section on perinatal pediatrics - American Academy of Pediatrics

Transcription

SECTION ON PERINATAL PEDIATRICS
NeWSletteR - March 2014
critical Role for Neonatologists
in Developing Neonatal
Pharmacotherapeutics
www.aap.org/perinatal
Perinatal News “At A GlANce”
lynne D. Willett, MD, FAAP, editor
Mary Nock, MD, FAAP, Associate editor
Vivian thorne, Design/Production
Ronald l. Ariagno, MD, FAAP, Jonathan
M. Davis, MD, FAAP and Mark l. Hudak,
MD, FAAP
Critical Role for Neonatologists in Developing
Neonatal Pharmocotherapuetics
1
View From the Chair
4
Neonatologists have robustly advanced the clinical
care of critically ill infants, often through individual
innovation. Despite an explosion of careful clinical
research in our field much of the bedside practice
and teaching is still based on anecdotal experience
and opinion and thus “the standard of care” varies
widely, not only regionally but even within practices.
Getting to Know Lily Lou
5
Spring Workshop Update
6
Coding Question
7
Scientific Discourse is Protected
by the First Amendment
8
Coding Committee
9
In particular, the practice of continuing to use and
accept the extrapolation of therapeutic drugs and
biologic products approved for use in older children
and adults as the basis for the treatment of
neonates has negatively impacted any systematic
progress toward acquiring important data on the
efficacy, safety, and pharmacokinetic (PK)/
pharmacodynamics (PD) profiles of these agents
through the required regulatory science and United
States Food and Drug Administration (FDA)
approval process. In addition, new devices and
tools are also needed to make important physiologic
and laboratory measurements to establish
endpoints to determine efficacy in neonates. In
older children, the percentage of drugs prescribed
“off label” (not approved for the use intended by the
FDA) has fallen from approximately 80% to 50%
over 15 years. But for neonates, over 90% of drugs
still have no label indications or inadequate
prescribing information to guide informed and safe
usage.
The American Academy of Pediatrics (AAP) has
lobbied for pediatric initiatives such as the Best
Pharmaceuticals for Children Act (BPCA) and
Pediatric Research Equity Act (PREA), and for
Neonatology expertise at the FDA. The FDA Safety
and Innovation Act (FDASIA), which was passed in
2012, has made BPCA and PREA permanent
Continued on Page 2
March of Dimes
10
The 9th Mosquito
12
ONTPD Update
14
Committee on Membership
14
Coding Answer
15
District News
16
Topic Advisory Group Report
24
In Memoriam
25
Perinatal Section Call for Awards
26
Keep a Cool Head
23
AHRQ Toolkit
25
Section Leadership
28
Research Committee
30
District Grants
30
Spring Workshop Schedule
32
2013 Young Investigator Awards
34
Call for Abstracts
35
Printing and mailing of this issue
supported through a grant from
Abbott Nutrition.
critical Role
age) from 2005-2010 studied for drug exposure were from
the Pediatrix Medical Group dataset, which had 290
NICU’s, 446,335 hospitalized infants. Three hundred and
ninety-nine drugs were prescribed for more than 1.5 million
exposures in the first 28 postnatal days. Of the 11 drugs
with a neonatal indication, 7 were never used in the
Pediatrix sample and the other four drugs (famotidine,
linezolid, nevirapine and rocuronium) were used
infrequently. Of the 28 drugs in the FDA study,
gastroesophageal reflux drugs (1st ranitidine, 3rd
lansoprazole and 4th famotidine) were most frequently
used in clinical practice (in spite of the lack of a clear
indication or physiologic rationale) and the second most
commonly used overall was inhaled nitric oxide. The
authors concluded that few hospitalized neonates (<0.5%)
were exposed to a drug approved for use in neonates.
From these data it appears that BPCA and PREA have not
increased needed study of “off patent” drugs for neonates.
The clear message is that we neonatologists, and not
industry alone, need to take the lead in redressing this
major deficiency in knowledge and to make a commitment
for change. What steps can we take to address this critical
need for progress?
Continued from Page 1
regulatory statutes. The BPCA authorizes the FDA to
extend marketing exclusivity for six months for a product for
which the manufacturer provides additional pediatric
labeling information, either because the product can be
anticipated to provide a meaningful therapeutic benefit or
because the FDA has requested specific information.
Under FDASIA, if a written request from FDA to the
sponsor does not include studies for neonates, FDA must
explain its rationale for the exclusion. PREA mandates a
pediatric assessment of drugs and biologic products if the
application involves a new indication, dosage form, route of
administration, dosing regimen or active ingredient. The
pediatric assessment must address safety and efficacy for
the clinical indication in all appropriate pediatric age
groups.
Under the BPCA of 2002, government agencies worked
with experts in pediatrics to develop and prioritize a list of
off patent drugs in use for which pediatric studies were
urgently needed. Four listings were published in the
Federal Register between 2003-2005. The NICHD and
FDA also established the Neonatal Drug Development
Initiative (NDDI). The initial 2004 workshop meeting was
chaired by Eduardo Bancalari, M.D. (Miami) and George P.
Giacoia, M.D. (NICHD) and included excellent
representation from neonatologists. The mission of the
workshop was to define a multiphase program to identify
knowledge gaps in neonatal pharmacology, clinical study
design, and outcome measures and to explore new study
designs appropriate for preterm and term newborns with
the goal of determining whether the drugs used in the
clinical management of newborns are safe and effective.
The proceedings of the workshop were published in a
series of papers in 2005 (Cl Ther.27:796-813) and 2006
(Pediatrics117;S1). It still remains true that most drugs
used to treat critically ill preterm and full term newborns do
not have sufficient data for appropriate dosing, efficacy and
safety. There are rare exceptions such as surfactant for the
treatment of premature infants with RDS and inhaled nitric
oxide for the full term and late preterm infants with hypoxic
respiratory failure and pulmonary hypertension.
Some ideas to open a conversation:
1. The Organization of Neonatal Training Program Directors
(ONTPD) membership and leadership should make a
commitment to develop new therapeutics and neonatal
science so there is an opportunity to facilitate advances in
Neonatology in the future. The ONTPD could play a
significant role in promoting the research that is needed
and offering these opportunities to fellows who are seeking
a research project.
Dr. Ariagno presented this proposal at the ONTPD 2013 fall
meeting. The discussion focused on the potential to
collaborate and to provide leadership to improve our
approach in how we make advances in Neonatology; the
invitation to make a commitment to play a key role in
promoting new and existing therapeutics and the neonatal
science that will support this effort; promote the research
that is needed; and provide opportunities for fellows
seeking research projects. They are in the process of
forming a task force to determine what are the
opportunities for collaboration among Program Directors
and between programs; identify research projects which
would be appropriate for training programs and their fellows
(e.g., biomarkers, receptors, drug metabolism, devices to
make important measurements of endpoints needed to
determine efficacy, tissue perfusion, cardiac output, renal
function, genomics to better understand the many
subgroups of neonates that we care for in NICU’s); identify
resources currently available and what is needed to
accomplish this research (e.g., core laboratories, registries,
banked bio samples, etc.); define how to contribute to the
science/research needed for drug and device development,
which will meet the requirements for “approval” and to
address the question of efficacy, safety and benefit/risk;
identify opportunities for collaboration (and possible
Recently, the report entitled “Drug Labeling and Exposure
in Neonates” (JAMA, December 9, 2013) reviewed the
FDA pediatric data for studies submitted between 19972010 to identify those studies and labeling changes that
included neonates. Neonates were included in 41 studies
of 28 drugs, with 23 of the drugs studied having labeling
changes (including PK information). There were a total of
24 neonatal labeling changes (one drug had 2). Forty-six
percent (11 of 24) of the labeling changes also included an
approval as safe and effective for neonates. Of note, these
drugs were studied for HIV (4) , anesthesia (3) and other
(4: plasma substitute volume expander, gastroesophageal
reflux, reduction of blood pressure and antibiotic).
The clinical cohort of neonates (infants up to 28 days of
2
funding) with Pediatric Trials Network, NICHD, FDA and the
Clinical and Translational Science Award Consortium Child
Health Oversight Committee (CC-CHOC) at NIH.
engage
Communicate with colleagues via electronic survey to learn
about what resources exist for therapeutic and device
development research. Do we have the expertise? What
training opportunities are available for neonatologists? Do
we have the methods and tools needed? What are the
resources at our Universities and with our Industry
partners? Do we have the motivation and interest? Do we
understand the need? What are the perspectives from
academia, clinical neonatologists, parents/community
groups, Industry, NIH, and FDA?
Consultation with FDA will be important, but the
responsibility to implement relevant neonatal science
research and trials that will lead to “approved” products or
labeling changes to treat neonates is a shared goal with
academia, clinical neonatologists, parents/community,
industry and FDA. Clearly, the ONTPD and fellowship
training programs constitute a significant resource that
could accelerate systematic advances in therapeutics and
the clinical care of neonates.
Funding
2. Outreach to our Trainees and Early Career
Neonatologists (TECaN) leadership and members to inform
and consult them regarding the issues and state of affairs.
It will be important to include them in discussions and
planning on how we can work together to advance the
development of therapeutics and devices for neonates.
Unquestionably, these individuals are the leaders of the
future and some may choose to pursue this line of research
for their career. The ONTPD proposal was shared with
TECaN and discussions with the leadership have started.
Follow up with a phone conference is planned.
Committee will explore and inform our colleagues on what
funds are available but currently are unknown to many e.g.,
Pharmacology T32 for training which has slot for
Pediatric/Neonatology interested trainee, Orphan diseases
funds for which neonatologists may be eligible. What are
the opportunities for informative Webinars, short-term
fellowships and meetings, which are not common venues
for neonatologists.
the five things this committee will accomplish are:
1. Provide relevant information and resources for the
Section and membership on the Website. Provide
information for training opportunities for neonatal
pharmacology and regulatory science.
3. Establish a “Strategies for Neonatal Therapeutics
Development Committee” as part of the next 5-year
strategic plan of the Section of Perinatal Pediatrics
(SoPPe). This committee will utilize the resources of the
AAP and SoPPe to develop a strategy to inform and involve
leaders in neonatology, academia and practice, to promote
advances in neonatal therapeutics and devices. The
SoPPe website can be a powerful way to communicate in
real time important informative links and resources
established by the Committee.
2. Review the survey of the ONTPD Task Force regarding
regarding available and needed resources for
accomplishing neonatal drug and device related research.
Consider expanding the survey to the Section membership
to identify available expertise, interest and laboratory
resources.
3. Collaborate with ONTPD to identify relevant and
practical research projects and neonatal science questions.
Consider that some of these research projects could be
developed into Maintenance of Certification (MOC) part IV
opportunities with SoPPe assistance.
The mission of the Committee would be to utilize the
resources of the AAP and the Section to develop a
strategy to inform and involve leaders in Neonatology,
academia and practice to promote the development of new
(and study of existing) drugs and devices.
4. Identify opportunities to help develop Public Private
Partnerships to facilitate a collaboration of key stakeholders
and funding sources.
This may be accomplished in three ways:
Inform
5. Work with the SoPPe on strategic planning to promote
the neonatologist’s role in the development of novel
therapeutics and devices. Recalibrate and organize how
this may be accomplished.
Establish the best way to inform how the advances in
Neonatology have evolved and the need to address the
knowledge gaps to improve the basis for “standard of care
practices”. Explore how to enable our colleagues to play a
role in the research of new and existing therapeutics.
Develop a list of research opportunities for fellows in
training, academic programs, and clinical practices. Explore
opportunities for collaboration and creation of registries for
some conditions (modeling after the ECMO registry), core
laboratories, clinical data and bio-specimen banks, as well
as biomarkers and endpoints to prove efficacy. Is it possible
that a major biomarker discovery in a neonate may be
significant for human biology across the life spectrum to
document the origins of adult disease?
4. Proposal to California Association of Neonatologists and
District IX Section on Perinatal Pediatrics to consider
therapeutic and device development and neonatal science
research for the California Clinical Research Network.
Instituting a task force with similar objectives as described
for ONTPD is now underway.
In summary, it is appreciated that neonatologists make drug
selections based on extrapolation of information developed
in children and adult populations and on what they consider
current standard of care, the availability of drug in the
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Continued on Page 4
Dr. Ariagno is pleased and honored to represent
Neonatology with the goal to evaluate our resources, add
new training opportunities, and meet the challenges for
therapeutic development through collaborations with
Academia, Clinical Neonatologists, parents/community,
Industry, NIH and FDA.
critical Role
hospital formulary, the level of comfort in using the drug in
the neonate based on what is known from the published
literature and what advice we may get from “experts” or
consultants. For many reasons there have been continuing
obstacles for neonates to fully benefit from the Neonatal
Drug Development approaches over the last decade. It is
time to have a “call to action” to re-examine what role
neonatologists can have in advancing the development of
new therapies and devices for the infants and the families
that we care for. Clearly ethical considerations are very
important in study design and research, but the ethics of
continuing to expose infants to unknown risks while
neglecting to obtain safety and efficacy data are
paramount. The will and commitment to take responsibility
must start here and now and hopefully with serious
discussion we may contribute to the appropriate
investigations needed for infants. It is clear that necessary
and rapid progress will require neonatologists to spearhead
future efforts to identify and to prioritize knowledge gaps
and to participate in addressing these deficiencies. SoPPe
has a unique and powerful opportunity, working through
ONTPD, TECaN, individual members, and various
state/regional neonatal collaboratives, to catalyze
advancement in this field.
Ronald L. Ariagno, M.D., FAAP, Professor Emeritus of
Pediatrics in the Division of Neonatal and Developmental
Medicine at Stanford University School of Medicine, Senior
ORISE Faculty Fellow in Neonatology at the FDA.
Jonathan M. Davis, M.D., FAAP, Professor of Pediatrics,
Chief of Newborn Medicine and Vice-Chair for Academic
Affairs at Tufts University School of Medicine, Chair of the
Neonatology Sub-Committee in the Office of Pediatric
Therapeutics at the FDA.
Mark L. Hudak, M.D., FAAP, Professor of Pediatrics and
Chairman of Pediatrics at University of Florida College of
Medicine at Jacksonville. Member of the Pediatric Advisory
Committee and Neonatology Sub-Committee, Office of
Pediatric Therapeutics, FDA
epilogue
March 2013 was the first meeting of the Neonatology SubCommittee, which was Dr. Ariagno’s initial experience at
the FDA. This meeting provided an opportunity to hear in
detail where we are in terms of therapeutic development for
neonates. At this meeting the invitation was made to him to
become a Faculty Fellow at the FDA, which (neonatal
expertise) was required legislatively, to learn and
collaborate with the FDA from a Neonatology perspective.
By August 19, 2013 funding from the Oak Ridge Institute
for Science and Education (ORISE) was obtained and his
appointment was approved. The mission was to represent
Neonatology, infants and families we serve by promoting
strategies with our FDA colleagues for advancing the
development of neonatal science and therapeutics. Over
the last several months he has had an immersion in the
activities of the FDA specifically in the Office of Pediatric
Therapeutics and with the Maternal and Pediatric Health
Staff in the Office of New Drugs with the focus on
Neonatology. When in his FDA office he attends all
activities relevant to Neonatology and if there are specific
questions he is available for consultation. All of the
resources of the FDA and access to expertise at the NIH
are made available and seeking consultation is
encouraged. A Neonatal Studies Discussion group occurs
each month on how to proceed from a Neonatology
perspective. The Pediatric Review Committee (PeRC)
meets monthly to review all pediatric study plans submitted
by Industry. When the Pediatric Trial Network group
presents at the FDA, he is invited to attend and participate.
View from the chair
David J Burchfield, MD, FAAP
Perinatal Section Recent Activities
This past year has been busy for the Section on Perinatal
Pediatrics, with our mission to improve the health of the
pregnant mother, the unborn fetus and the newly-born child
through the sponsorship of programs which encourage the
professional growth of the neonatal-perinatal providers,
continuously improve clinical care delivery, support
continuing and postgraduate education, foster basic,
clinical and outcomes research and seek to attain federal
and local funding for programs directed towards
maternal/child health. In this newsletter, I have chosen to
focus on two aspects of our mission, that being education
and quality.
educational Initiatives
2013 Fall Nce
Sergio Golombek, MD, (District II Representative)
assembled a vibrant 2 ½ day program for the perinatal
activities at the 2013 National Conference and Exhibition
held in October in Orlando. Linda Van Marter, MD initiated
the meeting with an inspiring Gerald Merenstein Lecture to
the young neonatologists on “Neonatal Cardiopulmonary
Epidemiology “ followed by a poster walk of 75 original
4
Continued on Page 7
Getting to Know...
Whats the best thing about where
you live?: Professionally--Alaska
has a small medical community
where an individual can make a
meaningful difference. I've been active
with our local AAP chapter, now
serving as vice president. Outside
the NICU--I love living in a naturally
magnificent setting, where moose
are born every year or so in our
own backyard, I can see the northern lights, and can
live at the edge of town but still drive to work in 15
minutes.
lily lou, MD, FAAP
District VIII executive
committee Representative
Medical School: University
of North Carolina at Chapel
Hill
Current Position: NICU
medical director, The Children's
Hospital at Providence-Alaska, the only Level III NICU
in the state…we never transport babies further than
1300 miles! We do transfer infants who need ECMO
or complex cardiac repair, but can generally care for
most neonatal medical or surgical diagnoses within
Alaska. We just opened our new 66 bed single-room
unit on December 2nd.
I've recently been inspired by---?: We just held our 25th
NICU reunion party. One of the guests had attended the
first one, just after she
was hospitalized in our
NICU as a newborn.
She has now graduated
from nursing school
and was recognized as
Employee of the Month
in her first nursing job
in Spokane. Her family
traveled back to
Anchorage for the reunion just to say thank you. She
hopes to eventually return to our NICU as a staff nurse.
Years in Practice: Finished fellowship at the
Children's Hospital at Yale-New Haven in 1992. I
spent time in both academic and non-academic roles
since then: stayed 4 years on faculty at Yale, then
went to a private practice in Greensboro, NC with
attending time at UNC-Chapel Hill, returned to a
university setting for 4 years in Albuquerque
(completed a 1-year fellowship in Medical Education),
then moved to Alaska
11-12 years ago.
Favorite Movie?: Cinema Paradiso
Family and Pets: Married
to Kraig, a professional
photographer. Honeymoon
in Alaska may have been
the prompt for our eventual
relocation to a place with moose, bears, glaciers and
volcanoes in our backyard. We currently have two
mini-Australian Shepherds keeping us busy.
The best gift you have ever received?: A classroom of
kids in Arusha, Tanzania singing Happy Birthday to me
in Kiswahili.
Something most people don't know about you: My
grandmother was 7 years old when she escaped the
fires and devastation of the San Francisco earthquake.
Your best advice for early career neonatologists:
Regardless of the formal outlines of your job, you can
find opportunities for teaching, research, community
service and leadership that fit your interests and
aptitudes--engage in more than just your clinical work;
be the good citizen only you can be, with the benefit of
your education, expertise and insight. Be thoughtful
about what you agree to do, especially when you are
the new person in the group. You will be more
productive if you do a few things very well than if you do
a lot of things without real commitment. Identify and
develop your mentor relationships, both as a recipient
and as a mentor yourself.
Best or favorite childhood memory: Frequent family
gatherings with my 4 sisters and 16 cousins in the
San Francisco Bay Area. We are more spread out
geographically now, but even more connected in
some ways.
Your hidden talent?: Connecting
people with shared interests,
recognizing and developing
special abilities in people.
Making telescopes from scratch
(look up Stellafane.org). Hosting
a legendary Valentine's brunch.
And learning how to be creative
with sticks and string (knitting) in
our long northern winters.
5
Spring Workshop
2014
workshops with hands-on training to use high
fidelity simulation for advanced neonatal
resuscitation and other complex neonatal
emergencies, innovation in genetic
diagnoses, ethical considerations in neonatal
medicine, and a session on hybrid academic
practices, discussing challenges for
neonatologists in community settings
affiliated with an academic program. Optional
sessions on leadership (Ken Slaw) and
quality improvement (John Hartline and Janet
Muri) will again be offered on Saturday
afternoon, building on last year’s
experiences.
April 4-6, 2014
Scottsdale, AZ
Using Evidence to
Innovate our Practice
The Perinatal Section’s Spring Workshop on
Perinatal Practice has for many years been
the place where neonatologists from across
the country have met to discuss the “how to”
as much as the “what to do” in practice of
neonatology. This meeting offers opportunity
for neonatologists to learn and develop
important leadership skills and process
concepts, which are necessary to work
effectively as a team to deliver the most care
effectively.
