Clinical Updates

Long-Term Treatment of Pediatric Chronic Inflammatory Demyelinating Polyneuropathy with Pulse Oral Corticosteroid Therapy
Long-Term Treatment of Pediatric Chronic Inflammatory Demyelinating Polyneuropathy with Pulse Oral Corticosteroid Therapy 150 150 JoAnna Pendergrass, DVM

Pediatric patients with chronic inflammatory demyelinating polyneuropathy can benefit from the safety and effectiveness of long-term pulse oral corticosteroid therapy. Chronic inflammatory demyelinating polyneuropathy (CIDP) affects the peripheral nervous system in children, causing weakness, sensory loss and depressed tendon reflexes. Pediatric patients with this rare, immune-mediated disease often undergo years of immunomodulatory therapy, with the…

read more
How Important is Fasting for Pediatric Routine Cholesterol Screening?
How Important is Fasting for Pediatric Routine Cholesterol Screening? 1024 575 Andrew Tran, MD

A nonfasting lipid panel is a great first-line screening tool to use. While it is ideal to have a fasting lipid panel, this can be difficult to obtain in practice. For the purposes of screening, I think that it is much more important to go ahead and get the nonfasting lipid panel while the patient…

read more
No More Sitting in the Dark?
No More Sitting in the Dark? 1024 728 Laura Dattner

A new study from the Center for Injury Research and Policy, Sports Medicine and Emergency Medicine is the first to document objectively self-paced physical and cognitive activity post-concussion among youth. The results suggest they may be able to engage in physical and cognitive activity as soon as tolerated post-concussion. Clinical guidelines for managing concussion in…

read more
Protecting an ‘Open Future:’ Improving Fertility Preservation Decision-Making for Young Males With Cancer
Protecting an ‘Open Future:’ Improving Fertility Preservation Decision-Making for Young Males With Cancer 1024 575 Katie Brind'Amour, PhD, MS, CHES
Color photo of Black father holding infant on shoulder in front of nursery background with clouds on the wall

Evidence from a new study highlights the importance of family-centered decision processes and clinician facilitation in improving fertility preservation uptake prior to cancer treatment. Numerous cancer treatments can reduce fertility or render some patients entirely infertile, but fertility preservation (FP) services have historically had low rates of uptake. When a young person is diagnosed with…

read more
A Quick and Reliable Method to Determine The Time to Full Weight Bearing in Patients Undergoing Intramedullary Limb Lengthening
A Quick and Reliable Method to Determine The Time to Full Weight Bearing in Patients Undergoing Intramedullary Limb Lengthening 1024 575 Lauren Dembeck

A new method to objectively measure bone healing may help the patient with an intramedullary lengthening nail make strides to full weight bearing status. Intramedullary limb lengthening is indicated for the treatment of limb length discrepancy and short stature. Traditionally, the procedure was done using external fixators, which must remain on the patient’s limb for…

read more
No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants
No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants 1024 575 Lauren Dembeck

Inconsistency among studies prompted researchers to take a closer look at the drug’s effects. Despite limited evidence supporting its use, prophylactic indomethacin treatment is often administered to very preterm infants within the first 24-hours after birth to reduce the risks of intraventricular hemorrhage and longer-term neonatal morbidities, such as bronchopulmonary dysplasia (BPD). Data from a…

read more
One Year Reflection: Behavioral Health Pavilion Adds to Industry-Leading Model of Care During Pandemic
One Year Reflection: Behavioral Health Pavilion Adds to Industry-Leading Model of Care During Pandemic 1024 538 Kaitlin Hall

The full impact of COVID-19 on children’s mental health likely won’t be known for some time. But even before the pandemic, pediatric mental health was in a national crisis, with one in five children living with a mental illness, and suicide the second leading cause of death for children 10 and older. That means the…

read more
Batten Disease Experts Publish Common Key Practices For Enzyme Replacement Therapy
Batten Disease Experts Publish Common Key Practices For Enzyme Replacement Therapy 1024 683 Lauren Dembeck

Neuronal ceroid lipofuscinosis type 2 disease is a rare, rapidly-progressing, neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 deficiency. This form of Batten disease has an onset between two to four years of age. Children with CLN2 disease may experience intractable epilepsy, progressive cognitive and motor decline, and loss of vision. Historically, most children…

read more
Early Intervention is Key to Avoid Hospitalization for Cyclic Vomiting Syndrome
Early Intervention is Key to Avoid Hospitalization for Cyclic Vomiting Syndrome 1024 683 Mary Bates, PhD
Health care provider talking to male teen patient

