2021 PEDIATRIC RESEARCH SYMPOSIUM - May 11
University of Michigan/Michigan Medicine Department of Pediatrics
Welcome to the MM Department of Pediatrics 'Research Day' highlighting research in pediatric/children's health medicine at the University of Michigan.
Symposium (virtual) Activities:
ANNUAL V. OPIPARI LECTURE (Grand Rounds)
Linda M. McAllister-Lucas, MD/PhD -
Chasing the MALT1 proto-oncoprotein: perspectives on a career in pediatric research.
Join Zoom Meeting: https://umich-health.zoom.us/j/93081397249?pwd=NGs3VTV6dE9qMURHdEhCbmZFQW9hdz09 (Meeting ID: 930 8139 7249 |Passcode: 662976)
VIRTUAL POSTER SESSION: (you are here)
This virtual poster session, which begins at 12:00 Noon, features work by students, residents, fellows, staff, and faculty. The posters/abstracts are numbered and categorized in tracks (basic science, clinical investigation, health services research, and quality improvement, medical education). To attend a virtual poster discussion, click on the 'chat' button during the poster session (12-1pm, May 11). A few posters feature a pre-recorded video presentation. List by author / List by #
PLATFORM/ORAL PRESENTATIONS: (click here for agenda)
Join Zoom Meeting: https://umich.zoom.us/j/93262954069
Meeting ID: 932 6295 4069
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More info: https://medicine.umich.edu/dept/pediatrics/research/annual-research-symposium
Filter displayed posters (89 keywords)
01: DEVELOPMENT OF A MOUSE MODEL OF HUMAN CORONAVIRUS NL63 (HCOV-NL63) INFECTION
J.K. Bentley, M. Han, C. Stroupe, H. Breckenridge, A. Mello, S. Jazaeris, A. Goldsmith, S.C. Baker, C.N. Lumeng, and M.B. Hershenson
02: ITACONATE INHIBITS THE GROWTH OF NONTUBERCULOUS MYCOBACTERIUM
Paul Breen1 and Lindsay Caverly1
03: GELSOLIN ATTENUATES NEONATAL HYPEROXIA-INDUCED PULMONARY INFLAMMATION AND HYPOALVEOLARIZATION: IMPLICATIONS FOR NOVEL TREATMENT OF BPD
Cui TX; Zhang YJ; Carson A; Popova AP
04: IDENTIFICATION OF CELL-SPECIFIC TRANSCRIPTS IN BRAIN REGIONS IMPORTANT FOR ENERGY HOMEOSTASIS
AG Diamant1, LD Faulkner1, A Rupp2, IE Gonzalez1, C Lu1, DP Olson1
05: TRANSCRIPTIONAL PROFILING OF THE RESPONSE TO THE TRICHLOROETHYLENE METABOLITE S-(1,2-DICHLOROVINYL)-L-CYSTEINE REVEALED ACTIVATION OF THE EIF2Α/ATF4 INTEGRATED STRESS RESPONSE IN TWO IN VITRO PLACENTAL MODELS
E. R. Elkin1, K. M. Bakulski2, J. A. Colacino1&3, D. Bridges3, B. A. Kilburn3, D. R. Armant3 & R. Loch-Caruso1
Conclusion: This study provides further insights into the mechanism of DCVC-induced cytotoxicity in placental cells by revealing the involvement of a specific stress signaling pathway.
06: LINC00402 IS A NOVEL REGULATOR OF ALLOGENEIC T CELL FUNCTION AND T CELL RECEPTOR SIGNAL TRANSDUCTION
D.C. Peltier1, S. Pitchiaya2, V. Ravikumar3, S.C. Wood4, K. Oravecz-Wilson5, Y. Sun5, A. Rao3, A.M. Chinnaiyan2, D. R. Goldstein4, and P. Reddy5
Methods/Results: Using multiple in vitro and in vivo laboratory models as well as T cells from two independent HSCT and one cardiac transplantation cohort, we found that LINC00402 was rapidly down-regulated upon T cell activation and was preserved by inhibiting T cell activation with multiple clinically relevant small molecule inhibitors. Functionally, depletion of LINC00402 using either anti-sense oligonucleotides or electroporation of CRISPR/Cas9 ribonucleoprotein complexes inhibited the proliferation of allo-T cells. Mechanistically, LINC00402 enhanced RAS activation, MEK1/2 activation, ERK1/2 activation, c-FOS nuclear accumulation, and the expression of the ERK/c-FOS-responsive genes IL-2 and EGR-1 following T cell receptor engagement.
