المؤلفون: Kaley Gonzalez, Megan Chang, Natalie L. Davis

المصدر: Section on Breastfeeding Program.

مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, Patient population, Mother's milk, Neonatal intensive care unit, business.industry, Incidence (epidemiology), Intensive care, Pediatrics, Perinatology and Child Health, Medicine, Level iv, business, Socioeconomic status

الوصف: Background/Purpose: Greater use of mother’s milk (MM) is associated with improved outcomes for preterm infants admitted to neonatal intensive care units (NICUs). Racial, mental-health, and socioeconomic disparities exist in provision of MM to preterm infants. Further research is needed to better identify modifiable barriers to providing MM in these high-risk populations. Our Level IV NICU serves a predominantly urban, underserved, low socioeconomic-status patient population, allowing us to better study this important demographic. The objective of this study was to evaluate incidence and predictors of provision of MM to early preterm infants …

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::982498b2d972100e7aa0911e2edb91b1Test
https://doi.org/10.1542/peds.147.3_meetingabstract.327Test

المؤلفون: Monica Mehta, Megan Chang, Lillian Assatourian, Rebecca Carter

المصدر: Pediatrics. 147:887-888

مصطلحات موضوعية: Diplopia, Weakness, medicine.medical_specialty, rhinorrhea, genetic structures, Photophobia, business.industry, Cellulitis, Emergency department, Orbital Cellulitis, medicine.disease, Rash, Dermatology, eye diseases, Anti-Bacterial Agents, Pediatrics, Perinatology and Child Health, medicine, Sore throat, Humans, Orbital cellulitis, medicine.symptom, business, Retrospective Studies

الوصف: Introduction Orbital cellulitis accounts for approximately 2,500 pediatric hospitalizations annually. Although suspicion for orbital cellulitis is high with presenting symptoms of proptosis, conjunctival swelling, diplopia, fever, and leukocytosis, a broad differential diagnosis should be considered. Case Description A previously healthy 8-year-old female presented to the emergency department after her teacher noticed one week of progressive right eye swelling. She endorsed photophobia, painful blurry vision, diplopia, as well as recent rhinorrhea, sore throat, and subjective fevers. She denied eye trauma, headache, dizziness, weakness, or rash. Social history was notable for emigration from Guatemala three years prior and lack of health insurance, though …

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::91e6a905e17459f8076e57b38092775bTest
https://doi.org/10.1542/peds.147.3ma9.887Test

المؤلفون: Megan Chang, Andrew N. Hashikawa, Dianne C. Singer, Alan Sielaff, Stuart Bradin, Amilcar Matos-Moreno, Sarah J. Clark, Anna Daly Kauffman, Matthew M. Davis

المصدر: American Journal of Disaster Medicine. 13:85-95

مصطلحات موضوعية: Adult, Parents, medicine.medical_specialty, Disaster Planning, Special needs, Logistic regression, Young Adult, Household survey, Surveys and Questionnaires, medicine, Humans, Child care, Schools, Communication, Infant, Newborn, Infant, Child Day Care Centers, General Medicine, Awareness, Middle Aged, Attitude, Equipment and Supplies, Child, Preschool, Family medicine, Disaster plan, Psychology, First aid

الوصف: Objective: Children in early learning settings are vulnerable to site-specific emergencies because of physical and developmental limitations. We examined parents’ knowledge of disaster plans in their child’s early learning settings. Methods: In May 2015, we conducted a nationally representative online household survey, including parents of children ages 0-5 years in child care settings. Parents were asked about their center’s disaster plans and key components: evacuation, special needs children, and disaster supplies. Bivariate analyses and logistic regression were conducted to identify factors associated with parental awareness of disaster plans. Results: Overall, 1,413 of 2,550 parents responded (rate = 55 percent). Sample included 1,119 parents of children 0-5 years old, with 24 percent (n = 264) requiring child care. Parents’ reported knowledge of five types of disaster plans: evacuation (66 percent), power outage (63 percent), severe weather (62 percent), lock-down (57 percent), and delayed parent pick-up (57 percent). Only 21 percent reported if plans included all four key components of evacuation (child identification, parent identification, rapid communication, and extra car seats). One-third (36 percent) reported plans accommodating special needs children. Parents’ knowledge of disaster supplies varied: generator (31 percent), radio (42 percent), water (57 percent), food (60 percent), and first aid (82 percent). Parents attending any disaster training events (34 percent) were more likely to be aware of all five types of disaster plans compared with parents who had not attended. Conclusions: Many parents were unaware of disaster plans at their children’s early learning settings. Although few parents attended training events, such participation was associated with higher levels of parental awareness .

