School absenteeism as a predictor of functional gastrointestinal disorders in children.

Introduction: Chronic abdominal complaints are common in school-aged children. Most affected children do not have underlying organic diseases but suffer from functional gastrointestinal disorders. While many children with chronic abdominal complaints experience school problems, no prospective studies have examined if school absenteeism is more common among children suffering from functional as opposed to organic gastrointestinal disorders.

What is tongue-tie and does it interfere with breast-feeding? - a brief review.

The most common symptom attributed to ankyloglossia is difficulty breast feeding due to poor latch, inefficient milk extraction and/or maternal nipple pain. During the past two decades, despite a declining birth rate, there has been a dramatic increase in the number of infants diagnosed with and treated for ankyloglossia in the United States, Canada and Australia. Despite a dramatic increase in the diagnosis and treatment of ankyloglossia in these countries, there remains no universally agreed upon definition of ankyloglossia and none of the published scoring systems have been rigorously validated.

Examining Pediatric Resident Electronic Health Records Use During Prerounding: Mixed Methods Observational Study.

Background: Electronic health records (EHRs) play a substantial role in modern health care, especially during prerounding, when residents gather patient information to inform daily care decisions of the care team. The effective use of the EHR system is crucial for efficient and frustration-free prerounding. Ideally, the system should be designed to support efficient user interactions by presenting data effectively and providing easy navigation between different pages.

The epidemiology of inflammatory bowel disease: Clues to pathogenesis?

Historically, inflammatory bowel disease (IBD) was most common in North America and Europe and more common with a north-south gradient. Over the past century, there has been a marked increase in IBD in general and in childhood IBD in particular and over the past 50 years IBD has spread into the developing world. The greatest risk factor of developing IBD is an affected family member.

Usability challenges with electronic health records (EHRs) during prerounding on pediatric inpatients.

Objective: Prerounding is critical for a healthcare team to develop a shared understanding of the patient's condition and to develop a care plan. However, the design of electronic health records (EHRs) often makes prerounding inefficient, ineffective, and time consuming. The goal of this study was to observe how residents use the EHR while prerounding to identify usability challenges associated with the design of EHRs.

First Bites-Why, When, and What Solid Foods to Feed Infants.

Humans are the only mammals who feed our young special complementary foods before weaning and we are the only primates that wean our young before they can forage independently. There appears to be a sensitive period in the first several months of life when infants readily accept a wide variety of tastes and this period overlaps with a critical window for oral tolerance. As a result, infants should be exposed to a wide variety of flavors while mother is pregnant, while mother is nursing and beginning at an early age.

Growth failure and metabolic acidosis due to total body sodium depletion in an infant with an ileostomy.

Sodium is an essential nutrient and inadequate sodium intake and/or excessive sodium losses can result in suboptimal growth. Infants with ileostomies are at significant risk of developing growth failure as a result of excessive sodium loss in their ileostomy effluent. Chronic sodium depletion can also limit the kidney's ability to excrete hydrogen and potassium ions, mimicking electrolyte abnormalities found in type 4 renal tubular acidosis.

Feeding Problems in Infants and Children: Assessment and Etiology.

Feeding problems in infants and young children are common. In healthy children who are developing and growing normally, feeding problems are usually not serious and can be managed conservatively by reassuring the family and providing them with anticipatory guidance and follow-up. A majority of serious childhood feeding problems occur in children who have other medical, developmental, or behavioral problems.

Bangladesh Environmental Enteric Dysfunction (BEED) study: protocol for a community-based intervention study to validate non-invasive biomarkers of environmental enteric dysfunction.

Introduction: Environmental enteric dysfunction (EED) is a subacute inflammatory condition of the small intestinal mucosa with unclear aetiology that may account for more than 40% of all cases of stunting. Currently, there are no universally accepted protocols for the diagnosis, treatment and ultimately prevention of EED. The Bangladesh Environmental Enteric Dysfunction (BEED) study is designed to validate non-invasive biomarkers of EED with small intestinal biopsy, better understand disease pathogenesis and identify potential therapeutic targets for interventions designed to control EED and stunting.

