Debora Porter

In honor of Pride Month, join us on 6/21 at 7pm ET for a special livestream event, "LGBTQ+MED: Full Spectrum Care," led by Dr. Søren Estvold from University of Medicine and Health Sciences https://www.youtube.com/watch?v=k5DsJWNAGsU via UMHS YouTube Channel

In honor of Pride Month, join us on 6/21 at 7pm ET for a special livestream event, "LGBTQ+MED: Full Spectrum Care," led by Dr. Søren Estvold from University of Medicine and Health Sciences https://www.youtube.com/watch?v=k5DsJWNAGsU via UMHS YouTube Channel

  OUT OF THE OLD BLACK BAG   New Relic Discovered in Troy Hill — Part 1 By  Anthony L. Kovatch, M.D.   Musical Accompaniment: “You Were Meant for Me” , sung by Helen Forrest and featured in the sentimental movie, “Penny Serenade.” Music by Nacio Herb Brown with lyrics by Arthur Freed (1929).   The neighborhood of Troy Hill rests on a plateau overlooking the Allegheny River on Pittsburgh’s Northside; it is approximately 3 kilometers long and only 1 kilometer wide. In the center of this quaint village sits the Chapel of Saint Anthony of Padua which purportedly contains sacred relics, including the complete skeletal remains of a saint named Demetrius, a tooth of the chapel’s patron Saint Anthony, and a thorn from the true Crown of Thorns of the crucifixion of the Christ. All of the 4,000 to 5,000 relics in the chapel have original certificates of authenticity from the Vatican (the oldest of which dates from August 12, 1716), except for one which mysterio...

A male infant born at 39 weeks’ gestation with weight 3200 g was referred to our center at four days of life for abdominal distention. The baby was born to a primiparous mother and breast fed exclusively. He had passed meconium on multiple occasions since birth. Despite gross abdominal distention, he had no vomiting. On perineal examination, small cysts were arranged in a “string of pearls” fashion, emerging from the anal dimple and reaching the mid scrotum along the midline raphe (blue arrow, Figure 1). source https://www.jpeds.com/article/S0022-3476(23)00356-6/fulltext?rss=yes

  Breast cancer is the most common cause of cancer in women in the United States (excluding skin cancer) and the second-leading cause of cancer death in women after lung cancer. The American Cancer Society estimates that in 2023, nearly 300,000 new cases of invasive breast cancer and more than 55,000 with early-stage ductal carcinoma in situ will be diagnosed in the U.S. Although mortality from breast cancer has dropped steadily over the last several decades due to early screening and better treatments, the ACS still expects about 43,700 will die from the disease in 2023. Despite the reduction in mortality, the incidence of breast cancer in the U.S. has actually been rising about 0.5% every year. Earlier this month, the U.S. Preventive Services Task Force (an independent government agency) issued  new and critically important draft recommendations for breast cancer screening. The USPSTF now recommends that all women  should be screened for breast cancer with mammogra...

  Like most conscientious and loving parents, Nancy Reynolds worries about her children (a lot!), even as they’ve gotten older and asserted their independence during their teen years: When my kids were young, I worried about whether they’d take a nap or share their toys during playdates. Now I worry about BIG stuff like them driving alone, staying safe when they’re out with friends, whether they’re aware of their surroundings when they’re walking to their car, and whether they’ll make good decisions when the chips are down. I can’t protect my kids from everything … I know that. But what I can do is prepare them, educate them and make them more aware .   Reynolds’ list of “50 Potentially Life-Saving Safety Tips Every Teenager Should Know” deserves to be read by every parent raising a child, and every teenager living in these dangerous times. Reading some of these commonsense reminders may trigger feelings of anxiety and sadness in some parents, like this everyday s...

