Debora Porter

*This post originally appeared on The PediaBlog on September 30, 2016.   Your Kids Are Watching You     In a fascinating article in this month’s  Pediatric News , pediatrician Barbara J. Howard uses evolutionary principles to explain why “do as I say, not as I do” is not an effective parental strategy: We have not evolved that far from our nonverbal ancestors to expect that words will speak louder than actions. Looking closely, you can see even very young infants gazing closely at their parents, then mirroring their facial expressions a few minutes later (because of slower processing). Mirroring is probably the correct word for this as the mirror neuron system of the brain has as its primary and crucial function allowing humans to copy what they see in others. Children look to model, especially those who are slightly older and more adept than they are. Older siblings bask in this adoration at times and squeal in frustration at other times that their ...

Come explore campus with us for #TourTuesday! Filled with scenic ocean views and state-of-the-art facilities, the St. Kitts campus offers a vibrant environment and community to study medicine. Would you study here? #studentlife #campustour #stkittslifestyle #shorts from University of Medicine and Health Sciences https://www.youtube.com/watch?v=2EvQbeN6hfw via UMHS YouTube Channel

Come explore campus with us for #TourTuesday! Filled with scenic ocean views and state-of-the-art facilities, the St. Kitts campus offers a vibrant environment and community to study medicine. Would you study here? #studentlife #campustour #stkittslifestyle #shorts from University of Medicine and Health Sciences https://www.youtube.com/watch?v=2EvQbeN6hfw via UMHS YouTube Channel

  Just when you think that the youth of today will overcome yesterday’s transgressions of their parents’ generation and lead humanity to a better future tomorrow, a headline like this comes along suggesting the apple may not fall far from the tree: FDA Warns Against Cooking Chicken in NyQuil   Carolyn Crist has the lede : The FDA has issued a warning against cooking chicken in NyQuil after a social media challenge that encouraged people to try it went viral.   Seriously? Called the “sleepy chicken challenge,” the trend tells people to cook chicken in NyQuil or similar over-the-counter cough and cold medications, which include ingredients such as acetaminophen, dextromethorphan and doxylamine. “The challenge sounds silly and unappetizing – and it is. But it could also be very unsafe,” the FDA said. “Boiling a medication can make it much more concentrated and change its properties in other ways.” Even if someone doesn’t plan to eat the chicken, inhaling the ...

To estimate the vaccine effectiveness (VE) against hospitalization and severe illness in adolescents due to infection with SARS-CoV-2 variants (gamma, delta, and omicron). source https://www.jpeds.com/article/S0022-3476(22)00861-7/fulltext?rss=yes

To compare serial changes in pulmonary function in contemporary infants with congenital diaphragmatic hernias (CDH) managed with a gentle ventilation approach. source https://www.jpeds.com/article/S0022-3476(22)00859-9/fulltext?rss=yes

  September is National Childhood Obesity Awareness Month. For decades, diagnoses of overweight and obesity have been viewed as the logical result of people making poor behavioral choices: If we didn’t eat so much sugar and fat contained in prepared and processed foods or if we got up off the couch and exercised every day, we wouldn’t have a problem with our body weight, right? But what if establishing and maintaining a healthy body weight went beyond our personal preferences and self-control? Obesogens are chemicals that have been shown to disrupt the body’s endocrine functions even at very low concentrations. By interfering with hormones, these endocrine disrupting chemicals (EDCs) work to increase the number and size of fat cells (adipocytes). Darbre’s Encyclopedia of Food Safety describes the mechanisms of action that may result in weight gain or in failure to lose excess weight: Obesogens are defined as compounds which cause weight gain. They may act directly to increa...

