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In Brief

Weaning Babies with NAS Better and Faster
 Weaning Babies with NAS Better and Faster 150 150 Kevin Mayhood
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Protocol enables babies born addicted to opioids to be weaned off the drugs faster. Adoption of a strict protocol has enabled six regional perinatal centers across Ohio to wean babies exposed to opioids in utero off drugs faster, send them home sooner and lower the use of adjunctive drugs, new research shows. In response to the skyrocketing…

How to Increase Adherence to Screening Guidelines for Children With Down Syndrome
 How to Increase Adherence to Screening Guidelines for Children With Down Syndrome 150 150 Abbie Miller
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Recent study shows that while most families and physicians support the guidelines, patients are not receiving the recommended screenings. Children with Down syndrome have multiple medical conditions and cognitive impairments related to the additional genetic material from chromosome 21. Because of common comorbid conditions in the Down syndrome population such as heart defects, hearing loss,…

Researchers Find Signatures of Rhinovirus Infection and Incidental Presence
 Researchers Find Signatures of Rhinovirus Infection and Incidental Presence 150 150 Kevin Mayhood
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Transcriptional profiling may speed discrimination between the two, aiding in clinical decisions. Transcriptional profiling, measuring the activity of thousands of genes at once to create a snapshot of cellular function, may make quick work of discriminating between active rhinovirus infection and incidental virus detection — and improve clinical decisions — researchers from Nationwide Children’s Hospital…

New Approach to Gathering Protein Signatures
 New Approach to Gathering Protein Signatures 150 150 Abbie Miller
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In the first comprehensive study of its kind, researchers simultaneously analyzed both host and bacteria protein signatures from a single, tiny tissue sample. A novel study from researchers at Nationwide Children’s Hospital has shown that it is possible to obtain both host and bacteria protein signatures in a sample smaller than the average human biopsy.…

Loss of MHCI in Motor Neurons Leads to ALS Astrocyte Toxicity
 Loss of MHCI in Motor Neurons Leads to ALS Astrocyte Toxicity 150 150 Abbie Miller
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New research shines a light on the role of MHCI in astrocyte-induced death of motor neurons in amyotrophic lateral sclerosis and pointing to a potential therapeutic target. Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a devastating progressive neurodegenerative disease that results in the death of motor neurons, the nerve cells that…

Eating Better, Not Less, May Be Key to Weight Management for Teens on DMPA
 Eating Better, Not Less, May Be Key to Weight Management for Teens on DMPA 150 150 Anne FitzSimons
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Research suggests teens weight gain on popular injectable contraceptive associated with micronutrient intake. Each year, thousands of teenage girls decide to use the injectable contraceptive depot medroxyprogesterone acetate (DMPA). They are drawn to DMPA’s long-acting convenience (it’s injected just four times a year) and near 100 percent efficacy. However, for some, the drug causes significant and seemingly…

Pay-for-Performance Incentives Impact Patient Care
 Pay-for-Performance Incentives Impact Patient Care 150 150 Naomi Makni, MHA
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First evaluation of pay-for-performance conducted by researchers at Nationwide Children’s Hospital. The first pay-for-performance (P4P) evaluation of pediatricians under a full-risk Medicaid accountable care organization (ACO) for children shows P4P incentives were partially responsible for higher performance on quality measures across Partners For Kids’ primary care network of employed and affiliated physicians, according to study authors at…

Involving Stakeholders Boosts Clinical Trial Participation
 Involving Stakeholders Boosts Clinical Trial Participation 150 150 Alayna DiMartini
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Stakeholder involvement in clinical trial design leads to greater recruitment and retention rates. By seeking the advice of patients, families and other stakeholders in designing a clinical trial investigating pediatric appendicitis, researchers at Nationwide Children’s Hospital found a way to significantly increase the number of people recruited and retained in the trial. Recruitment of patients…

Predicting the Efficacy of Immune-Based Therapies for Pediatric Solid Tumors
 Predicting the Efficacy of Immune-Based Therapies for Pediatric Solid Tumors 150 150 Jeb Phillips
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Expression of HLA class I and β-2-microglobulin may show how susceptible some cancers are to T-cell based immunotherapies. A number of possible immunotherapies for cancer are based on T-cells that can target and kill tumors. These cytotoxic T lymphocytes (CTLs) can only recognize tumor cells, though, if an antigen is expressed in the context of…

