Debora Porter

Velocity from Madebyvadim on Vimeo : “A colourful journey though uncharted cosmos” was the slogan and driving force behind this new short film. Vast space of the universe, close ups of “fast moving” near galactic bodies as well as explosions of stars, – all that I’ve tried to portray in a new experimental film.     source http://www.thepediablog.com/2022/04/30/cool-video-of-the-week-504/

In this volume of The Journal, Shifman et al utilize longitudinal data from the Scientific Registry of Transplant Recipients (SRTR) and the Health Resources and Services Administration (HRSA) database of primary care health professional shortage areas (HPSA) to characterize the association between living in primary care shortage areas and graft failure or death for pediatric liver transplant recipients.1 They studied a cohort of 5,769 children transplanted between 2005-2015 with 4 years of follow-up (through 2019), the authors found that children in HPSAs had an increased risk of graft failure and death compared with children living in non-HPSAs. source https://www.jpeds.com/article/S0022-3476(22)00403-6/fulltext?rss=yes

*This post originally appeared on The PediaBlog on April 29, 2015.   Month Of The Military Child (1)     By Damian Ternullo, M.D. , AHN Pediatrics – Pediatric Alliance (St. Clair)     April is the Month of the Military Child . I wanted to write this post on The PediaBlog  as a small reminder of the sacrifices many of our families have made — and continue to make — as their loved ones serve in our nation’s military. There are over 2 million children — ranging in age from newborns to eighteen — with family members who are on active duty, in the reserve, or are veterans of the wars in Afghanistan and Iraq. Military children live in all communities — not just those near large active-duty bases such as Fort Bragg, NC or Fort Stewart, GA. Many military children face unique challenges that our civilian neighbors are shielded from. These include family stressors such as deployment to a war zone, frequent moves, disrupted relationships with friends,...

To evaluate the impact of atopic dermatitis on families of pediatric subjects. source https://www.jpeds.com/article/S0022-3476(22)00342-0/fulltext?rss=yes

  OUT OF THE OLD BLACK BAG   Friends on Letterhead (Part 2) By  Anthony Kovatch, M.D.   Ties are the pediatrician’s substitute for the white coat; there are no restrictions on the degree of lunacy if they can cajole the frightened toddler (or teenager) into cooperation. Some of us acquired a rather impressive repertoire over the years — highlighting the holiday seasons or the reigning Disney character of the time period.     Dr. Mark Bellinger became legendary for his authentic impersonation of one Donald Duck. I did not have to make so much of an effort since my baggy, droopy eyelids gave patients the immediate impression of a human variant of Kermit the Frog! I think physicians who are so industrious at work that they always “feel behind” gravitate to diversions where the object of the endeavor is to beat the clock.   Mark became the heart and soul of the Fox Chapel High School Crew Team collaborating in coaching, fundraising, and student...

  OUT OF THE OLD BLACK BAG   Friends on Letterhead (Part 1) By  Anthony Kovatch, M.D.   This editorial reflects the opinions of the author and not those of The PediaBlog or Allegheny Health Network or the American Academy of Pediatrics. Or Scooby-Doo.   The road is wide and the stars are out And the breath of the night is sweet, And this is the time when wanderlust should seize upon my feet. But I’m glad to turn from the open road and the starlight on my face, And to leave the splendour of out-of-doors for a human dwelling place.  —  Opening lines of “Roofs” by American poet, Joyce Kilmer (1886-1918). During his deployment to Europe in World War I, he was killed by a sniper’s bullet at the age of 31, leaving behind a wife (also a poet and writer) and 5 children.   Who of us has not recited “Trees” , the simple, but profound, poem for which his name is synonymous?   Musical accompaniment : “The Circle Game” by Joni Mitchell ...

  Last week the Centers for Disease Control and Prevention issued a Health Alert Network Health Advisory warning pediatricians and other health providers to keep their eyes peeled for new cases of acute hepatitis. Lucy Hicks reports that 11 young children in two states — all previously healthy — developed the liver inflammation in the last 6 months, some quite severely: On April 14, the CDC said that nine cases have been recorded in Alabama since the fall of 2021. All of these cases have been in children between 1 and 6 years old, and two children have needed liver transplants. Two additional cases have been reported in North Carolina, according to Stat News, and both children have since recovered.   The mysterious outbreak is occurring simultaneously in Europe: Internationally, 108 cases have been reported in the United Kingdom, with 79 cases occurring in England. There are three documented cases in Spain, and similar cases are being reported in Denmark and th...