Study finds that waiting to go to the emergency department for treatment increases likelihood of hospitalization. Cyclic vomiting syndrome is a functional gastrointestinal disorder characterized by periodic episodes of intense nausea and vomiting lasting hours to days. During episodes, some children become very sick and require emergency department care and hospitalization to manage symptoms and…

read more
How Has the COVID-19 Pandemic Affected Measles Vaccination Rates?
How Has the COVID-19 Pandemic Affected Measles Vaccination Rates? 1024 575 Mary Bates, PhD
Toddler playing with toys

Researchers are concerned about declining vaccination rates in the Nationwide Children’s Hospital pediatric primary care network. One consequence of the COVID-19 pandemic is that more families are putting off their children’s preventive care visits, causing pediatric providers to worry about missed vaccines. In a recent study published in Pediatrics, researchers at Nationwide Children’s evaluated changes in…

read more
More to Telehealth Than Meets the Screen
More to Telehealth Than Meets the Screen 1024 535 Abbie Roth
Collage of health technology tools

Telehealth has become essential to American health care during the COVID-19 pandemic, but is it really the solution to our biggest access-to-care problems? When COVID-19 ignited stay-at-home orders, public and private insurers quickly relaxed the rules for covering telehealth visits. Health care systems responded in kind by rapidly expanding their telehealth capacity and training. Expanding…

read more
Updated Guidance on Oral Food Challenges
Updated Guidance on Oral Food Challenges 1024 575 Mary Bates, PhD

New report offers guidelines and examples for safely performing oral food challenges in clinical practice. Oral food challenges are integral for allergists to diagnose food allergies. In 2009, the Adverse Reactions to Foods Committee within the American Academy of Allergy, Asthma & Immunology published a report providing guidance for safely conducting an oral food challenge.…

read more
CMS Approves New Code for Adult Congenital Heart Disease Subspecialty
CMS Approves New Code for Adult Congenital Heart Disease Subspecialty 1024 683 Katie Brind'Amour, PhD, MS, CHES

The official billing code will enable growth of the subspecialty and is expected to result in improved patient care. In March, the Centers for Medicare and Medicaid Services (CMS) approved a unique code for subspecialists in adult congenital heart disease (ACHD). The code will allow board-certified ACHD specialists to bill as such, rather than as…

read more
Improving Guidelines for Pediatric Hypertension Diagnosis
Improving Guidelines for Pediatric Hypertension Diagnosis 1024 683 Natalie Wilson

It is vital to accurately recognize and diagnose hypertension in children to avoid long term morbidity and allow for appropriate treatment. A recent pilot study highlights additional diagnostic criteria for clinicians to consider. Pediatric hypertension, or high blood pressure (BP), has become increasingly common and now affects over 3% of children and adolescents. Untreated, hypertension…

read more
Redo Surgery After Anorectal Malformation Repair Can Improve Functional Outcomes
Redo Surgery After Anorectal Malformation Repair Can Improve Functional Outcomes 1024 575 Mary Bates, PhD

A reoperation can improve continence and quality of life in children still struggling with fecal incontinence following ARM repair. In a new study, researchers from Nationwide Children’s Hospital show that redo surgeries are   safe and may be an effective option for patients with fecal incontinence after an anorectal malformation repair. For many patients, a reoperation…

read more
When Should Breastfed Babies Be Supplemented?
When Should Breastfed Babies Be Supplemented? 1024 575 Vanessa Shanks

This question has received increasing attention in the last several years, especially when considering supplementation for late preterm and early term babies. As more hospitals focus on promoting and supporting breastfeeding, supplementation rates have decreased for infants in the newborn nursery. However, there has been increasing awareness from primary care providers who may see these…

read more
New Newborn Screening Approach Allows for Earlier Detection of Menkes Disease
New Newborn Screening Approach Allows for Earlier Detection of Menkes Disease 1024 575 Natalie Wilson

Targeted next generation DNA sequencing can enable improved clinical outcomes for any genetic disorder not detectable through other biochemical newborn screening methods. Menkes disease is a rare, X-linked recessive pediatric disease caused by gene mutations of the copper transporter gene, ATP7A, leading to low levels of copper in infants’ blood and brain, as well as abnormal…

read more
How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis?
How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis? 1024 575 Natalie Wilson
Parent and provider at child's hospital bed