Adenovirus or Kawasaki Disease?
 Adenovirus or Kawasaki Disease? 150 150 Tiasha Letostak, PhD
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Researchers investigate clinical and laboratory testing methods to accurately distinguish adenovirus from Kawasaki disease in children Kawasaki disease is a rare but serious condition in children that involves inflammation of the blood vessels, specifically the coronary arteries. It is the most common cause of pediatric acquired heart disease in the developed world. However, diagnosis is difficult…

Appalachian and Urban Children Face Similar Health Care Challenges
 Appalachian and Urban Children Face Similar Health Care Challenges 150 150 Katelyn Hanzel
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Research shows children in Ohio’s Appalachian counties face similar health care challenges to those in metropolitan areas Despite the fact that previous research shows the Appalachian region of the United States as limited in access to health care services, researchers at Nationwide Children’s Hospital have found that children with special health care needs in Appalachian…

Extremely Premature Infants Benefit from Early Extubation Attempts
 Extremely Premature Infants Benefit from Early Extubation Attempts 150 150 Jeb Phillips
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Early attempts associated with shorter hospital stays and lower incidence of bronchopulmonary dysplasia, even if reintubation is necessary Neonatologists often struggle with the timing of extubation. Although prolonged mechanical ventilation in premature infants is linked to the development of bronchopulmonary dysplasia (BPD), there has been considerable debate as to whether extubating too early may also…

Mouse Model Reflects Small Population but Could Provide Big Payoff
 Mouse Model Reflects Small Population but Could Provide Big Payoff 150 150 Kevin Mayhood
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First model of exon duplication causing DMD enables testing for potential therapies Duplication of exons, the parts of a gene that code for amino acids, cause six to 10 percent of cases of Duchenne muscular dystrophy, which is due to mutations in theDMD gene.  New research suggests skipping, or excluding, one copy of a duplicated exon during assembly…

Putting the Brakes on Myopia Progression
 Putting the Brakes on Myopia Progression 150 150 Abbie Miller
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Researchers are studying how well commercially available bifocal contact lenses limit the progression of myopia. Myopia, or nearsightedness, is a growing problem in the United States and around the world. Research suggests 30 to 40 percent of adults in Europe and the United States and up to 80 percent in Asia have myopia. It usually…

Using Antibiotics Alone for Children with Uncomplicated Appendicitis
 Using Antibiotics Alone for Children with Uncomplicated Appendicitis 150 150 Gina Bericchia
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One year follow-up of patients treated only with antibiotics found that 76 percent avoided surgery. Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family, finds a recent study led by researchers at Nationwide Children’s Hospital. Three out of four children with uncomplicated appendicitis…

Boosting Research With a Down Syndrome Biobank
 Boosting Research With a Down Syndrome Biobank 150 150 Abbie Miller
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A new biobank for Down syndrome blood samples will enable clinical and translational researchers everywhere to shed light on conditions related to Down syndrome, including Alzheimer’s disease. Certain conditions such as congenital heart disease, childhood leukemia and epilepsy are more common in patients with Down syndrome than in the general population. Other conditions, including solid…

Childhood Kidney Stones Associated With Atherosclerosis
 Childhood Kidney Stones Associated With Atherosclerosis 150 150 Katie Brind'Amour, PhD, MS, CHES
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Research could lead to early interventions to improve cardiovascular health. Kidney stones in children are increasingly common, and until recently were believed to be an isolated medical problem. But a study conducted by clinician-scientists at Nationwide Children’s Hospital has identified for the first time a significant association between kidney stones and atherosclerosis in children. Previous…

HIV in the Millennial World
 HIV in the Millennial World 150 150 Abbie Miller
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Adolescents and young adults ages 13 to 24 comprise an increasingly large proportion of new HIV infections in the United States. A new generation of youth is experiencing increasing rates of HIV transmission, and data from the Centers for Disease Control and Prevention (CDC) indicate half of those infected youth (ages 13-24) don’t even know…

Infantile Spasms Respond Poorly to Common First-Line Treatment
 Infantile Spasms Respond Poorly to Common First-Line Treatment 150 150 Jeb Phillips
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Researchers recommend other initial treatments after finding that topiramate has a low rate of infantile spasms remission. The early and effective treatment of infantile spasms has been associated with better developmental outcomes for patients, while delayed remission of the infantile spasms may contribute to poorer outcomes. In fact, a U.S. Consensus Report on infantile spasms…

