Caroline Okorie

All Publications

• Sparking a Movement, Not a Moment: Framework and Outcomes From a Pediatrics Department-Wide Coalition to Advance Anti-Racism ACADEMIC PEDIATRICS Yemane, L., Ramirez, M., Guerin, A., Floyd, B., Okorie, C. A., Ling, W., Addala, A., Figg, L., Talley, E. M., Chamberlain, L. 2023; 23 (5): 886-892

  View details for Web of Science ID 001039988800001

• A Visiting Rotation for Underrepresented in Medicine Pediatric Residents Is Valuable for Recruitment Into Pediatric Fellowships. Journal of graduate medical education Okorie, C. U., Kibrom, S., Rotandi, C. L., Guerin, A., Gans, H. A., Blankenburg, R. 2023; 15 (3): 397-399

  View details for DOI 10.4300/JGME-D-22-00793.1

  View details for PubMedID 37363674

• ATS Core Curriculum 2022. Pediatric Pulmonary Medicine: Updates in pediatric neuromuscular disease. Pediatric pulmonology Leon-Astudillo, C., Okorie, C. U., McCown, M. Y., Dy, F. J., Puranik, S., Prero, M., ElMallah, M. K., Treat, L., Gross, J. E. 2023

  Abstract

  The American Thoracic Society Core Curriculum updates clinicians annually in pediatric pulmonary disease. This is a concise review of the Pediatric Pulmonary Medicine Core Curriculum presented at the 2022 American Thoracic Society International Conference. Neuromuscular diseases (NMD) comprise a variety of conditions that commonly affect the respiratory system and cause significant morbidity including dysphagia, chronic respiratory failure, and sleep disordered breathing. Respiratory failure is the most common cause of mortality in this population. Substantial progress has been made in diagnosis, monitoring and treatment for NMD over the last decade. Pulmonary function testing (PFT) is utilized to objectively measure respiratory pump function and PFT milestones are utilized in NMD-specific pulmonary care guidelines. New disease modifying therapies are approved for the treatment of patients with Duchenne muscular dystrophy and spinal muscular atrophy (SMA), including the first ever approved systemic gene therapy, in the case of SMA. Despite extraordinary progress in the medical management of NMD, little is known regarding the respiratory implications and long-term outcomes for patients in the era of advanced therapeutics and precision medicine. The combination of technological and biomedical advancements has increased the complexity of the medical decision-making process for patients and families, thus emphasizing the importance of balancing respect for autonomy with the other foundational principles of medical ethics. This review features an overview of PFT, noninvasive ventilation strategies, novel and developing therapies, as well as the ethical considerations specific to the management of patients with pediatric NMD.

  View details for DOI 10.1002/ppul.26448

  View details for PubMedID 37144867

• Sparking a Movement, Not a Moment: Framework and Outcomes from a Pediatrics Department-Wide Coalition to Advance Anti-Racism: Running Title: Pediatrics Department Coalition to Advance Anti-Racism. Academic pediatrics Yemane, L., Ramirez, M., Guerin, A., Floyd, B., Okorie, C. U., Ling, W., Addala, A., Figg, L., Talley, E. M., Chamberlain, L. 2022

  Abstract

  BACKGROUND: The Stanford Pediatrics Advancing Anti-Racism Coalition (SPAARC) was created to promote a culture of anti-racism through immediate action, development of nimble systems, and longitudinal commitment towards equity.OBJECTIVE: Evaluate gaps in the Stanford Department of Pediatrics (DoP) efforts to advance anti-racism and form a coalition of faculty, staff, and trainees to prioritize, design, and implement targeted activities with immediate and long-term measurable outcomes.METHODS: A needs assessment was conducted across all DoP members in July-August 2020 to identify gaps in anti-racism efforts. Listening sessions were recorded and transcribed to extrapolate key themes and two rounds of consensus surveys were done to identify and prioritize actions. Actions teams were created and co-led by faculty-staff dyads with trainee representation. A final activity survey was conducted in January 2021 to determine the specific activities (i.e., interventions) each team would design and implement.RESULTS: Ten small group listening sessions (70 participants) and three surveys (1005 responses) led to the creation of seven action teams with associated activities (1) training (2) community engagement and research (3) communication (4) faculty and staff recruitment and advancement (5) leadership representation (6) human resources, and (7) staff engagement. 443 (41%) DoP members were directly involved in SPAARC through participation in the needs assessment, action teams, and/or implementation of activities.CONCLUSION: SPAARC can serve as an adaptable framework for how a DoP can create a coalition to identify gaps in anti-racism efforts and create and implement targeted activities with associated outcomes.

