Transition of adolescents with chronic health conditions to adult primary care: factors associated with physician acceptance.

Purpose: To assess the willingness of adult primary-care physicians to transfer young adults with special health care needs (YASHCN) into their practices, and the relative impact of patient characteristics and transition supports.

Methods: Survey of primary care internists and family practitioners using randomized patient characteristics and transition supports in clinical vignettes to assess physician willingness to accept a YASHCN into their practice.

Results: 404 responses were received from 601 surveys (response rate 67%).

Evaluation of the treatment of pectus carinatum with compressive orthotic bracing using three dimensional body scans.

Purpose: The purpose of this study is to measure the effectiveness of compressive orthotic brace therapy for the treatment of pectus carinatum using an adjusted Haller Index (HI) measurement calculated from 3D body scan (BS) images.

Methods: Pediatric patients with pectus carinatum were treated with either compressive orthotic bracing or observation. An adjusted BS Haller index (HI) was calculated from serial 3D BS images obtained on all patients.

A multicenter, open-label, observational study of testosterone gel (1%) in the treatment of adolescent boys with klinefelter syndrome or anorchia.

Purpose: To assess the safety and clinical outcomes of 6-month treatment with testosterone gel 1% therapy in adolescent boys with primary hypogonadism resulting from Klinefelter syndrome (KS) or anorchia.

Methods: This was a subgroup analysis of a multicenter, open-label study of adolescent boys (N = 86) with delayed puberty who received .5-5.

Site of initial diabetes education does not affect metabolic outcomes in children with T1DM.

Objective: To determine the difference in metabolic outcomes at 1 and 2 yr post type 1 diabetes mellitus (T1DM) diagnosis in children depending on the site of initial diabetes education: inpatient, vs. outpatient, vs. mixed locations.

A predictive model for SIVH risk in preterm infants and targeted indomethacin therapy for prevention.

Prophylactic indomethacin may decrease Severe Intraventricular Hemorrhage (SIVH). Our goal was to develop a predictive model for SIVH using parameters available by six hours of age. De-identified data for preterm infants born ≤ 34 weeks gestational age was abstracted from Vermont Oxford Network database.

Efficacy of clonidine versus phenobarbital in reducing neonatal morphine sulfate therapy days for neonatal abstinence syndrome. A prospective randomized clinical trial.

Objective: To compare the efficacy of clonidine versus phenobarbital in reducing morphine sulfate treatment days for neonatal abstinence syndrome (NAS).

Study Design: Prospective, non-blinded, block randomized trial at a single level III NICU (Neonatal Intensive Care Unit). Eligible infants were treated with a combination of medications as per protocol.

Inflammation-initiating illnesses, inflammation-related proteins, and cognitive impairment in extremely preterm infants.

Neonatal inflammation is associated with perinatal brain damage. We evaluated to what extent elevated blood levels of inflammation-related proteins supplement information about the risk of impaired early cognitive function provided by inflammation-related illnesses. From 800 infants born before the 28th week of gestation, we collected blood spots on days 1, 7 and 14, for analysis of 25 inflammation-related proteins, and data about culture-positive bacteremia, necrotizing enterocolitis (Bell stage IIIb), and isolated perforation of the intestine, during the first two weeks, and whether they were ventilated on postnatal day 14.

Necrotizing enterocolitis and the role of anemia of prematurity.

Necrotizing enterocolitis (NEC) is one of the most common surgical diseases of preterm infants, with significant short- and long-term morbidity and mortality. Although the etiology of NEC remains elusive, multiple factors adversely affecting the intestinal mucosal integrity of preterm infants are known to be associated with NEC. Anemia and red blood cell (RBC) transfusion-related gut injury have been shown to have strong correlation with NEC.

Surgical management of pediatric adhesive bowel obstruction.

Introduction: The objective of this study was to analyze a population-based database for recent trends in surgical management of pediatric adhesive bowel obstruction and compare open versus laparoscopic lysis of adhesions (LOA).

Subjects And Methods: Pediatric adhesive bowel obstruction cases were identified in the Kids' Inpatients Database from 1997, 2000, 2003, 2006, and 2009. Data analysis included patients' demographics, hospital variables, length of stay (LOS), and total hospital charges (THC).

Complementary and alternative medicine in children: an analysis of the recent literature.

Purpose Of Review: Although many publications have documented the use of complementary and alternative medicine (CAM) in children and adolescents, most have lacked the scientific rigor to establish clear benefits over so-called conventional medicine. We reviewed the literature published in the past year to identify the types of CAM most often studied in children, the variety of conditions to which these modalities are applied, and the methodologies used in the articles exploring the most prevalent CAM modalities.

