- Browse by Author
Browsing by Author "Schoelwer, Melissa J."
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Item Diagnosis of adrenal insufficiency in eosinophilic esophagitis: The importance of timing of cortisol measurements in interpreting low-dose adrenocorticotropic hormone stimulation testing(Elsevier, 2016-07) Schoelwer, Melissa J.; Nebesio, Todd D.; Pediatrics, School of MedicineComment on Adrenal Insufficiency after Chronic Swallowed Glucocorticoid Therapy for Eosinophilic Esophagitis. [J Pediatr. 2016]Item Infants With Congenital Adrenal Hyperplasia Are at Risk for Hypercalcemia, Hypercalciuria, and Nephrocalcinosis(Endocrine Society, 2017-08-01) Schoelwer, Melissa J.; Viswanathan, Vidhya; Wilson, Amy; Nailescu, Corina; Imel, Erik A.; Pediatrics, School of MedicineIn a retrospective study, most young children with CAH had at least one episode of hypercalcemia, whereas a smaller percentage was found to have hypercalciuria and/or nephrocalcinosis.Item Psychological assessment of mothers and their daughters at the time of diagnosis of precocious puberty(BioMed Central, 2015-03-16) Schoelwer, Melissa J.; Donahue, Kelly L.; Bryk, Kristina; Didrick, Paula; Berenbaum, Sheri A.; Eugster, Erica A.; Department of Pediatrics, IU School of MedicineBACKGROUND: Concerns about psychological distress are often used to justify treatment of girls with precocious puberty, but there is little evidence to support these concerns. The extent to which psychological problems are associated with central precocious puberty (CPP) compared with other forms of early puberty in girls has likewise not been established. METHODS: Girls presenting with untreated CPP, premature adrenarche (PA) or early normal puberty (ENP) were recruited from our pediatric endocrine clinic along with their mothers. Child psychological adjustment was assessed by child self-report and parent report. Parent self-reported personality, anxiety, and depression were also assessed. Differences between groups were explored using one-way ANOVA and Dunnett's T3 test. RESULTS: Sixty-two subjects (aged 7.5 ± 1.4 years, range 4.8-10.5) were enrolled, of whom 19 had CPP, 22 had PA, and 21 had ENP. Girls with ENP were significantly older (8.9 ± .9 years) than girls with CPP (6.9 ± 1.1 years, p < .001) and PA (6.6 ± 1.0 years, p < .001). Girls with PA had significantly higher BMI z-scores (1.7 ± .8) than girls with CPP (1.1 ± .6, p = .01) and ENP (1.2 ± .6, p = .04). More girls with PA and ENP were from racial minorities (47% and 50% respectively) than girls with CPP (32%). No group differences were found for any child measure of psychological adjustment. However, mothers of girls with PA scored significantly higher than mothers of girls with ENP on one measure of depression (p = .04) and stress (p = .01). CONCLUSIONS: While mothers of girls with PA report increased psychological distress on some measures, no differences in psychological adjustment were found at baseline amongst the girls themselves. Whether these results will change as puberty progresses in the PA and ENP groups or with treatment of CPP is unknown. Long-term prospective studies are needed in order to further investigate psychological correlates of early puberty in girls.Item The Use of 123I in Diagnostic Radioactive Iodine Scans in Children with Differentiated Thyroid Carcinoma(Liebert, 2015-08) Schoelwer, Melissa J.; Zimmerman, Donald; Shore, Richard M.; Josefson, Jami L.; Department of Medicine, IU School of MedicineBackground: Adult studies have shown that iodine-123 (123I) is as effective as 131I in detecting metastatic disease in patients with differentiated thyroid carcinoma. However, the type and administered activity of radioiodine used for diagnostic imaging of metastatic thyroid cancer has not been well studied in children. Here we describe our institution's experience with using 123I in diagnostic radioiodine scans in children with differentiated thyroid carcinoma. Methods: Every patient with differentiated thyroid carcinoma who completed diagnostic scanning followed by radioiodine therapy at our institution over the past 8 years was included in this retrospective chart review. Patient age, sex, presentation of thyroid disease, past medical history, thyrotropin, thyroglobulin, and antithyroglobulin antibodies were recorded. A single nuclear medicine radiologist evaluated all scans. Results: Thirty-three subjects completed 37 pairs of scans at a mean age of 13.4 years (range 6–17 years). The majority of subjects were female (81%) and had papillary thyroid cancer (91%). For diagnostic scanning, 5 received 2 mCi of 131I, 21 received 2 mCi of 123I, and 11 received 3 mCi of 123I. There was no statistically significant difference in rate of discordant scan pairs when comparing 131I and 123I (20% and 23% respectively, p=0.9). The detection of metastatic pulmonary disease on diagnostic scanning was not improved by increasing the dose of 123I from 2 mCi to 3 mCi (10% rate of missed lung detection with 2 mCi 123I vs. 20% with 3 mCi 123I). Conclusions: 123I is effective for use in diagnostic radioactive iodine scans in children with differentiated thyroid cancer. The primary advantages of using 123I include decreased radiation exposure and avoidance of stunning. However, in children there is a possibility of missed detection of metastatic pulmonary disease.