Developmental Changes in Anterior Corneal Astigmatism in Tohono O’odham Native American Infants and Children

Purpose: The purpose of this study was to evaluate the correlation between corneal astigmatism and the morphology of pterygium with anterior segment optic coherence tomography (AS-OCT). Material and Methods: The size of pterygium (horizontal length, vertical width) was measured manually; pterygium area and percentage extension of the pterygium onto the cornea were calculated. Anterior and posterior corneal astigmatism, Sim K, K1, K2 were measured using a dual Scheimpflug analyzer. Morphological patterns of the pterygium analyzed with AS-OCT were determined according to the extension of the pterygium apex below the corneal epithelium. Two tomographic patterns were identified: continuous and nodular. Correlation between anterior corneal astigmatism and pterygium size, percentage extension of the pterygium, and morphological pattern of the pterygium was analyzed. Results: The mean ages of the 47 patients were 49.4 ± 16.6 (22–80) years. Mean horizontal pterygium length, vertical width, pterygium area, and percentage extension of the pterygium were 2.8 ± 1.2 mm, 4.8 ± 1.6 mm, 7.42 ± 5.6 mm2 and 24.5 ± 10.4%, respectively. Mean anterior corneal astigmatism was 2.3 ± 2.3 D and simulated keratometry was 43.4 ± 2.02 D. In terms of the morphological pattern of the pterygium, 24 eyes had continuous, 23 eyes had a nodular pattern and the median (interquartile range) anterior corneal astigmatism was 1.87 (1.01–3.80) and 1.22 D (0.58–2.35), respectively ( p = 0.102). Other topographic and pterygium size parameters were similar between groups. Analyzing the correlations in groups separately, a positive moderate statistically significant correlation was present between vertical width, percentage extension, pterygium area, and anterior corneal astigmatism in both continuous and nodular groups. Conclusions: Although not statistically significant, anterior corneal astigmatism was higher in continuous group. Using AS-OCT to standardize the morphology of pterygium could provide additional clinical information.

Download Full-text

Another Look at WIC’s Breastfeeding Data: State Totals Reveal More Than Regional Averages

Journal of Human Lactation ◽

10.1177/0890334418797318 ◽

2018 ◽

Vol 35 (1) ◽

pp. 37-41 ◽

Cited By ~ 1

Author(s):

Shari Salzhauer Berkowitz

Keyword(s):

Native American ◽

Local Level ◽

The United States ◽

Regional Level ◽

Infants And Children ◽

Fiscal Year ◽

Future Research ◽

Supplemental Nutrition ◽

Nutrition Program ◽

Supplemental Nutrition Program

Background: Breastfeeding is known to be the most beneficial way of feeding infants, but 68% of the infants enrolled in the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children are fully formula fed. Mandated annual reports about breastfeeding aggregate data from the states into regions, which obscures important information. Research Aim: The aim of this study is to reexamine the data supplied by the Special Supplemental Nutrition Program for Women, Infants, and Children to identify which areas of the United States have the lowest incidence of breastfeeding infants. Methods: A retrospective cross-sectional observational study was conducted. Data from the Breastfeeding Data Local Agency Report were extracted, graphed, and analyzed. Results: Data provided from the Special Supplemental Nutrition Program for Women, Infants, and Children for fiscal year 2016 show that the range of fully formula fed infants at the regional level is 60% to 78%, while at the state level the range is wider, at 51% to 89%. The states with the largest numbers of fully formula fed infants were Mississippi (89%), Louisiana (88%), Alabama (88%), and Arkansas (87%). When examining data from all 90 reporting agencies, the range of fully formula fed infants was 38% to 95%. Conclusions: Aggregating state, Native American nation, and territorial data at the regional level resulted in a loss of important information. WIC’s current breastfeeding interventions may be more effective in some areas than others. Future research can examine successful and unsuccessful interventions on a state or local level.

Download Full-text

Biomarkers of pain in infants and children

Oxford Textbook of Pediatric Pain ◽

10.1093/med/9780198818762.003.0039 ◽

2021 ◽

pp. 412-421

Author(s):

Naama Rotem-Kohavi ◽

Susanne Brummelte ◽

Kenneth D. Craig ◽

Tim F. Oberlander

Keyword(s):

Stress Reactivity ◽

Life Experience ◽

Physiological Stress ◽

Clinical Care ◽

Infants And Children ◽

Developmental Changes ◽

Motor Disabilities ◽

Reflecting Function ◽

Health And Disease ◽

In Infants And Children

Biomarkers are commonly used in clinical care and research as indicators of diseases and physiological states. Preferably, a biomarker should be readily accessible, low in cost, easy to interpret, highly specific, and sensitive to health and disease. Owing to the complexity of the pain system, no unidimensional reliable biomarker for pain has been identified that meets all of these criteria to date. In children, neurologically dependent developmental changes, maturation of physiological stress reactivity systems, and life experience add additional layers of complexity to the use of biomarkers of pain. Nevertheless, readily available and reliable biomarkers reflecting function of the pain system would greatly enhance timely and appropriate understanding and treatment of pain, especially in infants and children with communication, cognitive, and motor disabilities. This chapter examines currently available pain-related biomarkers, their use, and limitations.

Download Full-text