Recent Findings: We identified 111 published articles on CAM use in children in 2011.

Missed opportunities in the treatment of pediatric appendicitis.

Introduction: This study sought to evaluate the outcomes of in-hospital delay and determine associated co-morbidities in the treatment of pediatric acute appendicitis.

Methods: This was a retrospective analysis of the national inpatient sample from 2000 to 2008. Immediate treatment was defined as treatment in hospital day 0 or 1.

A novel CaSR mutation presenting as a severe case of neonatal familial hypocalciuric hypercalcemia.

Background: Familial Hypocalciuric Hypercalcemia (FHH) is a generally benign disorder caused by heterozygous inactivating mutations in the Calcium-Sensing Receptor (CaSR) gene resulting in altered calcium metabolism.

Objective: We report a case of unusually severe neonatal FHH due to a novel CaSR gene mutation that presented with perinatal fractures and moderate hypercalcemia. CASE OVERVIEW: A female infant was admitted at 2 weeks of age for suspected non-accidental trauma (NAT).

Is partial colectomy the operation of choice in pediatric Clostridium difficile colitis?

Purpose: This study examined the national trends in incidence and surgical management of pediatric Clostridium difficle colitis (CDC) hospitalizations.

Methods: This was a cross-sectional Nationwide Inpatient Sample (NIS) analysis of pediatric CDC from 2000 to 2008. Data analysis included patient demographics, procedures, length of stay (LOS), total hospital charges (THC), and in-hospital mortality.

Exercise intolerance in obese children--is it asthma?

This is a pilot study designed to examine the frequency of asthma in obese children who have exertional dyspnea. Obese children who complained of breathlessness with exercise and who denied asthma were invited to enroll. If there was evidence of airflow limitation on spirometry, nebulized albuterol was administered and spirometry was repeated.

Condom availability program in an inner city public school: effect on the rates of gonorrhea and chlamydia infection.

Purpose: Sexual activity and sexually transmitted infection (STI) rates are high in adolescents. In this study, we sought to determine whether the initiation of a school-based condom availability program was associated with a decrease in STI rates.

Methods: We compared the rates of STIs in 15-19-yr-olds reported to the Massachusetts Department of Public Health for the 3 years before and after a condom availability program was introduced in Holyoke, MA, as compared with a similar city, Springfield, MA, which did not have such a program.

Association of necrotizing enterocolitis with anemia and packed red blood cell transfusions in preterm infants.

Objective: To determine association of anemia and red blood cell (RBC) transfusions with necrotizing enterocolitis (NEC) in preterm infants.

Study Design: A total of 111 preterm infants with NEC ≥ stage 2a were compared with 222 matched controls. In all, 28 clinical variables, including hematocrit (Hct) and RBC transfusions were recorded.

Bicalutamide plus anastrozole for the treatment of gonadotropin-independent precocious puberty in boys with testotoxicosis: a phase II, open-label pilot study (BATT).

Objective: To evaluate the efficacy, tolerability, and pharmacokinetics of bicalutamide plus anastrozole in young males with testotoxicosis.

Methods: This was a multicenter, open-label, single-arm, 12-month, Phase II pilot trial in 14 males (2-9 years) with testotoxicosis treated with bicalutamide (12.5, 25, 50, or 100 mg) and anastrozole (0.

Perinatal detection of gallstones in siblings.

Infant and pediatric cholelithiases are well-recognized conditions, thought to be predisposed to by several factors. Fetal cholelithiasis by comparison is a rare finding, and little is known about the natural history and clinical significance of echogenic foci in the fetal gallbladder. The occurrence of fetal gallstones has not been reported among siblings.

Glucose meters: a review of technical challenges to obtaining accurate results.

Glucose meters are universally utilized in the management of hypoglycemic and hyperglycemic disorders in a variety of healthcare settings. Establishing the accuracy of glucose meters, however, is challenging. Glucose meters can only analyze whole blood, and glucose is unstable in whole blood.

High flow nasal cannulae therapy in infants with bronchiolitis.

Objectives: To determine whether the introduction of heated humidified high-flow nasal cannulae (HFNC) therapy was associated with decreased rates of intubation for infants <24 months old with bronchiolitis admitted to a pediatric intensive care unit (PICU).

Study Design: A retrospective chart review of infants with bronchiolitis admitted before and in the season after introduction of HFNC.

Results: In the season after the introduction of HFNC, only 9% of infants admitted to the PICU with bronchiolitis required intubation, compared with 23% in the prior season (P=.