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Dive into the research topics where Marilyn Rice is active.

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Featured researches published by Marilyn Rice.


Pediatrics | 2011

Intestinal Parasite Screening in Internationally Adopted Children: Importance of Multiple Stool Specimens

Mary Allen Staat; Marilyn Rice; Stephanie Donauer; Sheena Mukkada; Michol Holloway; Amy Cassedy; Jennifer Kelley; Shelia Salisbury

OBJECTIVE: Our goal was to determine the prevalence of intestinal parasites in internationally adopted children, to examine factors associated with infection, and to determine if evaluating multiple stool specimens increases the yield of parasite identification. METHODS: We evaluated internationally adopted children with at least 1 stool specimen submitted for ova and parasite testing within 120 days after arrival to the United States. In children submitting 3 stool specimens, in which at least 1 specimen was positive for the pathogen studied, we examined whether multiple stool specimens increased the likelihood of pathogen identification. RESULTS: Of the 1042 children studied, 27% had at least 1 pathogen identified; with pathogen-specific prevalence of Giardia intestinalis (19%), Blastocystis hominis (10%), Dientamoeba fragilis (5%), Entamoeba histolytica (1%), Ascaris lumbricoides (1%), and Hymenolepsis species (1%). The lowest prevalence occurred in South Korean (0%), Guatemalan (9%), and Chinese (13%) children, and the highest prevalence occurred in Ethiopian (55%) and Ukrainian (74%) children. Increasing age was significantly associated with parasite identification, whereas malnutrition and gastrointestinal symptoms were not. Overall, the yield of 1 stool specimen was 79% with pathogen recovery significantly increasing for 2 (92%) and 3 (100%) specimens, respectively (P < .0001). Pathogen identification also significantly increased with evaluation of additional stool specimens for children with and without gastrointestinal symptoms. CONCLUSIONS: We provide data for evidence-based guidelines for intestinal parasite screening in internationally adopted children. Gastrointestinal symptoms were not predictive of pathogen recovery, and multiple stool specimens increased pathogen identification in this high-risk group of children.


Pediatric Infectious Disease Journal | 2013

Infectious complications of intrathecal baclofen pump devices in a pediatric population.

Michelle Dickey; Marilyn Rice; Douglas G. Kinnett; Robin Lambert; Stephanie Donauer; Michael A. Gerber; Mary Allen Staat

Background: Intrathecal baclofen (ITB) is an effective therapy for spasticity and dystonia in pediatric populations; however, there are associated infectious complications. Methods: Patients who had an initial ITB device implanted at our center were followed to determine the proportion of patients with infectious and noninfectious complications, identify risk factors for infection and describe the clinical presentations, treatment and outcomes of infectious complications. Results: Over the 15-year study period, 139 patients had an initial ITB device placed. The mean age at placement was 13.6 years (range: 6 months to 41 years). In the first year of follow-up, 83% had no complications or secondary procedures, 17% had at least 1 secondary procedure and 5% had an infectious complication. The median time until infection was 14 days (mean 33 ± 42 days). Patients with secondary spasticity or dystonia were more likely to have infections than patients with cerebral palsy (86% versus 14%; P < 0.0001). In the 94 patients with a first secondary procedure, 29% had at least 1 other procedure and 8% had an infection in the 1 year follow-up. Overall, 24 patients had 27 infections; 22% superficial, 33% deep and 45% organ space. Staphylococcus aureus was isolated in 50% of those with cultures obtained. Explantation was required in 59% of patients with an infection and differed by infection type: superficial (17%), deep (44%) and organ space (92%) (P = 0.004). Conclusions: Infectious complications were relatively uncommon; however, when present, frequently led to the explantation of the ITB pump device.


Vaccine | 2010

Serologic testing to verify the immune status of internationally adopted children against vaccine preventable diseases

Mary Allen Staat; Laura Patricia Stadler; Stephanie Donauer; Indi Trehan; Marilyn Rice; Shelia Salisbury

Definitive immunization guidelines for internationally adopted children are lacking. We examined whether these children had serologic evidence of protection against vaccine-preventable diseases. For children with ≥3 vaccine doses, overall protection was high for diphtheria (85%), tetanus (95%), polio (93%), hepatitis B (77%), and Hib (67%). For children ≥12 months of age with ≥1 dose of measles, mumps, or rubella vaccines, 95%, 72%, and 94% were immune, respectively. Children without immunization documentation had lower immunity. Serologic testing was useful in verifying the immunization status in internationally adopted children with and without documentation of immunizations.


