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Children with high BMI, female sex, and no-sports participation show differential health benefits from a 20-week school-based, mentored, behavioral change model program-Team Kipow! [Meeting Abstract]

Nguyen, A Q; Zieve, H; Li, L; Nam, J; Nagam, H; Phong, C; Chalmers, C; Nguyen, T; Zhang, L; Narayanan, N; Nagpal, N; Mietus-Snyder, M; Lucas, C T
Background/Purpose: According to the California Department of Education, in Orange County (OC), California, almost 37% of 5th graders are overweight or obese, and low-income and minority youth are most impacted. Obesity causes long-term health issues and has intergenerational implications [Wang et al., 2019]. Team Kid PowerOC (KiPOWOC) is an academic-community partnership initiated in 2015 to support school health policies and coach 5th graders in Title I elementary schools through on-site mentorship for behavioral change during lunch and recess. In 2017, KiPOWOC began an annual 20-week program at Thorman Elementary (75% of students enrolled in the Free or Reduced Lunch program, and 95% Latinx).
Method(s): Quasi-experimental pretest posttest design, without a control site, implemented over two academic years. Annually, volunteer health coaches spend 700-minutes with 5th graders (Weekly: 25-min lessons, 20-min meal coaching, and 25- min active play sessions). Pre- and post-test assessments included BMI percentile (BMI%), blood pressure (BP), mile-run, and health behaviors (HABITS questionnaire). Unadjusted analyses: Two-sample paired t-test. Adjusted analyses: Bonferroni correction.
Result(s): n=142; All: Ages 9-11 years, 37.3% with overweight or obese BMI, 56% female, 73% no-sports participation; BMI%, mean(SD): pre 64.25(30.28), post 60.86(30.69), p=0.0009, sBP change -5 mm Hg, p<0.0001, change in mile run time -0.65 minutes, p<0.0001. Subgroup analyses: Obese BMI (BMI >95th percentile): BMI% change -1.88%, p=0.0011; Females: BMI% change -5.5%, p=0.0003, sBP change -5 mm Hg, p=0.0002; No sports participation: BMI% change -4.1%, p=0.0009, sBP change -5 mm Hg, p<0.0001. No significant findings were identified in health behaviors consistently across subgroups. All significant results held significance after Bonferroni correction for multiple comparisons, except sBP among children with obese BMI.
Conclusion(s): Overall, KiPOWOC demonstrated a significant impact on participants' BMI%, sBP, and mile run. In subgroup analyses, findings held significance among children with obese BMI, female sex, and no-sports participation for BMI% and mile run. A significant difference was also noted in sBP for children with female sex, and no-sports participation. Although identifying subgroup differences was not the initial goal of KiPOWOC, findings highlight that KiPOWOC may have greater impact among low-income children with these characteristics. This is of particular interest when considering that children from lowincome communities have higher risk of obesity and face barriers to sports participation [Towne et al., 2018]. Future studies of KiPOWOC will further explore the subgroup findings identified, analyze study impact with the use of a comparison site, and grow partnerships with Title I OC schools
ISSN: 1098-4275
CID: 4849472

The Role of Superior Oblique Posterior Tenectomy Along With Inferior Rectus Recessions for the Treatment of Chin-up Head Positioning in Patients With Nystagmus