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6d71b23aa1e32b58a3921005d0b05e88Test
https://doi.org/10.5055/ajdm.2018.0290Test

المؤلفون: Megan Chang, Meekyung Han, Sadhna Diwan, Kathy Forward, Karly Comfort

المصدر: Journal of Family Studies. 26:441-458

مصطلحات موضوعية: medicine.medical_specialty, Family caregivers, 05 social sciences, Mental illness, medicine.disease, Mental health, Social support, 050902 family studies, medicine, Self care, lipids (amino acids, peptides, and proteins), 0501 psychology and cognitive sciences, 0509 other social sciences, Psychiatry, Psychology, Social Sciences (miscellaneous), 050104 developmental & child psychology, Chinese americans

الوصف: Family caregivers (FCs) of persons with mental illness (PMI) often experience caregiving burdens that contribute to poor mental health. As compared to European-American FCs, Asian-American FCs may ...

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::e89701d93c9770ec10e10e1974338b44Test
https://doi.org/10.1080/13229400.2017.1414704Test

المؤلفون: Venee N. Tubman, Mary E. Natoli, Gladstone Airewele, Jackson Coole, Rebecca Richards-Kortum, Kathryn Kundrod, Megan Chang

المصدر: The Lancet Global Health, Vol 9, Iss, Pp S13-(2021)

مصطلحات موضوعية: medicine.medical_specialty, Newborn screening, Hematology, medicine.diagnostic_test, business.industry, lcsh:Public aspects of medicine, Recombinase Polymerase Amplification, Nucleic acid test, lcsh:RA1-1270, General Medicine, Molecular biology, genomic DNA, Internal medicine, Genotype, Medicine, Globin, business, Genotyping

الوصف: Background Sickle cell anaemia is a common, life-threatening disorder caused by a point mutation in the β globin gene. The high cost and complexity of conventional diagnostic methods limit the scope and sustainability of newborn screening for sickle cell anaemia and other haemoglobin disorders in resource-limited areas. Although several point-of-care tests are commercially available, most are antibody-based tests, which cannot be used in patients who have recently received a blood transfusion. Additionally, very low levels of sickle haemoglobin (HbS) in premature babies and some newborns may cause errors in immunoassays. DNA analysis provides the most reliable approach to diagnose haemoglobin disorders. However, DNA analysis is not currently available at the point of care due to its cost and complexity. Here, we describe a rapid, low-cost nucleic acid test that uses real-time fluorescence to detect the point mutation encoding HbS in one round of isothermal recombinase polymerase amplification. Methods Venous and capillary blood samples were obtained from healthy volunteers who were recruited by word of mouth. Venous blood samples from patients with varying genotypes seen in the Sickle Cell Disease Program at Texas Children's Hematology Center were collected and deidentified under IRB-approved exemption. Genotypes, as determined by qualitative isoelectric focusing combined with quantitative high performance liquid chromatography (HPLC) to confirm a diagnosis, were provided with the blood samples. The assay was evaluated with genomic DNA extracted from a set of blood samples of varying genotypes using the Axxin T8-ISO, a low-cost, field-deployable benchtop fluorimeter. Findings The developed assay demonstrated 100% sensitivity for both the βA globin and βS globin alleles, and 94·7% and 97·1% specificity for the βA globin allele and βS globin allele, respectively (n=91). We also demonstrate a complete sample-to-answer workflow using a two-step lysis method and direct input of lysate into the allele-specific assay, and genotyping of blood samples in an open-source, custom built fluorimeter whose components cost less than US$850. Interpretation This sample-to-answer nucleic acid test has the potential to be adapted to other disease-causing point mutations in genomic DNA. The technology described could streamline diagnosis in resource-limited settings of patients with sickle cell anaemia who have recently undergone a blood transfusion, with a comparable cost to protein-based tests. Funding NIH K23-HL148548-01A1.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::531c5a3463876fb31d92ff1e41948621Test
https://doi.org/10.1016/s2214-109xTest(21)00121-2

