Debora Porter

To develop a reliable and valid scoring tool (Pediatric Bowel Management Scoring Tool, PBMST) to better guide management of constipation in pediatric patients. source https://www.jpeds.com/article/S0022-3476(22)00067-1/fulltext?rss=yes

  While the SARS-CoV-2 Omicron variant is significantly more contagious than the versions of coronavirus that came before it, there is a persistent misunderstanding that getting sick with the virus results in mild symptoms. Omicron appears to cause milder disease in unvaccinated and vaccinated people who get sick with it, but the symptoms are far from what many doctors consider  mild , at least according to most people I speak to who have recently battled and survived the infection, and say they never want to get sick with it again. The massive surge of people testing positive for the Omicron variant has subsided in many parts of the country over the last several days, which is very good news for everyone wishing to discard their N95 and KN95 face masks and return to “normalcy”. Over the last 2 weeks , positive COVID tests dropped nationally from their peak of over 805,000 new cases per day on January 15 to 537,784 on January 29. Pressure on health care systems, hospitals,...

The American Academy of Pediatrics recommends universal hemoglobin screening for iron deficiency anemia utilizing hemoglobin <110 g/L at the one-year-old well child visit. Our retrospective study suggests the need for combined hemoglobin and serum ferritin iron deficiency screening and raising the diagnostic serum ferritin threshold to 24-25 μg/L. source https://www.jpeds.com/article/S0022-3476(22)00081-6/fulltext?rss=yes

To study the cytogenetic patterns, congenital heart disease, and thyroid dysfunction in children with Down syndrome. source https://www.jpeds.com/article/S0022-3476(22)00065-8/fulltext?rss=yes

Daddy’s Home by Tony Rubino and Gary Markstein (GoComics.com)     source http://www.thepediablog.com/2022/01/30/sunday-funnies-491/

To evaluate the feasibility of endoscopic gastrojejunal tube (GJT) placement in infants and children. source https://www.jpeds.com/article/S0022-3476(22)00070-1/fulltext?rss=yes

Dr Wilhelmi addresses the higher false positive rate of smooth muscle antibodies (SMA) or anti-actin antibodies (AAA) that was observed in our original article in comparison with other adult studies. (2, 3) Specifically, he discusses the higher specificity of indirect immunofluorescence (IFA) technique to detect SMA in comparison with enzyme linked immunosorbent assay (ELISA) to detect AAA in lieu of SMA, in autoimmune hepatitis type 1 (AIH-1) which could explain our finding of relatively higher false positive rate. source https://www.jpeds.com/article/S0022-3476(22)00069-5/fulltext?rss=yes

Khayat et al retrospectively evaluated the prevalence and clinical significance of autoantibodies in overweight and obese children with nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH) compared with those with autoimmune liver disease (ALD), specifically autoimmune hepatitis (AIH) or primary sclerosing cholangitis (PSC).1 source https://www.jpeds.com/article/S0022-3476(22)00068-3/fulltext?rss=yes

Pass the Ball from Nathan Boey on Vimeo : Idea: 3 second animation of a ball. Pass it to someone in another country They pick up where you left off. 40 animators 40 months in the making…     source http://www.thepediablog.com/2022/01/29/cool-video-of-the-week-491/

°*This post originally appeared on The PediaBlog on January 28, 2020.   Is 98.6 °F Still “Normal”?     Normal body temperature is 98.6°F (37°C). Alice Park explains how we came to accept that number — way back in 1871: That number was determined by a German physician, based on millions of readings from 25,000 German patients, taken by sticking thermometers under their arms. When doctors in the U.S. and Europe repeated the experiment in local populations, they came up with the same number, so it stuck.   Stanford University researchers analyzed data that was collected during the Civil War in 1862 until 2017. Park says humans are cooling off as the years and decades go by, suggesting that “the standards that doctors have been using to define normal temperature and fever might need to be reworked”: The team found that average body temperatures in the earliest database, from the Union Army veterans, were higher than the temperatures recorded in each...

