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  1. Article ; Online: Update on Juvenile Spondyloarthritis.

    Aeder, Lita / Onel, Karen B

    Pediatrics in review

    2021  Volume 42, Issue 11, Page(s) 581–589

    Abstract: Spondyloarthritis (SpA) ...

    Abstract Spondyloarthritis (SpA)
    MeSH term(s) Adolescent ; Arthritis, Juvenile/diagnosis ; Arthritis, Juvenile/epidemiology ; Arthritis, Juvenile/therapy ; Child ; Humans ; Sacroiliac Joint ; Sacroiliitis/diagnosis ; Sacroiliitis/epidemiology ; Sacroiliitis/etiology ; Spondylarthritis/diagnosis ; Spondylarthritis/epidemiology ; Spondylarthritis/therapy ; Spondylitis, Ankylosing
    Language English
    Publishing date 2021-11-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 774515-1
    ISSN 1526-3347 ; 0191-9601
    ISSN (online) 1526-3347
    ISSN 0191-9601
    DOI 10.1542/pir.2020-000810
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  2. Article ; Online: Glitches in the utilization of telehealth in pediatric rheumatology patients during the COVID-19 pandemic.

    Balmuri, Nayimisha / Onel, Karen B

    Pediatric rheumatology online journal

    2020  Volume 18, Issue 1, Page(s) 78

    Abstract: Telehealth is an extraordinary advancement of modern medicine. It has increased access to care for underserved populations and, in the case of pediatric rheumatology, has expanded the reach of a limited work force. During the Coronavirus Disease 2019 ( ... ...

    Abstract Telehealth is an extraordinary advancement of modern medicine. It has increased access to care for underserved populations and, in the case of pediatric rheumatology, has expanded the reach of a limited work force. During the Coronavirus Disease 2019 (COVID-19) pandemic, telehealth has radically changed the way healthcare workers have been able to deliver care while maintaining social distance. In addition to the infectious havoc of COVID-19, the pandemic has further altered the psychosocial milleu of our society which directly impacts the wellness and safety of our pediatric rheumatology patients. These psychosocial factors may be difficult to assess and triage solely using telehealth. The objective of this short review is to educate practitioners on the psychosocial concerns exacerbated by the COVID-19 pandemic and to discuss the possible hurdles in utilization of telehealth to care for our vulnerable patient population.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Child ; Child Abuse ; Coronavirus Infections ; Depression ; Humans ; Mental Health ; Pandemics ; Patient-Centered Care ; Pediatrics ; Pneumonia, Viral ; Rheumatology ; Risk Assessment ; SARS-CoV-2 ; Social Environment ; Substance-Related Disorders ; Telemedicine
    Keywords covid19
    Language English
    Publishing date 2020-10-15
    Publishing country England
    Document type Letter ; Review
    ZDB-ID 2279468-2
    ISSN 1546-0096 ; 1546-0096
    ISSN (online) 1546-0096
    ISSN 1546-0096
    DOI 10.1186/s12969-020-00477-y
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  3. Article ; Online: Lyme disease presenting as persistent severe photophobia.

    Wang, Frederick M / Zaidman, Gerald W / Onel, Karen B / Kelleher, Erin

    Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus

    2021  Volume 25, Issue 1, Page(s) 52–54

    Abstract: Long-term photophobia in children that has no obvious cause is uncommon and presents a diagnostic dilemma. It may produce significant discomfort and result in social isolation and school absence. We present the case of a 5-year-old boy who presented with ...