The Scottsdale meeting provides a chance to
meet current leaders in the Section and to
welcome members of the Trainee and Early
Career Neonatologists (TECaN) group,
leaders of the future. This relatively small
meeting also allows attendees to learn from
and benchmark with one another through
expanded use of the Audience Response
System (ARS) following presentations,
interactions in small workshop settings and
with unstructured time in the Arizona
sunshine. Neonatologists at any career
stage will find this meeting to be a great
educational experience.
This year we will meet again at the
DoubleTree Resort in Scottsdale, Arizona on
April 4-6 2014. The theme will be “Using
Evidence to Innovate our Practice”,
continuing our focus on the process of
practice improvement, and will also include
sessions on coding and budgeting, as well
as opportunity to hear updates and provide
input into new policies and clinical
statements under consideration by the
Committee on Fetus and Newborn.
This unique conference consistently receives
outstanding reviews and offers opportunity to
learn aspects of neonatology not offered
elsewhere. See you in Arizona!
Plenary sessions will feature the Butterfield
Lecture, presented by Apgar Awardee,
George Gregory, who will provide a historic
view of innovation of neonatal care with
CPAP. Mark Del Monte will again challenge
the audience to look beyond the hospital
setting in advocating for our patients
regionally and nationally. Attendees will
have the opportunity to hear from the AAP
President-elect, who will provide an overview
of the Academy’s priorities and respond to
audience questions.
Howard Kilbride, MD, FAAP
2013 Workshop Presentations
Check out the full schedule and the speaker
presentations from the 2013 workshop
on our website:
www2.aap.org/sections/perinatal/presentations.html
Breakout sessions will include tracks on
clinical, financial/management, and early
career topics. Highlights for this year include
6
View From the chair
will be moving closer to outcomes-based reimbursement,
and if we are not leading this effort, we will be forever trying
to catch up. It is my contention that neonatologists should
define neonatal quality and I hope over the next year, the
Section can impact how these measures are carried
forward. This initiative will take the efforts of the leading
experts in our field who have a working knowledge of
neonatology, quality and measurement.
works, most from fellows or early career neonatologists.
Saturday morning was highlighted by 10 oral presentations
as well as the annual Cone History lecture given by Jeffery
Maisels entitled “Sister Jean Ward, Phototherapy and
Jaundice – A Unique Human and Photochemical
Relationship”. Saturday afternoon was focused on
“Transfusion Medicine” and perfectly fit the model the
Section is striving for in our educational offerings—that is,
dynamic, clinically relative education delivered by both
“seasoned” educators like Bob Christensen and Ed La
Gamma while concurrently opening doors for the rising
stars in our field, this time represented so adeptly by
Martha Sola-Visner and Matthew Saxonhouse. Sunday
morning brought more practical, relevant discussions on
”Neonatal Palliative Care” by Margarita Bidegoin,
“Treatment of Neonatal Hypothyroxinemia” by Nigel Paneth
and “Neonatal Dialysis” by Brad Warady. The perinatal
sessions closed on Sunday afternoon with a workshop on
CPAP by Rangasamy Ramanathan and a “Mock Trial” led
by Gil Martin, Jay Goldsmith and Av Fanaroff.
the future
“The future ain’t what it used to be” is a quote from my
favorite philosopher, Yogi Berra and is very applicable
today. Society has a right and expectations for high quality
care delivered by compassionate and competent
physicians. Outcomes will no longer be concealed in
department quarterly M&M conferences but rather be easily
searchable by the public, the payer, and our patients’
families. Members of our Section support this, and
ultimately this will lead to better care and outcomes. Also
applicable to this famous Yogi-ism is how postgraduate
medical education and educational processes will need to
change. The Section is exploring novel delivery systems
for education that would supplement the classical medical
conference.
2014 Workshop on Perinatal Strategies
However, as Yogi also said, “you can observe a lot by
watching” and during these early years of outcomes
reporting, much has been done incorrectly which could
lead to inappropriate characterizations and, worse,
clinicians chasing inappropriate goals. We need to aid the
reporters in making sure that the correct measures are
used to define quality.
The theme of this year’s meeting, “Using evidence to
innovate practice” will feature speakers who will help the
attendee run a more effective clinical practice. This year’s
meeting is particularly innovative and will bring
internationally renowned speakers to lead workshops on
topics ranging from using electronic medical records to
improve your practice to evidence-based family counseling
techniques. This year’s workshop will be particularly
important with new ICD 10 implementation around the
corner. These topics are aimed to improve clinical care
delivery in our neonatal ICUs.
Quality Initiatives
coding Question
Quality is an important domain for the Section and will only
gain in importance over the next few years. In the last
newsletter, I reported our progress with new PIMS on the
American Board of Pediatrics website. However, a more
fundamental issue is apparent that I feel the Section must
give attention, and that is in defining and measuring quality.
As an example, just this week I was shown the Joint
Commission perinatal quality indicators that will go into
effect January 2014. The indicator for neonatal quality is
“bloodstream infections”. It will use the hospital’s
administrative database to determine this outcome. The
flaws in such a system are obvious. Another example is
the U.S. News & World Report annual publication for top 50
status. One might argue that this is not a reflection of our
care that neonatologists should pay attention to, however it
is one that the public, hospital administrators and
department chairs pays attention to.
A 2300 gram former 26 week gestational age infant,
now 40 days of age is preparing for discharge. A car
seat test is ordered as part of the discharge planning
process. The baby is still on continuous
cardiorespiratory monitoring. The car seat test
procedure takes 90 minutes and includes,
continuous nursing observation, continuous
recording of pulse oximetry, heart rate and
respiratory rate. The neonatologist interprets the
results of the testing and recommends that the baby
be discharged in a car bed for repeat testing at the
pediatrician’s office in one month.
The Correct Codes are:
A. 99479, 94780, 94781
B. 99479
C. 99472, 94780, 94781
If one looks at the U.S. News & World Report questionnaire
for Neonatology, there are numerous measures being
collected that truly do not measure quality. Importantly, we
Look for the answer on page 15.
7
Scientific Discourse is Protected by the
First Amendment
attempting to replicate the described experiments,
conducting their own experiments, or analyzing or refuting
the soundness of the experimental design or the validity of
the inferences drawn from the results. In a sufficiently novel
area of research, propositions of empirical ‘fact’ advanced
in the literature may be highly controversial and subject to
rigorous debate by qualified experts. Needless to say,
courts are ill-equipped to undertake to referee such
controversies. Instead, the trial of ideas plays out in the
pages of peer-reviewed journals, and the scientific public
sits as the jury.”
edward e. lawson, MD
editor, Journal of Perinatology
Department of Pediatrics
Johns Hopkins School of Medicine
Recently, the freedom of scientific discourse was tested by
a federal lawsuit brought against many defendants one of
whom was the Journal of Perinatology. The Journal of
Perinatology is the official journal of the Section of Perinatal
Pediatrics of the American Academy of Pediatrics and is
edited by me. The lawsuit (ONY, Inc. v. Cornerstone
Therapeutics, Inc.) alleged that a manuscript which, at that
point, had appeared only in electronic format (‘Advanced
Online Publication’) was materially false and that its
publication injured the plaintiff – ONY, Inc. The suit was
first argued in the New York Western District Court. That
court granted a defendants’ motion for dismissal. ONY, Inc.
appealed and the case was argued at the United States
Court of Appeals, Second Circuit on April 25, 2013 and a
decision rendered on June 26, 2013. A search using
Google and the lawsuit title recovered at least two sites
where the decision of the Court of Appeals is openly
available verbatim. This decision is important for all people
publishing scientific manuscripts as it establishes the legal
boundaries by which the First Amendment of the US
Constitution protects those publications, their authors,
editors and publishers.
the court’s decision goes on to state:
“Where, as here, a statement is made as part of an
ongoing scientific discourse about which there is
considerable disagreement, the traditional dividing line
between fact and opinion is not entirely helpful. It is clear to
us, however, that while statements about contested and
contestable scientific hypotheses constitute assertions
about the world that are in principle matters of verifiable
‘fact,’ for purposes of the First Amendment and the laws
relating to fair competition and defamation, they are more
closely akin to matters of opinion, and are so understood
by the relevant scientific communities. In that regard, it is
relevant that plaintiff does not allege that the data
presented in the article were fabricated or fraudulently
created. …... But when the conclusions reached by
experiments are presented alongside an accurate
description of the data taken into account and the methods
used, the validity of the authors' conclusions may be
assessed on their face by other members of the relevant
discipline or specialty.
(1)
The suit alleged commercial impropriety, but the court
decided the case largely based upon speech protections in
the First Amendment. A major aspect of the case revolves
around whether reports, based upon evidence derived by
use of the scientific process, are fact or opinion. The court
ruled that, unless intentionally deceptive, statements of
opinion are protected by the First Amendment as free
speech. In determining whether scientific publications
constitute fact or opinion, the decision contains the
following statements:
We therefore conclude that, to the extent a speaker or
author draws conclusions from non-fraudulent data, based
on accurate descriptions of the data and methodology
underlying those conclusions, on subjects about which
there is legitimate ongoing scientific disagreement, those
statements are not grounds for a claim …. “
Finally the court opinion states:
“Even if the conclusions authors draw from the results of
their data could be actionable, such claims would be
weakest when, as here, the authors readily disclosed the
potential shortcomings of their methodology and their
potential conflicts of interest.”
“Scientific academic discourse poses several problems for
the fact-opinion paradigm of First Amendment
jurisprudence. Most conclusions contained in a scientific
journal article are, in principle, ‘capable of verification or
refutation by means of objective proof,’ …. Indeed, it is the
very premise of the scientific enterprise that it engages with
empirically verifiable facts about the universe. At the same
time, however, it is the essence of the scientific method that
the conclusions of empirical research are tentative and
subject to revision, because they represent inferences
about the nature of reality based on the results of
experimentation and observation. Importantly, those
conclusions are presented in publications directed to the
relevant scientific community, ideally in peer-reviewed
academic journals that warrant that research approved for
publication demonstrates at least some degree of basic
scientific competence. These conclusions are then
available to other scientists who may respond by
These opinions represent the unanimous opinion of the
three judge federal court. Scientists, authors and editors
will take heart in this decision. Apparently, for the first time,
this decision establishes that scientific papers, when
meeting criteria that are well accepted by the scientific
community, are best judged by the scientific community
rather than the judicial system. This gives protection to
those writing and publishing papers based upon the
scientific method and its well described tenants.
A recent search by me revealed a considerable response in
the ”blogosphere” regarding this decision. Generally, the
spirit was supportive, but some concerns were expressed
8
coding committee Report
regarding how the decision may be applied commercially.
For instance, one comment was concerned that the FDA
may become limited in its ability to regulate new drug
approvals.
Stephen A Pearlman, MD, MSHQS
The Coding Committee continues to work hard on behalf of
SoPPE members. This year we saw approval of new
codes for hypothermia which are 99481 for total body
systemic hypothermia, per day, in the neonate 28 days of
age or younger and 99482 for selective head hypothermia,
per day, in the neonate 28 days or younger. However, these
codes did not get valued with RVUs. This means that each
of us needs to negotiate with our payers. Therefore the
committee developed a new procedural code for the
initiation of cooling to replace the existing codes listed
above. This code was presented to the CPT Editorial
Board on October 11 and was approved In January, this
new code will be presented to the RUC for RVU valuation.
Readers of the Journal of Perinatology may have noted the
letters to the editor published in the same issue as the
original article (2-5). While usually such letters are published
in succeeding issues to the original, in this case the print
release of the original article was delayed by the publisher
because of the suit. Throughout the legal process, the
article itself remained available in the Advance Online
Publication electronic format and was fully searchable on
the usual electronic search engines. Two of the letters
were published on-line (2, 3) during the legal process. Those
letters and the final two (4, 5) were simultaneously published
with the original article in February 2013 pursuant to an
agreement between the litigants which was, in part, met by
publication of the letter in reference 4. Curious readers
may find the letters interesting in regards to the degrees to
which the letters approach the concerns raised within the
letters and by which the letters adhere to the standards
described in the court’s decision. In my opinion, discerning
readers may find discrepancies in the manner of identifying
conflict of interest and misinformed logic as well as other
issues that are similar to those the suit’s plaintiff objected to
in the original article.
There are also new codes for physician direction of
neonatal/pediatric transport (99485, 99486). The RVUs for
99485 are 2.18 and for 99486 are 1.90 and are printed in
CPT 2013. CMS decided to bundle this code into the
Neonatal Critical Care Codes even though they were
valued by the RUC.
Another new set of codes was developed for Physician to
Physician Telephone Consultation. These codes are 99446
– 5-10 minutes, 99447 - 11-20 minutes, 99448 – 21-30
minutes, 99449 – 31+ minutes). They can be used for
interprofessional telephone assessment and management
service provided by a consultative physician to a patient
treating physician. These codes have been approved by
the CPT Editorial Panel in May and will appear in CPT
2014. Their RVU values are not available at this time.
conflict of Interest:
As Editor of the Journal of Perinatology, Dr. Lawson
receives financial support from Nature Publishing Group.
Nature Publishing Group supported Dr. Lawson’s legal
representation.
The Coding Toolkit was revised in preparation for ICD-10
and is available as a searchable database. A print version
will be available in April to Section members. The
Committee is producing a new updated Quick Reference
Guide for Neonatal Coding and Documentation in
preparation for ICD-10 which will begin in October 2014.
We hope that many of you will take advantage of this
publication as a resource for your group and your coders.
Acknowledgement
The author wishes to thank Mr. Robert D. Balin of Davis
Wright Tremaine, LLP for his personal support and
professional representation throughout the proceeding of
this lawsuit.
Reference list
1 Ramanathan R, Bhatia JJ, Sekar K, Ernst FR. Mortality in
preterm infants with respiratory distress s(5) Cummings JJ. Is
there evidence for a mortality difference between natural
surfactants? J Perinatol 2013 Feb;33(2):161-2.yndrome
treated with poractant alfa, calfactant or beractant: a
retrospective study. J Perinatol 2013 Feb;33(2):119-25.
Special coding Seminar
at the Spring Workshop
Friday, April 4, 2014
2 Cummings JJ. Is there evidence for a mortality difference
between natural surfactants? J Perinatol 2013 Feb;33(2):1612.
This seminar is designed to instruct neonatologists
about CPT codes and how they are used in daily
practice. It will provide an update on the new
changes in CPT and ICD-10 codes. Application of
codes to various patient conditions and situations
will be explored using ARS. Discussion will include
recommendations from you on the needs and
limiations of the current codes. Sign up now at
www.aap.org/livecme.
3 Ramanathan R, Bhatia JJ, Sekar K, Ernst FR. Response to
Cummings. J Perinatol 2013 Feb;33(2):162-5.
4 Egan EA. In response to mortality in preterm infants with
respiratory distress syndrome treated with poractant alfa,
calfactant or beractant: a retrospective study. J Perinatol
2013 Feb;33(2):165-6.
5 Ramanathan R, Bhatia JJ, Sekar K, Ernst FR. Response to
Dr Egan's letter. J Perinatol 2013 Feb;33(2):166-7.
9
March of Dimes
capping a three-year campaign by the March of Dimes to
champion this important initiative.
Scott Berns, MD, FAAP
US Preterm Births drop to 15-year low
The United States’ preterm birth rate dropped for the sixth
consecutive year in 2012 to 11.5 percent, a 15-year low. The
March of Dimes estimates that, since 2006, about 176,000
fewer babies have been born too soon because of
improvement in the preterm birth rate, potentially saving about
$9 billion in health and societal costs.
The 2012 preterm birth rate among non-Hispanic black infants
remains the highest of all the racial groups at 16.8 percent,
down from 18.5 percent in 2006 and the lowest in more than
20 years. The gap between blacks and whites has been slowly
narrowing, but the preterm birth rate among non-Hispanic
blacks is still more than 1.5 times the rate of non-Hispanic
whites.
The national preterm birth rate peaked in 2006 at 12.8 percent
after rising steadily for more than two decades, according to
the National Center for Health Statistics. The 2012 rate is a 10
percent improvement since the 2006 peak and the best rate
since 1998. When compared to 2006, almost all states had
lower preterm birth rates in 2012.
Prematurity Awareness Month and World Prematurity Day
– Highlights, including the National Report card
On November 1st, the March of Dimes released its 6th annual
Premature Birth Report Card. Although the United States
preterm birth rate improved, the U.S. again earned a “C” on
the report card. On the 2013 Report Card, 31 states, the
District of Columbia, and Puerto Rico saw improvement in their
preterm birth rates between 2011 and 2012, earning seven –
Alaska, California, District of Columbia, Georgia, Indiana,
Kentucky and New Jersey – better grades. Six states earned
an “A,” nineteen states earned a “B,” 17 states and the District
of Columbia received a “C,” five states got a “D,” and only
three states and Puerto Rico received an “F” on the report
card. The Report Card compares each state’s preterm birth
rate to the March of Dimes goal of 9.6 percent of all live births
by 2020. The Report Card information for the U.S. and states
are available online at: marchofdimes.com/reportcard.
On November 17, families around the world observed World
Prematurity Day to raise awareness that preterm birth is a
serious problem worldwide. Individuals around the world were
asked to show their support for prematurity prevention efforts
by going to Facebook and posting a story and a picture of their
child, family member or friend whose child was born too soon.
As part of World Prematurity Day, fans, families and volunteers
could send their friends a “virtual hug” through Facebook and
other social media sites to show that they care about
premature babies. The “Hugs” campaign reflects the benefits
of kangaroo care, when parents hold their premature baby
skin-to-skin.
PReeMIe Reauthorization Act signed into law
In 2006, the original PREEMIE Act (P.L. 109-450) brought the
first-ever national focus to prematurity prevention. The 2008
Surgeon General’s Conference on the Prevention of Preterm
Birth required by the Act generated a public-private agenda to
spur innovative research at the National Institutes of Health
(NIH) and Centers for Disease Control and Prevention (CDC)
and support evidence-based interventions to prevent preterm
birth.
leading Health and Philanthropic Organizations Outline
Plan to Address Global Burden of Preterm Birth
On November 14, leading researchers and global health
organizations issued a call-to-action to advance a
comprehensive research agenda to address the global burden
of preterm birth, which has become the leading cause of
newborn deaths worldwide.
The Bill & Melinda Gates Foundation, the Eunice Kennedy
Shriver National Institute of Child Health and Human
Development, the Global Alliance to Prevent Prematurity and
Stillbirth (GAPPS), and the March of Dimes Foundation
convened scientific experts from around the world to develop a
“Solution Pathway” for preterm birth. This strategic research
plan spans the spectrum of discovery, development, and
delivery of research needed to both accelerate prevention and
reduce preterm birth death and disability. Developed by more
than 30 scientific experts in the field of preterm birth and
maternal-child health, the agenda was published as a
commentary online in The Lancet Global Health.
The agenda calls for:
• Innovative research in the biology of pregnancy and
preterm birth, and bringing new technologies and
methodologies to the field of preterm birth research and
prevention.
• Accelerating research for use of practical and affordable
interventions known to improve survival of preterm
infants in low- and middle-income countries.
• Improving availability of data to better understand the
global burden of preterm birth, identify populations at
risk, and evaluate impact of programs aimed at reducing
preterm birth and death and disability.
• Fostering innovation and collaboration to translate
research into practice.
The development of a shared research agenda comes at a
time when multiple global initiatives have gained crucial
momentum to address newborn mortality and preterm birth,
including the Millennium Development Goals, Every Woman
Every Child, and the Every Newborn global action plan.
New Pregnancy-Focused electronic Health History
Software Available
A free, state-of-the-art, computer-based tool to help identify
and address potential pregnancy conditions that may put the
health of the mother and her baby at risk now is available to
health care providers. The Pregnancy and Health Profile, an
electronic computer-based tool, developed by March of Dimes,
the National Coalition for Health Professional Education in
On November 27, President Barack Obama signed into law
the PREEMIE Reauthorization Act. The law renews federal
research, education and intervention activities related to
preterm birth and infant mortality for another five years,
10
Genetics, Genetic Alliance, and Massachusetts General
Hospital, gathers a pregnant woman’s and her partner’s family
health histories and information about their lifestyle and
behavior that could affect newborn health. The software
completed a one-year pilot test.
Save the Date!
