Pedi Press

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Fall 2015 Vol. 4, Issue 4 l l o o o o k k i i n n g g a a h h e e a a d d . . . . . . It’s FLU SEASON again. Get Vaccinated! Pedi Press A Quarterly Publication of the Department of Pediatrics This issue begins with a “remembrance of times past”: the feature article on the 10year anniversary of Hurricane Katrina’s landing and the allout effort put forth by the department to meet the medical needs of refugee children from New Orleans. The department meeting is highlighted with the teaching and scholarship awards, as well as summaries of presentations given by three faculty leaders. CRIS announces the Annual Education Retreat, which will be held Friday, December 4, and provides information about the speakers. Various sections that are highlighted are Tropical Medicine, Newborn Center, Emergency Medicine, and Centers for Hematology & Oncology. ChofSA welcomes their inaugural class of residents, and BIPAI features events in Botswana and Uganda. Other features are Research Highlights and Updates, follwed by Health Updates and Alerts. Dr. Mark Kline and the entire Department also congratulate Mr. Mark Wallace on being named Best NonProfit CEO for Houston Business Journal’s 2015 CSuite Awards. He garnered the highest score from the judges out of finalists in all categories and was named HBJ’s Executive of the Year. IN THIS ISSUE Feature Article 2 Department News 4 Faculty Updates 6 CRIS 12 Tropical Medicine 14 Newborn Center 16 Emergency Med 17 Hematology & Oncology 18 ChoSA 19 BIPAI 20 Research Updates 24 Health Updates 28 c c o o n n g g r r a a t t u u l l a a t t i i o o n n s s

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Fall 2015 VVooll.. 44,, IIssssuuee 44

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It’s FLU SEASON again. Get Vaccinated!

Pedi Press A Quarterly Publication of the Department of Pediatrics


This  issue  begins  with  a  “remembrance  of  times  past”:  the  feature  article  on  the  10-­‐year  anniversary  of  Hurricane  Katrina’s  landing  and  the  all-­‐out  effort  put  forth  by  the  department  to  meet  the  medical  needs  of  refugee  children  from  New  Orleans.      The  department  meeting  is  highlighted  with  the  teaching  and  scholarship  awards,  as  well  as  summaries  of  presentations  given  by  three   faculty   leaders.    CRIS  announces  the  Annual  Education  Retreat,  which  will  be  held  Friday,  December  4,  and  provides  information  about  the  speakers.  Various  sections  that  are  highlighted  are  Tropical  Medicine,  Newborn  Center,  Emergency  Medicine,   and  Centers   for  Hematology  &  Oncology.      ChofSA  welcomes  their  inaugural  class  of  residents,  and    BIPAI  features  events  in  Botswana  and  Uganda.    Other  features  are  Research  Highlights  and  Updates,  follwed  by  Health  Updates  and  Alerts.        


Dr.   Mark   Kline   and   the   entire   Department   also   congratulate  Mr.   Mark   Wallace   on   being   named   Best   NonProfit   CEO   for  Houston  Business  Journal’s  2015  C-­‐Suite  Awards.    He  garnered  the   highest   score   from   the   judges   out   of   finalists   in   all  categories  and  was  named  HBJ’s  Executive  of  the  Year.  


Feature  Article     2  Department  News   4      Faculty  Updates   6      CRIS       12      Tropical  Medicine   14      Newborn  Center               16      Emergency  Med   17      Hematology  &              Oncology       18  ChoSA       19  BIPAI       20  Research  Updates   24  Health  Updates     28  


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 Feature Article  

In  August   2015,  Houston   and  other   cities   set   aside   time   to   remember   the   events  that  occurred  10  years  previously,  when  Hurricane  Katrina,  the  most  costly  natural  disaster   in   U.S.   history,   occurred.   BCM/TCH   physicians   played   primary   roles   in  providing   care   for   evacuees   from  New   Orleans,   Louisiana   (NOLA),   and   the   Texas  Children’s   Hospital   Emergency   Center   (TCH   EC)   personnel   established   a   unique  clinic,   the   Mobile   Pediatric   Emergency   Response   team   (MPERT),   to   care   for  pediatric  patients  in  the  Reliant  Arena  .           Hurricane  Katrina  made  its  first  landfall  on  the  tip  of  the  Florida  peninsula  on  August  25,  2005,  before  crossing  it  and  entering  the  Gulf  of  Mexico,  where  it  took  a  westward   track  and   four  days   later  made   landfall   as  a   Category  3  hurricane  near  Buras-­‐Triumph,   Louisiana.     Hurricane-­‐force   winds   extended   120   miles   from   the  center.     At   the   time,   it   was   the   fourth   most   intense   hurricane   on   record   in   the  Atlantic  and  the  strongest  in  the  Gulf  of  Mexico.    A  third  landfall  was  made  near  the  Louisiana-­‐Mississippi  border  on  August  29,  with  winds  still  at  120  mph.    On  August  28,  then  NOLA  mayor,  Ray  Nagin,  had  ordered  a  mandatory  evacuation,  and  the  city  provided   several   “refuges   of   last   resort,”   including   the   Louisiana   Superdome,   for  people  unable  to  leave  the  city.    The  Superdome  was  shelter  for  some  26,000  people  

when  the  storm  came  ashore.    The  storm’s  surge  led  to  53  breaches  in  levees  that  were  protecting  metro  NO,  and  the   Superdome   sustained   significant  damage,   later   requiring   evacuation   of   those  sheltered   there.     The   city  was  

devastated.    Help  was  needed.    People  had  to  be  evacuated.     In  Houston,  then  Mayor  Bill  White  and  other  officials   offered   the  Astrodome,  which   they  said  could   house   as   many   as   18,000   survivors,   as   a  place   of   shelter.     Other   emergency   centers,  including   the   newer  Reliant  Park  next   door  and  the   George   R.   Brown   Convention   Center  downtown,  also  provided  shelter.         Early  in  the  morning  of  August  30,  executives  at  the  Tulane  University  Medical  Center  (TUMC)  in   NO   contacted   TCH   officials   requesting  assistance.    Immediately,  a  command  center  was  opened   to   begin   coordinating   transports   of  patients.     TCH   expected   only   a   select   group   of  pediatric  patients   from  TUMC,  but  as  all  of  NO’s  hospitals   began   making   frantic   efforts   to   find  

placements  for  patients,  a  mass  evacuation  of  all  patients  from  ICUs  of  TUMC  and  Children’s  Hospital  New  Orleans  (CHNO)  was  needed.  TUMC,  CHNO,  and  TCH,  along  with  other   institutions  nationwide,  worked  tirelessly  for   the  next  72  hours  to  evacuate  all  pediatric  patients  and  their  families  from  the  two  NO  hospitals.     As  physicians  and  other  healthcare  providers  watched  the  news  of  the  NO  evacuations  to  Houston  and  realized  the  numbers  were  considerably  higher  than  first  anticipated,  they  realized  that  alternate   locations  for  providing  health   care  were  needed,   or   else   the   local  hospital   EDs  would   be   overwhelmed.    With   the   100,000   square-­‐foot  space  in  the  Reliant  Arena  designated  for  providing  healthcare,  a  clinic  was  constructed  using  display  curtains  and  poles  and  Red  Cross  cots.    HCHD  was  assigned  to  manage  the  administrative  concerns  and  provide  medical  care  using   volunteers   and   nurses   from   HCHD.     Staffing   was   organized   through   the   BCM   department   of   family   and  community   medicine,   with   help   also   provided   by   departments   of   Pediatrics,   Internal   Medicine,   Radiology,  Obstetrics  and  Gynecology,  and  other  specialties.    Calls  went  forth  for  volunteers  from  BCM/TCH.  

1100 YYeeaarrss LLaatteerr:: RReemmeemmbbeerriinngg——aanndd LLeeaarrnniinngg ffrroomm——KKaattrriinnaa  

Photo Credit: Jeff Schmaltz, MODIS Rapid Response Team, NASA/GSFC  


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On  September  4,  two  pediatric  ER  physicians  from  TCH,  Drs.  Paul   Sirbaugh   and   Allen   Kline,   arrived   at   1:30   AM,   after  spending  the  previous  two  days  helping  to  triage  patients  as  they  arrived.    Initially,  pediatric  space  was  comprised  of  only  

two  beds  within  the  adult  “general  care”  clinic   space.     The   two   beds   were  replaced   by   eight   chairs,   used   to  evaluate  and  manage  an  estimated  100  pediatric   patients   during   the   next   8  hours.     Numerous   problems   prevailed  with   regard   to   triaging   patients,  providing   prescriptions,   and   trans-­‐porting  the  most  ill  patients  to  TCH  EC.         Within  hours  of  assessing  the  scene,  the  pediatricians  contacted  the  director  of  pharmacy  at  TCH,  and  two  hours   later,  members  of  the  TCH  pharmacy  arrived  with  medications  and  supplies.    They  assessed  the  situation  to  determine  the  best  place  to  set  up  an  on-­‐site  pediatric  pharmacy.    Seven  days  after  landfall   (3   days   after   TCH   received   the   first   telephone  call),  the  pediatric  MPERT  was  fully  operational,  had  four  beds   to   triage   with   a   25-­‐bed   isolation   unit   created  adjacent   to   it,   was   staffed   24   hours   by   physicians   and  nurses,   and   had   a   pharmacy   in   place.  Dr.   Sirbaugh   later  remarked   that,   “Initially,   the   officials   in   charge   of   the  response  were  slow  to  warm  up  to  our  presence,  labeling  us   a   “rogue”   clinic  with   a   misguided   mission.    However,  those   arguments  were  muted  by   the  pleas   for  help   from  both  the  outnumbered  and  underprepared  personnel  and  the  desperate  families  in  need  of  medical  attention.”     Dr.  Sirbaugh,  who  by  default  had  assumed  the  role  of  medical  director,  was  asked  formally  to  assume  that  role  by  the  Harris  County  Command.      For  approximately  two  weeks,  Dr.   Sirbaugh   left   his   job   at  TCH   to   spearhead   the  TCH   effort   to   expend   the   resources   needed   for   the  

displaced   children.     Children   and   adolescents   received   medical  care  as  good  as  or  better  than  they  had  received  at  home.    