To characterize losses from the pediatric tuberculosis (TB) infection care cascade in order to identify ways to improve TB infection care delivery. source https://www.jpeds.com/article/S0022-3476(22)00860-5/fulltext?rss=yes

To evaluate cytomegalovirus (CMV) viral load dynamics in blood and saliva during the first two years of life in symptomatic and asymptomatic infected infants and to identify whether these kinetics could have practical clinical implications. source https://www.jpeds.com/article/S0022-3476(22)00862-9/fulltext?rss=yes

To quantify the rate of venous thromboembolism (VTE) in patients with pediatric intestinal failure (PIF) and identify associated risk factors. source https://www.jpeds.com/article/S0022-3476(22)00856-3/fulltext?rss=yes

To evaluate the association between empirical antibiotic therapy in the first postnatal week in uninfected infants born very preterm and the risk of adverse outcomes until discharge. source https://www.jpeds.com/article/S0022-3476(22)00851-4/fulltext?rss=yes

            Obesity prevalence in children and adolescents, by age, race, and Hispanic origin, United States, 2015 to 2018. *   *   *   *   *   September is National Childhood Obesity Awareness Month . Sponsored by the Centers for Disease Control and Prevention, the monthlong observance shines a light on the growing epidemic of childhood obesity and provides guidance on prevention and treatment. According to the CDC, nearly one out of every five children and teenagers (19.7%) living in America today earns a diagnosis of obesity based on their body mass index (BMI equal to or greater than 30.0 kg/m² or greater than the 95th percentile for age). Last year we learned that an even greater percentage of children and teenagers (25%) are overweight and at risk of developing obesity and the medical and psychological complications associated with the condition, including: • type 2 diabetes • hypertension • heart disease • m...

To evaluate the cost-effectiveness of universal newborn screening using stool color card or direct bilirubin (DB) testing when comparing with no screening for biliary atresia in Japanese setting. source https://www.jpeds.com/article/S0022-3476(22)00850-2/fulltext?rss=yes

Previous Presentations: Portions of this study were presented as a poster during the Pediatric Academic Societies Virtual Meeting, April 30th - June 4th, 2021; as a poster during the International Newborn Brain Virtual Conference, February 10-12, 2022; and as a poster during the Pediatric Academic Societies Meeting, April 21-25, 2022, Denver, CO. source https://www.jpeds.com/article/S0022-3476(22)00849-6/fulltext?rss=yes

To studysexually transmitted Chlamydia trachomatis infections (STCTs), teenage pregnancies, and payment defaults in individuals born preterm as proxies for engaging in risk-taking behavior. source https://www.jpeds.com/article/S0022-3476(22)00854-X/fulltext?rss=yes

(s): To assess and characterize healthcare resource utilization (HRU) in children with the rare, genetic, multisystem disorder, Alagille syndrome (ALGS). source https://www.jpeds.com/article/S0022-3476(22)00855-1/fulltext?rss=yes

To identify impacts of patient and family engagement in child health research on the research process, research teams, and patient and family partners. source https://www.jpeds.com/article/S0022-3476(22)00852-6/fulltext?rss=yes

Annually, more than 200,000 febrile infants younger than 90 days are evaluated in U.S. emergency departments (EDs)1 and other outpatient settings. Although urinary tract infections (UTIs) are common in these infants, the main concerns involve invasive bacterial infections (IBI), defined by bacteremia or bacterial meningitis. The reported IBI rates range from approximately 1 to 5% in prospective studies, with higher rates in the youngest infants.2-4 To address the persistent variability in care of these febrile infants despite substantial research performed over several decades, the American Academy of Pediatrics (AAP) published guidelines for the management of well-appearing febrile infants 8-60 days old. source https://www.jpeds.com/article/S0022-3476(22)00848-4/fulltext?rss=yes

  A recent review on The PediaBlog of the American Academy of Pediatrics’ most recent update on reducing the incidence and severity of influenza this coming flu season reminded  parents to make sure everyone in the family is immunized by Halloween ( “Flu Before Boo” ), before the “tsunami” of influenza washes over our region in the Northern Hemisphere: Many people think of the flu as a bad cold and don’t realize that it can be a very serious illness. The flu causes thousands of deaths in the US every year, even among healthy children. About 33 to 199 children and teens die each year of flu – 80% of those children were not fully vaccinated. The flu vaccine is the best tool we have to protect children, especially those with special health care needs. With COVID still present in our communities, it is even more important to encourage flu and COVID-19 vaccination in the same visit.   In addition to receiving vaccines that are “the single best way to reduce the risk ...

