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Clinical Updates

Treating Intrauterine Opioid Exposure in Infants Born Preterm
 Treating Intrauterine Opioid Exposure in Infants Born Preterm 1024 575 Deborah L. Ungerleider, MD, FAAP
By: Deborah L. Ungerleider, MD, FAAP

We need a protocol to evaluate and treat neonatal abstinence syndrome in preterm infants. Neonatal abstinence syndrome (NAS) occurs when infants who are exposed to opioids in utero develop withdrawal signs and symptoms after birth.1 According to past studies, NAS occurs in 55% to 94% of infants exposed to opioids, with an increasing incidence between…

A Patient-Centered Medical Home for Pediatric Inflammatory Bowel Disease
 A Patient-Centered Medical Home for Pediatric Inflammatory Bowel Disease 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

The Center for Pediatric and Adolescent IBD serves as a case study for comprehensive, multidisciplinary care. In a new paper published in Inflammatory Bowel Disease, researchers from Nationwide Children’s describe the multidisciplinary care model at the Center for Pediatric and Adolescent Inflammatory Bowel Disease as an example of a pediatric specialty medical home. The researchers…

Validity of the WISC-V Intelligence Testing in Children With Autism Spectrum Disorder
 Validity of the WISC-V Intelligence Testing in Children With Autism Spectrum Disorder 1024 575 Mary Bates, PhD
By: Mary Bates, PhD

Evaluating thinking and reasoning abilities for children with autism using conventional intelligence tests can be done, but with some caution. The Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) is one of the most widely used intelligence tests for children. However, little is known about the validity of this test in children with autism spectrum…

Codetection of Respiratory Bacteria in Infants With RSV Infection Associated With Worse Outcomes
 Codetection of Respiratory Bacteria in Infants With RSV Infection Associated With Worse Outcomes 1024 575 Lauren Dembeck
By: Lauren Dembeck
Color photo of Black father holding infant on shoulder in front of nursery background with clouds on the wall

The interaction between the bacteria and respiratory syncytial virus (RSV) appears to be synergistic. Researchers are now working to understand the underlying biological mechanisms. Researchers at Nationwide Children’s Hospital have discovered that codetection of Haemophilus influenzae and Streptococcus pneumoniae in the upper respiratory tract of previously healthy infants with RSV infection was independently associated with…

Microsurgery for Acute Flaccid Myelitis: Personalized Approach Leads to Remarkable Recoveries
 Microsurgery for Acute Flaccid Myelitis: Personalized Approach Leads to Remarkable Recoveries 1024 440 Lauren Dembeck
By: Lauren Dembeck

Children from around the world are coming to Nationwide Children’s for specialized care for AFM with lower extremity involvement. Dr. Amy Moore invented many of the procedures that are leading to remarkable recoveries for these patients. After an ordinary cold, most people continue with life as usual; however, in some rare cases, a previously healthy…

Learning in Real Time to Overcome COVID-19 and MIS-C
 Learning in Real Time to Overcome COVID-19 and MIS-C 1024 491 Natalie Wilson
By: Natalie Wilson
Illustrations of clock faces at different times and angles

When multisystem inflammatory syndrome in children (MIS-C) emerged in May 2020, the new condition made headlines. Although rare, MIS-C can appear in kids about a month after they’ve recovered from infections with SARS-CoV-2, the virus that causes COVID-19 — even if they haven’t felt sick at all. “We don’t know why some children develop MIS-C,”…

Lubiprostone Found to be Safe, as Effective as Placebo in Children With Constipation
 Lubiprostone Found to be Safe, as Effective as Placebo in Children With Constipation 1024 680 Mary Bates, PhD
By: Mary Bates, PhD
Close up color photo of little boy holding hands on his belly

The medication, FDA-approved for adults, may benefit older pediatric patients with less of a behavioral component to their constipation. Pediatric functional constipation, though common, remains challenging to treat. Lubiprostone is a medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of constipation and irritable bowel syndrome with constipation in adults. In…

Long-Term Follow-up Study Shows Cannabidiol is Safe and Effective for Lennox-Gastaut Syndrome
 Long-Term Follow-up Study Shows Cannabidiol is Safe and Effective for Lennox-Gastaut Syndrome 695 473 Mary Bates, PhD
By: Mary Bates, PhD
Black and white environmental portrait of Dr. Anup Patel standing in the hospital in his lab coat with his hand in his pocket

Long-term treatment with highly purified plant-based CBD shows continued seizure reduction and no new side effects. The results of a long-term open-label extension trial of plant-derived, highly purified cannabidiol (CBD) show the treatment is effective and safe long term for patients with Lennox-Gastaut syndrome. The treatment had a similar safety profile as in the original…

