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Informing the Discussion on rhGH for Idiopathic Short Stature
 Informing the Discussion on rhGH for Idiopathic Short Stature 150 150 Juan F. Sotos, MD
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Growth hormone treatment for children with idiopathic short stature has remained controversial. Based on my experience and that of others, I recommend treatment. The use of growth hormone for idiopathic short stature has remained controversial in the field of endocrinology, mainly because of previous…

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A New Take on Obesity Prevention: The Maternal-Child Relationship
 A New Take on Obesity Prevention: The Maternal-Child Relationship 150 150 Tiasha Letostak, PhD
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In the past 30 years, obesity has quadrupled in adolescents and more than doubled in children, affecting even preschool-aged children. The majority of childhood obesity prevention strategies focus on energy balance, targeting behaviors and environmental changes to increase physical activity, decrease sedentary behavior or…

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Mystery Rising: Why is T1D Incidence Rising Globally?
 Mystery Rising: Why is T1D Incidence Rising Globally? 150 150 Katie Brind'Amour, PhD, MS, CHES
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Type 1 diabetes used to be rare. Late 19th-century estimates put its incidence at about 0.004 percent of the world’s population. But by the end of the 20th century, most nations reported a number 350 times that rate. With many countries continuing to experience…

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Stressed Out: Toxic Stress and Child Brain Development
 Stressed Out: Toxic Stress and Child Brain Development 150 150 Dave Ghose
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Stress, in small doses, can be good for children. When they argue with another child over a toy or attend a new school or daycare, the experience can teach them valuable coping skills. Even a more intense event, such as the death of a…

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Getting to the Point: Are Safety Needles Really Safe?
 Getting to the Point: Are Safety Needles Really Safe? 150 150 Kelli Whitlock Burton
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Sharp hypodermic needles are, as the name implies, sharp. Just ask the nearly 400,000 U.S. health care workers who are accidentally pricked each year. Most needle sticks aren’t serious, but the potential for exposure to bloodborne diseases has led many hospitals to discontinue the…

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Building the Modern-Day Vaccine
 Building the Modern-Day Vaccine 150 150 Katie Brind'Amour, PhD, MS, CHES
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Vaccine development used to be straightforward. Now, the challenges are many and the successes are few. What will it take to overcome the obstacles presented by both immunology and society? For 160 years, vaccine after vaccine succeeded at safely and effectively preventing its targeted…

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

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Body, Heal Thyself: Harnessing Our Innate Immunity
 Body, Heal Thyself: Harnessing Our Innate Immunity 150 150 Katie Brind'Amour, PhD, MS, CHES
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What the urinary tract’s front-line defenses can teach us about our innate ability to self-heal …. and thwart antibiotic resistance. Antibiotic resistance is on the rise, health care-acquired infections are becoming harder to treat and even simple infectious illnesses account for billions of dollars…

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Enteral Therapy on Trial
 Enteral Therapy on Trial 150 150 Katie Brind'Amour, PhD, MS, CHES
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Micah Cohen sat down at the dining room table in his family’s Columbus, Ohio, home and took the first sip of a new therapy he hoped would relieve the symptoms of his Crohn’s disease. The thick, sweet chocolate shake, rich with nutrients, felt heavy…

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Delays and Difficulties: Fecal Microbiota Transplants as Therapy
 Delays and Difficulties: Fecal Microbiota Transplants as Therapy 150 150 Katie Brind'Amour, PhD, MS, CHES
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Use of fecal microbiota transplantation to treat a wide range of disorders is in limbo while the FDA decides how to regulate the therapy. Between 1997 and 2007, Clostridium difficile bacterial infections among U.S. children more than doubled and its mortality rate among all U.S. cases…

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An Unwelcome Blast from the Past: Vitamin K Deficiency Bleeding
 An Unwelcome Blast from the Past: Vitamin K Deficiency Bleeding 150 150 Kelli Whitlock Burton
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Most pediatric specialists who began practicing medicine in the mid-1960s have probably never seen a case of vitamin K deficiency bleeding. Robert Sidonio, MD, had seen just one, and that was during his fellowship. And then, in February 2013, an infant came in to the…

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Thinking Outside the (Tool) Box: How Techniques From Alzheimer’s Research Illuminate the Pathophysiology of Preeclampsia
 Thinking Outside the (Tool) Box: How Techniques From Alzheimer’s Research Illuminate the Pathophysiology of Preeclampsia 150 150 Katie Brind'Amour, PhD, MS, CHES
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Irina Buhimschi, MD, has a habit of getting lost. In July 2007, that poor sense of direction proved to be a fortunate flaw. Having wandered into the wrong presentation at the Protein Society’s national conference, she hovered in the back to get her bearings.…

