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In Brief

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
Microvessles

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
Three beautiful children with blond hair and freckles standing with parents outdoors. Boy is 4 years old. Main focus on the girls (6 and 9 years).

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
By: Tyanna Snider, Psy.D

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
By: Abbie Miller

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
By: Jennifer Smith, MS, RD, CSP, LD, LMT

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
By: Tiasha Letostak, PhD

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
By: Abbie Miller

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
By: Kelly Kelleher, MD, MPH

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
By: Anne Unger

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
By: Marc Levitt, MD

Reducing Practice Variation in Pediatrics
 Reducing Practice Variation in Pediatrics 150 150 Jonathan Slaughter, MD, MPH
By: Jonathan Slaughter, MD, MPH

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
By: Tiasha Letostak, PhD

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…

What Do DALYs Mean for Pediatrics?
 What Do DALYs Mean for Pediatrics? 150 150 Dave Ghose
By: Dave Ghose

An emerging, innovative metric could radically change childhood health policy. A new way of looking at illness is beginning to change how public health officials view life and death. The concept — called DALYs — offers a fuller view of disease that could have a big impact on pediatrics if embraced. Unlike death tolls —…

Adolescents, Young Adults and Cancer: What Are the Issues?
 Adolescents, Young Adults and Cancer: What Are the Issues? 150 150 Abbie Miller
By: Abbie Miller

Adolescents and young adults with cancer have unique needs that may explain their plateau in survival rates, despite improved survival rates in other age groups. At an age when achieving independence and experiencing life milestones are most important, adolescents and young adults facing a cancer diagnosis must meet unique challenges. These challenges may contribute to…

Talking to Adolescent Patients About Marijuana
 Talking to Adolescent Patients About Marijuana 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

With legalization spreading across the United States, it’s hard to know what to say to teens curious about marijuana. Legal in 23 states and the District of Columbia. Renowned in pop culture. Affectionately called everything from “wacky tobaccy” to “hippie lettuce.” Marijuana isn’t going away. Despite its popularity and availability, many youths — and clinicians…

Do You Believe in Integrated Health Care?
 Do You Believe in Integrated Health Care? 150 150 Miguel Saps, MD
By: Miguel Saps, MD

Patients are more than a segregated set of organ systems. Treating them as whole beings requires the practice of integrated medicine. I believe in an integrated approach to health care. The care of patients is often envisioned as fractionated, with different specialists taking care of different organs or organ systems — a model that I…

A Watershed Moment for Cancer Virotherapy
 A Watershed Moment for Cancer Virotherapy 150 150 Timothy Cripe, MD, PhD
By: Timothy Cripe, MD, PhD

A recent decision may define the future of virotherapy’s role in the clinical treatment of cancer. At 4:50 pm on Wednesday, April 29 2015, the votes were cast: 22 in favor, 1 against. With this overwhelming majority, an advisory committee sent a clear message to the FDA recommending the first marketing approval for a live virus cancer…

Crohn’s Disease Not Exempt From Racial Disparities
 Crohn’s Disease Not Exempt From Racial Disparities 150 150 Gina Bericchia
By: Gina Bericchia

Disparities exist among pediatric Crohn’s patients of different races for a number of health care metrics. A study published in the journal Inflammatory Bowel Diseases found significant differences in hospital readmissions, medication usage and both medical and surgical complications of children with Crohn’s disease related to race. In the study, black children had a 1.5 times higher frequency…

Prodigy and Autism Share a Common Genetic Link, Study Finds
 Prodigy and Autism Share a Common Genetic Link, Study Finds 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

Researchers have discovered the first molecular genetic evidence for a shared etiology between prodigy and autism. A new study published in the journal of Human Heredity last month found that child prodigies share some of the same genetic variations with people who have autism. These findings could help geneticists better understand the molecular genetic underpinnings of autism and prodigy…

Patients Without Borders
 Patients Without Borders 150 150 Dave Ghose
By: Dave Ghose

Immigrant children represent the fastest growing segment of the U.S. population. What can pediatricians do to help these vulnerable patients? James Duffee, MD, MPH, watched the immigrant population change dramatically during his 15 years as a community health pediatrician and child psychiatrist in Springfield, Ohio. When he founded the Rocking Horse Community Health Center in 1999,…

To Rest or Not To Rest?
 To Rest or Not To Rest? 150 150 Kevin Mayhood
By: Kevin Mayhood

