators published in JAMA Pediatrics shows that racial disparities in suicide…

From What-if to Widely Available – A Proposed Path for Tissue Engineered Vascular Grafts
 From What-if to Widely Available – A Proposed Path for Tissue Engineered Vascular Grafts 150 150 Abbie Miller
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What if you could utilize tissue engineering, imaging and 3D printing technologies to bring the benefits of a tissue engineered vascular graft to every child who needs one? Children born with a single ventricle heart defect undergo a series of surgeries and procedures to reroute the blood flow through their heart. The Fontan operation is…

Is Caregiver Education About Sickle Cell Trait Effective?
 Is Caregiver Education About Sickle Cell Trait Effective? 1024 575 Abbie Miller
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Color photo of Black father holding infant on shoulder in front of nursery background with clouds on the wall

Researchers evaluate the standardized education in Ohio to determine if it achieves high caregiver knowledge. Despite universal newborn screening that detects the presence of sickle cell trait (SCT), only 16 percent of Americans with SCT know their status. To address this issue, in Ohio, in-person education is offered to caregivers of referred infants with SCT.…

How Can We Optimize Fertility Related Discussions With Male Survivors of Childhood Cancer?
 How Can We Optimize Fertility Related Discussions With Male Survivors of Childhood Cancer? 150 150 Abbie Miller
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A recent study suggests that fertility is a “later” issue for adolescents and young adults, rather than a “now” concern, leading to low rates of conversation with health care providers. Survival rates for pediatric cancers exceed 80 percent. But late effects can persist throughout the survivor’s lifetime. Among those late effects, infertility may have both…

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…

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,…

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…

Small Trial of Omega Fatty Acid Supplementation in Toddlers Born Preterm Points to Possible Therapeutic Intervention
 Small Trial of Omega Fatty Acid Supplementation in Toddlers Born Preterm Points to Possible Therapeutic Intervention 1024 575 Abbie Miller
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Color close up image of young baby girl looking at hanging toys

Researchers show that supplementation of omega fatty acids may improve symptoms associated with autism spectrum disorder in toddlers who were born very preterm. Researchers from Nationwide Children’s Hospital have shown that omega fatty acid supplements may improve autism spectrum disorder symptoms in toddlers who were born very preterm (<29 weeks gestation). The study was published in The Journal…

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…

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…

Building Heart Valves From Extracellular Matrix
 Building Heart Valves From Extracellular Matrix 150 150 Abbie Miller
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Physicians at Nationwide Children’s Hospital describe the use of an extracellular matrix cylindar valve in the mitral position. At The Heart Center at Nationwide Children’s, Patrick McConnell, MD, a pediatric cardiothoracic surgeon, is using an alternative to the traditional cadaveric, mechanical or biological replacement valve. In a recent case report published in Echocardiography, Dr. McConnell and his colleagues describe the…

Two Classes of GGAA-Microsatellites in a Ewing Sarcoma Context
 Two Classes of GGAA-Microsatellites in a Ewing Sarcoma Context 150 150 Abbie Miller
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Characterization of GGAA-microsatellites provides insight in the role of noncoding DNA in cancer susceptibility and therapeutic development. In a study published in PLOS ONE, researchers describe two types of GGAA-microsatellites and their roles in EWS/FLI binding and gene regulation in Ewing sarcoma. Ewing sarcoma is the second most common pediatric bone malignancy. It is initiated by chromosomal…

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…

A New Paradigm for Treating Transcription Factor-Driven Cancers
 A New Paradigm for Treating Transcription Factor-Driven Cancers 150 150 Abbie Miller
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Researchers describe how the association of the EWS/FLI transcription factor with GGAA-microsatellites drives Ewing sarcoma. In the current issue of Proceedings of the National Academy of Sciences, researchers from Nationwide Children’s Hospital describe a new paradigm for treating transcription factor-driven cancers. The study focuses on Ewing sarcoma and how the EWS/FLI transcription factor drives the malignancy…