Conclusions: These data suggest LINC00402 expression is down-regulated by a negative feedback loop following T cell activation, it promotes allo-T cell proliferation, and it enhances a RAS-MEK-ERK-c-FOS pathway following T cell activation. Because of its T cell-specific expression and impact on allo-T cell responses, targeting LINC00402 may improve outcomes after allo-HSCT and solid organ transplantation.
07: MAGNETICALLY POWERED MICROWHEEL THROMBOLYSIS OF OCCLUSIVE THROMBI IN ZEBRAFISH
Chia-Jui Ku,1 Hao Hao Pontius,1 Dante Disharoon,2 David Marr,2 Keith Neeves,2 and Jordan Shavit1
08: SEPM PROTEASE ACTIVATES THE BLP ENCODED PEPTIDE PHEROMONE IN STREPTOCOCCUS PNEUMONIAE.
Samantha Ratner1, Parker Cole1, John Richardson1, Suzanne Dawid1
09: ID1 IS A KEY TRANSCRIPTIONAL REGULATOR OF DIPG INVASION AND IS TARGETABLE WITH CANNABIDIOL
Viveka Nand Yadav1*, Micah K. Harris1, Dana Messinger1, Chase Thomas1, Jessica R. Cummings1, Tao Yang2, Rinette Woo3, Robert Siddaway4, Martin Burkert5,6, Stefanie Stallard1,Tingting Qin7, Brendan Mullan1, Ruby Siada1, Ramya Ravindran1, Michael Niculcea1, Xuhong Cao8, Maria G. Castro9, Pedro R. Lowenstein9, Rajen Mody1, Arul Chinnaiyan8, Pierre Desprez3, Sean McAllister3, Cynthia Hawkins4, Sebastian Waszak5,6, Sriram Venneti1,8, and Carl Koschmann1*
10: INFLUENCES OF THE MICROBIOME ON DEVELOPMENT OF IMMUNOPROTEASOME ACTIVITY
1C Chang, 1A Vageesh, 2,3K Vendrov, 2,3VB Young, and 1,3JB Weinberg
69: DEVELOPMENT OF ULTRA-RAPID SEQUENCING-BASED ASSAYS FOR INTRA-OPERATIVE H3K27M MUTATION STATUS DETECTION
Jack Wadden1,2, Brandon Newell1, Josh Bugbee1, Robert Dickson3, Carl Koschmann4, David Blaauw2, Satish Narayanasamy1, Reetuparna Das1
11: RETHINKING THE RETINOPATHY OF PREMATURITY EXAMINATION: QUANTITATIVE ANALYSIS OF VEGF IN INFANT TEARS AS A BIOMARKER
J. Magnani1; O. Moinuddin2; M. Pawar2; S. Sathrasala3; C. Besirli2; R. Vartanian1
12: ASTHMA IS ASSOCIATED WITH AN INCREASED RISK OF POOR OUTCOMES IN HOSPITALIZED PATIENTS WITH COVID-19
Amy Ludwig MD1,2, Caryn Brehm MD3, Christopher Fung MD4, Shijing Jia MD3, Jonathan P. Troost PhD5, Laura Leuenberger MD1, Rayan Kaakati MD1, Catherine Tarantine MD1, Ella Christoph MD1, Michael W. Sjoding MD3, Njira Lugogo MD3
13: INCREASED INTERLEUKIN-8 LEVELS AND INTERLEUKIN-1 RECEPTOR ANTAGONIST ARE ASSOCIATED WITH ORGAN SYSTEM FAILURES IN CRITICALLY ILL CHILDREN
Silvia Ardila1, Mary K. Dahmer1, Heidi M. Weeks1, Michael W. Quasney1, Anil Sapru2, Martha A.Q. Curley3, Heidi Flori1
Methods: We tested the association between the number of extrapulmonary organ system failures (OSFs) and levels of IL-8 and IL-1ra in children enrolled in the Genetic Variation and Biomarkers in Acute Lung Injury (BALI, R01HL095410) study, an ancillary study to the RESTORE clinical trial (U01HL086622). We hypothesized that there would be an association between elevated levels of both biomarkers and increased number of OSFs. Children with IL-8 or IL-1ra values on days 0-5 (day 0 is the day of intubation) were included in the analyses. Plasma IL-8 and IL-1ra were assayed by ELISA. Biomarker data was log transformed. Association of biomarker levels with OSFs was analyzed on days 1-4 with organ failure stratified into 0, 1, 2 and 3 or more OSFs. Univariate analysis significance was determined using the Kruskal-Wallis test. Multivariable logistic regression was adjusted for age, sepsis, race/ethnicity and severity of oxygenation defect (as measured by oxygenation index and/or oxygenation saturation index levels).