To provide a valid, continuous reference interval, including a 10th percentile cut-off, for Hammersmith Infant Neurological Examination (HINE) scores based on 3-7 months old term infants with weight appropriate for gestational age. source https://www.jpeds.com/article/S0022-3476(22)00058-0/fulltext?rss=yes

To determine whether the combination of systemic corticosteroids and nebulized epinephrine, compared with standard care, reduces the duration of positive pressure support in children with bronchiolitis admitted to intensive care. source https://www.jpeds.com/article/S0022-3476(22)00057-9/fulltext?rss=yes

We measured the sodium content of donor human milk (DHM) and calculated the estimated intake at a feeding volume of 160 ml/kg/day. Mean sodium content of unfortified DHM was 102.0 mg/L (4.4mEq). As <1% of bovine-fortified samples met recommendations, infants born preterm who are predominantly fed DHM likely require additional sodium. source https://www.jpeds.com/article/S0022-3476(22)00055-5/fulltext?rss=yes

Breast milk is a complex matrix of bioactive components that provides health benefits for newborns.(1, 2) Preterm infants that are fed maternal breast milk versus formula experience less necrotizing enterocolitis (NEC) (3, 4), retinopathy of prematurity (ROP) (5, 6), and improved neurodevelopmental outcomes (7). Despite this, challenges remain in thoroughly accounting for all the effects that breast milk can have on newborn health due to the large variability in breast milk composition and difficulties in the past with the sampling of breast milk and analysis of metabolites. source https://www.jpeds.com/article/S0022-3476(22)00056-7/fulltext?rss=yes

  The evidence about the safety and efficacy of the COVID-19 vaccines has only grown stronger since Pfizer’s mRNA version was approved for emergency use in December 2020. Misinformation has been clarified about the infection and the vaccines that help prevent serious outcomes, and disinformation has been debunked over and over again during the course of the pandemic. The PediaBlog addressed one stubborn myth last May: One rumor making the rounds about COVID-19 vaccines is that they can interfere with fertility. They can’t. It’s a myth. Ongoing surveillance by the three vaccine makers have failed to reveal negative effects impacting fertility in men or women. There doesn’t appear to be any mechanism of action by which reproductive functions would by damaged by any one of the three vaccines in use against COVID-19.   There have been anecdotal reports of erratic menstrual cycles in women who receive COVID vaccines. A new study  confirms that some women do indeed exp...

  In 2020, The PediaBlog reviewed new nutritional guidelines from the American Heart Association and U.S. government agencies intended to help parents improve their children’s dietary health. In addition to replacing saturated fat (mostly from animal protein) with healthier unsaturated fat to reduce the risk of heart disease, the recommendations targeted sugar in the typical American diet: Reduce added sugars to lessen unhealthy weight gain and the consequences of obesity-related health outcomes. Five food categories contribute nearly 70% of added sugar intake: • Sugar-sweetened beverages (SSB) • Desserts and sweet snacks • Coffee and tea (with their additions of sugar and flavorings) • Candy • Breakfast cereals and breakfast bars   Lisa Bodnar explains  what “added sugars”really are… Added sugars are sugars and syrups that are added to foods during processing or preparation or later at the table. They can be natural sugars, like honey, or artificial sw...

Breastfeeding Protects The Heart By Brian W. Donnelly, M.D., F.A.B.M. AHN Pediatrics — Pediatric Alliance Northland     A  study  published this month in the Journal of the American Heart Association found that breastfeeding is associated with a reduced risk for maternal cardiovascular disease (CVD). The Austrian researchers combed the literature for studies that measured risk for stroke and coronary heart disease events in relation to the presence of breastfeeding. A progressive risk reduction of all CVD outcomes was found, with duration of breastfeeding from 0-to-12 months. This means breastfeeding was protective in a dose-dependent way (i.e., the longer the mother breastfed, the greater was the protection she enjoyed). Previous studies have demonstrated that prolonged breastfeeding is linked to a lower maternal risk for breast cancer, ovarian cancer, and type 2 diabetes mellitus. This study adds to what we know about prolong...