Dennis the Menace by Hank Ketcham ( arcamax.com/thefunnies )                                 source http://www.thepediablog.com/2022/09/25/sunday-funnies-524/

BLUE CURRY from Gobelins pro on Vimeo : The greatest life lessons are learned through the simplest experiences. When your kitchen turns into your biggest classroom… and Mom just serves you a plate of wisdom.     source http://www.thepediablog.com/2022/09/24/cool-video-of-the-week-525/

With the advent of the touchscreen smartphone era following the release of the Apple iPhone in 2007, technical innovations have resulted in an explosion of direct-to-consumer electronic devices with tremendous processing speed and memory, along with the ability to package multiple forms of sensor hardware in a pocket-sized package. The latest wave of innovation has focused on the boundary between body and technology, finding new ways to capture physiology in a form that is unobtrusive and non-invasive. source https://www.jpeds.com/article/S0022-3476(22)00718-1/fulltext?rss=yes

The event will be hosted by Earl Mainer, Sr. Associate Director of Admissions for the Southeast & Puerto Rico, who will discuss how UMHS St. Kitts has become one of the most popular medical schools for Puerto Rican students, as well as important information about the admissions process and how our graduates successfully return to practice medicine in Puerto Rico. The event will be streamed live in English on the UMHS YouTube channel as well as on the UMHS Facebook and LinkedIn pages. Family and friends are encouraged to join! from University of Medicine and Health Sciences https://www.youtube.com/watch?v=onAPVXXnlDM via UMHS YouTube Channel

The event will be hosted by Earl Mainer, Sr. Associate Director of Admissions for the Southeast & Puerto Rico, who will discuss how UMHS St. Kitts has become one of the most popular medical schools for Puerto Rican students, as well as important information about the admissions process and how our graduates successfully return to practice medicine in Puerto Rico. The event will be streamed live in English on the UMHS YouTube channel as well as on the UMHS Facebook and LinkedIn pages. Family and friends are encouraged to join! from University of Medicine and Health Sciences https://www.youtube.com/watch?v=onAPVXXnlDM via UMHS YouTube Channel

*This post originally appeared on The PediaBlog on September 23, 2016.   The Five-Second Rule     You know how it goes. You’re about to put a delicious bite of food into your mouth when it suddenly slips out of your fingers and goes “splatt” on the floor. Do you pick it up and throw it away? Remember, it’s delicious. Or, do you pick it up as quickly as you can, declare the “five-second rule,” pick off a speck of dirt (or dog hair) and pop it into your mouth? What do you do if it’s your baby’s pacifier that lands on the floor instead of a tasty morsel of food? Toddlers and children who come to our office for a sick visit, a checkup, or a shot will receive a pretzel stick if they are good. (Okay, everyone gets one!) Sometimes the pretzel stick gets dropped on the floor. “There is no five-second rule here,” I say as I race to pick up the broken pretzel, throw it out, and replace it with a new one before the child realizes what just happened. “Hold on t...

  OUT OF THE OLD BLACK BAG   Return to Camelot — Part 3 By  Anthony Kovatch, M.D.   Perhaps the premonition of a premature death is not acquired solely by what one witnesses during their lifetime, especially their childhood.   Perhaps the premonition is also inherent in our DNA.   Regardless of the truth, I think it is incumbent on us to be proactive in the matter rather than fatalistic, as was “Papa” Hemingway: “The world breaks everyone and afterward many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially. If you are none of these you can be sure it will kill you too but there will be no special hurry.”           — From “A Farewell to Arms,” thought by some to be his greatest novel   It is improbable that Death thinks like the Army Corps of Engineers, whose motto is: “The Difficult We Do Immediately. The Impossible ...

