Clinical Updates

Advancing Genomics-Driven Precision Medicine in the NICU
Advancing Genomics-Driven Precision Medicine in the NICU 1024 683 Natalie Wilson

According to the Children’s Hospitals Neonatal Consortium, as many as half of newborns hospitalized in level IV neonatal intensive care units (NICUs) due to critical illness have an underlying genetic condition. Most don’t get their diagnosis for months or even years. However, clinical assays, new testing modalities and clinical trials are improving their care. Advanced…

Intraoperative Evaluation of Penile Blood Flow During Bladder Exstrophy
Intraoperative Evaluation of Penile Blood Flow During Bladder Exstrophy 150 150 Mary Bates, PhD

Laser angiography technology allows for real-time measurements of penile perfusion during exstrophy repair operations. In a new pilot study, researchers from the Pediatric Urology Midwest Alliance (PUMA) demonstrated that intraoperative laser angiography is a safe and easy method to evaluate penile perfusion during bladder exstrophy closure. The optimal technique for repair of bladder exstrophy in…

Ask a Specialist: When Should Primary Care Providers Refer Dental Injuries to the Emergency Department?
Ask a Specialist: When Should Primary Care Providers Refer Dental Injuries to the Emergency Department? 150 150 Ehsan N. Azadani, DDS, MS

An expert reveals the most common red flag dental injuries that should be referred to the ED and what precautions PCPs can take before sending the child.   The most time-sensitive dental injury is the avulsion of a permanent tooth; that is, when the permanent tooth is completely knocked out of its socket (and the…

Improving Outcomes for Infants and Children With Congenital Hypothyroidism
Improving Outcomes for Infants and Children With Congenital Hypothyroidism 1024 575 Mary Bates, PhD
Toddler playing with toys

A quality improvement project identifies high-risk patients and ensures they receive necessary care.   Congenital hypothyroidism (CH) is one of the most common preventable causes of intellectual disability. In the United States and many other countries, newborns are tested a 24-72 hours after birth for CH as part of standard screening tests. This condition must…

Reducing Opioid Prescriptions for Common Pediatric Urologic Procedures
Reducing Opioid Prescriptions for Common Pediatric Urologic Procedures 1024 682 JoAnna Pendergrass, DVM
smiling baby being held up by an adult

To address the national opioid epidemic, clinician-scientists developed a quality improvement initiative to achieve significant, long-term reductions in opioid prescriptions after common pediatric urologic procedures.   Opioids are commonly prescribed for pediatric urologic procedures. However, studies have reported a troubling practice of overprescribing opioids in pediatric health, contributing to the ongoing opioid epidemic. “There is…

Multidisciplinary Treatment Is Effective for Patients With Rumination Syndrome
Multidisciplinary Treatment Is Effective for Patients With Rumination Syndrome 150 150 Jessica Nye, PhD

Tiered, multidisciplinary behavioral treatment is effective at improving symptoms of rumination syndrome (RS) among children and adolescents, even in the outpatient setting.   Children with RS present with repeated, effortless regurgitation of undigested food. Although limited data about treatment are available, previous studies have indicated that inpatient treatment can improve outcomes among pediatric patients with…

Pediatric Obesity Can Be Treated Safely and Effectively
Pediatric Obesity Can Be Treated Safely and Effectively 1024 575 Abbie Miller

New guidelines from the American Academy of Pediatrics emphasize evidence for safe, effective treatment of pediatric obesity for long-term benefit of children and adolescents.   More than 14.4 million U.S. children and adolescents have obesity, making it one of the most common chronic conditions facing American youth and families. Obesity is a chronic disease associated…

Addressing the Clinical Challenges of Caring for Children with Cystic Fibrosis and Autism Spectrum Disorder
Addressing the Clinical Challenges of Caring for Children with Cystic Fibrosis and Autism Spectrum Disorder 150 150 JoAnna Pendergrass, DVM

A recent study sheds light on the unique clinical challenges faced by children with cystic fibrosis and autism spectrum disorder and offers potential solutions to these challenges.   Cystic fibrosis (CF) and autism spectrum disorder (ASD) pose significant clinical and emotional burdens to patients and their families. A concurrent CF-ASD diagnosis presents even greater challenges, but…

5 Things Neonatologists Should Know About Vitamin K Deficiency
5 Things Neonatologists Should Know About Vitamin K Deficiency 1024 683 Mary Bates, PhD

