Debora Porter

  Know someone who needs to find a pediatrician for their kids? The idea can be a bit overwhelming for brand new parents or for families with children moving away to a new location. That’s because most parents value the trusting relationship they develop with their children’s health providers. Pediatricians Allison S. McBride, M.D. and Lindsay A. Thompson, M.D. write in JAMA Pediatrics Patient Page that parents may not have much time to make such an important personal decision for themselves and their kids: After the initial excitement settles, many parents find themselves researching the safest car seat, the best day care, or ways to understand their child’s behavior. From social media, friends, family, and the internet, information is almost endless about how to care for your child, keep them safe, and help them grow. It is thrilling and overwhelming, exciting and stressful. You will want to choose a clinician to help you navigate all of these issues, from common childhood...

To assess the diagnostic and treatment practices among a variety of subspecialists at pediatric institutions in the United States. source https://www.jpeds.com/article/S0022-3476(22)00983-0/fulltext?rss=yes

Calvin and Hobbes by Bill Watterson ( GoComics.com )   source http://www.thepediablog.com/2022/10/30/sunday-funnies-529/

Omelette from Madeline Sharafian on Vimeo : I wanted to make something that focuses on how meaningful it is to make food for someone you love. My family’s lives practically revolve around cooking for each other, so it’s a theme that I’m deeply attached to. I hope you enjoy it!     source http://www.thepediablog.com/2022/10/29/cool-video-of-the-week-530/

To address gaps in routine recommended care for children with Down syndrome, through quality improvement during the COVID-19 pandemic. source https://www.jpeds.com/article/S0022-3476(22)00982-9/fulltext?rss=yes

Ongoing sustainability of the EAE Hub system is supported by the Riley Children’s Foundation, Kiwanis Indiana Three Wishes Campaign, and Robert Helen Haddad Family Foundation. Additional support to A.M. and R.K. is provided by Indiana University Leadership Education in Neurodevelopmental and Other Related Disabilities (IU-LEND; HRSA T73MC00015). The authors have no conflicts of interest. source https://www.jpeds.com/article/S0022-3476(22)00984-2/fulltext?rss=yes

*This post originally appeared on The PediaBlog on October 28, 2020.   LDs — Did You Know? (1)     Did you know? •  Learning and attention issues are more common than most people think. According to the National Center for Learning Disabilities (NCLD), up to 20% of American schoolchildren (1 in 5 students) face brain-based obstacles that prevent them from learning effectively and efficiently in school. •  Learning and attention issues are brain-based problems affecting reading, writing, math, organization, focus, listening comprehension, social skills, motor skills, or a combination of these. •  Learning and attention issues are NOT the result of low intelligence, poor vision or hearing, or lack of access to quality instruction. •  Risk factors for the presence of learning disabilities include genetics, environmental toxin exposure (we’ve extensively covered the effect of lead on developing brains here ), and adverse childhood experie...

  Earlier this year, the Governor’s Highway Safety Association reported that pedestrian deaths by motor vehicles reached a 40-year high in 2021. GHSA counted 7,485 pedestrians killed — about 20 each day in the U.S. — in 2021. That’s 11.5% higher than the number of pedestrian fatalities the year prior, says Sarah Polus: An estimated 7,485 people were killed while on foot last year, compared to 6,711 in 2020, according to the Governors Highway Safety Association (GHSA). Seven states reported an increase of more than 30 percent in the number of people on foot struck and killed in motor vehicle crashes.   Statistically, October 31 is an especially treacherous date for child pedestrians. According to the National Safety Council, children are more than twice as likely to be hit by a car and killed on Halloween than on any other day of the year. Most deaths occur in residential neighborhoods during trick-or-treating. A research letter in JAMA Pediatrics in 2019 identified...

  Each year on The PediaBlog , we review advice to help kids stay safe on Halloween. After two years of living through a global pandemic and with the community level of COVID-19 currently running in the low range, pediatricians everywhere expect that trick-or-treating will return in full force when the kids head out the door next week. Allegheny Health Network issued a press release  last week reminding everyone to stay safe while enjoying the sweet and (hopefully) not-too-spooky holiday: “This year is a special one for our clinical teams as we can once again strongly encourage families and their children to participate in Halloween activities and trick-or-treating events to enjoy the season and spend time with their peers,” said Ned Ketyer, MD, pediatrician and communications advisor at the AHN Pediatric Institute. “Following approval of COVID-19 vaccinations in children older than five months, we have seen increasing rates of acceptance which provides an added lay...