Vermont Oxford Network
2014 Annual Quality Congress
The electronic health tool includes a patient-friendly
questionnaire that is filled out by the patient in a health care
office on a computer tablet. The software translates the family
health information and suggests potential risks for health care
providers to focus on during an office visit. Information from
the tool, including the potential risks and background
information for health provider, can be integrated into existing
electronic health records or the software can operate as a
stand-alone system for primary prenatal care practices. The
software can be downloaded free at: http://www.nchpeg.org/
Reducing Major Morbidities
in the NICU
Chicago, IL
October 30 - November 2, 2014
Preconference events: October 30–31
Quality Congress: November 1–2
Details and registration at www.vtoxford.org
More than 600 patients and 75 obstetricians, family medicine
practitioners, nurse midwives and nurses took part in the pilot
projects. More than 95 percent of the patients reported that the
tool was easy to use and understand. Clinicians said the tool
engaged and educated patients, efficiently collected
information and improved patient ability to identify and act on
family history risks.
March of Dimes enhances Online Support for NIcU
Families
calendar of events
The March of Dimes has significantly enhanced Share Your
Story (Shareyourstory.org), providing new features to help
parents. Share Your Story is an interactive, online community
where families who have a baby born prematurely, with birth
defects, or with other serious health problems can receive
support and information from others who understand the
challenges and uncertainties of complicated pregnancy, the
Neonatal Intensive Care Unit (NICU) experience or the loss of
a newborn.
cAN/District IX conference
coronado Island, cA
February 28 - March 2, 2014
2014 Spring Workshop on
Perinatal Practice Strategies
Scottsdale, AZ
April 4-6, 2014
Pediatric Academic Societies (PAS)
Vancouver, canada
May 3-6, 2014
New technology built into the site enables parents to upload
pictures and video that demonstrates their babies’ progress
and development. The addition of new profile avatars makes it
easier to find friends and other members based on shared
pregnancy and birth experiences. Share Your Story is
monitored seven days a week by March of Dimes volunteer
parents who are veteran contributors to the site.
SAN (District X Meeting)
Marco Island, Fl
May 22-25, 2014
District VIII Perinatal Meeting
Denver, cO
May 29-June 1, 2014
Update: March of Dimes NIcU Family Support® Program
Since 2001, NICU Family Support has provided services to
over 550,000 families nationwide, growing to over 120 hospital
partnerships offering comfort and information to over 90,000
families annually in every state, Washington DC and Puerto
Rico. As the program has expanded, so have its services to
meet the changing needs of hospitals and families.
Perinatal District VI Meeting
chicago, Il
September 5-6, 2014
AAP National conference & exibition
San Diego, cA
October 11-14, 2014
The March of Dimes has improved services by developing a
core curriculum consisting of five education sessions for NICU
families. These parent education sessions have been
standardized and will be provided in all NICU Family Support
sites in 2014. Providing this core curriculum ensures quality
and consistency of information and messages to families while
their baby is in the NICU.
For more information about the program, its new core
curriculum, materials, or NICU staff development, contact
Jessamyn Ressler-Maerlender at
jresslermaerlender@marchofdimes.com.
Hot topics
Washington, Dc
December 7-10, 2014
11
the Ninth Mosquito
In the IMS, Ross fared poorly, earning a reputation for
being a “so-so” doctor. His love for the pen and poetry
exceeded that for the stethoscope and the syringe.
However, Ross began thinking about malaria—a disease
that was all around him. He read the existing literature and
noted that there were huge knowledge gaps. How do the
parasites Laveran discovered, get into humans? How do
they spread? Why do some patients remain asymptomatic
carriers, and others die from bouts of fever and anemia?
tonse N. K. Raju, MD, FAAP
Chief, Pregnancy and Perinatology Branch,
Eunice Kennedy Shriver National Institute
of Child Health and Human Development, National
Institutes of Health, Bethesda, MD
According to the website
No More Malaria, 200
million people are infected
globally with malaria at
any given time. It remains
one of the top three killers
of children. In the early
1900s, nearly five million
people died annually from
malaria in India alone.
From the tropics to the old
world, from the Antarctic
through the Americas,
malaria ruined cities and
countries and destroyed
populations. In its empire,
the sun seldom used to
set.
Then, a suggestion from Patrick Manson triggered Ross's
thinking. Working in China, Manson had discovered that
elephantiasis was caused by a germ that remained
dormant in human blood and
grew inside the mosquitos.
Manson suspected that malaria
parasites, too, matured inside
mosquitos and escaped
through their eggs into stagnant
pools of water. Drinking of
contaminated water led to
human malaria.
With permission of the Library &
Archives Service, London School of
Hygiene & Tropical Medicine
Despite its menacing
notoriety, the cause of malaria remained a mystery well into
the 1880s. One hypothesis ascribed it to breathing “foul
air”, thus christening it malaria, from the Latin, mal for bad
and aria for air.
Three scientists in the final two decades of the 19th century
deciphered the etiology and pathogenesis of malaria. In
1880, Alfonso Laveran, a French army surgeon working in
Algeria, studied blood smears from malaria patients under
microscope and discovered some crescent-shaped bodies
in the red blood cells. He was not sure what they were. But,
on November 6th of the same year, in a blood smear from
a different patient, he found some of these parasites
throwing off menacing flagella that were moving “in an
animated nature” (his quote). He was soon convinced that
those must be the malaria bugs. It was later determined to
be the protozoan parasite of the genus Plasmodium. Later,
Ronald Ross, a British medical officer in the Indian Medical
Service (IMS), discovered its life cycle, with significant
guidance from the famous Scottish parasitologist Sir
Patrick Manson.
Ronald Ross was born in 1857 in
Almora, north India. He wanted to study
the humanities—but his father, Sir
Campbell Ross, asserted that arts and
literature were for the lazy, and that
Ronald should study medicine to serve
in the British IMS with dignity. Ronald
enrolled in a London medical college,
and after graduation, dutifully joined the
IMS.
Ronald Ross in 1899 (London School of Tropical
Medicine and Hygiene, CDC website)
Ross followed this reasoning
and experimented with
Ronald Ross Hospital in
mosquitoes, birds and men.
Secunderabad, India in the early
From Manson he had learned 1900s
how to prepare mosquitoes for examination using the new
microscope he had purchased in London. He kept reporting
all of his research progress to his mentor Manson through
regular correspondence.
However, Ross’s research design could be seen as
gruesome from today’s ethical standards for clinical
research. He made his assistants with and without malaria
sleep inside mosquito nets filled with freshly bred live
mosquitoes. The “volunteers” were required to catch as
many live mosquitoes as they could, but only after they had
been bitten by the mosquitos. He paid 2 anna (about a
dime), incentive money for each live mosquito caught.
Ross would then dissect the captured creatures at varying
intervals and tracked the stages of the parasite’s life cycle
inside the mosquitos that had their final human-blood meal.
Like Laveran, Ross also discovered flagellated forms of the
malaria parasite in the walls of the midgut of some
mosquitoes. He tried, but failed, to “transmit” the disease to
human volunteers by making them drink the water
contaminated with mosquito eggs, and by having them
bitten by malaria-infected mosquitoes. He failed because,
unknown to him then, those were of the Aëdes and Culex
mosquito species, in which the malaria parasite did not
survive.
Then came the fateful day: August 20,1897. When Ross
was at his post in the south Indian city of Secunderabad,
his assistants had caught ten mosquitos that had bitten
several malaria patients over the past few days. Ross
noted that these mosquitos were of a newer kind, with
distinct spots on their wings. As he dissected one after the
other over a two day period, he found nothing new inside
12
the first eight mosquitos. But on
August 20th, in the superficial
tissues of the midgut of the ninth
mosquito, which had bitten a
malaria patient a few days earlier,
Ross found a form of the parasite
he had never seen before—a
circular disk with black dots
inside, or the cystic form. In a
flash, a new theory struck Ross:
Could these be the intermediate Ross with his wife, Rosa
Bloxam Ross, and his
stages of the parasite, which
assistants in front of his Indian
complete their sexual
laboratory. With permission of
reproduction inside the stomachs the Library & Archives Service,
of mosquitos? Thrilled, he called London School of Hygiene &
that as the “Mosquito Day”. But, Tropical Medicine
before he could explore this theory, the military transferred
him to Bombay. Two more years ensued before he could
find another cystic stage of the parasite inside a mosquito
stomach.
Although the complete eradication of malaria still remains a
major goal, Ross's discovery in Secunderabad on that hot
summer day was a benchmark episode in the history of
man’s struggle against the microbes. Now August 20th of
each year is celebrated as the World Mosquito Day and
November 6th, the World Malaria Day honoring Ross and
Laveran for their respective discoveries.
Meanwhile, some Italian scientists (who had been informed
of all of Ross’s discoveries secretly by Manson) had
identified and named the new mosquito with spotted wings
as Anopheles, as perhaps being responsible for
transmitting malaria. Ross was infuriated by Manson’s
actions and felt cheated by the elder scientist. However,
swallowing his pride, he spent many more disappointing
monsoons in India, pursuing his theory of malaria parasite’s
life cycle, working with malaria-infected birds, the
Anopheles mosquitoes, and human patients and
volunteers.
1 Imagine No Malaria website: www.nomoremalaria.org
Medical history is full of human research that may be
considered unethical at best, gruesome and heinous at
worst. But, how do we rate Ross’ research? Can we
approve his method because of the limited contemporary
knowledge, the horrific nature of malaria, and that Indians,
already at high risk for malaria, were not at an incremental
risk by getting deliberately exposed to the mosquitos?
Should we accept his methods because of the greater good
it did and that he was on the right side of history and the
medical science? Don’t we all design studies with such
altruistic principals and hopes? Shouldn’t we?
Some References.
2 Magill FN. The Nobel Prize Winners: Physiology or
Medicine. Volume 1 1901-1944. Pasadena, CA, Salem
Press. 1991; 39-49
3 The Nobel Prizes Website. http://www.nobelprize.org/
4 Ross and the Discovery that Mosquitoes Transmit
Malaria Parasites. Centers for Disease Control and
Prevention. Website
http://www.cdc.gov/malaria/about/history/ross.html
He finally pieced together the life cycle of malaria parasites.
The parasitic forms with whiskers were the male cells,
fertilizing the female cystic forms inside the mosquito
stomachs. They reproduce and wait (in the wings!) in the
stomachs and salivary glands of the mosquito, until the
latter goes for its next bloody meal. While the mosquito
feeds on its victim, the germs escape through the mosquito
saliva (or the regurgitated stomach juice), and enter the
victim’s blood stream through the wound caused by the
mosquito bite.
When Ross presented this concept before the British
Medical Association in 1898, it was received with
thunderous applause. Its publication in 1899 brought Ross
worldwide acclaim.
Ross retired from the British military service in 1899 and
traveled widely, organizing malaria eradication programs in
Africa and the tropics. He published medical and literary
works. He was knighted in 1912 and was appointed
consulting physician for the British army during the First
World War. After a prolonged illness, Ross died in 1932.
In 1902, Ronald Ross received the Nobel Prize in
Physiology or Medicine—this was the second year of the
initiation of the prestigious prize. In 1907, Alfonso Laveran,
too, received a Nobel Prize for his discovery of the malaria
parasite.
The memorial tablet on the wall of the building that was
once the Begumptet Hospital, Secunderabad, India.
Wellcome Images courtesy of LJ Bruce-Chwatt.
13
ONtPD Update
christiane Dammann, MD, FAAP, chair
ONtPD Fall Meeting in Orlando
The annual ONTPD meeting was held at the NCE in
Orlando on October 24th. Presentations included: match
results and new timeline, FDA Initiative: Newborn Drug
Development, ABP Subspecialty Initiative – Final
Recommendations, Pediatric Milestones and NAS,
Neonatal EPAs, Documenting Handoff-tools and
evaluation, Updates from TeCaN, and council election
results. All presentations are now on the ONTPD website at
www.aap.org/ONTPD.
Dr. Lieh-Lai’s (Senior Vice-President, Medical Accreditation
ACGME) update on the NAS (N=NOW) was presented.
The goal is to promote innovation by making improvements
to the programs, while reducing the burden. “Indicators” of
Performance are ADS update, board performing rates,
resident surveys, case logs, and resident evaluation and
feedback. Subspecialty programs are even more tightly
connected to the core programs. Subspecialty will start to
report milestones in November 2014.
ACGME-Webinars available at http://www.acgmenas.org/index.html
Dr. McGuiness summarized the requirements for
Subspecialty Clinical Training and Certification (SCTC).
1 Career pathway tracking is permissible, while scholarly
activity requirements will not change. Flexibility to
accommodate individualized professional development
is encouraged.
2 Program Director is responsible for ensuring oversight
and assessment of clinical performance, informed by
input of other faculty, and accomplished through a
clinical competence committee.
Dr. Bendel summarized ONTPD survey results for
“Handoffs in the NICU” done ideally Face to Face/In
Person, at the bedside using standardized approach to key
concepts which are backed-up with details via EMR -“No
single tool will meet every situation.”
Drs. Rice and Parker presented an EPAs - (Entrustable
Professional Activity) Update. All of the comments from the
CoPS website and from the AAP meeting in Orlando have
been reviewed and the committee is currently considering
whether to add a procedural EPA and whether to delete the
chronic care EPA. Individual programs may, of course, add
any additional EPAs they feel are required for their
individual Programs. Once the EPAs have been finalized in
the spring of 2014, the competencies and milestones will
be mapped to individual EPAs to aid the evaluation of
fellow performance.
Website Update: (www.aap.org/ONtPD)
The ONTPD website continues to be a source of up to date
information on the changes related to NAS and EPAs. The
council’s corner is written quarterly, providing discussion on
topics relevant to program directors, written by ONTPD
Council members. Recent selections have included a
review of the new match process by Susan Aucott, and a
discussion on the impact of individualized residency
training track system on the preparedness for subspecialty
training by Christiane Dammann. Resources for fellows
and fellow applicants, such as funding opportunities and
application time lines are also available on the website.
Christiane Dammann, MD; Ward Rice, MD, PhD; Sue
Aucott, MD; ONTPD Council
committee on Membership
William D. engle, MD, FAAP
In the fall of 2013, there were almost 3200 members in The
Section on Perinatal Pediatrics, a 4% increase from July 2012.
We are the largest sub-specialty section in the Academy, and
we hope to continue our recent growth. Much of this
expansion has been through the dedicated efforts of TECaN
(Training and Early Career Neonatologists), a group that is
supported by and an integral part of the Section. Of note, the
Section offers free membership to trainees who are members
of AAP.
According to ABP records, over 50% of the over 5,500 Board
Certified Neonatologists are either not AAP members or are
AAP but not Perinatal Section members. It is clear that there
is room for improvement in our percentage of neonatologists
who become and remain section members. Katy Lerman
(AAP Manager, Membership Marketing) is helping us in our
recruiting efforts. Katy has developed material to send to
these individuals. There are many benefits to Section
membership, and if you have a colleague who has not joined
or renewed, your support of the Section would be greatly
appreciated.
We also are continuing to recruit physicians in countries other
than the US who desire Section membership. Many Section
members have a strong interest in global health and have
interacted closely with physicians overseas. A vote of the
Section membership regarding this issue passed in the spring
of 2012, and we are now in the process of working out the
logistics of contacting potential international members. You
can take a look at our brochure/flyer on the Section website; in
the “Neonatologists” section, click on “More for
Neonatologists” then scroll down. If you have a colleague or
contact in another country who might want to consider this,
please pass along this information.
The Section offers affiliate membership to licensed physicians
(DOs and MDs) who are not otherwise eligible for membership
in the American Academy of Pediatrics, but who have a
special interest in Perinatal Pediatrics, and to healthcare
professionals such as Nurse Practitioners, Nurses and
Respiratory Therapists who are working in Neonatal-Perinatal
Medicine. The Section is a collaborative effort that thrives on
the basis of input from many diverse but related groups; if you
work with someone who might desire affiliate membership (the
cost is $85), please direct them to the Section website:
www.aap.org/perinatal.
14
As a Section member, you have access to many member
benefits, including the monthly Journal of Perinatology, the
Section newsletter, meeting discounts and free publications
such as Guidelines for Perinatal Care. Also, in advocating for
our members, the Section is working with the American Board
of Pediatrics (ABP) to find workable solutions to well-described
problems relating to Part IV of the ABP Maintenance of
Certification requirements. Additional benefits can be found
on the website.
coding Answer
the correct answer is (B).
Code 99479 is the code for subsequent intensive
care, per day, for the evaluation and management of
the recovering low birth weight infant (present body
weight of 1500-2500 grams). Code 94780 is the code
for car seat/bed testing for airway integrity, neonate,
with continual nursing observation and continuous
recording of pulse oximetry, heart rate and respiratory
rate, with interpretation and report; 60 minutes. Code
94781 is the code for each additional full 30 minutes.
Code 99472 is the code for subsequent inpatient
pediatric critical care, per day, for the evaluation and
management of a critically ill infant or young child, 29
days through 24 months of age. (CPT 2013 pages
42-43; Coding for Pediatrics 2013, pages 147-149).
In an effort to better understand our specialty and
membership, a small group was formed (Cherrie Welch, Sue
Aucott, Dick Powers and Bill Engle) to assist Carrie
Radabaugh at AAP with development of a Membership
Survey. If you are asked to complete this survey, your input
would be of great value.
As reflected by its mission, the Section continues to play a
strong advocacy role on behalf of mothers, fetuses, and
babies. Recent efforts include our contribution to the Towards
Improving the Outcome of Pregnancy report (March of Dimes),
our collaborative work on addressing disparities in birth
outcome, and our testimony to the Food and Drug
Administration regarding critical drug shortages.
The car seat/bed testing codes (97480, 94781) if
used in the hospital are bundled with the
critical care code (99472) and the intensive care code
(99479). However, the car seat/bed code can be
reported on the same date as the subsequent
hospital care codes (99231-99233) and discharge
day management codes (99238, 99239). This differs
if the repeat test is performed in the pediatrician’s
office where the code is not bundled.
The Section on Perinatal Pediatrics plays a critical role in the
enhancement of care for mothers and infants, and it provides
important benefits for personal growth and career
development to its members. Thank you very much for your
support of the Section and its important mission.
Workshop on Perinatal Practice Strategies
April 4-6, 2014 - Scottsdale, AZ
Comments from Training Fellows who attended the 2013 Workshop
“I wasn’t quite sure what to expect coming here, but it has far exceeded my expectations. I’m going home full of questions and ideas for
practice, made a new group of friends amongst my peers. We’ve discussed everything from how we all plan to expand TECaN
participation in our districts to how we can be organizing our education at the program level. We have found overlapping areas of
interest and the atmosphere has been so encouraging that I have felt comfortable enough to introduce myself to physicians whose
names have been on my bookshelf for years. I am going home feeling encouraged, enthusiastic, and much more a part of the fabric of
the neonatology community. Thank you, R. Y. Malekadeli”
“This conference has been an invaluable experience for a second year fellow. The chance to interact, discuss career plans and share
my research with pioneers and leaders of the field has been an experience that I will never forget. Thank you! Saila Ghanta”
“As a fellow, the opportunity to attend the Workshop on Perinatal Practice Strategies has been a wonderful experience. The opportunity
to gather both with other fellows from around the country and practitioners with more experience has led to the formation of invaluable
relationships. Amanda England”
“I truly enjoyed the smaller, intimate format of the conference. One of the most valuable experiences from this conference was the
opportunity to meet and converse with leaders in the field of neonatology in a manner that fellows do not normally experience.
Additionally, the break-out groups were exceptional, and directly applicable to real world practice. In addition to meeting some of the
superstars of neonatology, the other amazing benefit was the opportunity to meet other TECaN professionals from other districts and
hear their perspectives on how medical practice is done all over the country. Through these new relationships, I gained a deep
appreciation for the potential this meeting has for building a sense of community within our profession. I could see firsthand how
building a strong network of colleagues can help me develop as a neonatologist, and by extension, help the patients in my practice.
Thanks again! Cecile Osman"
“As a fellow at a program without a strong TECaN presence, I have been relatively unaware of the fantastic work the Section on
Perinatal Pediatrics and TECaN in particular have undertaken over the past several years. Attending this conference has been a
wonderful opportunity to meet fellows and early career neonatologists, as well as become involved in the initiatives of the Section and
TECaN. Additionally, the formation of professional and research collaborations is an integral part of a career in academic neonatology,
and this workshop facilitated the institution of these invaluable relationships. I hope not only to attend this conference in future years,
but also encourage other fellows in my program to apply for funding to attend. Matt Egalka”
15
DIStRIct I:
John Zupancic
MASSACHUSETTS
the Primary care of the Preterm Infant
conference will take place on Friday, March 7,
2014 from 7:30 am to 4:30 pm at the
Massachusetts Medical Society Headquarters at
Waltham Woods, in Waltham, Massachusetts.