  For the second year in a row it has been a relatively quiet influenza season throughout the United States. Thanks to face mask mandates, options for working at home, travel restrictions, and other factors related to preventing the spread of SARS-CoV-2, the influenza virus has found it hard to find enough vulnerable hosts to wreak its typical annual havoc. As the biphasic pattern on the chart above indicates, the relaxation of those COVID-19 restrictions over the last couple of months has resulted in an unusual second wave of seasonal influenza infections throughout the country. Influenza activity is significantly higher than it was when The PediaBlog took a peek in February. Influenza activity varies by region. Activity is highest in the northeast, south-central and mountain regions of the country. — CDC Weekly U.S. Influenza Surveillance Report for Week 15, ending April 16, 2022.     The good news is that hospitalizations and deaths from influenza remain b...

Hi and Lois by Robert “Chance” Brown, Brian Walker and Greg Walker ( arcamax.com/thefunnies )           source http://www.thepediablog.com/2022/04/24/sunday-funnies-502/

EARTH DAY 2020 from Michelle Valberg on Vimeo .   source http://www.thepediablog.com/2022/04/23/cool-video-of-the-week-503/

Machine learning (ML) holds the possibility of improving racial health inequalities by compensating for human bias and structural racism. However, unanticipated racial biases may enter during model design, training, or implementation and perpetuate or worsen racial inequalities if ignored. Pre-existing racial health inequalities could be codified into medical care by ML without clinicians being aware. To illustrate the importance of a commitment to anti-racism at all stages of machine learning, we examine ML in predicting severe sepsis in Black children, focusing on the impacts of structural racism that may be perpetuated by ML and difficult to discover. source https://www.jpeds.com/article/S0022-3476(22)00339-0/fulltext?rss=yes

*This post originally appeared on The PediaBlog on April 22, 2013.   Happy Earth Day     Today might be a good day to take a little walk.  Feel the sun. Feel the breeze.  Close your eyes.  Take a deep breath.  Take your time. This might be a good day to think.  For just a few moments. Think about why acknowledging Earth Day is important for your children. Whether you live in the middle of a large city, the middle of nowhere, or someplace in between, Earth Day should be acknowledged and celebrated. Happy Earth Day!   source http://www.thepediablog.com/2022/04/22/flashback-friday-203/

  The American Lung Association will release its 23rd annual “State of the Air” Report 2022 later this morning. While the organization  last year  noted significant progress in cleaning up air pollution over the last few decades, the benefits haven’t been equally shared coast-to-coast in some communities: [M]ore than 40% of Americans—over 135 million people—are living in places with unhealthy levels of ozone or particle pollution. The burden of living with unhealthy air is not shared equally. People of color are over three times more likely to be breathing the most polluted air than white people.   The changing climate threatens air quality in new and dangerous ways: High ozone days and spikes in particle pollution, related to extreme heat and wildfires, are putting millions more people at risk and adding challenges to the work states and cities are doing across the nation to clean up air pollution.   Air quality has improved in some locales more th...

To examine the association between antibiotic and acid suppressant prescriptions in the first two years and subsequent childhood psychiatric disorder treatment. source https://www.jpeds.com/article/S0022-3476(22)00345-6/fulltext?rss=yes

To develop and validate a diagnostic prediction model that can distinguish between juvenile idiopathic arthritis (JIA) and chronic musculoskeletal pain syndromes (CMPS based on patient-reported outcomes. source https://www.jpeds.com/article/S0022-3476(22)00344-4/fulltext?rss=yes

To measure plasma levels of vascular endothelial growth factor (VEGF) and several cytokine pathway genes (IL-6 IL-8, IL-10) during the first week of life to examine the relationship between protein expression and likelihood of developing respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD source https://www.jpeds.com/article/S0022-3476(22)00343-2/fulltext?rss=yes

  According to the most recent public opinion survey conducted by the Yale Program on Climate Change Communication, almost three-quarters of American adults in 2021 believed correctly that climate change is real and happening now. Also, most agreed with the overwhelming scientific consensus that burning fossil fuels, which releases heat-trapping greenhouse gases into the atmosphere, is the main cause. 65% of adults who were surveyed said they were worried about climate change. Ask children and teenagers about climate change and the environment and those numbers go way up. A landmark survey  conducted last year involving 10,000 young people ages 16-25 in 10 countries revealed the degree of worry in young people: • 84% were at least moderately worried; 59% were very or extremely worried about climate change. • More than half of the respondents reported feeling sad, anxious, angry, powerless, helpless, and/or guilty. • 45% said their feelings about the climate crisi...