To determine if providing respiratory support to very preterm infants that fail to breathe regularly during deferred cord clamping reduced red cell transfusion. source https://www.jpeds.com/article/S0022-3476(22)00847-2/fulltext?rss=yes

A 4-week-old male born at 33-week gestation presented with repetitive bilateral eyelid blinking with feeds. The pregnancy was complicated by maternal syphilis and methamphetamine exposure. Prenatal laboratory tests on admission showed maternal rapid plasma reagin (RPR) positivity (1:64), and the baby was subsequently found to have a positive serum RPR (1:4) and positive venereal disease research laboratory (VDRL) in cerebrospinal fluid (1:1). The baby's urine toxicology screen was negative. The general examination demonstrated hepatomegaly and syphilitic rhinitis (snuffles); there were otherwise no ocular, bone, audiologic, dermatologic, or dental abnormalities. source https://www.jpeds.com/article/S0022-3476(22)00845-9/fulltext?rss=yes

Cross-sectional analyses of four nationally representative samples indicate disparities in family-centered care occur among U.S. children and youth with special health care needs by race and ethnicity, family income and composition, insurance coverage, and health care setting. Measured confounds including children’s health and impairment severity do not explain the disparities. source https://www.jpeds.com/article/S0022-3476(22)00846-0/fulltext?rss=yes

  OUT OF THE OLD BLACK BAG   Return to Camelot — Part 2 By  Anthony Kovatch, M.D.   As the family members were dispersing, I dwelt on the legacy into which I had been adopted 40 years hence, and, even more so, to the interview of the American press with First Lady Jacqueline Kennedy following JFK’s untimely assassination in 1963.   It was “Jackie” who first attached the term “Camelot” to the two years of the Kennedy presidency with its grandeur, glamor, and unrivaled idealism.   That short epoch in time embodied qualities reminiscent of the romanticized Camelot of Arthur, Guinevere, and Lancelot:   youth, fashion, charisma, legendary bravery.   This sentiment of Jackie helped to dispel the national stigma surrounding the tragedies that beset America’s first family:   the curse of the Kennedy’s.     I think that every human life is fraught with unforeseen danger and that all families have their intrinsic “curse,” whether it ...

  OUT OF THE OLD BLACK BAG   Return to Camelot — Part 1 By  Anthony Kovatch, M.D.   Musical accompaniment:  “Camelot” by Lerner and Loewe; sung here Richard Harris playing King Arthur.   “Winter must be  cold for those with no warm memories… we’ve already missed the spring!”              — Terry McKay in “An Affair to Remember”   It was long overdue.   Even as an in-law, or perhaps because I was an in-law whose role in the “Lyons Family Dynasty” was often from the outside-looking-in, I sensed a weakening of the glue adhering the generations together since the grand matriarch Mary Irene (a facsimile of the late Queen Elizabeth II with a rivaling sense of humor) passed away in 2018. No better time for an inaugural Lyons Family reunion than in the dog days of the summer of 2022. For my own selfish reasons, I was concerned that the generations comprising Mary and Jack Lyons’ grandchildren and gre...

To compare the discriminative performances of the 2018-National Institutes of Health (NIH) and the 2019-Jensen bronchopulmonary dysplasia (BPD) definitions to the 2001- (NIH) definition on neurodevelopmental and respiratory adverse outcome at two- and five years corrected age (CA). source https://www.jpeds.com/article/S0022-3476(22)00844-7/fulltext?rss=yes

Join UMHS on Tuesday, 9/20 at 5pm ET for the "Closing the Deaf Gap in Healthcare: Giving a Voice To Deaf Patients” livestream in recognition of September as Deaf Awareness Month & International Week of Deaf People September 19-25, 2022. from University of Medicine and Health Sciences https://www.youtube.com/watch?v=QjRhZi1uf34 via UMHS YouTube Channel