This program will help to increase awareness of
issues regarding the preterm infant and will
provide pediatric primary care providers with
practical strategies to care for this population.
This program will be conducted under the joint
sponsorship of the BIDMC Department of
Neonatology, Boston University School of
Medicine, and the Massachusetts Chapter of the
American Academy of Pediatrics. The activity
has been approved for AMA PRA Category 1
Credit TM. For more information contact Dara
Brodsky (dbrodsky@bidmc.harvard.edu) or
Vincent c. Smitg
(vsmith1@bidmc.harvard.edu).
the New england Neonatal Quality and
Safety Forum will be held Wednesday, May 28,
2014, 11:30am-7pm, at the Massachusetts
Medical Society in Waltham MA. This is the
third year of this event that seeks to bring
together perinatal health care providers
throughout New England to celebrate and
support quality improvement initiatives in
maternal and newborn health care. This year’s
keynote speaker is Wanda Barfield Captain in
U.S. Public Health Service and Director of the
Division of Reproductive Health at the Centers
for Disease Control and Prevention. In addition,
the conference will include clinical and methods
workshops and a poster fair showcasing quality
improvement and patient safety projects. For
more information, including the call for
abstracts, please contact Munish Gupta
(mgupta@bidmc.harvard.edu) or Alan Picarillo
(alan.picarillo@umassmemoral.org) or visit
www.neoqic.org.
The spring meeting of the Neonatal Quality
Improvement collaborative of
Massachusetts (NeoQIC) will be Thursday,
March 20, 2014 from 11:00 am to 2:30 pm at
Beth Israel Deaconess Medical Center in
Boston. The spring NeoQIC Massachusetts
Neonatal Abstinence Syndrome Improvement
Project meeting will be Wednesday, April 8,
2014, from 9:30 am to 4 pm, at the Doubletree
Hotel in Westborough MA. For more info on
either of these meetings, contact Alan Picarillo
(alan.picarillo@umassmemorial.org) or
Munish Gupta (mgupta@bidmc.harvard.edu),
or visit www.neoqic.org.
Beth Israel Deaconess Medical Center
Heather Burris is the recipient of an NIH
Patient Oriented Career Development (K)
Award. Her grant titled, “The Toxic Environment
and the Epigenetics of Fetal Growth,” will
facilitate the examination of factors responsible
for prematurity and other adverse birth
outcomes.
Vincent Smith has been promoted to Assistant
Professor of Pediatrics at Harvard Medical
School.
Ivan D. Frantz III and Maggie everett have
joined the faculty of the Beth Israel Deaconess
Medical Center Department of Neonatology.
Barbara Shepherd has been appointed Medical
Director of the Continuing Care Nursery at Beth
Israel Deaconess – Plymouth. She will be joined
by Associate Director Maggie everett. Beth
Israel Deaconess – Plymouth is a new formal
affiliation of the Beth Israel Deaconess Medical
Center and the former Jordan Hospital serving
the residents of southeastern Massachusetts.
Boston Children’s Hospital
Helen christou has been appointed as the new
Director of the Harvard Neonatal-Perinatal
Medicine Fellowship Training Program. As
Associate Director for the past five years, Dr.
Christou has already been a dedicated mentor
and vital contributor to the Program. In her new
position, she will expand her role in advising
fellows and helping them to navigate the
intricacies of their clinical training, scholarly
work, and eventual career directions.
Brigham and Women’s Hospital
The Brigham and Women’s Hospital Newborn
Medicine has undergone some restructuring
with the creation of a new Department of
Pediatric Newborn Medicine. terrie Inder has
been appointed as the new Chair and has been
undertaking extensive review of the clinical,
research and educational activities within the
Department. She has been joined from St.
Louis by junior faculty members, cynthia
Ortinau, with a research focus in the impact of
congenital heart disease on brain injury and
brain development; christopher McPherson
who will lead a new clinical and academic NICU
pharmacy unit; and lianne Woodward, an
internationally recognized psychologist with a
focus on longitudinal follow up studies on
outcome in high risk infants such as preterm
infants. In addition, Steve Ringer has been
appointed as the new Director of Newborn
Services within the BWH Labor and Delivery
with a focus on resuscitation and triage of
transitioning newborns. A new Division of
Newborn Pediatricians has been established
within the Department encompassing all
Pediatric trained hospitalist and staff in the
department that serve well baby care, assist in
NICU and labor and delivery. lise Johnson
has been named the Division Director. Finally,
new space is being developed to house the
faculty on the 4th floor of the Connors and
Womens buiding and within the Peter Bent
Brigham building as the new neonatal intensive
care unit building plan will be initiated in August
2014. The new NICU plan has been approved
by the Department of Public Health and will
house 46 single family rooms, 18 infants in 6
three bed large shared rooms and two
transitional care rooms.
Floating Hospital for Children at Tufts Medical
Center
Diana Bianchi has been elected to the Institute
of Medicine.
16
Sarbattama Sen received a K-series mentored
clinical training award from the National
Institutes of Health, as well as a Hood Grant for
her work on Maternal Obesity and Neonatal
Outcome.
Jonathan Davis was elected to the Council of
the American Pediatric Society.
RHODE ISLAND
Women and Infants Hospital of Rhode Island
Betty Vohr received the Society for Pediatric
Research’s 2013 Douglas K. Richardson Award
for Perinatal and Pediatric Healthcare Research.
This award honors the lifetime achievement of
an investigator who has displayed a sustained
record of excellence as a clinical investigator.
Marcia W. VanVleet served as the region 1 cochair of the Academic Pediatrics Association
(APA) Spring Regional Meeting in Amherst, MA.
She was recognized by the Academic Pediatric
Association for her contributions to the society
and its mission in her capacity as Chair of
Region I.
Stephen Sheinkopf was appointed to the
Special Joint Commission to Study the Quality
of Life and Create Positive Outcomes for
Individuals with Autism in the State of Rhode
Island.
Anoop S. Pulickal Chief Fellow in the
Neonatal-Perinatal Medicine Fellowship
Program, received the award for the best oral
platform presentation by a neonatal fellow at the
2013 New England Perinatal Society’s annual
meeting. The title of his research presentation
was, “Protection Against Neonatal Candidiasis
by a Monoclonal Antibody Targeting the Candida
albicans Adhesin, Als3p.”
thomas Murphy, Fellow, received a Top Poster
Award at the 2013 Annual Leadership
Conference of the National Association of
Children’s Hospitals, held from 10/13-15/13 in
New Orleans, LA. The title of the poster was
“Establishing Sustainable Culture Change
Through Team Training”. Dr. Murphy was also
the recipient of an award for Best Presentation
in Clinical Science at the American Academy of
Pediatrics’ 39th Annual New England
Conference on Perinatal Research, held
October 5-6, 2013 in Chatham, MA.
VERMONT
Vermont Oxford Network
The Vermont Oxford Network is the proud
recipient of the 2014 Mavis and Stan Graven
Award for Leadership. The award honors an
individual or group whose work makes
substantial contributions to the betterment of the
physical and developmental environment of the
high-risk neonate. William H. edwards, Section
Chief, Neonatology, Professor of Pediatrics,
Geisel School of Medicine at Dartmouth and a
Director of the Vermont Oxford Network,
accepted the award on behalf of the
membership of the Vermont Oxford Network on
February 7, 2014 at the 27th Annual Gravens
Conference, “Nurturing and Nourishing in the
NICU.”
Mark your calendar for the Vermont Oxford
Network’s 2014 Annual Quality Congress in
Chicago, convening October 30–November 2.
This year’s congress, “Reducing Major
Morbidities in the NICU,” features distinguished
speakers, including Kristi Watterberg, David
edwards, Michele Walsh, John lantos, and
others, along with plenaries, breakouts, and a
robust Learning Fair. Details and registration at
www.vtoxford.org
For the first time, AAP/TECaN and the Vermont
Oxford Network teamed up to offer five
scholarships to the 2013 Vermont Oxford
Network’s Annual Quality Congress. Along with
the scholarships came mentorship in abstract
preparations and podium presentation
opportunities. The five fellows chosen for this
honor were Anastasia Ketko from the
University of Michigan Children’s Hospital,
Jennifer McGuirl from Montefiore Medical
Center, Mary Fay from Dartmouth Hitchcock
Medical Center, Melissa engel from the
University of Minnesota, and Nneka Nzegwu
from Yale University. Of the 200 abstracts juried
into the conference, AAP/VON scholar’s
Anastasia Ketko’s abstract on her team’s
important QI work, “Approaches to Saturation
Alarm Fatigue in a Single-Patient Bed Unit,”
received the honor of being chosen for podium
presentation at the 2013 VON Annual Quality
Congress. Readers can view her excellent
presentation at http://9slides.com/embed/2013AMQC-Ketko-and-Soll-Saturation-Alarms-and-R
OP
DIStRIct II:
Sergio Golombek
NEW YORK
Children’s Hospital at Montefiore/Albert Einstein
College of Medicine
On September 16, 2013, we welcomed back
Sheri Nemerofsky as the incoming Director of
Newborn Services at Montefiore’s Wakefield
Division. Sheri replaced elizabeth Hailu who
relocated to Canada, joining the Neonatology
group at Children’s Hospital of Montreal, McGill
University Medical Centre.
The Division of Neonatology is pleased to
announce that thomas Havranek has joined
our group. Tom has been a member of the
faculty at St. Louis University and the Cardinal
Glennon Children’s Medical Center for the past
6 years. Tom's email is
thavrane@montefiore.org.
The Division of Neonatology also welcomes
Yogangi Malhotra. Yogangi completed her
fellowship at Yale and has been a faculty
member at the New York Medical College and
Maria Fareri Children's Hospital for the past 2
years. She is currently based at Montefiore's
newest site at New Rochelle Hospital.
Robert Angert has joined the NICHD-funded
National Children's Study as an ad hoc reviewer
on the Pediatric Terminology Harmonization
Initiative and Adverse Events Working Group
whose goal is to describe terminology in 15
different Pediatric domains. Adverse Events and
Perinatology are the domains that are currently
underway. Rob has joined the Perinatology
group.
The Division of Neonatology, in collaboration
with the Division of Pediatric Cardiology, hosted
a regional conference, establishing Screening
for critical congenital Heart Disease: the
Next Phase of Newborn Screening, at the
Albert Einstein College of Medicine. Invited
speakers included William Walsh and Robert
Koppel. New York State implements universal
CCHD screening in January 2014.
Cohen Children's Medical Center of New
York/North Shore-Long Island Jewish Health
System
The Division of Neonatal-Perinatal Medicine at
Cohen Children’s Medical Center of New York
has a new director, Richard Schanler, who also
oversees all the neonatal services of the North
Shore-LIJ Health System. Dr. Schanler is the
Editor of the newly published AAP/ACOG
Breastfeeding Handbook for Physicians. He coauthored the first randomized trial of human milk
vs. formula and, along with Dr. Ahrabi, fellow in
Neonatal-Perinatal Medicine, authored a review
on feeding human milk in the NICU. He was an
invited speaker at the AAP NCE, University of
Minnesota, and University of Miami national
conferences and the Excellence in
Pediatrics/Global Breastfeeding Initiative in
Doha, Qatar.
Under the direction of Mohamed Ahmed,
colleagues from Cardiology, Pulmonary, ENT,
Neonatology, Pharmacy, and Nutrition have
formed a multidisciplinary Pulmonary
Hypertension Team for prevention and treatment
of neonates and children.
Vita Boyar is now a Neonatologist certified in
Wound Care by the American Association of
Wound Care. She leads active “Skin Teams” in
Neonatology and Pediatrics.
Donna Baranek presented “Developing an NNP
Novel Business Model” at the LI NAPNAP
conference and, along with Annmarie
Gennattasio, presented “Introduction and
Formation of the NNP Service” at the 16th
Annual Neonatal Advanced Practice Nursing
Forum, Washington, DC where both were
recipients of the Advance Practice Nursing
Center of Excellence Award for 2013.
terri A. cavaliere has been chosen as
representative of the National Association of
Neonatal Nurses and Nurse Practitioners on the
planning board of Hot Topics in Neonatology.
Icahn School of Medicine at Mt. Sinai/Kravis
Children’s Hospital
Annemarie Stroustrup is the recipient of an
NIH Mentored Patient-Oriented Research
Career Development Award (K23). She studies
the long-term neurodevelopmental and
behavioral impact of hospital-based chemical
exposures sustained during infancy.
Maria Fareri Children’s Hospital at Westchester
Medical Center/New York Medical College
Shetal Shah joined the faculty of Maria Fareri
Children’s Hospital at New York Medical College
in late spring. Dr. Shah has interests in the
immunology of the lung in response to
17
hyperoxia, immunization and public health
delivery in the NICU, and advocacy. This past
summer he was elected Treasurer of the New
York (District II) Chapter 2 of the local American
Academy of Pediatrics and serves on the New
York State AAP Policy and Advocacy
Committee. This past fall he was named to the
Society for Pediatric Research Advocacy
Committee.
Sergio G. Golombek was an invited speaker at
the 1st International Neonatology Course in
Talca, Chile in August. Also, together with
Augusto Sola and Jose Maria Perez from
SIBEN, he lectured at the II International
Symposium of HIE in Sao Paulo, Brazil and at
the XII Annual Pediatric Conference in
Acapulco, Mexico,
Heather Brumberg is designated
representative of the AAP's Council on
Environmental Health to the Reproductive and
Children's Environmental Health Working Group
(a partnership of the Environmental Protection
Agency, Pediatric Environmental Health
Specialty Units, ACOG, AAP, American Society
of Reproductive Medicine, and other related
organizations). She is also the AAP chapter
Secretary.
New York University Langone Medical Center
Pradeep Mally has been appointed as the Chief
of the Division of Neonatology in the
Department of Pediatrics at NYU Langone
Medical Center. Dr. Mally is an Associate
Professor of Pediatrics and Director of the
fellowship training program in NeonatalPerinatal Medicine. A graduate of Kasturba
Medical College, India, Dr. Mally trained in
Pediatrics at Maimonides Medical Center and
completed his Neonatal-Perinatal fellowship
training at the Regional Neonatal Center, New
York Medical College-Westchester Medical
Center, Valhalla, NY.
Martha caprio has been promoted to the rank
of Associate Professor in the Department of
Pediatrics. Dr. Caprio has also been appointed
as the Medical Director of the NICU at NYU
Langone Medical Center.
University of Rochester Medical
Center/Golisano Children’s Hospital
Design work has been completed and
construction is in progress on a new Golisano
children’s Hospital. The new facility will have
44 single patient NICU rooms. Our current NICU
will be renovated to have 24 single patient
rooms, increasing our bed capacity to 68.
Patricia R. chess has been promoted to
Professor of Pediatrics and Rita Dadiz has
been promoted to Associate Professor of
Pediatrics.
Congratulations to two of our colleagues, Rita
Dadiz and laurie Steiner, on their selection for
membership in the Society for Pediatric
Research.
timothy P. Stevens joined the Neonatal Expert
Work Group of the NYS Perinatal Quality
Collaborative, a learning collaborative focused
on reducing the incidence of Central Line
Associated Bloodstream Infection in all NYS
NICUs and postnatal growth restriction among
infants < 31 weeks’ gestation cared for at NYS
Regional Perinatal Centers.
tom Mariani was chosen as Vice Chair of the
Gordon Research Conference on Lung
Development, Injury and Repair. He will become
Chair in 2015.
Nirupama laroia was an invited speaker at the
National Neonatology Conference, held at
Hyderabad, India Dec. 13-15, 2013. She spoke
on “Vitamin D during Pregnancy and Neonatal
Outcomes” and moderated a session on
“Pulmonary Graphics and Evidence-Based
Neonatal Respiratory Interventions Impacting
Long-Term Outcomes.”
Michael O’Reilly was an invited speaker at the
3rd Annual Munich Lung Conference held
October 4-5, 2013 in Munich, Germany.
laurie Steiner received a grant from the
American Society of Hematology Scholars
Program to investigate LSD1 in erythroid
maturation.
DIStRIct III:
Sue Aucott
Susan Vannucci) for the 9th Hershey
Conference on Developmental Brain Injury that
will take place on June 3-6, 2014 in St.
Michael’s, MD. For further information, please
go to
http://www.hopkinscme.edu/CourseDetail.aspx/8
0032202
We had the pleasure of hosting Maria
Delivoria-Papadopoulos, Chief of the Section
of Neonatal Care at St. Christopher's Hospital
for Children, for a lecture entitled “50 years of
Neonatology: The Road Less Traveled”. In her
honor, the Maria Delivoria-Papadopoulos Prize
for Outstanding Research in Neonatal
Neuroscience has been established in order to
assist young investigator attendance for
presentation at national meetings.
Susan Aucott chaired the annual Organization
of Neonatal Training Program Directors
(ONTPD) meeting at the Perinatal Section of the
AAP meeting on October, completing her 2 year
term as Chair of the ONTPD Council.
NEW JERSEY
MidAtlantic Neonatology Associates
DELAWARE
Christiana Care Health System
David A. Paul was appointed Interim Chair,
Department of Pediatrics, Christiana Care
Health System.
Michael Antunes was appointed Associate
Director of Neonatology at Christiana Care
Health System.
Michael Spear presented “The Use of Role
Playing to Teach Interdisciplinary
Communication Skills in Palliative Care” at the
Section of Hospice and Palliative Medicine at
the AAP meeting in Orlando. He was also
appointed to the Education Committee with the
Section of Hospice and Palliative Medicine of
the AAP.
Stephen Pearlman presented at the District VI
Perinatal meeting on “Coding Matters 2013” and
presented a new code for therapeutic
hypothermia to the CPT Editorial Panel in Los
Angeles. He participated in the Mock Trial at the
Perinatal Section Program at the AAP NCE in
Orlando, FL and gave a QI Seminar at the Hot
Topics meeting in Washington, DC on
“Strategies to Increase the Use of Breast Milk in
the NICU”.
Ursula Guillen was awarded a DE-CTR pilot
grant for a project looking at decision aids for
parents regarding care of peri-viable infants.
She is also a mentor for a resident at CHOP to
evaluate these decision aids in Spanish
speaking mothers. This project was awarded a
grant from the Gerber Foundation.
MARYLAND
Johns Hopkins University
Renee Boss has been elected to the Society for
Pediatric Research.
Frances Northington will be the co-chair (with
MidAtlantic Neonatology Associates will be
hosting our 6th annual regional Neonatology
conference, neoFORUM, on June 5th and 6th,
2014 at Goryeb Children’s Hospital and
Fiddler’s Elbow Country Club. William W. Hay,
Jr. from University of Colorado, tomoki Arichi
from King’s College London, and tiffany Field
from University of Miami will be among our
guest speakers. There will be a Poster
Symposium to highlight research initiatives from
throughout the state of New Jersey. William
Hay will be the keynote speaker at the Medical
Directors Dinner on Thursday evening, June 5th,
at Fiddler’s Elbow Country Club. NICU Medical
Directors throughout the state will be attending
as well as researchers and administrators.
PENNSYLVANIA
Children’s Hospital of Pittsburgh/Magee
Women’s Hospital UPMC
Jon Watchko is PI on a new grant awarded by
the Mario Lemieux Foundation to study
cerebelllar injury in preterm infants.
Misty Good has been awarded an NIH
Pediatric Research Loan Repayment Award
2013-2015.
Sean Frederick is serving as the interim Chief
Medical Information Officer at The Children’s
Hospital of Pittsburgh.
humanity, humility and honor.
Janet Weis Children’s Hospital at Geisinger
Kerry Weiss joined the Department of
Neonatology in July 2013 and works with Ravi
Agarwal in staffing the Tambur NICU at
Geisinger Wyoming Valley Medical Center in
Wilkes-Barre, PA.
Anne Russo joined the Department of
Neonatology at the Janet Weis Children’s
Hospital NICU in August 2013. Anne completed
her pediatric residency and Neonatology
fellowship at Weill Cornell Medical College in
New York City.
ed everett received approval for
compassionate use of Omegavan in the
treatment of neonatal cholestasis.
Ray Hayes continues to manage the physician
assistant residency program in Neonatology.
This successful program graduated its third
resident candidate in December 2013.
James cook has received financial support to
implement a second March of Dimes Family
Support Program in the Tambur NICU at
Geisinger Wyoming Valley Medical Center in
Wilkes-Barre, PA. Geisinger is the first US
Health System to implement this family-centered
support service on a system-wide basis.
St. Christopher's Hospital for Children/Drexel
University College of Medicine
endla K. Anday has been appointed by the
AAP to the editorial board of NeoReviews Plus.
