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In Brief

First Implantable Hemodynamic Monitoring Device in Single Ventricle Fontan Anatomy
 First Implantable Hemodynamic Monitoring Device in Single Ventricle Fontan Anatomy 150 150 Abbie Miller
By: Abbie Miller

The first IHM in a patient with Fontan anatomy and physiology enables real-time monitoring of central venous and pulmonary artery pressures. While the Fontan procedure has improved the short- and mid-term outcomes for patients born with single ventricle anatomy, long-term complications of Fontan circulation include heart failure. These complications are thought to be secondary to…

Neurologists Urged to Consider MCA When Evaluations Don’t Support Claims
 Neurologists Urged to Consider MCA When Evaluations Don’t Support Claims 150 150 Kevin Mayhood
By: Kevin Mayhood

Up to half of medical child abuse cases include neurological symptoms Medical child abuse (MCA) is highly variable, but neurologists are in a position to help detect up to half of these cases, researchers at Nationwide Children’s Hospital report. Consistent with the authors’ clinical experience, studies estimate that abusive caregivers make up, exaggerate or induce…

Signaling Pathway Changes May Flag CAVD, Offer Target for Therapies
 Signaling Pathway Changes May Flag CAVD, Offer Target for Therapies 150 150 Kevin Mayhood
By: Kevin Mayhood

Loss of TgfB1 from the endothelium leads to a reduction in Sox9 expression and valve calcification. A team of researchers has identified a molecular signaling pathway that, when altered, can contribute to calcific aortic valve disease (CAVD). The finding may provide a method for early diagnosis — many patients don’t learn they have the disease until it’s in the final…

Helping the Sickest Children Navigate the Health Care System
 Helping the Sickest Children Navigate the Health Care System 150 150 Jeb Phillips
By: Jeb Phillips

Care coordination focuses on better outcomes for children with medical complexity. Consider a child with cerebral palsy who needs a feeding tube to eat. She has special equipment for a basic life function. She requires regular visits with a primary care physician and specialists in neurology, orthopedics and gastroenterology. She has frequent acute infections that lead to emergency department visits.…

Predicting Risk for Chronic Renal Disease in Children
 Predicting Risk for Chronic Renal Disease in Children 150 150 Kevin Mayhood
By: Kevin Mayhood

Studies using a new contrast agent have the potential to determine if infants born premature develop a full complement of nephrons. A new magnetic resonance imaging contrast agent enables researchers to see the number and volume of blood-filtering nephrons in rodent kidneys and donated human adult kidneys, potentially offering a way to diagnose chronic renal disease far earlier than current…

Vaccine Fails to Reactivate Immunity to Hepatitis C Virus
 Vaccine Fails to Reactivate Immunity to Hepatitis C Virus 150 150 Abbie Miller
By: Abbie Miller

T cells remain inactivated even after immunization in subjects with persistent, controlled infections. Two papers recently published in Hepatology uncovered evidence of permanent immune system damage after hepatitis C virus (HCV) infection. The studies used a vaccine currently in clinical trials to attempt to restore immunity against HCV in animal models and humans with chronic HCV infection. “In chronic HCV, CD8+…

A Novel Approach to Pediatric Fecal and Urinary Incontinence
 A Novel Approach to Pediatric Fecal and Urinary Incontinence 150 150 Jeb Phillips
By: Jeb Phillips

A 9-year-old girl with caudal regression syndrome is the first child in the United States to be treated with pudendal nerve stimulation. Neuromodulation of the sacral nerve, or sacral nerve stimulation, is rarely but increasingly used in children to help control fecal and urinary incontinence when standard medical management has failed. The treatment involves the implantation of a device…

On the Front Lines
 On the Front Lines 150 150 Anne FitzSimons
By: Anne FitzSimons

Pediatricians can reverse health disparities among the LGBT population. A recent position paper from the American College of Physicians (ACP) examines health disparities experienced by the lesbian, gay, bisexual and transgender (LGBT) population in the United States and includes recommendations for improving access to care. The ACP found that some policies and accompanying social stigma of LGBT persons has led…

Hearing Without Cochlear Nerves
 Hearing Without Cochlear Nerves 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

Auditory brainstem implant devices may help young children with sensorineural hearing loss. Sensorineural hearing loss (SNHL) is the most common type of hearing loss, accounting for about 90 percent of all hearing loss worldwide. SNHL involves damage to the inner ear (cochlea) or to the nerve pathways from the inner ear to the brain, and thus cannot be managed via…

Identifying Characteristics Associated With Timely Follow-Up Psychiatric Care
 Identifying Characteristics Associated With Timely Follow-Up Psychiatric Care 150 150 Kevin Mayhood
By: Kevin Mayhood

Nearly one in three youths with mood disorders receive no outpatient care within 30 days of psychiatric hospital discharge. More than diagnoses and demographics influence whether youths receive critical outpatient care following psychiatric hospitalization. Individual attributes and aspects of the hospital where they receive treatment as well as the community they live in play roles, researchers from The Ohio State…

Weaning Babies with NAS Better and Faster
 Weaning Babies with NAS Better and Faster 150 150 Kevin Mayhood
By: Kevin Mayhood

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
By: Abbie Miller

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
By: Kevin Mayhood

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
By: Abbie Miller

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
By: Abbie Miller

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
By: Anne FitzSimons

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
By: Naomi Makni, MHA

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
By: Alayna DiMartini

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
By: Jeb Phillips

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
By: Tiasha Letostak, PhD

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 Scott
By: Katelyn Scott

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
By: Jeb Phillips

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
By: Kevin Mayhood

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
By: Abbie Miller

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
By: Gina Bericchia

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
By: Abbie Miller

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
By: Katie Brind'Amour, PhD, MS, CHES

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
By: Abbie Miller

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
By: Jeb Phillips

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
By: Tiasha Letostak, PhD

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
By: Kevin Mayhood

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
By: Gina Bericchia

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
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…

New Drug Advances Cystic Fibrosis Care
 New Drug Advances Cystic Fibrosis Care 150 150 Kevin Mayhood
By: Kevin Mayhood

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
By: Abbie Miller

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
By: Kevin Mayhood

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
By: Kevin Mayhood

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
By: Dave Ghose

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
By: Tiasha Letostak, PhD

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
By: Abbie Miller

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
By: Jan Arthur

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
By: Abbie Miller

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
By: Jeb Phillips

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
By: Jeb Phillips

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
By: Tiasha Letostak, PhD

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
By: David Stukus, MD

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
By: Dave Ghose

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
By: Abbie Miller

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
By: Anthony Audino, MD

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
By: Susan Colasce, MD and Elizabeth Varga

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.”…