Vitamin K prophylaxis is safe and effective. Why are more parents refusing it, and what can be done? In a new perspective paper in the Journal of Perinatology, researchers from Nationwide Children’s say that vitamin K prophylaxis is an essential component of newborn care and yet, parental refusal of the intervention is on the rise.…

The PROMISE Program Reduces Cardiac Arrests in High-Risk Patients
The PROMISE Program Reduces Cardiac Arrests in High-Risk Patients 600 400 Mary Bates, PhD

This proactive quality improvement initiative improved outcomes for high-risk pediatric cardiology patients undergoing cardiac intervention. Faculty within The Heart Center at Nationwide Children’s recently initiated proactive risk mitigation strategies to reduce post-procedural cardiac arrests in high-risk congenital heart patients. In a new paper, the team used quality improvement methodology to show that their efforts resulted…

Using 3D Motion Capture Technology to Improve Outcomes
Using 3D Motion Capture Technology to Improve Outcomes 150 150 Mary Bates, PhD

  Kirsten Tulchin-Francis, PhD Kirsten Tulchin-Francis, PhD, joined Nationwide Children’s in March 2022 as director of orthopedic research and director of the Honda Center for Gait Analysis and Mobility Enhancement. In a Q&A, she discusses how she uses motion capture technology to improve outcomes for pediatric patients. What is your area of expertise? I have…

Quality Improvement in Primary Care Improves Dental Utilization and Oral Health Outcomes in Children
Quality Improvement in Primary Care Improves Dental Utilization and Oral Health Outcomes in Children 1024 680 JoAnna Pendergrass, DVM
toddler brushing teeth

Quality improvement provides an effective, standardized approach to increasing pediatric dental utilization and improving oral health outcomes in primary care settings. According to a recent study by pediatric dentist David Danesh, DMD, MPH, MS, and his research team at Nationwide Children’s Hospital, children receiving fluoride varnish at medical practices with an oral health quality improvement…

5 Things to Know About Prune Belly Syndrome
5 Things to Know About Prune Belly Syndrome 1024 683 Abbie Miller
Linda Baker, MD

Linda Baker, MD, urologist, principal investigator, and one of the world’s foremost experts on prune belly syndrome, recently joined Nationwide Children’s Hospital as the co-director of the Kidney and Urinary Tract Center. She shares some important things to know about this rare disease. 1. Prune belly is a rare, congenital malformation. Prune belly syndrome (PBS)…

Myopericarditis After COVID-19 Vaccination
Myopericarditis After COVID-19 Vaccination 1024 683 Katie Brind'Amour, PhD, MS, CHES

A meta-analysis of international studies offers more detailed insight into the severity and outcomes of vaccine-related myopericarditis in the adolescent and young adult population. Concerns over myopericarditis and other cardiovascular complications in teens and young adults have gained considerable media attention. While myopericarditis-related data have been well characterized in adults with and without vaccination, the…

New Guidelines for Care of Children With Cerebral Palsy
New Guidelines for Care of Children With Cerebral Palsy 1024 683 Abbie Miller
Young child with Cerebral Palsy

Guidelines from the American Academy of Pediatrics and the American Academy for Cerebral Palsy and Developmental Medicine highlight advances in diagnosis, care and outcomes for children and adolescents with cerebral palsy. In late 2022, the American Academy of Pediatrics and the American Academy for Cerebral Palsy and Developmental Medicine released new guidelines to help primary…

Virtual Support for Educating Parents of Newborns with Sickle Cell Trait
Virtual Support for Educating Parents of Newborns with Sickle Cell Trait 1024 681 Mary Bates, PhD
Black couple with newborn

A supplementary videoconferencing program engages parents and reduces worry about sickle cell trait status. Nearly 3 million people in the U.S. have sickle cell trait (SCT), in which they inherit one sickle cell gene and one normal gene. Individuals with SCT are usually asymptomatic; however, two parents with SCT have a 25% chance of having…

Fertility-Related Care for Girls With Turner Syndrome
Fertility-Related Care for Girls With Turner Syndrome 150 150 Mary Bates, PhD

Recent survey of providers shows fertility counseling and referrals are delivered inconsistently in this population. Researchers from Nationwide Children’s recently assessed practices surrounding fertility-related care among clinical providers who treat girls with Turner syndrome. They found that fertility counseling and referral rates remain inconsistent and identified common barriers to fertility care in this population. Turner…