  New data published on Friday from the Centers for Disease Control and Prevention show that booster shots with mRNA vaccines made by both Pfizer and Moderna are effective in preventing infections with the highly contagious Omicron variant. Apoorva Mandavilli says boosters are even better at keeping infected individuals out of the hospital: The extra doses are 90 percent effective against hospitalization with the variant, the agency reported. Booster shots also reduced the likelihood of a visit to an emergency department or urgent care clinic. The extra doses were most effective against infection and death among Americans aged 50 and older, the data showed. Over all, the new data show that the vaccines were more protective against the Delta variant than against Omicron, which lab studies have found is partially able to sidestep the body’s immune response.   The evidence shows just how much protection against Omicron is boosted by the third dose: Vaccine effectivene...

Adam@Home by Rob Harrell (GoComics.com)                       source http://www.thepediablog.com/2022/01/23/sunday-funnies-490/

Alaska from Tim Kellner on Vimeo : When I was a kid I would stare up at the giant stuffed grizzly bear in the Buffalo Science Museum and imagine seeing it alive and in the wild. That dream finally came true. I can’t even begin to describe with words my experiences in Alaska so hopefully this video will capture just a small piece.     source http://www.thepediablog.com/2022/01/22/cool-video-of-the-week-490/

In the article “Lung Ultrasound for Prediction of Bronchopulmonary Dysplasia in Extreme Preterm Neonates: A Prospective Diagnostic Cohort Study” by Mohamed et al (J Pediatr 2021;238:187-92), there was an error in representing sensitivity and specificity values in this article in Table II. The correct version of the table appears below. Three sentences also contain errors related to the table error. The third sentence of the results section in the abstract should read “The score of >10 at all 3 time points had higher specificity (0.89, 0.89, and 0.77), sensitivity (0.87, 0.90, and 0.92), and corresponding clinically important positive and negative likelihood ratios.” In the third paragraph of the discussion, sentences four and five should read “Low false positive rate cut-off (high specificity) will allow infants not to be subjected to prophylactic interventions, which have potential for harm (eg, hydrocortisone for prevention of BPD). source https://www.jpeds.com/article/...

In the commentary “Strict glycemic control in very low birthweight infants using continuous glucose monitoring reduces dysglycemic” included in the Current Best Evidence section (J Pediatr 2021;238:338-42. doi: https://doi.org/10.1016/j.jpeds.2021.08.057), a word was inadvertently left out of the title and an author's first name was misspelled. The correct title should be “Strict glycemic control in very low birthweight infants using continuous glucose monitoring reduces dysglycemic episodes” and the correct spelling of the author's name is Kathryn Beardsall, MD. source https://www.jpeds.com/article/S0022-3476(22)00002-6/fulltext?rss=yes

Why is Research at Caribbean Medical Schools Important? Marie McGillycuddy: Welcome to Medical school in five minutes where we bring you topics pertaining to medical school that will benefit anyone in medical school or anyone who is interested in joining medical school. My name is Marie McGillicuddy, and I will be your host. Joining us today is Dr. Fakoya and he is the associate professor of growth and developmental anatomy and histology at the University of Medicine and Health Sciences in St. Kitts. Dr. Fakoya has published in numerous journals and books in overseas research at the University. Please check out some of his published works here: https://scholar.google.com/citations?user=3UOdzoYAAAAJ&hl=en Dr. Fakoya, thank you for joining us today. I have one primary question for you. Why is conducting research in medical school important? Dr Fakoya: Well, Marie, thank you. Thank you for having me. And that's a very good question. Conducting research in medical school is an esse...