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…

Mechanism for Expulsion of DNA from NTHI Described
 Mechanism for Expulsion of DNA from NTHI Described 150 150 Abbie Miller
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Researchers at Nationwide Children’s publish breakthrough discovery revealing how DNA and DNABII proteins are released into the biofilm matrix. Nontypeable Haemophilus influenzae (NTHI) bacteria, a common culprit in otitis media, are known for their ability to create dense biofilms. As the subject of much biofilm and vaccine research, they are increasingly understood as complex and surprising organisms.…

Immune Profiling Leads to Implications for Immunotherapy for NF1-Associated Tumors
 Immune Profiling Leads to Implications for Immunotherapy for NF1-Associated Tumors 150 150 Abbie Miller
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Profiling reveals histologic subtype distinctions and heterogeneity of neurofibromatosis type 1-associated tumors. Neurofibromatosis type 1 (NF1) — an autosomal dominant disorder affecting approximately one in every 3,500 people — results in dysfunctional neurofibromin, a protein expressed throughout the body and involved in the RAS signaling pathway. Virtually all patients with NF1 develop benign peripheral nerve…

Neurosurgery May Provide Lasting Relief From Spasticity
 Neurosurgery May Provide Lasting Relief From Spasticity 1024 575 Abbie Miller
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Selective dorsal rhizotomy can provide life-changing results, but patients work hard in physical and occupational therapy to get there. When Sushma Manjunatha watches her daughter sleep, she sees something new. Instead of being tightly curled up, with legs pulled in, her daughter’s legs are stretched out, finally relaxed. This change is the result of a…

The First Study of Oncolytic HSV-1 in Children and Young Adults With Cancer Indicates Safety and Tolerability
 The First Study of Oncolytic HSV-1 in Children and Young Adults With Cancer Indicates Safety and Tolerability 1024 575 Abbie Miller
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The phase 1 trial shows safety and tolerance of HSV1716 in the pediatric population; evidence of viral replication in the blood and acute inflammation on PET/CT scans suggest a phase 2 trial for dosage and efficacy is warranted. HSV1716 – an oncolytic herpes simplex virus-1 – has been studied in adults via injection into the…

A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts
 A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts 1024 575 Abbie Miller
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image of heart with fontan conduit highlighted

A pair of surgeon-researchers is perfecting tissue engineered vascular grafts through bench, clinical and computational modeling studies.

Discovery to Drug Development: Expanding the Role of Academic Centers
 Discovery to Drug Development: Expanding the Role of Academic Centers 1024 575 Abbie Miller
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As more researchers at academic centers become involved in drug development, institutions are responding with support and guidance. Researchers at academic institutions regularly make discoveries about disease processes and potential therapeutic agents. Translational medicine is focused on moving these discoveries out of the laboratory and into the clinic where they can potentially help patients. But…

Human Trafficking: How many victims have you treated?
 Human Trafficking: How many victims have you treated? 1024 575 Abbie Miller
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Data shows that health care providers may be coming into contact with victims and those at risk with more frequency than expected. How many victims have you treated? The answer is probably higher than you think. According to a report published in the Annals of Health Law, 88 percent of sex trafficking survivors reported contact with…

Two Investigational Antitumor Agents Work Better Together Against MPNST and Neuroblastoma
 Two Investigational Antitumor Agents Work Better Together Against MPNST and Neuroblastoma 150 150 Abbie Miller
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The synergistic effects of a kinase inhibitor and an oncolytic herpes virus show promise for difficult-to-treat neuroblastomas and malignant peripheral nerve sheath tumors. Two investigational agents, Aurora A kinase inhibitor (alisertib) and HSV1716, a virus derived from HSV-1 and attenuated by the deletion of RL1, have shown some antitumor efficacy in early clinical trials as…