  Halloween marks the beginning of two months that effectively sabotage everyone’s best efforts to eat healthy and maintain a healthy body weight. Registered dietician Taylor Sutton has some ideas to help limit not only the sweet and high-density calories that define Halloween treats, but also feelings of stress and guilt that have a way of sticking around until the new year arrives and we can all turn the page: Tip #1: Don’t buy candy early You may have noticed Halloween candy displays popping up at the grocery store around Labor Day. Although it can be tempting to stock up ahead of time, save candy shopping for a of couple nights before Halloween so that there isn’t a stockpile of candy sitting in your pantry before its time for trick-or-treaters to come by.   Sutton recommends a smart and healthy “pre-game” meal: Tip #2: Eat nutritious meals leading up to Halloween night Feeding the body with satisfying and balanced meals before trick-or-treating can help reduce...

  Here we are in the final week of October, waiting for the expected fall surge of COVID-19, anticipating a brutal influenza season (CDC is already reporting “early increases in seasonal influenza activity” in most states), knowing that other respiratory viruses are gaining traction as the weather gets cold and people gather together closely indoors. RSV (respiratory syncytial virus) is one of the most common and most contagious respiratory viruses out there. RSV appears every autumn and hangs around until early springtime, causing typical cold symptoms (runny nose, congestion, cough) in most people and more serious disease (wheezing, respiratory distress, dehydration) especially in the youngest among us, as we learned on The PediaBlog in 2016: In the United States, according to the CDC, nearly 60,000 children under the age of five are admitted to the hospital with RSV bronchiolitis and pneumonia every year. For every child hospitalized, approximately 30 more are sick enoug...

Daddy Daze by John Kovaleski  ( arcamax.com/thefunnies )           source http://www.thepediablog.com/2022/10/23/sunday-funnies-528/

NOX ATACAMA II from Martin Heck on Vimeo : Home to the darkest and cleanest skies in the world, the Atacama Desert offers views to the nightsky like no other. 2 years after the very successful first video “Nox Atacama” we return to this magnificent region and get rewarded with uncountable numbers of stars and fantastic nebulae in one of the most quiet a empty places on earth. Not a single noise distracts from the grand show the nightsky has to offer. Filmed over a month in Mar/April 2019, I worked in freezing temperatures, altitudes up to 5200m/17000ft, salt lakes and icy slopes. The Atacama is not welcoming to life and equipment. The lack of oxygen makes it tough to get anything done in these high altitudes. But it provides without doubt for epic and vast vistas of one of the greatest landscapes on earth.     source http://www.thepediablog.com/2022/10/22/cool-video-of-the-week-529/

UMHS 2020 graduate Dr. Cynthia Kudji Sylvester and her daughter Dr. Jasmine Kudji are two gutsy women indeed. Back in spring 2020, at the beginning of the COVID-19 pandemic, Dr. Cynthia Kudji Sylvester matched into the family medicine residency program at LSU Health Systems in New Orleans. Her daughter Dr. Jasmine Kudji also matched into LSU Health Systems in general surgery. When we interviewed them for the UMHS Endeavour, the story of a mother-and-daughter doctor duo matching into the same hospital system went viral worldwide. They were on “NBC Nightly News,” “The Today Show with Hoda Kotb and Jenna Bush,” profiled in People magazine, and more. The Kudjis were approached by the producers of “Gutsy,” an Apple TV + series hosted by Hillary and Chelsea Clinton. “Gutsy” is an eight-episode series featuring such renowned women as comedians Wanda Sykes and Amy Schumer, famous mother and daughter actors Goldie Hawn and Kate Hudson, comedy writer Amber Ruffin, TV star Mariska Hargitay, activ...

UMHS 2020 graduate Dr. Cynthia Kudji Sylvester and her daughter Dr. Jasmine Kudji are two gutsy women indeed. Back in spring 2020, at the beginning of the COVID-19 pandemic, Dr. Cynthia Kudji Sylvester matched into the family medicine residency program at LSU Health Systems in New Orleans. Her daughter Dr. Jasmine Kudji also matched into LSU Health Systems in general surgery. When we interviewed them for the UMHS Endeavour, the story of a mother-and-daughter doctor duo matching into the same hospital system went viral worldwide. They were on “NBC Nightly News,” “The Today Show with Hoda Kotb and Jenna Bush,” profiled in People magazine, and more. The Kudjis were approached by the producers of “Gutsy,” an Apple TV + series hosted by Hillary and Chelsea Clinton. “Gutsy” is an eight-episode series featuring such renowned women as comedians Wanda Sykes and Amy Schumer, famous mother and daughter actors Goldie Hawn and Kate Hudson, comedy writer Amber Ruffin, TV star Mariska Hargitay, activ...

