Nocturia and Blood Pressure Elevation in Adolescents.

Nocturia has been increasingly recognized as a manifestation of various non-urological conditions including hypertension. In adults, blood pressure (BP) elevation has been identified as a robust correlate of nocturia, but such a relationship has not been studied in pediatric populations where nocturia is often attributed to hormonal, sleep, physiological or psychological disorders. Accordingly, this study aimed to determine the relationship between nocturia and BP elevation in adolescents.

Evaluation of a Childhood Obesity Program Serving a High-Need Population in Brooklyn, New York Using Survival Analysis.

In this study, we used survival analysis to evaluate whether contact hours intensity was associated with a reduction in time to improvement of various BMI metrics over a 5-year follow-up period at the Live Light Live Right pediatric obesity program in Brooklyn, New York. This was a single-center retrospective longitudinal study of 406 patients during 2010-2016. Participants were categorized based on hours of exposure to Live Light Live Right's interventions; high contact hours (≥50 h) vs.

Healthcare Economics of a Coronavirus Disease 2019 Pop-Up Vaccination Center.

: Creation of pop-up vaccination sites at trusted community locations has been encouraged to address vaccine hesitancy and provide equitable access to COVID-19 vaccination in minority communities. This study sought to study the healthcare economics of a community-based COVID-19 pop-up vaccination center in terms of the following: costs associated with operating the vaccination center, analysis of billing data from patients who received the Moderna COVID-19 vaccine, and costs of hospitalization for COVID-19 which may be avoided with widespread vaccination. : The pop-up vaccination center was located in Port Jefferson Station, NY, USA.

Insights into the challenges and facilitators to physical activity among brooklyn teens enroled in a weight management programme.

Purpose: A qualitative study was carried out to explore obese adolescents' understanding of physical activity, perceptions of the ideal body type and to identify facilitators of and barriers to physical activity.

Methods: Twenty-two adolescents 12-18 years of age and 14 of their parents were recruited from an obesity intervention programme in Brooklyn, New York, from June to November 2017. Data were collected using focus groups and individual semi-structured interviews, followed by interpretative phenomenological analysis of the transcripts.

The Correlation Between Parental Perceptions and Readiness to Change with Participation in a Pediatric Obesity Program Serving a Predominantly Black Urban Community: A Retrospective Cohort Study.

Background: This study assessed whether maternal BMI and perceptions about weight and reported level of readiness to change was correlated with compliance to a pediatric lifestyle modification program targeting a hard-to-reach urban population with a high prevalence of severe obesity.

Methods: The Parental Readiness Questionnaire (PRQ) was administered to the child's mother at program entry. The PRQ consisted of forty-seven multiple-choice and 10-point Likert scale questions regarding family demographics, exercise and eating habits, attitudes about health, body image, and weight, and the desire to improve nutrition and physical activity.

A real-world evaluation of a tertiary care childhood obesity intervention to reduce metabolic risk in a hard-to-reach urban population.

Background: Research on outcomes associated with lifestyle interventions serving pediatric populations in urban settings, where a majority have severe obesity, is scarce. This study assessed whether participation in a lifestyle intervention improved body mass index (BMI) percentile, BMI z-score, blood pressure, and lipid levels for children and adolescents.

Methods: The Live Light Live Right program is a lifestyle intervention that uses medical assessment, nutritional education, access to physical fitness classes, and behavioral modification to improve health outcomes.

Ethnic Differences in Lipid Profiles of Overweight, Obese, and Severely Obese Children and Adolescents 6-19 Years of Age.

Background: Ethnic differences in lipid profiles exist in children and adolescents. This study assessed whether variations in lipid profiles present in overweight and obese youth were also observed in severely obese youth. Variations could explain the lower prevalence of the metabolic syndrome in certain ethnic groups at even severe levels of obesity.

Designing a group therapy program for coping with childhood weight bias.

Research indicates that the negative psychosocial consequences of childhood obesity may reflect the degree of weight bias and mistreatment affecting the child. Even though comprehensive practice models evolve over time, the intense distress of these children calls for more timely intervention. Using a modification of social research and development methodology, a short-term group therapy approach using cognitive and behavioral methods was designed.

Managing cardiovascular risk in overweight children and adolescents.

The scientific, medical, and lay communities are currently confronted with a serious medical and public health problem related to the marked non-remitting worldwide epidemic of obesity. This ever-increasing prevalence of obesity is accompanied by a host of inherently associated co-morbidities. As a result, obesity is fast becoming the major cause of premature death in the developed world.

NT-proBNP Levels Improve the Ability of Predicting a Hemodynamically Significant Patent Ductus Arteriosus in Very Low-Birth-Weight Infants.

Purpose: A hemodynamically significant Patent ductus arteriosus (HsPDA) in premature infants is known to be associated with significant morbidity. Recently brain natriuretic peptides and superior mesenteric artery (SMA)-resistive indices have been used to effectively diagnose HsPDA.

Objective: To assess the sensitivity and specificity of N-terminal proBNP (NT-proBNP) in predicting an HsPDA diagnosed by clinical and echocardiographic criteria including pulsatility index (PI) of SMA.

In utero diagnosis of agenesis of the ductus arteriosus in a twin pregnancy: an unusual case presentation.

Agenesis of the ductus arteriosus is a rare congenital cardiac anomaly which should be considered within the differntial prenatal diagnosis of hydrops fetalis.

