
Hilary Seeley
Clinical Assistant Professor, Pediatrics - Endocrinology and Diabetes
Clinical Focus
- Pediatric Endocrinology
Professional Education
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Fellowship: Stanford University Pediatric Endocrinology Fellowship (2017) CA
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Residency: UCSF Pediatric Residency (2013) CA
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Medical Education: University of California Davis School of Medicine (2010) CA
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Board Certification: American Board of Pediatrics, Pediatric Endocrinology (2017)
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Board Certification: American Board of Pediatrics, Pediatrics (2015)
All Publications
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Parathyroid Autofluorescence in Pediatric Thyroid Surgery: Experience With False Positive and False Negative Results.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
2023
Abstract
Devices for near-infrared light stimulation of autofluorescence (NIRAF) allow for intraoperative identification of parathyroid glands with high sensitivity in adults. However, their performance in the pediatric population is unknown. In this case series with chart review at a tertiary academic children's hospital, we investigated pediatric patients undergoing thyroid surgery and concurrent use of a probe-based NIRAF device. Thirteen patients (ages 6-18 years) underwent thyroid and/or neck dissection procedures, and 2 patients had revision procedures for a total of 15 cases with the NIRAF device. Eight cases had NIRAF values that matched surgeon opinion of parathyroid tissue or histology when available. Six cases had false positive NIRAF readings (40.0%) and 1 case had false negative readings (6.7%). Compared with surgeon opinion or histology, the NIRAF device confirmed 26 of 34 parathyroid gland candidates (76.5%). These devices need further investigation in pediatric patients, whose tissues may have different autofluorescence characteristics.
View details for DOI 10.1002/ohn.272
View details for PubMedID 36939554
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Sociodemographic Disparities in the Diagnostic Management of Pediatric Thyroid Nodules.
JAMA otolaryngology-- head & neck surgery
2022
Abstract
Importance: Thyroid cancer is the most common pediatric endocrine malignant neoplasm. Disparities in the workup of thyroid nodules may be significantly associated with thyroid cancer outcomes.Objective: To determine the association of sociodemographic factors with the odds of receiving a biopsy, timeliness of the procedure, and risk of nodule malignancy.Design, Setting, and Participants: This was a retrospective cross-sectional study using insurance claims data from the Optum Clinformatics Data Mart database. The study cohort comprised pediatric patients diagnosed with single thyroid nodules between 2003 and 2020. Data analysis was performed from January 1, 2003, to June 30, 2020.Main Outcomes and Measures: Multivariable logistic regression models were used to identify demographic variables associated with biopsy and nodule malignant neoplasm. A multivariable linear regression model was used to assess the time between thyroid nodule diagnosis and biopsy.Results: Of 11 643 children (median [IQR] age at diagnosis or procedure, 15 [12-17] years; 8549 [73.2%] were female and 3126 [26.8%] were male) diagnosed with single thyroid nodules, 2117 (18.2%) received a biopsy. Among the patients who received a biopsy, 304 (14.4%) were found to have a malignant nodule. Greater parental education was associated with a shorter diagnosis-to-biopsy interval (mean difference, -7.24 days; 95% CI, -13.75 to -0.73). Older age at nodule diagnosis (odds ratio [OR], 1.11; 95% CI, 1.09-1.13) and female gender (OR, 1.25; 95% CI, 1.11-1.40) were associated with increased odds of receiving a biopsy, while Black/African American (OR, 0.80; 95% CI, 0.65-0.99) and Hispanic (OR, 0.84; 95% CI, 0.72-0.99) patients had lower odds of receiving a biopsy compared with White patients. Finally, female gender (OR, 1.08; 95% CI, 0.80-1.47) was not associated with lower odds of nodule malignant neoplasm.Conclusions and Relevance: Findings of this cross-sectional study highlight disparities in the diagnostic management of pediatric thyroid nodules. These results call for future work to ensure equitable access to thyroid care for all children.
View details for DOI 10.1001/jamaoto.2022.3167
View details for PubMedID 36227590
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Type 1 Diabetes is Associated with Bone and Muscle Deficiencies in Children and Adolescents
WILEY. 2020: 76
View details for Web of Science ID 000593119300207
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Type 1 Diabetes Mellitus and the Presence of Other Autoimmune Disease
JOURNAL OF PEDIATRICS
2020; 223: 19-+
View details for Web of Science ID 000551283500006
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LEG LEAN MASS IS CORRELATED WITH BONE MINERAL DENSITY IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES
KARGER. 2017: 418
View details for Web of Science ID 000412595404225