Pediatric Critical Care Medicine | 2012

2009 pandemic influenza A (H1N1) in critically ill children in Cincinnati, Ohio.

Carrie I. Morgan; Michael J. Hobson; Brandy Seger; Marilyn Rice; Mary Allen Staat; Derek S. Wheeler

Objective: To compare the clinical features, management, and outcome of critically ill children with H1N1 to children with seasonal influenza from the previous three influenza seasons. Design: The overall number of hospitalizations and the proportion cared for in the pediatric intensive care unit during the H1N1 epidemic period and the three previous influenza seasons (2007-2009) were determined. Medical records of patients admitted to the pediatric intensive care unit with H1N1 and seasonal influenza infection were reviewed. Setting: Cincinnati Children’s Hospital Medical Center, a large, 523-bed hospital located in Cincinnati. Patients: Hospitalized children with laboratory-confirmed seasonal or H1N1 infection. Measurements: Study variables included demographic data (age, gender), clinical factors (weight, Pediatric Risk of Mortality III scores, presenting signs and symptoms, comorbid conditions), management (length of mechanical ventilation, other treatments, including high-frequency oscillatory ventilatory support, inhaled nitric oxide, or extracorporeal membrane oxygenation), and outcome (overall and pediatric intensive care unit length of stay and mortality). Main Results: Overall, 312 children were hospitalized with H1N1 and 222 with seasonal influenza from the three previous seasons. Children with H1N1 infection were significantly less likely to require pediatric intensive care unit care compared to children with seasonal influenza infection (14% vs. 24%, p = .02). Compared to children with seasonal influenza, children in the pediatric intensive care unit with H1N1 were older (median age in months 107 vs. 68, p = .05) and significantly more likely to have comorbid conditions (64% vs. 40%, p = .03), especially respiratory conditions. While there were no significant differences in severity of illness by Pediatric Risk of Mortality III scores or pediatric intensive care unit length of stay, children with H1N1 were significantly less likely to have acute respiratory failure (p = .04) or die compared to children with seasonal influenza infection (p = .03). Conclusions: In contrast to other studies, we found that critically ill children with H1N1 had a significantly lower morbidity and mortality compared to children with seasonal influenza.


Pediatrics | 2010

Hepatitis A in Internationally Adopted Children: Screening for Acute and Previous Infections

Roohi Y. Abdulla; Marilyn Rice; Stephanie Donauer; Kelly R. Hicks; Dustin Poore; Mary Allen Staat

OBJECTIVE: The goal was to determine the prevalence of acute hepatitis A virus (HAV) infection and immunity among internationally adopted children. METHODS: Children seen at the International Adoption Center between September 25, 2006, and September 30, 2008, and were screened for HAV within 4 months after their arrival in the United States were eligible for the study. The age- and country-specific prevalence of acute HAV infection and immunity were determined. RESULTS: Overall, 288 children underwent HAV serological testing. Of the 279 with total HAV serological results, 29% had positive findings. Immunity varied according to region and country. The prevalence was lowest among children born in Asia/Pacific Rim region (17%) and highest among children born in Africa (72%). Only 13% of children <2 years of age were immune, compared with 80% of children 12 to 17 years of age (P = .002). Increasing age and birth region were associated independently with immunity. Positive HAV immunoglobulin M test results were found for 3 (1%) of 270 children; all were without symptoms. Their ages were 18, 27, and 41 months, and they were born in Kazakhstan, Russia, and the Latin America/Caribbean region, respectively. The father of 1 child developed HAV infection after arriving home. CONCLUSIONS: HAV immunity among internationally adopted children varied according to age and country of origin; 1% had acute infections. HAV screening is useful for determination of the need for HAV immunization and for prevention of transmission to family members and close contacts.


Pediatric Infectious Disease Journal | 2010

Estimating the Rotavirus Hospitalization Disease Burden and Trends, Using Capture-recapture Methods

Mary Allen Staat; Marilyn Rice; Stephanie Donauer; Daniel C. Payne; Joseph S. Bresee; T. Christopher Mast; Aaron T. Curns; Margaret M. Cortese; Beverly Connelly; Monica M. McNeal; Richard L. Ward; David I. Bernstein; Umesh D. Parashar; Shelia Salisbury

