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FYI Fridays
May 22, 2015
Have a safe and happy Memorial Day!
Making the right call
We are actively working on improving our partnership with primary care physicians (PCP) and other referring physicians.  PCPs are a critical part of the health team for our patients and their families.  They provide care and support.  We have heard examples where PCPs, both locally and throughout the state, have learned about major unexpected medical events from families they met at the grocery story.  This is wrong and we can fix it.  Children’s of Alabama will be ensuring that admission and discharge information is automatically and reliably sent to referring physicians.  This is great and welcome news.  But we need to do our part too.  Towards this end, I am asking all physicians (all faculty, fellows and residents) at Children’s of Alabama to commit to calling referring physicians/PCPs within 12 hours when any of the following occur:
  1. Patient death
  2. Unplanned transfer to the ICU
  3. Unplanned surgery
It is my expectation that this communication will be by a resident, fellow or attending physician and that it will be documented in the chart.  Ultimately, the attending physician of record will be responsible for notifying the PCP/referring physician or delegating this communication.  This is what you would want from us if you were a PCP/referring physician and this is what you would want if your child were hospitalized here.  Thank you for making this an important part of caring for the children of Alabama.
Mitch Cohen
100% Pass Rate for Three Fellowships Announced
Recent graduates of three fellowship programs had a 100% Board Passing rate. Names of those who took the test and their fellowship programs are noted below. Congratulations to the graduates and to their fellowship programs.
Pediatric Rheumatology
Melissa Mannion
Pediatric Hematology-Oncology
Elizabeth Alva
Michael Gleason
Samer Kaylani
Stephanie Heidemann
Pediatric Emergency Medicine
Chris Restrepo
Heather Mitchell
Worth Barbour
Arianna Shirk
Laura Lindsay
Elizabeth Yust
2015 Dixon Fellows Announced

The Dixon Foundation endows this fellowship training program annually in Pediatrics to support postdoctoral training and research in approved Pediatric subspecialties and to prepare outstanding fellows for a career in academia.  This year, Dixon Fellows Franco Diaz, Jegen Kandasamy, Zach LeBlanc and Sara Oliver are graduating and Aaron Grubbs will continue his fellowship in his third year of training. Congratulations to you all.
Dr. Gershon
Dr. Anne Gershon will present the Charles A. Alford Memorial Lectureship at Grand Rounds
Noon, June 4th
Dr. Gershon is the director of the Division of Pediatric Infectious Disease and Professor of Pediatrics at Columbia University College of Physicians and Surgeons, a position she has held for the past 26 years. Her research, which included examining the epidemiology, diagnosis, immunology, latency, prevention and treatment of VZV, played a crucial role in the final steps of the vaccine’s licensure and broad public use.  Dr. Gershon continues to study the safety and efficacy of varicella vaccine, including the growth and pathogenesis of VZV in cell culture and latency of VZV in humans and animal models.

Click here for a list of our Pediatric Highlighted Events

 Pediatric Grand Rounds Link
The Jewish Festival of Shavuot begins on Saturday evening, May 23, 2015.  Shavuot means “weeks” in Hebrew and marks the 49 days (7 weeks or shavuot) that it took the biblical Jews to travel from Egypt to Mount Sinai.  The festival also marks the giving of the Torah (the Five Books of Moses) at Mount Sinai.  Like many other Jewish holidays, Shavuot began as an agricultural festival in ancient days.  Shavuot originally marked the end of the spring barley harvest and the beginning of the summer wheat harvest, with offerings from both brought to the Temple in Jerusalem.  Special customs on Shavuot include staying up all night to study Torah, which symbolizes a commitment to learning and openness to it.

Clinical and Basic Science
SOM Faculty 

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

Link to NIH Weekly Funding Opportunities
The deadline for submission of
information for inclusion in the
FYI Fridays newsletter is
10:00am on the preceding Thursday.
FYI Fridays Archive
Dr. Simpson
Dr. Tina Simpson has been accepted as a Scholar in the 2015 UASOM Faculty Scholars Program in Health Disparities and Culturally Responsive Care.  
Pediatric Residency News
Four Infectious Disease Legends 
will be present at the
 June 4th  Stagno Report 
7:30 am - Bradley Lecture Center

Anne Gershon, MD
Director of the Division of
Pediatric Infectious Disease
Columbia University

Mike Gershon, MD
Professor of Pathology and
Cell Biology
Columbia University

Sam Katz, MD*
Chairman Emeritus of Pediatrics
Duke University School of Medicine 

Cathy Wilfert, MD
Scientific Director of the Elizabeth Glaser Pediatric AIDS Foundation 

*Dr. Sam Katz, the father of the measles vaccine will present. Breakfast will begin at 7:30 in the Bradley Lecture Center with Stagno Report beginning at 8.  
All faculty and fellows are welcome!

Pediatric Resident
Graduation Banquet

June 5th, 6:00 pm
All faculty and fellows welcome!
Please check email for evite invitation.
Email with any questions. 
New Grants
Veronica Sanchez, PhD, 
(Ped-Infectious Disease)
PI - Analysis of the macrophage 
membrane proteome: effects 
of viral infection. National 
Institute of Allergy and Infectious 
Diseases. R03. $73,000. 
05/19/2015 – 04/30/2017. 

Ann Klasner, MD (Ped-Emer Med) 
EMSC State Partnership Grant.  
Alabama Department of Public 
Health. $25,000. 
03/01/2015 - 02/29/2016.

Namasivayam Ambalavanan MD 
(Ped–Neonatology) Azithromycin 
to Prevent BPD in Ureaplasma-
Infected Preterms. University of 
Maryland (Baltimore). $39,166. 
03/01/2015 - 02/29/2016.