The most recent in a series of publications on management of uncomplicated appendicitis showed patients and families cited the same concerns when electing either surgery or nonoperative treatment. Antibiotics alone have been shown to successfully treat uncomplicated appendicitis in children. But patients, families and surgeons may differently evaluate risks and benefits of this treatment option.…

read more
Novel Intervention Helps Infants With Cerebral Palsy Develop Arm and Hand Function
Novel Intervention Helps Infants With Cerebral Palsy Develop Arm and Hand Function 1024 683 Abbie Roth

A new NIH-funded randomized controlled trial shows that an intervention combining a patented soft restraint harness, therapist coaching and parent training increases reach smoothness, fine motor skills and tactile sensation in the more-affected upper extremity. For the first time in infants with CP under 2, a clinical trial of this type of intervention was shown…

read more
Choking Education an Important Element of Care for Prader-Willi Syndrome Families
Choking Education an Important Element of Care for Prader-Willi Syndrome Families 1024 575 Katie Brind'Amour, PhD, MS, CHES

Choking prevention and intervention education offer a simple way to address this common cause of death among PWS patients. Individuals with Prader-Willi Syndrome (PWS) suffer from poor oral muscle control, generalized low muscle tone that can make it hard to swallow properly, a poor gag reflex and an insatiable desire to eat. Together with a…

read more
Novel Use of Vedolizumab Resolves Steroid-Refractory Acute Graft-Versus-Host Disease in a Pediatric Transplant Recipient
Novel Use of Vedolizumab Resolves Steroid-Refractory Acute Graft-Versus-Host Disease in a Pediatric Transplant Recipient 1024 575 Lauren Dembeck

Vedolizumab is a monoclonal antibody that targets α4β7 integrin present on gut homing T cells and is indicated for adult inflammatory bowel disease Physicians at Nationwide Children’s Hospital have successfully treated steroid-refractory gastrointestinal acute graft-versus-host disease (SR GI aGVHD) with adjuvant vedolizumab therapy in a pediatric allogeneic hematopoietic cell transplant (HCT) recipient. The case was…

read more
How a Network of Hospitals Reduced Average Age at Cerebral Palsy Diagnosis to 9.5 Months
How a Network of Hospitals Reduced Average Age at Cerebral Palsy Diagnosis to 9.5 Months 1024 683 Katie Brind'Amour, PhD, MS, CHES

In just one year, hospital teams working as part of a network to implement international cerebral palsy diagnosis guidelines successfully reduced average age at diagnosis from 19.5 months to 9.5 months. More than 50% of all eventual cerebral palsy (CP) cases spend time in the Neonatal Intensive Care Unit, making early CP evaluation a crucial…

read more
THRIVING After Severe Bronchopulmonary Dysplasia
THRIVING After Severe Bronchopulmonary Dysplasia 1024 731 Abbie Roth

Meet Willow. She was born via emergency C-section at just 22 weeks. Doctors at the delivering hospital told Willow’s mom Cortney that her baby’s chances of survival were low. But after a long journey through the newborn intensive care unit (NICU) at Nationwide Children’s Hospital, Willow is a vivacious 4-year-old looking forward to starting kindergarten…

read more
Percutaneous Occlusion Linked to Respiratory Improvements in Low-Weight Infants with PDA
Percutaneous Occlusion Linked to Respiratory Improvements in Low-Weight Infants with PDA 1024 575 Abbie Roth

Percutaneous occlusion for patent ductus arteriosus (PDA) in infants weighing less than 6 kg is associated with potential longer term improvements in respiratory health, research by investigators at Nationwide Children’s Hospital shows. “A new device for PDA closure recently approved by the FDA has potential to reduce the incidence of device-related complications. This important work…

read more
A Major Milestone in Cystic Fibrosis Treatment
A Major Milestone in Cystic Fibrosis Treatment 1024 575 Mary Bates, PhD
Illustration of lungs on blue silhouette of upper chest on black background

A triple medication combination could be life-changing for the majority of patients with cystic fibrosis. A Phase III clinical trial shows that elexacaftor added to ivacaftor and tezacaftor improves lung function and quality of life in cystic fibrosis patients with the most common genetic mutation, F508del. The triple therapy, known as Trikafta, could effectively treat 90%…

read more
A New Therapeutic Era in Pediatric Functional and Motility Disorders
A New Therapeutic Era in Pediatric Functional and Motility Disorders 150 150 Katie Brind'Amour, PhD, MS, CHES

