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FYI Fridays
May 15, 2015
How are we doing?

Russell HospitalThis is an appropriate time to reflect on the progress towards the goals we set for the DOP this year.  Starting with Safety, we have made several major advances.  We have focused on reducing serious safety events (SSEs) and codes outside the ICU as precursor events to SSEs.  As recently presented at the faculty meeting, in 2014 the rate of SSEs decreased by 53% from 2013. In the first 4 months of 2015, the rate of SSEs has decreased by an additional 24% over 2014.  We will not be content until there is no preventable harm to children but I am extremely pleased with the progress we have made.  We believe that our process learning from root cause analysis (RCA) will further reduce the SSE rate over the next year.
Our goal to improve access to care continues to be the most important clinical focus.  We have significantly reduced the wait time for third next available appointments in Gastroenterology and improved in Neurology.  Still, we are not close to our goal of 10 days.  We have recruited 18 new faculty who have started or will begin work this summer.  We will continue to increase faculty size to meet clinical demand until we achieve this goal.  In addition, major recruiting efforts are underway to find a director for the new Division of Developmental and Behavioral Pediatrics, and a director for the Office for Faculty Development.
We have improved our NIH rankings to #17 and new grants this year are on track for us to further improve our funding and ranking.  We have established the Pediatric Research Office (PRO) and it has already begun to help investigators in the DOP advance their research programs.  The UAB CTSA received an excellent (fundable) NIH priority score and this will further advance our research infrastructure over the next 5 years.
The board pass rate for pediatric residents and med-peds residents has remained perfect (100%) and we have begun to expand the number of fellowship opportunities to provide a consistent training pathway for subspecialists who can join us and other outstanding Departments of Pediatrics as future faculty.  

FYI Fridays continues to be an important mechanism for communication but we seek to do better.  We are recruiting for a Communications Specialist to help us better serve those in the DOP, improve our website and the ways we communicate with our partners throughout Alabama in improving the health of the Children of Alabama.

Mitch Cohen
 Alabama Child Health Improvement Alliance (ACHIA) News
The Alabama Child Health Improvement Alliance (ACHIA) is rolling out the Help Me Grow Alabama (HMGA) Developmental Screening collaborative to help primary care practices increase identification of children at risk of developmental and behavioral delays as well as connect these children to appropriate resources.

Currently, only 12% of Alabama’s children complete the recommended standardized screens. As a result, children with delays are not identified until kindergarten or later.  Using screens more than doubles identification of those at risk at an age when early intervention leads to optimal outcomes.

Advantages for practices working in the collaborative setting include access to content experts such as Myriam Peralta, MD, peer-to-peer learning among collaborative members, and measuring improvement to be certain the changes are leading to better care. In addition, providers on the team are eligible for 25 points American Board of Pediatrics (ABP) Maintenance of Certification Part 4 and 20 points of Continuing Medical Education (CME).  This is the first ACHIA collaborative where CME is awarded for Performance Improvement as well as ACHIA’s  first “all virtual” collaborative where participation is through an online platform. HMGA runs from May 2015-January 2016. For more information, contact Cason Benton, MD, FAAP
Cason Benton
The 2015 Employee Engagement and Faculty Engagement Surveys are live now through May 18. Take your confidential survey today.
Presentations by Our Colleagues

Dr. Durant
Nefertiti Durant, M.D.   
has been invited to present 
"Physical Activity and Exercise in Treating Obesity in
Minority Populations"
at the 
2016 Annual Meeting of the Endocrinology Society
Boston, MA

UAB Neonatology Perinatal 
Grand Rounds

Optimal Oxygenation of the
Newborn - What Do We Know?
Ola Didrik Saugstad, MD, PhD
Professor of Pediatrics at the University of Oslo
Director of Department of 
Pediatric Research
Consultant in Neonatology
May 20, 2015
3:00 pm
5320 Women and Infants Center

Bradford Dean Dixon
Memorial Lectureship Presents

 ““Unraveling the pathophysiology of Autism Spectrum Disorders (ASD): after gene discovery,
then what?”
Matthew W. State, MD, PhD
Chair, Department of Psychiatry
Oberndorf Family Distinguished
Professor in Psychiatry
University of CA, San Francisco

May, 21, Noon
Bradley Lecture Center
Faculty interested in attending a round table discussion with Dr. State on May 21 from 10:30-11:30 click here to reserve a spot

Click here for a list of our Pediatric Highlighted Events

 Pediatric Grand Rounds Link

UAB Comprehensive
Cancer Center

Pilot Grant in Pediatric Cancer
Request for Applications
Deadline: 5pm, May 22

Clinical and Basic Science
SOM Faculty 

Call for Lead Mentor applications
Application Deadline 
5pm, Friday, May 29

Link to NIH Weekly Funding Opportunities
Pediatric Residency News

Please join us tomorrow for the
9th Annual Spring Scramble
May 16, 2015 at 5:30 p.m.

at Brookwood Village and
the Lakeshore Trail
Followed by Live Music, Games, Saw's Food Truck,
Dreamcakes and Steel City Pops

Click here for more information!