Escuder, Anna G; Ranka, Milan P; Lee, Kathy; Nam, Julie N; Steele, Mark A
PURPOSE/OBJECTIVE:To evaluate the clinical outcomes of bilateral superior oblique posterior 7/8th tenectomy with inferior rectus recession on improving chin-up head positioning in patients with horizontal nystagmus. METHODS:Medical records were reviewed from 2007 to 2017 for patients with nystagmus and chin-up positioning of 15° or more who underwent combined bilateral superior oblique posterior 7/8th tenectomy with an inferior rectus recession of at least 5 mm. RESULTS:Thirteen patients (9 males and 4 females) were included, with an average age of 7.3 years (range: 1.8 to 15 years). Chin-up positioning ranged from 15° to 45° degrees (average: 30°). Three patients had prior horizontal muscle surgeries, 1 for esotropia and 2 for horizontal null zones causing anomalous face turns. Ten patients underwent other concomitant eye muscle surgery: 3 had esotropia, 1 had exotropia, and 2 had biplanar nystagmus null point requiring a horizontal Anderson procedure. Four patients underwent simultaneous bilateral medial rectus tenotomy and reattachment. All patients had improved chin-up positioning. Eight patients had complete resolution, whereas 5 had minimal residual chin-up positioning. Three patients developed an eccentric horizontal gaze null point with compensatory anomalous face turn with onset 2 weeks, 2 years, and 3 years postoperatively. Average follow-up was 42.7 months. No postoperative pattern deviations, cyclodeviations, or inferior oblique overaction were seen. No surgical complications were noted. CONCLUSIONS:Bilateral superior oblique posterior 7/8th tenectomy in conjunction with bilateral inferior rectus recession is a safe and effective procedure for improving chin-up head positioning in patients with horizontal nystagmus with a down gaze null point. [J Pediatr Ophthalmol Strabismus. 201X;XX(X):XX-XX.].
PMID: 29809265
ISSN: 1938-2405
CID: 3165822

The Role of Superior Oblique Posterior Tenectomy Combined with Inferior Rectus Recession for the Treatment of Chin Up Head Positioning in Patients with Nystagmus [Meeting Abstract]

Escuder, Anna G; Ranka, Milan P; Lee, Kathy; Nam, Julie N; Steele, Mark A
ISSN: 0146-0404
CID: 2507142

Bilateral posterior tenectomy of the superior oblique muscle for the treatment of A-pattern strabismus

Ranka, Milan P; Liu, Grace T; Nam, Julie N; Lustig, Marc J; Schwartz, Shirah R; Hall, Lisabeth S; Furlan, Louis E; Ceisler, Emily J; Steele, Mark A
PURPOSE: To evaluate the efficacy of bilateral posterior superior oblique tenectomy for the treatment of A-pattern strabismus due to superior oblique overaction regardless of the magnitude of the pattern. METHODS: The medical records of patients with A-pattern esotropia or exotropia in the presence of superior oblique overaction who underwent combined horizontal muscle surgery along with bilateral superior oblique posterior 7/8 tenectomy from 2003 to 2013 were retrospectively reviewed. Patients with at least 3 months' follow-up were included. RESULTS: A total of 73 patients were included. Of these, 46 had esotropia; 27, exotropia. The preoperative A-pattern deviation for the study population was 19.6Delta +/- 11.4Delta (range, 10-60), with a final postoperative patten collapse of 18.2 +/- 3.6. Superior oblique overaction was 2.3 +/- 0.7 preoperatively and 0.3 +/- 0.7 postoperatively. Overall, 87.7% of patients had a successful collapse of their pattern to <10Delta following the initial bilateral superior oblique posterior tenectomy, with an additional 4.1% following a second procedure. Of patients with a pattern deviation of <25Delta, 87.9% had successful collapse of the pattern following 1 surgery, and 86.7% of patients who had a pattern of >/=25Delta had successful collapse. Postoperatively, 7 patients demonstrated mild inferior oblique overaction. No surgical complications were noted. CONCLUSIONS: A uniform dose of bilateral posterior 7/8 tenectomy surgery successfully collapses A-pattern deviations of all magnitudes.
PMID: 25262558
ISSN: 1091-8531
CID: 1259922

Surgical management of conjunctival loiasis [Case Report]

Nam, Julie N; Reddy, Shantan; Charles, Norman C
An increase in world travel has resulted in the appearance of tropical and third-world diseases in nonendemic locations. We report a case from New York City of an adult African eye worm, Loa loa, and the technique of its paralysis and removal from the epibulbar conjunctiva
PMID: 18645443
ISSN: 0740-9303
CID: 81350

The retinotopic distribution of localized attention assessed using the multifocal visual evoked potential [Meeting Abstract]

Kirzhner, M; Nam, JN; Clemens, CJ; Holopigian, K
ISSN: 0146-0404
CID: 55466

Reliability of perimetry: Measures of acuity, contrast sensitivity, and luminance detection [Meeting Abstract]

Nam, JN; Kirzhner, M; Clemens, CJ; Holopigian, K; Seiple, W
ISSN: 0146-0404
CID: 55467