Brilliant Mind of Edison Lee by John Hambrock ( Arcamax.com/thefunnies )           source https://www.thepediablog.com/2023/05/21/sunday-funnies-558/

Sun Moon London from Luke Miller on Vimeo : Filmed up to 2520mm from various locations around London featuring October 5th 2017 Harvest moon and January 1st 2018 Supermoon.     source https://www.thepediablog.com/2023/05/20/cool-video-of-the-week-559/

Technological advancement and accrual of evidence-based interventions have expanded fertility preservation (FP) options for those at-risk for iatrogenic infertility. We use the term “iatrogenic” infertility, that is infertility resulting from medical care, intentionally as it is inclusive of all pediatric and young adult patients who will receive therapies that threaten their future fertility. Increasingly, as technologies advance, FP procedures are becoming feasible in non-experimental settings for pre-and post-pubertal patients (Table 1). source https://www.jpeds.com/article/S0022-3476(23)00344-X/fulltext?rss=yes

To evaluate genetic evaluation practices in newborns with the most common birth defect, congenital heart defects (CHD), we determine the prevalence and the yield of genetic evaluation across time and across patient subtypes, before and after implementation of institutional genetic testing guidelines. source https://www.jpeds.com/article/S0022-3476(23)00343-8/fulltext?rss=yes

To investigate among U.S. infants born <37 weeks gestational age a) racial and ethnic disparities in sudden unexpected infant death (SUID) and b) state variation in SUID rates and Non-Hispanic Black (NHB) – Non-Hispanic white (NHW) SUID disparity ratio. source https://www.jpeds.com/article/S0022-3476(23)00346-3/fulltext?rss=yes

Onasemnogene abeparvovec treats spinal muscular atrophy (SMA) by delivering a functional SMN1 gene. Necrotizing enterocolitis (NEC) typically occurs in preterm infants. We report two term infants diagnosed with SMA who presented with NEC after onasemnogene abeparvovec infusion. We discuss potential etiologies and propose monitoring for NEC after onasemnogene abeparvovec therapy. source https://www.jpeds.com/article/S0022-3476(23)00341-4/fulltext?rss=yes

*This post originally appeared on The PediaBlog on May 19, 2017.   Bottoms Up   These days I suspect most of us will take good news anywhere we can find it. Last week, the Centers for Disease Control and Prevention announced  in Morbidity and Mortality Weekly Report a positive development for teen health: During 1991–2007, the prevalence of current drinking among high school students declined significantly, from 50.8% (1991) to 44.7% (2007), and then significantly declined to 32.8% in 2015. The prevalence of binge drinking increased from 31.3% in 1991 to 31.5% in 1999, and then significantly declined to 17.7% in 2015.   Data from the national Youth Risk Behavior Survey (“a cross-sectional, biennial school-based survey of 9th–12th grade students in U.S. public and private schools that monitors the prevalence of health risk behaviors) does reveal a bit of bad news, as Abigail Abrams gently informs  us: Despite the overall decrease, re...

A 3-year-old girl presented with a skin nodule of unclear duration. On history, her mother mentioned persistent “ringworm” that had been present for a couple years and tended to flare during the summer months. All lesions were asymptomatic. Past treatments had included intermittent use of hydrocortisone and topical antifungal creams, without consistent response. Examination revealed a firm, mobile subcutaneous nodule of the anterior lower leg (Figure 1A), and annular mildly erythematous non-scaly plaques on the dorsal left ankle (Figure 1B) and dorsal right foot (Figure 1C). source https://www.jpeds.com/article/S0022-3476(23)00345-1/fulltext?rss=yes

  So while you’re on this lonely trip Keep a watch for other ships And if by chance our vessels pass While you’re on this lonely trip Keep a watch for other ships And if by chance our vessels pass Perhaps we’ll meet at last — Lonely Trip by Trey Anastasio   May is Mental Health Awareness Month In a new report  from the Office of the Surgeon General entitled “Our Epidemic of Loneliness and Isolation, Vivek Murthy, M.D. prioritizes loneliness — a feeling he says is experienced by half of American adults — as a public health concern: Loneliness is far more than just a bad feeling—it harms both individual and societal health. It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day, and even greater than that associated with obesity and physical inactivity. And the harmful cons...