Penn State Children’s Hospital
charles Palmer is proud to announce the
completed expansion of the NICU and
Continuing Care Nursery as they begin
recruiting for more NNP and medical staff.
tammy corr has joined the Division following
her fellowship in Pittsburgh.
timothy W. Palmer and Kenneth Slaw have
initiated a Leadership Program for the fellows in
the Department of Pediatrics at the Penn State
Children’s Hospital.
timothy W. Palmer was named Society Head
for the Bond Learning Society of the Penn State
College of Medicine.
DIStRIct IV:
cherrie Welch
Einstein Medical Center Montgomery
Einstein Medical Center Montgomery, voted as
one of the most beautiful hospitals in the
country, celebrated its first anniversary on
September 29, 2013 and was recognized as
Best New Team at the 2013 Temple Ambler
March for Babies in April. Katie Durrwachter,
Meyrick Sarmiento and Mayuri Vegasana
recently joined the original core team comprised
of Moira Winstanely, Jocelyn Austria, celina
Sindall, Jody Zisk, and David J. Hoffman, with
the mission of treating babies and families with
18
KENTUCKY
University of Louisville
David Adamkin, Professor of Pediatrics and
Director of the Division of Neonatal Medicine,
was awarded a grant from Sigma-Tau
Pharmaceuticals, Inc. for “A Phase Ib/IIa
Randomized, Placebo Controlled Study of the
Safety and Efficacy of Once Daily Dosing of
STP206 in Premature Very Low Birth Weight
and Extremely Low Birth Weight Neonates.” He
has also authored a chapter in the 4th Edition
Workbook in Practical Neonatology (Polin and
Yoder, in press) and serves on the Editorial
Board for Nowiny Lekarskie (Medical News),
Poznan University of Medical Sciences.
NORTH CAROLINA
Wake Forest Baptist Medical center/Brenner
children’s Hospital
Peter Porcelli will be serving a four-year term
on the Communications Committee of The
Society for Pediatric Research, which started
December 1, 2013.
christine Bishop has joined our faculty. Dr.
Bishop completed her Neonatology fellowship at
the University of Texas Health Science Center in
2008 and is coming to us from Miami Valley
Hospital, Wright State University Boonshoft
School of Medicine.
leslie Peedin, our third year Neonatology
fellow, will be joining the Neonatology faculty at
East Carolina University/Pitt Memorial Hospital
upon her graduation this summer.
Amy Bamber from Mercer University School of
Medicine will be beginning her fellowship with us
this fall.
Brenner Children’s Hospital was ranked #36
among the Best Hospitals US News and World
Report for Neonatology.
TENNESSEE
The Monroe Carell Jr. Children’s Hospital at
Vanderbilt
The Mildred Stahlman Division of Neonatology
at Vanderbilt University has named Susan H.
Guttentag as the new Director of the Division of
Neonatology within the Department of Pediatrics
at the Monroe Carell Jr. Children’s Hospital at
Vanderbilt. Susan is joining Vanderbilt
University on Feb. 1, 2014. Dr. Guttentag is a
physician-scientist who leads a highly respected
research program studying lung development
with a focus on alveolar type 2 cell biology,
including their contributions to pulmonary
physiology and pathology. She was named after
an extensive national search. Serving on the
search committee were H. Scott Baldwin;
Kelly Bennett, Associate Professor of
Obstetrics and Gynecology and Director of the
Division of Maternal Fetal Medicine; Fred lamb,
Cornelius Vanderbilt Professor of Pediatrics;
Jeff Reese, Associate Professor of Pediatrics;
and Margaret (Meg) Rush, Professor of Clinical
Pediatrics and Chief of Staff for Children’s
Hospital.
Bill Walsh Is delighted to be stepping down as
Interim Division Head
Jay Shenai hosted the recent 33rd Annual
Neonatal Advances and Controversies
Conference in Nashville with outstanding
speakers from around the country including
Donna Ferriero, Saul Karpen, Anthony chan,
Robert Ward, Jeffrey Whitsett as well as
Vanderbilt faculty members Jay Shenai, Kevin
Kelly, Hendrik Weitkamp, tom Doyle, and
Melinda Markham.
Stephen Patrick from Ann Arbor joined our
faculty in July 2013 to continue his work on the
nationwide increased use of pain medications
during pregnancy and improving health
outcomes.
chris lehmann has been appointed to the first
panel of Accreditation for Health Informatics and
Information Management Education and is the
Editorial Chair of MedInfor 2013, Copenhagen,
Denmark.
Fellow News:
carla collado is now in Houston with Pediatrix
Medical Group; courtney Gutman is in
Knoxville at the University of Tennessee; David
ehrmann is moving to Richmond, VA to join Bon
Secours Hospital with Commonwealth
Neonatology; and Angela Fagiana has gone
with the USAF to US Naval Hospital in Okinawa.
Incoming fellows are chadi eltaha and Wael
Alrifai from University of South Alabama, Kevin
Dufendach from the Mayo Clinic, and Matthew
Durbin from Loyola University Medical Center.
VIRGINIA
Fairfax Neonatal Associates, P.C. (FNA) is a
pediatric multi-specialty physician group that
provides Neonatologists and Neonatal Nurse
Practitioners to the NICUs at Inova Children’s
Hospital, Inova Fair Oaks Hospital, Inova
Loudoun Hospital, and Sentara Northern
Virginia Medical Center.
Inova Children’s Hospital
Gerber Foundation for her research on the use
of erythromycin and its effect on reflux-related
apneic events.
DIStRIct V:
Mary Nock
INDIANA
In January 2011, 13 Indiana NICUs formed the
Indiana Vermont-Oxford Network Quality
collaborative (IVON Qc). The first IVON QC
project aimed to reduce the Indiana NEC rate by
using human milk to feed premature infants. The
IVON QC observed a significant reduction in
total NEC, from the baseline of 8% in 2010
(n=652) to 3.9% in 2011-2012 (n=1,272) and
there was a trend of reduced surgical NEC from
2.9% in 2010 (n=652) to 1.6% in 2011-2012
(n=1272). In 2014, the IVON QC will begin a
new project based on an ACOG position paper
issued in December 2012, which concluded that
delaying the umbilical cord clamping of infants
born <33 weeks reduces severe IVH by 50%.
The 2014 IVON QC project will expand to
include obstetrical colleagues. The IVON QC
applied for an Indiana Department of Health
grant.
MICHIGAN
In August, Inova Children’s Hospital NICU was
awarded recertification for the Joint
Commission’s Gold Seal of Approval for
Prematurity. Inova Children’s Hospital was the
first in the nation to earn this award and is
currently one of only nine centers in the nation
to have this distinction. The NICU was also
recently ranked 35th in the nation by the U.S.
News & World Report.
Danielle F. Huntington, a founding member of
FNA retired this year after 37 years. Dr.
Huntington had a distinguished career and we
thank her for her contributions to Neonatology
and for the impact she had on the lives of
thousands of babies in the Washington, DC
metro area. Dr. Huntington will remain active in
the transition to ICD-10 and on FNA’s
Compliance Committee.
Inova Loudoun Hospital
FNA welcomes our new partner, Beatrice
Runkle, who joined us at Inova Loudoun
Hospital.
University of Virginia
Children’s Hospital of Michigan
Faculty members that joined us in 2013 are
Prem Arora and Vaneet Kalra.
Three new fellows started on July 1, 2013:
Vanessa celleri-Gomezcoello, Anuja
Bandyopadhyay, and Stephanie Gallagher
Athina Pappas and Monika Bajaj were
honored with Wayne State University School of
Medicine College Teaching Awards on Oct. 29,
2013.
Seetha Shankaran received the 2013
Children's Hospital of Michigan Distinguished
Alumni Award on Oct. 10, 2013
The 11th Annual Enrique Ostrea Jr. Endowed
Lectureship was held Oct. 31-Nov. 1, 2013 with
guest speaker Wally carlo who spoke on the
topics of "Essential Care of Neonates: How to
Save a Million Lives per Year" and
"Supplemental Oxygen in Extremely Preterm
Infants: Friend or Foe?"
OHIO
Nationwide Children’s Hospital
The NICU at UVA is expanding. We are in the
midst of opening a new 8-bed pod with
increased square footage. This will bring the
total capacity of the NICU to 53 beds.
David Kaufman was an invited speaker at
several conferences including GEM11 located in
Vienna, Austria in September where he
discussed fungal infections and prophylaxis in
the NICU.
Jonathan Swanson completed his M.S. in
Healthcare Quality & Safety from Thomas
Jefferson University.
Brooke Vergales was named the Assistant
Fellowship Director for Neonatology.
Third-year fellow, Fara Davalian, was awarded
grants from the Thrasher Foundation and
19
trent tipple was awarded one of seven ATS
Foundation Recognition Awards for Outstanding
Early Career Investigators for his project
entitled, “Targeting Thioredoxin Reductase-1 to
Prevent Bronchopulmonary Dysplasia.”
Jonathan Slaughter was awarded a K08 from
NHLBI to study the "Comparative Effectiveness
of NSAID Treatment versus No Treatment for
PDA in Preterm Infants."
Rainbow Babies and Children’s Hospital
The 10th edition of Fanaroff and Martin`s
Neonatal-Perinatal Medicine edited by Richard
Martin, Avroy Fanaroff and Michele Walsh is
in press with a Fall 2014 release date.
This spring, Richard Martin will be speaking at
Neonatology meetings in Porto Alegre, Brazil;
Antalya, Turkey; and Middlesbrough, United
Kingdom.
Richard Martin has been appointed as Section
Editor in Neonatology for UpToDate.
Monika Bhola has been promoted to Associate
Professor of Pediatrics.
DIStRIct VI:
thomas George
The 6th annual District VI conference was well
attended and was a tremendous success with
outstanding regional and national speakers.
SAVE THE DATE for the 7th Annual District VI
controversies in Neonatal clinical care
Meeting scheduled for September 5-6, 2014 at
the Hilton Magnificent Mile, Chicago.
Children’s Hospital and Medical Center, Omaha,
NE. will sponsor the 5th Annual “New
Frontiers in Neonatology” conference April 10
and 11. The first day will focus on neonatal and
pediatric transport. Keynote speaker the second
day will be Kristi Watterberg. Visit
www.childrensomaha.org/upcomingconferences
for more information.
ILLINOIS
Northwestern University/Lurie Children’s
Hospital
We welcomed 3 new faculty members this year:
Patrick Myers, Stephannie Voller and Ann
Downey.
The new Division Head for Neonatology will be
Aaron Hamvas from Washington University
who will start in March 2014.
Children’s Hospital of Illinois, Peoria
Kamlesh Macwan received the Outstanding
Inpatient Teaching Physician Award from the
Pediatric residency program.
Jim Hocker was promoted to Associate
Professor of Clinical Pediatrics
Loyola University, Maywood
Maliha Shareef chaired a session and
presented her research at the BIT’s First Annual
World Congress of Pediatrics in October 2013 in
Dalian, China.
University of Chicago
Ameth Aguirre along with Hortensia Solano,
Director of Neonatology at Del Nino Hospital,
Panama, organized the first Helping Babies
Breathe Provider Course in Guna Yala, Panama
in conjunction with the Ministry of Health.
IOWA
University of Iowa Children’s Hospital
Jack Widness was interviewed for the podcast
feature on the Pediatric Research website for
his article: “Tracking Donor RBC Survival in
Premature Infants: Agreement of Multiple
Populations of Biotin Labeled RBCs with Kidd
Antigen Mismatched RBCs”.
Jack Widness was designated a Safety Monitor
for the NIFH sponsored PENUT trial.
larry Meyer, third year Neonatal-Perinatal
Medicine fellow received the Frederick M.
Kenny Award for Outstanding Research
Presentation by a fellow at the 2013 Midwest
Annual Meeting of the MWSPR.
KANSAS
Josh Petrikin was named Assistant Medical
Director for the Neonatal Genomics at the
Center for Pediatric Genomic Medicine at
Children’s Mercy Hospital.
Sunflower Neonatology Associates, Overland
Park
Josh Petrikin completed his term as President
of the District VI Association of Neonatologists.
Dena Hubbard was elected President of the
District VI Association of Neonatologists at the
annual meeting in September 2013.
Brian carter is site PI for the NICHD funded
study “Neonatal Neurobehavior and Outcomes
in Very Preterm Infants,” the objective of which
is to assess the ability of the NICU Network
Neurobehavioral Scale performed at 35 weeks
gestation to identify preterm infants at risk for
later neurocognitive impairment. The lead site
for this multi-institutional investigation is Women
and Infants Hospital-Rhode Island (PIs Barry
lester and Michael O’Shea).
Midwest Women’s Care and Sunflower
Neonatologists had another successful regional
Neonatology meeting in October 2013. Mark
your calendars for next year’s symposium to be
held in Kansas City on November 14, 2014 with
keynote speaker Wally Carlo.
University of Kansas Medical Center, Kansas
City
Prabhu Parimi and colleagues described a new
University of Kansas Hospital project “eonatal
Medical Home: A Novel Post-Discharge Care
Model in Medical Home News in October.
MINNESOTA
University of Minnesota/Ampaltz Children’s
Hospital, Minneapolis
Sara Ramel was elected to the Society for
Pediatric Research.
The Midwest Society for Pediatric Research had
a successful meeting in Minneapolis in October
2013 hosted by the University of Minnesota.
Local planning leaders were Raghu Rao and
carrie George.
Raghu Rao was elected President of the
MWSPR at the October meeting.
The 18th Annual Neonatal Nutrition Conference
hosted by the Division of Neonatology (Michael
Georgieff, Division Head) was well attended
with terrific presentations by Bill Hay, Richard
Schanler, Rob Schulman, John Dagle, Tarah
Colaizy and Cami Martin. Save the date for the
19th annual conference to be held October 9-10
2014.
Mary Pylipow left the Division to become
Medical Director of the Mission Children’s
Hospital NICU in Asheville, NC.
MISSOURI
corey Iqbal was appointed fetal surgeon for the
Elizabeth J. Ferrel Fetal Health Center after
completion of pediatric surgery fellowship at
Children’s Mercy and fetal surgery training at
UCSF. The Fetal Health Center has been
delivering and offering immediate care for
infants with fetal anomalies since December
2010.
Cox Health Medical Center, Springfield
The Neonatologists at Cox Health Medical
Center: Joseph eccher, Sarah Kuhlman,
Marie McGettigan, Ann Hilmo and Whitney
cline are excited that construction began on a
new 28 bed NICU to open early 2015.
NEBRASKA
University of Nebraska Medical Center / Omaha
Ann Anderson-Berry was elected to the
Society for Pediatric Research.
John Grebe will replace David Bolam as the
District VI representative to the Coding
Committee. Dave is stepping down after serving
on the Committee since its inception.
SOUTH DAKOTA
Sanford Children’s Hospital, Sioux Falls
laurie Hogden joined Sanford Children’s
Hospital from the University of Wisconsin.
John Grebe recently obtained his Masters in
Healthcare Administration Degree
St Luke’s Hospital of Kansas City
John callenbach will retire in April 2014; he
was the founding medical director of the NICU
at St Luke’s Hospital. His medical acumen will
be missed as he pursues his many other
interests.
Barbara carr, Medical Director, announces the
creation of the Heart of America Mother’s Milk
Bank at St. Luke’s Hospital of Kansas City, a
HMBANA affiliated non-profit human milk bank
that can ship donor human milk to any NICU in
need – contact kcmilkbank@saint-lukes.org.
Children’s Mercy Hospital, Kansas City
Howard Kilbride received the Founder’s Award
from the Midwest SPR at the 2013 Annual
Meeting. He has been an active in the MWSPR
for over 20 years and has served as a member
of the council, Secretary-Treasurer and
President.
DIStRIct VII:
William engle
MISSISSIPPI
Because of the high rate of infant mortality in
Mississippi, Mary currier, the head of the
Mississippi Health Department, has asked
Neonatologists from around the state to
participate in an initiative to reduce infant
mortality. Regionalization is a goal that has been
addressed many times in the past but never fully
achieved. The goal is to have infants delivered
at facilities with the appropriate level of care
whenever possible. This group will investigate
coordination of private and university resources
and how local obstetricians might be rewarded
for timely transfers of high risk mothers to
hospitals with a higher level of care.
Blair E. Batson Hospital for Children/University
20
of Mississippi, Jackson
Omega Alpha Medical Society.
This spring, Praveen Kumar took over as the
head of the Division of Neonatology at the Blair
E. Batson Hospital for Children in Jackson,
Mississippi, the only children's hospital in
Mississippi. Infants from all around Mississippi
are transferred to Jackson and over 60% of the
premature infants born in Mississippi are cared
for at this facility. Dr. Kumar's appointment
followed the retirement of Phil Rhodes, a
distinguished scholar and clinician for many
years at University Medical Center. Dr. Kumar
was previously in Chicago at Lurie's Children
Hospital for 15 years.
liz Heyne was awarded the 2013 Texas
Pediatric Society Distinguished Service Award.
TEXAS
Baylor College of Medicine
Michael e. Speer and George Mandy gave
invited presentations at the Semmelweis
Nemzetosegei Neonatologiai Szeminarium in
Budapest, Hungary on September 10, 2013.
Jeffrey R. Kaiser gave two invited talks at the
IV International Perinatal Congress, Instituto
Nacional de Perinatología, November 7th and
8th in Mexico City, Mexico.
Binoy Shivanna was awarded a NIH K08
research grant “Modulation of Neonatal
Hyperoxic Lung Injury by the Aryl Hydrocarbon
Receptor.”
Jonathan Davies, third year fellow, received a
2013 Marshall Klaus Perinatal Research Award
for his work that explores the role that
adenosine plays in the development of BPD.
Athis Arunachalam, third year fellow, received
the 2013 Section on Perinatal Pediatrics Young
Investigator Award for his platform presentation
entitled “P2Y2 Purinergic Receptor Function Is
Essential for Pathogenesis of Sepsis” at the
October 2013 American Academy of Pediatrics
National Conference and Exhibition in Orlando,
FL.
charleta Guillory was recently appointed to the
AAP Committee on Federal Government Affairs,
Subcommittee on Access to Care. She also
presented “March of Dimes - Folic Acid Update:
a Public Health Campaign” at the 1st Annual
World Congress of Nutrition and Health 2013 in
Dalian, China on October 12-14.
The Texas Pediatrics Society gave charleta
Guillory and Alice Gong of the University of
Texas Health Science Center, San Antonio, the
Society’s Executive Board Award for The Texas
Pulse Oximetry Project (TXPOP) and
development of the TXPOP Tool Kit.
UT Southwestern, Dallas
New Division of NPM Faculty for 2013-14:
Divya Rajan, Allury Arora, Shalini
Ramachandran, Mackenzie Frost and
Katherine Stumpf.
Mambarambath Jaleel, Becky ennis, luc
Brion, and Venkat Kakkilaya graduated from
the Clinical Effectiveness and Safety Course at
UTSW.
Myra Wyckoff was named UTSW PI for the
Neonatal Research Network.
Audra Stewart was named PI for the Chimes
Study.
Dorothy Sendelbach was elected to the Alpha
One of our third year fellows, charitharth lal,
received a Travel Award for the 2013 National
Conference and Exhibition in Orlando, FL. In
addition, he was a finalist for the Basic Science
Young Investigator Award, Southern Society of
Pediatric Research.
In September 2013, The Division of NeonatalPerinatal Medicine at The University of Texas
Southwestern Medical Center and Children's
Medical Center Dallas partnered to create the
first Neonatal Telemedicine Program in Texas.
This service utilizes specialized equipment and
broadband transmission to allow two-way, realtime interactive communication between our
Neonatologists and distant-site hospital
practitioners. We are able to virtually examine
newborns using specialized cameras and
stethoscopes, and view and discuss medical
tests with colleagues in real time. In some
cases, TeleNICU consultation will eliminate the
need for transport to the Level IV referral NICU.
The Division began coverage of the University
Hospital St. Paul NICU on September 1, 2013.
DIStRIct VIII:
lily lou
The District VIII Perinatal Section's 38th
Annual conference will be held at the Marriott
City Center in Denver, CO May 29-June 1,
2014. Topic highlights include: Neonatal
resuscitation, Down Syndrome, cooling therapy
for birth asphyxia, hypoglycemia, neonatal
respiratory failure, perinatal ethics, and
quality/process improvement. There will also be
breakout sessions on quality and process
improvement, fellow education, and neonatal
advanced practice. Links to more details and
registration instructions can be found at
http://www.district8perinatal.org.
ALASKA
Susan Soto will take on the role of NICU
Medical Director at Alaska Regional Hospital
beginning in January 2014.
