Echocardiographic Predictors of Hospital Outcomes in Preterm Neonates with Patent Ductus Arteriosus and Clinical Suspicion of Pulmonary Hypertension.

Background: Preterm neonates often have an echocardiogram performed in the first few days of life for suspicion of pulmonary hypertension and patent ductus arteriosus. The usefulness of this echocardiogram in predicting outcomes in this population are unknown. The objective of this study was to investigate associations between initial echocardiographic assessment and hospital outcomes in preterm neonates with patent ductus arteriosus and clinical suspicion of pulmonary hypertension.

Participation in a School-Based Wellness Initiative Associated With Improved K-12 Student Body Mass Index Trends.

Background: Associations between school participation in an academic medical center-supported school-based wellness initiative and programmatic components implemented with change in average student body mass index (BMI) over time were examined.

Methods: This was an observational study of 103 K-12 South Carolina schools over school years 2014-2018, classified as participating (n = 87 schools, 27,855 students) or non-participating (n = 16 schools; 3608 students). Associations between students' BMI z-score (BMIz) and school participation were evaluated by linear multilevel mixed-effects modeling using data from FitnessGram and the School Wellness Checklist© (SWC), respectively.

Hemodynamic Effects of High-dose Levothyroxine and Methylprednisolone in Brain-dead Potential Organ Donors.

Background: Hormonal replacement therapy is administered to many brain-dead organ donors to improve hemodynamic stability. Previous clinical studies present conflicting results with several randomized studies reporting no benefit.

Methods: Consecutive adult donors (N = 199) were randomized to receive high-dose levothyroxine, high-dose methylprednisolone, both (Combo), or no hormonal therapy (Control).

Investigation of a Common Clinical Approach to Poor Growth in Preterm Infants.

Objective: This study aimed to determine the effect of elevated energy intake with medium-chain triglyceride (MCT) oil or formula powder on growth velocity and weight z-score in very low birth weight infants receiving human milk and human milk fortifier.

Study Design: This was a cohort study of infants exposed to MCT oil or formula powder for at least 7 days. Mean 7-day change in growth velocity and weight z-scores were compared pre- and postintervention.

Early continuous renal replacement therapy during infant extracorporeal life support is associated with decreased lung opacification.

Lung opacification on chest radiography (CXR) is common during extracorporeal life support (ECLS), often resulting from pulmonary edema or inflammation. Concurrent use of continuous renal replacement therapy (CRRT) during ECLS is associated with improved fluid balance and cytokine filtration; through modification of these pathologic states, CRRT may modulate lung opacification observed on CXRs. We hypothesize that early CRRT use during infant ECLS decreases lung opacification on CXR.

Primary Care Providers Welcome Smartphone Apps That Assist in Pediatric Weight Management.

Primary care providers (PCPs) have few resources to manage their overweight/obese patients. The purpose of study was to determine if technological resources, such as smartphone apps, may be useful for weight management counseling. PCPs were surveyed about their current use of resources for obesity management and whether smartphone apps would be helpful.

The Safety of Mother's Milk® Tea: Results of a Randomized Double-Blind, Controlled Study in Fully Breastfeeding Mothers and Their Infants.

Background: Various natural products are reported to improve maternal milk supply yet are not necessarily safe for infants. Researchers have not systematically studied galactagogue teas for safety.

Research Aim: This study evaluates the safety of a galactagogue tea in breastfeeding women and their infants, assessing short- and long-term adverse effects.

Biological correlates of self-reported new and continued abstinence in cannabis cessation treatment clinical trials.

Background: The agreement between self-reported cannabis abstinence with urine cannabinoid concentrations in a clinical trials setting is not well characterized. We assessed the agreement between various cannabinoid cutoffs and self-reported abstinence across three clinical trials, one including contingency management for abstinence.

Methods: Three cannabis cessation clinical trials where participants reported use and provided weekly urine samples for cannabis and creatinine concentration measurements were included.

Direct-to-adolescent text messaging for vaccine reminders: What will parents permit?

Background: Direct-to-adolescent text messaging may be a consideration for vaccine reminders, including human papilloma virus (HPV), but no studies have explored the minimum age at which parents would allow adolescents to receive a text message.

Methods: We distributed a survey to parents of 10-17 year olds during any office visit in two practice based research networks in South Carolina and Oklahoma. We asked about parental preference for receiving vaccine reminders for their adolescent, whether they would allow the healthcare provider to directly message their adolescent, and if so, what would be the acceptable minimum age.

Enhancing Postdischarge Asthma Care by Using Pharmacy Claims and Telephone Follow-up.

Background And Objectives: Asthma is a common reason for hospital readmission. The majority of children are not receiving adequate preventive care after discharge. Our objective is to decrease return visits to the emergency department (ED) or hospital for asthma through a series of interventions (eg, access to real-time claims data and structured follow-up phone calls) designed to increase preventive care.

Newborn Screening for Sickle Cell Disease in St. Vincent and the Grenadines: Results of a Pilot Newborn Screening Program.

To pilot a newborn screening program for sickle cell disease (SCD) in St. Vincent and the Grenadines using a novel partnership method to determine the feasibility of a universal newborn screening program in this country. : A prospective study of mothers and their newborns was conducted between January 1, 2015, and November 1, 2015, at the country's main hospital.

Underdiagnosis and Lower Rates of Office Visits for Overweight/Obese Pediatric Patients in Rural Compared with Urban Areas.

Objectives: This study compared the number of children enrolled in Medicaid in rural and urban areas of South Carolina with an overweight/obesity diagnosis and the mean rates of office visits with overweight/obesity diagnosed.

Methods: Medicaid claims data from 2012 for children in three South Carolina counties, categorized as urban, rural high resource, and rural low resource, were used to identify those who had been diagnosed as being overweight/obese during any encounter. Logistic and Poisson regressions were performed to predict whether overweight/obese children in each county would receive an overweight/obesity visit diagnosis and to calculate the mean rate of total office visits with an overweight/obesity diagnosis in each county.

Understanding the Constipation Conundrum: Predictors of Obtaining an Abdominal Radiograph During the Emergency Department Evaluation of Pediatric Constipation.

Objectives: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED.

Methods: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014.

Associations Between Patient Characteristics and the Amount of Arthritis Medication Information Patients Receive.

Little is known about factors associated with the receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumatoid arthritis (RA; n = 328) completed an online cross-sectional survey.

Qualitative development of the sinus control test: a survey evaluating sinus symptom control.

Background: Ideal management of chronic rhinosinusitis (CRS) requires ongoing monitoring of disease and its control. Existing control instruments are limited in their correlation to patient reported outcomes, the need for endoscopy, or lack of validation from a multidisciplinary group. The goal of this study was to develop a patient-based Sinus Control Test (SCT) for determining CRS control.

Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial.

Objective: Compare effectiveness of maternal vitamin D3 supplementation with 6400 IU per day alone to maternal and infant supplementation with 400 IU per day.

Methods: Exclusively lactating women living in Charleston, SC, or Rochester, NY, at 4 to 6 weeks postpartum were randomized to either 400, 2400, or 6400 IU vitamin D3/day for 6 months. Breastfeeding infants in 400 IU group received oral 400 IU vitamin D3/day; infants in 2400 and 6400 IU groups received 0 IU/day (placebo).

"Beat the Shock Clock": An Interprofessional Team Improves Pediatric Septic Shock Care.

Ideal care for septic shock (SS) is difficult. This interprofessional quality improvement intervention in a mid-volume pediatric emergency department aimed to reduce time to vascular access, fluid resuscitation, and antibiotics for SS. Intensive education, a care pathway, and an order set were applied.