Four things to know about your short bowel patients

short bowel syndrome

Short bowel syndrome is commonplace to Danielle Stamm, RN, FNP-BCR. As one of the dedicated nurse practitioners in the Center for Advanced Intestinal Rehabilitation (CAIR) at Boston Children’s Hospital, she sees children with this rare but serious condition on a daily basis. But what’s familiar to Stamm and her colleagues is unusual to many other clinicians. …Read More

Hypertension in kids: When to refer

high blood presssure
(Illustration: Fawn Gracey)

We typically associate hypertension with older people, but elevated blood pressure isn’t an uncommon finding in children and adolescents. According to the American Academy of Pediatrics (AAP), pediatric hypertension occurs in 2 to 5 percent of kids and is one of the top five chronic diseases in children.

Despite those numbers, the diagnosis is missed in up to 75 percent of pediatric patients in primary care settings. “We should be checking blood pressure at every routine well-child visit for kids age 3 and older, and more often in kids with cardiometabolic risk factors, such as obesity and diabetes,” says Corinna Rea, MD, MPH, a pediatrician in Boston Children’s Primary Care at Longwood. …Read More

In Myanmar, oncology expertise travels from nurse to nurse

Image of global health team with nurses in Myanmar Through the Dana-Farber/Boston Children’s Global Health Initiative and World Child Cancer, oncology nurse Amy Federico, RN, CPNP, had the opportunity to travel to Yangon, Myanmar, to share her oncology expertise with the staff at Yangon Children’s Hospital. Amy’s interest in global health began eight years ago, but the trip to Myanmar in October 2017 strengthened her commitment to share her knowledge across borders. Amy, who is a nurse practitioner specializing in care of patients with solid tumors at the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, reflects on her experience abroad:

My interest in global health care has developed over the past eight years since I started attending the Society of International Oncology Pediatric annual conferences. So when Lisa Morrissey, MPH, MSN, RN, CPHON, asked me to join her and Kathryn Barrandon, MPH, BSN, CPN, on an educational trip to Myanmar, I enthusiastically accepted.

One of the pediatric oncologists at Yangon Children’s Hospital requested solid tumor nursing education so I knew this would be a wonderful opportunity to share my years of oncology experience, especially my expertise in caring for patients with solid tumors. The experience would also give me a better global perspective of health care delivery in another part of the world.

On October 27, we set off on our 22-hour, three-leg, 8,300-mile journey from Boston to Yangon. I realize now, more than ever, that access to health care depends upon where you are born and where you live.

The day after our arrival, Lisa, Katie and I toured the oncology ward. I was astounded by the overly crowded — yet oddly quiet — patient bays, ill-looking children and desperate-yet-hopeful parents. Occasionally, a parent or patient would poke his or her head out a door or up to a window, curious about the three of us visitors. Admittedly, I was saddened by the environment.

The next day, I was relieved when we returned and were greeted by 32 energetic and excited nurses from nine hospitals across four Myanmar states. In addition to providing oncology education, our goals were to advocate for specialty nursing practice and to provide collegial support to conference attendees. …Read More

New guidelines for GERD: What every pediatrician should know

clinical guidelines for GERD

Spitting up is a normal occurrence for young infants — as long as a child is growing well and not developing other problems, such as breathing difficulties, the problem will resolve on its own without treatment. But how can you determine if your patient has gastroesophageal reflux disease (GERD)? New expert guidelines draw on the latest research findings to help advise specialists and primary care providers on the evaluation and treatment of GERD in infants and children.

Rachel Rosen, MD, MPH, director of the Aerodigestive Center at Boston Children’s Hospital, served as lead author on these international guidelines.

“Over the last 10 years, there has been an explosion of advances not only in our understanding the pathophysiology of reflux, but also in the diagnostic tests to evaluate reflux and problems that masquerade as reflux,” she explains. “In prior guidelines, the focus was on acid-related disease and treatment with acid suppression. We now know that gastroesophageal reflux, particularly in infants and young children, is often non-acidic, so treating patients with acid suppression is ineffective. This is a true paradigm shift.” Here, Rosen shares some highlights that every pediatrician should know.

…Read More