20 years ago, treatment options were limited for children with functional gastrointestinal (GI) and motility disorders. Now, a growing list of drugs, behavioral and dietary care plans, and an advanced, forward-looking technique – neuromodulation – are transforming pediatric GI care. Gastrointestinal (GI) disorders are notoriously difficult to diagnose. Virtually all functional and motility-related GI problems…

read more
CMV Testing: Why You Don’t Need Legislation to Make It a Good Idea
CMV Testing: Why You Don’t Need Legislation to Make It a Good Idea 1024 575 Samantha Morsink

CMV is the leading non-genetic cause of sensorineural hearing loss in infancy and childhood. Identification of newborns with congenital CMV infection can improve their outcomes by early intervention programs and/or antiviral treatment. Cytomegalovirus, or CMV, infects almost everyone at some point in time, and it is one of the most common congenital infections worldwide. While…

read more
What You Need to Know About Tick-Borne Diseases
What You Need to Know About Tick-Borne Diseases 1024 575 Mike Patrick, MD

Ranges of disease-carrying ticks are shifting in the United States. Combined with family travel, this means physicians and families should have a wider lens on what tick-borne diseases they might encounter. Ticks represent a major vector for the transmission of human disease. Their abundance and geographic range have expanded in recent years, largely due to…

read more
Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families
Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families 1024 575 Abbie Roth

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…

read more
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

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…

read more
Opening the Door to Adult Medicine
Opening the Door to Adult Medicine 1024 575 Katie Brind'Amour, PhD, MS, CHES

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…

read more
Could Earlier Spirometry Get CF Inpatients Home Sooner?
Could Earlier Spirometry Get CF Inpatients Home Sooner? 150 150 Katie Brind'Amour, PhD, MS, CHES

A retrospective chart review suggests early spirometry is associated with shorter length of stay. As multicenter studies examine whether length of hospital stay and duration of treatment can be safely shortened for cystic fibrosis-related pulmonary exacerbations, physician-researchers at Nationwide Children’s Hospital have been exploring another unresolved angle related to these admissions: when to do pulmonary…

read more
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

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,…

read more
Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care
Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care 1024 575 Rachael Hardison
Teen girl with backpack

An estimated 20 percent of children struggle with mental health illness. As awareness grows, the call for primary care physicians to play a leading role in care grows louder. One in five children will struggle with a mental health illness by the age of 12, but a recent survey by the American Academy of Pediatrics…

read more
Neurosurgery May Provide Lasting Relief From Spasticity
Neurosurgery May Provide Lasting Relief From Spasticity 1024 575 Abbie Roth

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…

read more
Childhood Kidney Stones: Their Surprising Connection to Future Disease
Childhood Kidney Stones: Their Surprising Connection to Future Disease 150 150 Jeb Phillips

Once thought to be an adult condition, urinary stone disease is increasingly found in children – and may be related to the development of cardiovascular disease, chronic kidney disease and low bone density. By one well-regarded estimate, the risk of developing urinary stone disease in childhood doubled between 1997 and 2012. That’s worrying enough on…

read more
Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements
Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements 150 150 Kevin Mayhood

Case study shows reduction in bipolar youth’s psychotic mania, depression and anxiety Medications unchanged, a severely bipolar girl’s depressive, manic and psychotic symptoms improved significantly during the two years her mother added omega-3 supplements to her daily diet. The case, reported by researchers at Nationwide Children’s Hospital and Ohio State University Wexner Medical Center, is…

read more
InSight: Restoring Normal Habits
InSight: Restoring Normal Habits 471 285 Tiasha Letostak, PhD

SACRAL NERVE STIMULATION (SNS) is a new treatment that helps control urinary incontinence and fecal soiling. For some children, the nerves that control urination and bowel movements do not work correctly. The SNS unit consists of a small, safe battery and wire under the skin and sends signals to the sacral nerve. The signals help restore…

read more
InSight: Working Up the Nerve
InSight: Working Up the Nerve 150 150 Katie Brind'Amour, PhD, MS, CHES

Using regional anesthesia to numb nerves reduces pain and speeds recovery in pediatric orthopedic surgery. Ultrasound-guided regional anesthesia has been used in adult patients for more than a decade but is now being used more regularly in pediatric patients, especially for orthopedic procedures. Femoral nerve block, in which the femoral nerve is numbed, is among…

read more