Featured Researcher — Jonathan Slaughter, MD, MPH
Featured Researcher — Jonathan Slaughter, MD, MPH 150 150 Katie Brind'Amour, PhD, MS, CHES

Jonathan Slaughter, MD, MPH, neonatologist and principal investigator in the Center for Perinatal Research at Nationwide Children’s Hospital, works to identify best practices and reduce treatment variation to improve neonatal clinical care and outcomes. His career took off when, after casually observing practice variation across the institutions where he received training, he noticed that preterm…

Genomic Medicine Translational Protocols – What Do They Mean for Patients Everywhere?
Genomic Medicine Translational Protocols – What Do They Mean for Patients Everywhere? 1024 614 Elizabeth Varga
abstract art of magnifying glass over DNA strand

As part of the Journey to Best Outcomes, Nationwide Children’s Hospital has dedicated significant resources to genomic medicine, named as a key accelerator in the 2017-2021 strategic plan and as one of the three pillars that will be utilized to integrate research and clinical care over the next five years. In response, the Steve and…

Low-Resource Screening Tool Demonstrates Superior Predictive Value for Cerebral Palsy in Infants
Low-Resource Screening Tool Demonstrates Superior Predictive Value for Cerebral Palsy in Infants 1024 683 JoAnna Pendergrass, DVM

The use of lower-resource screening tools for cerebral palsy in infants can help increase early detection of the condition and promote access to early interventions.   A recent study reported that the Hammersmith Infant Neurological Examination (HINE), when compared with the Test of Infant Motor Performance (TIMP), had the better predictive value for detecting cerebral…

Using Hormone Therapy First Drives Earlier Remission From Infantile Epileptic Spasms Syndrome
Using Hormone Therapy First Drives Earlier Remission From Infantile Epileptic Spasms Syndrome 1024 575 Natalie Wilson

Recent research conducted at Nationwide Children’s Hospital demonstrated standardizing hormone therapy as the first treatment for infantile spasms improved rates of early remission. Infantile epileptic spasms syndrome (IESS) is an uncommon epilepsy syndrome characterized by seizures called infantile spasms that begin between 1 and 24 months of age (with a peak age of onset at…

New Nomogram Helps Optimize 3-D Rotational Angiography for Congenital Cardiac Catheterization
New Nomogram Helps Optimize 3-D Rotational Angiography for Congenital Cardiac Catheterization 1024 775 Katie Brind'Amour, PhD, MS, CHES

Clinician-researchers studied a large number of 3-D rotational angiography (3DRA) cases to identify patient and practice factors that produce the highest quality images. In an effort to aid in the successful application of 3-D rotational angiography (3DRA) in cardiac catheterization labs worldwide, a team of clinicians at Nationwide Children’s Hospital retrospectively reviewed 208 3DRAs to…

Bowel Management Program Improves Urinary Symptoms Associated with Pediatric Functional Constipation
Bowel Management Program Improves Urinary Symptoms Associated with Pediatric Functional Constipation 150 150 JoAnna Pendergrass, DVM

A one-week bowel management program can significantly improve urinary symptoms in children with functional constipation, possibly eliminating the need for extensive urologic testing. Molly Fuchs, MD, a urologist at Nationwide Children’s Hospital, and her research team recently demonstrated that a bowel management program (BMP) significantly improved urinary symptoms in children with functional constipation. Functional constipation…

Clearing Up Confusion On Cleft Lip and Palate
Clearing Up Confusion On Cleft Lip and Palate 600 400 Emily Siebenmorgen

There’s a common misconception that cleft lip and cleft palate is a third-world disease. The truth is: it’s very common in the United States. In fact, it’s the most common birth defect after congenital heart disease, occurring in one in 700 births. That’s around 5,000 births per year. On a recent episode, PediaCast host Mike…

Celebrating More Than 100 Heart Transplants — And a Host of Other Heart Program Achievements
Celebrating More Than 100 Heart Transplants — And a Host of Other Heart Program Achievements 1024 746 Deipanjan Nandi, MD, MSc

Deipanjan Nandi, MD, MSc, shares an update about treating heart failure at Nationwide Children’s Hospital. From transplant to ventricular assist devices and pharmaceutical options, the patient-centered care offers innovative options for patients with heart failure.