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Adult Congenital Heart Disease: Let’s Finish What We Started
 Adult Congenital Heart Disease: Let’s Finish What We Started 150 150 Curt Daniels, MD
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Congenital heart disease is the most common birth defect, diagnosed in nearly 1 percent of all births in the United States. Traditionally, life expectancy in many infants with severe CHD was limited to months. However, advances in medical and surgical care have led to remarkable…

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The End of “Under 12″
 The End of “Under 12″ 150 150 Kelli Whitlock Burton
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UNOS board eliminates age classification for child lung transplant candidates and alters rules for pediatric heart transplants. Many in the pediatric field were surprised last year when a federal judge ordered that a 10-year-old Pennsylvania girl with cystic fibrosis be added to the national adult…

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Mock MRI Scanners to Reduce Anesthesia Use
 Mock MRI Scanners to Reduce Anesthesia Use 150 150 Katie Brind'Amour, PhD, MS, CHES
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Initial research supports the use of MRI practice sessions and mock scanners to avoid sedation and alleviate patient and parent anxiety before an MRI. Studies exist for populations such as patients with ADHD and diabetes, but to date no studies appear to investigate the use of a…

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Using Zinc for Growth Delays in Babies Born Preterm
 Using Zinc for Growth Delays in Babies Born Preterm 150 150 Katie Brind'Amour, PhD, MS, CHES
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Zinc supplementation in extremely low birth-weight (ELBW) infants with chronic lung disease improves weight gain and linear growth, according to a retrospective study performed at Nationwide Children’s Hospital. The study is one of the first to look at the association between zinc supplementation and growth in…

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Do Your Patients Understand You? Strategies to Improve Patient-Provider Communication
 Do Your Patients Understand You? Strategies to Improve Patient-Provider Communication 150 150 Tiasha Letostak, PhD
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The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as the degree to which an individual has the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions. However, over a third…

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The Dilemma of Undertriaged Trauma Cases
 The Dilemma of Undertriaged Trauma Cases 150 150 Katie Brind'Amour, PhD, MS, CHES
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Nationally, at least one in three children ages 5 and under with major trauma receive their definitive care at a level III trauma center or non-trauma center, according to arecent study in the American Journal of Emergency Medicine. Among children ages 6 to 17, the…

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Out of Drugs: Planning for the Unthinkable
 Out of Drugs: Planning for the Unthinkable 150 150 Dave Ghose
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Pediatric cancer specialists have faced an enormous challenge in recent years. With critical chemotherapy drugs often in short supply, they’ve been forced to improvise alternative treatments or purchase medicine from questionable secondary sources. These practices raise safety and ethical concerns. Emerging evidence indicates that…

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ADHD Medications Do Not Curb Adult Height
 ADHD Medications Do Not Curb Adult Height 150 150 Tiasha Letostak, PhD
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According to the Centers for Disease Control and Prevention, the number of children being diagnosed with attention deficit hyperactivity disorder (ADHD) has increased from 7.8 percent to 11 percent in the last decade. Specifically, approximately 2 million more U.S. children between the ages of 4…

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AAP Statement on School Start Times May Be Challenging to Implement
 AAP Statement on School Start Times May Be Challenging to Implement 150 150 Katie Brind'Amour, PhD, MS, CHES
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The American Academy of Pediatrics published a statement in August supporting delayed start times for middle and high schools to help combat chronic sleep deprivation. Research indicates adolescents naturally experience a shift in their circadian rhythm that makes sleep difficult prior to 11 PM. But since…

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Sinus Infection Test Could Curb Antibiotic Overuse
 Sinus Infection Test Could Curb Antibiotic Overuse 150 150 Tiasha Letostak, PhD
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Antibiotic misuse, overuse and resistance have significant consequences for patients and hospitals, but determining the primary cause of sinusitis remains a clinical challenge for physicians. Now, diagnostic technology co-invented by researchers at The Ohio State University and Nationwide Children’s Hospital will better equip physicians…

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Reframing Hope in Pediatric End-of-Life Care
 Reframing Hope in Pediatric End-of-Life Care 150 150 Tiasha Letostak, PhD
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As physicians, you want to do more good than harm. And it is often believed that telling the truth about poor end-of-life expectations will lead to hopelessness in patients and families, causing more harm than good. But study after study on prognostication has shown…

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“Learning” Health Care Organizations
 “Learning” Health Care Organizations 150 150 Kelly Kelleher, MD, MPH
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In the push toward innovative health care, “learning” systems may offer solutions for evaluating new technologies without the challenges of randomized trials. “The only constant is change.” – Heraclitus The pace of innovation in health care is breathtaking and unlikely to slow in our…

