Interventions to improve liver enzyme screening testing in obese patients aged <18 years in a public hospital, Chicago, IL, 2017-2018.

Introduction: Our study objective was to determine the health care provider liver enzyme screening testing (LEST) rates in obese pediatric patients at risk for nonalcoholic fatty liver disease (NAFLD), with the goal of improving NAFLD LEST after specific system-wide provider intervention.

Methods: We conducted a bi-phased retrospective electronic medical record review of health care practitioner encounters to determine LEST in overweight/obese (body mass index≥25) patients between ages 2 and 18 years in our outpatient clinics. Intervention activities included lectures to staff and residents, fliers distributed to providers, monthly email reminders, and computer stickers placed on all terminals.

A fracture, a family, legal entanglement, expensive investigation, and a familiar disease.

Osteogenesis imperfecta can be commonly mistaken for child abuse because of similar pattern of injuries. AA is a 3-week-old baby who presented to our emergency department with excessive crying. Skeletal survey revealed subacute spiral fracture of the right humerus, right posterior eighth and ninth ribs, acute fracture of the left femur, bowing of tibia and femur, and osteopenia.