Results: 432 patients were included in the analysis. Univariate analysis indicated that increasing levels of IL-8 were associated with increasing number of OSFs on days 0-4 (p<0.05). Increasing levels of plasma IL-1ra were associated with increasing number of OSFs (1, 2 and 3 or more) on days 1-4 (p<0.05). Multivariable analyses also showed that increasing IL-8 was independently associated with increasing numbers of OSFs on days 1-4 (p<0.05) as compared to no OSFs. Multivariable analyses showed that increasing IL-1ra levels were independently associated with increased odds of 1 OSF on days 1 and 2 (p<0.05), 2 OSFs on day 2 (p=0.01), and 2 or more OSFs on days 1-4 (p<0.01) as compared to no OSFs.
Conclusions: Plasma IL-8 and IL-1ra levels are increased in pediatric patients with increasing number of OSFs on days 1-4 after acute respiratory failure. These biomarkers may be useful, if measured early and serially in the course of acute respiratory failure, in evaluating the severity of multiple organ dysfunction syndrome in critically ill children. These data also indicate the potential for targeted anti-inflammatory treatment in these patients.
14: CLINICAL CHARACTERISTICS, TREATMENT PATTERNS AND OUTCOMES OF CHILDREN AND ADULTS WITH BIOPSY PROVEN MINIMAL CHANGE DISEASE FROM THE CURE GLOMERULONEPHROPATHY NETWORK STUDY (CureGN)
J.Balk, V.Kurtz, D.Gipson
15: A SURVEY OF CAMP LEADERSHIP TO ASSESS IMMUNIZATION REQUIREMENTS, POLICIES AND PRACTICES IN A NATIONAL COHORT OF SUMMER CAMPS
C Bunke, N Schellpfeffer, B Garst, S Bradin, M, Tracey Gaslin, A Dubin, M Ambrose, AN Hashikawa
16: SERIAL PLASMA AND CSF CELL-FREE TUMOR DNA (CF-TDNA) TRACKING IN DIFFUSE MIDLINE GLIOMA PATIENTS UNDERGOING TREATMENT WITH ONC201
E Cantor1, K Wierzbicki1, RS Tarapore2, K Ravi1, C Thomas1, R Cartaxo1, VN Yadav1, R Ravindran1, AK Bruzek1, J Wadden1, CM Babila1, AR Kawakibi1, S Ji1, J Ramos1, A Paul1, I Wolfe1, M Leonard1, P Robertson1, A Franson1, R Mody1, H Garton1, Y Odia3, C Kline4, NA Vitanza5, S Khatua7, S Mueller6, JE Allen2, S Gardner8, C Koschmann1
17: ASSOCIATION BETWEEN NUMBER OF ADVERSE CHILDHOOD EXPERIENCES, ACADEMIC ACHIEVEMENT, AND EMOTION REGULATION AT KINDERGARTEN IN A NATIONALLY REPRESENTATIVE SAMPLE
K. Chan-Zlatopolsky1, H. Weeks2, N. Kaciroti3, P. Shah1,4
18: PSYCHOLOGICAL FUNCTIONING IN PEDIATRIC PATIENTS WITH SINGLE VENTRICLE CONGENITAL HEART DISEASE: A META-ANALYSIS AND SYSTEMATIC REVIEW
Christine Charpie1, Megan Wilde2, Kate Saylor3, Melissa Cousino2, and Amanda McCormick2
19: MEASLES MUMPS RUBELLA (MMR) VACCINE UPTAKE DURING 2019 MEASLES OUTBREAK IN MICHIGAN
J. Fisher1*; A. Wu1*; E. Yoon1
20: EPIDEMIOLOGY OF HOSPITALIZATIONS FOR ASTHMA IN CHILDREN IN THE UNITED STATES 2006 - 2016
Emily Fretz, MD, Acham Gebremariam, MS, Fola Odetola, MB CHB, MPH
21: LACK OF ASSOCIATION BETWEEN DELIRIUM AND UNPLANNED EXTUBATIONS: A CASE-CONTROL STUDY
M. Gabrial1,H. McCaffery2,R. Eikstadt3,M.K. Dahmer1,N. Malas4
22: PRECISION MEDICINE PROOF OF CONCEPT FOR TNF INHIBITION IN FSGS AND TREATMENT RESISTANT MINIMAL CHANGE DISEASE
D. Gipson1, L. Mariani2, W. Ju2, S. Eddy2, H. Desmond1, V. Kurtz1, R. Eikstadt1, C. Klida1, M. Kretzler2, H. Trachtman3
23: PARENTAL DECISION-MAKING IN PEDIATRICS: HEALTHCARE PROVIDERS’ PERSPECTIVES & ROLES
