Infant consumption of 100% lactose-based and reduced lactose infant formula in the United States: Review of NHANES data from 1999 to 2020.

Objectives: An acceptable alternative to human milk is US Food and Drug Administration (US FDA)-registered infant formula, which must meet the requirements of the US FDA Infant Formula Act. Human milk contains lactose, but some infant formulas may contain alternative carbohydrate sources such as corn syrup solids, maltodextrin, and sucrose. Recent research shows that infant-formula made with corn syrup solids may be associated with increased obesity risk in the first 5 years of life.

Cross-Sectional Analysis of Infant Diet, Outcomes, Consumer Behavior and Parental Perspectives to Optimize Infant Feeding in Response to the 2022 U.S. Infant Formula Shortage.

Unlabelled: In May of 2022, millions of U.S. parents encountered uncertainty in safely feeding their infants due to the infant formula shortage.

Nutrition Content of Young Child Formulas.

Objective: European Society for Pediatric Gastroenterology, Hepatology and Nutrition and the American Academy of Pediatrics state that young child formula (YCF) is not considered necessary for healthy children. Despite these recommendations, YCF accounts for approximately 13% of overall formula sales. Five percent of infants less than 1 year of age in the United States are being fed YCF.

The Impact of eConsults on Access to Specialty Care for the Uninsured in Rural Texas.

Objective: This study evaluated the impact of eConsults on access to specialty care for uninsured patients in Central Texas.

Methods: eConsults for four specialties, cardiology, gastroenterology, rheumatology, and endocrinology, were implemented in a large, multi-site federally qualified health center. Data were collected on specialty care access and utilization for a one-year period before and after implementation of the new process.

Nutritional and Safety Concerns of Infant Feeding Trends.

Objective: The American Academy of Pediatrics (AAP) and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition recommend either exclusively breastfeeding for at least 6 months or an u.S. Food and Drug Administration-reviewed infant formula or donor breast milk from an established milk bank as alternatives.

Offering preimplantation genetic testing for monogenic disorders (PGT-M) for conditions with reduced penetrance or variants of uncertain significance: Ethical insight from U.S. laboratory genetic counselors.

Preimplantation genetic testing for monogenic disorders (PGT-M) was originally developed to identify embryos affected with serious childhood-onset disorders, but its use has recently broadened. Guidance on the use of PGT-M in the United States (U.S.

Disparities in Telehealth Utilization Within Pediatric Gastroenterology: One Academic Center's Experience.

Objectives: While the use of telemedicine has accelerated significantly with the recent pandemic, it has also magnified disparities in access to telemedicine. This study aims to look at telemedicine utilization patterns within a large pediatric gastroenterology practice.

Methods: A retrospective study of ambulatory care visits within Yale-New Haven Hospital's pediatric gastroenterology practice during the peak expansion of the telemedicine program was conducted.

Impact of Pediatric Electronic Consultations in a Federally Qualified Health Center.

Access to pediatric specialty care is a challenge, particularly for medically underserved populations. One evolving method that has shown promise in helping ameliorate this disparity is electronic consultations (e-consults). This retrospective cohort study compared two groups: patients referred to pediatric cardiology, endocrinology, or pulmonology from a Federally-Qualified Health Center 10 months before the implementation of an evidence-based care pathway and those referred in the 10 months after implementation.

Assessment of Community Pediatric Providers' Approach to Children With .

In 2016, the European and North American Societies for Pediatric Gastroenterology, Hepatology, and Nutrition updated guidelines for management of in children, adjusting the previous diagnostic and therapeutic approaches in response to changing epidemiology and antibiotic resistance patterns. In this study, we assessed knowledge, practice habits of management, and adherence to new guideline recommendations among one state's community pediatric providers. The majority of the surveyed community pediatric providers are not following the new pediatric guidelines for management.

Non-FDA-Reviewed Imported European Formula Use Among Parents in Urban Pediatric Private Practice.

In 2018, the American Academy of Pediatrics warned consumers over the increasing use of imported infant formulas. The purpose of this study was to assess the usage of imported European infant formula among parents in a large urban private practice. An anonymous survey was distributed at well-child appointments to a convenience sample of parents at an urban private pediatric practice from November 2017 to March 2018.

Impact of Endocrinology eConsults on Access to Endocrinology Care for Medicaid Patients.

Access to endocrinologists is a particular challenge for medically underserved populations. Electronic consultations (eConsults) are a promising tool to help address this problem. This retrospective cohort study compared two groups: (1) Medicaid patients referred to an endocrinologist 1 year before the implementation of eConsults and (2) those referred in the 1 year after implementation.