Ebola in Children Creates Ethical Quandary
 Ebola in Children Creates Ethical Quandary 150 150 Kevin Mayhood
By: Kevin Mayhood

Do you keep a parent in the room while the virus rages inside a child? The Ebola outbreak in Guinea, Liberia and Sierra Leone has challenged emergency preparedness at Children’s Hospitals and Clinics of Minnesota like nothing before — even more than the early days of AIDS and outbreaks of measles and H1N1 flu, says Infection Prevention…

A Shift in the Antibiotic Prophylaxis Debate?
 A Shift in the Antibiotic Prophylaxis Debate? 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

The RIVUR trial laid to rest certain questions surrounding antimicrobial prophylaxis in children with vesicoureteral reflux. But it also launched a new debate. The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trialwas supposed to provide clear direction for pediatric urologists. To date, it is the largest double-blind, placebo-controlled, randomized, multicenter study examining urinary tract infection…

Conflicting Directions for BPD Treatment
 Conflicting Directions for BPD Treatment 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Treatment of bronchopulmonary dysplasia differs dramatically among institutions. But why does variation matter? Recent studies report extreme variation among hospitals ordering three common medications for chronic lung disease, or bronchopulmonary dysplasia, calling into question the appropriateness of their use and the reason for their prescription. “In the use of diuretics, inhaled bronchodilators and inhaled corticosteroids,…

Placental Transfusion Confusion
 Placental Transfusion Confusion 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Medical professional organizations cannot reach consensus regarding delayed cord clamping and umbilical cord “milking.” Nearly every relevant professional organization has its own recommendations for placental transfusion techniques known as delayed umbilical cord clamping and milking. But it’s unclear whether additional research will lead to consensus. The American Congress of Obstetricians and Gynecologists and American Academy of Pediatrics say there’s…

Study Finds Cow’s Milk is Added to Breast Milk and Sold to Parents Online
 Study Finds Cow’s Milk is Added to Breast Milk and Sold to Parents Online 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Deceptive Internet advertisements for human breast milk may put infants at risk. What do parents (and doctors) need to know about milk sharing? A study published yesterday on the safety of human breast milk bought over the Internet found that 10 percent of samples contained added cow’s milk. The discovery that purchased samples of human milk may…

The Continence Predictor Index
 The Continence Predictor Index 150 150 Marc Levitt, MD
By: Marc Levitt, MD

Are We Properly Capturing the Maternal-Child Health Continuum?
 Are We Properly Capturing the Maternal-Child Health Continuum? 150 150 Irina Buhimschi
By: Irina Buhimschi

An obstetrician doing research at a children’s hospital may seem out of place. But not according to one clinician-scientist, who believes that maternal health and child health are inextricably intertwined. Traditionally, doctors divide into those who practice adult medicine and those who practice pediatrics. With the exception of family physicians, there is little crossover in…

Advancing Pediatric Anesthesiology Through Research
 Advancing Pediatric Anesthesiology Through Research 150 150 Joseph Tobias, MD
By: Joseph Tobias, MD

Pediatric anesthesiology research is a relatively new phenomenon. But one clinician-scientist believes it is the key to bringing the field into the “big leagues” of evidence-based medicine. Over the past 30 years, the field of pediatric anesthesiology has expanded with the recognition of the need for specialized training, the development of fellowship programs and, most…

Early Detection of Bipolar Spectrum Disorders in High-Risk Children
 Early Detection of Bipolar Spectrum Disorders in High-Risk Children 150 150 Abbie Miller
By: Abbie Miller

A new study finds key symptoms are associated with the development of bipolar disorder among children of parents with the condition. New research published today in the American Journal of Psychiatry indicates a strong link between subthreshold manic episodes and likelihood of developing bipolar disorder in children of parents with bipolar disorder. The study’s findings could…

Illuminating Vasospasm in Children with Traumatic Brain Injury
 Illuminating Vasospasm in Children with Traumatic Brain Injury 150 150 Jan Arthur
By: Jan Arthur

Understanding reasons for dangerous vessel constriction following brain injury may help define treatment or prevention options. Vasospasm, or severe narrowing of blood vessels, is a dangerous complication observed in children with moderate to severe traumatic brain injury. In a paper recently published in Critical Care Medicine, investigators at Nationwide Children’s Hospital have further defined the prevalence,…