Impact of Maternal HbA1c Levels ≤6% and Race in Nondiabetic Pregnancies on Birthweight and Early Neonatal Hypoglycemia.

Objective: To evaluate whether pregnancy glycated hemoglobin (HbA1c) levels of ≤6% and maternal race impacts neonatal hypoglycemia and birthweight, and whether diabetes and beta blocker use during pregnancy additively impacts neonatal outcomes.

Study Design: Retrospective chart review of 4769 infants born at ≥34 weeks; 21 482 glucose measurements were assessed. Predefined groups were infants born to mothers without documented pregnancy conditions (group N), prenatal exposure of beta blockers (group B), diabetes (group D), or both (group DB).

Participation in a Fruit and Vegetable Prescription Program for Pediatric Patients is Positively Associated with Farmers' Market Shopping.

: The primary objective was to investigate the association between participation in a farmers' market fruit and vegetable prescription program (FVPP) for pediatric patients and farmers' market shopping. : This survey-based cross-sectional study assessed data from a convenience sample of 157 caregivers at an urban pediatric clinic co-located with a farmers' market. Prescription redemption was restricted to the farmers' market.

Umbilical Cord Blood Lead Level Disparities between Flint and Detroit.

Objective: The lead-in-water impact of the Flint water crisis on the youngest and most neurodevelopmentally vulnerable population was largely unknown. The objective of this study was to investigate and compare cord blood lead levels (CBLLs) in newborns in Flint, Michigan, after the Flint water crisis, to a group of Detroit newborns.

Study Design: Mothers of 99 Flint newborns were surveyed about potential lead exposures.

Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program.

Public health recommendations suggest limiting child consumption of fruit juice in favor of whole fruit due to juice's high sugar content, lack of fruit fiber, and potential for excess intake. However, replacing juice with whole fruit may be particularly challenging for low-income and minority children, who report the highest intake of 100% juice. To address access and affordability challenges among low-income children, researchers partnered with pediatricians in an urban food desert community, to introduce a fruit and vegetable prescription program (FVPP) that provided a $15 prescription for fresh produce to every child during each office visit.

Caregiver Experiences With an Innovative Farmers' Market Incentive Program for Children in Flint, Michigan.

An innovative farmers' market incentive program designed specifically for children was implemented to address persistent challenges with accessing fresh, nutrient-rich foods in a food desert community. The current study sought to qualitatively examine caregiver perceptions of the incentive program. Following distribution of farmers' market incentives to all children (ages 0 to 15 years) at 43 Flint-area early childcare facilities and elementary schools, researchers conducted semistructured interviews with 37 caregivers (mean age = 39.

Fruit and Vegetable Prescriptions for Pediatric Patients Living in Flint, Michigan: A Cross-Sectional Study of Food Security and Dietary Patterns at Baseline.

Though fruit and vegetable consumption is essential for disease prevention and health maintenance, intake among children fails to meet dietary recommendations. Limited access to and the affordability of fresh produce, particularly among low-income youth, are barriers to adequate intake. To address these challenges, researchers and pediatricians in Flint, Michigan, expanded a successful fruit and vegetable prescription program that provides one $15 prescription for fresh fruits and vegetables to every child at every office visit.

Continuous pulse oximetry and respiratory rate trends predict short-term respiratory and growth outcomes in premature infants.

Background: To examine the correlation between interval vital signs recorded by nursing staff and continuous monitor recordings, and to determine whether aggregated monitor recordings can better predict impending escalation of respiratory support in premature infants.

Method: Preterm infants on noninvasive respiratory support or room air (RA) were prospectively enrolled. Nursing-and monitor-recorded pulse oximetry (SpO2) and respiratory rates (RR) data were recorded daily.

Skull osteomyelitis as a rare complication of cat scratch disease.

, the causative agent of cat scratch disease (CSD), is one of the most common causes of regional lymphadenitis in children. Other less common manifestations of infection including fever of unknown origin, neuroretinitis, and osteomyelitis are being increasingly recognized. We describe a 3-year-old female with a recent history of typical CSD involving lymph nodes who developed osteomyelitis of the skull, a very rarely recognized complication of this infection.

My tummy hurts - a case report of abdominal pain and macrocytic anemia caused by hypothyroidism.

Unlabelled: A 6-year-old female presented with chronic intermittent abdominal pain for 1 year. She underwent extensive investigation, imaging and invasive procedures with multiple emergency room visits. It caused a significant distress to the patient and the family with multiple missing days at school in addition to financial burden and emotional stress the child endured.