The Heart Center Team Employs New Device to Remove High-Risk Blood Clot
The Heart Center Team Employs New Device to Remove High-Risk Blood Clot 1024 670 Emily Siebenmorgen

This first-in-pediatrics procedure was performed by Arash Salavitabar, MD, interventional cardiologist at Nationwide Children’s Hospital.  When a pediatric patient sought care for an accidental gunshot wound to the abdomen, a central line infection during his course at a large regional hospital led to a much more serious blood clot in his right atrium. His case…

InSight: Total Pancreatectomy With Islet Autotranplantation: The Basics
InSight: Total Pancreatectomy With Islet Autotranplantation: The Basics 1024 500 Katie Brind'Amour, PhD, MS, CHES
illustrated cross section of islets from pancreas

Download a PDF version of this image.       This feature was published in the Fall/Winter 2022 print issue. Download the full issue.  Image credit: Mandy Root-Thompson for Nationwide Children’s

TPIAT: A Way Forward for Chronic Pancreatitis
TPIAT: A Way Forward for Chronic Pancreatitis 1024 500 Katie Brind'Amour, PhD, MS, CHES
illustrated cross section of islets from pancreas

Nationwide Children’s Hospital has assembled a veritable “dream team” of pancreatitis and pediatric transplant surgery experts to offer what they hope will become the world’s preeminent pediatric center for complex pancreatic care. Imagine your child suffering from a sudden, debilitating episode of abdominal pain. No obvious cause, no cure, just pain so severe it requires…

Integrating Behavioral Health and Primary Care Increases Access and Equity
Integrating Behavioral Health and Primary Care Increases Access and Equity 1024 683 Mary Bates, PhD

With mental health concerns on the rise, more primary care providers are integrating behavioral health services in their practices.  Despite increasing demand for behavioral health care, multiple barriers still exist that limit access for pediatric patients. In recent years, primary care settings across the country have responded by integrating mental health specialists into their practices.…

Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia
Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia 1024 683 Mary Bates, PhD

Study emphasizes importance of identifying those patients who will respond to treatment. Certain pulmonary function test parameters in newborns with bronchopulmonary dysplasia are associated with bronchodilator response, according to a new study from researchers at Nationwide Children’s Hospital. The team also found that responders had evidence of greater dysanaptic lung growth than nonresponders. Bronchodilators are…

The Latest Developments in Limb Lengthening and Reconstruction Research
The Latest Developments in Limb Lengthening and Reconstruction Research 1024 683 Katie Brind'Amour, PhD, MS, CHES
Dr. Iobst with patient

Orthopedic experts publish an invited review of the past year’s most significant papers in the field of limb deformity correction and lengthening. To aid clinicians and surgeons who don’t have time for an annual deep-dive into the literature of their subspecialty, The Journal of Bone & Joint Surgery publishes yearly reviews courtesy of invited guest…

Do Symptom Scores and pH Impedance Correlate in Infants Treated for Gastroesophageal Reflux?
Do Symptom Scores and pH Impedance Correlate in Infants Treated for Gastroesophageal Reflux? 1024 683 Lauren Dembeck

Gastroesophageal reflux (GER) — the passage of gastric contents into the esophagus — is a physiologic process that can be considered normal or abnormal depending on whether troublesome symptoms and/or complications also occur. In infants, it is difficult for clinicians to distinguish between GER and pathophysiologic GER disease (GERD). “Current diagnostic criteria for GERD are…

Telehealth Has the Potential to Bridge Gaps in Psychiatric and Behavioral Health Care
Telehealth Has the Potential to Bridge Gaps in Psychiatric and Behavioral Health Care 1024 535 Jessica Nye, PhD
Collage of health technology tools

A growing body of evidence supports telebehavioral health delivery for children, adolescents and their families, as outcomes are comparable to in-person treatment delivery. Despite evidence of efficacy, regulatory and financial concerns and technology barriers continue to impede widespread uptake of telebehavioral health. “There have definitely been silver linings to the pandemic, and this is one…

Quality Improvement Scorecard Enhances Safety for Newborns
Quality Improvement Scorecard Enhances Safety for Newborns 1024 683 Emily Siebenmorgen

The collaborative program between academic and community hospitals improves neonatal care quality. In a recent study published in The Journal of Pediatrics, researchers from Nationwide Children’s Hospital and affiliated level one and two community hospital nurseries implemented a quality improvement (QI) scorecard and found improvements in important perinatal outcomes. “Roughly half of all newborns in…