Join UMHS on Tuesday, 9/20 at 5pm ET for the "Closing the Deaf Gap in Healthcare: Giving a Voice To Deaf Patients” livestream in recognition of September as Deaf Awareness Month & International Week of Deaf People September 19-25, 2022. from University of Medicine and Health Sciences https://www.youtube.com/watch?v=QjRhZi1uf34 via UMHS YouTube Channel

To evaluate the clinical effect of sodium glycerophosphate (NaGP) in parenteral nutrition solutions on mineral metabolism in extremely low birth weight (ELBW) infants. source https://www.jpeds.com/article/S0022-3476(22)00821-6/fulltext?rss=yes

  Having trouble getting your toddler to fall asleep and stay asleep at night? You’re not alone : Many parents find their toddler’s bedtime to be the hardest part of the day. Children this age often resist going to sleep, especially if they have older siblings who are still awake. The good news is that there are ways you can try to help make bedtime go more smoothly.   Sleep expert Autumn Dettmann says it’s pretty common for toddlers’ nighttime sleep to become disrupted when they make their “big nap transition”: The average age to transition from 2 naps down to 1 falls between 15-18 months. This transition can take a lot of time to iron out and if we aren’t compensating with an earlier bedtime during it, overtiredness can rear it’s ugly head!   Eventually, youngsters give up their naps altogether. Pediatrician Claire McCarthy has some ideas to help them out with that transition: Most children give up naps between the ages of 3 and 5. If a child can stay up...

Luann by Greg Evans ( GoComics.com )               source http://www.thepediablog.com/2022/09/18/sunday-funnies-523/

To Evaluate the prevalence of hemosiderin laden macrophages in children with bronchopulmonary dysplasia (BPD) and assess for an association between hemosiderin laden macrophages and pulmonary arterial hypertension. source https://www.jpeds.com/article/S0022-3476(22)00823-X/fulltext?rss=yes

Although the term “shared decision making” would not be officially coined until the 1983 President’s Commission report on Deciding to Forego Life-Sustaining Treatment,[1] the concept was described 10 years earlier by Duff and Campbell in their highly controversial 1973 publication in the New England Journal of Medicine.[2] In discussing 299 consecutive deaths that occurring in a special-care nursery (what is now known as a neonatal intensive care unit [NICU]), Duff and Campbell spoke the unspeakable by acknowledging that 43 (14 per cent) of the deaths were related to withholding treatment: “After careful consideration of each of these 43 infants, parents and physicians in a group decision concluded that prognosis for meaningful life was extremely poor or hopeless, and therefore rejected further treatment.”[2 at p. source https://www.jpeds.com/article/S0022-3476(22)00820-4/fulltext?rss=yes

To establish consensus practices among a panel of national experts for the discharge of premature infants with bronchopulmonary dysplasia (BPD) from the hospital to home. source https://www.jpeds.com/article/S0022-3476(22)00822-8/fulltext?rss=yes

OK KL Kuala Lumpur from Joerg Daiber on Vimeo : Kuala Lumpur, commonly known as KL, is the national capital and largest city in Malaysia. Greater Kuala Lumpur is among the fastest growing metropolitan regions in Southeast Asia, in both population and economic development.     source http://www.thepediablog.com/2022/09/17/cool-video-of-the-week-524/

A two-month-old infant boy, born at 35+1 week via Cesarean section with birth weight 2610 grams due to preterm premature rupture of membrane, was referred for evaluation of sudden onset bilateral buccal protrusions. His mother denied any trauma history previously, nor were any congenital disorders found. source https://www.jpeds.com/article/S0022-3476(22)00824-1/fulltext?rss=yes

In 1989, Allen Buchanan and Dan Brock published their groundbreaking work on surrogate decision making entitled: Deciding for Others: The Ethics of Surrogate Decision Making in which they developed a decision making framework that could apply to adults and children.[1] It entailed 4 principles: 1) underlying ethical values; 2) authority principle; 3) guidance principle; and 4) intervention principle. Whereas the underlying ethical values in adult decision-making are self-determination and well-being, in pediatrics they placed greater priority on well-being followed by self-determination and then added a third value—parental interests because they understood that parents are not fiduciaries who always act in their child’s best interest, but must balance the child’s needs and interests with the needs and interests of other family members (including themselves).[2] In fact, for each principle, Buchanan and Brock distinguished how the framework applied for adults versus pediatrics. sourc...