L. Gruppen1; M. Carley2; M.D. Gardner1; D. Stacey2; K.I. Suorsa-Johnson1; D.E. Sandberg1
24: RESPIRATORY FAILURE AND SHOCK IN A 7-MONTH-OLD BOY
Atchison C1,2, Holleran E1, Garcia A1, Chang YK1, Rappaport, L1
DISCUSSION: The differential diagnosis at presentation includes sepsis, meningoencephalitis, toxic ingestion, non-accidental trauma, inborn error of metabolism, idiopathic pulmonary hypertension, heart failure of any etiology, and pulmonary veno-occlusive disease. Additional history is notable for the patient being exclusively breastfed, with mother consuming 0.5 to 3 pounds of corn starch daily and little additional caloric intake. The patient has rapid improvement after initiation of enteral feeds with standard infant formula and with normalization of cardiac function and improved neurologic status during a 26 day admission. Thiamine level on day 12 of admission was below normal range and the diagnosis of infantile beriberi was made.
THE CONDITION: Infantile beriberi is caused by an inadequate dietary intake of thiamine. Thiamine serves important functions in oxidative energy metabolism, as well as in the production of neurotransmitters, myelin, and nucleic acids. Intracellular thiamine is an important component of the enzyme complexes of pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase, which are responsible for production of the citric acid cycle precursor acetyl-CoA and citric acid cycle component succinyl-CoA, respectively. Without these thiamine-dependent enzymes, cellular energy production shifts towards anaerobic metabolism with resulting increase in cellular pyruvate and lactate.
TREATMENT: Current literature suggests a low threshold for attempting a therapeutic thiamine challenge as a diagnostic tool in the setting of acutely ill infants with clinical concerns for deficiency, with some sources suggesting that intramuscular or slow-push intravenous thiamine infusion be part of routine resuscitation.
25: PEDIATRIC VACCINATION HABITS AMONG ARAB AMERICANS IN SOUTHEAST MICHIGAN
M. A. Ismail1,2,3, M. Kabalan2,4, H. Redah2,4, Z. Bazzi2,4, H. Shamroukh2,4, R. A. Blackwood2,3,5 MD PhD
26: EFFECTS OF THE COVID-19 PANDEMIC ON INPATIENT ADMISSIONS AMONG ADOLESCENTS WITH RESTRICTIVE EATING DISORDERS
Jary, J. M.1; Sturza, J.; Miller, C.A1; Prohaska, N.; Van Huysse, J.3; Bravender, T.2; Otto, A.K.1
27: PREVALENCE OF CONGENITAL HEART DISEASE IN INFANTS WITH CONGENITAL CYTOMEGALOVIRUS INFECTION AT A TERTIARY PEDIATRIC HOSPITAL
N. Kline1; A. McCormick;1 M. Pesch1
28: CHARACTERISTICS OF PEDIATRIC PATIENTS WITH CANDIDEMIA AND RISK FACTORS FOR DISSEMINATED CANDIDIASIS
KE Leopold, EC Lloyd, and JB Weinberg
29: INITIAL IMPACT OF COVID-19 PANDEMIC ON PEDIATRIC ONCOLOGY CARE AND OVERALL EXPERIENCES
S Ngo,1 L Sedig,2 Y Wang,3 M Murillo,3 E Stuchell,3 A Edmonds,2 I Wolfe,3 S Choi,2 R Mody,2 R Jasty-Rao2
30: BILATERAL PELVIC OSTEITIS AND PREMATURE EPIPHYSEAL CLOSURE IN RELATION TO SYSTEMIC ISOTRETINOIN USE IN A TEENAGE MULTI-SPORT ATHLETE
Mara Nydes, MD; Michael Anacker, MD
31: BILIBLANKET UTILIZATION FOR OUTPATIENT TREATMENT OF NEWBORN JAUNDICE
K Orringer1, S Kileny1, K Salada 2,4, E Sahloul2, A Gebremariam3, M Skoczylas5, E Yoon1.