Fourteen   days   after   landfall,   the   number   of  pediatric   patients   requiring   care   was   drastically  

reduced,   and   the   clinic   hours  were   shortened  to  8:00  am  to  8:00  pm.    TCH  began  removing  supplies   and   equipment,   and   the   physician  staffing   was   turned   over   to   the   county  officially   on   day   15.     A   full   report   of   the  TCH   efforts   was   published   in   a   special  supplement   of  Pediatrics   in   May  2006.    Dr.  

Sirbaugh   later   published   an   article   on   his  experiences.  (see  link  below)    



“Before 2005 and Hurricane Katrina, pediatrics was an afterthought, at best, in the minds of most of our region’s disaster planners . . . . Pediatric leadership can now expect to be invited to most disaster-planning meetings in the region. . . In my opinion there was little national dialogue regarding pediatric disaster response before Katrina. Whereas 9/11 began the conversation on disaster preparedness, Katrina focused the attention specifically on children.”

--Dr. Paul Sirbaugh


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WHAT’S HAPPENING Department News . . .

Among   those   Pediatric   faculty   recognized   for   teaching   and   evaluation   were   Drs.   Marni   Axelrad,   Carlos   Javier  Campos-­‐Lopez,  Heather   Crouse,  David  Curtis,   Cara  Doughty,  Kala  Kamdar,  Richard  Kellermayer,   Curtis  Kennedy,  Daniel   Leung,  Kathryn  Leung,   Caridad  Martinez,   Brent  Mothner,   Pablo   Motta,   Lenora  Noroski,  Olutoyin  Olutoye,  Kevin  Roy,  Manish  Shah,  Poyyapakkam  Srivaths,  Joyee  Vachani,  D’Juanna  White-­‐Satcher,  and  Jason  Yustein.  

Faculty Receive Teaching and Scholarship Awards

Dr.  Fernando  Stein,  Professor,  was  one  of  two  recipients  of  the  Baylor  College  of   Medicine   Presidential   Awards.    Established   in   1999,   the   Barbara   and  Corbin   J.   Robertson,   Jr.,   Presidential  Award   for   Excellence   in   Education  recognizes   faculty   members   who   have  made   long-­‐standing,   consistent   and  highly   valued   contributions   to   the  educational   mission   of   the   College.  Recipients   become   members   of   the  Baylor  Society  of  Presidential  Educators  and   receive   a   crystal   award   and  $10,000.  

Fulbright & Jaworski Faculty Excellence Awards

Presidential Award


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Baylor Pediatric Awards of Excellence in Teaching

On  October  7,  2015,  Dr.  Mark  Kline,  Chairman,  presented  awards  of  excellence  in  teaching  to  six  faculty  members,  recognizing  their  outstanding  contributions  to  the  department  and  to  patient  care.  

Sanjiv  Harpavat,  M.D.,  Ph.D.,  received  the  Award  of  Excellence  for  Presentation  at  Baylor  Pediatric  Grand  Rounds  for  the  “most  outstanding  presentation”  during  the  academic  year  of  July  1,  2014  through  June  30,  2015,  for  his  presentation  on  November  7,  2014,  entitled,  “A  Prospective  Screen  for  Biliary  Atresia.”  

Robert  G.  Voight,  M.D.,  received  the  Award  of  Excellence  for  Presentation  at  Baylor  Pediatric  Grand  Rounds  for  the  “most  outstanding  presentation  by  a  Senior  Faculty  Member”  during  the  academic  year  of  July  1,  2014  through  June  30,  2015,  for  his  presentation  on  July  11,  2014,  

Claire  E.  Bocchini,  M.D.,  received  the  Award  of  Excellence  for  Most  Outstanding  Performance  in  Teaching  during  the  academic  year  of  July  1,  2014  through  June  30,  2015,  for  “teaching  .  .  .  judged  to  be  of  exceptional  educational  value  by  virtue  of  the  appropriateness  of  the  content,  superiority  of  organization  and  clarity,  and  excellence  of  style,  presentation  and  interaction;  and  her  dedication  of  teaching.”  

 Michelle  D.  Barajaz,  M.D.,  received  the  Award  for  Achievement  in  Educational  Innovation  for  her  “outstanding  innovations  in  medical  education,”  based  on  her  “achievement  in  developing,  organizing,  implementing,  and  administrating  the  new  Pediatric  Residency  Program  at  The  Children’s  Hospital  of  San  Antonio.”  

Jeffrey  R.  Starke,  M.D.,  received  the  Award  for  Lifetime  Excellence  in  Teaching  “in  recognition  of  sustained  excellence  in  teaching  over  a  professional  lifetime  career  in  Pediatrics.”  His  teaching  was  “judged  to  be  of  exceptional  educational  value  by  virtue  of  the  appropriateness  of  the  content,  superiority  of  organization  and  clarity,  and  excellence  in  the  style  of  presentation  .  .  .  consistently    .  .  .  during  a  lifetime  of  teaching.”  

Mary  L.  Brandt,  M.D.,  received  the  Award  for  Excellence  in  Teaching  by  a  Non-­‐Pediatric  Faculty  Member,  in  recognition  that  “her  teaching  during  the  year  has  been  of  exceptional  educational  value,  her  dedication  to  teaching  has  been  outstanding,  and  her  performance  as  a  clinician  has  provided  a  superb  role  model.”  


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Faculty Meeting – 2015 Research Updates  



TCH   ranked   4th   among   the   top   children’s  hospitals   in  the  United  States  for  federal   fund-­‐ing,  receiving  a  total  of  $72  million.      The  Department  also  performed  exceptionally  well  in  new  grant  funding.    Faculty  members  received  a  total  of    33  new  NIH  grants,   for  a   total  of  $11,674,585.    This   funding   included  15  new  R01  grants  and  a  new  K08  grant.     In  addition,  the  Department  received  $9,524,070  through  10  new  “other”  government  grants  and  $2,261,441  through  17  new  competitive  foundation  grants.    Dr.  Orange  noted  that  383  faculty  are  engaged  to  some  extent  in  research,  ranging  from  less  than  25%  of  their  time  to  more  than  75%.          

Dr.  Jordan  Orange,  Vice-­‐Chair  for  Research,  presented  Research  Updates  for  2015  at  the  Faculty  Meeting  held  on  October  7.    These  are  highlights  from  those  updates.    

Department Ranks High on Funding  

Get Connected: Join VIICTR  

An   exciting   opportunity   for   collaborating   and  networking  with   other   researchers   at  BCM/TCH  and  beyond   is   the   Virtually   Integrated   Institutions   for  Clinical  &  Translational  Research  (VIICTR).    Using  his  own  profile  as  an  example,  Dr.  Orange  demonstrated  how  the  system  works   for   finding  colleagues  and   for  developing   one’s   individual   profile   so   that   it   can   be  accessed  by  researchers  with  similar  interests,  as  well  as  students  and  trainees  seeking  mentorship  (through  a   level-­‐specific   mentorship   selection   field).     He   also  showed   how   to   search   for   individuals   using   key  words,   the   individual’s  name,  or   the   institution.     The  system   also   lists   the   individual’s   publications  automatically,  deriving  them  from  MEDLINE/PubMed  and   other   sources   and   indicates   if   the   publications  have   or   have  not   been   verified   by   the   profile   owner.    In  addition,  the  website  provides  four  video  tutorials.    Dr.   Orange   encouraged   faculty   members   to   submit  their  own  profiles  and  to  make  use  of  this   innovative  tool  for  collaborating  on  research.      6  

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Research  Resources  Office  Miki  Gillis:  [email protected]  

 Executive  Vice-­‐Chair  

Dr.  Susan  Blaney:  [email protected]    

Vice-­‐Chair  Dr.  Jordan  Orange:  [email protected]  

 Associate  Vice-­‐Chairs  

Dr.  Lisa  Bomgaars  (Clinical  and  CRC):  [email protected]  

Dr.  Kristy  Murray  (basic):  [email protected]  

PSTDP Adds Rich Culture for Developing


An   innovative,   one-­‐of-­‐its-­‐kind   program,   the  Pediatrician-­‐Scientist   Training   &   Development  Program   (PSTDP)  has  been  added  to   the  offerings  at  BCM/TCH  as  a  way  to  provide  a  “de-­‐convoluted”  path-­‐way  for  physicians   to  become  successful,   independent  pediatrician   scientists.     The   new   three-­‐year   pediatric  residency  track,  under  the  program  leadership  of  Drs.  Jordan   Orange,   Jake   Kushner,   and   Andrea   Burns,  takes  full  advantage  of  the  extraordinary  environment  found  in  the  Texas  Medical  Center.    In  its  first  year,  the  program  received  159  applications,  a  pool  from  which  22   candidates   were   selected   for   2-­‐day   intervews   and  four   physicians   were   matched   to   form   the   inaugural  2015-­‐18   class.   Already,   another   100   applicants   have  sought  to  be  considered.  