The new NICU and L&D units at The Children’s
Hospital at Providence-Alaska opened fully on
December 9, 2013. This will bring the
complement of Level III NICU beds to 66.
Changes in Maternal-Fetal Medicine: corinna
Muller left Alaska in September of 2013 for a
return to an academic position at her fellowship
alma mater, Geisinger Medical Center. George
Gilson retired in December 2013, with plans to
do some international medical work in Rwanda.
Alaska is one of 6 states to earn an ‘A’ grade on
the March of Dimes Premature Birth Report
Card with a prematurity rate of 9.2% for 2012.
The Franklin Delano Roosevelt Award was
presented to Ward Hurlburt (Alaska’s chief
medical officer) on November 16, 2013.
COLORADO
University of Colorado Anschutz Campus
laura Brown was named the Abbott Nutrition
21
Young Investigator for the Western Society for
Pediatric Research 2014 meeting. She also was
elected to represent the Pediatric Section as a
council member for the Perinatal Research
Society. She spoke at the Perinatal Biology
Symposium hosted in Snowmass, CO in August,
2013 as well as at the Frontiers in Pregnancy
Research Symposium hosted by the March of
Dimes and University of Colorado Department
of OB/GYN in Aurora, CO in September, 2013.
William (Bill) Hay, Jr. received the WSPR
Joseph W. St. Geme Jr. Education Award.
Susan Niermeyer spoke on Global Efforts in
Neonatal Resuscitation and co-presented the
accomplishments and future directions of the
China Neonatal Resuscitation Program,
Freedom of Breath Fountain of Life with her
Chinese colleague, Xu Tao, at the 1st Beijing
International Forum of Pediatric Development in
November 2013.
clyde Wright presented work related to oxygen
toxicity and neonatal lung injury at the 34th
Annual Perinatal Clinical Update and the
Neonatal Advanced Practice Conference at
Children's Hospital Colorado. He was invited as
a discussion panelist to the Assembly on
Pediatrics Live Journal Club presented by the
American Thoracic Society where he presented
data from his work on role of NFkB in neonatal
hyperoxic lung injury. Third year resident Megan
Gossling presented work done in Dr. Wright's
lab as a platform presentation at the SPR
Annual Meeting in Washington, DC. Dr. Wright
also received an SPR Young Investigator
Coaching Program Award.
Paul Rozance was named Secretary-Treasurer
Elect of the Perinatal Research Society. He also
joined the editorial boards of the Journal of
Endocrinology and the Journal of Molecular
Endocrinology. He presented a lecture at the
2013 Aspen/Snowmass Perinatal Biology
Symposium and was named the Organizing
Chair of the 2016 Symposium.
Josh Benjamin, second year Neonatology
fellow, will be giving an oral presentation at
WSPR in January, 2014 on the effects of chronic
hypoxemia on insulin secretion in a sheep
model. Additionally, this past summer he was
nominated for a NICU Heroes Award (presented
by Hand to Hold and Mead Johnson Nutrition).
Amy Blake, first year Neonatology fellow, was
awarded the Student Research Award (House
Officer Category) at the Pediatric Academic
Societies Meetings in 2013.
erica Mandell, third year Neonatology fellow,
presented her work entitled, “Vitamin D
attenuates lung injury and improves survival in
infant rats after antenatal endotoxin exposure”
this past October at the 2013 AAP NCE
Conference in Orlando where she received the
Young Investigator Award from the AAP Section
of Perinatal Pediatrics and a travel grant to the
2014 NEO Conference. She is also the recipient
of a Marshall Klaus Perinatal Research Award
for her work in vitamin D and lung injury.
HAWAI'I
Tripler Army Medical Center
Amy Becker (Farace) and Aaron clark
graduated from their fellowships at John A.
Burns School of Medicine and are continuing as
Staff, attending at TAMC for this coming year.
Other new staff joining the Tripler ranks are
eleana Beadle, Kelly Bear, and Antonio
Henandez.
Brenda Stryjewski was appointed as the
Program Director for the Neonatal-Perinatal
Fellowship at the John A. Burns School of
Medicine and Tripler Army Medical Center
taking the place of Sarah lentz-Kapua who left
the Hawaiian islands after a stint of nearly 20
years in the Army.
Kapi‘olani Medical Center for Women and
Children
cherilyn Yee, a former Neonatal Hospitalist, is
now a 1st year fellow in the NPM program at
JABSOM and TAMC.
New additions to the Neonatology group include
Pat chun who completed her fellowship at UW
and Roxanne Arcinue who completed her
fellowship at USC/LA Children's.
Sneha Sood is the recipient of a HRSA grant
and is additionally working on multiple grants to
enhance neonatal resuscitation training,
targeting the development of in-house
resuscitation teams in hospitals with delivery
services in rural areas of the state.
IDAHO
St. Luke’s Children’s Hospital
St. Luke’s Neonatology is pleased to announce
the addition of Nathan thornton and elizabeth
Gibson to our Boise practice, and Jennifer
Merchant to our Twin Falls practice.
Warm wishes to Ron coen as he embarks on
his third attempt at retirement!
NEW MEXICO
University of New Mexico Children’s Hospital
Kristi Watterberg was appointed Chair of the
AAP Committee on Fetus and Newborn for a
four-year term starting July 2013. She has also
been awarded an R01 from NHLBI to study
"Adrenal function and adverse CV outcomes at
age 6 after extremely preterm birth".
Renate Savich was an invited consultant to the
first Indonesian Pediatric Society Neonatal
Resuscitation Training of the Trainer Course in
Jakarta, Indonesia December 9-11, 2013. She
was appointed to the AAP Helping Babies
Breathe Steering Committee and attended the
HBB Global Development Alliance meeting in
September 2013. Dr. Savich was also an
invited speaker on FAS and NAS at the
Standards of Care: Treatment Advances for the
High-Risk Neonate conference in Overland
Park, Kansas in November 2013
WASHINGTON
University of Washington Medical Center
After more than 14 years, Dennis Mayock is
stepping down as the University of Washington
Medical Center NICU Medical Director so that
he can devote more time to the division's
growing clinical research program. thomas
Strandjord, current NICU Associate Medical
Director, will assume the role as Medical
Director and David loren will assume duties as
the Associate Medical Director.
Two new fellows joined us in July 2013: eric
Peeples from Phoenix Children’s Hospital and
Jayalakshmi Ravindran from our own
residency program.
DIStRIct IX:
Andrew O. Hopper
CALIFORNIA
California Association of Neonatologists (CAN)
terri Slagle assumed the role of CAN President
in March 2013 and Yvonne Vaucher was
elected Vice President/President-Elect of CAN.
The 20th Annual cAN/District IX Section on
Perinatal Pediatrics conference, cool topics
in Neonatology, is planned for February 28March 2, 2014 in Coronado, California. Topics
will include surgical repair of congenital heart
disease, long term follow-up of premature
infants, developmental care in the NICU,
amplitude integrated EEG in premature babies,
use of probiotics, inflammation and altered lung
development, understanding neurally adjusted
ventilatory assist (NAVA) ventilation, effects of
anesthesia on the developing brain, minimizing
collateral damage of pediatric surgery, functional
echocardiography, using ultrasound in the NICU,
and neonatal strokes. The CPQCC Preconference program on February 28th will focus
on disasters during neonatal transport: natural,
man-made, and diagnosis driven. Additionally,
the CPT coding workshop, presented by Gil
Martin will cover new changes in neonatal
coding for 2014 and proposed changes for
2015.
cecile l. Osman, Neonatology fellow at the
Keck School of Medicine of USC, was elected to
serve as the District IX representative to TeCAN.
CAN has established a task force to coordinate
disaster planning throughout NICUs in the state.
Under the leadership of Douglas carbine, the
group is developing a toolkit to provide guidance
to NICU leaders on development of NICU
Disaster Preparedness Programs, to facilitate
development of NICU emergency operation
plans, to promote regional workshops and
webinars on in-depth NICU disaster
preparedness training, and to develop metrics to
track development of NICU preparedness
programs through CPQCC.
California Perinatal Quality Care Collaborative
(CPQCC)
The Optimizing NICU Length of Separation
Collaborative’s first Learning Session was held
on 6/7/13 in Sacramento with 24 participating
hospitals. CPQCC also has a second group of
16 NICUs working on optimizing NICU length of
separation individually, using a structured singlesite improvement model recommended by
CPQCC. QI projects to date have accounted for
over 400 MOC submissions and CPQCC is the
largest contributor of MOC submissions to the
American Board of Pediatrics.
Brian tang, Stanford Developmental
Pediatrician, is working with a task force to start
a California HRIF Professional Organization.
22
California Maternal Quality Care Collaborative
(CMQCC)
CMQCC has developed the Maternal Data
Center (MDC), an online tool that generates a
wide range of perinatal metrics to assist
hospitals in improving clinical quality.
Specifically, the MDC links existing sources of
data to calculate dozens of hospital- and
physician-level metrics, benchmarking statistics
and drill-down information. These are presented
via an interactive and easy-to-use tool for use
by clinicians, managers, hospital administrators
and public health professionals. 50 California
hospitals are already participating in the MDC
and Washington hospitals are poised to join in
2014 as part of their statewide Safe Deliveries
Roadmap Project. The MDC is also being
utilized to support numerous QI and research
projects, including the CMQCC Pre-eclampsia
Collaborative, the CPQCC NICU Length of Stay
Collaborative, a severe maternal morbidity
validation study, and the Los Angeles County
Strong Start project testing new models of
prenatal care delivery. For more information
about the MDC, please contact Anne castles at
acastles@cmqcc.org.
Children’s Hospital Orange County
The 11th annual Academic Day for
Neonatologists of Southern California was held
at CHOC Children’s Hospital on November 21,
2013. The meeting drew 130 attendees from
various academic programs in Southern
California including 28 fellows and 80 neonatal
faculty and community Neonatologists. This
year’s meeting was co-chaired by Rangasamy
Ramanathan and Vijay Dhar. Speakers
included Diana Farmer, who spoke on fetal
surgeries; Howard Stein, who spoke on NAVA
ventilation; David Kaufman, who spoke on
neonatal sepsis; and Rangasamy
Ramanathan, who spoke on NIPPV ventilation.
The program ended with a “Life After
Fellowship” dinner for all attendee fellows where
invited faculty provided important career
guidance. The next ANOSC meeting is
scheduled for November 13, 2014.
Kaiser Permanente Medical Group
KP continues to care for about 10% of all births
in the State (>70,000 births) at 28 medical
centers, of which 14 are level 3, 13 are level 2,
and one level 1
Major current regional CQI projects include:
Implementation of standardized VLBW feeding
protocols across all level 3 NICUs, including
provisions for donor milk access and feeding
residual algorithms; implementation and
evaluation of decision support algorithms based
on risk assessment tools for early onset sepsis
likelihood; electronic medical record "best
practice alerts" to assist in real-time
identification of candidates for therapeutic
hypothermia; and efforts to increase our rates of
breast milk production at discharge for mothers
of VLBW.
Michael Kuzniewicz served on the expert panel
supporting the current CPQCC collaborative on
length of separation.
Kaiser Hospital Fontana
In May 2013, a new 28 private bed NICU
opened.
Kaiser Fontana has been designated as the
second neonatal transport hub for Kaiser
Permanente in Southern California. They are
developing a neonatal transport team which
should be operational mid-2014.
Huy truong joined the Neonatology staff in
August as our 6th Neonatologist. In addition,
two full time pediatric surgeons, edward Yoo
and cindy tai, joined the staff.
University of California Davis
Robin Steinhorn, Chair of Pediatrics, will be
featured speaker at the Western Society for
Pediatric Research, Western Perinatal Club on
January 24th in Carmel, CA.
Sutter Memorial Medical Center, Sacramento
Rachel Garner has relocated from University of
Arizona to join the Sutter Health Medical Group.
The Sutter Memorial Hospital NICU will open a
new Women’s and Children’s Center during
Spring 2014.
University of California San Diego
In February 2013, the Divisions of Neonatology
at UC San Diego and Rady Children’s combined
as a single division. This coincided with the
retirements of Neil Finer at the end of February
and Frank Mannino at the end of June. Both
Dr. Finer and Dr. Mannino are now Emeritus
Professors. The new Division Director is
lawrence (lance) Prince, who comes from
Vanderbilt University as a basic research
physician scientist working in mammalian lung
development and inflammation. The combined
division now has more than 23 full-time faculty
and covers two regional centers as well as a
handful of satellite level 2 NICUs.
Gail Knight has stepped into the role of Clinical
Director overseeing Rady Children’s Hospital
and the 5 satellite NICUs. A national search is
underway to fill a second Clinical Director
position for UCSD Medical Center.
Four new junior faculty members officially joined
the Neonatal Division this year: Farhad Imam
(Harvard), Richard Song (UCSD), Krishelle
Marc-Aurele (UCSD) and Dawn Reeves
(University of Arkansas).
Loma Linda University Medical Center
Congratulations to Mitchell Goldstein, recipient
of the 2013 Stanley Graven Award, awarded by
the National Perinatal Association to honor his
work and the significant contribution he has
made toward enhancement of the cause of the
NPA which is to promote health and well-being
of mothers, babies and families
lawrence D. longo, a Loma Linda University
Health researcher and pioneer in the field of
developmental physiology, has written a new
book, The Rise of Fetal and Neonatal
Physiology, a historic account about the field of
fetal and newborn development. Almost a
decade in the making, the book reviews the
rapid growth of the study of developmental
physiology from the mid- to late-20th century as
it became one of the major disciplines in the
biomedical sciences. Understandings in the field
led to establishment of the disciplines of
obstetrical Perinatology and pediatric
Neonatology.
Aprille Febre joined the Division of
Neonatology as an Assistant Professor of
Pediatrics.
Santa Clara Valley Medical Center
Balaji Govindaswami, Chief of the Division of
Neonatology and NICU Director at the Santa
Clara Valley Medical Center, was honored by
the March of Dimes as the 2013 Advocacy and
Government Affairs Volunteer champion at the
Beverly Hills Hotel on 12/6/2013.
University of California San Francisco
George Gregory received the prestigious
Virginia Apgar Award from the American
Academy of Pediatrics for his significant
contributions in the development of CPAP for
preterm infants. George received his award from
Sam Hawgood at the October AAP National
Conference in Orlando. Previous Apgar
awardees in the Division are Bill tooley (1989)
and John clements (1994).
Roberta and Phil Ballard shared the Maureen
Andrew Mentor Award from the Society for
Pediatric Research.
Stanford University
Heidi Feldman, the Ballinger-Swindells
Endowed Professor in Developmental and
Behavioral Pediatrics in the Division of Neonatal
and Developmental Medicine, published
Redesigning Health Care for Children with
Disabilities. The book has been described by
reviewers as "A fresh approach to thinking about
the care of children with disabilities [that] helps
define a true 21st century approach to inclusion”
and, “An enlightened, transformative roadmap
for healthcare teams serving children and youth
with developmental disabilities.”
Gary Shaw, Professor of Pediatrics in the
Perinatal Outcomes and Epidemiology Program
of the Division of Neonatal and Developmental
Medicine, received the March of Dimes Agnes
Higgins Award at the 141st annual meeting of
the American Public Health Association in
Boston on November 4th, in recognition of his
work showing that what a woman consumes
during pregnancy may increase her baby's risk
of developing a birth defect. The March of
Dimes established the Agnes Higgins Award in
1980 to recognize her role in improving maternal
health during pregnancy and the health of
babies.
Vinod Bhutani, Professor of Pediatrics in the
Division of Neonatal and Developmental
Medicine, was the recipient of the Landmark
Award at the AAP NCE in Orlando on October
27th in recognition of his contribution to
prevention of kernicterus through development
of the Bhutani curves for hour-specific bilirubin
levels in term infants. He was also the recipient
of Lifetime Achievement Award from the
National Society of Neonatologists in India
earlier this year.
Nicole Yamada, a fellow in Neonatal-Perinatal
Medicine at Stanford, received a Marshall Klaus
Perinatal Research Award for her project entitled
"Determination of the rate of common deviations
23
from the NRP algorithm and evaluation of
focused strategies for remediation” under the
mentorship of louis Halamek.
Katherine Mccallie and Stephanie Smith have
been promoted to Clinical Assistant Professors
in the Division of Neonatal and Developmental
Medicine at Stanford University School of
Medicine.
The California Transport Cooling Trial (CTCT)
has completed enrollment. Priya Akula, a
fellow in Neonatal-Perinatal Medicine at
Stanford, and Krisa Van Meurs, the Rosemarie
Hess Endowed Professor in Neonatal and
Developmental Medicine, were co-PIs for this
study. The trial compared temperature
regulation during transport using standard
clinical practice to device servo-regulated
cooling using the Tecotherm Neo (Inspiration
Healthcare, LTD) in NICUs across California.
Ronald Ariagno, Professor Emeritus of
Pediatrics in the Division of Neonatal and
Developmental Medicine at Stanford University,
has been appointed Senior ORISE Faculty
Fellow in Neonatology at the FDA. He is
working at the Office of Pediatric Therapeutics
and with the Maternal Pediatric Health Staff in
the Office of New Drugs in Washington, DC.
Henry c. lee has joined the Division of
Neonatology as Assistant Professor of
Pediatrics and was appointed Director of
Research for CPQCC.
District X:
Mark Hudak
FLORIDA
University of Florida
leslie Parker and Josef Neu received an NIH
R-01 grant entitled "Routine Aspiration of
Residual Gastric Contents in Very Low Birth
Weight Infants". Also, Dr. Parker and Sandra
Sullivan received an NIH R-15 entitled
"Adequate Breast Milk for Improved Health of
Very Low Birth Weight Preterm Infants".
Wellington Medical Center, Wellington
Anil Sharma has assumed the responsibilities
of Medical Director at Wellington Regional
Medical Center. Also joining the practice at
WRMC are Shahriar Mokrian from SUNY
Stonybrook and Armea Botros from HarborUCLA Medical Center. edith Morales will also
be arriving in March, having completed her
fellowship training at Harbor-UCLA.
GEORGIA
David levine at Columbus Regional Health has
helped to organize GAPQC (Georgia Perinatal
Quality Collaborative), a statewide perinatal
quality collaborative. The vision of GAPQC is to
network every perinatal stakeholder in Georgia
with the goal of improving the health and birth
outcomes of all mothers and babies in Georgia.
David and catherine Bonk, an obstetrician
from Atlanta, are co-chairing pilot efforts with 6
Georgia centers with initial projects scheduled to
roll out in the first few months of 2014. GAPQC
has garnered the support of a number of
important stakeholders, including the Georgia
AAP, the March of Dimes, and the Georgia
Department of Community Health.
Emory University
April Dworetz published an op-ed in the New
York Times on August 4, 2013 entitled "End of
Life, at Birth" on the 50th anniversary of the
death of President John F. Kennedy’s son,
Patrick Bouvier, from respiratory distress
syndrome (see:
(http://www.nytimes.com/2013/08/05/opinion/en
d-of-life-at-birth.html?_r=0). Many of us who
have read this editorial have experienced the
feelings that Dr. Dworetz relates when providing
aggressive care to infants with uncertain
prognoses. She spoke about a related topic,
“Overwhelming Options or Best Interests?” at
the Princeton Ira W. DeCamp Bioethics Seminar
at the invitation of Peter Singer, the director of
Princeton's Center of Human Values. Dr.
Dworetz also participated, via Skype, in a
discussion about end-of-life care in neonates
and ethical aspects of disability for a session of
Dr. Singer’s course, "Practical Ethics." She has
been elected as co-chair of the Rehabilitation
and Disability affinity group of the American
Society for Bioethics and Humanities.
topic Advisory Group Report
Gilbert Martin, MD, FAAP
The Topic Advisory Group (TAG) plans and coordinates specific issues for the World
Health Organization (WHO). These groups advise WHO on specific issues but as far as
the International Classification of Diseases is concerned, drafts of topics, protocols for
trials and production timelines are presented.
There is a Topic Advisory Group for almost all specialties including pediatrics and
obstetrics. A subgroup dealing with perinatal issues has been developed.
ICD-9-CM stands for International Classification of Diseases, Ninth Revision, Clinical
Modification and is based on WHO's Ninth Revision of ICD. The Health Insurance
Portability and Accountability Act (HIPPA) named it as the standard for reporting
diagnoses in 2003. In 2009 the Department of Health and Human Services (HHS) issued
a regulation requiring ICD-9 to become ICD-10. There have been several
postponements but the final date for ICD-10 is October 1 2014. After this compliance
date ICD-9 codes will not be accepted and any transactions with these codes will be
rejected.