32: ASSESSMENT OF A PROCEDURAL CURRICULUM USING 3D PRINTED AIRWAYS TO TEACH PEDIATRIC FLEXIBLE BRONCHOSCOPY
N. Painter, MD1, T. Saba, MD2
33: PROSPECTIVE STUDY OF CYSTIC FIBROSIS PATIENTS BY LUNG MRI TECHNOLOGY AND CLINICAL MEASURES OF PULMONARY FUNCTION
K. Qussous1, S.Nasr1, L.Caverly1
34: VACCINE ATTITUDES AND HOSPITALIZATION IN PEDIATRICS
J. Sparks1; R. Rannefors2; K. Schwenk3; Y. Feygin4; G. Marshall5
35: STANDARD VS. HIGH-RISK BRONCHIOLITIC PATIENTS: MANAGEMENT AND OUTCOMES
S. Razoky, K. Monroe, MD, MS, E. Jacobson, MD
36: COMPARISON OF TARGETED AGENTS SELECTED BY THE CNS TAP TOOL VERSUS A MOLECULARLY- DRIVEN TUMOR BOARD
H.J. Roberts1, K. Ravi1, B. Marini1, C. Kline2, S. Mueller3, C. Koschmann1, A. Franson1*
37: ORAL FEEDING AS A PREDICTOR OF OUTCOMES AFTER NEONATAL SEIZURES-A NEONATAL SEIZURE REGISTRY STUDY
K. Roberts, MD1; J. Barks, MD1; H. Glass, MDCM, MAS2; R. Shellhaas, MD, MS1, for the Neonatal Seizure Registry.
38: THE IMPACT OF HEMOLYSIS ON VACCINE RESPONSE IN SICKLE CELL DISEASE
Shayan Sengupta MD, Matthew Rees MD, Yuijie Wang, Joy Christensen, Diamond Thomas, Elaina Reese, BreAnna Simpson, Terri Stillwell MD, Sharon Singh MD
39: PRE-OPERATIVE NUTRITIONAL MARKERS AS PREDICTORS OF POST-OPERATIVE NUTRITIONAL STATUS, LOS, AND READMISSION RATES IN PEDIATRIC PATIENTS UNDERGOING HEART TRANSPLANT
J Sill, S Lukich, R Lowery, S Yu, K Schumacher
40: THE HEALTH ECONOMIC IMPACT OF NEPHROTIC SYNDROME IN THE UNITED STATES
C. Simon1, E. Salmon1, H. Desmond1, S. Massengill2, D. Gipson1
41: Multisystem Organ Dysfunction in the Setting of Uncontrolled Systemic Lupus Erythematosus
Alex Sliwicki, M.D.1; Leah Rappaport, M.D.2
Discussion: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that can affect multiple organ systems. Macrophage activation syndrome (MAS), which is a secondary form of hemophagocytic lymphohistiocytosis, is a rare but life-threatening complication of uncontrolled rheumatologic conditions. In this case, a patient with known rheumatologic disease presented with concerning laboratory findings consistent with multisystem organ dysfunction. The initial differential was broad and early determination of a ferritin level was vital in making the diagnosis and shifting attention from septic workup to high dose steroids. Findings consistent with MAS include fever, pancytopenia, elevated transaminases, hypertriglyceridemia, and elevated ferritin. Conclusion: While infection would certainly be high on the differential for a patient with fever and organ dysfunction, for patients with underlying rheumatologic disease Macrophage Activation Syndrome should be considered and early screening ferritin can guide diagnosis and management.
42: INFORMED CONSENT FOR UROGENITAL SURGERY IN PEDIATRIC DIFFERENCES OF SEX DEVELOPMENT: A PROVIDER PERSPECTIVE
K.I. Suorsa-Johnson1; M.D. Gardner1; P. Lee2,3; B.A. Kogan4; S.A. Berenbaum2; D.E. Sandberg1
Objective. This project aimed to examine contemporary informed consent processes.
Design/Method. Members of the Societies for Pediatric Urology (SPU; n=142) and the Pediatric Endocrine Society (PES; n=115) completed an online survey in 2020 about clinical decision-making in DSD, where a section focused on informed consent. A literature review and discussion with key stakeholders generated four statements for inclusion in informed consent documents. Providers were asked to rate their level of agreement (1=Strongly Disagree; 4=Strongly Agree) for statements to be included and whether these were listed on surgical consent forms currently in use. Statements (paraphrased) included: 1) there is an on-going debate whether surgery is in the best interest of the child; 2) genital anomalies may involve multiple procedures to correct; 3) in the future, your child may disagree with their assigned gender and request surgery to reverse the current surgery; and 4) alternatives to the surgical procedure (including rejecting all surgery) have been fully explained.