Targeted Muscle Reinnervation for Amputees Offers Chance at Less Pain, More Prosthetic Options
 Targeted Muscle Reinnervation for Amputees Offers Chance at Less Pain, More Prosthetic Options 1024 684 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

The innovative procedure pioneered by surgeons at The Ohio State University and Nationwide Children’s Hospital reduces postoperative pain and enables control of bioprosthetics.   What started as Department of Defense-funded research in adult amputees at The Ohio State University Medical Center about 6 years ago has morphed into standard of care treatment for children undergoing…

Ask A Specialist: Management of Labial Adhesions in Prepubertal Girls
 Ask A Specialist: Management of Labial Adhesions in Prepubertal Girls 1024 680 Geri Hewitt, MD
By: Geri Hewitt, MD

What is the appropriate management of asymptomatic and symptomatic labial adhesions in a prepubertal girl? The management of labial adhesions has really evolved over time. The most important thing is to make sure you have the correct diagnosis and it’s not some other problem with the vagina opening. Labial adhesions are isolated (not associated with…

Ask A Specialist: When Should Patients With Molluscum Contagiosum Be Referred to Dermatology?
 Ask A Specialist: When Should Patients With Molluscum Contagiosum Be Referred to Dermatology? 1024 575 Patricia Witman, MD
By: Patricia Witman, MD
Toddler playing with toys

What are the current treatment recommendations for moderate to severe molluscum, and when would you suggest referring to a dermatologist? Molluscum contagiosum is an infection caused by a virus that typically results in benign, mild skin disease characterized by lesions (Mollusca) that are small, raised and usually white, pink or flesh colored with a dimple…

Specialized Treatment for Severe Bronchopulmonary Dysplasia Increases Survival
 Specialized Treatment for Severe Bronchopulmonary Dysplasia Increases Survival 1024 683 Mary Bates, PhD
By: Mary Bates, PhD
Dr. Edward Shepherd

Most infants with established BPD referred to Nationwide’s BPD Center improve and survive, despite the severity of their illness. In a new study, researchers analyzed the in-hospital outcomes for preterm infants with established bronchopulmonary dysplasia (BPD) referred to Nationwide Children’s Comprehensive Center for BPD. They found that despite the high degree of illness severity in…

Postoperative Care for Benign Ovarian Neoplasms
 Postoperative Care for Benign Ovarian Neoplasms 150 150 Mary Bates, PhD
By: Mary Bates, PhD

Study suggests no benefit from routine imaging and supports symptomatic imaging for postoperative management of benign ovarian neoplasms. In a new study, researchers at Nationwide Children’s Hospital led a collaboration with eight children’s hospitals examining the follow-up care and subsequent outcomes of pediatric patients after surgery for a benign ovarian neoplasm to develop evidence-based recommendations…

Stent Implantations Are an Option for Small Patients
 Stent Implantations Are an Option for Small Patients 1024 670 Mary Bates, PhD
By: Mary Bates, PhD

Stents that can be dilated to adult size are safe and effective for the treatment of coarctation of the aorta in young patients. Studies have demonstrated stent implantation is more effective and safer than balloon angioplasty for the treatment of coarctation of the aorta in adult and older pediatric patients. In smaller patients, however, particularly…

Video Game-Based Therapy Makes Cardiopulmonary Rehabilitation Program More Patient-Centric
 Video Game-Based Therapy Makes Cardiopulmonary Rehabilitation Program More Patient-Centric 1024 683 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
Smiling boy outside

Patients can benefit from traditional therapeutic services as well as engaging, updated approaches to improve lung capacity and fitness.  The Cardiopulmonary Rehabilitation Program at Nationwide Children’s Hospital, launched in 2005 after a year-long pilot, has long offered services for patients to improve their ability to engage in exercise, school and activities of daily living. As…

Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients
 Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients 1024 752 Mary Bates, PhD
By: Mary Bates, PhD
Top-down view of heart valves

The new technique could potentially reduce the number of lifetime surgeries required by these patients, researchers say. In a new study, researchers from Nationwide Children’s Hospital report that pediatric patients who underwent cylinder mitral valve construct, a new technique for replacing the mitral valve, had improved left ventricular function over time. In addition, there were…

Robotic Surgery Is Here to Stay
 Robotic Surgery Is Here to Stay 150 150 Abbie Miller
By: Abbie Miller

A recent publication describes increases in the use of robotic surgery in children’s hospitals across the country.  The use of robotic surgery in tertiary children’s hospitals has been on the rise since the 2000s. In a recent publication, researchers from Nationwide Children’s Hospital sought to characterize the use and growth in acceptance of robotic surgeries…