  May is Mental Health Awareness Month As we have discovered during this May’s observance of  Mental Health Awareness Month , the United States currently finds itself mired in a mental health crisis , a predicament the American Academy of Pediatrics declared a national emergency  for children and adolescents in 2021. Self-harm (including cutting and burning) and suicide have been on the rise in the U.S. in recent years, especially during the pandemic. A study published this month in Pediatrics examines which children and teens are at highest risk for serious self-harm injuries and suicide. The researchers note that suicide risk is based on a number of personal and social factors: Risk for suicide is likely the result of a complex interaction between a number of diverse and dynamic factors ranging from individual (eg, psychiatric comorbidities), family (family history of mental disorders, family conflict, and support), social support (friend network, outpatient psy...

We report 3 pediatric patients who present with only non-anaphylactic symptoms of alpha-gal syndrome. This report highlights the necessity of not discounting alpha-gal syndrome from a differential diagnosis for patients with recurrent gastrointestinal distress and emesis after consuming mammalian meat, even in the absence of an anaphylactic reaction. source https://www.jpeds.com/article/S0022-3476(23)00334-7/fulltext?rss=yes

Caffeine has become one of the most prescribed drugs in neonatal medicine.1-3 The effects of this medication on mortality, neonatal morbidities, and child development have been rigorously studied in the Caffeine for Apnea of Prematurity (CAP) trial.4-7 The World Health Organization (WHO) has included caffeine citrate in its short core list of essential medicines for neonates.8 However, caffeine remains unavailable or unaffordable in many middle-and-low-income countries.9 At the same time, regional and national guidelines are promoting potentially unsafe therapeutic drift in some high-income countries. source https://www.jpeds.com/article/S0022-3476(23)00336-0/fulltext?rss=yes

To analyze laboratory testing results from pediatric patients newly diagnosed with celiac disease (CD) in order to determine the utility of each test derived from recommended guidelines. source https://www.jpeds.com/article/S0022-3476(23)00335-9/fulltext?rss=yes

Dr. Tendai Marume recently matched into an internal medicine residency program at Thomas Jefferson University Hospital in Philadelphia, PA. He took a year off before applying to the Match to pursue his love for teaching and worked as a Clinical Instructor of Preclinical Sciences at UMHS in St. Kitts. Dr. Marume also worked with UMHS students extensively via distance learning during the dark days of the COVID-19 pandemic back in 2020.  The UMHS Endeavour spoke to Dr. Marume about his journey at UMHS, his background, why he chose UMHS over other medical schools, what interests him about internal medicine and also teaching, and more. Read more: https://www.umhs-sk.org/blog/dr.-tendai-marume-on-internal-medicine-residency-in-philadelphia-pa from University of Medicine and Health Sciences https://www.youtube.com/watch?v=VWWTRAqQbaI via UMHS YouTube Channel

Dr. Tendai Marume recently matched into an internal medicine residency program at Thomas Jefferson University Hospital in Philadelphia, PA. He took a year off before applying to the Match to pursue his love for teaching and worked as a Clinical Instructor of Preclinical Sciences at UMHS in St. Kitts. Dr. Marume also worked with UMHS students extensively via distance learning during the dark days of the COVID-19 pandemic back in 2020.  The UMHS Endeavour spoke to Dr. Marume about his journey at UMHS, his background, why he chose UMHS over other medical schools, what interests him about internal medicine and also teaching, and more. Read more: https://www.umhs-sk.org/blog/dr.-tendai-marume-on-internal-medicine-residency-in-philadelphia-pa from University of Medicine and Health Sciences https://www.youtube.com/watch?v=VWWTRAqQbaI via UMHS YouTube Channel

