Pediatric Medicine
http://hdl.handle.net/1803/9959
2024-03-28T14:43:12ZResearching the Experiences of Children with Cancer: Considerations for Practice
http://hdl.handle.net/1803/10228
Researching the Experiences of Children with Cancer: Considerations for Practice
Boles, Jessika; Daniels, Sarah
Children and adolescents with cancer often participate in medical and psychosocial research throughout their diagnosis and treatment. Furthermore, this involvement frequently extends into the survivorship period. Sometimes referred to as "doubly vulnerable" research participants, children and adolescents with cancer are not only minors, but also minors facing significant medical, developmental, and psychosocial stressors associated with chronic illness. Thus, it is important to exercise care in designing and conducting research with this population; however, these considerations have not been adequately addressed in pediatric healthcare literature. Therefore, the purpose of this review is to describe the research preferences and experiences of children and adolescents with cancer to identify techniques for supporting this population as research participants. By incorporating developmentally appropriate, context-specific, and child-centered adjustments, researchers can help children and adolescents with cancer effectively and meaningfully describe their illness experiences while also developing a positive outlook on future research participation.
2019-08-01T00:00:00ZAgreement Between Two Procalcitonin Assays in Hospitalized Children
http://hdl.handle.net/1803/10004
Agreement Between Two Procalcitonin Assays in Hospitalized Children
Katz, Sophie E.; Sartori, Laura F.; Szeles, Andras; McHenry, Rendie; Stanford, J. Eric; Xu, Meng; Colby, Jennifer M.; Halasa, Natasha; Williams, Derek J.; Banerjee, Ritu
Introduction Agreement between available procalcitonin (PCT) assays is unclear. We sought to compare concordance between Roche and bioMerieux PCT assays using pediatric samples. Methods We evaluated 213 plasma samples from 208 children. We tested each sample on both the Roche and bioMerieux PCT platforms. Results At ranges < 2 mu g/L, the Roche platform had a mean negative bias of 0.13 mu g/L versus the bioMerieux platform. This bias resulted in PCT levels that crossed accepted cut points in 12.7% of patients. Conclusions PCT levels measured on either platform are similar, especially at PCT ranges used for antibiotic decision-making algorithms. Funding This work was supported by an investigator-initiated research agreement through bioMerieux and by the National Institute of Allergy and Infectious Diseases Childhood Infection Research Program (ChIRP), National Institute of Health and the National Center for Advancing Translational Sciences of the National Institute of Health.
2019-09-01T00:00:00ZLonger Breastfeeding Associated with Childhood Anemia in Rural South-Eastern Nigeria
http://hdl.handle.net/1803/9962
Longer Breastfeeding Associated with Childhood Anemia in Rural South-Eastern Nigeria
Buck, Sean; Rolnick, Kevin; Nwaba, Amanda A.; Eickhoff, Jens; Mezu-Nnabue, Kelechi; Esenwah, Emma; Mezu-Ndubuisi, Olachi J.
Introduction. Child mortality rate in sub-Saharan Africa is 29 times higher than that in industrialized countries. Anemia is one of the preventable causes of child morbidity. During a humanitarian medical mission in rural South-Eastern Nigeria, the prevalence and risk factors of anemia were determined in the region in order to identify strategies for reduction. Methods. A cross-sectional study was done on 96 children aged 1-7 years from 50 randomly selected families. A study questionnaire was used to collect information regarding socioeconomic status, family health practices, and nutrition. Anemia was diagnosed clinically or by point of care testing of hemoglobin (Hb) levels. Results. 96 children were selected for the study; 90 completed surveys were analyzed (43% male and 57% females). Anemia was the most prevalent clinical morbidity (69%), followed by intestinal worm infection (53%) and malnutrition (29%). Mean age (months) at which breastfeeding was stopped was 11.8 (+/- 2.2) in children with Hb <11mg/dl (severe anemia), 10.5 +/- 2.8 in those with Hb = 11-11.9mg/dl (mild-moderate anemia), and 9.4 +/- 3.9 in children with Hb >12mg/dl (no anemia) (P=0.0445). Conclusions. The longer the infant was breastfed, the worse the severity of childhood anemia was. Childhood anemia was likely influenced by the low iron content of breast milk in addition to maternal anemia and poor nutrition. A family-centered preventive intervention for both maternal and infant nutrition may be more effective in reducing childhood anemia and child mortality rate in the community.
2019-01-01T00:00:00ZRandomized Controlled Trial of the Safety and Immunogenicity of Revaccination With Tetanus-Diphtheria-Acellular Pertussis Vaccine (Tdap) in Adults 10 Years After a Previous Dose
http://hdl.handle.net/1803/9961
Randomized Controlled Trial of the Safety and Immunogenicity of Revaccination With Tetanus-Diphtheria-Acellular Pertussis Vaccine (Tdap) in Adults 10 Years After a Previous Dose
Decker, Michael D.
Background. Reduced-antigen-content tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is recommended in many countries for boosting immunity in adolescents and adults. Although immunity to these antigens wanes with time, currently available Tdap products are not labeled for repeat administration in the United States.
Methods. We performed an observer-blinded, randomized controlled trial in 1330 adults aged 18 to <65 years who received either the Tdap (n = 1002) or tetanus-diphtheria (Td) (n = 328) vaccine 8 to 12 years after a dose of Tdap vaccine administered previously. Solicited adverse events following immunization were documented for 7 days after vaccination, and serious adverse events and adverse events of medical significance were documented for 6 months after vaccination. Levels of antibodies against component vaccine antigens were measured before and 1 month after vaccination.
Results. A solicited adverse event was reported by 87.7% of Tdap and 88.0% of Td vaccine recipients. We found no significant differences in the rates of injection-site reactions, systemic reactions, or serious adverse events between the vaccine groups. A robust antibody response to each pertussis antigen in the Tdap-vaccinated group was found; postvaccination-to-prevaccination geometric mean antibody concentration ratios were 8: 1 (pertussis toxoid), 5.9 (filamentous hemagglutinin), 6.4 (pertactin), and 5.2 (fimbriae 2 and 3). Postvaccination geometric mean concentrations of tetanus antibody (4.20 and 4.74 IU/mL, respectively) and diphtheria antibody (10.1 and 12.6 IU/mL, respectively) were similar in the Tdap and Td groups, and the rates of seroprotection against tetanus and diphtheria were >99% in both groups.
Conclusions. A second dose of Tdap vaccine in adults approximately 10 years after a previous dose was well tolerated and immunogenic. These data might facilitate consideration of providing Tdap booster doses to adults.
Only Vanderbilt University affiliated authors are listed on VUIR. For a full list of authors, access the version of record at https://academic.oup.com/jpids/article/8/2/105/4845935
2019-06-01T00:00:00Z