Results and Conclusions. Mean (SD) agreement scores and uptake (% reporting their practices’ informed consent document includes each statement) were as follows: Ongoing debate m=3.29 (0.65), 39.5%; Multiple procedures m=3.67 (0.55), 54.6%; Gender conflict and surgical reversal m=3.30 (0.64), 38.2%; Alternatives, including no surgery, explained m=3.57 (0.56), 53.4%. Endocrinologists (m=3.55) showed greater agreement with including these statements than Urologists (m=3.38), t(234)=2.61, p=.01. In an area of healthcare where parent-proxy decision-making is contentiously debated, the discrepancy between what providers identify as desirable versus actual practice with regard to informed consent is notable.
43: TRANSGENDER YOUTHS’ SEXUAL HEALTH AND EDUCATION: A QUALITATIVE ANAYLSIS
R. Warwick1; A. Araya2; D. Shumer2; E. Selkie3
44: PROVIDER TESTING PRACTICES FOR CONGENITAL CYTOMEGALOVIRUS: CONSISTENTLY INCONSISTENT
Kate L. Wilson1 and Megan H. Pesch2
45: OUTCOMES AFTER MYECTOMY AND MITRAL VALVE REPAIR IN HYPERTROPHIC CARDIOMYOPATHY
Steven Wilson, MD; Francis Pagani, MD; Sara Saberi, MD
46: VARIATIONS IN OBJECTIVE KNOWLEDGE AMONG DECISION SUPPORT PERSONS OF PATIENTS WITH EARLY STAGE BREAST CANCER
Victoria A. Wytiaz, MD, MA; Christine M. Veenstra, MD, MSHP; Sarah T. Hawley, PhD, MPH
Methods: Patients with stage 0-II breast cancer reported to Georgia and LA SEER registries in 2014-15 and their key decision support person (DSP) were surveyed separately. DSPs were asked 4 objective knowledge questions regarding breast cancer treatment with responses dichotomized into high/low knowledge. Bivariate analyses and multivariable regression models were used to assess associations between DSP knowledge and important DSP characteristics (type of DSP, age, race, education), level of DSP engagement in 3 domains of patients’ decision-making (feeling informed about decisions, extent of and satisfaction with their involvement in decisions, and being aware of patients’ values/preferences), and patient clinical factors (stage, chemotherapy receipt, radiation receipt, type of surgery).
Results: 2502 patients (68% RR) and 1203 eligible DSPs (70% RR) responded. Most DSPs were husbands or daughters. 21% were Latino, 17% were black, 20% had
Conclusions: Objective knowledge about breast cancer treatment was varied among DSPs of patients with breast cancer. Highly engaged DSPs (aware and satisfied) were more likely to have high knowledge, suggesting that involving DSPs may be an untapped mechanism for improving patients’ understanding of treatment options. These finding suggest that DSPs can play a role in improving decision quality in patients, and that interventions focused on decision-making may benefit from modules directed to DSPs as well as patients.
47: MUSLIM PEDIATRIC FASTING PRACTICES AMONG DIABETIC CHILDREN: A MIXED METHOD APPROACH
E. Dabaja1, H. Shihan1, M. Dabaja2, A. Chehimi2, Z. Berry2, M. Elhassan2
70: ENHANCED MYELOID LEUKOCYTES IN OBESE CHILDREN AND ADOLESCENTS AT RISK FOR METABOLIC IMPAIRMENT
Gállego-Suárez C1, Bulan A2, Hirschfeld E3, Wachowiak P2, Abrishami S2, Griffin C2, Sturza J4, Tzau A2, Hayes T2, Woolford SJ3, Lumeng CN5,6, Lee J2,3 and Singer K2,5,6
Objective: We aimed to examine if myeloid leukocyte profiles (monocytes and neutrophils) are associated with metabolic impairment in children and adolescents with obesity, and if sex, age, or race influence this relationship.
Methods: 282 children ages 8–17 were evaluated. Predictor variables were absolute neutrophil counts (ANC), absolute monocyte count, monocyte subtypes and C reactive protein (CRP). Outcome variables were waist circumference, fasting glucose and insulin, HOMA-IR, HbA1c(%) and lipid profiles. Pearson correlation coefficients were used to determine associations between predictor and outcome variables. Wilcoxon two-sample tests were used to evaluate differences by sex.