EVALI and MIS-C: Overlapping Diagnoses
 EVALI and MIS-C: Overlapping Diagnoses 1024 575 Mary Bates, PhD
By: Mary Bates, PhD

Taking a thorough history can differentiate these similarly presenting conditions. In a new report, researchers from Nationwide Children’s Hospital describe six patients admitted to the hospital with concerns for MIS-C who were later diagnosed with EVALI. The researchers discuss the factors that led them to differentiate between the two disorders and arrive at the correct…

Occurrence and Cost of Infections After Heart Transplant
 Occurrence and Cost of Infections After Heart Transplant 1024 683 Mary Bates, PhD
By: Mary Bates, PhD
Dr. Emily Hayes

Researchers identify risk factors, long-term outcomes of vaccine-preventable infections following heart transplantation in pediatric patients. Recently, a study using the Pediatric Health Information System (PHIS) database found that one in six pediatric solid organ transplant recipients were hospitalized with respiratory syncytial virus (RSV) or vaccine-preventable illness in the first five years after transplant. Within this…

Providing Education and PrEP for Teens at Risk for HIV
 Providing Education and PrEP for Teens at Risk for HIV 1024 683 Abbie Miller
By: Abbie Miller

In a recent PediaCast CME, Mike Patrick, MD, and Megan Brundrett, MD, share important information about offering PrEP and HIV-related education in your primary care practice. Listen to the Full Episode About 20% of new cases of HIV, the virus that causes Acquired Immunodeficiency Syndrome (AIDS), are occurring in youth aged 13 to 24. HIV/AIDS…

Does Twinkle Artifact on Ultrasound Indicate a Kidney Stone in Pediatric Patients?
 Does Twinkle Artifact on Ultrasound Indicate a Kidney Stone in Pediatric Patients? 150 150 Mary Bates, PhD
By: Mary Bates, PhD

The presence of twinkle artifact on ultrasound is a useful, though imperfect, tool for diagnosing kidney stones in children. For pediatric patients, ultrasound is the recommended imaging modality used to diagnose kidney stones. Several findings are used to identify stones on ultrasound, including the presence of an echogenic focus, posterior acoustic shadowing, or twinkle artifact.…

Dehumanizing Language in the Health Care System Harms Children With Incarcerated Family Members
 Dehumanizing Language in the Health Care System Harms Children With Incarcerated Family Members 1024 683 Rosemary Martoma, MD and Kelly Kelleher, MD, MPH
By: Rosemary Martoma, MD and Kelly Kelleher, MD, MPH

Dehumanizing Language Causes Harm Labels and language matter. Language has the power to condemn or redeem, and words reflect our values and beliefs as clinicians, scholars, and members of the community.” – Bedell et al., Humanity: Person-First Language in Correctional Health Epidemiology, American Journal of Epidemiology Children with incarcerated family members frequently face stigma and…

Surgical Management of Recurrent Patellar Instability in the Pediatric Population
 Surgical Management of Recurrent Patellar Instability in the Pediatric Population 1024 575 Mary Bates, PhD
By: Mary Bates, PhD

Medial patellofemoral ligament reconstruction via the quadriceps turndown technique is safe and effective in young patients. In a new study, researchers from Nationwide Children’s Hospital demonstrate the safety and efficacy of the quadriceps turndown technique for medial patellofemoral ligament reconstruction in pediatric and adolescent patients. Patellar instability is a common knee condition in children and…

What is “Dry Drowning,” and How Do I Talk to Parents About It?
 What is “Dry Drowning,” and How Do I Talk to Parents About It? 1024 683 Daniel Scherzer, MD and Bema Bonsu, MD
By: Daniel Scherzer, MD and Bema Bonsu, MD

The concern about so called “dry drowning” (which is not an actual medical phrase; neither is “secondary drowning”) is based on the fear that a child can unexpectedly succumb to respiratory problems some unpredictable time after swimming. This fear has been exacerbated by media reports dramatizing events without fully explaining them. The concept that dry…

Unraveling Intractable Functional Constipation: Manometries Are Still the Gold Standard
 Unraveling Intractable Functional Constipation: Manometries Are Still the Gold Standard 1024 680 Natalie Wilson
By: Natalie Wilson
Close up color photo of little boy holding hands on his belly

Cine-MRI recordings can’t replace colonic manometries when assessing motility among children with functional constipation, but they may offer additional information. And conducting both MRIs and manometries simultaneously is feasible. While functional constipation (FC) is common in childhood, and most children who experience it respond well to behavioral interventions or treatment with laxatives, some children continue…