Zoledronic Acid Safe and Effective for Use in Children and Young Adults, Study Shows
 Zoledronic Acid Safe and Effective for Use in Children and Young Adults, Study Shows 150 150 Tiasha Letostak, PhD
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The medication improves bone density and reduces fractures in patients with neuromuscular disorders that lead to paralysis. Children with neuromuscular disorders that lead to quadriplegia (paralysis of all four limbs) or paraplegia (paralysis of the legs and lower body) are at risk for low bone density and prone to fractures, a medical condition known as…

Common Infections Associated With Childhood Stroke
 Common Infections Associated With Childhood Stroke 150 150 Kevin Mayhood
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Routine vaccinations appear to be protective. Minor infections, including the common cold, appear to trigger arterial ischemic stroke (AIS) in children, an international study shows. At the same time, a full or nearly full regimen of childhood immunizations appears to be protective in children. The research, published in the journal Neurology, also indicates long-suspected cold medicines don’t…

Genetic Testing for Pediatric Epilepsy Can Be Complicated but Beneficial
 Genetic Testing for Pediatric Epilepsy Can Be Complicated but Beneficial 150 150 Gina Bericchia
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Application of genetic testing in pediatric epilepsy requires understanding of the advantages and limitations of testing modalities The use of genetic testing in pediatric epilepsy is complicated and the list of known epilepsy genes changes almost daily. The steps from a doctor initially evaluating a patient when they first demonstrate the symptoms of epilepsy to genetic diagnosis…

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

New Drug Advances Cystic Fibrosis Care
 New Drug Advances Cystic Fibrosis Care 150 150 Kevin Mayhood
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Orkambi helps reduce infections and slows loss of lung function in some patients. Matt Hennessey knew he was on the experimental medicine and not a placebo just days after he began participating in a drug trial. He felt better. The addition of Orkambi pills to his daily routine was just another part of his maintenance…

Sickle Cell Disease: Global Disparities in Prevalance and Outcomes
 Sickle Cell Disease: Global Disparities in Prevalance and Outcomes 150 150 Abbie Miller
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Unique challenges exist for people with sickle cell disease depending on where they live. An estimated 300,000 to 500,000 babies worldwide are born with sickle cell disease (SCD) each year. In Africa and India, where SCD is most prevalent, newborn testing is not performed, and many children with sickle cell disease die before they are…

Marijuana Exposure in Young Children
 Marijuana Exposure in Young Children 150 150 Kevin Mayhood
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Researchers call for states to enact controls protecting all minors. When states legalize marijuana for medical or recreational use, the number of children younger than 6 exposed to the drug spikes that year and continues to rise annually, researchers at Nationwide Children’s Hospital report. And the number of children classified as victims of major exposures…

Suicides Rising Among Young Black Children, Rural Adolescents
 Suicides Rising Among Young Black Children, Rural Adolescents 150 150 Kevin Mayhood
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Researchers are parsing data for trends and intervention targets. Researchers in central Ohio are gaining surprising insights they hope will lead to fewer children and adolescents committing suicide. While the suicide rate among white children 5 to 11 years old has declined since 1993, the rate among black children in the same age group has…

Hidden Victims
 Hidden Victims 150 150 Dave Ghose
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Pediatricians acknowledge the emerging public health challenge of child commercial sexual exploitation. Public health officials no longer think that human trafficking is just a problem in the developing world. Increasing awareness has focused attention on the exploitation of children in the United States, showing that medical professionals can uncover problems in their own backyards. “I…

Severely Obese by Kindergarten: What’s a Doctor to Do?
 Severely Obese by Kindergarten: What’s a Doctor to Do? 150 150 Tiasha Letostak, PhD
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The numbers of children and adolescents with severe obesity have continued to rise in the past 30 years, but only a few centers provide evidence-based care for severe childhood obesity. Childhood obesity affects 17 percent of children in the United States, and nearly one-third of these children are severely obese. The prevalence rates of children…

Methadone Weaning: The Role of the Pharmacist
 Methadone Weaning: The Role of the Pharmacist 150 150 Abbie Miller
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Pharmacist-led methadone tapers are improving outcomes and reducing practice variation in pediatric intensive care units. In neonatal and pediatric intensive care units, opioid use is necessary for controlling pain and as an adjunct to sedation during mechanical ventilation. However, after as few as five days of use, approximately 50 percent of patients will experience withdrawal…