Faculty Publish Their Research Results in High-Impact Journals  

During  CY  2014/15,  faculty  published  1454  articles  in  peer-­‐reviewed  journals   indexed  in  PubMed.    Of  those,  42  were  published  by   journals  with   an   impact   factor  of   20   or   greater.     Journals   included   NEJM,   Lancet,  JAMA,  Nature,  Nature  Genetics,   and  Cell.    Another  148  papers   were   published   by   journals   having   an   impact  factor  of  10  or  greater.    Also,  faculty  papers  were  most  frequently  published  in  PLOS  (33),  Pediatrics  (27),  and  Blood  (19).      


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Faculty Meeting – 2015 Education Updates  

Dr.  Geeta  Singhal  Associate  Vice-­‐Chair  of  Educational  Affairs          Dr.  Satid  Thammasitboon  Associate   Director,   Center   for   Research,   Innovation   and   Scholarship   in   Medical  Education  (CRIS)        Dr.  Susan  Gillespie  Director  of  Medical  Student  Electives  and  Associate  Program  Director,  House  Staff  Education            Dr.  Alisa  Acosta  Associate  Program  Director,  House  Staff  Education            Dr.  Deborah  Hsu  Associate  Program  Director,  House  Staff  Education      

Education Leadership Appointments Announced  

Dr. Teri Turner, Vice‐Chair for Education, followed Dr. Orange’s presentation with Education Updates for 2015. These are highlights from her presentation.

In   addition   to   recognizing   the   recipients   of   the   Excellence   in   Teaching   Awards   (see   page   5),   Dr.  Turner  announced  the  four  following  Education  Leadership  appointments:  


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Department Shines at BCM Showcase of Educational Scholarship  

The   BCM   Showcase   of   Educational   Scholarship   is   an   annual   event   that   is   “Baylor’s   premier   venue   for  highlighting  work  in  medical  education  utilizing  a  peer-­‐reviewed  format.”    The  venue  is  open  to  anyone  holding  a  current  BCM  academic  appointment  (student,  post-­‐doc,  resident,  fellow,  faculty)  and  to  individuals  enrolled  in  the   Health   Education   Fellowship   Program   at   UT-­‐Houston   Medical   School   or   in   the   University   of   Houston’s  Masters   of   Education   in   Teaching   with   an   emphasis   in   the   health   sciences   program.     The   applications   must  demonstrate   clear   evidence   of   scholarship   specific   to   education,  which   reflects   situations   in  which   educators  pose  and  systematically  investigate  questions  related  to  improving  teaching  and  learner  outcomes.    Dr.  Turner  noted  that  of  the  18  posters  that  were  accepted  for  presentation,  60%  were  from  the  Department  of  Pediatrics.    The  Department  also  was  honored  by  having  two  of  the  three  Showcase  Winners:      Dr.   Kathryn   Ostermaier.   Sr.   Mentor:   Dr.   Robert   Voigt.     Presentation:   “Teaching  Developmental  Behavioral  Pediatrics  to  Residents.”  (pictured  right)      Dr.  Anita  Mantha.    Sr.  Mentor:  Dr.  Rhit  Shenoi.    Presentation:    “Safe-­‐Seat:  An  Educational  Program  and  Child  Passenger  Safety  for  Pediatric  Residents.”  (no  photo  available)        

Applicants to Residency Program Outdistance National Numbers  

BCM Offers Nine Pediatric Residency Training Programs

BCM-Houston Categorical Pediatrics BCM-San Antonio Categorical

Pediatrics Global Health Pediatrics

Pediatrician-Scientist Training & Development Program (PSTPD)

Child Neurology Categorical Neurodevelopmental Disabilities

(NDD) Preliminary Combined Internal Medicine-Pediatrics

Medical Genetics-Pediatrics Child Neurology Neurosciences

Noting  that  BCM  offers  nine  Pediatric  Residency  Programs,  Dr.  Turner  compared  national  numbers  of  applicants  with   the   number   received   at   BCM.     The   BCM/TCH   residency   programs   outdistanced   national   rates   of   U.S.  applicants  by  17%  and  exceeded  overall  national  standards  (see  graph  below,  top  right).    She  also  pointed  out  that  U.S.   applicants   to   the   categorical   pediatric   residency   program   at   ChofSA   has   grown   considerably   from   2015   to  2016  (see  graph  below,  bottom  right).    (Data  for  2016  are  preliminary,  as  the  applicant  process  is  still  open.)  


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Faculty Meeting – 2015 Isolation Unit Update

Need for Pediatric Biocontainment Unit Explained

Dr.  Amy  S.  Arrington,  Asst.  Professor,  brought  everyone  up  to  date  on  the  new—and  unique—isolation  unit  at  Texas  Children’s  Hospital,  West  Campus.  

Dr.  Arrington  began  by  identifying  the  biocontainment  units  in  the  U.S.  in  2014:  Special  Clinic  Studies  Unit:  NIH  (Maryland)  (4  rooms,   7   beds),   Saint   Patrick   Hospital:   NIH   (Montana)   (3  rooms),   Emory   University:   CDC   (Georgia)   (2   rooms),   and  University  of  Nebraska  Medical  Center   (Nebraska)  (10  beds).    All  four  sites  were  designated  for  adults.         In  December  2014,  TCH  announced  plans  to  build  a  special  isolation   unit   for   children   with   highly   contagious   diseases  such   as   Ebola   and   other   emerging   diseases.   The   Center   was  designed  for  special  isolation  and  boasts:  •    state-­‐of-­‐the-­‐art   center   equipped   to   deal   with   serious  

emerging  pathogens  •   the   only   specially   and   specifically   designed   pediatric  

containment  unit  in  the  world  •    resource  for  community,  state,  and  beyond  •    a  means  for  physicians  to  change  the  way  they  approach  ALL  infectious  diseases  and  patient  isolation  at  TCH  

The   team   involved   visited   the   Nebraska   and   Emory  biocontainment  unit   to   gain  understanding  about   the  design   of   a   unit   and   the   priorities.     Key   ideas   they  learned  were:  

 •    Unit  flexibility  is  key  for  changing  functionality  •    Communication  is  challenging  in  full  isolation  mode  •    Protocol  for  family  visitation  is  challenging  and         varies  •    Unit-­‐based  BSL3  lab  is  beneficial  to  unit  operations  •    Biohazard  trash  is  a  huge  challenge  •    A  true  team  mentality  and  preparedness  is  CRUCIAL     to  success  


Getting Started: Learning from Others

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Dr.   Arrington   described   the   5th-­‐floor  expansion   at   West   Campus   as   having   18  additional   beds   opening   October/  November   2015:   10   acute-­‐care   beds   and   8  special  isolation  rooms.    All  18  rooms  will  be  utilized   as   acute   care   when   SIU   is   inactive.    SIU   supporting   facilities   include   a   consult  room  located  outside  the  unit  and  equipped  with  telemedicine,  a  family  room  outside  the  unit,  a  BSL3  laboratory  inside  the  unit,  three  large   autoclaves   for   trash   sterilization,   and  staff  locker/shower  room.    

Education  and  training  are  critical  for  the  proper  performance  of  an  SIU.    Dr.  Arrington  noted  that  a  volunteer  group  of  nurses  and   physicians   must   be   educated   and   trained   to   care   for  children   with   highly   contagious   diseases,   diseases   with   low  prevalence   and   rare   occurrence,   and   diseases   with   potential  high  risk  to  caregivers.     It   requires  a  determined  team  that   is  flexible,  dependable,  altruistic,  and  prepared,  as  well  as  ready  to  activate  with  short  notice.        

       The  multidisciplinary  team  is  comprised  of  physicians   specializing   in   intensive   care,  infectious   diseases,   emergency,   hema-­‐tology   and   global   health,   as   well   as  hospitalists;   nurses   trained   for   the  emergency   center,   intensive   care,   NICU,  BMT,   cardiac   ICU,   and   acute   care;  laboratory  support  and  EVS;  and  infection  control  and  security.      