Why is Research at Caribbean Medical Schools Important? Marie McGillycuddy: Welcome to Medical school in five minutes where we bring you topics pertaining to medical school that will benefit anyone in medical school or anyone who is interested in joining medical school. My name is Marie McGillicuddy, and I will be your host. Joining us today is Dr. Fakoya and he is the associate professor of growth and developmental anatomy and histology at the University of Medicine and Health Sciences in St. Kitts. Dr. Fakoya has published in numerous journals and books in overseas research at the University. Please check out some of his published works here: https://scholar.google.com/citations?user=3UOdzoYAAAAJ&hl=en Dr. Fakoya, thank you for joining us today. I have one primary question for you. Why is conducting research in medical school important? Dr Fakoya: Well, Marie, thank you. Thank you for having me. And that's a very good question. Conducting research in medical school is an esse...

To examine characteristics of children referred for obesity management based on referral frequency, child- and referrer-related variables associated with re-referral, and determine whether re-referral increased treatment initiation. source https://www.jpeds.com/article/S0022-3476(22)00022-1/fulltext?rss=yes

Neonatal septicemia (sepsis) remains a major cause of worldwide morbidity and mortality among term and preterm infants. The term “sepsis” originates from the Greek meaning “to rot.” The modern term came into use in 1914 and meant a change in symptomatology caused by infection and identified by a set of subjective and objective factors.1 In the 21st century, the generally accepted criterion is organ dysfunction accompanying infection. The consensus definition for sepsis has continued to evolve but remains difficult to define, particularly in the neonatal intensive care unit (NICU). source https://www.jpeds.com/article/S0022-3476(22)00006-3/fulltext?rss=yes

*This post originally appeared on The PediaBlog on January 21, 2015.   Say It Ain’t So, Joe!     Alexandra Sifferlin adds pizza to the growing list of topics pediatricians should discuss with their patients and parents: Pizza is a ubiquitous part of the American diet, but a new study finds that it’s an even bigger contributor than we thought—so big, researchers say, that physicians should address pizza intake during doctors’ visits. To figure out how much pizza kids and adolescents are eating, researchers looked at the diets of children ages 2 to 11 and teens aged 12 to 19 from 2003-2010. They found that pizza makes up about 20% of kids’ daily calories on days when they eat pizza—and despite the insistence of some politicians that pizza should be considered a vegetable for its ample tomato sauce, those calories aren’t coming from an onslaught of veggies.   Karen Bardossi looks at the study just published in Pediatrics  and adds: Pizza is t...

To compare outcomes in children with congenital heart disease (CHD) undergoing noncardiac surgery by presence of chronic conditions (CCI) and identify associated risk factors. source https://www.jpeds.com/article/S0022-3476(22)00017-8/fulltext?rss=yes

To perform an economic evaluation to estimate the return on investment (ROI) of making available telemedicine consultations from a healthcare payer perspective, and to estimate the economic impacts of telemedicine under a hypothetical scenario where all rural hospitals providing level I neonatal care in California had access to telemedicine consultations from neonatologists at level III and level IV Neonatal Intensive Care Units (NICUs). source https://www.jpeds.com/article/S0022-3476(21)01225-7/fulltext?rss=yes

  We all learned early in the course of the pandemic that the prognosis of adults infected with SARS-CoV-2 is better for some and worse for others. For example, while children, for the most part, appear to be spared the worst of what the virus has to offer, hospitalizations, complications, and deaths are more common in people who are elderly. According to data from the Centers for Disease Control and Prevention, of the 850,000 Americans who have now died from COVID-19, 621,000 (73%) were age 65 and above. People who are poor and have insufficient access to high quality health care are also at risk for negative outcomes. Members of minority communities have been facing disproportionate risks since the start of the pandemic. And doctors know that patients living with heart disease and hypertension, chronic lung disease, immunosuppression, cancer, heart disease and hypertension, obesity, diabetes, and other pre-existing health conditions have a harder time surviving COVID-19. Chil...