To compare the effects of noninvasive neurally adjusted ventilatory assist (NIV-NAVA) to nasal continuous positive airway pressure (NCPAP) in achieving successful extubation in preterm infants. source https://www.jpeds.com/article/S0022-3476(22)00340-7/fulltext?rss=yes

The time has come to vaccinate children under 12 years of age against SARS-CoV-2 (1). Issues regarding the reliability, safety, and efficacy of the Coronavirus Disease 2019 (COVID-19) vaccines have complicated the process of immunizing children, in addition to the decision of parents to vaccinate their children (2). Without international universal consensus, pediatric societies in various countries are establishing childhood COVID-19 vaccination positions (3-7). source https://www.jpeds.com/article/S0022-3476(22)00331-6/fulltext?rss=yes

To identify factors associated with prenatal, perinatal, and postnatal outcomes, and determine medical care utilization for fetuses and infants with trisomy 13 (T13) and trisomy (T18). source https://www.jpeds.com/article/S0022-3476(22)00324-9/fulltext?rss=yes

To assess the level of knowledge, attitudes and behaviors regarding vaccination in preterm infants among Primary Care Pediatricians (PCPs) and Neonatal Intensive Care Units (NICUs) healthcare workers (HCWs). source https://www.jpeds.com/article/S0022-3476(22)00341-9/fulltext?rss=yes

    Environmental Working Group’s 2022 Shopper’s Guide to Pesticides in Produce  analyzed samples of non-organic produce sold throughout the United States and found that more than 70% were contaminated with potentially harmful pesticides, even after they had been washed, peeled, or scrubbed. The report indicates the U.S. lags behind other developed countries in protecting public health from toxic chemicals: This year’s version of the guide, which analyzes the latest test data from the Department of Agriculture and Food and Drug Administration, also reveals that over 50 percent of potatoes, spinach, lettuce and eggplant had detectable levels of at least one of three bee-killing neonic insecticides banned in the European Union but still allowed for use on U.S. produce.   Produce that makes up EWG’s Dirty Dozen were contaminated with more pesticides compared to other crops. Other key findings: • More than 90 percent of samples of strawberries, apples, cherrie...

Pediatric primary care is a trusted source for treatment and information. In the 6 months after COVID-19 vaccines became available for adolescents, we administered 2,286 doses (1,270 to patients; 1,016 to household members) to 1,376 individuals (64.1% Black; 10.1% Latinx), providing opportunities to address family concerns in a familiar location. source https://www.jpeds.com/article/S0022-3476(22)00337-7/fulltext?rss=yes

We appreciate the comments of Chasnoff and Gardner and the opportunity for discussion. The purpose of our article is not “standardizing the clinical definition of neonatal opioid withdrawal syndrome (NOWS).” Instead, the purpose is to develop a standardized bedside definition of opioid withdrawal in the neonate – one that is applicable to both NOWS and neonatal abstinence syndrome (NAS). This is an important distinction, as our findings center on the creation of standardized clinical criteria for the diagnosis of opioid withdrawal, recognizing it as a continuum of variable expression in neonates. source https://www.jpeds.com/article/S0022-3476(22)00336-5/fulltext?rss=yes

Jilani et al1 report standardizing the clinical definition of neonatal opioid withdrawal syndrome (NOWS) is an important contribution to a condition affecting thousands of infants. However, there are points of clarification needed. source https://www.jpeds.com/article/S0022-3476(22)00335-3/fulltext?rss=yes

Cochius–den Otter et al raise an important point about the results of our recent randomized trial, which found that addition of intravenous sildenafil did not reduce treatment failure in infants receiving inhaled nitric oxide (iNO) for persistent pulmonary hypertension of the newborn (1). As they note, the dosing regimen tested in our randomized, placebo-controlled trial (0.1 mg/kg over 30 minutes, followed by a maintenance infusion of 0.72 mg/kg/day) mg/kg/hour) was roughly half of the highest dosing cohort studied by Steinhorn et al in a nonrandomized, dose-escalation study (0.4 mg/kg over 3 hours, followed by a maintenance infusion of 1.6 mg/kg/day) (2). source https://www.jpeds.com/article/S0022-3476(22)00334-1/fulltext?rss=yes