West Campus Expansion Makes Room for Special Isolation Unit (SIU)

SIU Requires Unique Education, Training & Preparation


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CRIS: Center for Research, Innovation & Scholarship  

CRIS and TCH Announce Annual Education Retreat Friday, December 4  

Outstanding Speakers to Present Lectures at Retreat  

Dr.   Nancy   Spector   (pictured   left)  will  be   the  speaker   for   the  Dr.  Kelly  Descioli  Memorial  Lecture.    The  lectureship   is  named  for  Dr.  Descioli,  a  much  loved  Associate  Professor  of  Pediatrics  at  BCM  and  TCH  who  lost  a  hard-­‐fought   battle   with   brain   cancer   in   2013,   after   being   diagnosed   in  2005.    Dr.  Spector  is  Professor  of  Pediatrics  at  Drexel  University  College  of   Medicine   and   the   Associate   Residency   Program   Director,   Associate  Chair   of   Education   and  Faculty   Development,   and  Program  Director   at  St.  Christopher’s  Hospital   for  Children.     She  has  served  as    Chair  of   the  Association   of   Pediatric   Program   Directors   (APPD)   Faculty   and   Professional   Development  

Task  Force  and  as  Chair  of  the  APPD  Mentorship  Program,  as  well  as  numerous  other  national  positions  and  is  the  recipient  of  several  leadership  awards.      Dr.   Jennifer  Christner  (pictured  above,  right),  the  new  Dean  of  the  Medical  School  at  BCM,  will  give  the  Plenary  Session.    Dr.  Christner  is  known  for  her  creativity  in  approaching  the  learning  process  and  for  her  understanding  of  the  requirements  of  documenting  the  quality  of  education  programs.    She  has  been  recognized  for  her  work  in  faculty  development,  teaching,  and  research  and  has  an  outstanding  record  in  mentoring  students,  residents,  and  fellows  in  clinical  practice  and  research.    She  was  twice  (2010,  2012)  named  the  Top  Pediatric  Teacher  of  the  Year  at  University  of  Michigan.    She  is  a  board-­‐certified  pediatrician  specializing  in  adolescent  medicine  and  has  been  in  practice  more  than  20  years,  as  well  as  serving  previously  as  associate  dean  for  undergraduate  medical  education  at  SUNY  before  coming  to  BCM.  


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CRIS Provides Ongoing Resources for Faculty    

Manuscript/Proposal Editing

CRIS also provides a Department of Pediatrics editor for assistance with manuscripts and grant proposals. Editing is done electronically, using Word with “track changes” so the author(s) can see and accept/reject the edits. You also can get help with “rejected” manuscripts, using the reviewers’ comments to improve your manuscript.

For editorial help, contact Dr. Lee Ligon at [email protected]

Fulbright and Jaworsky Portfolio Consultation

CRIS is pleased to provide individual consultation for preparing F&J Portfolios. Workshops also are available through BCM, but when you need specific help or consultation, CRIS is here to help! For personalized consultation, contact. Dr. Anne Gill at

[email protected]

CRIS Announces Leadership Changes    

The   Center   for   Research,   Innovation   and   Scholarship  (CRIS)   is   proud   to   announce   the   appointment   of   Dr.  Satid   Thammasitboon   as   its   Associate   Director.     Dr.  Thammasitboon   has   been   involved   with   CRIS   since   its  inception   and   makes   valuable   contributions   in  qualitative   research   and   analysis.     He   replaces   Dr.  Dorene   Balmer,   who   has   recently   transitioned   to   the  Children’s   Hospital   of   Philadelphia.     We   wish   her   the  very   best   in   her   new   appointment   and   welcome   Dr.  Thammasitboon  to  this  position.  


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Tropical Medicine  

Carlos Slim Foundation Renews Commitment to Fighting Chagas  

by  Dipali  Pathak    Through   a   contribution   to   the  National   School   of   Tropical  Medicine  at  Baylor  College   of   Medicine   for   the   Chagas   Vaccine   Initiative,   the   Carlos   Slim  Foundation  has  renewed  its  commitment  to  combat  one  of  the  major  neglected  tropical   diseases   in   Latin   America.   On   September   30,   2015,   the   Foundation  announced   a   $2.6   million   grant   to   researchers   at   BCM   National   School   of  Tropical  Medicine  for  the  development  of  a  therapeutic  vaccine.         Chagas   disease,   also   known   as   American   trypanosomiasis,   is   found  throughout   the   poorest   parts   of   the   Americas.   It   is   a   vector-­‐borne   disease,  caused  by  the  single-­‐celled  parasite  called  Trypanosoma  cruzi  [pictured  right],  which  is  transmitted  to  humans  by  triatomine     “kissing”  bugs  and  affects  millions  of  people   in   the  American  continent,   including   the  United  States.  The  disease  is  an   important  cause  of  heart  disease   in  Latin  America.  Between  5  and  10  million  people   live  with  Chagas  disease  in  this  region,  including  more  than  1  million  who  suffer  severe  heart  disease  known  as  Chagasic  cardiomyopathy.  An  estimated  one  in  four  people  infected  with  T.  cruzi  will  go  on  to  develop  heart  complications.    

Celebration at Baylor College of Medicine of the donation from the Carlos Slim Foundation of $2.6 million donation to fight Chagas. (Left to right: Dr. Paul Klotman, BCM President; Dr. Roberto Tapia-Conyer, CEO of the Carlos Slim Foundation; Dr. Mark Kline, BCM Chairman of Pediatrics and TCH Physician-in-Chief; Dr. Maria Elena Bottazzi, Deputy Director of the vaccine center; and Dr. Peter Hotez, Dean of the School of Tropical Medicine). Photo courtesy of BCM  

“Together  with  the  Carlos  Slim  Foundation  and  a  consortium  of  partners  in  Mexico  and  elsewhere,  including  the  Autonomous  University  of  Yucatán  and  the  Center  for  Research  and  Advances  Studies  of  Mexico  (CINVESTAV),  we  are  working   to  develop  an   innovative   therapeutic  vaccine   to  prevent   the  dreaded  cardiac  complications  of  Chagas  disease,  which  include  heart  conduction  disturbances,  aneurysms  and  even  sudden  death.”    

-­‐-­‐Dr.  Peter  Hotez.    14  

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Conference Explores Global Health Strategies for U.S. and Mexico

By  Nathaniel  Wolf,  MLS    On  September  29  -­‐30  a  conference  organized  by   The   National   School   of   Tropical   Medicine  (NSTM)   along   with   Rice   University’s   Baker  Institute   and   others   featured   leaders   in  government,   education,   commerce,   and   the  nonprofit   sector   from   the   United   States   and  Mexico.   The   conference,   entitled   The   United  States  and  Mexico:  Addressing  a  Shared  Legacy  of   Neglected   Tropical   Diseases   and   Poverty,  was   paired   with   a   workshop   at   Rice   where  students   learned  about  career  paths  in  global  health   as   well   as   ways   for   students   to   get  involved  in  efforts  to  help  reduce  the  massive  disease   burden   caused   by   neglected   tropical  diseases  around  the  world.       Dr.  Peter  Hotez  spoke  about  Blue  Marble  Health,  a  concept  based  on  new  findings  that  neglected  tropical  diseases  and  diseases  of  poverty  affect  not  only  citizens   of   impoverished   countries   but   also   the   extremely   poor   in   developed   countries   around   the   world,  including   the  United  States.   “The   fact   that  12  million   impoverished  Americans  are  affected   suggests   that  NTDs  rank  among  our  nation’s  most  common  health  disparities.  They  occur  at  the  confluence  of  extreme  poverty  and  our  warm  subtropical  climate,”  said  Dr.  Hotez  in  a  post  on  the  Baker  Institute  Blog.       Dr.  Mitchell  Wolfe,  deputy  assistant  secretary  for  the  Office  of  Global  Health  in  the  U.S.  Department  of  Health  and  Human  Services,  gave  the  Keynote  Address,  titled  U.S.  NTD  Strategy  and  U.S.-­‐Mexico  Border  Health  Projects.         Director  General  of  the  Carlos  Slim  Foundation,  Dr.  Roberto  Tapia-­‐Conyer  spoke  on  disease  and  poverty  and  Mexico,  as  well  as  Dr.  Mercedes  Juan  López,  Mexico’s  Secretary  of  Health.    

Tropical Medicine Professor Accepted to Fulbright Specialist Program Roster

Dr.  Oluwatoyin  Asojo  began  mentoring  young  scientists  long  before  coming  to  BCM.    This   summer,   she   completed  her   15th   year  mentoring  ACS   Project   SEED  high   school  students  and  her  1st  year  as  mentor  for  BCM’s  Summer  Medical  and  Research  Training  (SMART)  program.  She   is  also  an  ACS  chemistry  ambassador  and   is  mentoring  a  K-­‐5  science   teacher   at   an   inner   city   elementary   school.   Recently,   she   has   become  interested   in   quantifying   the   success   of   programs   aimed   at   underprivileged   and  minority   students,   in   hopes   of   learning   how   to   situate   these   programs   in   the   most  effective   ways.   Dr.   Asojo   and   colleagues   presented   a   poster   entitled,   “Long-­‐term  educational   outcomes   of   two   NIH-­‐funded   components   of   Baylor   College   of   Medicine  (BCM)’s   Summer   Medical   and   Research   Training   (SMART)   Program”   at   the   annual  showcase   of   educational   scholarship,   and   a   paper   is   being   submitted   to   the   Journal  Academic  Medicine.   The  project  was  completed  as   partial   fulfillment  of   requirements  for   the  Master   Teachers   Fellowship  Program  by  Dr.   Asojo   and   Dr.   Kendal  Hirschi   of  BCM’s   Children’s   Nutritional   Research   Center.   Their   analysis   revealed   that   BCM’s   SMART   program   closes  anticipated  doctoral  degree  completion  gaps  for  participants  from  groups  traditionally  underrepresented  in  STEM.         This  summer,  Dr.  Asojo  was  also  accepted  into  the  Fulbright  Specialist  Roster,  allowing  her  to  apply  for  grants  for  a  2-­‐  to  6-­‐week  studies  in  one  of  144  participating  countries,  where  she  will  collaborate  with  local  researchers  on   a   research   topic   of   interest.   Her   focus   area   is   chemistry   education   and   she   intends   to   develop   sustainable  research  programs  in  resource-­‐limited  settings.  