ICD-10 has an expanded disease classification, includes health-related conditions and
provides greater specificity at the sixth and seventh character level
Some examples of the crosswalk between ICD-9 and ICD-10 are:
1. pneumothorax/ pneumomediastinum, newborn
- 770.2 (ICD-9)
pneumothorax, neonate - P25.1 (ICD-10)
pneumomediastinum, neonate - P25.2 (ICD-10)
2. Small for gestational age - 764.0 (ICD-9)
Light for gestational age - P05.0 (ICD-10)
- normal length, decreased weight
Small for gestational age - P05.1 (ICD-10)
- decreased length, decreased weight
It will not be an easy process to switch from ICD-9 to ICD-10. There are courses
available to prepare billing offices and physicians on a simplified approach to this
diagnosis coding. The number of diagnosis codes will increase from 14,000 plus to
69,000 plus. If the CPT physician code does not match the ICD-10 diagnosis code there
will be a delay in reimbursement.
Information on ICD-10-CM is available from the National Center for Health Statistics
(NCHS) at www.cdc.gov/nchs/icd/icd10cm.htm. The Centers for Medicare and Medicaid
Services (CMS) is responsible for the development and maintenance of the ICD-10
inpatient code set. Information is available from
www.cms.hhs.gov/ICD10/01_Overview.asp#TopOfPage.
The American Academy of Pediatrics will continue to provide information regarding the
ICD-9-CM and ICD-10-CM code sets in order to make the transition timely.
ICD-11 is now complete in its beta phase. There are 2400 plus codes that are different
from the ICD-10 set, with many additional codes that are new. This beta phase
document has had much more input then either ICD-9 or ICD-10. Although "beta" in
general is meant to describe documents that are open to the public, the beta ICD-11
document is not yet ready for primetime.
The original objective for ICD-11 was to have a final version by 2015. It will be more of
digital tool and used linked data from many sources. There will in fact be a greater
degree of specificity.
For example, in ICD-11, there is a section entitled, "secondary neonatal hypoglycemia".
The subsections are:
Neonatal hypoglycemia secondary to pancreatic tumor
Neonatal hypoglycemia secondary to nesidioblastosis
Neonatal hypoglycemia secondary to decreased glycogen stores (prematurity, IUGR)
I predict that ICD-11 will not be released until 2018.
24
In Memoriam
Nicholas Nelson, MD
Nicholas Macy Nelson M.D., 84, died at his
home at the Highlands Retirement Community
in Topsham, Maine, on Sunday, January 26.
The third of four sons, he was born in
Baltimore, Maryland on June 11, 1929 to Cyril and Elise
(Macy) Nelson and was raised in New Brunswick, New
Jersey. He was educated at Deerfield Academy (1946),
Yale University (1950), and Cornell University Medical
College (1954). Immediately upon graduation from medical
school, he married Virginia Araminta Wilke and began his
internship, followed by a residency at Bellevue Hospital in
New York City. He served in the U.S. Army Medical Corps
in France (1956-1958) and upon his return to the U.S.
became a Senior Resident at Children’s Hospital Medical
Center in Boston. He then accepted a Fellowship at the
Boston Lying-In Hospital under the supervision of Dr.
Clement Smith, considered the father of Neonatology,
becoming one of the first pediatricians in the then new
discipline. After three years in private practice in his
hometown of New Brunswick, NJ, he returned to the
Boston area as the Senior Pediatrician and Associate
Director in the Laboratory for Neonatal Research at Boston
Hospital for Women, where he could pursue his passion for
research and education in nNeonatology. In 1970, he was
invited to become the Founding Chairman of Pediatrics for
the Penn State University College of Medicine in Hershey,
Pennsylvania and over the next 18 years built an
outstanding department of individuals who loved what he
loved - children, education, and research. Dr. Nelson
stepped down as Chair in 1989 but continued as a
professor in the Department of Pediatrics until his
retirement in 1998, during which time he took a leave of
absence to care full-time for his beloved wife of 39 years
who died peacefully at home in 1993.
In addition to his love of children and family, he thoroughly
enjoyed the written word and throughout his career
authored and edited many medical articles, journals, and
textbooks. His textbook on neonatology, written in
partnership with his mentor Dr. Smith, is considered a
classic in the field. A loving, supportive, and compassionate
husband, father, and grandfather, Nick instilled in his
children an appreciation for life-long learning and pursuing
a career they love. When asked by his youngest daughter,
“Dad, are you reading that for work or for fun?” he
responded, “That’s the best part, I can’t tell the difference.”
Upon his retirement, he took great pleasure in continuing
his education, traveling, attending music and arts
performances, engaging in lively political discussions, and
visiting family. His central focus each year was the time
spent on Monhegan Island - his family’s treasured summer
home since 1922 - where he was surrounded by his four
children, their families and friends, his nieces and
nephews, and many lifelong friends. A summer resident of
Maine his entire life, he became a year-round resident in
2003. In addition to his wife, Nicholas was preceded in
25
death by his three brothers: Guerdon, Irwin, and Michael.
He is survived by his four children: Elise Macy Nelson (Erik
Lilleskov) of Houghton, Michigan; Wilke Edward Nelson
(Karen) of Centreville, Virginia; Holden Williams Nelson
(Susan) of North Yarmouth, Maine; and Maren Nelson
Nagem of Falmouth, Maine, as well as nine grandchildren:
Nick, Lena, Allie, Eli, Will, Rory, Noah, Ben, and Nate. A
private memorial service will be held this summer. Memorial
donations may be made in honor of Nicholas M. Nelson to
Penn State Hershey, supporting pediatric education and
research at PSH Children’s Hospital, about which Nick was
so passionate (givetopennstatehershey.org).
In Memoriam
Albert l. Pizzica, DO, FAAP
Albert L. Pizzica, age 65, of Wayne,
PA, passed away on December 14,
2013. Born in Norristown, PA, he was
the son of the late Albert J. and Helen
Pizzica (nee Dougherty).
Dr. Pizzica was a board certified
pedicatrician and neonatologist. After
completing fellowship training at Thomas Jefferson
University in Philadelphia, PA, Dr. Pizzica worked as a
Clinical Neonatologist for 33 years in a university or
university-affiliated hospital in Philadelphia. After leaving full
time Clinical Neonatology in 2009, Dr. Pizzica started a
company which owns and operates primary care Pediatric
Offices and Newborn Services in Philadelphia County. He
served as President and Chief Medical Officer. The
company currently employs over 35 health care providers
and staff.
Dr. Pizzica was a past president of the National Perinatal
Association based in New York. He was also the recipient
of their highest award, The Stan Graven Award for Life
Long Contributions to Perinatal Health. He chaired or
represented many perinatal health care advocacy groups
over the years.
Dr. Pizzica is survived by his wife Susan B. Pizzica (nee
Barclay), his children Albert J. (Meghan Walsh), Paul L.
(Melissa Rossi), Thomas F., David B., Christopher B. and
Allison M. and 5 grandchildren Maya, Albert, Paige,
Gwyneth, and Luke.
Contributions in his memory to the Al Pizzica Scholarship
Fund at National Perinatal Association, 457 State Street,
Binghamton, NY 13901 would be appreciated.
Neonatal landmark Award
2014 Section on Perinatal
PediatricS awardS
Awarded for a seminal contribution, which has
had a major impact on neonatal-perinatal
practice. Not necessarily the original description or
publication but recipient could be the individual
responsible for dissemination and acceptance
within/by the professional and/or lay community. To
be eligible the “event” must have occurred at least 15
years ago, and the nominee must not have received
the Virginia Apgar Award. The award can be awarded
posthumously.
call For noMinationS
deadline: March 15, 2014
The American Academy of Pediatrics’ Section on
Perinatal Pediatrics is now accepting nominations for
the 2014 Virginia Apgar Award, the Neonatal
Education Award and the Neonatal Landmark Award.
Virginia Apgar Award
The Landmark Award is sponsored by a grant from
Mead Johnson Nutrition.
This award is given annually to an individual whose
career has had a continuing influence on the well
being of newborn infants.
All award recipients are chosen at the Perinatal
Spring Workshop, April 4-6, 2014 in Scottsdale,
Arizona. Final AAP Board of Directors approval will be
granted in June of 2014 and the recipient will be
notified at that time. The awards will be presented at
the meeting of the Perinatal Section during the 2014
National Conference & Exhibition of the American
Academy of Pediatrics in San Diego, CA.
All AAP fellows interested in Perinatal Pediatrics are
invited to submit nominations. The nominee need not
be a member of the AAP. The nomination should
include a cover letter and a curriculum vitae of the
nominee. A second letter in support of the
nomination is required and up to four support letters
will be accepted. Candidates who have been
previously nominated but not selected may be renominated by a letter indicating renewal of their prior
nomination. It is not necessary to resubmit all the
paper work, as long as the original nomination
package was complete.
If you wish to nominate an individual, or yourself,
please submit:
• a letter of interest including justification as to why
this individual should receive the award;
The Apgar Award is sponsored by a grant from
Abbott Nutrition.
• the candidate’s curriculum vitae;
• two supporting letters from two members of the
Section on Perinatal Pediatrics
Neonatal education Award
ALL INFORMATION MUST BE COMPLETE BEFORE
MAILING IN YOUR NOMINATION. the
nominations must be received by March 15, 2014.
Please send all nominations to:
Jim Couto, MA
American Academy of Pediatrics
141 N.W. Point Blvd
Elk Grove Village, IL 60007
jcouto@aap.org
847/434-7656
This award will be given annually to an individual who
has made outstanding contributions to education
in neonatal-perinatal medicine. The recipient will
receive a cash award.
The Neonatal Education Award is sponsored by a
grant from Mead Johnson Nutrition.
CAN/AAP District IX Section on
Perinatal Pediatrics
20th Annual Conference
Current Topics and Controversies in
Perinatal and Neonatal Medicine
Coronado Island Marriott Resort
SAVE THE DATE!
District VI Perinatal Pediatrtics
Meeting
Controversies in
Neonatal Clinical Care
February 28 - March 2, 2014
For more meeting information:
http://www.cme.ucla.edu or
http://www.canneo.org
Chicago, IL
September 5-6, 2014
26
Keep a cool Head
Stephen A. Pearlman MD, MSHQS, FAAP
Gilbert I. Martin MD, FAAP
The issue of coding for total body or selective head
hypothermia has evolved over the past few years. Many in
our field may be justifiably confused and we thought it
would be helpful at this juncture to explain where we have
been and hopefully where we are heading.
Codes for cooling first appeared in the CPT book in 2012
as add on codes for each of the three days of hypothermia
treatment. Since at the time these codes were first
developed this procedure was considered evolving
technology the codes developed were 0260T and 0261T
which are called Category III codes. Category III CPT
codes are not assigned an RVU value and thus often will
not result in any remuneration. Nonetheless, we performed
an informal survey and based on that recommended
neonatologists attempt to negotiate fees on the basis of 3.8
RVUs for each day of cooling. Later in 2012, members of
the coding committee decided to attempt to convert these
category III codes into category I codes since we believed
that the literature supported the fact that hypothermia had
now become the standard of care. Most of the codes we
use on a daily basis are category I. We presented this
information to the AMA CPT Editorial Panel and they
concurred. The codes were ultimately given the numbers
99481 and 99482 and appear in CPT in 2014.
The CPT Editorial Panel is just the first step in the process
of having a code approved and valued. Following this, the
AAP conducted a survey of neonatologists to set an RVU
value to each of these codes. The results of the survey
were presented to the RUC committee of the AMA in early
2013. That committee decided not to give these new codes
an RVU value for two reasons. One was that many of the
people who completed the survey did not actually perform
cooling. This occurred because the AMA usually insists
upon a random sample of neonatal providers and does not
exclude those who do not perform a procedure from
completing the survey. The second reason the RUC
denied valuing these codes was because, in their opinion,
some of the work included in the cooling codes overlapped
the work outlined in the critical care codes. Their denial
left us pretty close to where we started. Although we now
had approved category I codes, each of us would need to
negotiate a rate of payment with our payers.
Members of the coding committee, working together with
the support staff from the AAP, took a two pronged
approach to find a solution to this problem. First, we
discussed performing a non-random survey of
neonatologists who we knew performed cooling regularly
with the research sub-committee of the RUC. The
committee accepted our proposal. The second idea was to
replace the two E/M codes (99481-99482) as a single
procedural code that encompassed the work of the
initiation of hypothermia which we felt represented the bulk
27
of the work involved. We wrote the code and presented it
to the CPT editorial panel in October of 2013. They
approved the new code. In November and December of
2013 the AAP conducted the survey on the non-random
sample of neonatologists and in January 2014 will present
it to the RUC for valuation. It is very important for Section
members who receive one of these surveys to fill it out
promptly.
So is your head spinning yet? (Pun intended) Let me
simplify this for you. Beginning in January 2014, one
should use the approved category I codes, 99481 and
99482 to report total body and head cooling, respectively.
Since these codes do not have RVU values assigned to
them you will have to negotiate rates with your payers. The
new procedural code for initiation of cooling has not yet
completed the valuation process. If the RUC accepts our
valuation recommendations in January, the new code will
be assigned a number, an RVU value and will be usable
beginning in 2015. If that is the case, the previously
approved codes, 99481 and 99482, will be deleted.
So in the meanwhile, keep a cool head and we will keep
you posted!
New AHRQ toolkit Designed to Improve
Safety of Fragile Newborns
A new toolkit is available to help improve the safety of
infants born preterm or with complex congenital
conditions as they transition from the neonatal
intensive care unit to their home. Funded by the
Agency for Healthcare Research and Quality, the
toolkit features information on how to create a Health
Coach Program, where the “Health Coach” serves as
a teacher and facilitator who encourages open
communication with the parents/caregivers to identify
their needs and concerns and facilitates follow-up care
for the infant by primary care providers. As an online
product, the Health Coach Program can customize a
broad range of information for each family based on
their needs and concerns. Included are approximately
30 fact sheets, directed to either the clinician or the
infant’s family, on topics that range from medications
to breastfeeding to insurance coverage tips. For your
free copy of the toolkit, go to
www.ahrq.gov/nicutoolkit.
executive committee Roster 2014-2014
David J Burchfield MD FAAP
Chairperson
Univ of Florida College of Medicine
Dept Pediatrics/Neonatology
PO Box 100296
Gainesville, FL 32610-0296
Phone: (352)273-8985
burchdj@peds.ufl.edu
Term: 11/01/2012-10/31/2014
cherrie D Welch MD MPH FAAP
DISTRICT IV, Exec Comm Member
Wake Forest University School of
Medicine
Medical Center Blvd.
Winston Salem, NC 27157-0001
Phone 336-716-4663
cwelch@wakehealth.edu
Term: 11/01/2012 - 10/31/2015
DeWayne M Pursley MD MPH FAAP
Immediate Past Chair
Beth Israel Deaconess Medical Ctr
Dept of Neonatology
330 Brookline Ave Rm RO-318
Boston, MA 02215-5400
Phone: (617)667-3276
dpursley@bidmc.harvard.edu
Term: 10/31/2012-10/31/2014
Mary Nock MD FAAP
DISTRICT V, Exec Comm Member
Rainbow Babies & Childrens Hospital
11100 Euclid Avenue
Cleveland, OH 44106
Phone: (216)844-3387
mary.nock@uhhospitals.org
Term: 11/01/2011 - 10/31/2014
Renate D Savich MD FAAP
Chairperson Elect
UNM Health Science Center
Pediatrics/Neonatology
ACC 3rd Fl / MSC 10 5590
Albuquerque, NM 87131-0001
Phone: (505)272-3967
rsavich@unm.edu
Term: 11/01/2006 - 10/31/2016
John A F Zupancic MD ScD FAAP
DISTRICT I, Exec Comm Member
Beth Israel Deaconess Medical Ctr
Dept Of Neonatology, Rose 318
330 Brookline Ave
Boston, MA 02215-5400
Phone: (617)667-3276
jzupanci@bidmc.harvard.edu
Term: 11/01/2009 - 10/31/2012
Sergio G Golombek MD MPH FAAP
DISTRICT II, Exec Comm Member
Regional Neonatal Center
Maria Fareri Childrens Hospital
Pediatrics/Neonatology
100 Woods Road
Valhalla, NY 10595-1530
Phone: (914)493-8488
Sergio_golombek@nymc.edu
Term: 11/01/2010-10/31/2014
Susan Aucott MD FAAP
DISTRICT III, Exec Comm Member
Johns Hopkins University
600 N Wolfe St/Nelson 2-133
Baltimore, MD 21287
Phone: 410/955-5259
saucott@jhmi.edu
Term 11/01/2012 - 10/31/2015
thomas N George MD FAAP
DISTRICT VI, Exec Comm Member
University of Minnesota
Amplatz Children's Hospital
Division of Neonatology
East Building Mb632
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone: 612/624-6595
tgeorge@umn.edu
Term: 11/10/2012 - 10/31/2015
William D engle MD FAAP
DISTRICT VII, Exec Comm Member
University of Texas Southwestern
5323 Harry Hines Blvd
Dallas, TX 75390-9063
Phone: (214)648-3906
William.Engle@utsouthwestern.edu
Term: 02/10/2009 - 10/31/2014
lily J lou MD FAAP
DISTRICT VIII, Exec Comm Member
Alaska Neonatology Associates
3340 Providence Dr Ste 366
Anchorage, AK 99508-2627
Phone: 907/212-6810
lilylou@mindspring.com
Term: 11/01/2012 - 10/31/2015
Andrew Hopper MD FAAP
DISTRICT IX, Exec Comm Member
Department of Pediatrics
Loma Linda University
School of Medicine
11175 Campus St.
Loma Linda, CA 92350
ahopper@llu.edu
Term: 11/01/2013 - 10/31/2017
28
Mark Hudak MD FAAP
DISTRICT X, Exec Comm Member
Univ of Florida College of Medicine
653-1 West 8th Street
Jacksonville, FL 32209
Phone (904)244-3508
mark.hudak@jax.ufl.edu
Term: 11/10/2011 - 10/31/2014
carl l Bose MD MPH FAAP
Of Counsel
University of North Carolina Hospitals
Div of Neonatal/Perinatal Medicine
101 Manning Dr, CB #7596
Chapel Hill, NC 27599-7596
cbose@med.unc.edu
PeRINAtAl SectION cHAIRS
AND lIAISONS
Ronald l Ariagno MD FAAP
Chair, Research Committee
Stanford University Medical Center
Neonatal & Developmental Med
750 Welch Rd Ste 315
Palo Alto, CA 94304-1510
Phone: (650)723-5711
rla@stanford.edu
William Benitz MD FAAP
Committee on Fetus and Newborn
Stanford University Medical Center
Div of Neo/Dev Medicine
750 Welch Rd Ste 315
Palo Alto, CA 94304-1510
Phone: (650)723-5711
benitzwe@stanford.edu
Avroy A Fanaroff MD FAAP
Chair, History Committee
Case Western Reserve University
Div Neonatology / RBC 3100
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone: (216)844-3387
aaf2@case.edu
edward e lawson MD FAAP
Editor, Journal of Perinatology
Sutland/Pakula Newborn Critical Care
Center
Charlotte R. Bloomberg Children's
Center - Mailstop 08004
1800 Orleans St. / Rm 8513 - 8 South
Baltimore, MD 21287
Phone: (410)955-5259
elawson@jhmi.edu
Gilbert I Martin MD FAAP
Chair, TAG
415 S Mannington Pl
West Covina, CA 91791-2254
Phone: (626)332-8981
gimartinmd@yahoo.com
thomas Parker MD FAAP
TECaN Mentor
Childrens Colorado
13121 E 17th Ave
Aurora, CO 80045
thomas.parker@
childrenscolorado.org
Stephen A Pearlman MD MSHQS
FAAP
Chair, Coding Committee
462 Baneswood Circle
Kennett Square, PA 19348
Phone: (302)733-2410
spearlman@christianacare.org
Ann R Stark MD FAAP
Chair, Fellow Education Committee
Vanderbilt University Medical Center
2200 Children’s Way
Nashville, TN 37232-005
Phone: (615)343-7660
ann.r.stark@vanderbilt.edu
linda J Van Marter MD MPH FAAP
Chair, Website Committee
TECaN Mentor
Newborn Medicine/Hunnewell 4
300 Longwood Ave
Boston, MA 02115-5724
Phone: (617)355-6027
Linda.vanmarter@childrens.harvard.edu
executive committee Roster 2014-2014
Howard W Kilbride MD FAAP
Chair, Perinatal Workshop Planning
Childrens Mercy Hospital
2401 Gillham Rd, Neonatology
Kansas City, MO 64108
hkilbride@cmh.edu
lynne D Willett MD FAAP
Editor, Section Newsletter
Children’s Hospital and Med Center
8200 Dodge St
Omaha, NE 68114-4113
Phone: (402)955-6140
ldw923@gmail.com
Krithika lingappan MD FAAP
TECaN Chair
Texas Childrens Hospital
6621 Fannin Street, Suite W6104
Houston, TX 77030-2303
lingappa@bcm.edu
ORGANIZAtION lIAISONS
Wanda Barfield MD MPH FAAP
Liaison, Centers for Disease Control
(CDC)
4770 Buford Highway NE, MS K-22
Atlanta, GA 30341
Phone: (770)488-6231
Wjb5@cdc.gov
Scott D Berns MD MPH FAAP
Liaison, March of Dimes
March of Dimes
1275 Mamaroneck Ave
White Plains, NY 10605-5201
Phone: (914)997-4290
sberns@marchofdimes.com
christiane Damman MD FAAP
Chair, Organization of Neonatal
Training Program Director
Tufts University
800 Washington St
Boston, MA 02111-1552
Phone: (617)636-4233
cdammann@tuftsmedicalcenter.org
MaryAnne laffin MS FNP cNM
FAcNM
Liaison, National Perinatal Association
8836 242 Street
Bellerose, NY 11426
Phone: (917)376-3081
29
Nicole Rouvinez-Bouali
Liaison, Canadian Pediatric Society
Academic Neonatologist
University of Ottawa, Canada
President, Neonatal-Perinatal Section,
Canadian Pediatric Society
CANADA
Phone: 1-613-737-8561 (Sheila)
nrouvinezbouali@ottawahospital.on.ca
Garrett K lam MD
Liaison, Society for Maternal-Fetal
Medicine
UT Chattanooga
902 McCallie Ave
Chattanooga, TN 37403
Phone: (423)664-4460
lam@rocob.com
tonse N K Raju MD DcH FAAP
Liaison, National Institutes of Health
281 Shadow Glen Ct
Gaithersburg, MD 20878-7417
Phone: (301)402-1872
rajut@mail.nih.gov
erin l Keels APRN MS NNP-Bc
Liaison, National Association of
Neonatal Nurses
700 Childrens Dr
Columbus, OH 43205-2664
Phone: 614/506-5097
erin.keels@nationwidechildrens.org
AAP StAFF
Jim couto, MA
Director, Division of Hospital
and Surgical Services
141 Northwest Point Blvd
Phone: (847)434-7656
Fax: (847)434-8000
jcouto@aap.org
Vivian thorne
Manager, Division of Hospital
and Surgical Services
Phone: (847)434-7669
vthorne@aap.org
Research committee Report
District Grants
Ronald l. Ariagno, MD, FAAP, chair
Deadline: March 15, 2014
Premature Infant Follow-up care toolkit
(Update over the last 1.5 years)
The Section on Perinatal Pediatrics offers grants for
educational or organization purposes within the individual
perinatal districts of the Academy, with a total of $4,000 per
district. Applicants must be members of the Section on
Perinatal Pediatrics.