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1 in 8 Children Exposed to Violence 5 or More Times in a Year
 1 in 8 Children Exposed to Violence 5 or More Times in a Year 150 150 Tiasha Letostak, PhD
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The average pediatric subspecialist sees two to four child polyvictims each day. What can physicians do to help these children and their families? According to the National Survey of Children’s Exposure to Violence (NatSCEV), 60 percent of children have directly experienced or indirectly witnessed…

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Liquid Danger
 Liquid Danger 150 150 Dave Ghose
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Henry Spiller, MS, DABT, never used to worry too much about nicotine poisoning. If a child ate a cigarette, he might throw up but wasn’t going to die. Then e-cigarettes took off about seven years ago and changed the equation. Now, Spiller and other…

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Witnessing a Parent’s Injury Can Leave Kids with PTSD, Study Suggests
 Witnessing a Parent’s Injury Can Leave Kids with PTSD, Study Suggests 150 150 Tiasha Letostak, PhD
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When parents have an injury, their children are more likely to experience symptoms of post-traumatic stress disorder, or PTSD. What can pediatric health professionals do to help these families? In June, Pediatrics published the first-ever study examining the effect of civilian parents’ injuries on their uninjured…

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Antibiotics Alone are a Successful Treatment for Uncomplicated Acute Appendicitis in Children
 Antibiotics Alone are a Successful Treatment for Uncomplicated Acute Appendicitis in Children 150 150 Kelli Whitlock Burton
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Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery that leads to less pain and fewer missed school days, according to a pilot study. The research, led by a team at Nationwide Children’s Hospital and published online…

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Mentoring Junior Faculty: Fostering Tomorrow’s Leaders
 Mentoring Junior Faculty: Fostering Tomorrow’s Leaders 150 150 Katie Brind'Amour, PhD, MS, CHES
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Clinicians from institutions nationwide offer insight on how to piece together effective mentorship strategies in pediatrics. Mentoring may be a familiar concept to most pediatric professionals, but whether it occurs effectively in practice is less obvious. Research on the topic suggests a widespread lack…

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Gene Therapy’s Road to Redemption
 Gene Therapy’s Road to Redemption 150 150 Kelli Whitlock Burton
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Fifteen years ago, gene therapy suffered a highly visible fatality, leaving the field in shambles. Now, one team’s efforts at gene therapy for muscular dystrophy suggest the field may finally be on track to deliver on its initial promise. During the first few weeks…

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Aiming for Zero
 Aiming for Zero 150 150 Kelli Whitlock Burton
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Efforts to eliminate preventable harm in pediatric care are making progress. But can we make it to zero? In October 2008, Richard Brilli, MD, stood in a silent conference room, waiting for his audience to digest the news he’d just delivered: hundreds of significant…

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Evolution of an Atlas
 Evolution of an Atlas 150 150 Katie Brind'Amour, PhD, MS, CHES
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Adult brain atlases have existed for years. Why is it so crucial — and so difficult — to build one for preemies? Even experts need maps. They give perspective, scale and orientation. They can show both current location and the final destination. And in…

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A Brave New World of Data
 A Brave New World of Data 150 150 Katie Brind'Amour, PhD, MS, CHES
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According to William C. Ray, PhD, of the Battelle Center for Mathematical Medicine in The Research Institute at Nationwide Children’s Hospital, novel techniques prototyped for understanding protein data could soon enable the visualization of large sets of demographic data, displaying contingency tables and group…

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Printed Motion: Holding Molecular Movement
 Printed Motion: Holding Molecular Movement 150 150 Katie Brind'Amour, PhD, MS, CHES
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When student researcher Shareef Dabdoub discovered the appealing aesthetics of a transcriptional regulator from the Streptococcus family, he knew that cellular biology had handed him a work of art. And by using a computer program to predict the 3-D configuration of the molecule and its most…

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By the Book: Anticoagulation for CHD
 By the Book: Anticoagulation for CHD 150 150 Kelli Whitlock Burton
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The American Heart Association (AHA) has released its first evidence-based guidelines on anticoagulation in congenital heart disease (CHD). Anticoagulation is a key element in managing patients with congenital heart disease. Despite the therapy’s widespread use, there are no established guidelines on anticoagulants in this…

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Diagnosis Focus
 Diagnosis Focus 150 150 Katie Brind'Amour, PhD, MS, CHES
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Up to one in 10 blood clots in women occur in teen contraceptive users. When a teenage girl presents with chest pain, most doctors likely think first of anxiety, muscle injury or heartburn. In most cases, this is entirely appropriate. But if the girl…

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A Knowledge Gap
 A Knowledge Gap 150 150 Kelli Whitlock Burton
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Study suggests many pediatricians feel unqualified to treat genetic conditions.

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(Some Other) Mother’s Milk
 (Some Other) Mother’s Milk 150 150 Katie Brind'Amour, PhD, MS, CHES
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Women who can’t breastfeed often turn to the Internet for breast milk. But is it safe?

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