Did we find the cause of SIDS?: A critical review of “Butyrylcholinesterase is a potential biomarker for SIDS”

Teaching Rounds / December 19, 2022

by Hawa Tunkara, MD (’23)
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Health Equity carries many definitions, but a central theme is: having equal opportunity to live a healthy life 12345.  Physicians often find themselves taking care of a patient whose health is a product of factors they cannot not exactly control. We can all likely think of a patient whose social circumstance created barriers in their treatment plan. We are trained to take care of the patient in front of us. However, if healthy equity aligns with our work where is our place to tackle the structures that make our patient’s sick?

On the road towards Health Equity: finding an intersection between public health and medicine

Brown Around Town: Community Advocacy, Teaching Rounds / December 19, 2022

by Hawa Tunkara, MD (’23)
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Health Equity carries many definitions, but a central theme is: having equal opportunity to live a healthy life 12345.  Physicians often find themselves taking care of a patient whose health is a product of factors they cannot not exactly control. We can all likely think of a patient whose social circumstance created barriers in their treatment plan. We are trained to take care of the patient in front of us. However, if healthy equity aligns with our work where is our place to tackle the structures that make our patient’s sick?

Growth Attenuation Therapy in Children with Severe Physical and Cognitive Disabilities

Diving Deep in the Ocean State: Hasbro Electives / June 2, 2022

by Julia R. Donner, MD (’23)
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The goal of therapy for Ashley’s family and of those like hers is to prolong care time at home within the family and make this care more feasible to prevent transition to facilities. Lifting and transferring of children becomes more challenging the larger they grow and formation of bed sores and other side effects of being sedentary become a larger issue with increasing size. Growth attenuation could potentially prevent these effects and allow for better quality of life for these children as they age and are able to remain at home. 

HORMONES AND THE HEART

Diving Deep in the Ocean State: Hasbro Electives / January 21, 2022

Julia Donner, MD (’23)
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Prolongation of QT interval carries increased risk for sudden life threatening arrythmias, specifically torsades de pointes (TdP) and sudden cardiac death (SCD). Female gender is a risk factor for arrythmias, specifically drug related TdP, and both endogenous and exogenous sex hormones affect the QT interval. The impact of gender and gonadal steroids on cardiac rhythm and arrhythmias is recognized and is more prominent in females than in males. There is a higher propensity towards arrhythmia in females than males and rate corrected QT intervals are longer in females than males. While QTc intervals are longer in women than in men, this difference only becomes apparent after puberty suggesting that sex hormones may be responsible. In addition, progesterone, not estrogen has dominant effect on ventricular repolarization in women. Androgens are known to be protective and higher serum progesterone concentrations may be protective against drug-induced QT interval lengthening. 

Childhood Obesity in COVID-19: Ways to Counsel

Teaching Rounds / January 10, 2022

by Leslia Gonzalez (’22)
reviewed by Celeste Corcoran
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Childhood obesity has been a growing problem for many years. The COVID pandemic has unfortunately exacerbated this. A study published in JAMA that utilized the Kaiser Permanente Southern California population found an increase in childhood obesity across all ages, with the largest being within the age group of 5-11 yo. There was an increase of approximately 9%. We have seen this trend amongst our patient population as well.

OUCH MY BACK! Spondylolysis in the Pediatric Population

Teaching Rounds / January 10, 2022

by Maya Spencer (’22)
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Spondylolysis is a stress fracture that occurs within the vertebrae, typically at the pars interarticularis. When the fracture occurs bilaterally and completes all the way through the bone this can progress to spondylolisthesis, where the vertebrae slides anteriorly over the bone below it. As children are becoming more active in sports at an earlier age with a higher intensity of practice this is becoming an increasingly common condition in the pediatric population.

IT TAKES A VILLAGE: Community Approach to Preventing Child Abuse

Diving Deep in the Ocean State: Hasbro Electives / August 26, 2021

by Greg Lopez (’24)
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If we can identify community risk factors that contribute to higher rates of child maltreatment, we do our kids a disservice if we do not actively confront those issues. Thinking upstream widens the scope of possible solutions, as any approach that seeks to reduce poverty or make communities safer becomes viable. Advocating for causes like universal healthcare, increased wages, and more affordable housing would all directly impact risk factors of child maltreatment by providing socioeconomic benefits to families and communities. These broader efforts, in conjunction with existing targeted interventions, provide a truly comprehensive approach to addressing child maltreatment and ensure that we are doing everything we can to keep kids safe.

HEART ON FIRE: Post-COVID Vaccine Myocarditis

Diving Deep in the Ocean State: Hasbro Electives / August 2, 2021

by Torie Quinn, DO (’23)
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n between the Pfizer and Moderna mRNA SARS-CoV-2 vaccines and myocarditis. Recently, Marshall et al. Pediatrics. 2021 illustrated a case series of seven healthy males aged 14-19 who, just like the patient above, presented with chest pain within four days of their second dose of the Pfizer vaccine and were found to have ST elevations, significant troponin leak, cardiac dysfunction and positive cardiac MRI findings. 

While this is fascinating and ever-evolving science, it also highlights what I believe to be one of the most crucial skills in pediatrics – the ability to sift through the literature, look parents in the eyes, and counsel them on how to keep their children safe. It requires shared decision making, anticipatory guidance, and benefit-risk discussions. Because while we as medical professionals view a 12-in-one-million chance of developing myocarditis after receipt of a vaccine that can help curtail a pandemic as a significant benefit, parents will understandably focus on the risk of their child being one of those 12.