  View details for DOI 10.1016/j.acap.2022.10.003

  View details for PubMedID 36216211

• Pediatric Pulmonary Year in Review 2021: Sleep Medicine. Pediatric pulmonology Okorie, C. U., Afolabi-Brown, O., Tapia, I. E. 2022

  Abstract

  Pediatric pulmonology publishes original research, review articles, and case reports on a wide variety of pediatric respiratory disorders. In this article, we summarized the past year's publications in sleep medicine and reviewed selected literature from other journals in this field. We focused on original research articles exploring aspects of sleep-disordered breathing in patients with underlying conditions such as Cystic Fibrosis, asthma, and sickle cell disease. We also explored sleep-disordered breathing risk factors, monitoring, diagnosis, and treatment; and included recent recommendations for drug-induced sleep endoscopy and ways to monitor and improve PAP adherence remotely. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1002/ppul.26047

  View details for PubMedID 35779240

• The Use of Auto-Titrating Continuous Positive Airway Pressure (AutoCPAP) for Obstructive Sleep Apnea Syndrome in Children with Obesity CHILDREN-BASEL Benke, S., Okorie, C. A., Tablizo, M. A. 2021; 8 (12)

  View details for DOI 10.3390/children8121204

  View details for Web of Science ID 000735595100001

• Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea. Children (Basel, Switzerland) Hady, K. K., Okorie, C. U. 2021; 8 (11)

  Abstract

  Pediatric obstructive sleep apnea syndrome (OSAS) is a disorder of breathing during sleep, characterized by intermittent or prolonged upper airway obstruction that can disrupt normal ventilation and/or sleep patterns. It can affect an estimated 2-4% of children worldwide. Untreated OSAS can have far reaching consequences on a child's health, including low mood and concentration as well as metabolic derangements and pulmonary vascular disease. Most children are treated with surgical intervention (e.g., first-line therapy, adenotonsillectomy); however, for those for whom surgery is not indicated or desired, or for those with postoperative residual OSAS, positive airway pressure (PAP) therapy is often employed. PAP therapy can be used to relieve upper airway obstruction as well as aid in ventilation. PAP therapy is effective in treatment of OSAS in children and adults, although with pediatric patients, additional considerations and limitations exist. Active management and care for various considerations important to pediatric patients with OSAS can allow PAP to be an effective and safe therapy in this population.

  View details for DOI 10.3390/children8110979

  View details for PubMedID 34828692

• ATS Core Curriculum 2021. Pediatric Pulmonary Medicine: Pulmonary Infections. ATS scholar Gross, J. E., McCown, M. Y., Okorie, C. U., Bishay, L. C., Dy, F. J., Astudillo, C. L., Muhlebach, M. S., Abu-Nassar, S., Chen, D. Y., Hossain, N., Wang, R., Klouda, T., Martiniano, S. L., Lenhart-Pendergrass, P., Kirkby, S., Ortenberg, R., McSparron, J. I., Wang, T., Hayes, M. M., Coruh, B. 2021; 2 (3): 452-467

  Abstract

  The following is a concise review of the Pediatric Pulmonary Medicine Core reviewing pediatric pulmonary infections, diagnostic assays, and imaging techniques presented at the 2021 American Thoracic Society Core Curriculum. Molecular methods have revolutionized microbiology. We highlight the need to collect appropriate samples for detection of specific pathogens or for panels and understand the limitations of the assays. Considerable progress has been made in imaging modalities for detecting pediatric pulmonary infections. Specifically, lung ultrasound and lung magnetic resonance imaging are promising radiation-free diagnostic tools, with results comparable with their radiation-exposing counterparts, for the evaluation and management of pulmonary infections. Clinicians caring for children with pulmonary disease should ensure that patients at risk for nontuberculous mycobacteria disease are identified and receive appropriate nontuberculous mycobacteria screening, monitoring, and treatment. Children with coronavirus disease (COVID-19) typically present with mild symptoms, but some may develop severe disease. Treatment is mainly supportive care, and most patients make a full recovery. Anticipatory guidance and appropriate counseling from pediatricians on social distancing and diagnostic testing remain vital to curbing the pandemic. The pediatric immunocompromised patient is at risk for invasive and opportunistic pulmonary infections. Prompt recognition of predisposing risk factors, combined with knowledge of clinical characteristics of microbial pathogens, can assist in the diagnosis and treatment of specific bacterial, viral, or fungal diseases.

  View details for DOI 10.34197/ats-scholar.2021-0034RE

  View details for PubMedID 34667993

• The Use of Auto-titrating Continuous Positive Airway Pressure (autoCPAP) for Obstructive Sleep Apnea Syndrome in Children with Obesity Benke, S., Okorie, C. A., Platter, L., Tablizo, M. A. AMER THORACIC SOC. 2021