المؤلفون: Hsin-Yi Lee, Win Phyu, Taryar Zaw, Megan Chang, Jonathan K. Park

المصدر: Radiology Case Reports
Radiology Case Reports, Vol 12, Iss 1, Pp 102-107 (2017)

مصطلحات موضوعية: lcsh:Medical physics. Medical radiology. Nuclear medicine, medicine.medical_specialty, lcsh:R895-920, medicine.medical_treatment, Case Report, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Embolization, 0302 clinical medicine, medicine.artery, Superior gluteal artery, Biopsy, Medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Interventional radiology, medicine.diagnostic_test, Endovascular, business.industry, food and beverages, Internal iliac artery, Surgery, cardiovascular system, Radiology, business, 030217 neurology & neurosurgery

الوصف: Pelvic traumatic and iatrogenic pseudoaneurysms supplied by the internal iliac artery are very rare but can present with pain, nerve compression, and rupture. Particularly with more chronic pseudoaneurysms, their imaging appearance can be confusing and they can be mistaken for tumors. We present two cases of pelvic pseudoaneurysms supplied by the superior gluteal artery that were initially mistaken for masses and subsequently biopsied. We report the subsequent successful endovascular embolization technique subsequently utilized for both of these cases. A high index of suspicion should be maintained to avoid biopsy of these lesions. In the appropriately selected patient, an endovascular approach may be safely used to perform embolization.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5c5b94b62b1d80165c805379b866fde1Test
http://europepmc.org/articles/PMC5310381Test

المؤلفون: Ofelia A. Alvarez, Zhongbo Hu, Simone Megan Chang, Ramzi T. Younis

المصدر: Blood. 132:4938-4938

مصطلحات موضوعية: Pediatric intensive care unit, Pediatrics, medicine.medical_specialty, Blood transfusion, business.industry, medicine.medical_treatment, Immunology, Exchange transfusion, Cell Biology, Hematology, Phlebotomy, medicine.disease, Biochemistry, Preoperative care, Sickle cell anemia, Obstructive sleep apnea, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, 030212 general & internal medicine, Complication, business

الوصف: Background:The prevalence of obstructive sleep apnea syndrome (OSA) in children with sickle cell disease (SCD) is higher than in the general pediatric population. Adenotonsillectomy involves significantly increased risks in patients with SCD because of the need for general anesthesia,which could induce a vaso-occlusive event. Various preoperative regimens have been suggested to reduce peri-operative risks for SCD patients. Objective: We retrospectively reviewed the perioperative management for pediatric SCD patients undergoing adenotonsillectomy. We sought to identify the optimal preoperative hemoglobin (Hb) level for patients to have lowest risk of post-operative complications. Methods: Children between 1 and 18 years old with SCD including HbSS, HbSC, HbS beta thalassemia (Sβ0 and Sβ+) who underwent adenotonsillectomy from 2007 to 2017 were identified at Holtz Children's Hospital. Patients without these diseases who underwent the procedures were collected as a control. The study was approved by the University of Miami Institutional Review Board (IRB). De-identified data were exported to GraphPad Prism version 5.02 to perform the statistical analyses. Means were analyzed by student t test, rates by Chi-squared test. p < 0.05 is considered statistically significant. Results: Thirty-four patients with SCD (mean 7.1 yrs) and 145 controls (mean 7.0 yrs) were identified with adenotonsillectomy (see Table 1). SCD patients had significant longer hospital stay (2.6 versus 0.9 days, p< 0.001), and higher postoperative complication rates than the control group (20.6% vs 4.0%, p= 0.02). Most of the sickle cell patients' complications were hypoxemia (5 out of 7), except one supraventricular tachycardia and one headache. Four out of 7 patients with pretransfusion (pretrx) Hb level above 10 g/dL received manual exchange transfusion to keep Hb over 10 g/dL. None had complication or PICU stay. When patients' pretrx Hb levels was 9-10 g/dL, 5/8 received transfusion without significant complications, with the goal of not increasing post transfusion Hb over 11.5 g/dL. Most patients with pretrx Hb level 7-9 g/dL received simple blood transfusion. For patients with preoperative Hb level 9-11.5 g/dL, the PICU transfer rate was significantly lower than ones with Hb = 11.5 g/dL (11.5% vs 60%, p=0.04; see Figure 1). Complication rates were also lower in the Hb 9-11.5 g/dL group, but without statistical difference (19.2% vs 40%, p=0.3). Data is limited by small sample size in the SCD group. Conclusion(s): We concluded that for pediatric SCD patients planning for adenotonsillectomy, it is better to keep the posttransfusion Hb level at least above 9 mg/dL but less than 11.5 g/dL before procedure to avoid significant post operational complications. If pretransfusion Hb level is above 9 mg/dL, exchange transfusion by partial phlebotomy or simple transfusion (not to exceed 11.5 g/dL) may be considered. Disclosures No relevant conflicts of interest to declare.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::fedc2b0ed3983a8a3ba53066bc00a229Test
https://doi.org/10.1182/blood-2018-99-119452Test