An Ethical Discussion of Parental Care Preference
 An Ethical Discussion of Parental Care Preference 150 150 Jan Arthur
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Two infants with the same prognosis have parents with different preferences in terms of care. What should the medical team do? The article, “Two Infants, Same Prognosis, Different Parental Preferences,” published in the May 2015 issue of Pediatrics, presents a challenging ethical dilemma that brings into question the best interest standard and quality-of-life value judgments among…

Visualizing Gene Therapy for SMA
 Visualizing Gene Therapy for SMA 150 150 Abbie Miller
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Spinal muscular atrophy (SMA), a degenerative neuromuscular disease, is the most common genetic cause of death for infants. Virtually all children affected with SMA type 1 die by 2 years of age. In 2014, Jerry Mendell, MD, director of the Center for Gene Therapy in the Research Institute at Nationwide Children’s Hospital, began a phase 1 gene transfer clinical…

Study Links Acute Infections With Later Functional Gastrointestinal Disorders
 Study Links Acute Infections With Later Functional Gastrointestinal Disorders 150 150 Jeb Phillips
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Link between acute infection in preschoolers and development of FGIDs in school-aged children could point toward interventions. Functional gastrointestinal disorders (FGIDs) are among the most common pediatric health conditions and often first appear in school-aged children. Acute diarrhea, also very common, often first manifests in preschoolers. A recently published prospective study shows that there may…

Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns
 Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns 150 150 Jeb Phillips
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Recent studies show the practice can offer circulatory advantages for infants born extremely preterm or with critical congenital heart disease. The practice of immediate or early umbilical cord clamping after birth has been the norm since research in the 1950s and 1960s showed that most blood volume for full term babies was achieved “within the…

Taking a Closer Look at the Relationship Between Type 2 Diabetes and Cardiovascular Disease
 Taking a Closer Look at the Relationship Between Type 2 Diabetes and Cardiovascular Disease 1024 575 Tiasha Letostak, PhD
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A new study reveals surprising results regarding vascular stiffness of coronary microvessels in the presence of type 2 diabetes. Type 2 diabetes mellitus (T2DM) is a chronic condition that affects the glucose metabolism as a result of insulin resistance. Patients with T2DM are two to four times more likely to have a heart attack than non-diabetic patients.…

Become a Myth Buster: Use Evidence-Based Medicine to Change Clinical Care
 Become a Myth Buster: Use Evidence-Based Medicine to Change Clinical Care 150 150 David Stukus, MD
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Medical myths abound, even among good doctors. How are medical myths perpetuated and how can they be stopped? When was the last time you took a step back and questioned your medical decision making? Why did you decide to prescribe that treatment at that dosage and for that exact duration? Was that test truly necessary…

Helping the Child by Helping the Mom
 Helping the Child by Helping the Mom 150 150 Dave Ghose
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Pediatricians can help babies by doing a better job screening new mothers for postpartum depression. Up to 20 percent of new mothers experience postpartum depression, but studies show that nearly half go undiagnosed. If pediatricians were to play a greater role in identifying mothers experiencing symptoms, they could play an important role in helping these…

Stress Dose Hydrocortisone Effects on Neurodevelopment for Extremely Low Birthweight Infants
 Stress Dose Hydrocortisone Effects on Neurodevelopment for Extremely Low Birthweight Infants 150 150 Abbie Miller
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First placebo-controlled study on stress dose hydrocortisone and neurodevelopment shows that higher doses of hydrocortisone are not associated with brain injury or neurodevelopmental impairments, but may not be effective in reducing risk for bronchopulmonary dysplasia. Hydrocortisone is one of the 15 most frequently prescribed medications in extremely low birth weight (≤1000 g) infants in the…

Challenges of Adolescent and Young Adult Cancer
 Challenges of Adolescent and Young Adult Cancer 150 150 Anthony Audino, MD
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Among the unique challenges of AYA cancer, anxiety often increases after treatments are completed as the patient reintegrates back into “normal life.” The definition of the adolescent and young adult (AYA) cancer patient has evolved over time, but it is now formally defined as those diagnosed with cancer at ages 15 through 39. AYA patients are a…