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Newborn Center  


Dear Colleagues:

I am writing to let you know that I met with Newborn Center faculty and staff

this afternoon to announce a medical leadership change. Dr. Steve Welty has

decided to step down from his position as Head of the Section of Neonatology

in the Department of Pediatrics at Baylor and Texas Children’s. As most all of

you know, Steve has been an integral part of all of our programs in neonatology

for much of the past 25 years. He was a faculty member here from 1990 through

2000, before leaving for the Ohio State University and Nationwide Children’s

Hospital, and he returned to Baylor and Texas Children’s in 2011 to serve as

Section Head and Service Chief. Steve has led with diligence, thoughtfulness,

discernment and a deep understanding of the field of neonatology. As a

colleague for 33 years, I am personally grateful for all of his friendship and

support. After a total of about 15 years in the role of Chief of Neonatology

(including 10 years at Nationwide Children’s), Steve will continue on as a

valued faculty member in the Section of Neonatology, with a particular focus on

development of a new program in Global Neonatology.

I am pleased to announce that Dr. Gautham Suresh will assume new

responsibilities as Section Head and Service Chief in Neonatology, effective

today. Gautham joined the faculty in January of this year as a Professor of

Pediatrics. He was named to the role of Chief Medical Officer for the Newborn

Center in May. Gautham is a nationally recognized expert in quality

improvement in the field of neonatal-perinatal medicine, with extensive

involvement in both the Vermont Oxford Network and the Cochrane

Collaborative. Over the past eight months, he has distinguished himself as a

highly collaborative and forward-thinking leader. Please join me in wishing

Gautham well in this vital leadership role.

Very best wishes,


a message from the chairman . . .  


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Emergency Medicine  

     Dr.   Corrie   Chumpitazi,   the   National  Operations  Chair  for  the  Society  for  Pediatric  Sedation   Provider   Course,   co-­‐directed   the  pre-­‐course   for   the   National   Pediatric  Hospital   Medicine   Conference   in   San  Antonio,   in   July,   along   with   Dr.   Jason  Reynolds,   who   is   on   Baylor   Faculty   at   the  Children's   Hospital   of   San   Antonio.     The  students   came   from   across   the   country:  Washington  (state)  to  Maine.            Students  participated  in  the  11-­‐hour  simulation  course  in  the  Christus  San  Rosa  regional  Simulation  Center  at  CHofSA.    Dr.  Chumpitazi  also  taught  at  the  National  Society   for  Pediatric  Sedation  Conference   in  St.  Louis,  MO,     in  May  2015,  and  once  again  co-­‐directed   the  Sedation  Provider  Course  in  Salt  Lake  City  on  August  28  and  29.  

Pre-course in Pediatric Sedation Held in San Antonio  

Dr.  Corrie  Chumpitazi,  Dr.  Jason  Reynolds,  and  Amber  Rogers,  of  the  section  of  hospital  medicine  and  assistant  director  of  sedation  services  at  TCH  

Dr.  Corrie  Chumpitazi  and  student  


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Centers for Hematology & Oncology  

On   September   12,   the   Cancer   and  Hematology   Centers,   a   joint   program   of  BCM/TCH,   held   the   opening   exhibit   of  Making  a  Mark,©  an  exhibition  of  art  and  creative  writing  by  children  with  cancer.    The  event,  which  ran  until  October  9,  was  held  on   the  Auxiliary  Bridge   of   the   third  floor  of  the  Clinical  Care  Center  at  TCH.  It  was   sponsored   by   the   Periwinkle   Foundation   and   open   to   the  public.     Making   A   Mark   enables   children   with   cancer   and   their  siblings   to   express   themselves   and   to   be   empowered   through  creativity  as  a  part  of  the  healing  process.    The  exhibit  is  open  to  children  from  treatment  centers  around  the  world,  and  this  year  features   works   representing   14   different   nationalities.     The  exhibition   at   TCH   was   the   first   stop   on   a   journey   traveling   to  venues   throughout   the   country.     The   Periwinkle   Foundation,  located   in   Houston,   develops   and   provides   many   programs   that  

positively  change  the  lives  of  children  who  are  challenged  by  cancer  and  other  life-­‐threatening  illnesses  and  receive  care  at  TCH.    In  addition  to  the  creative  arts  projects,  it  offers  camps,  a  survivor  program,  and  other  events.    

Making the Mark© Sponsors Exhibition at TCH  

Bell Announces Another Victory and Brings Hope  

A  new  bell  signifies  another  victory!    On  July  14,  Ethan   Williamson,   a   9-­‐year-­‐old   survivor   of  sarcoma,   jubilantly   rang   a   bell   that   signifies   a  great   deal   to   him   and   other   patients   at   the  Children’s  Cancer  and  Hematology  Centers.    The  bell  was  donated  by  the  Williamson  family.    It  is  for   patients   to   ring   to   commemorate   receiving  their   final   cancer   or   hematology   treatment.     A  plaque   hangs   next   to   the   bell   to   explain   its  significance.  Dr.  Poplack  noted  how  meaningful  the  bell  is  as  a  sign  of  hope  for  the  thousands  of  patients   who   are   treated   each   year   at   TCH   for  cancer  and  blood  disorders.    


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Faculty Honored with Recognition  

Dr.  Mark   Gilger,   Pediatrician-­‐in-­‐Chief   of   the  Children’s  Hospital  of  San  Antonio   (CHofSA)  and  Professor  of  Pediatrics  at  BCM,  was  the  recipient  of  a  2015  Health  Care  Hero  Award  in  the  Outstanding  Physician  –  Hospital-­‐Based  category  from  the  San  Antonio  Business  Journal.  Dr.  Gilger  was  at  an  international  conference  and  unable  to  attend  the  award  ceremony  but  was  honored  at  a  reception  at  CHofSA  by  his  colleagues.    

Also,   ten  pediatric   subspecialists   at  were  selected  as   Best   Doctors   in   America   for  2015.  Included   in   the   list  are   four   critical   care  specialists:  Dr.   Elumalai   Appachi,  Dr.   Timothy  Tong,  Dr.  Matei  Petresu,  and  Dr.  Clint  Woosley.  Additionally,  Dr.  Lisa  Buckmiller,  ENT;  Dr.   Elizabeth   Roeder,   Genetics;   Dr.   Daniel   Sedillo,   Hospital   Medicine;   and  Dr.   Donald  Currie,  Pediatric  Physical  Medicine  and  Rehabilitation,  made   the   list.  Dr.   Adam  Noel   and  Dr.   James   Noel,  both  gastroenterologists  and  brothers,  were   also   selected.   Profiles   appeared   in   the   September   edition  of  San  Antonio  Magazine.    

Inaugural Residents Receive Warm Welcome  

On   July,   10,   inaugural   residents   began   their   training   through   BCM’s   new   pediatric   residency   program   based   at  CHofSA.  These  residents  will   train   for   the  next   three  years   to  become  pediatricians   through   the  program,  which  adds   ten   primary   care   residency   spots   to   south   Texas.   Primary   care   physicians   are   the   first-­‐line   providers   for  medical  care,  and  the  Association  of  American  Medical  Colleges  has  identified  primary  care  as  one  of  the  areas  in  which   they   anticipate   a   future   physician   shortage.   A   “Meet   and   Greet”   was   held   to   welcome   the   students,   and  guests  were  encouraged  to  write  notes  to  the  students  wishing  them  well  and  even  recommending  their  favorite  restaurants  in  San  Antonio.    

“Our  entire  faculty  and  staff  are  so  excited  about  the  arrival  of  our  first  class  of  Baylor  residents,”  said  Dr.  Michelle  Barajaz,  pediatric  residency  program  director  for  Baylor/San  Antonio.  “This  is  a  very  strong  group  of  young  pediatricians  who  are  beginning  a  truly  unique  opportunity  to  work  closely  with  faculty  who  have  come  from  all  over  the  country  to  help  build  our  program  and  our  hospital.  All  of  the  employees  here  have  welcomed  them  into  the  Children’s  Hospital  of  San  Antonio  family  with  open  arms.”  