    Abstract Long-term photophobia in children that has no obvious cause is uncommon and presents a diagnostic dilemma. It may produce significant discomfort and result in social isolation and school absence. We present the case of a 5-year-old boy who presented with chronic photophobia due to interstitial keratitis that was the result of Lyme disease.
    MeSH term(s) Child ; Child, Preschool ; Humans ; Keratitis/diagnosis ; Lyme Disease/complications ; Lyme Disease/diagnosis ; Lyme Disease/drug therapy ; Male ; Photophobia/diagnosis ; Photophobia/etiology
    Language English
    Publishing date 2021-02-24
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1412476-2
    ISSN 1528-3933 ; 1091-8531
    ISSN (online) 1528-3933
    ISSN 1091-8531
    DOI 10.1016/j.jaapos.2020.09.003
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  4. Article: Glitches in the utilization of telehealth in pediatric rheumatology patients during the COVID-19 pandemic

    Balmuri, Nayimisha / Onel, Karen B

    Pediatr Rheumatol Online J

    Abstract: Telehealth is an extraordinary advancement of modern medicine. It has increased access to care for underserved populations and, in the case of pediatric rheumatology, has expanded the reach of a limited work force. During the Coronavirus Disease 2019 ( ... ...

    Abstract Telehealth is an extraordinary advancement of modern medicine. It has increased access to care for underserved populations and, in the case of pediatric rheumatology, has expanded the reach of a limited work force. During the Coronavirus Disease 2019 (COVID-19) pandemic, telehealth has radically changed the way healthcare workers have been able to deliver care while maintaining social distance. In addition to the infectious havoc of COVID-19, the pandemic has further altered the psychosocial milleu of our society which directly impacts the wellness and safety of our pediatric rheumatology patients. These psychosocial factors may be difficult to assess and triage solely using telehealth. The objective of this short review is to educate practitioners on the psychosocial concerns exacerbated by the COVID-19 pandemic and to discuss the possible hurdles in utilization of telehealth to care for our vulnerable patient population.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #864211
    Database COVID19

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  5. Article ; Online: The value of the patient global health assessment in polyarticular juvenile idiopathic arthritis: a nested cohort study.

    Trachtman, Rebecca / Issa, Rula / Pan, Stephanie / Wilson, Karen M / Lovell, Daniel J / Onel, Karen B

    Journal of patient-reported outcomes

    2021  Volume 5, Issue 1, Page(s) 50

    Abstract: Objective: The objectives were: 1) to explore the discordance between the Patient Global Health Assessment (PtGA) scores, the Physician Global Health Assessment (PhGA) scores, and Pain scores; and 2) to explore whether the PtGA during disease remission ... ...

    Abstract Objective: The objectives were: 1) to explore the discordance between the Patient Global Health Assessment (PtGA) scores, the Physician Global Health Assessment (PhGA) scores, and Pain scores; and 2) to explore whether the PtGA during disease remission is associated with future disease flare in pJIA.
    Methods: Data from an NIH funded clinical trial (NCT00792233) evaluating flare were used (N = 137). PtGA, PhGA, and Pain scores were assessed. Flare was defined as any active arthritis. Spearman's correlation coefficients were calculated, and multivariable logistic regression was performed.
    Results: 122 patients had records of flare status, of which 63 developed flare, and 42 of these patients had a visit immediately prior to flare. For study subjects with a visit immediately prior to flare, the PtGA, pain scores, and PhGA all increased at time of flare. For every unit increase in PtGA and Pain scores, there was a 9% and 23% higher odds of developing flare, respectively (p = 0.76, p = 0.40). For every unit increase in the PhGA score, there was a substantially lower odds of developing flare (p = 0.05).
    Conclusion: Our results demonstrate that the PtGA and Pain scores are strongly correlated with each other and increased at the visit prior to flare, while the PhGA scores are not. Further, the PtGA and Pain score have some predictive value for flare, while the PhGA does not. These findings highlight the value of patient input in medical care and decision-making, and support the development and use of more sophisticated PROs in the care of JIA patients.
    Language English
    Publishing date 2021-06-26
    Publishing country Germany
    Document type Journal Article
    ISSN 2509-8020
    ISSN (online) 2509-8020
    DOI 10.1186/s41687-021-00328-8
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  6. Article ; Online: Tumor necrosis factor inhibitors and cancer in juvenile idiopathic arthritis: disentangling the web.