To compare the efficacy of MRCP with ERCP in children for the identification of PD variants. source https://www.jpeds.com/article/S0022-3476(22)00009-9/fulltext?rss=yes

  Last year on The PediaBlog, we learned that eating five servings a day of vegetables and fruits dramatically lowers the risk of death in adults from all causes, including from heart attacks and strokes, cancer, and chronic lung diseases. So how are we measuring up? A national survey published last January in the CDC’s Morbidity and Mortality Weekly Report found that in 2017, only 7.1% of teenagers met USDA recommendation of eating two servings of fruit a day, and only 2% ate the recommended three vegetables every day. The researchers cited several barriers for insufficient consumption, including teens’ lack of taste preference for fruits and vegetables, the lack of home availability of fresh produce, and the presence of highly available, inexpensive, unhealthy food options. The same CDC research team recently analyzed fruit and vegetable intake in adults. Compared to America’s youth population, grownups aren’t doing that much better: The percentage of U.S. adults ...

To evaluate the characteristics and treatment outcomes of pediatric Langerhans cell histiocytosis (LCH) patients with thymic involvement (TI). source https://www.jpeds.com/article/S0022-3476(22)00008-7/fulltext?rss=yes

One of my earliest memories growing up was staying home from school for a week to recover from (and not spread!) a bad case of chickenpox. The story goes that once my older brother developed the classic symptoms, my parents decided to put me in the same room and expose me to his respiratory secretions so I could get infected and “get it over with.” No varicella vaccine existed way back when, and I have no doubt my parents wanted to get it over with. Sticking me in the same room as my brother solved their dilemma while I got sick, fevered and covered from head to toe with the tiny water blisters that itched like crazy and left a couple of scars. To be fair, though, I did get it over with. With the more infectious but apparently less damaging Omicron variant now dominating the COVID landscape, some parents have borrowed the idea of holding “Pox Parties” so popular long ago. Sandee LaMotte discovered that “Omicron Parties” are all the rage: “It’s caught on like wildfire,” agreed Dr. ...

To characterize growth and anthropometric measurements in females with Rett Syndrome (RTT) and compare these measurements with functional outcomes. source https://www.jpeds.com/article/S0022-3476(22)00010-5/fulltext?rss=yes

To identify and critically appraise available clinical practice guidelines (CPGs) targeting male circumcision using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. source https://www.jpeds.com/article/S0022-3476(22)00007-5/fulltext?rss=yes

Thank you for your comment. The second episode began 48 hours after receiving the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) messenger ribonucleic acid (mRNA) vaccine. (1) In addition to clinical symptoms of myocarditis, troponin elevation and EKG abnormalities, cardiac MRI showed low normal LV ejection fraction (53%), trivial pericardial effusion, sub-epicardial late gadolinium enhancement (LGE) in the left ventricular mid lateral and apical regions. The distribution of LGE was identical to that seen on the prior episode of myocarditis. source https://www.jpeds.com/article/S0022-3476(21)01233-6/fulltext?rss=yes

  Last week, AHN Pediatrics hosted a Facebook Live event to answer parents’ questions regarding the COVID-19 pandemic (you can watch it here on Pediatric Alliance’s Facebook page). The questions we received beforehand and during the Q & A were outstanding and appreciated, with so many moms and dads contributing to a healthy and civil discussion. Several parents asked about which types of face masks best protect their kids and those around them. (Remember: My mask protects you and your mask protects me.) Before we get to that, however, let’s talk about why the CDC (and most pediatricians , too)  recommends that kids wear masks during the pandemic, especially while attending school: Consistent and correct mask use is a critical strategy for preventing the transmission of SARS-CoV-2, the virus that causes COVID-19. CDC recommends that schools require universal indoor mask use for students, staff members, and others in kindergarten through grade 12 (K–12) school setting...

Cul de Sac by Richard Thompson ( Arcamax.com/thefunnies )           source http://www.thepediablog.com/2022/01/16/sunday-funnies-489/