  Abstract

  Positive airway pressure can be an effective and safe therapy for children with obstructive sleep apnea syndrome (OSAS). Few studies have assessed the safety and efficacy of autoCPAP in pediatric patients with obesity.This was a retrospective chart review of children with obesity (Body Mass Index (BMI) > 99th percentile), ages 2-18, diagnosed with OSAS (Obstructive Apnea-Hypopnea Index (OAHI) > 1/h) and used autoCPAP with 30-day adherence. Exclusion criteria included patients with complex comorbidities. Adherence was defined as autoCPAP use ≥4 h/night for at least 21/30 days. Baseline PSG OAHI was compared to the AHI from the 30-day autoCPAP compliance report. We also compared autoCPAP 30-day 95th percentile pressures with the pressures from PAP titration.The study included 19 children, ranging 5-15 years old. The median BMI was 99.6th percentile and average adherence was 25/30 nights with mean of 7.3 h/night. The median OAHI was 12.3/h on baseline PSG and the 30-day autoCPAP download AHI decreased to 1.7/h. No adverse outcomes were identified. The average difference between 95th percentile autoCPAP pressure and PAP titration pressure was 0.89 cmH20.Our study suggests autoCPAP is effective and safe for the treatment of OSAS in pediatric patients with obesity. Using autoCPAP may reduce delays in treatment. Additional research is needed to verify the long-term effectiveness of autoCPAP in this population.

  View details for Web of Science ID 000685468903106

  View details for PubMedID 34943400

• Sleep Disordered Breathing and Prader-Willi Syndrome Complex Sleep Breathing Disorders Okorie, C. U., Ingram, D. G. Springer. 2021: 197-203

  View details for DOI 10.1007/978-3-030-57942-5_18

• ATS Core Curriculum 2020. Pediatric Pulmonary Medicine. ATS scholar Gross, J. E., McCown, M. Y., Okorie, C., Bishay, L. C., Dy, F. J., Rettig, J. S., Baker, C. D., Balmes, J. R., Barber, A. T., Bose, S. K., Casey, A., Hawkins, S. M., Kass, A., Keim, G., Mokhallati, N., Montgomery, G., Peranteau, W. H., Serrano, R., Vece, T. J., Yehya, N., Boyer, D., Hayes, M. M. 2020; 1 (4): 456–75

  Abstract

  The American Thoracic Society Core Curriculum updates clinicians annually in adult and pediatric pulmonary disease, medical critical care, and sleep medicine, in a 3- to 4-year recurring cycle of topics. These topics will be presented at the 2020 International Conference. Below is the pediatric pulmonary medicine core, including pediatric hypoxemic respiratory failure; modalities in noninvasive management of chronic respiratory failure in childhood; surgical and nonsurgical management of congenital lung malformations; an update on smoke inhalation lung injury; an update on vaporizers, e-cigarettes, and other electronic delivery systems; pulmonary complications of sarcoidosis; pulmonary complications of congenital heart disease; and updates on the management of congenital diaphragmatic hernia.

  View details for DOI 10.34197/ats-scholar.2020-0022RE

  View details for PubMedID 33870313

• The nocturnal-polysomnogram and "non-hypoxic sleep-disordered-breathing" in children SLEEP MEDICINE Guilleminault, C., Huang, Y., Chin, W., Okorie, C. 2019; 60: 31–44

  View details for DOI 10.1016/j.sleep.2018.11.001

  View details for Web of Science ID 000473718100006

• Sleep The Handbook of Personal Health and Wellbeing for Physicians and Trainees Okorie, C. U. edited by Weiss Roberts, L., Trockel, M. Springer International Publishing. 2019
• Allergic Bronchopulmonary Aspergillosis. Journal of fungi (Basel, Switzerland) Tracy, M. C., Okorie, C. U., Foley, E. A., Moss, R. B. 2016; 2 (2)

  Abstract

  Allergic bronchopulmonary aspergillosis (ABPA), a progressive fungal allergic lung disease, is a common complication of asthma or cystic fibrosis. Although ABPA has been recognized since the 1950s, recent research has underscored the importance of Th2 immune deviation and granulocyte activation in its pathogenesis. There is also strong evidence of widespread under-diagnosis due to the complexity and lack of standardization of diagnostic criteria. Treatment has long focused on downregulation of the inflammatory response with prolonged courses of oral glucocorticosteroids, but more recently concerns with steroid toxicity and availability of new treatment modalities has led to trials of oral azoles, inhaled amphotericin, pulse intravenous steroids, and subcutaneously-injected anti-IgE monoclonal antibody omalizumab, all of which show evidence of efficacy and reduced toxicity.

  View details for DOI 10.3390/jof2020017

  View details for PubMedID 29376934

  View details for PubMedCentralID PMC5753079

• Diagnosis And Management Of Sporadic Pulmonary Arteriovenous Malformation Not Associated With Hereditary Hemorrhagic Telangiectasia Okorie, C., Bhargava, S. AMER THORACIC SOC. 2016

  View details for Web of Science ID 000390749605287

• A Presentation Of Hepatopulmonary Syndrome In A Five Year Old During Evaluation For Miliary Tuberculosis Okorie, C. U., Mark, J. D. AMER THORACIC SOC. 2015

  View details for Web of Science ID 000377582808172

• Successful Treatment Of Mineral Oil Associated Lipoid Pneumonia In An Infant Okorie, C., Powers, M. AMER THORACIC SOC. 2013

  View details for Web of Science ID 000209839101412