  May is Mental Health Awareness Month Yesterday on The PediaBlog , we heard U.S. Surgeon General Vivek Murthy, M.D. call on parents to help their kids cope with “the crisis of our time,” children’s declining mental health: “The most important thing that you can do for your child during turbulence is to make sure that they know you love them and that they can talk to you,” he said. “For them just to know it’s OK for them to talk to you, it’s not something to be ashamed of, and there are people they can go to for help … can go a long way to helping a child feel that they’re not alone.”   According to a new survey conducted by Nationwide Children’s Hospital, half of parents who were asked pointed to social media as a major reason for the mental health crisis in children: Concerns continue to grow about the impact social media use has on the mental health and well-being of children and adolescents. According to a new national survey […], half (50%) of parents of child...

To compare disease severity and mortality differences between female and male patients with CDH. source https://www.jpeds.com/article/S0022-3476(23)00329-3/fulltext?rss=yes

There is an urgent need to identify best practices for hospital treatment of youth with malnutrition secondary to restrictive eating disorders, including anorexia nervosa (AN) and avoidant/restrictive food intake disorder (ARFID). Certain physical health complications of malnutrition, such as bradycardia, hypotension, and hypothermia, often lead to hospitalization. These acute medical complications improve with refeeding, or short-term nutritional rehabilitation, and will resolve with ongoing recovery. source https://www.jpeds.com/article/S0022-3476(23)00330-X/fulltext?rss=yes

  Last week on The PediaBlog , we began observing  Mental Health Awareness Month by taking the time to “look around, look within” and recognize how important the safety of our surroundings — in our homes, in our communities, outside in nature — is for supporting our mental health. We also acknowledged a frightening statistic indicating that teenage girls in America are in trouble : 1 in 3 reported thinking seriously about attempting suicide in 2021, according to research from the CDC. Is it not surprising, then, when we hear U.S. Surgeon General Vivek Murthy, M.D. refer to declining mental health in youth as “the crisis of our time”? Matt Richtel reveals another data point supporting Dr. Murthy’s concern: Mental health-related visits to emergency rooms by children, teenagers and young adults soared from 2011 to 2020, according to a report published on Monday in the Journal of the American Medical Association. The sharpest increase was for suicide-related visits, whi...

To evaluate neurodevelopmental outcomes at 5.5 years of age in children who were previously randomized to cow milk-based infant formula (control) or similar formula (milk fat globule membrane plus lactoferrin [MFGM+LF]) with added sources of bovine MFGM and bovine LF (bLF) through 12 months of age. source https://www.jpeds.com/article/S0022-3476(23)00331-1/fulltext?rss=yes

Arlo and Janis by Jimmy Johnson ( GoComics.com )         Happy Mother’s Day!   source https://www.thepediablog.com/2023/05/14/sunday-funnies-557/

Everest – A Time Lapse Film – II from Elia Saikaly on Vimeo : Experience the beauty of Mt. Everest at night in time-lapse. While most climbers slept, I attempted to capture some of the magic that the Himalayan skies have to offer while climbing to the top of the world. No where else on the planet have I ever seen the Milky Way so clear, so vivid and so very much alive. It takes a great deal of discipline to stay up all night capturing the magic for the world to experience. Cameras freeze.Shutters freeze. Batteries freeze. Humans freeze. The high altitude environment is debilitating at best. Your body is taking a constant beating by the low levels of oxygen in the atmosphere. The higher you climb of course, the worse this becomes. And yet… this is heaven on Earth for me. This is my comfort zone. This is where I feel alive. This is where the combination of my love for imagery, astrophotography, storytelling and connection with the mountains all intersect. I toss logic out the wind...