Results: CRP (p< 0.0001), ANC (p< 0.0018), and classical monocytes [CD14++CD16−] (p=0.05) were significantly higher in children with obesity. CRP, ANC and classical monocytes showed positive correlations with waist circumference, fasting insulin, HOMA-IR and triglycerides. CRP was positively associated with ANC (p=0.05). ANC demonstrated positive correlation with classical monocytes in patients with obesity (p<0.001). Some of these associations were influenced by sex, race, and age.
Conclusions: CRP and myeloid leukocyte populations, specifically classical (pro-inflammatory) monocytes [CD14++CD16-] and absolute neutrophil counts, are associated with metabolic impairment and cardiovascular risk factors in children with obesity, suggesting that these cells may play a critical role in metabolic disease. Race, gender and age interactions between monocytes and metabolic parameters were significant.
48: PARENT ACCEPTANCE OF PEDIATRIC INTEGRATED CARE SURVEY REVISED: RESEARCH IN-PROGRESS
R. Birnbaum, A. Cook, T. Bruni, D. Haggerty, A. Caserta
49: TRANSGENDER HEALTHCARE PERCEPTIONS SHARED THROUGH SOCIAL MEDIA
AC Murphey1, V Stoody2, H Glick1, E Selkie2,3
50: PATTERNS OF PRIMARY CARE, SPECIALTY CARE, AND PREVENTIVE SERVICE USE AMONG PRIVATELY INSURED CHILDREN WITH SICKLE CELL ANEMIA
S Ng1, KP Chua1, K Dombkowski1, S Creary2, S Reeves1
51: PROVIDERS OF AMBULATORY HEALTHCARE IN CHILDREN AND ADOLESCENTS WITH SICKLE CELL ANEMIA
P. Patel1, K. Dombkowski1, S. Reeves1
52: USING STATE PUBLIC HEALTH DATA TO IDENTIFY PERSONS POTENTIALLY ELIGIBLE FOR THE FLINT REGISTRY
Hannah K. Peng1; Marina Goulas2; Kevin J. Dombkowski1
53: THE ASSOCIATION OF SOCIOECONOMIC STATUS AND PEDIATRIC SEPSIS OUTCOMES
K.B. Phelps1; R.P. Barbaro, MD1,2; G.L. Freed2,3; E.F. Carlton1,2
54: UNDERSTANDING THE FAST FOOD EATING HABITS AND CULTURAL TAILORING PREFERENCES OF HISPANIC YOUTH
J. Villegas1, X. Wen1, A. Grabowski1, T. Kowalski-Dobson1, E. Elahi1, J. Bergman1, D. Brown1, X. Zhu1, S. J. Woolford1
55: COMPARING MORTALITY OUTCOMES IN YOUNG ADULTS WITH SEVERE SEPSIS ADMITTED TO PICUS VERSUS MICUS
S. Zakutansky1; E. Carlton2; E. Viglianti3
58: INFANT SAFE SLEEP ANTICIPATORY GUIDANCE IN PEDIATRIC PRIMARY CARE
A Samandur1, D Singer2, P Danziger3, K Orringer3
56: PEDIATRIC CROSS-COVER EMERGENCIES CURRICULUM
T. Broome1; E. Muallem2; K. Levy3
60: USE OF RESIDENT-PREPARED CHALK TALKS TO ENHANCE MEDICAL STUDENT EDUCATION
A. Kendall1; B. Pritz1; E. Jacobson1
57: MEASURING ADHERENCE TO PEDIATRIC OTITIS MEDIA GUIDELINES IN THE MICHIGAN MEDICINE EMERGENCY DEPARTMENT
R. Chouaib1; D. Majed1; N. Sulieman1; M. Bradley1; F. Saad1; T. Hart-Johnson2; R. A. Blackwood2, 3
59: IMPROVING THE EFFICACY OF THE RAPID RESPONSE TEAM (RRT)
M. Pliakas1; D. McKissic1; K. Phelps1,2; A. Mazloom1,2; E. Carlton1,2; L. Rappaport1,3
61: DEVELOPMENT OF GUIDELINES FOR PEDIATRIC BLOOD CULTURE VOLUME AT THE UNIVERSITY OF MICHIGAN
Zoe Raglow, Meredith Sharp, Alison Tribble
62: IMPROVING PATIENT SAFETY FOR PATIENTS WITH TYPE 1 DIABETES ON DILUTED INSULIN: SUPPORTING NURSE AND RESIDENT EDUCATION
L. Reynolds1, A. Garrity1, N Said1, I. Thomas1, J. Lee1
63: SCREENING FOR CELIAC DISEASE IN PATIENTS NEWLY DIAGNOSED WITH TYPE 1 DIABETES – AN INSTITUTIONAL REVIEW
A. Rompca1; G. Lee2
64: PHYSICIAN SURVEY REGARDING PEDIATRIC MUSLIM FASTING IN MICHIGAN
E. Dabaja1; E. Sahloul2; S. Haider1
65: PATIENT UNDERSTANDING AND PERSPECTIVES OF ANTIBIOTICS AND ANTIBIOTIC RESISTANCE FOLLOWING HOSPITAL DISCHARGE
Erica Smith MD, D Giesler MD, L Petty MD, V Chopra MBBS, S Krein, PhD, RN, J Horowitz MA, V Vaughn MD, MSc
66: LESSONS FROM THE FIELD: CHALLENGES OF INITIATING A HUMAN TRAFFICKING PROTOCOL IN SCHOOL-BASED HEALTH CENTERS
V.B. Stoody1; A.L. Kuznia2,3