Hormonal Contraception Safer Than Expected For Women With Diabetes
 Hormonal Contraception Safer Than Expected For Women With Diabetes 150 150 Abbie Miller
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Women with diabetes often fall through the cracks when it comes to prescription contraception. A new study illuminates the issues and highlights safe options. The use of contraception to prevent unplanned pregnancies is an important aspect of women’s health. For women with chronic health conditions, family planning has important implications for the health of the…

Subclinical Muscle Involvement May be Missed With Amyopathic Juvenile Dermatomyositis Diagnosis
 Subclinical Muscle Involvement May be Missed With Amyopathic Juvenile Dermatomyositis Diagnosis 150 150 Abbie Miller
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Study shows that some children diagnosed with amyopathic dermatomyositis have subclinical muscle involvement, highlighting the need for standardized workup and treatment protocols. Juvenile dermatomyositis (JDM) is an autoimmune disease that classically presents in preschool to school aged children with a rash and muscle weakness. In some cases, children may present with the rash, but no muscle…

For AYA Females With Rhabdomyosarcoma, Consider Routine Examination or Imaging of Breasts
 For AYA Females With Rhabdomyosarcoma, Consider Routine Examination or Imaging of Breasts 150 150 Abbie Miller
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Rhabdomyosarcoma with breast involvement is found almost exclusively in females. A recent case series highlights the need for guidelines for follow-up imaging. Rhabdomyosarcoma (RMS) is a soft tissue sarcoma associated with metastasis and inferior outcomes in adolescent and young adult (AYA) patients (those with cancer diagnosis at age 15-39 years). Metastases to the breast have…

What Do Space Rocks Have to Do With Preterm Birth?
 What Do Space Rocks Have to Do With Preterm Birth? 150 150 Abbie Miller
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A brief history of nanobacteria and their implications for human health. I remember when nanobacteria were a really big deal. Press-conference-by-POTUS-about-evidence-of-extraterrestrial-life-level big deal. I hadn’t thought much about them until recently, when they made a surprise appearance in a presentation on idiopathic preterm birth by Irina Buhimschi, MD, director of the Center for Perinatal Research at The…

From Military Zones to Pediatric Trauma Centers, Implementing Massive Transfusion Protocols
 From Military Zones to Pediatric Trauma Centers, Implementing Massive Transfusion Protocols 150 150 Abbie Miller
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While military and adult research has shown massive transfusion protocols to be lifesaving, implementation and validation in pediatrics lags. When someone is critically injured with life-threatening bleeding, the primary objective of the care team is to stop the bleeding and replace the lost blood. Historically, children in this situation were administered red blood cells (RBCs)…

Solving the Problem of Managing Big Genomic Data
 Solving the Problem of Managing Big Genomic Data 150 150 Abbie Miller
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Researchers at Nationwide Children’s Hospital complete a first-of-its-kind project to evaluate a large-scale genomic data management system on the scale of up to one million genomes. The influx of genomics data resulting from the increasing affordability of whole exome/genome sequencing and President Obama’s Precision Medicine Initiative requires a novel technological solution to data storage, communication…

How to Integrate Genomics into Clinical Practice
 How to Integrate Genomics into Clinical Practice 150 150 Abbie Miller
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Recommendations from the Clinical Genetics Think Tank outline five key areas of focus for bringing genome and exome sequencing into the clinic. Clinical genome and exome sequencing (CGES) as a diagnostic tool is altering practice for clinical geneticists, genetic counselors and other clinical specialists. The Clinical Genetics Think Tank (CGTT) has identified five areas of…

In Sight: Two Stage Surgery for Epilepsy
 In Sight: Two Stage Surgery for Epilepsy 150 150 Abbie Miller
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Surgery proves to be a viable option for patients with medically refractory epilepsy. Childhood onset epilepsy affects 1 percent of children worldwide. About 25 to 30 percent of these patients will have medically refractory epilepsy, continuing to have seizures despite using two or more antiseizure medications. Options for this group of patients include intercranial epilepsy surgery, Vagus…