Clinical Hypnosis, an Effective Mind-Body Modality for Adolescents with Behavioral and Physical Complaints.

Mind-body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t'ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind-body tool that serves as an adjunct to conventional medical care for the adolescent patient. Clinical hypnosis specifically uses self-directed therapeutic suggestions to cultivate the imagination and facilitate the mind-body connection, leading to positive emotional and physical well-being.

An Exploration of Behavioral Health Productivity and Billing Practices Within Pediatric Primary Care.

OBJECTIVES : To provide descriptive information on behavioral health (BH) productivity and billing practices within a pediatric primary care setting. METHODS : This retrospective investigation reviewed 30 months of electronic medical records and financial data. RESULTS : The percent of BH provider time spent in direct patient care (productivity) was 35.

Adherence to hydroxyurea medication by children with sickle cell disease (SCD) using an electronic device: a feasibility study.

Adherence to hydroxyurea (HU) is a significant modifying factor in sickle cell vaso-occlusive pain. We conducted a study using an electronic medication container-monitor-reminder device (GlowCap™) to track adherence and determine whether use of this device affected rates of HU adherence. Subjects were regular attendees to our clinic.

Feasibility and Perceptions of Cell Phone-Based, Health-Related Communication With Adolescents in an Economically Depressed Area.

We examined the feasibility and perception of cell-based (texting, voicemail [VM], and email/social media), health-related communication with adolescents in Genesee County, MI, where 22% reside below the poverty level. Results of an anonymous survey found that 86% of respondents owned a cell phone, 87% had data, 96% texted, 90.5% emailed/used social media, and 68% had VM.

Elevated Blood Lead Levels in Children Associated With the Flint Drinking Water Crisis: A Spatial Analysis of Risk and Public Health Response.

Objectives: We analyzed differences in pediatric elevated blood lead level incidence before and after Flint, Michigan, introduced a more corrosive water source into an aging water system without adequate corrosion control.

Methods: We reviewed blood lead levels for children younger than 5 years before (2013) and after (2015) water source change in Greater Flint, Michigan. We assessed the percentage of elevated blood lead levels in both time periods, and identified geographical locations through spatial analysis.

Pain management trend of vaso-occulsive crisis (VOC) at a community hospital emergency department (ED) for patients with sickle cell disease.

Pain management at the emergency department (ED) for vaso-occulsive crisis (VOC) for patients with sickle cell disease has not been optimum, with a long delay in giving the initial analgesic. We conducted a retrospective survey over a 7-year period to determine our ED's timing in giving pain medication to patients with VOC as a quality improvement project. We compared different periods, children vs adults, and the influence of gender in the analgesic administration timing.

Forme Fruste of HLH (haemophagocytic lymphohistiocytosis): diagnostic and therapeutic challenges.

Infants and young children often present with a persistent febrile episode, sick appearance and negative infectious disease work-up. These patients present serious diagnostic and therapeutic problems to those who provide medical care, particularly since these children are clinically sick. We present a 13 month old child who presented with this clinical challenge.

Postinduction Supportive Care of Pediatric Acute Myelocytic Leukemia: Should Patients be Kept in the Hospital?

Children with AML become profoundly neutropenic while they undergo remission induction chemotherapy. It is unknown whether these children should be kept in the hospital while they are severely neutropenic to prevent life-threatening complications associated with neutropenia and reduce fatality. We at our institution routinely discharge patients after completing remission induction chemotherapy in the presence of profound neutropenia, unless it is clinically contraindicated.

Acute haemolytic anaemia and myolysis due to G6PD deficiency.

A 2-year-old African-American male patient with sickle cell trait developed cough, red coloured urine, pallor and fatigue. The patient was hospitalised. Diagnostic workup showed that he was glucose 6 phosphate dehydrogenase (G6PD) deficient in erythrocytes.

A rapid increase in the normal white cell counts without blasts as the initial presentation of T-cell acute lymphoblastic leukaemia.

A 5-year-old girl with multiple enlarged cervical lymph nodes consistent with Epstein-Barr virus infection showed a rapid increase in the white blood cell counts (myeloid cells and lymphocytes) without blasts over a week period. Bone marrow evaluation performed after a week's observation unexpectedly showed replacement of the marrow with T lymphoblasts. A presentation of T-cell acute lymphoblastic leukaemia (T-ALL) in this fashion is very unusual.