    Onel, Karen B / Onel, Kenan

    Arthritis and rheumatism

    2012  Volume 64, Issue 4, Page(s) 966–969

    MeSH term(s) Antirheumatic Agents/adverse effects ; Arthritis, Juvenile/complications ; Arthritis, Juvenile/drug therapy ; Female ; Humans ; Male ; Methotrexate/adverse effects ; Neoplasms/epidemiology ; Neoplasms/etiology ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
    Chemical Substances Antirheumatic Agents ; Tumor Necrosis Factor-alpha ; Methotrexate (YL5FZ2Y5U1)
    Language English
    Publishing date 2012-04
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 127294-9
    ISSN 1529-0131 ; 0004-3591 ; 2326-5191
    ISSN (online) 1529-0131
    ISSN 0004-3591 ; 2326-5191
    DOI 10.1002/art.34349
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    Zs.A 24: Show issues Location:
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    Zs.MO 523: Show issues

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  7. Article ; Online: The clinical spectrum of juvenile idiopathic arthritis in a large urban population.

    Tesher, Melissa S / Onel, Karen B

    Current rheumatology reports

    2012  Volume 14, Issue 2, Page(s) 116–120

    Abstract: Urban populations present particular challenges for medical providers. Patients are extremely diverse, with varied socioeconomic, cultural, and ethnic backgrounds. Physicians caring for children with juvenile idiopathic arthritis must be prepared to ... ...

    Abstract Urban populations present particular challenges for medical providers. Patients are extremely diverse, with varied socioeconomic, cultural, and ethnic backgrounds. Physicians caring for children with juvenile idiopathic arthritis must be prepared to interact effectively with many types of families who bring with them varied experiences and expectations. Pediatric rheumatologists should be familiar with patient characteristics that can influence disease outcomes. Access to care is affected by place of residence, referral delays, parental education, and the child’s insurance status. Patients of different ethnic backgrounds vary in their trust of physicians and health systems. Understanding of risk in medical decision making is influenced by ethnicity as well. Adherence also varies by ethnic group, with African American patients reporting lower adherence than Caucasian patients. Issues of doctor– patient communication and use of complementary and alternative medicine are also affected by cultural factors. Especially for physicians working in a large metropolitan area, an understanding of societal factors influencing patient behavior is essential to provide optimal care for children with juvenile idiopathic arthritis.
    MeSH term(s) Arthritis, Juvenile/diagnosis ; Arthritis, Juvenile/therapy ; Child ; Healthcare Disparities ; Humans ; Urban Population
    Language English
    Publishing date 2012-02-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057357-1
    ISSN 1534-6307 ; 1523-3774
    ISSN (online) 1534-6307
    ISSN 1523-3774
    DOI 10.1007/s11926-012-0237-7
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    Zs.A 5531: Show issues Location:
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  8. Article: Attitudes and Approaches for Withdrawing Drugs for Children with Clinically Inactive Nonsystemic JIA: A Survey of the Childhood Arthritis and Rheumatology Research Alliance.

    Horton, Daniel B / Onel, Karen B / Beukelman, Timothy / Ringold, Sarah

    The Journal of rheumatology

    2017  Volume 44, Issue 3, Page(s) 352–360

    Abstract: Objective: To assess the attitudes and strategies of pediatric rheumatology clinicians toward withdrawing medications for children with clinically inactive juvenile idiopathic arthritis (JIA).: Methods: Members of the Childhood Arthritis and ... ...