Predicting Disease Severity and Assessing Long-Term Outcomes of Pediatric La Crosse Virus
Predicting Disease Severity and Assessing Long-Term Outcomes of Pediatric La Crosse Virus 1024 683 JoAnna Pendergrass, DVM

Limited data exist on mosquito-borne La Crosse Virus in children, underscoring the importance of determining which patients are at risk for severe disease and long-term neurobehavioral difficulties.   La Crosse Virus (LACV) is a neuroinvasive arbovirus spread by the Aedes triseriatus mosquito, causing symptoms such as vomiting, seizures and altered mental status (AMS). Within the…

Cardiopulmonary Rehabilitation Post-COVID: Could Your Patient Benefit?
Cardiopulmonary Rehabilitation Post-COVID: Could Your Patient Benefit? 1024 728 Abbie Miller

The road to recovery from COVID-19, the disease caused by SARS-CoV-2, is not always smooth, short or straight. For adults and children, long COVID, a condition where symptoms such as fatigue, headache and decreased respiratory function persist after the virus has “cleared” the body, can add increased stress and hardship. Additionally, even mild cases of…

BRUE: What Is It? How Is It Treated?
BRUE: What Is It? How Is It Treated? 1024 575 Abbie Miller

BRUE –brief resolved unexplained event – whether you pronounce it brew-EE or brOO, it might be a term you haven’t run across since medical school. In a recent resident-led episode of PediaCast CME, Meghan Fennell, MD, and Vanessa Thiel, MD, break down everything you need to know about BRUE. Listen to the PediaCast CME Episode…

Functional Neurological Disorders: What Pediatric Neurologists Should Know
Functional Neurological Disorders: What Pediatric Neurologists Should Know 150 150 Mary Bates, PhD

The diagnosis is common, yet this group of disorders has been subjected to confusion and stigma throughout history. Functional neurological disorders are a collection of disorders in which patients experience neurological symptoms, such as numbness, weakness, seizure-like events, or abnormal gait or movements, but without a visible underlying pathology. Underlying mechanisms for these disorders are…

Nafcillin is a Safe Alternative to Vancomycin for Empirical Treatment of Late-Onset Sepsis Among Infants in the NICU
Nafcillin is a Safe Alternative to Vancomycin for Empirical Treatment of Late-Onset Sepsis Among Infants in the NICU 1024 681 Mary Bates, PhD
sleeping infant

Guidelines to reduce vancomycin use at three Ohio NICUs did not impact mortality rate. In 2014, the Neonatal Antimicrobial Stewardship Program at Nationwide Children’s Hospital recommended nafcillin rather than vancomycin for empirical therapy of possible late-onset sepsis in infants without a history of methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. In a new study, researchers…

Strategies and Resources for Managing Anxiety in Pediatric Patients
Strategies and Resources for Managing Anxiety in Pediatric Patients 1024 575 Katie Brind'Amour, PhD, MS, CHES

Anxiety disorders are one of the most common mental health diagnoses affecting children, making regular assessment and robust care resources essential to both primary and specialty care practices. Data from 2016-2019 report indicates that nearly 1 in 10 children ages 3-17 have ever been diagnosed with an anxiety disorder — a number believed to have…

Is 3D Anorectal Manometry Preferable to Traditional Anorectal Manometry in Children With Functional Constipation?
Is 3D Anorectal Manometry Preferable to Traditional Anorectal Manometry in Children With Functional Constipation? 1024 680 Mary Bates, PhD
Close up color photo of little boy holding hands on his belly

Study finds 3D-ARM is less comfortable and does not provide additional information compared to traditional ARM.   In a recent pilot study, researchers from Nationwide Children’s compared outcomes and patient experience of a new three-dimensional (3D) anorectal manometry (ARM) technique compared to regular ARM in children with functional constipation. They found that the use of…

Moving Emergency Medicine Research Forward
Moving Emergency Medicine Research Forward 1024 614 Abbie Miller

Utilizing exception from informed consent studies and a national network of emergency medicine experts, clinician-scientists are advancing research to uncover best practices and improve care. Exception from informed consent (EFIC) is a special rule set utilized by the U.S. Food and Drug Administration (FDA) to support research in emergency situations. The word exception is particularly…