Resident physicians as human information systems: sources yet seekers.

Objective: To characterize question types that residents received on overnight shifts and what information sources were used to answer them.

Materials And Methods: Across 30 overnight shifts, questions asked of on-call senior residents, question askers' roles, and residents' responses were documented. External sources were noted.

The Broad Street pump revisited: dairy farms and an ongoing outbreak of inflammatory bowel disease in Forest, Virginia.

We report an ongoing outbreak of ulcerative colitis and Crohn's disease in Forest, Virginia involving 15 unrelated children and teenagers who resided in close proximity to dairy farms. Some of our cases demonstrated serologic evidence of Mycobacterium avium subspecies paratuberculosis infection, suggesting its potential role as an etiologic agent.

Changes in inflammation and QoL after a single dose of infliximab during ongoing IBD treatment.

Background And Objectives: Infliximab is used increasingly as maintenance therapy for inflammatory bowel disease (IBD); however, the effects of a single maintenance dose of infliximab are unclear with respect to the quality of life and hormones related to growth and puberty. The aim of the present study was to determine the time course of inflammatory, hormonal, and quality-of-life changes following a single dose of infliximab in the context of ongoing therapy, as related to presence of IBD symptoms at time of administration.

Methods: Children and adolescents with IBD receiving ongoing therapy with infliximab for clinical indications were recruited.

The Development of a Web-based Resident Sign-out Training Program.

Patient sign-out is a mechanism for transferring information, responsibility, and/or authority from one set of caregivers to another. Little research has addressed what information should be communicated during sign-out and how sign-out should be conducted and evaluated. As hospital residents conduct many sign-outs and have limited time in general, targeted web-based training and evaluation have the potential to enhance Graduate Medical Education.

Collaborating With Physicians to Redesign a Sign-Out Tool: An iterative, multifaceted approach with users - even busy ones - can yield a satisfying and efficient product.

Physician sign-out is a mechanism for transferring patient information from one group of hospital care-givers to another at shift changes. Support tools are critical to the success of sign-out. To ensure that a tool is effective, designers must collaborate with end users, but collaboration can be difficult when working with users who are busy and have irregular schedules.

Exploring the relationship between parental worry about their children's health and usage of an internet intervention for pediatric encopresis.

Objective: To investigate whether parental worry about their children's health predicts usage of a pediatric Internet intervention for encopresis.

Methods: Thirty-nine families with a child diagnosed with encopresis completed a national clinical trial of an Internet-based intervention for encopresis (www.ucanpooptoo.

Real world use of an Internet intervention for pediatric encopresis.

Background: The Internet is a significant source of medical information and is now being shown to be an important conduit for delivering various health-related interventions.

Objective: This paper aimed to examine the utility and impact of an Internet intervention for childhood encopresis as part of standard medical care in a "real world" setting.

Methods: Patients diagnosed with encopresis were given a Web-based information prescription to use an Internet intervention for pediatric encopresis.

Benign transient hyperphosphatasemia associated with Epstein-Barr virus enteritis in a pediatric liver transplant patient: a case report.

Transient hyperphosphatasemia was found in a 3-year-old male liver transplant recipient. The condition was associated with diarrheal disease due to the Epstein-Barr virus (EBV). Immunosuppression was tapered and valganciclovir prescribed for 3 months, after which the diarrhea resolved and the EBV polymerase chain reaction assays became negative.

Adequacy of information transferred at resident sign-out (in-hospital handover of care): a prospective survey.

Background: During sign-out (handover of care), information and responsibility about patients is transferred from one set of caregivers to another. Few residency training programmes formally teach resident physicians how to sign out or assess their ability to sign out, and little research has examined the sign-out process.

Objective: To characterise the effectiveness of the sign-out process between resident physicians on an acute care ward.