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Thaker, Vidhu V.

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Thaker

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Vidhu V.

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Thaker, Vidhu V.
Author's Publications: search.filters.isAuthorOfPublication.1b7e411d-1a5e-4033-9c23-0a61b005582e

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    Suboptimal Clinical Documentation in Young Children with Severe Obesity at Tertiary Care Centers
    (Hindawi Publishing Corporation, 2016) Brady, Cassandra C.; Thaker, Vidhu V.; Lingren, Todd; Woo, Jessica G.; Kennebeck, Stephanie S.; Namjou-Khales, Bahram; Roach, Ashton; Bickel, Jonathan; Patibandla, Nandan; Savova, Guergana; Solti, Imre; Holm, Ingrid; Harley, John B.; Kohane, Isaac; Crimmins, Nancy A.
    Background and Objectives. The prevalence of severe obesity in children has doubled in the past decade. The objective of this study is to identify the clinical documentation of obesity in young children with a BMI ≥ 99th percentile at two large tertiary care pediatric hospitals. Methods. We used a standardized algorithm utilizing data from electronic health records to identify children with severe early onset obesity (BMI ≥ 99th percentile at age <6 years). We extracted descriptive terms and ICD-9 codes to evaluate documentation of obesity at Boston Children's Hospital and Cincinnati Children's Hospital and Medical Center between 2007 and 2014. Results. A total of 9887 visit records of 2588 children with severe early onset obesity were identified. Based on predefined criteria for documentation of obesity, 21.5% of children (13.5% of visits) had positive documentation, which varied by institution. Documentation in children first seen under 2 years of age was lower than in older children (15% versus 26%). Documentation was significantly higher in girls (29% versus 17%, p < 0.001), African American children (27% versus 19% in whites, p < 0.001), and the obesity focused specialty clinics (70% versus 15% in primary care and 9% in other subspecialty clinics, p < 0.001). Conclusions. There is significant opportunity for improvement in documentation of obesity in young children, even years after the 2007 AAP guidelines for management of obesity.
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    Hypothyroidism in Infants With Congenital Heart Disease Exposed to Excess Iodine
    (Endocrine Society, 2017) Thaker, Vidhu V.; Galler, Marjorie F.; Marshall, Audrey C.; Almodovar, Melvin C.; Hsu, Ho-Wen; Addis, Christopher J.; Feldman, Henry; Brown, Rosalind; Levine, Bat-Sheva
    Thyroid hormone is critical for neonatal brain development, and even transient hypothyroidism can cause adverse neurocognitive outcomes. Infants exposed to excess iodine are at risk of developing hypothyroidism, especially those with congenital heart disease (CHD), because they are routinely exposed to excess iodine from intravenous iodinated contrast media and topical antiseptics. The aim of the present study was to identify the proportion of neonates with CHD exposed to iodine who developed hypothyroidism and to identify the associated risk factors. This was a retrospective study of neonates undergoing cardiac catheterization at Boston Children’s Hospital during a 3-year period, some of whom also underwent cardiac surgery. Hypothyroidism was defined as an elevated thyroid-stimulating hormone level (>20 mIU/L at 24 to 96 hours of age and >15 mIU/L at >96 hours of age by heel-stick sampling and >9.1 mIU/L at 1 to 20 weeks of age by serum testing). Multivariate logistic regression was performed to predict the odds of developing hypothyroidism. Hypothyroidism was diagnosed incidentally in 46 of 183 infants (25%) with CHD after iodine exposure. Controlling for baseline cardiac risk, postnatal age, and gestational age, we found a fourfold increase in odds of developing hypothyroidism in neonates with serum creatinine >0.9 mg/dL and a fourfold increase in those who underwent more than three procedures. Hypothyroidism in neonates with CHD exposed to excess iodine is associated with multiple procedures and impaired renal function. Routine serial monitoring of thyroid function in these neonates is warranted. Future studies should examine the association between hypothyroidism and neurocognitive function in this population.