Understanding Genetic Predisposition to Cancer
 Understanding Genetic Predisposition to Cancer 1024 683 Susan Colasce, MD and Elizabeth Varga
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When should families who have children with cancer be concerned about inherited cancer predisposition? One of the most common questions parents ask when their child is diagnosed with cancer is, “Does this put my other children at higher risk for developing cancer as well?” Most of the time, the answer to this question is “no.”…

Psychological Strategies for Pediatric Weight Management
 Psychological Strategies for Pediatric Weight Management 150 150 Tyanna Snider, Psy.D
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Motivational interviewing, having developmentally appropriate expectations, and behavioral strategies are among the tools needed to support pediatric weight management. Almost everyone has tried to stop a bad habit or change a negative behavior – it’s hard! Think about all the New Year’s resolutions you’ve made, and how successful you have been at keeping or reaching…

Making Progress: Advances in Life-Long Care for ACHD
 Making Progress: Advances in Life-Long Care for ACHD 150 150 Abbie Miller
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With adults comprising two-thirds of the CHD population, the AHA has released a scientific statement outlining the needs of this growing demographic. The need for a life-long approach to cardiac care for patients with congenital heart disease is a crusade that has been long fought by pediatric cardiologists and adult CHD specialists for over 40…

Enteral Therapy Thursday: Professionals Sharing the Patient Experience
 Enteral Therapy Thursday: Professionals Sharing the Patient Experience 150 150 Jennifer Smith, MS, RD, CSP, LD, LMT
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A multidisciplinary team puts themselves on enteral nutrition for a day to gain insights into the patient experience. Enteral nutrition for Crohn’s disease is a well-established practice using liquid formulas to treat Crohn’s disease.  Patients who choose this form of treatment either drink the prescribed amount of formula or receive the formula via a feeding…

Using Informatics to Help Identify Patients for Research
 Using Informatics to Help Identify Patients for Research 150 150 Tiasha Letostak, PhD
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Researchers use Informatics for Integrating Biology and the Bedside (i2b2), a system that can rapidly convert a large amount of clinical data into searchable information, to dramatically reduce the time needed for patient cohort identification. Patient cohort identification, or the process of finding patients with shared characteristics, is an important first step in the early…

Researchers Describe Molecular Switch Controlling “Chameleon” Bacteria
 Researchers Describe Molecular Switch Controlling “Chameleon” Bacteria 150 150 Abbie Miller
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Closing the gap on developing a vaccine for middle ear infections. Researchers at Nationwide Children’s Hospital in Columbus, Ohio, and Griffith University’s Institute for Glycomics in Australia have discovered groundbreaking evidence that will help vaccine developers in their search for a vaccine against multiple infections of the respiratory tract, including middle ear infections. The research, published today in Nature…

Racism in Our Hospitals and Communities: Everyone Matters
 Racism in Our Hospitals and Communities: Everyone Matters 150 150 Kelly Kelleher, MD, MPH
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Let’s touch all families by erasing racism from children’s hospitals. Here at Nationwide Children’s Hospital, we are engaged in an important new initiative: Everyone Matters. The idea is simple — we each have effects that ripple far beyond us through our everyday actions and attitudes toward each other, our patients and our community. Those effects can be…

Do Overly Restrictive Feeding Practices Contribute to Obesity?
 Do Overly Restrictive Feeding Practices Contribute to Obesity? 150 150 Anne Unger
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Researchers are discovering that the way caregivers feed their kids may be just as important as what they give them to eat. It is estimated that by 2020, 16 million kids under the age of 5 will be obese. Currently, most public health initiatives are focused on promoting healthy eating and physical activity to reverse…

Designing a Center for Collaborative Care
 Designing a Center for Collaborative Care 150 150 Marc Levitt, MD
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Reducing Practice Variation in Pediatrics
 Reducing Practice Variation in Pediatrics 150 150 Jonathan Slaughter, MD, MPH
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With variations in practice existing even between practitioners at the same institution, research can provide the keys to standardizing care and improving outcomes. Practice variation occurs when care providers diagnose or treat patients differently, even in the setting of similar disease presentation and risk factors. Variations in care have been noted at the geographic level…

Data-Driven Health Care Delivery
 Data-Driven Health Care Delivery 150 150 Tiasha Letostak, PhD
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Health care enterprise data warehouse (EDW) technology, analytics and cross-functional teams are leading to improved quality and efficiency of patient care. Big data has big potential, but despite the value of electronic health record (EHR) systems in digitizing care at hospitals, data-driven improvements are commonly hindered by an inability to measure and analyze this data…