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Funding Helps Build Future for Youth in Botswana

With  recent  funding,  Baylor  Children’s  Clinical  Centre  of   Excellence   has   expanded   its   partnership   with  Stepping   Stones   International   (SSI).   SSI   is   an  innovative   after-­‐school   and   community   outreach  program   that   was   established   in   2006   in   Mochudi,  Botswana.     The   holistic   programme   combines   life  skills,   leadership,   psychosocial   support,   and  community   mobilization   to   empower   youth   to   heal  the   scars   of   the   past   and   reconnect   with   their   lost  childhood   while   growing   into   self-­‐sufficient   young  adults.             Under   the   “For   Africa’s   Children   Every   Time”  (FACET)   “Finding   the   Leader   Within”   Leadership  Programme,   SSI   has   provided   a   seed   grant,  programming   materials,   and   guidance   to   BIPAI  Botswana,   enabling   them   to   support   out-­‐of-­‐school  youth   aged   16-­‐25   in   a   leadership   programme   in   the  Gaborone   area.     In   the   past,   BIPAI   has   worked   with  SSI   to  establish  a  satellite  Teen  Club  program,  which  was   designed   to   help   HIV-­‐positive   youth   lead  successful  lives,  both  professionally  and  personally.     The  year-­‐long  leadership  program  targets  youth  in   the   16-­‐   to   25-­‐year-­‐old   group   and   has   curricula  focused   on   leadership   skill   development,   career  development  skills,  healthy  and  productive  lifestyles,  financial   and   business   literacy,   and   information   and  computer   technology   training.     Participants   receive  mentorship   from   volunteers   and   community  members   and,   when   possible,   are   placed   in  apprenticeships  or  job  internships.         The  establishment  of  the  program  in  Gaborone  is  especially   vital   in   enabling   youth   to   become  productive   members   of   society   and   to   have   a  flourishing,  successful  life.  It  will  help  meet  the  needs  of  a  changing  population  base,  as  children   transition  from  pediatric  to  adolescent  and  then  adult  care.      

Rotary Sponsors and Greater Houston Supporters Provide Equipment  

On  Friday,  June  12,   Rotary   Club   President   John   Cunliffe  

handed   over   medical   equipment   to   Dr.   Mogomotsi  Matshaba   for   the   Botswana   -­‐   Baylor   Children's  Clinical   Centre   of   Excellence's   Botswana   Outreach  Programme.  

The   equipment   was   purchased   with   funds   provided  by   a   Global   Grant   from   the   Rotary   Foundation  together   with   11   Rotary   clubs   in   the   USA   and   the  Houston   club   plus   six   Rotary   districts   including  District   9400.   President   Cunliffe   was   supported   by  Past   Presidents   John   McCrory,   William   Lee,   William  McLellan,   Barbara   Butchart,   President-­‐Elect   Itamar  Azoulay,   and   Rotarians   Chris   Sharp,   Jerome   Mafeni,  Graham  Burt,  and  Ed  Pettitt.    20  

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Botswana Team Celebrates Childhood Cancer Survivors




On   September   23,   a   celebration   with   a  “superhero”   themed   party   was   held   for   the   pediatric  cancer  patients  at  the  Baylor  Bristol-­‐Myers  Squibb  Phatismong  Adolescent  Centre.    The  party  was  the  vision  of  Amanda  Slone,  the   project   manager/care   coordinator.     With   the   help   of   Dr.  Jeremy   Slone   and   numerous   volunteers   and   donations   from  local  charities  and  businesses,  it  was  a  great  success.    

Thirty-­‐seven   children,   including   both   cancer   survivors   and  patients  receiving  therapy,  were  celebrated  as  superheroes  and  given   T-­‐shirts   with   a   “Botswana   Kids   Fighting   Cancer”   logo.    Parents,  donors,  and  staff  received  gold  ribbons  to  pin  on  their  shirts.     The   superheroes   feasted   on   delicious   food,   had   their  faces   painted,   participated   in   a   jam   session,   added   their  handprints  to  a  collage,  played  in  a  soft-­‐play  area,  and  posed  in  a   superhero-­‐themed   photo   booth.     Fallen   superheroes   were  honored  with  a  moment  of  silence  and  a  bubble  blessing.    In  addition   to  celebrating   the  children,  a  goal  of   the  party  was  to   raise   awareness   that   children   in   Botswana   do   have   cancer  but   there   is   hope,   as   they   can   get   diagnosed,   treated,   and  survive.  



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   People   living   with   HIV/AIDS   in   the   remote   Bukeda   district   of  Uganda   have   been   struggling   to   get   access   to   care.   In   order   to  improve   the   situation   in   the   Bukeda   district,   Baylor-­‐Uganda  partnered  with  the  United  States  government  to  construct  a  new  anti-­‐retroviral  therapy  clinic.          

     Typically,   more   than   870  patients   with   HIV/AIDS  flocked  to  the  Bukeda  Health  Center   everyday   for   HIV  treatment,  but  because  of  the  limited   facilities   and   capa-­‐bilities,  many  did  not  receive  care.   With   the   new   clinic,  they  now  have  access  to  care,  and  the  hope  is  that  the  area  will   experience   the   same  success   that   has   been  achieved  elsewhere.      

“We  know  that  ART  is  prevention,  but  if  we   fail   to   get   people   into   care   due   to  poor  quality  health  services,  Bukeda  will  continue   to   lag   behind   with   high   new  HIV  infections.”    

-­‐-­‐Dr.  Adeodata  Kekitiinwa  (pictured  left)  

Remote Area in Uganda Gets New Anti-Retroviral Therapy  


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Play Therapy Provides Psychosocial Support  


Centre Recognized by Uganda Paediatric Association  


Baylor-­‐Uganda  supports  Article  31  of  the  U.  N.  Convention   on   Children’s   rights,   which  provides   for   the   right   to   leisure,   play,   and  culture,   by   providing   play   therapy.     The  therapy  offers  a  form  of  psychosocial  support  to   children   and   young   people   and   their  caretakers.    It  is  thought  to  promote  symptom  resolution,   stability,   and   competence   in  children,  especially  those  affected  by  violence,  abuse,   trauma,   antisocial   behavior,   and  learning   difficulties.     It   also   helps   build   self-­‐esteem   in   orphans   and   other   vulnerable  children.    Friday,  which  is  family  clinic  day,  is  the   busiest   day   of   the   week,   with  approximately   20   children   gathered   at   any  given  time.    The  children  are  provided  various  toys   such   as   balls   and   skipping   ropes,   and  parents  often  sit  along  the  edges  of  the  play  area  to  watch  while  they  wait  for  their  names  to  be  called.    The  activities  provide  a  welcome  distraction   for   both   the   children  and  caretakers.     In  addition   to   providing  a  safe  time  of  play,  the  Centre  also  offers  parents  a  reprieve  from  parenting  and  the  children  some  relief  from  the  reality  of  their  status,  as  well  as  opportunities  to  support  one  another.  

Baylor-­‐Uganda  was  recognized  recently  by  the  Uganda  Paediatric  Association  during  the  11th  Scientific   Conference.   Both   the   medical   and  psychosocial   interventions   to   improve   the  lives   of   children   living   with   and   affected   by  HIV/AIDS  and  their  families  were  recognized.     Sandra  Amodot,  Baylor-­‐Uganda’s  Psycho-­‐social  Manager   (pictured  right),  was  awarded  the   best   abstract   certificate   presented   on  “Integrating   Early   Childhood   Development   in  HIV   Care:   Experiences   from   Baylor-­‐Uganda.”    The  study  was  conducted  with  Drs.  Adeodata  Kekitiinwa,   Heather   Lukolyo,   Vincent  Tukei   and   Rita   Atugonza.     Based   on   the  recognition   that   40-­‐85%   of   children   younger  than   8   years   have   some   form   of  developmental   delay,  due   to   chronic   illnesses  or   other   causes,   and   that   they   have   unique  development  needs  that  require  early  and  routine  interventions,  the  objective  was  to  highlight   the  experience  of  integrating   early   childhood   development   into   the   treatment   for   HIV.   The   following   accomplishments   were  highlighted:   700   caregivers   were   reached   quarterly   through   child   development   sessions;   500   children   were  supported  quarterly  through  the  OVC  program;  2,400  children  interacted  through  play  therapy  during  their  clinic  appointments;  203   teenage  mothers  were   supported  quarterly  with   information,   family  planning,   and  nutrition;  1,748   children  were   assessed   for   nutrition;   20  students   graduated   through  university;   and  600   caregivers  were  trained  on  income-­‐generating  activities  and  supported  to  form  savings  groups.  


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Research Highlights and Updates  


Study Shows Developmental Effects on Infants Born with Transient Low Glucose Levels  

Dr.  Jeffrey  R.  Kaiser,  Professor,  and  colleagues  reported  that  data  from  infants  born  at  the  University  of  Arkansas  for  Medical  Sciences  hospital  revealed  that  newborns  with  transient  low   blood   sugar   have   lower   literacy   and   math   achievement   test   scores   in   fourth   grade.    UAMS   screens   all   newborns   for   sugar   levels   during   their   first   three   hours   after   birth,  providing   important   information   for   the   study,   for   which   Dr.   Kaiser   was   Principle  Investigator.         Persistent   and   very   low   glucose   levels   in   newborns   are   known   to   be   associated   with  brain  damage  and  poor  long-­‐term  development,  but  the  effects  of  transient  low  levels  have  not  been  studied  previously.    The  baby  gets  glucose   from  the  mother   in  utero  through  the  placenta  and  after  birth  from  either  the  mother’s  milk  or  formula;  the  baby  also  produces  it  

in  the  liver.      The  levels  can  drop  if  there  is  too  much  insulin  in  the  blood,  the  baby  fails  to  produce  enough  glucose  or  does  not  have  sufficient  glucose  scores,  or  the  breast  milk  or  formula  does  not  provide  enough  glucose.         The  researchers  were  able  to  use  data  from  more   than  30,000  infants  and  matched  data   from  1,395   infants  born   in  1998  with  their  2008  achievement  test  scores.    The  study  included  children  with  normal   levels  at  birth  and  those  with  transiently  low  levels  and  found  that  early  transient  hypoglycemia  was  associated  with  decreased  proficiency   on   literacy   and   mathematics   test,   the   children   who   had   been   born   with   normal   glucose   levels  indicating   about   20   percent   more   proficiency.     Dr.   Kaiser   stressed   that   the   study   is   preliminary   and   further  research   is   needed,   but   it   provides   evidence   of   the   impact   of   early   transient   newborn   hypoglycemia   that   if  corroborated  by  other  researchers  should  lead  to  screening  all  infants  so  those  who  need  treatment  can  receive  it  and  cognitive  defects  can  be  prevented.  Currently,  most  hospitals  screen  only  those  whose  mothers  have  diabetes,  babies  born  prematurely,  and  those  who  are  small  or  large  for  gestational  age.    