المؤلفون: Molly Adams, Crystal Gines, Megan Chang, Giselle Staffaroni, Jason Crawford, Amanda Burr

المصدر: The American Journal of Occupational Therapy. 72:7211510198p1-7211510198p1

مصطلحات موضوعية: medicine.medical_specialty, Occupational Therapy, Sensory processing, Autism spectrum disorder, medicine.medical_treatment, Stress (linguistics), medicine, Audiology, Psychology, medicine.disease, Sleep in non-human animals

الوصف: Date Presented 4/20/2018 This project aimed to show the importance of including the sensory processing preferences of parents of children with autism spectrum disorder in family intervention Primary Author and Speaker: Megan Chang Additional Authors and Speakers: Amanda Burr, Giselle Staffaroni, Molly Adams, Crystal Gines, Jason Crawford

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::8c6fb1684733af124406209d9e624ab9Test
https://doi.org/10.5014/ajot.2018.72s1-po6019Test

المؤلفون: Barbara Moran, Stephanie Loh, Sarah Mcdonald, Megan Chang, Diana Nguy, Megan Sadou

المصدر: The American Journal of Occupational Therapy. 72:7211510182p1-7211510182p1

مصطلحات موضوعية: medicine.medical_specialty, Sensory processing, Sleep quality, medicine.medical_treatment, media_common.quotation_subject, Audiology, Sleep in non-human animals, Preference, Poor sleep, Occupational Therapy, medicine, Quality (business), Psychology, media_common

الوصف: Date Presented 4/20/2018 The study showed that it is important for occupational therapy practitioners to address sensory needs in developing sleep education and consultation for community-dwelling older adults. Primary Author and Speaker: Megan Chang Additional Authors and Speakers: Megan Sadou, Stephanie Loh, Sarah Mcdonald, Barbara Moran, Diana Nguy

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::5dba04502ac8ccdf665275e0f217a062Test
https://doi.org/10.5014/ajot.2018.72s1-po4021Test

المؤلفون: Tiffany Shen, Andrea L. Cheville, Jeffrey R. Basford, Megan Chang

المصدر: Supportive Care in Cancer. 21:229-233

مصطلحات موضوعية: Male, medicine.medical_specialty, business.industry, Nursing research, Pain medicine, Cancer, Middle Aged, medicine.disease, United States, Cross-Sectional Studies, Oncology, Neoplasms, medicine, Physical therapy, Humans, Female, Guideline Adherence, Prospective Studies, Practice Patterns, Physicians', Stage iv, business, Fatigue, Aged

الوصف: Fatigue among patients with cancer is prevalent, disabling, and treatable. While fatigue management guidelines have been in place for a decade, their use remains unclear.We surveyed 160 patients with stage IV lung (40), breast (40), colon (40), and prostate (40) cancer who reported moderate to severe fatigue (i.e.,5 of 10 on an 11-point numerical rating scale). Participants were queried about receipt of treatments in fatigue management domains emphasized in the National Comprehensive Cancer Network guidelines: general management strategies, activity enhancement, psychosocial strategies, and pharmaceuticals.The cohort was half male, had a mean age of 67, and reported an average fatigue rating of 6.4. Participants reported treatment or receipt of specific guidance in the fatigue management domains as follows: general management strategies 16.8 %, activity enhancement 11.9 %, psychosocial strategies 9.9 %, and pharmaceuticals 37.3 %. Fatigue7 of 10 increased the likelihood of instruction in activity enhancement but no other domain.The low rates of guideline-congruent treatment reported here are concerning, particularly as better validated behavioral treatments were the least prescribed.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ee76fe7dc83cec8d458e347230165619Test
https://doi.org/10.1007/s00520-012-1515-7Test