To evaluate distribution profiles of total cholesterol (TC), lipoprotein cholesterol (LDL-C), and apolipoprotein B (apoB) as candidate markers of familial hypercholesterolemia (FH) in newborns, taking into consideration potential confounding factors, such as gestational age, birthweight, sex, and race. source https://www.jpeds.com/article/S0022-3476(23)00317-7/fulltext?rss=yes

Medical toxicology (MT) education in United States (US) pediatrics residency programs has not been described in over two decades; however, childhood poisonings account for over 1.2 million calls to US poison centers (PCs) annually [1], many of which are exploratory/unsupervised ingestions in young children that result in high rates of Emergency Department (ED) visits and hospitalizations [2, 3, 4]. As of 2020, poisoning and drug overdose are a leading cause of death in children and adolescents [5]. source https://www.jpeds.com/article/S0022-3476(23)00321-9/fulltext?rss=yes

Dr. Ralston is a Board-Certified physician with the American Academy of Family Physicians and is currently finishing up his third year of a family medicine residency at CoxHealth in Springfield, Missouri. The UMHS Endeavour spoke to this friendly, ambitious young doctor about his how he first became interested in medicine and attended Wichita State University, why he chose UMHS over other medical schools, his medical education and his positive experience bringing his wife to St. Kitts to live while he studied, his current residency and why he is so enthusiastic about starting his sports medicine fellowship soon. Read more: https://www.umhs-sk.org/blog/dr.-grant-ralson-19-on-upcoming-sports-medicine-fellowship-in-ar from University of Medicine and Health Sciences https://www.youtube.com/watch?v=bQwaU245Vks via UMHS YouTube Channel

Dr. Ralston is a Board-Certified physician with the American Academy of Family Physicians and is currently finishing up his third year of a family medicine residency at CoxHealth in Springfield, Missouri. The UMHS Endeavour spoke to this friendly, ambitious young doctor about his how he first became interested in medicine and attended Wichita State University, why he chose UMHS over other medical schools, his medical education and his positive experience bringing his wife to St. Kitts to live while he studied, his current residency and why he is so enthusiastic about starting his sports medicine fellowship soon. Read more: https://www.umhs-sk.org/blog/dr.-grant-ralson-19-on-upcoming-sports-medicine-fellowship-in-ar from University of Medicine and Health Sciences https://www.youtube.com/watch?v=bQwaU245Vks via UMHS YouTube Channel

To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use. source https://www.jpeds.com/article/S0022-3476(23)00316-5/fulltext?rss=yes

*This post originally appeared on The PediaBlog on May 12, 2022.   The Crying Soul Of Medicine     May is Mental Health Awareness Month   Over the past three days we’ve examined the disturbing trend of declining mental health in young Americans. Yesterday we learned that the rise of anxiety, depression, eating disorders, and other mental health conditions predates the onset of the COVID-19 pandemic by more than a decade. Surveys of medical providers who care for kids and families in despair indicate a generation of health professionals pushed to the limit during the pandemic. When Jennifer Abassi notes that 1 in 5 physicians (20%) say they intend to leave clinical practice, you can sense the damage COVID-19 has inflicted on the soul of medicine: Over the past 2 years, more than 36 ,000 survey responses from clinicians across the country have painted an alarming picture of a workforce that’s increasingly burned out, traumatized, anxious, and depressed....

Food security is understood in its broadest sense as the ability to ensure consistently and satisfactorily food and water to meet the energy requirements the body needs for survival and life, under adequate hygienic conditions. The commonly accepted international definition is the one developed at the World Food Summit in 1996 according to which all people, at all times, must have physical, social, and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences to lead an active and healthy life1. source https://www.jpeds.com/article/S0022-3476(23)00322-0/fulltext?rss=yes

A 12-year-old boy presented with a slow-growing, asymptomatic, midline neck lesion, which had been present since he was three years old. The lesion was initially more superior in the neck and over the years had migrated inferiorly. The patient denied any respiratory distress, pain, or difficulty with swallowing. Physical exam revealed a 2.0 x 1.5 cm smooth, non-tender, mobile, subcutaneous nodule on the anterior midline neck (Figure 1) that moved anteriorly with swallowing and tongue protrusion (Figure 2; video available at www.jpeds.com). source https://www.jpeds.com/article/S0022-3476(23)00319-0/fulltext?rss=yes