Research Team Finds No Increase in Waste of Food at Schools  


Researchers   at   the   USDA/ARS  Children’s   Nutrition   Research  Center   at   BCM/TCH   have   found  that  no   increase   in  waste   in   fruits  and  vegetables  occurred    after  the  new   school   lunch   guidelines  were  put   in   place.   Dr.   Karen   Cullen,  Professor,  and  her  colleagues,  Tzu-­‐An   Chen   and   Jayna   M.   Dave,  conducted   the   research   at   eight  elementary   schools   in   southeast   Texas   where   dietitians  anonymously   observed   what   foods   children   in  

kindergarten   through   5th   grade   selected   in   the   cafeteria   lunch   line   and   how   much   of   what   they   selected   they  actually  ate.    They  found  that  more  fruits  and  juices  were  selected  after  the  implementation  of  the  new  guidelines,  which  require  that  students  select  a  fruit  or  vegetable  to  have  the  meal  count  as  reimbursable,  and  those  students  who   selected   these   items   consumed   the   same   amount   as   before.   The   only   item  with   higher  waste   after   the   new  guidelines  were  put   in  place  was  legumes.  Dr.  Cullen  emphasized  the  need  to  do  more  to  ensure  that  children  are  eating  more  fruits  and  vegetables,  grains  and  proteins.      

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Research Team Part of Consortium to Focus on Pediatric Brain Cancer  

Dr.   Xiao-­‐Nan   Li,   Assoc.   Professor,  will   lead   a  BCM   research   team   that  will   focus   on  brain  cancer,   the   leading   cause   of   cancer-­‐related  deaths   in  children.     Co-­‐PI   is  Dr.  Susan   Blaney,  Professor.    Other  members  of  the  team  are  Dr.  Will  Parsons,  Assoc.  Professor,  who  will  direct  the   genomic   analysis   of   the   mouse   model   tumors,   and   Drs.   Robia   Paulter,   Rao   Pulvarthi,  Patricia  Baxter  and  Jack  Su,  along  with  Dr.  Adekunle  Adesina  of  TCH.       The  research  team  is  part  of  a  five-­‐group  consortium  that   received  a  5-­‐year  grant  from  the   National   Cancer   Institute,   part   of   the   National   Institutes   of   Health.   The   Pediatric  Preclinical   Testing   Consortium   will   address   key   challenges   related   to   the   development   of  new  therapies  for  children  with  cancer  and  will  address  an  important  barrier  to  developing  new   drugs   for   the   treatment   of   childhood   cancers:   producing   reliable   data   from   studies  involving  laboratory  and  animal  models  that  can  help  to  prioritize  which  therapeutic  agents  to  pursue  in  human  clinical  trials.         Dr.   Li   has   developed   a   unique   surgical   procedure   that   allows   for   safe   and   rapid  implantation   of   human   brain   tumor   cells   into   various   locations   in   mouse   brains.     The  resulting  tumor  models  both  look  and  act  like  human  tumor,  so  researchers  are  able  to  study  the  disease  mechanisms  and  test  new  therapeutic  approaches.         For  this  project,  the  researchers  will  perform  a  series  of  in  vitro  and  in  vivo  assays  to  1)  examine   therapeutic   efficacy,   which   will   be   performed   in   genetically-­‐appropriate   models  using   animal   survival   and   quantitative   changes   of   tumor   regression/progression   as   end  points,  and  2)  understand  mechanisms  of  cell  killing  and  causes  of  resistance  to  therapy.         The  other  four  institutions  involved  in  the  consortium  and  their  research  areas  are  Albert  Einstein   College   of   Medicine,   New   York,   N.Y.   –   osteosarcoma;   Children’s   Cancer   Research  Institute,   San   Antonio   –   sarcoma   and   renal   cancers;   Children’s   Hospital   of   Philadelphia   –  neuroblastoma;  and  Children’s  Cancer  Institute,  Sydney,  Australia  –  leukemia.    The  Research  Triangle  Institute,  Durham,  N.C.,  is  the  coordinating  center.  


“Our objective is to make use of our unique panel of animal models to examine therapeutic efficacy of new agents and to analyze mechanisms of action and therapy resistance in high-grade glioma, medulloblastoma and ependymoma. Our hypothesis is that these patient-specific model tumors will respond to anti-cancer therapies similarly to the corresponding human primary tumors, and the effective agents identified through this system would have better chances of clinical success.”

--Dr. Xiao-Nan Li  


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Institutional Collaboration Finds Clue to Halt Leukemia Relapse  

Dr.   Michele   Redell,   Assoc.  Professor,   along   with   Rice  chemist   Dr.   Zachary   Ball   and  MDACC   oncologist   and   Division  Head   of   Internal   Medicine   Dr.  David  Tweardy,  published  results  in  the  journal  Angewandte  Chemie  of   a   study   showing   that   a   small  molecule  could   deliver   a   one-­‐two  

punch   to  proteins   that   resist   chemotherapy   in  patients  with   acute   myeloid   leukemia   (AML).     Their   study  addresses   a   protein   domain   one   considered   to   be   of  little  importance  but  may  actually  be  the  key  to  helping  patients   who   are   fighting   AML   avoid   a   relapse.       The  protein,   STAT3   (signal   transducer   and   activator   of  transcription   3),   interferes   with   chemotherapy   by  halting   the   death   of   cancerous   cells,   thereby   allowing  them   to   proliferate.     The   molecule   that   the   team  discovered   locates   and   then   attacks   a   previously  unknown  binding  site  on  STAT3,  disrupting  its  disease-­‐promoting   activity.     This   discovery  was  made   possible  by  an  earlier  discovery  in  Dr.  Ball’s  lab,  which  enables    

researcher  to  identify  on  a  molecular  level  the  target  of  action  for  drug  molecules  by  using  rhodium-­‐based    inorganic   complexes   that   recognize   specific   folds   in   a  protein   chain   and   catalyze   minute   changes   in   those  sequences.     The   process   creates   a   “tag”   for   later  analysis.    The  STAT3  protein  is  thought  to  be  a  factor  in  the  relapse  of  nearly  40%  of  children  with  AML  and  has  been  a   target  for   scientists  trying   to  shutdown  cancer.    Previous   research   focused   on   only   one   region   of  STAT3,   with   little   success.     This   research   focused   on  the  proteins  coiled  coils,  using  a  new  proximity-­‐driven  rhodium(II)   catalyst   known   as   MM-­‐206.     It   finds   and  modifies  an  inhibitor-­‐binding  site  on  the  coiled  coil  and  delivers   the   inhibitor   naphthalene   sulfonamide   to   the  modified  site.       Co-­‐authors   of   the   paper   are   BCM   postdoctoral  associates  Wei  Liu  and  Xin  Long,  researchers  Michael  Krueger   and  Mikhail   Kolosov;   BCM   Asst.   Professors  Alexandra   Stevens   and   Edward   Allan   Sison   (above,  right);   and   MDACC   Asst,   Professor   Moses   Kasembeli;  and   Rice   graduate   students   Matthew   Minus   and  Farrukh  Vohidov.  

Dr.   Huda   Y.   Zoghbi,   Professor,   has   been   awarded   a   Javits   Neuroscience   Investigator  Award  from  the  National  Institute  of  Neurological  Disorders  and  Stroke.  The  award  is  named  in  honor  of  the  late  Sen.  Jacob  Javits  of  New  York,  a  strong  advocate  for  neurological  research  who  died  of  amyotrophic  lateral  sclerosis.  It  is  a  conditional,  seven-­‐year  research  grant  given  to  scientists  by  the  National  Advisory  Neurological  Disorders  and  Stroke  Council.  The  initial  grant   period   is   for   four   years,  with   an   additional   project   period   added   after   administrative  review.     Noting   Dr.   Zoghbi’s   “distinguished   record   of   substantial   contributions   in   the   field   of  neurological   science,”   the   Institute   awarded   the   seven-­‐year   grant   to   support   research   into  spinocerebellar  ataxia  1,  the  first  gene  she  identified  and  a  major  focus  of  her  laboratory  for  

more  than  two  decades.  Spinocerebellar  ataxia  1  is  inherited  dominantly  and  is  one  of  several  diseases  that  occur  because  of  glutamine  amino  acid  (CAG)  repeats,  rendering  it  unwieldy  and  non-­‐functional.  The  disorder  affects  gait,  speech,  and  other  activities  governed  by  voluntary  muscles,  eventually  resulting  in  death.     Dr.  Zoghbi  will  use   the  grant  to  extend  her  work  into   the  mechanism  by  which  the  mutant  protein  ATAXIN-­‐1  cannot  be  folded  properly  in  the  cell,  interfering  with  the  action  of  neurons.  The  aims  of  the  research  project  are  to  lower  the  level  of  toxic  protein  in  the  cell,  screen  human  cells  in  culture  and  the  fruit  fly  for  additional  drug  targets  that  can  help  lower  the  levels  of  the  protein,  and  explore  modifications  and  interactions  of  the  Ataxin-­‐1  protein  to  understand  features  that  would  be  relevant  outside  the  cerebellum  of  the  brain.  The  results  have  the  potential  to  increase   the   understanding   of   other   neurological   diseases   with   similar   patterns,   including   Huntington’s,  Parkinson’s  and  Alzheimer’s.  