Pediatric Residency is pleased to announce the
Pediatric Chief Residents
Courtney Campbell, MD
Adam Hurst, MD
Samuel Strachan, MD


Pediatric Resident
Graduation Banquet

June 5th, 6:00 pm
All faculty and fellows welcome!
Please check email for evite invitation.
Email with any questions. 
Dr. Ambal
A study published in March in the Journal of Pediatrics by Dr. Namasivayam Ambalavanan, and his team, "Integrated genomic analyses in bronchopulmonary dysplasia," has generated much interest in the field and was highlighted by two editorials in the same journal:
Undiagnosed Diseases Program
Pediatric Consulting MD
Case Review
Monday, May 18th
7:30-8:30 am
Surgical Commons
We will then resume every-other-month meetings on third Mondays, starting July 20th.
The deadline for submission of information for inclusion in the FYI Fridays newsletter is 10:00am on the preceding Thursday.
FYI Fridays Archive
New Grants
Four grants were selected to received the first School of Medicine
AMC21 Reload Multi-investigator grants:  
  1. “Congenital CMV Infection in a Highly Seroimmune, Urban Maternal Population”,  PI-William Britt, M.D.
  2. “Protein O-GlcNAcylation: Central Mediator of Metabolic Induced Cardiovascular Complications”, PI-John Chatham, Ph.D.
  3. “The Pathogenesis and Treatment of Chronic Bronchitis”, 
    PI-Steven Rowe, M.D.
  4. “Optimizing Patient Engagement in Recommended Health Care: A Patient-Centered Approach”, PI-Kenneth Saag, M.D. (With team member Dr. Smita Bhatia
Click here to read the full announcement letter.
Smita Bhatia MD (Ped-Hem/Onc) Childhood Cancer Survivor Study. St. Jude Children's Research Hospital. $2,855. 01/05/2015 - 11/30/2015.
Smita Bhatia MD (Ped-Hem/Onc) Comprehensive Approach to Improve Medicine Adherence in Pediatric Leukemia. National Cancer Institute/NIH/DHHS. $570,751. 01/01/2015 - 12/31/2015.
Smita Bhatia MD (Ped-Hem/Onc) Low Dose Tamoxifen in Hodgkin Lymphoma Survivors for Breast Cancer Risk. National Cancer Institute/NIH/DHHS. $348,987. 01/01/2015 - 05/31/2016.
Smita Bhatia MD (Ped-Hem/Onc) Role of Genetic Susceptibility in Therapy-Related Subsequent Malignancies. National Cancer Institute/NIH/DHHS. $89,068. 01/01/2015 - 11/30/2015.
Waldemar Carlo MD (Ped – Neonatology) Cooperative Multicenter Neonatal Research Network - UAB National Institute of Child Health and Human Development/NIH/DHHS. $288,605. 04/01/2015 - 03/31/2016.
Waldemar Carlo MD (Ped – Neonatology) Discovery Laboratories, Inc. $2,150. 11/13/2014 - 11/12/2015.
Marilyn Crain MD (Ped – ID) Pediatric HIV/AIDS Cohort Study: Surveillance Monitoring for ART Toxicities Study (SMARTT) PHACS 101 (aka TDF). Harvard School of Public Health. $70,080. 08/01/2014 - 07/31/2015.
Karen Fowler PhD (Ped – ID) Influenza Immunization of Children in India (A Study in Ballabgarh, North India) (extension of Direct and Indirect Protection by Influenza Vaccine Given to Children in India). University of Colorado. $100,000. 09/30/2014 - 09/29/2015.
William King MD (Ped ) Booster Seat Advocacy Program. Alabama Department of Public Health. $10,000. 10/01/2014 - 09/30/2015.
Wendy Landier, PhD (Ped - Hem/Onc) Quadrivalent Human Papillomavirus (HPV) Vaccine in Cancer Survivors. National Cancer Institute/NIH/DHHS. $551,166. 04/01/2015 - 03/31/2016.
Alyssa Reddy MD (Ped - Hem/Onc) Millennium Pharmaceuticals, Inc. $3,000. 10/01/2012 - 11/01/2012.
Recent and Upcoming Publications
 2015 Mar;166(3):531-7.e13. doi: 10.1016/j.jpeds.2014.09.052. Epub 2014 Nov 6. Integrated genomic analyses in bronchopulmonary dysplasia. Ambalavanan N, Cotten CM, Page GP, Carlo WA, Murray JC, Bhattacharya S, Mariani TJ, Cuna AC, Faye-Petersen OM, Kelly D, Higgins RD; Genomics and Cytokine Subcommittees of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.
See articles discussed above for more information regarding this publication.
 2015 May 6. pii: 1099800415585157. Associations of Maternal and Infant Testosterone and Cortisol Levels With Maternal Depressive Symptoms and Infant Socioemotional Problems. Cho J, Su X, Phillips V, Holditch-Davis D.
This study examined the associations of testosterone and cortisol levels with maternal depressive symptoms and infant socioemotional (SE) problems that are influenced by infant gender.