Background: Rotavirus surveillance is needed to provide estimates of disease burden and to evaluate the effect of vaccination programs. Our objective was to use capture-recapture methods to estimate rotavirus hospitalization rates and to examine trends over time. Methods: Children <3 years of age residing in Hamilton County, Ohio hospitalized with acute gastroenteritis, and laboratory-confirmed rotavirus between 1997 and 2008 were identified through 2 independent surveillance systems: an active system with prospective enrollment of children admitted with acute gastroenteritis and a passive system of children identified by rotavirus testing as part of their usual medical care. Capture-recapture methods compared cases from both systems to estimate the number of missed cases from either system. Using census data for Hamilton County, rates per 10,000 with 95% confidence intervals (CI) for rotavirus hospitalizations were estimated. Results: Overall, 486 cases were identified using active surveillance and 244 using passive surveillance, with 127 cases captured by both. Using capture-recapture methods, the overall rate in children <3 years old was 26.9/10,000; CI: 24.1, 30.6. Rates varied by year: highest in 1998 (48.1/10,000; CI: 32.4, 92.2) and lowest in 2008 (3.2/10,000; CI: 2.1, 6.1) after rotavirus vaccine introduction. Among children <5 years old, rates were highest in <3-month-old children (51.8/10,000; CI: 39.4, 75.1) and lowest in older age groups: 24 to 35 months (20.5/10,000; CI: 14.7, 30.3) and 36 to 59 months (4.1/10,000; CI: 2.9, 7.2). Rates from capture-recapture methods and adjusted active system were comparable. Conclusions: Capture-recapture methods were a useful tool to estimate rotavirus disease burden and to monitor trends, especially in the era of rotavirus immunization.


Vaccine | 2013

Rotavirus-associated hospitalization and emergency department costs and rotavirus vaccine program impact☆

April Kilgore; Stephanie Donauer; Kathryn M. Edwards; Geoffrey A. Weinberg; Daniel C. Payne; Peter G. Szilagyi; Marilyn Rice; Amy Cassedy; Ismael R. Ortega-Sanchez; Umesh D. Parashar; Mary Allen Staat

OBJECTIVES To determine the medical costs of laboratory-confirmed rotavirus hospitalizations and emergency department (ED) visits and estimate the economic impact of the rotavirus vaccine program. PATIENTS AND METHODS During 4 rotavirus seasons (2006-2009), children <3 years of age hospitalized or seen in the ED with laboratory-confirmed rotavirus were identified through active population-based rotavirus surveillance in three US counties. Medical costs were obtained from hospital and physician billing data, and factors associated with increased costs were examined. Annual national costs were estimated using rotavirus hospitalization and ED visit rates and medical costs for rotavirus hospitalizations and ED visits from our surveillance program for pre- (2006-2007) and post-vaccine (2008-2009) time periods. RESULTS Pre-vaccine, for hospitalizations, the median medical cost per child was


Vaccine | 2010

Factors associated with protective antibody levels to vaccine preventable diseases in internationally adopted children

Laura Patricia Stadler; Stephanie Donauer; Marilyn Rice; Indi Trehan; Shelia Salisbury; Mary Allen Staat

3581, the rotavirus hospitalization rate was 22.1/10,000, with an estimated annual national cost of


Clinical Infectious Diseases | 2017

Enterovirus D68 Infection Among Children With Medically Attended Acute Respiratory Illness, Cincinnati, Ohio, July–October 2014

Holly M. Biggs; Monica M. McNeal; W. Allan Nix; Carolyn M. Kercsmar; Aaron T. Curns; Beverly Connelly; Marilyn Rice; Shur-Wern Wang Chern; Mila M. Prill; Nancy Back; M. Steven Oberste; Susan I. Gerber; Mary Allen Staat

91 million. Post-vaccine, the median medical cost was


Pediatric Blood & Cancer | 2018

Glucose-6-phosphate dehydrogenase deficiency in internationally adopted children

Rachel Spring; Hanna Schlaack; Marilyn Rice; Mary Allen Staat; Charles T. Quinn

4304, the hospitalization rate was 6.3/10,000 and the estimated annual national cost was

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Mary Allen Staat

Cincinnati Children's Hospital Medical Center

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Stephanie Donauer

Cincinnati Children's Hospital Medical Center

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Shelia Salisbury

Cincinnati Children's Hospital Medical Center

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Daniel C. Payne

Centers for Disease Control and Prevention

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Umesh D. Parashar

Centers for Disease Control and Prevention

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Aaron T. Curns

National Center for Immunization and Respiratory Diseases

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Amy Cassedy

Cincinnati Children's Hospital Medical Center

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Beverly Connelly

Cincinnati Children's Hospital Medical Center

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Indi Trehan

Washington University in St. Louis

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