Comparison of Imported European and US Infant Formulas: Labeling, Nutrient and Safety Concerns.

Objective: Infant formula in the United States is highly regulated. The American Academy of Pediatrics (AAP) has reported concerns over the use of non-Food and Drug Administration (FDA)-registered imported infant formulas. The purpose of this study is to identify Internet purchased and recommended imported European infant formulas and compare them with FDA labeling and nutrient requirements.

Creating a Program for Junior Faculty Professional Development: A Tool Kit.

Introduction: Junior academic faculty must balance increasing clinical responsibilities whilst maintaining academic portfolios aimed at promotion. Our goal was to design, implement, and evaluate a curriculum for career development amongst junior faculty in pediatrics.

Methods: Following the Kern method of curriculum development, we performed a needs assessment of junior faculty via an electronic survey to identify areas for career development.

Reduced Cost Of Specialty Care Using Electronic Consultations For Medicaid Patients.

Specialty care accounts for a significant and growing portion of year-over-year Medicaid cost increases. Some referrals to specialists may be avoided and managed more efficiently by using electronic consultations (eConsults). In this study a large, multisite safety-net health center linked its primary care providers with specialists in dermatology, endocrinology, gastroenterology, and orthopedics via an eConsult platform.

Segmentation of Both Diseased and Healthy Skin From Clinical Photographs in a Primary Care Setting.

This work presents the first segmentation study of both diseased and healthy skin in standard camera photographs from a clinical environment. Challenges arise from varied lighting conditions, skin types, backgrounds, and pathological states. For study, 400 clinical photographs (with skin segmentation masks) representing various pathological states of skin are retrospectively collected from a primary care network.

Assessment of Community Pediatric Providers' Approach to a Child With Celiac Disease and Available Serological Testing Associated With a Large Tertiary Care Center.

An evidence-practice gap for use of celiac disease testing can lead to poor resource utilization. False positive tests may lead to unnecessary diet changes, gastroenterology consults, parental/patient concern, and additional testing and expenses complicated by varied available celiac bundles. An understanding of pediatric provider practices according to guideline recommendations further improves this gap.

Impact of dermatology eConsults on access to care and skin cancer screening in underserved populations: A model for teledermatology services in community health centers.

Background: The clinical outcome of teledermatology with dermoscopy in large-scale primary care networks remains unclear.

Objective: We evaluate the impact of implementing a teledermatology consultation program with dermoscopy on a statewide scale, focusing on access to care and skin cancer screening for medically underserved populations.

Methods: Descriptive retrospective cohort study of 2385 dermatology referrals from primary care from June 2014 through November 2015.

Prevalence and Patterns of Marijuana Use in Young Adults With Inflammatory Bowel Disease.

Objectives: Recent studies in adults report symptom relief with marijuana use in patients with inflammatory bowel disease (IBD). We assessed the prevalence, pattern, effects, and adverse effects of marijuana use in young adults with IBD.

Methods: We conducted a prospective questionnaire survey study at a pediatric IBD clinic.

Tissue Transglutaminase Levels Are Not Sufficient to Diagnose Celiac Disease in North American Practices Without Intestinal Biopsies.

Background: Celiac serology is crucial for the diagnosis of celiac disease in children. The American guideline for celiac disease in children suggested that positive serology should be followed by confirmatory intestinal histology. The relationship between high tissue transglutaminase titers and celiac disease in children has not been well investigated in children from North America.

Lysosomal acid lipase deficiency: diagnosis and treatment of Wolman and Cholesteryl Ester Storage Diseases.

Lysosomal acid lipase (LAL) is responsible for the hydrolysis of cholesterol esters and triglycerides. LAL is coded by the LIPA gene on chromosome 10q23.31.

Conjugated Hyperbilirubinemia in a Child with Streptococcus pneumoniae-associated Hemolytic Uremic Syndrome.

Conjugated hyperbilirubinemia is a rare complication of hemolytic uremic syndrome (HUS). We report a case of a 2-year-old female with Streptococcus pneumonia-associated HUS (SP+ HUS) who developed severe cholestasis. It is important for pediatric gastroenterologists to be aware of manifestations of HUS, and that although rare, cholestasis can be one of the early findings in patients with SP+ HUS.

Cholesteryl ester storage disease: protean presentations of lysosomal acid lipase deficiency.

Objective: LIPA gene mutations result in deficiency of lysosomal acid lipase and present phenotypically as Wolman disease or cholesteryl ester storage disease (CESD) depending on the level of deficiency. Patients with CESD may often be misdiagnosed because symptoms may be nonspecific. Symptoms may present in infancy if there is complete loss of lysosomal acid lipase or in early childhood or adulthood when there is partial loss.