*This post originally appeared on The PediaBlog on October 21, 2015.   Mealtime Rules For Picky Eaters   Author Sally Sampson and pediatrician Natalie Degate Muth have been working with children and parents to overcome a common source of stress in some families:     Picky eaters — children with a limited repertoire of “acceptable” foods who refuse even to try any other type of food — can wreak havoc on a peaceful family meal. While most pronounced in toddlers, pickiness often extends into preschool and elementary school years. Undoing picky eating at this age is particularly challenging since food preferences by now are pretty firmly established.   Together, their Picky Eater Project  for the New York Times’ Motherlode blog takes the eating goals of each family member and helps plan ways to achieve them. They expect everyone to follow these “mealtime rules” : 1. As parents, we will be good role models. We will only ask the kids to ea...

CDC COVID Data Tracker 10/19/22 (Click 0n image to enlarge)   Anyone interested in following the mutation journey of the pandemic virus, SARS – CoV-2, is going to need a scorecard. Since early summer, Omicron BA.5 has been the dominant subvariant causing COVID-19 in the United States, and it still accounts for almost 70% of all acute COVID-19 infections. But as the graphic above indicates, new and potentially more dangerous subvariants are arriving in droves and slowly pushing BA.5 out of the way. Take BA.4.6, for example — directly descended from BA.4 — which now accounts for 12.2% of new cases in the U.S. this week. There are two other up-and-coming subvariants — BQ.1 and BQ.1.1, both evolved from the currently dominant BA.5 — that have public health experts alarmed. Adrianna Rodriguez  reports  that combined, both new strains account for 11.4% of new cases this week: BQ.1 and BQ.1.1, the newest strains , have gained the attention of top health experts due to i...

  Earlier this month, the U.S. Preventive Services Task Force (USPSTF) issued recommendations on universal screening for anxiety, depression, and suicide risk in all children and adolescents. USPSTF recommends pediatric health providers screen children for anxiety every year beginning at 8 years old: Anxiety disorder, a common mental health condition in the US, comprises a group of related conditions characterized by excessive fear or worry that present as emotional and physical symptoms. The 2018-2019 National Survey of Children’s Health (NSCH) found that 7.8% of children and adolescents aged 3 to 17 years had a current anxiety disorder. Anxiety disorders in childhood and adolescence are associated with an increased likelihood of a future anxiety disorder or depression.   Screening for depression should begin at age 12: Depression is a leading cause of disability in the US. Children and adolescents with depression typically have functional impairments in their...

Join us on October 19th, at 7 pm EDT, for our Virtual Discussion, “Women’s Cancer Awareness: Doctors Discuss Ovarian, Cervical, and Breast Cancer Screening,” hosted by three incredible women doctors in their fields. On the panel, we have UMHS 2016 graduate Miriam Bernstein, MPH, MD, Natalie Osborne, MD, who works at Joseph France General Hospital in St. Kitts, & UMHS 2019 graduate Laura Tafuri, MD. This event is to educate & bring attention to future doctors on Ovarian Cancer, Cervical Cancer, & Breast Cancer screening. from University of Medicine and Health Sciences https://www.youtube.com/watch?v=_TIKmNAsnSk via UMHS YouTube Channel

Join us on October 19th, at 7 pm EDT, for our Virtual Discussion, “Women’s Cancer Awareness: Doctors Discuss Ovarian, Cervical, and Breast Cancer Screening,” hosted by three incredible women doctors in their fields. On the panel, we have UMHS 2016 graduate Miriam Bernstein, MPH, MD, Natalie Osborne, MD, who works at Joseph France General Hospital in St. Kitts, & UMHS 2019 graduate Laura Tafuri, MD. This event is to educate & bring attention to future doctors on Ovarian Cancer, Cervical Cancer, & Breast Cancer screening. from University of Medicine and Health Sciences https://www.youtube.com/watch?v=_TIKmNAsnSk via UMHS YouTube Channel

To describe the association between neighborhood opportunity measured by the Child Opportunity Index 2.0 (COI) and patterns of hospital admissions and disease severity among children admitted to US pediatric hospitals. source https://www.jpeds.com/article/S0022-3476(22)00905-2/fulltext?rss=yes

  Most of us think of viruses like we think of the common cold or a gastrointestinal bug: a brief inconvenience that gets better in a few days. But sometimes even common viruses inflict significant and in some cases permanent damage to the bodies and lives of infected people. Take enterovirus, for instance, which typically causes mild sniffles and perhaps a cough in most people. However, in rare cases, one strain of enterovirus (EV-D68) can also attack the nervous system and cause acute flaccid paralysis (AFM)  in children, potentially leading to permanent muscle weakness and lifelong disability. 30 or 40 years after suffering an infection with poliovirus — a devastating pathogen nearly eradicated by global immunizations programs but recently enjoying a comeback  — significant muscle weakness and disability can return as post-polio syndrome . Sometimes a virus stays dormant in the body after the initial symptoms resolve, only to come to life years and even decad...