The “Toolkit for the Follow-up Care of the Premature Infant”
is a multidisciplinary, electronic, interactive toolkit with a
web-based interface, which has been developed by
MedImmune in collaboration with the National Initiative for
Children’s Healthcare Quality (NICHQ). The Toolkit, which
first launched in May 2011, is organized into 6 sections:
Introduction, Discharge Planning, Outpatient Follow-up
Care, Parent/Caregiver, Tools, and References. It has
been developed for healthcare providers to assist in the
transition of the premature infant from hospital to outpatient
care, to facilitate accurate transfer of pertinent patient
information and to help provide evidence-based practical
measures for consideration in the care of the premature
infant. The Toolkit provides age-specific information that
highlights what is unique for the premature infant from birth
to 12 months corrected age. The goal is to help improve
the care and outcomes of premature infants. The Toolkit
can help facilitate care of the premature infant by general
pediatricians and other healthcare providers. These tools
are intended to complement the care healthcare providers
currently provide; however, the Toolkit is not intended to be
a substitute for or an influence on the independent clinical
judgment of the healthcare professional.
1. Organizations that have featured the Preemie Toolkit in
their respective newsletter and/or website:
• The Kentucky Perinatal Association
• The Council of International Neonatal Nurses (COINN)
• National Medical Association (NMA)
• Texas Pediatric Society (TX AAP Chapter)
• The Colorado Perinatal Care Council and Department
of Health have agreed to disseminate and implement
the Preemie Toolkit in the state.
1. Focus of the grant must be on perinatal pediatrics.
2. The purpose of the grant may be educational,
organizational or both.
3. District-wide programs directed toward general and
subspecialty pediatricians will be prioritized.
4. Grants may be used jointly by neighboring districts.
5. Grant applications must include title, purpose,
specific objectives, target audience,
proposal/program content and budget.
6. Applications should be discussed with your District
Representative on the Section’s
Executive Committee prior to submission.
7. The planned activity should not conflict with the
Section’s spring workshop (April 4-6, 2014)
or the AAP ‘s National Conference
(October 10-14, 2014)
8. Following the sponsored program, a copy of the
brochure, number of people attending and
their professional affiliations and program
evaluations results should be submitted as soon as
possible after the meeting or by June 1, 2014 to
Jim Couto, MA, Director,
Division of Hospital & Surgical Services,
141 Northwest Point Blvd.,
the submission deadline is March 15, 2014. Proposals
should be sent to Jim Couto, MA at the above address. A
letter of support from the District Representative on the
Executive Committee of the Section on Perinatal Pediatrics
is recommended and should be forwarded with the
proposal.
2) Thus far, the only EMR Company that has agreed to
incorporate the content of the Toolkit’s various medical
forms into its pediatric EMR software was Physicians
Computer Company (PCC).
This Toolkit can be accessed at www.preemietoolkit.com.
30
SOUTHEASTERN ASSOCIATION OF
NEONATOLOGISTS
May 22-25, 2014
Marco Island Marriott
Resort and Spa
Marco Island, Florida
www.southeastneo.org
Hot Topics
in Neonatology
December 7-10, 2014
Omni Shoreham Hotel, Washington, DC
For over 30 years, Hot Topics has been THE
premiere neonatal conference, with more than
1,000 neonatologists and perinatologists
attending each year.
This activity is jointly sponsored by:
Huntsville HospitalSystem
Supported in part by grants from
Mead Johnson Nutrition
American Academy of Pediatrics ~ Perinatal Section (District X)
Guest Faculty
Alan Jobe, MD
Gilbert Martin, MD
John Zupancic, MD
Eric Reynolds, MD
Join us for the Pre-Conference
Neonatal Quality at Hot Topics
December 7, 2014
For details on the
conference, submitting
an abstract, exhibiting
or receiving MOC Part
IV credit, visit
www.hottopics.org
Jonathan Davis, MD
Michael Cotton, MD
James Moore, MD
SAN Contact person:
Barry D. Chandler, M.D., Executive Director
Phone: (954) 838-2628
E-mail: barry.chandler@shcr.com
The Florida Society of Neonatologists and AAP District X
Perinatal Section will also hold their meetings during this
conference.
AAP District VIII Section
on Perinatal Pediatrics
Register online at: www.southeastneo.org
May 29 - June 1, 2014
Designation: Huntsville Hospital System designates this continuing
educational activity for 17 AMA PRA Category 1 Credits™ .
more information related to CME, please email Traci Conley at
traci.conley@hhsys.org. Register online
at www.southeastneo.org.
Denver City Center Marriott
For more information, visit
www.district8perinatal.org
The conference agenda will be filled
with insightful, cutting-edge
educational topics in perinatal, fetal,
and neonatal medicine by
knowledgeable, thoughtful regional
and national speakers.
31
2014 Workshop on Perinatal Practice Strategies
Scottsdale, AZ
April 4-6, 2014
9-10:00 am
cONcURReNt SeSSIONS
(E) Early Career; (C) Clinical
Focus; (M) Management Focus
A1
Resuscitation training :
Advanced Simulation (c,e)
Renate Savich, MD
FRIDAY, APRIl 4
7:30am 12:15pm
coding Seminar (Optional)
Gilbert Martin, MD
Richard Molteni, MD
Stephen Pearlman, MD
A2
counseling Families for Infants
with life-limiting Diagnoses (c, e)
Annie Janvier, BSc, PhD, MD
Keith Barrington, MD
A3
transitioning to Medical Director of the NIcU:
Budgets and Financial essentials (M)
Richard Molteni, MD
A4
NIH Grant Mechanisms and How to Write Fundable
NIH Grant Applications (e)
Tonse Raju, MD, DCH
A5
Aligning NIcU Practice with the World Out there:
Payers, Policy and You (M)
John Zupancic, MD
A6
Hybrid Neonatal Practices: Incorporating
Academics into the community Setting (c, e)
Scott Guthrie, MD
Judy Aschner, MD
10:15-11:15 am
cONcURReNt SeSSIONS
B1
Resuscitation training:
Advanced Simulation (c, e)
Renate Savich, MD
B7
Apnea and Desats: When Do We Intervene? (c)
Richard Martin, MD
B8
How to Better Understand Budgets and
Reimbursement for the experienced NIcU
Medical Director (M)
Richard Molteni, MD
Advocacy for Newborn care in a changing
Political environment
Mark Del Monte, JD
B9
Using the eMR to Improve evidence-Based
Medicine Practice (c)
P. Brian Smith, MD, MPH, MHS
4:00 pm
Intensive care for Fragile Neonates: What is the
Value of life?
Annie Janvier, BSc, PhD, MD
B10
top ten trends likely to Affect Practice
Management (M)
Kenneth Slaw, PhD
5:00 pm
town Hall Meeting
Sandra Hassink, MD, AAP President-Elect
B14
6:15 pm
Welcome Reception
Supported by Abbott Nutrition
Introduction to the NeoFellows Program: the
Recruitment Process (e)
Chris Retajczyk, MD
Carey Osborne, DASPR
1:00 3:00 pm
Networking for Non-Physician
Coding and Billing Staff
1:00 pm
L. Joseph Butterfield Lecture
Respiratory Support in the Premature Infant
Eduardo H. Bancalari, MD
Supported by Abbott Nutrition
2:00 pm
Using evidence to Innovate Practice:
challenges and Opportunities
3:20 pm
SAtURDAY, APRIl 5
11:30 am 12:30 pm
8:00 am
Perinatal Section at Work
David Burchfield, MD
C1
Resuscitation training: Advanced Simulation(c, e)
Renate Savich, MD
8:30 am
tecaN Report
Krithika Lingappan, MD
C2
counseling Families for Infants
with life-limiting Diagnoses (c, e)
Annie Janvier, BSc, PhD,, MD
32
cONcURReNt SeSSIONS
Workshop on Perinatal Practice Schedule
Optimizing Mechanical
Ventilation: the Art and Science (c)
Steve Donn, MD
SUNDAY, APRIl 6
8:00 am
committee on Fetus and Newborn Report
Kristi Watterberg, MD
C12
Advanced coding: Are You
Ready for the changes? (M)
Gilbert Martin, MD
9:15 am
Management of Infants with BPD: evidencebased or eminence-Based?
Steve Donn, MD
C13
Social Media Update: So Much
More than Facebook (c, e)
Clara Song, MD
C15
How to Prepare for an Interview:
Mock Interview (e)
Douglas Deming, MD
C11
10:00 am GeR: lack of evidence for the Approach to
Diagnosis and Management
Richard Martin, MD
10:30 am translating evidence of Use/Misuse of
Medication into Practice Improvement
P. Brian Smith, MD, MPH, MHS
11:00 am Panel Discussion
12:30
lUNcH: Supported by Mead Johnson
Nutrition
1:30-4:30 pm Half-Day Seminars (optional)
D1
leadership 301: Mastering the
Strange World of change
Kenneth Slaw, PhD
D2
Making the Best Use of Your Data: Perform
Quality Improvement and earn MOc
John Hartline, MD
Janet Muri, MBA
11:20 am ARS Free-For-All
John Hartline, MD
11:55 am closing Remarks
Howard Kilbride, MD, Course Director
William Silverman lecture
at PAS 2014
Sunday, May 4, 2014 - 3:15 pm
NICU Follow-Up Club at PAS 2014
Saturday, May 3, 2014, 12:45 – 2:15 pm
Vancouver, BC
“No Good Deed Goes Unpunished: the SUPPORt
controversy and the Future of evidence-Based
Neonatology?
John Lantos, MD
“NICU Follow-Up Models of Care: Lessons
Learned From Other Countries”
Anne Synnes, MDCM, MHSC,FRCPC
University of British Columbia
The 27th Annual Gravens Conference on
The
Annual
Conference
the28th
Physical
andGravens
Developmental
on th e Physical
and
Developmental
Environment
of the
High
Risk Infant,
Environment of th e High Risk Infant,
in collaboration with the March of Dimes.
March 4-7, 2015
in collaboration with the March of Dimes
For detailed information visit www.cme.hsc.usf.edu
Click on ‘course calendar’ and choose February 2014
For
detailed information, visit
Or email brose@health.usf.edu
www.cme.hsc.usf.edu. Or email
brose@health.usf.edu.
Sponsored by:
33
The following trainees, who presented their research at the
2013 AAP NCE Perinatal Section Program, were awarded
NCE travel grants by the AAP and received invitations to
the NEO Conference in Orlando, FL. Travel, lodging, and
registration fees for these award winners are supported
through a grant made possible by the NEO conference.
2013 Young Investigator Award Winners
The Young Investigator Award is given to fellows based on
the quality of research presented at the AAP NCE Perinatal
Pediatrics Program as judged by a panel of members of the
section Executive Committee. The winners receive a
$1000 prize supported by Mead-Johnson Nutrition.
Oral Presentations
charitharth V. lal, University of Texas Southwestern
Medical Center, Dallas TX “Bronchopulmonary Dysplasia Development Of A Developmental Therapy”
Meiyun Ma, Children’s Hospital Los Angeles, University of
Southern California Keck School of Medicine, Los Angeles
CA “Cardiovascular Response to Prone Positioning in the
Neonates”
erica Mandell DO
University of colorado, Denver cO
Vitamin D Attenuates Lung Injury and Improves Survival in
Infant Rats after Antenatal Endotoxin Exposure
Shaon Sengupta, Children’s Hospital of Philadelphia,
Philadelphia PA “Hyperoxia and Phototherapy Alter
Circadian Gene Expression”
Anoop S. Pulickal, Women and Infants Hospital , Warren
Alpert School of Medicine, Providence RI “Perinatal
Protection Against Invasive Neonatal Candidiasis By a
Monoclonal Antibody Targeting the Candida Albicans
Adhesin, Als3p”
Athis Arunachalam, Baylor College of Medicine, Houston
TX “P2Y2 Purinergic Receptor Function Is Essential for
Pathogenesis of Sepsis”
Sarah Majstoravich, Medical University of South Carolina,
Charleston SC “Body Fat Composition of Neonates At Risk
for Growth Failure”
erica Mandell, University of Colorado, Denver CO “Vitamin
D Attenuates Lung Injury and Improves Survival in Infant
Rats after Antenatal Endotoxin Exposure”
Poster Presentations
Sreenivas Karnati, Children’s Hospital of Michigan, Wayne
State University, Detroit MI “Does Vitamin D Deficiency At
Birth Affect the Risk and Or Severity of Bronchopulmonary
Dysplasia (BPD) Among VLBW Infants?”
Umesh Paudel, Maria Fareri Children’s Hospital at
Westchester Medical Center, Valhalla NY “Is the Functional
Polymorphism of Matrix Metalloproteinase-9 Associated
With Bronchopulmonary Dysplasia in Extremely Low Birth
Weight Infants?”
Ashley lucke, University of Texas Southwestern Medical
Center, Dallas TX “A Five Year Prospective Study Of
Hypothermia Therapy and Neurodevelopmental Impairment
(NDI) In Infants With Hypoxic-Ischemic Encephalopathy
(HIE)”
Dr. Mandell is currently a third year fellow in NeonatalPerinatal Medicine at the University of Colorado. She
earned her medical degree at the Kansas City University of
Medicine and Biosciences and completed her Pediatric
residency at St. Christopher’s Hospital for Children.
The overall goal of this project was to determine whether
Vitamin D treatment could improve survival and preserve
lung growth after antenatal exposure to endotoxin. Their
specific approach was to study the effects of Vitamin D in
both in vivo and in vitro models of inflammation. They
speculated that Vitamin D therapy may preserve lung
growth through enhancement of endothelial and ATII cell
function and growth in experimental chorioamnionitis.
Dr. Mandell was first exposed to research during her
undergraduate years as she investigated the role of growth
factors, specifically vascular endothelial growth factor,
during fetal lung development in a rat model of
oligohydramnios. She knew from an early age she would
be a neonatologist, but what she did not know until this
experience is that she wanted to be a physician-scientist.
Her basic science research interests followed her to
residency where she began investigating hypoxic brain
injury of the newborn. As she began thinking about
neonatal fellowship she found herself drawn back to
developmental lung basic science work. As a result, she
sought out the Pediatric Heart and Lung Center at the
34
University of Colorado. Fellowship has allowed her to
actively participate and apply research and evidence-based
medicine in everyday clinical practice. The need for
effective treatments or preventative strategies for CLD and
BPD are essential to a neonatologist, thus her basic
science work with Vitamin D and BPD will allow better
understanding of the medical needs and treatments to
provide for her patients.
He would like to credit his research mentor Dr.
Thevananther, Dr. Thevanather’s lab and the Section of
Neonatology at Baylor College of Medicine for supporting
his interest in academic medicine.
Athis Arunachalam MD
Baylor college of Medicine, Houston tX
call for Abstracts
P2Y2 Purinergic Receptor Function Is Essential for
Pathogenesis of Sepsis
2014 AAP Annual Meeting
San Diego, cA
Friday, April 11, 2014
at 11:59pm eSt
The abstract submission website for the 2013 AAP
National Conference and Exhibition (NCE)
is now open at
https://aap.confex.com/aap/2014/cfp.cgi
The Perinatal Section gives a number of awards to
trainees with abstracts accepted for presentation at
the section program:
Travel Awards of up to $1000 will be awarded to
residents or fellows based on quality of research as
judged by a panel of members of the Section on
Perinatal Pediatrics Executive Committee. Distance
from the AAP NCE venue is also considered.
Dr. Arunchalam is currently a third year fellow in NeonatalPerinatal Medicine at Baylor College of Medicine (Texas
Children’s Hospital), TX. He received his medical degree
from Stanley Medical College, India. After completing
Pediatric training in India, he moved to the United States
and completed his Pediatric residency at the Unterberg
Children’s Hospital, Monmouth Medical Center, NJ.
During residency, Dr. Arunchalam studied the impact of
pulse oximetry use and an oxygen saturation nomogram in
the delivery room on neonatal resuscitation practices,
under the mentorship of Dr. Kirby Rekedal. His clinical
experience in Pediatrics and Neonatology ignited his
interest in sepsis. His research focuses on evaluating the
role of purinergic signaling in sepsis. In the project, “P2Y2
Purinergic Receptor is Essential for the Pathogenesis of
Sepsis,” he was able to show that P2Y2 purinergic receptor
is required for the amplification of inflammatory response in
sepsis resulting in multiorgan injury and death in a mouse
model of polymicrobial sepsis. His goal is to further
elucidate the molecular mechanisms behind sepsis and
translate his research into developing novel therapeutic
targets against sepsis. Following the completion of his
fellowship, he would like to continue his career in academic
medicine.
Two $1000 Young Investigator Awards are awarded
to fellows selected to give platform presentations of
their research at the AAP NCE Perinatal Section
program and are based on quality of research as
judged by a panel of members of the Section on
Perinatal Pediatrics Executive Committee.
NEO Conference invitations will go to the top ten
abstracts presented by fellows at the AAP NCE
Perinatal Pediatrics program as judged by a panel of
members of the Section on Perinatal Pediatrics
Executive Committee. Travel, lodging, and
registration fees for the awardees to attend the NEO
conference will be supported by the conference.
For more information, email abstracts@aap.org.
35
Elk Grove Village, IL 60007-1098
The AAP Section on Perinatal Pediatrics would like to thank Abbott Nutrition
for supporting the following Section activities:
• NeoReviews Plus
• Perinatal Section Newsletter
• Virginia Apgar Award
• thomas cone Jr History
lectureship
• l. Joseph Butterfield lectureship
• Perinatal Spring Workshop
• Perinatal/Neonatal Fellows conference
• trainees and early career
Neonatologists (tecaN)
• Gerald Merenstein lecture

section on perinatal pediatrics - American Academy of Pediatrics

Transcription

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