    Abstract Objective: To assess the attitudes and strategies of pediatric rheumatology clinicians toward withdrawing medications for children with clinically inactive juvenile idiopathic arthritis (JIA).
    Methods: Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed an anonymous electronic survey on decision making and approaches for withdrawing medications for inactive nonsystemic JIA. Data were analyzed using descriptive statistics.
    Results: Of 388 clinicians in CARRA, 124 completed surveys (32%), predominantly attending pediatric rheumatologists. The most highly ranked factors in decision making for withdrawing medications were the duration of clinical inactivity, drug toxicity, duration of prior activity, patient/family preferences, joint damage, and JIA category. Diagnoses of rheumatoid factor-positive polyarthritis and persistent oligoarthritis made respondents less likely and more likely, respectively, to withdraw JIA medications. Three-quarters of respondents waited for 6-12 months of inactive disease before stopping methotrexate (MTX) or biologics, but preferences varied. There was also considerable variability in the strategies used to reduce, taper, or stop medications for clinically inactive JIA; most commonly, clinicians reported slow medication tapers lasting at least 2 months. For children receiving combination MTX-biologic therapy, 63% of respondents preferred stopping MTX first. Most clinicians reported using imaging only seldom or sometimes to guide decision making, but most were also reluctant to withdraw medications in the presence of asymptomatic imaging abnormalities suggestive of subclinical inflammation.
    Conclusion: Considerable variability exists among pediatric rheumatology clinicians regarding when and how to withdraw medications for children with clinically inactive JIA. More research is needed to identify the most effective approaches to withdraw medications and predictors of outcomes.
    Language English
    Publishing date 2017-03
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.161078
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  9. Article ; Online: Mucosal-associated Lymphoid Tissue (MALT) Lymphoma in Association With Pediatric Primary Sjogren Syndrome: 2 Cases and Review.

    Tesher, Melissa S / Esteban, Ysabella / Henderson, Tara O / Villanueva, Gabriela / Onel, Karen B

    Journal of pediatric hematology/oncology

    2018  Volume 41, Issue 5, Page(s) 413–416

    Abstract: Mucosal-associated lymphoid tissue (MALT) lymphoma is rare in the pediatric population, but primary Sjogren syndrome is a well-established risk factor for this malignancy. This report describes 2 cases of MALT lymphoma in children with Sjogren syndrome. ... ...

    Abstract Mucosal-associated lymphoid tissue (MALT) lymphoma is rare in the pediatric population, but primary Sjogren syndrome is a well-established risk factor for this malignancy. This report describes 2 cases of MALT lymphoma in children with Sjogren syndrome. A 15-year-old girl developed MALT lymphoma of the parotid gland as the presenting symptom of Sjogren syndrome. In the second case, a 15-year-old boy with known Sjogren syndrome presenting mainly with arthritis was diagnosed with MALT lymphoma, also of the parotid gland. With early diagnosis and treatment, outcomes in pediatric MALT lymphoma are generally encouraging. Pediatric oncology specialists should be aware of the association of MALT lymphoma with Sjogren syndrome and have a high index of suspicion for this malignant complication.
    MeSH term(s) Adolescent ; Early Diagnosis ; Female ; Humans ; Lymphoma, B-Cell, Marginal Zone/complications ; Male ; Parotid Gland/pathology ; Sjogren's Syndrome/complications
    Language English
    Publishing date 2018-10-29
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1231152-2
    ISSN 1536-3678 ; 1077-4114 ; 0192-8562
    ISSN (online) 1536-3678
    ISSN 1077-4114 ; 0192-8562
    DOI 10.1097/MPH.0000000000001321
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    Zs.A 1537: Show issues Location:
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  10. Article ; Online: Anti-tumor necrosis factor therapy and cancer risk in patients with autoimmune disorders.

    Onel, Karen B / Onel, Kenan

    Arthritis care & research

    2010  Volume 62, Issue 7, Page(s) 1024–1028

    MeSH term(s) Antirheumatic Agents/adverse effects ; Autoimmune Diseases/drug therapy ; Autoimmune Diseases/immunology ; Humans ; Immunocompromised Host ; Neoplasms/immunology ; Risk Factors ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; Tumor Necrosis Factor-alpha/immunology
    Chemical Substances Antirheumatic Agents ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2010-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645059-3
    ISSN 2151-4658 ; 0893-7524 ; 2151-464X
    ISSN (online) 2151-4658
    ISSN 0893-7524 ; 2151-464X
    DOI 10.1002/acr.20228
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