Gregory Friedman MD 
(Ped-Hem/Onc) Targeting Pediatric 
Medulloblastoma with Engineered 
Herpes Simplex Virus. Rally 
Foundation. $50,000. 
04/01/2015 - 03/31/2016.

Monisha Goyal MD  
(Ped – Neurology) 
GW Research LTD. $39,510. 
02/24/2015 - 02/23/2016.

Announcing a new process for ED referrals:
Effective May 26th all referral calls for ED will now go through the COA Placement Center initially.  If you  are sending a patient  who needs an evaluation in the ED you will now call the Placement Center and they will take down the information.  If you feel you need to speak to an ED attending for information that can’t be translated in an incoming patient report, after you give the info to the bed placement personnel, they can arrange contact with the ED attending.

We are making this change in order to improve our response times to the extremely high volume of phone calls that come to the ED on an hourly basis.  We realize that physicians have waited an inordinate amount of time to speak with an ED attending because we are often unable to take a phone call due to a trauma or resuscitation.  This new process will allow you to give the referral information without always having to wait for an ED physician to be available.
REMINDER: Express Admission Unit (EAU) exists for those patients that you are accepting for admission.
Kathy Monroe
Dr. MILK (Mothers Interested in Lactation Knowledge) is a group for physicians who are pregnant, breastfeeding, or have previously breastfed. As you may know, while physician mothers have a high initiation rate of breastfeeding, we have one of the lowest success rates of all high-risk groups! The new Birmingham chapter will meet here monthly to support each other through balancing breastfeeding, pumping, and working. 
Next meeting:
Thursday, May 28
Lactation room, 1st floor McWane Bldg (by the Lactation Consultant offices)
Babies and pumping are welcome at this meeting! We will have a few articles with helpful tips, and a lactation consultant will be present. There is no specific agenda - just a place to discuss problems, advice, and encouragement for balancing breastfeeding and pumping as physicians and mothers. 

Please email Rebecca Cantu ( with questions or to receive future updates about meetings. Physicians (including residents, fellows, and medical students) from all specialties are welcome. Visit for more information (and click Join Dr. MILK) and to be added to the Facebook group with access to hundreds of other physician mothers who can provide support and advice.
Recent and Upcoming Publications
 2015 May 9. pii: S1521-6616(15)00162-X. doi: 10.1016/j.clim.2015.05.001. Gut microbes, Immunity, and Spondyloarthritis. Stoll ML.
This is a review of the roles that alterations in microbial populations and in immunologic reactivity to the microbiota play in the pathogenesis of spondyloarthritis.

Pediatr Pulmonol. 2015 May 14. doi: 10.1002/ppul.23214. Thymic hyperplasia and chylothorax. Hartzell KM, Hines KC, Hoover WC.
This case report describes a previously unreported association of thymic hyperplasia resulting in spontaneous chylothorax.

Acta Neuropathol Commun. 2015 May 21;3(1):30. doi: 10.1186/s40478-015-0211-5. Identification of targets for rational pharmacological therapy in childhood craniopharyngioma. Gump JM, Donson AM, Birks DK, Amani VM, Rao KK, Griesinger AM, Kleinschmidt-DeMasters BK4, Johnston JM, Anderson RC, Rosenfeld A,Handler M, Gore L, Foreman N, Hankinson TC.

N Engl J Med. 2015 May 17. Lumacaftor-Ivacaftor in Patients with Cystic Fibrosis Homozygous for Phe508del CFTR. Wainwright CE, Elborn JS, Ramsey BW, Marigowda G, Huang X, Cipolli M, Colombo C, Davies JC, De Boeck K, Flume PA, Konstan MW, McColley SA, McCoy K, McKone EF, Munck A, Ratjen F, Rowe SM, Waltz D, Boyle MP; TRAFFIC and TRANSPORT Study Groups.
This study demonstrated that a combination of CFTR modulators that target the basic defect, a corrector and a potentiator, exhibited clinical benefit in patients homozygous for the most common mutation, including improved lung function and a pronounced reduction in CF pulmonary exacerbations.  These phase 3 data form the basis of an application for approval of this treatment, and could be applicable to almost half of the US CF population.
Behrens EM, Cron RQ. Kill or be killed. J Immunol. 2015 Jun 1;194(11):5041-3.
This invited commentary discusses the importance of the pillar article from 1999 (Science 1999;286:1957-9) describing the first gene defect (perforin) to be associated with the fatal autosomal recessive disorder, familial hemophagocytic lymphohistiocytosis (fHLH). Identifying a defect in perforin mediated cytolytic activity in natural killer cells and CD8 cytotoxic T lymphocytes opened the door for the discovery of other genetic causes of fHLH involved in the delivery of perforin containing granules to the immunologic synapse between the killer cell and its antigen presenting target cell. Perhaps, more importantly, this manuscript exposed the critically important role of the perforin cytolytic pathway in dampening the host immune response. The pro-inflammatory cytokine storm that results from defective perforin mediated cytolysis is likely secondary to prolonged engagement and increased cytokine cross talk between the defective killer lymphocytes and the antigen presenting cells. As heterozygous mutations in fHLH genes are now being identified as contributing to the much more common secondary forms of HLH and the related condition, macrophage activation syndrome (MAS), more and more individuals with HLH/MAS are being identified as potential candidates for anti-cytokine therapies therapeutics (e.g. IL-1 blockade) which are now available.  
Associated podcast:
Copyright © 2015 The UAB Department of Pediatrics, All rights reserved.