Assessment of email communication skills of rheumatology fellows: a pilot study.

Physician-patient email communication is gaining popularity. However, a formal assessment of physicians' email communication skills has not been described. We hypothesized that the email communication skills of rheumatology fellows can be measured in an objective structured clinical examination (OSCE) setting using a novel email content analysis instrument which has 18 items.

Salt, aldosterone, and insulin resistance: impact on the cardiovascular system.

Hypertension and type 2 diabetes mellitus (T2DM) are powerful risk factors for cardiovascular disease (CVD) and chronic kidney disease (CKD), both of which are leading causes of morbidity and mortality worldwide. Research into the pathophysiology of CVD and CKD risk factors has identified salt sensitivity and insulin resistance as key elements underlying the relationship between hypertension and T2DM. Excess dietary salt and caloric intake, as commonly found in westernized diets, is linked not only to increased blood pressure, but also to defective insulin sensitivity and impaired glucose homeostasis.

Association of obesity and hypertension with left ventricular geometry and function in children and adolescents.

Obesity, especially when complicated with hypertension, is associated with structural and functional cardiac changes. Recent studies have focused on the prognostic impact of the type of left ventricular (LV) geometric remodeling. This study looked at the prevalence and clinical correlates of LV geometric patterns and their relation to cardiac function in a sample of predominantly African-American (AA) youth.

Association of lipid abnormalities with measures and severity of adiposity and insulin resistance among overweight children and adolescents.

Obesity and lipid abnormalities in children may increase premature cardiovascular disease risk, but the relationship of dyslipidemia with adiposity among obese children is not well defined. The authors performed a cross-sectional analysis of children and adolescents (N=698) in 3 age groups (3-8 years, 9-11 years, and 12-18 years; 53% female, 81% African American, and 16% Hispanic) attending an obesity treatment program. More than 50% of the sample had abnormal levels of triglycerides (TG) or high-density lipoprotein (HDL) cholesterol or both.

Replacing an academic internal medicine residency program with a physician assistant--hospitalist model: a comparative analysis study.

This study describes a comparative analysis of replacing medical residents with physician assistants and hospitalists on patient outcomes in a community hospital. Prospective data during the physician assistants-hospitalists service for 2 years was compared with 2 years of retrospective data of the medical residents model. Outcome measures included mortality, adverse events, readmissions, and patient satisfaction.

Efficacy and cost comparisons of bronchodilatator administration between metered dose inhalers with disposable spacers and nebulizers for acute asthma treatment.

Background: Despite demonstration of equivalent efficacy of beta agonist delivery using a metered dose inhaler (MDI) with spacer vs. nebulizer in asthma patients, use of a nebulizer remains standard practice.

Objectives: We hypothesize that beta agonist delivery with a MDI/disposable spacer combination is an effective and low-cost alternative to nebulizer delivery for acute asthma in an inner-city population.

Multiple brain abscesses: an initial presentation in a child with an undiagnosed sinus venosus atrial septal defect.

Cerebral abscess is a serious condition and in children the commonest cause is cyanotic congenital heart disease. We report a 12-year old male who presented with multiple brain abscesses. After an extensive evaluation including a transesphageal echocardiogram (TEE), we found a previously undiagnosed sinus venous atrial septal defect (ASD).

Improvement of cardiac auscultation skills in pediatric residents with training.

Cardiac murmurs, most of which are harmless, are present in more than 50% of children. Good auscultation skills are required to prevent unnecessary referrals. The auscultation skills of a group of 21 pediatric residents were assessed.

Utility of the modified ATP III defined metabolic syndrome and severe obesity as predictors of insulin resistance in overweight children and adolescents: a cross-sectional study.

Background: The rising prevalence of obesity and metabolic syndrome (MetS) has received increased attention since both place individuals at risk for Type II diabetes and cardiovascular disease. Insulin resistance (IR) has been implicated in the pathogenesis of obesity and MetS in both children and adults and is a known independent cardiovascular risk factor. However measures of IR are not routinely performed in children while MetS or severe obesity when present, are considered as clinical markers for IR.

HIV-related pulmonary hypertension.

With the availability of better treatment and prophylactic regimens for the infectious complications of human immunodeficiency virus (HIV), the non-infectious complications are gaining greater attention. HIV-related pulmonary arterial hypertension (HIV-PAH) is one of these. The incidence of HIV-PAH is estimated at 0.

Room air entrainment during beta-agonist delivery with heliox.

Studies of the efficacy of heliox in patients with severe asthma have shown mixed results. Among the factors that are responsible for variable outcomes, the failure of heliox delivery systems to prevent room air entrainment (RAE) during beta-agonist delivery is probably the most critical. While keeping the rotameter flow rate (FR) of heliox mixed 70:30 to a nebulizer at 10 L/min, the FR of heliox from a second gas source to a T-connector (TC) was increased during the delivery of the beta-agonist with a conventional T-nebulizer delivery system (TNDS).

Emergency department as the main source of asthma care.

Many asthma patients use the emergency department (ED) as the sole source of asthma care. This is considered inadequate and poor practice. This prospective study revealed that young age, lack of evening clinic, forgetting to keep the appointment, conflicting priorities of daily life, and easy access to the ED on an as-needed basis for urgent care, medications, and prescriptions, and failure to use inhaled corticosteroids were significant while lack of insurance or access to asthma clinic were not significant factors in exclusive use of the ED.