Diagnosis of a pediatric illness can also be a stressful and traumatic experience for parents and family members. Caring for a child with a chronic health condition imposes long-term stressors for the family.4 Parents of children with chronic health conditions frequently experience mental health difficulties including anxiety, depression, and traumatic stress.5 Parental mental health exerts a powerful influence on child developmental and behavioral trajectories and is often a stronger predictor of child outcomes than disease- or treatment-related factors.6,7 source https://www.jpeds.com/article/S0022-3476(22)00906-4/fulltext?rss=yes

An otherwise healthy 8-year-old girl presented with a 2-week history of asymptomatic skin eruption. A week before the onset, she had experienced mild fever, sore throat, and coryza for which she received symptomatic treatment without any significant sequelae. History of similar complaints were also elicited in some of her school friends. The lesions were not associated with any atopic diathesis, preceding inflammatory dermatoses, drug intake, or suggestive systemic finding. On cutaneous examination, multiple discrete hypopigmented macules and patches of varying sizes (0.5 – 1.5 cms) without any surface change was seen to be distributed symmetrically involving the dorsal and ventral aspects of bilateral lower limbs. source https://www.jpeds.com/article/S0022-3476(22)00897-6/fulltext?rss=yes

To investigate why certain at-risk individuals develop celiac disease, we examined the association of proton pump inhibitors (PPI), histamine-2 receptor antagonist (H2RA), and antibiotic prescriptions in the first six months of life with an early childhood diagnosis of celiac disease. source https://www.jpeds.com/article/S0022-3476(22)00900-3/fulltext?rss=yes

To compare the effect of intact cord versus clamped cord resuscitation on the physiological transition of neonates receiving positive pressure ventilation (PPV) at birth. source https://www.jpeds.com/article/S0022-3476(22)00898-8/fulltext?rss=yes

  Last week, the CDC and the FDA approved the newest bivalent COVID-19 vaccine for use as a single booster dose for children down to the age of 5 years old (for Pfizer’s vaccine; Moderna’s booster is available for children 6 and older). The new booster , which contains components of the early coronavirus variants plus the more recent Omicron B.4 and B.5 strains, has already been received by more than 15 million Americans since it was approved for ages 12 and up early last month: Updated COVID-19 vaccines add Omicron BA.4 and BA.5 spike protein components to the current vaccine composition, helping to restore protection that has waned since previous vaccination and targeting recent Omicron variants that are more transmissible and immune-evading. FDA’s authorization of updated (bivalent) COVID-19 vaccines for this younger age group, and CDC’s recommendation for use, are critical next steps forward in our country’s vaccination program—a program that has helped provide increas...

To compare the quality of life (QoL) for parents of children with inborn errors of metabolism (IEM) requiring a restricted diet with French population norms and investigate parental QoL determinants. source https://www.jpeds.com/article/S0022-3476(22)00895-2/fulltext?rss=yes

Take It From The Tinkersons by Bill Bettwy ( arcamax.com/thefunnies )           source http://www.thepediablog.com/2022/10/16/sunday-funnies-527/

To characterize delivery of goal-concordant end-of-life (EOL) care among children with complex chronic conditions and to determine factors associated with goal-concordance. source https://www.jpeds.com/article/S0022-3476(22)00881-2/fulltext?rss=yes

To evaluate the impact of a parenteral lipid emulsion containing fish oil compared with a soybean-oil based lipid emulsion on the cognitive outcome and behavior of preschool children with extremely low birth weight (ELBW) . source https://www.jpeds.com/article/S0022-3476(22)00901-5/fulltext?rss=yes

Hills on Fire II 4K from StealthGoose Productions on YouTube .   Watch Hills on Fire 4K: Vermont Fall  here .   source http://www.thepediablog.com/2022/10/15/cool-video-of-the-week-528/

Acute kidney injury (AKI) is common among hospitalized children, especially those receiving intensive care. Diagnosed in the setting of rising serum creatinine levels or the development of oligoanuria, AKI has been associated with poor in-hospital outcomes; children with AKI are more likely to require mechanical ventilation, experience longer lengths of stay, and have higher mortality rates1,2. Although these short-term associations have been well described across a myriad of studies and cohorts, the relationship between AKI and longer-term outcomes is less established. source https://www.jpeds.com/article/S0022-3476(22)00904-0/fulltext?rss=yes