Indicators of Blood Clot Potential Directly Relate to Nephrotic Syndrome Severity
 Indicators of Blood Clot Potential Directly Relate to Nephrotic Syndrome Severity 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Researchers in the NEPTUNE network and collaborators at Nationwide Children’s Hospital have confirmed their preclinical studies demonstrating a direct correlation between the severity of disease and prothrombotic biomarkers in patients with nephrotic syndrome. Nephrotic syndrome (NS) dramatically increases the risk of a life-threatening blood clot, but until recently, clinicians have had no reasonable biomarker to…

The First Opioid-Prescribing Guidelines for Children Who Require Surgery
 The First Opioid-Prescribing Guidelines for Children Who Require Surgery 1024 573 Lauren Dembeck
By: Lauren Dembeck

Providers should recognize the risks of opioids, maximize nonopioid regimens, and educate families appropriately. The first opioid-prescribing guidelines to address the unique needs of children who require surgery have been published by an expert panel in JAMA Surgery. The new guidelines aim to help health care professionals caring for children and adolescents in the perioperative…

A New Kind of Rectal Diversion in Classic Bladder Exstrophy
 A New Kind of Rectal Diversion in Classic Bladder Exstrophy 1024 754 Jeb Phillips
By: Jeb Phillips

  This article appeared in the Spring/Summer 2021 print issue. Download the full issue.   Medical illustrations by Mandy Root-Thompson for Nationwide Children’s Hospital Source: V. Rama Jayanthi, chief of Urology at Nationwide Children’s Hospital To learn more about the procedure and it’s applications, read A Surprising Approach to Classic Bladder Exstrophy.

A Surprising Approach to Classic Bladder Exstrophy
 A Surprising Approach to Classic Bladder Exstrophy 1024 754 Jeb Phillips
By: Jeb Phillips

A procedure developed at Nationwide Children’s Hospital comes with possible risks but can have a huge impact on quality of life. It’s become clearer over the last two years that a “good outcome” for children born with classic bladder exstrophy is in the eye of the beholder. One of the best outcomes, nearly everyone would…

Pediatricians Offer Valuable Oral Health Services for the Very Young, Before and Throughout Pandemic
 Pediatricians Offer Valuable Oral Health Services for the Very Young, Before and Throughout Pandemic 1024 680 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
toddler brushing teeth

Medical professionals see very young children much more frequently during the first several years of life than dentists, and many states’ Medicaid programs have seized the opportunity to reimburse pediatricians for preventive oral care, such as fluoride application and oral hygiene education. Despite reimbursement options and national guidelines recommending dental care begin by age 1,…

Even Severe Asthma Can Improve if Guidelines Are Followed
 Even Severe Asthma Can Improve if Guidelines Are Followed 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

Patients treated with adequate medications and asthma family education can significantly improve irrespective of asthma severity. Severe asthma accounts for 5-8% of patients with asthma, but this group is more challenging to treat and is responsible for up to 40% of total asthma-care expenses. The majority of patients with severe asthma have difficult-to-treat asthma (in…

Global Study Highlights Antibiotic Overuse in the NICU
 Global Study Highlights Antibiotic Overuse in the NICU 1024 683 Abbie Miller
By: Abbie Miller
Baby in NICU

Antimicrobial stewardship programs were associated with lower antibiotic use, regardless of the country’s income level. Excessive antibiotic use among infants born preterm in the newborn intensive care unit (NICU) is associated with poor patient outcomes, such as sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia and others, and contributes to the emergence of multi-drug resistant microbes. A new…

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
By: 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…

How Important is Fasting for Pediatric Routine Cholesterol Screening?
 How Important is Fasting for Pediatric Routine Cholesterol Screening? 1024 575 Andrew Tran, MD
By: 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…

No More Sitting in the Dark?
 No More Sitting in the Dark? 1024 728 Laura Dattner
By: 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…

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
By: 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…

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
By: 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…

No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants
 No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants 1024 575 Lauren Dembeck
By: Lauren Dembeck
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

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…

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
By: 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…

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
By: 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…

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
By: 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…

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
By: 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…

More to Telehealth Than Meets the Screen
 More to Telehealth Than Meets the Screen 1024 535 Abbie Miller
By: Abbie Miller
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…

Updated Guidance on Oral Food Challenges
 Updated Guidance on Oral Food Challenges 1024 575 Mary Bates, PhD
By: 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.…

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
By: 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…

Improving Guidelines for Pediatric Hypertension Diagnosis
 Improving Guidelines for Pediatric Hypertension Diagnosis 1024 683 Natalie Wilson
By: 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…

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
By: 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…

When Should Breastfed Babies Be Supplemented?
 When Should Breastfed Babies Be Supplemented? 1024 575 Vanessa Shanks
By: 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…

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
By: 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…

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
By: 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.…