J Surg Res. 2015 Apr 8. pii: S0022-4804(15)00404-7. doi: 10.1016/j.jss.2015.04.007. Surgical management and morbidity of pediatric magnet ingestions. Waters AM, Teitelbaum DH, Thorne V, Bousvaros A, Noel RA, Beierle EA.
Rare earth magnets are extremely powerful magnets that have been marketed as toys for children.  These objects, when ingested, can result in severe injuries.  We conducted a survey of the membership in the Surgical Section of the American Academy of Pediatrics to determine the magnitude and consequences of magnet ingestions in the pediatric population.  We found that most incidents of ingestion (90%) involved more than one magnet.  Although many could be removed endoscopically, a significant number of children required surgical intervention for magnet removal and many of them had major complications secondary to multiple magnet ingestion including gastrointestinal perforations and fistulae.  The magnets tend to move through the GI tract at different rates and become attached to each other trapping neighboring loops of bowel between them.  The results of the study demonstrated the need for increased public awareness as to the dangers of these magnets and high suspicion of caregivers that expeditious removal of these foreign bodies is crucial.     

Curr Opin Rheumatol. 2014 Sep;26(5):538-42. doi: 10.1097/BOR.0000000000000090. Risk of malignancy associated with biologic agents in pediatric rheumatic disease. Mannion ML, Beukelman T.
This article summarizes the published knowledge about the risk of cancer associated with biologic agents in children with rheumatic disease.

J Clin Lab Anal. 2014 Sep;28(5):405-8. doi: 10.1002/jcla.21701. Epub 2014 Mar 20. Comparison of methods, storage conditions, and time to analysis of serum and urine creatinine measured from microsamples by liquid chromatography mass spectrometery (LC/MS) vs. Jaffe. Askenazi DJ, Moore JF, Fineberg N, Koralkar R, Clevenger S, Sharer JD.
Measurement of serum creatinine (SCr) and urine creatinine (UCr) with tiny amounts of sample (as low as 10 mcl) would maximize exploration and minimize iatrogenic blood loss. We performed an evaluation in six healthy adults to determine differences between SCr and UCr values in different methodologies and storage environments and time. We found that Scr values showed no significant differences between liquid chromatology/ Mass Spectrometry (LC/MS) vs. Jaffe. UCr measured by Jaffe is lower than samples measured by LC/MS. UCr measurements by LC/MS vary more over time, mostly due to the sample measured after 1 year; therefore, storage of urine for more than 90 days measured by LC/MS may provide altered results.

Pediatrics. 2015 May 11. pii: peds.2014-2000. BMI and Magnitude of Scoliosis at Presentation to a Specialty Clinic. Gilbert SR, Savage AJ, Whitesell R, Conklin MJ, Fineberg NS.
Patients with high BMI and scoliosis are more likely to present with larger curves, but not more likely to require surgery. This is concerning because of the national trend of increasing childhood obesity and because scoliosis treatment may be more complicated in larger curves. Socioeconomic factors may also be barriers to access.

Oncogene. 2015 May 11. doi: 10.1038/onc.2015.126. The BET bromodomain inhibitor JQ1 suppresses growth of pancreatic ductal adenocarcinoma in patient-derived xenograft models. Garcia PL, Miller AL, Kreitzburg KM, Council LN, Gamblin TL, Christein JD, Heslin MJ, Arnoletti JP, Richardson JH, Chen D, Hanna CA, Cramer SL, Yang ES, Qi J, Bradner JE, Yoon KJ.
Gregory Friedman, Li Nan, Blake Moore, Tina Etminan, Brent Orr, Joseph Chewning, David Crossman, G Yancey Gillespie. Tumor location remodels transcriptomic profiles in a pediatric medulloblastoma xenograft. Abstracts from the 3rd Biennial Conference on Pediatric Neuro-Oncology Basic and Translational Research. Neuro Oncol 2015 Jun; 17(Suppl 3): 32.
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