We appreciate the opportunity to respond to the thoughtful comment raised by Dr. Ng regarding our article “Clinically Meaningful BMI change impacts pediatric NAFLD”. We would also like to thank Dr. Ng for his interest in our manuscript. source https://www.jpeds.com/article/S0022-3476(23)00315-3/fulltext?rss=yes

I congratulate Khurana et al. for their publication entitled “Clinically Meaningful BMI Change Impacts Pediatric NAFLD”, and also for the excellent outcomes shared in the paper which reflects a very successful pediatric NAFLD multidisciplinary program.1 This retrospective study describes a BMI-z-score reduction of above 0.25 to be associated with significant improvements in NAFLD through reductions in serum aminotransferase levels. Patients who were successful in achieving BMI-z-score of above 0.25 appeared to be significantly younger (mean age and standard deviation 11.7+/-3.5 years) than those who did not (13+/-2.9 years). source https://www.jpeds.com/article/S0022-3476(23)00314-1/fulltext?rss=yes

To examine how social deprivation and residential mobility are associated with primary care use in children seeking care at community health centers (CHCs) overall and stratified by race and ethnicity. source https://www.jpeds.com/article/S0022-3476(23)00313-X/fulltext?rss=yes

  May is Mental Health Awareness Month. This year’s theme  is “Look Around, Look Within”: This Mental Health Month, challenge yourself to examine your world and how it can affect your overall health. Look around, look within – from your neighborhood to genetics, many factors come into play when it comes to your mental health.   It sometimes escapes our notice how much our surroundings — stable housing in safe communities with ample access to the outdoors and nature — affect our health: Our surroundings play a significant role in shaping our thoughts, emotions, behaviors, and overall health, and learning about the impact of our surroundings on our mental health is a valuable way to take control of our own well-being.   Having stable and safe housing is important in maintaining mental health: Housing is more than just protection from the outdoor elements. Safe and stable housing is a basic need, and it can be difficult or impossible to care for your me...

To evaluate how geography, ethnicity, ancestry, and race, and/or religion (GEAR) and social determinants of health (SDOH) data are reported and discussed in three European pediatric journals and to compare practices between European and American journals. source https://www.jpeds.com/article/S0022-3476(23)00302-5/fulltext?rss=yes

To describe the distribution of peak bilirubin levels among infants born before 29 weeks’ gestation in the first 14 days of life and to study the association between quartiles of peak bilirubin levels at different gestational ages and neurodevelopmental outcomes. source https://www.jpeds.com/article/S0022-3476(23)00306-2/fulltext?rss=yes

To assess which potential future outcomes are most important to parents of children with bronchopulmonary dysplasia (BPD), a disease that affects future respiratory, medical, and developmental outcomes for children born preterm. source https://www.jpeds.com/article/S0022-3476(23)00303-7/fulltext?rss=yes

To examine how height and youth as well as parenting characteristics associate with quality of life (QoL) and self-esteem among healthy youth undergoing growth evaluation with growth hormone (GH) testing . source https://www.jpeds.com/article/S0022-3476(23)00308-6/fulltext?rss=yes

  May is Mental Health Awareness Month  and, boy, do we really need to “take some time to look around, look within” in 2023. According to Mental Health America, approximately 50 million adults living in the United States (roughly 20%) have a diagnosable mental health condition. Over the course of a lifetime, 46 percent of Americans will someday meet the criteria for a diagnosable mental health condition, and about half will develop conditions by the age of 14. Americans who identify as Black/African American, Latinx/Hispanic, Asian American/Pacific Islander, Native American/Alaska Native, and multiracial all have higher risks for developing mental health problems in their lifetimes. The nearly 15 million Americans who self-identify as LGBTQ+ are especially at high risk, with 39% reported to have experienced a mental illness in the past year. But no one is immune from developing anxiety and major depression — two of the most common mental health disorders in Am...