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Clinical Updates

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 Miller
By: Abbie Miller

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…

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
By: 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…

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
By: 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…

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
By: 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…

THRIVING After Severe Bronchopulmonary Dysplasia
 THRIVING After Severe Bronchopulmonary Dysplasia 1024 731 Abbie Miller
By: Abbie Miller

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…

From Clinician Ideas to Commercially-Available Clinical Devices
 From Clinician Ideas to Commercially-Available Clinical Devices 150 150 Kevin Mayhood
By: Kevin Mayhood

Pressure wounds were a common complication following a tracheostomy, often resulting in advanced-stage wounds, national studies showed. Nationwide Children’s Hospital was no different but Kris Jatana, MD, and Charles Elmaraghy, MD, surgeons in the Department of Otolaryngology, knew they could improve these outcomes. Brendan Boyle, MD, and Alex Green, DO, were fellows in the Division…

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 Miller
By: Abbie Miller
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

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…

A Major Milestone in Cystic Fibrosis Treatment
 A Major Milestone in Cystic Fibrosis Treatment 1024 575 Mary Bates, PhD
By: 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%…

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
By: 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…

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
By: 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…

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

Update: July 2021, this content has been reviewed for accuracy. The downloadable practice tool has been replaced with an updated version. 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…

Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families
 Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families 1024 575 Abbie Miller
By: Abbie Miller

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

Primary Care Provider Guide to Neonatal Abstinence Syndrome Follow Up
 Primary Care Provider Guide to Neonatal Abstinence Syndrome Follow Up 150 150 Nationwide Children's
By: 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…

Opening the Door to Adult Medicine
 Opening the Door to Adult Medicine 1024 575 Katie Brind'Amour, PhD, MS, CHES
By: 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…

Could Earlier Spirometry Get CF Inpatients Home Sooner?
 Could Earlier Spirometry Get CF Inpatients Home Sooner? 150 150 Katie Brind'Amour, PhD, MS, CHES
By: 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…

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
By: 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,…

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
By: 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…

Neurosurgery May Provide Lasting Relief From Spasticity
 Neurosurgery May Provide Lasting Relief From Spasticity 1024 575 Abbie Miller
By: Abbie Miller

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…

Childhood Kidney Stones: Their Surprising Connection to Future Disease
 Childhood Kidney Stones: Their Surprising Connection to Future Disease 150 150 Jeb Phillips
By: 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…

Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements
 Omega-3 Supplements Tied to Notable, Sustained Mental Health Improvements 150 150 Kevin Mayhood
By: 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…

InSight: Restoring Normal Habits
 InSight: Restoring Normal Habits 471 285 Tiasha Letostak, PhD
By: 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…

Acetabular “Fleck” Sign Predictive of Labral Avulsion
 Acetabular “Fleck” Sign Predictive of Labral Avulsion 150 150 Abbie Miller
By: Abbie Miller

A “fleck” sign on the postreduction CT scan calls for high suspicion of labral pathology, even in cases of congruent closed reductions. Traumatic posterior hip dislocations and subluxations are typically treated with a closed reduction in pediatric patients. For patients who have a congruent hip reduction, the course of treatment often ends here. However, a new study…

InSight: Working Up the Nerve
 InSight: Working Up the Nerve 150 150 Katie Brind'Amour, PhD, MS, CHES
By: 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…