A5019409882- Pulmonary Hypertension Research and Treatments
- Neonatal Health and Biochemistry
- Pediatric Urology and Nephrology Studies
- Herpesvirus Infections and Treatments
- Cytomegalovirus and herpesvirus research
- Vascular Anomalies and Treatments
- Patient Safety and Medication Errors
- Metabolism and Genetic Disorders
- Innovations in Medical Education
- Urinary Tract Infections Management
- Appendicitis Diagnosis and Management
- Neonatal and fetal brain pathology
- Parvovirus B19 Infection Studies
- Cardiovascular Issues in Pregnancy
- Electronic Health Records Systems
- Neonatal and Maternal Infections
- Health Sciences Research and Education
- Urological Disorders and Treatments
- Family and Patient Care in Intensive Care Units
- Infant Health and Development
- Ultrasound in Clinical Applications
- Clinical Reasoning and Diagnostic Skills
- Winter Sports Injuries and Performance
- Sports injuries and prevention
- Pneumonia and Respiratory Infections
University of Utah
2006-2023
Primary Children's Hospital
2016-2022
Intermountain Healthcare
2016-2021
National Patient Safety Foundation
2016
Quality Research
2016
Children's Hospital of Philadelphia
2016
Boston Children's Hospital
2016
Boston Medical Center
2016
Boston University
2016
LDS Hospital
2006
Pulmonary arterial hypertension (PAH) is clinically characterized by a sustained elevation in mean pulmonary artery pressure leading to significant morbidity and mortality. The disorder typically sporadic, such cases the term idiopathic PAH (IPAH) used. However, that occur within families (familial (FPAH)) display similar clinical histopathological features, suggesting common etiology. Heterozygous mutations of type II member TGF-beta cell signaling superfamily known as BMPR2 on chromosome...
Background— Vasoreactivity tests are fundamental in evaluating pulmonary arterial hypertension (PAH). Mutations of the transforming growth factor-β type II receptor gene, BMPR2 , predispose to development and may alter response vasodilators. Previous investigations have not examined relationship mutations vasoreactivity. Methods Results— We identified 133 consecutive unrelated patients with either idiopathic or familial PAH. Sixty-six were excluded because we lacked DNA samples (n=18)...
OBJECTIVE: This study compares the performance of urine dipstick alone with microscopy and both tests combined as a screen for urinary tract infection (UTI) in febrile infants aged 1 to 90 days. METHODS: We queried Intermountain Healthcare data warehouse identify dipstick, microscopy, culture performed between 2004 2011. UTI was defined >50 000 colony-forming units per milliliter pathogen. compared unstained or (“combined urinalysis”) RESULTS: Of 13 030 identified, 6394 (49%) had all...
Abstract Background The effects of pulmonary arterial hypertension on cardiovascular and physical function are well documented. Limited information exists regarding the cognitive despite patient reports problems with memory attention. Our primary purpose was to determine if a prospectively identified cohort patients had sequelae. secondary relationships between sequelae neuropsychological test scores depression, anxiety, quality life. Methods Forty-six adults underwent assessment function,...
The bone morphogenetic receptor type II gene is the major genetic determinant for inherited form of pulmonary arterial hypertension. However, deleterious mutations this are not observed in majority subjects who develop condition spontaneously and familial disease displays age- sex-dependent penetrance, indicating requirement additional environmental and/or modifiers development.We investigated polymorphic variation serotonin transporter gene, a biological candidate predisposition to vascular...
Assessing the effectiveness of quality improvement curricula is important to improving this area resident education.To assess ability Quality Improvement Knowledge Application Tool (QIKAT) differentiate between residents who were provided instruction in QI and those not, when scored by individuals not involved designing QIKAT, its scoring rubric, or curriculum instruction.The QIKAT a 9-item self-assessment proficiency administered an intervention control group. The was longitudinal...
It is unknown whether febrile infants 29 to 60 days old with positive urinalysis results require routine lumbar punctures for evaluation of bacterial meningitis.
Residency programs are expected to educate residents in quality improvement (QI). Effective assessments needed ensure gain QI knowledge and skills. Limitations of current tools include poor interrater reliability requirement for scorer training.To provide evidence the validity Assessment Quality Improvement Knowledge Skills (AQIKS), which is a new tool that provides summative assessment pediatrics residents' ability recall concepts apply them clinical scenario.We conducted quasi-experimental...
The objective of this study was to compare demographic injury and treatment characteristics hospitalized pediatric cases falls from chair lifts other ski snowboarding injuries identify potential interventions for preventing lifts.Retrospective query the trauma registry Utah's only center children younger than 18 years requiring hospitalization a or November 2004 February 2014.There were 443 during period. Twenty-nine (7%) fell height while riding lift. Children falling more likely be (6.9 vs...
Abstract Introduction Quality improvement (QI) knowledge and skills are considered ACGME core competencies within the domains of practice-based learning improvement, systems-based practice....
Introduction: The use of computed tomography (CT) in the emergency department (ED) evaluation pediatric patients for suspected appendicitis can be safely reduced. However, published examples reduced CT also report increased MRI utilization, ED length stay, hospitalization rates, and in-ED surgical consultation. In addition, previous studies recommended follow-up undifferentiated abdominal pain, yet none with surgeons. Therefore, we implemented a diagnostic algorithm that includes an option...
Objective The lack of evidence-based criteria to guide chest radiograph (CXR) use in young febrile infants results variation its with resultant suboptimal quality care. We sought describe the features associated radiographic pneumonias infants. Study design Secondary analysis a prospective cohort study 18 emergency departments (EDs) Pediatric Emergency Care Applied Research Network from 2016 2019. Febrile (≥38°C) aged ≤60 days who received CXRs were included. CXR reports categorised as ‘no’,...
Previous studies have reported on the evaluation of patients diagnosed with appendicitis. Very little is known about all evaluated for suspected Patients beyond physical examination laboratory and imaging testing, then found not to appendicitis, are more difficult identify. Data readily available in administrative databases may be used identify these patients.A multidisciplinary team developed a surrogate definition evaluating appendicitis children based data. Appendicitis was "suspected" if...
Background: We previously derived and validated a prediction rule for SBIs (urinary tract infections [UTI], bacteremia, or bacterial meningitis [BM]) in 1821 febrile infants < 60 days the Pediatric Emergency Care Applied Research Network (PECARN). The includes 3 variables (using modified cutoffs): A normal urinalysis (UA), defined by absence of nitrites, leukocyte esterase 5 WBCs/hpf, absolute neutrophil count (ANC) 4000 cells/mm3 (empirically at 4090) procalcitonin (PCT) 0.5 ng/ml 1.71)....
Background: Urinary tract infections (UTIs) are the most common serious bacterial infection in young febrile infants, and urinalysis (UA) is an accurate screening test for emergency department (ED) evaluation. Precise estimates of risk concomitant bacteremia and/or meningitis (invasive infections; IBI) infants ≤ 60 days have been based on presence UTIs rather than positive UAs, lack large prospective study. Objective: We sought to determine prevalence IBIs 0-28 …