Multi-Disciplinary Team Develops Evidence-Based Guidelines for Acute Management of Persistent Pulmonary Hypertension in Newborns
Multi-Disciplinary Team Develops Evidence-Based Guidelines for Acute Management of Persistent Pulmonary Hypertension in Newborns 200 133 Katie Brind'Amour, PhD, MS, CHES

What began as an internal effort to simplify practice has transformed into published evidence-based guidelines to standardize care for acute stabilization and management of newborns with pulmonary hypertension.   Persistent pulmonary hypertension of the newborn (PPHN) is a highly varied and changeable condition that presents a challenge for clinical management, even among tertiary care centers…

Perceptions About Type 2 Diabetes Differ Among Adolescent Patients, Parents and Physicians
Perceptions About Type 2 Diabetes Differ Among Adolescent Patients, Parents and Physicians 1024 683 JoAnna Pendergrass, DVM

Differing perceptions about type 2 diabetes among teens, parents and physicians can create barriers to diagnosing and managing the disease.   Type 2 diabetes (T2D) is becoming increasingly prevalent in adolescents, with a median age of diagnosis of 13.5 years in the pediatric population. Managing pediatric T2D is challenging, given that traditional medical and non-medical…

Which Surgical Approach for Catheterizable Channels in Bowel and Bladder Management Is Best?
Which Surgical Approach for Catheterizable Channels in Bowel and Bladder Management Is Best? 150 150 Jessica Nye, PhD

Specific patient characteristics, such as appendix size, may help guide clinicians when deciding which surgical approach to use for patients in need of catheterizable channels for bladder and bowel management. Many patients with neurologic disorders experience urinary and fecal incontinence. The appendix or the transverse ileal tube can be repurposed as a catheterizable channel to…

What Psychosocial Interventions Are Well Established for the Treatment of Bipolar Disorder in Youth?
What Psychosocial Interventions Are Well Established for the Treatment of Bipolar Disorder in Youth? 150 150 Lauren Dembeck

Clinical psychology researchers at Nationwide Children’s Hospital recently published a comprehensive review of evidence-based psychosocial treatments for bipolar disorder in youth.  Bipolar spectrum disorders (BPSDs) are chronic, recurrent conditions characterized by episodic mood disturbance alternating between periods of depression and (hypo)mania. These conditions are associated with considerable impairment, reduced quality of life, high rates of…

The Success of an EMR-Based Health-Related Social Needs Screen in Pediatrics
The Success of an EMR-Based Health-Related Social Needs Screen in Pediatrics 1024 683 Deborah L. Ungerleider, MD, FAAP

Standardized universal HRSN screening with an EMR system and follow-up by social work consults can be successful and contribute to reducing health disparities.   Health-related social needs (HRSNs), sometimes referred to as social determinants of health (SODH), are the risk factors of food insecurity, lack of stable housing and poverty, all of which can play…

First Multicenter, Prospective Study of Surgical Approach and Short-term Outcomes in Patients Undergoing Total Pancreatectomy With Islet Autotransplantation
First Multicenter, Prospective Study of Surgical Approach and Short-term Outcomes in Patients Undergoing Total Pancreatectomy With Islet Autotransplantation 150 150 Lauren Dembeck

The goal of the prospective study is to critically evaluate current clinical practices to determine which should be adopted or abandoned. It will also provide an opportunity to evaluate patients’ quality of life after total pancreatectomy with islet autotransplantation.   For children and adults with debilitating pancreatitis that fails to respond to medical and endoscopic…

The Importance of Body Composition in Cystic Fibrosis
The Importance of Body Composition in Cystic Fibrosis 150 150 Mary Bates, PhD

Lean mass deficits are common in pediatric patients with cystic fibrosis and associated with impaired lung and bone health. Now, experts are calling for increased use of body composition measurements in clinical care.  In cystic fibrosis — a multisystem disorder characterized by progressive lung disease, pancreatic insufficiency, malabsorption and malnutrition — nutrition status is correlated with…

Postoperative Management of Flexor Tendon Injuries in Children
Postoperative Management of Flexor Tendon Injuries in Children 150 150 Mary Bates, PhD

One month of immobilization followed by a modified Duran protocol leads to good outcomes. Pediatric flexor tendon injuries can be challenging due to children’s smaller anatomy and possible treatment nonadherence. In adults, immediate to early active motion for flexor tendon repairs has become standard, as prolonged postoperative immobilization can lead to adhesion formation and joint…