67: ASSESSING BARRIERS TO CARE AND OPPORTUNITIES FOR IMPROVEMENT IN THE CARE OF PATIENTS AWAITING INPATIENT PLACEMENT IN THE EMERGENCY DEPARTMENT AFTER ADMISSION
Samiksha Tarun1, Jessica Hoffman1, Maria Pliakas1, Julie Barrett1, and Emily Jacobson1
Methods: In March 2020, we surveyed all house officers in the University of Michigan system to assess perceptions about ED boarding. We obtained 171 responses. Of the responses, there was wide range of participants from different fields and levels of training. We received the most responses from internal medicine house officers (n=50), pediatrics (n=35) and emergency medicine (n=19). Training years from one year to greater than five years was evenly represented amongst respondents.
Results: House officers perceived that the care of boarded patients was less safe when compared to patients who were not boarded (p < 0.05). Additionally, other contributing factors identified in the survey included communication barriers, orders that are incorrectly carried out, missed medications, delays in care, and overall differences in expected management of patients among providers of boarded patients.
Conclusions: There are numerous aspects of boarding in the ED that can be improved upon amongst all providers to increase the safety of boarding.
68: ASSESSING THE ACCURACY OF CORD BLOOD CULTURES IN ASYMPTOMATIC, TERM INFANTS
S VanOmen1; A Rompca1; S Tomajko2; S Poley2; R Schumacher2
Objective: This study aimed to determine the accuracy of obtaining cord blood cultures on healthy, asymptomatic term infants on admission to this institution by assessing the false-positive rate, or contamination rate.
Methods: Cord blood cultures were obtained from 119 asymptomatic, term/near term infants from October 2018 to March 2020. All infants had no risk factors for sepsis and remained clinically stable throughout their admission. Cord blood cultures were obtained by two neonatal nurse practitioners. A standardized guideline for obtaining cultures was developed and used.
Results: Cord blood cultures from placental blood were obtained in 118 infants. There were 3 positive cord blood cultures that grew coagulase-negative Staphylococcus, Staphylococcus epidermidis, and Corynebacterium species. All three of these samples were attributed to contamination, due to the nature of the bacteria species that grew and clinical stability of infants from which they were obtained. These findings demonstrated a false-positive rate of 2.5% with 95% CI [0.005, 0.072], which is comparable to the most recent false-positive rate of peripheral blood cultures at this institution (1.5% in 2020, 1.3% in 2019, 1.39% in 2018).
Conclusion: These findings support the accuracy of obtaining blood cultures from cord blood as opposed to drawing blood from newborns on admission. This also allows for a larger blood sample to be obtained, which decreases the false-negative rate as well. These cord blood cultures obtained on healthy, term infants can be used to establish a control rate, with further studies on obtaining cord blood cultures from premature and unstable infants. Use of cord blood for admission labs in these infants has the potential to reduce the amount of blood loss and minimize blood transfusions, which have been associated with decreased risk of intraventricular hemorrhage, retinopathy of prematurity, necrotizing enterocolitis and death2.
1Medeiros PB, Stark M, Long M, Allen E, Grace E, Andersen C. Feasibility and accuracy of cord blood sampling for admission laboratory investigations: A pilot trial. J Paediatr Child Health. 2020 Nov 10. 2Galel S, Fontaine MJ. Hazards of neonatal blood transfusion. Neoreviews. 2006;7(2):e69-e75.