Faculty Receives Recognition with Grant Funding for Research


Page 27: Pedi Press

Chevron Extends Support for Angola Sickle Cell Initiative  


The  Angola  Sickle  Cell   Initiative,  a  public-­‐private  partnership  of  BCM,  TCH,  the  Republic  of  Angola,  and   Chevron,   was   launched   in   2011   with   an  initial   grant   of   $4   million   from   Chevron.     That  support  has  been  renewed  with  an  additional  $5  million   in   funding   over   5   years.   In   August,  representatives   from   all   organizations   met   in  Luanda,   Angola,   at   a   ceremony   to   celebrate   the  continued   support.     Dr.   Gladstone   Airewele  leads  the  initiative,  which  includes  an  education  and  training  component,  which  has  trained  more   than   1,700   Angolans,   including   local   physicians,   nurses,   laboratory   technicians,  phlebotomists,  social  workers,  and  research  coordinators.  


With  more   than  12,000  babies   born  annually  with   sickle  cell   disease,   the  African  nation  has  one  of   the   highest  rates   of   the  disease,   as  well  as  a  high  death   rate   of   children  younger   than  5   years   old.     Since   the  program  was  launched   in   2011,   more   than   121,000   infants   have   been   screened.     More   than   1,700   infants   and   children   are  receiving  treatment  through  the  program,  the  foundation  of  which  is  based  on  the  BIPAI  model,  which  treats  more  than  250,000  children  with  HIV/AIDS  in  centers  in  Africa  and  Romania.      

Signing   the   Memorandum   of   Agreement   between  the  Ministry  of  Health  of  Angola,  Chevron,  TCH  and  BIPAI.  Dr.  David  Poplack,  Director,  Texas  Children’s  Cancer   and   Hematology   Centers;   Ali   Moshiri,  President,   Chevron   Africa   and   Latin   America  Exploration   and  Production  Company;   and  Dr.   José  Vieira   Dias   Van-­‐Dunem,   Minister   of   Health   of  Republic  of  Angola.  

Dra.  Vanda  Andrade,  General  Manager,  Business  Support   Services,   Southern   Africa   Strategic  Business   Unit   for   Chevron   Africa   and   Latin  America   Exploration   and   Production   Company;  Dr.   David   Poplack,   Director,   Texas   Children’s  Cancer   and   Hematology   Centers;   Dr.   José   Vieira  Dias   Van-­‐Dunem,  Minister   of  Health   of  Republic  of   Angola;   Dra.   Joana   Lina   Cándido,   Lwini  Foundation  Vice  President;  Ali  Moshiri,  President,  Chevron   Africa   and   Latin   America   Exploration  and   Production   Company;   and   John   Baltz,  Managing   Director,   Southern   Africa   Strategic  Business   Unit   for   Chevron   Africa   and   Latin  America   Exploration   and   Production   Company  pose  for  a  photo  during  the  ceremony.    


Page 28: Pedi Press


Health Updates and Alerts  

Flu Season is Here: Time to Get Vaccinated!  

Flu   season   occurs   during   the   fall   and   winter   months,  and   getting   vaccinated   is   critical   to   preventing   its  spread.     Dr.   Pedro   Piedra   noted   that   this   year’s  trivalent  vaccine  has  been  redesigned,  with  two  of  three  vaccine  strains  from  previous  years   replaced  with  new  strains.     The   third   strain   is   the   pandemic   H1N1.     In  some  cases,  a  quadrivalent  formulation  will  be  available  and   probably   is   a   better   option   “because   it’s   going   to  ensure  that  you  have  coverage  against  any  of   influenza  B  lineages  that  may  circulate,”  Dr.  Peidra  added.         Universal  vaccination  is  the  best  means  of  protecting  everyone   from   flu,   with   the   more   people   who   are  

protected   against   the   strain(s)   circulating,   the   less   likely   that   an   influenza   will   be   able   to   take   hold   and   cause  complications.    Dr.  Piedra  recommends  vaccinations  for  pregnant  women  during  any  trimester,  which  will  transfer  the   antibodies   to   the   infant   and,   thereby,   provide   passive   protection   during   the   first   six   months   of   life.     Also,  everyone  working  in  the  healthcare  environment  should  be  vaccinated  for  both  personal  protection  and  to  reduce  the  risk  of  spreading  flu  to  others.    The  vaccine  requires  approximately  one  to  two  weeks  to  take  effect  and  provide  full  protection,   so   the  early  one  gets  vaccinated,   the  better.    Those  younger   than  eight  years  who  have  not  been  vaccinated  previously  will  need  a  second  dose  four  weeks  after  receiving  the  first  dose.  

Child’s Behavior May Indicate Physical Problems  

Physicians   are   alerting   parents   and   teachers   to   the   fact   that   some   children’s  behavioral   problems  may  be   caused  by   health   problems   such   as   hearing  loss,   sleep   apnea,   or   a   voice   problem.     Some   children   may   not   have   the  cognitive  skills  to  realize  that  they  have  a  hearing  problem,  or  they  may  be  embarrassed   to   admit   it   and   tend   to  withdraw.     In   some   cases,   children  

may  hear  only  parts  of  what  the  teacher  is  saying.    In  other  cases,  sleep  apnea,  which   can   affect   individuals   of   all   ages,   may   result   in   daytime   sleepiness,  

hyperactivity,   and   attention   problems.     A   third   problem   involves   voice   issues,   symptoms   of   which   include  hoarseness,  frequent  voice  loss,  difficulty  being  heard  or  understood,  and  pain  when  talking.    Children  with  these  conditions   may   be   more   negatively   perceived   by   teachers   and   may   not   participate   because   they   feel   self-­‐conscience.     Dr.   Julina   Ongkasuwan,   who   treats   patients   at   TCH,   recommends   that   parents   who   suspect   their  children   have   health   ailments   or   indications   of   learning   disabilities   consult   with   their   pediatricians   to   have  appropriate  tests  or  evaluations  done.    


Page 29: Pedi Press

The  National  Athletic  Trainers’  Association   has   released   new  guidelines  for  treating  athletes  with   potential   spinal   cord  injuries   on   the   field.     Two   of  the   main   changes   are   related  to   1)   the   technique   used   for  spine  boarding  the  athlete  and  2)  the  timing  of  removal  of  the  athlete’s   protective   equip-­‐ment.     The   guidelines   also  changed  the   terminology  from  spinal   immobilization   to   spinal  motion  restriction,  as  complete  immobilization   is   impossible  during   transfers   and   removal  of  equipment.  

  Previously,   a   technique   called  logrolling   was   used   to   position   the  injured  athlete  onto  a  backboard   for  transfer.     The   protective   equipment  typically   was   left   on   the   injured  athlete,   based   on   the   idea   that   it  might   help   avoid   potentially  aggravating   the   injury   on   the   field  and   that   it   provides   stability   to   the  cervical   spine   during   transport.   The  new   recommendations   come   after  studies  have  evaluated  spinal  motion  during  simulated  injuries  in  cadavers  and   found   that   an   eight-­‐person   lift  better   minimizes   the   motion   of   the  

cervical   spine.     Hence,   this   type   of   lift   is   recommended   over  logrolling  whenever  possible.    The  new  guidelines  also  call   for   safe,   controlled   removal   from   the   athlete   of  equipment   such   as   shoulder   pads   and   helmets  before  starting  the  transfer.         BCM   sports   medicine   expert   Dr.   Theodore  Shybut   applauded   the   new  guidelines,   noting  that   the   sports   medicine   providers   on   the  sidelines   are   the   people   who   are   best  equipped   to   remove   the   equipment,   under-­‐stand   how   the   equipment   works,   and   are  able   to   remove   it   with   the   least   amount   of  trauma.    He  also  emphasized  the  importance  of  having   a   good   team   of   sports   medicine   experts  on  the  field  during  athletic  events  and  the  need  for  emergency  action  planning  so  that  the  care  team  can  rehearse   the   processes   of   removing   equipment   and  performing   the  spine  boarding  procedure,  prior   to  actually  encountering  spine  injuries.      

 New Guidelines Recommended for Sports Spinal Cord Injuries



“It’s important to realize that in cases where the injured athlete is face down you have to get them face up to ensure airway access and properly assess the athlete; in those cases, you may have to logroll them. Also, the eight-person lift is only possible if you have enough people who are trained to do this safely.The logroll is not something that you absolutely cannot do, but the eight-person lift is the preferred technique because less c-spine motion occurs.”

-- Dr. Theodore Shybut

Page 30: Pedi Press


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