*This post originally appeared on The PediaBlog on September 16, 2015.   Limiting Screen Time     Yesterday, we looked at the reasons why the American Academy of Pediatrics discourages the use of screen-based media in children under the age of two, even if the programs, apps, or topics are educational. The AAP expects pediatricians to address this with parents: Pediatricians should explain to parents the importance of unstructured, unplugged play in allowing a child’s mind to grow, problem-solve, think innovatively, and develop reasoning skills. Unstructured play occurs both independently and cooperatively with a parent or caregiver. The importance of parents sitting down to play with their children cannot be overstated.   As we’ve seen previously , cognitive and language development is enhanced greatly when parents read to their children. Technology is no replacement for the face-to-face interaction that being read to all...

To determine the trends in inhaled nitric oxide utilization in the late phase of hospitalization in a large Japanese cohort of extremely preterm infants and evaluate its benefit on long-term outcomes. source https://www.jpeds.com/article/S0022-3476(22)00817-4/fulltext?rss=yes

To implement and to evaluate the effectiveness of the Uniformed Services Constipation Action Plan (USCAP) in our gastroenterology clinic for children with functional constipation. source https://www.jpeds.com/article/S0022-3476(22)00812-5/fulltext?rss=yes

This study shows that only 12.5% (2/16) laboratory reports included age-appropriate pediatric reference ranges for all lipid/lipoproteins. Use of erroneous reference range(s) could lead to missed alerts of dyslipidemia in up to 97.3% (TC), 93.6% (HDL-C), 94.8% (LDL-C) and 87.8% (TG) of youth in the population based NHANES-cohort. The findings highlight the potential missed opportunities for reinforcing lifestyle counseling for dyslipidemia in addition to obesity in youth. source https://www.jpeds.com/article/S0022-3476(22)00726-0/fulltext?rss=yes

Dr. Svarakic shares her story of matching into an Internal Medicine residency in Chicago. I'm originally from St. Louis, Missouri. I'm a first-generation Serbian. My parents immigrated in the late '80s, early '90s. Did my undergraduate at the University of Illinois. And then decided med school was the right move for me. Applied to UMHS and in my 4th year, I matched in Internal medicine at the Chicago Medical School here in Chicago, Illinois, which is part of Rosalind Franklin University. My dad is a psychiatrist at WashU and one of his residents actually was a UMHS grad. So when I was researching where to go, that was really impressive to me that she matched at a really great program. She offered to meet with me and give me some insight into what it was like for her at UMHS, what she liked about it, and the opportunities that were available to her through UMHS. So I met with her. She really had a lot of insight into the quality of the rotations. Were there any professor...

Dr. Svarakic shares her story of matching into an Internal Medicine residency in Chicago. I'm originally from St. Louis, Missouri. I'm a first-generation Serbian. My parents immigrated in the late '80s, early '90s. Did my undergraduate at the University of Illinois. And then decided med school was the right move for me. Applied to UMHS and in my 4th year, I matched in Internal medicine at the Chicago Medical School here in Chicago, Illinois, which is part of Rosalind Franklin University. My dad is a psychiatrist at WashU and one of his residents actually was a UMHS grad. So when I was researching where to go, that was really impressive to me that she matched at a really great program. She offered to meet with me and give me some insight into what it was like for her at UMHS, what she liked about it, and the opportunities that were available to her through UMHS. So I met with her. She really had a lot of insight into the quality of the rotations. Were there any professor...