We read with interest the trial by Pierce et al investigating sildenafil in addition to inhaled nitric oxide (iNO) in newborns with PPHN. As stated, based on this trial, sildenafil is not superior to placebo(1). However, we feel that this conclusion needs adjustment. source https://www.jpeds.com/article/S0022-3476(22)00333-X/fulltext?rss=yes

As President of the European Pediatric Association/Union of National Pediatric Societies and Associations (EPA/UNEPSA), I would like to thank Dr Gallegos et al, for their interest in the EPA-UNEPSA commentary on the importance of Coronavirus vaccination in children1. source https://www.jpeds.com/article/S0022-3476(22)00332-8/fulltext?rss=yes

  Friday is Earth Day! The theme for this year’s international Earth Day celebration — held every year on April 22 — is Invest In Our Planet : Because a green future is a prosperous future. We need to act (boldly), innovate (broadly), and implement (equitably). It’s going to take all of us. All in.   Businesses, governments, and citizens — everyone accounted for, and everyone accountable. A partnership for the planet. And while there is still time to solve the climate crisis, time to choos e BOTH a prosperous and sustainable future, and time to restore nature and build a healthy planet for our children and their children, time is short.   Unfortunately, the latest reports recently issued by the Intergovernmental Panel on Climate Change (IPCC 6th Assessment Reports) indicate  we have no time to spare to make meaningful changes in order to reverse course, away from climate chaos and towards a hopeful and healthy future for our children. United Nation...

Moderately Confused by Jeff Stahler ( GoComics.com )     source http://www.thepediablog.com/2022/04/17/sunday-funnies-501/

Story of Flowers from James Paulley on Vimeo: Collaborating with artist Azuma Makoto and illustrator Katie Scott, we created an animation exploring the life cycle of flowers. A launch event at the Ark Hills South Tower Roof Garden in Tokyo presented the work alongside Azuma’s exquisite sculptures, giving children the opportunity to get lost in the Story of Flowers.     source http://www.thepediablog.com/2022/04/16/cool-video-of-the-week-502/

*This post originally appeared on The PediaBlog on April 15, 2015.   Music On The Brain     Last week on The PediaBlog, we looked at a small  study that used MRI scans to reveal anatomic brain changes in children who experienced prenatal and postnatal exposure to air pollution, specifically polycyclic aromatic hydrocarbons (PAH) — the byproducts of burning fossil fuels. In that case, researchers saw a diminution of white matter, along with its clinical effects: We detected a dose-response relationship between increased prenatal PAH exposure (measured in the third trimester but thought to index exposure for all of gestation) and reductions of the white matter surface in later childhood that were confined almost exclusively to the left hemisphere of the brain and that involved almost its entire surface. Reduced left hemisphere white matter was associated with slower information processing speed during intelligence testing and with more sever...

To investigate associations between nucleated red blood cell (NRBC) counts of neonates with hypoxic-ischemic encephalopathy (HIE), acute perinatal sentinel events, and neurodevelopmental outcomes. We also examined the mechanism causing elevated counts. source https://www.jpeds.com/article/S0022-3476(22)00329-8/fulltext?rss=yes

  As we all wait for Mother Nature to decide when winter will finally end, the 60 million Americans who suffer from seasonal allergic rhinitis (hay fever) are bracing themselves for an itchy and sneezy spring. Stocking up on tissues and antihistamines is an annual ritual for many allergy suffers. Emma Polen spoke with a couple of local allergists who encourage their patients to keep those N95 face masks handy when they work and play outdoors: Dr. Merritt Fajt, assistant professor of medicine at the University of Pittsburgh and a specialist in UPMC’s Pulmonary, Allergy and Critical Care Medicine division, said that even before COVID-19, she was already suggesting mask-wearing for patients with severe allergies when they were going to do yard work. “When more people were wearing masks outside, there was a definite decrease in the amount of symptoms from outdoor allergies in susceptible patients,” Dr. Fajt said.   Evidence collected during the pandemic clearly shows tha...