Annual Report - UConn Health
Transcription
Annual Report - UConn Health
CONNECTICUT CHILDREN’S MEDICAL CENTER - DEPARTMENT OF PEDIATRICS & PEDIATRIC SURGICAL SPECIALTIES Annual Academic Report 2014 Chair’s Summary . . . . . . . . . . . . . . . . . . . 1 Human Genetics . . . . . . . . . . . . . . . . . . 44 The Year’s Highlights . . . . . . . . . . . . . . . . . 6 Infectious Diseases & Immunology . . . . . . . . . 46 Academic Administration . . . . . . . . . . . . . . 9 Neonatology . . . . . . . . . . . . . . . . . . . . 48 Adolescent Medicine . . . . . . . . . . . . . . . . 11 Nephrology . . . . . . . . . . . . . . . . . . . . . 52 Anesthesiology . . . . . . . . . . . . . . . . . . . 12 Pediatric Neurology . . . . . . . . . . . . . . . . . 53 Cardiology . . . . . . . . . . . . . . . . . . . . . 13 Pediatric Neurosurgery . . . . . . . . . . . . . . . 55 Cardiothoracic Surgery . . . . . . . . . . . . . . . 15 Orthopaedic Surgery . . . . . . . . . . . . . . . . 56 Child & Adolescent Psychiatry . . . . . . . . . . . 16 Otolaryngology . . . . . . . . . . . . . . . . . . . 58 Children’s Center for Community Research (C3R) . 18 Pain & Palliative Medicine . . . . . . . . . . . . . 59 Community Pediatrics . . . . . . . . . . . . . . . . 20 Pathology . . . . . . . . . . . . . . . . . . . . . . 61 Pediatric Critical Care . . . . . . . . . . . . . . . . 22 Plastic Surgery . . . . . . . . . . . . . . . . . . . 63 Pediatric Dentistry . . . . . . . . . . . . . . . . . 24 Pulmonary Medicine . . . . . . . . . . . . . . . . 65 Developmental & Rehabilitation Medicine . . . . . 26 Radiology . . . . . . . . . . . . . . . . . . . . . . 67 Digestive Diseases, Hepatology, & Nutrition . . . . 28 Research . . . . . . . . . . . . . . . . . . . . . . 69 Emergency Medicine . . . . . . . . . . . . . . . . 30 Rheumatology . . . . . . . . . . . . . . . . . . . 71 Pediatric Endocrinology & Diabetes . . . . . . . . 33 Transplant Surgery . . . . . . . . . . . . . . . . . 72 General Pediatrics . . . . . . . . . . . . . . . . . . 35 Urology . . . . . . . . . . . . . . . . . . . . . . . 73 Pediatric General & Thoracic Surgery . . . . . . . 37 Graduate Medical Education Residency . . . . . . . 75 Pediatric & Adolescent Gynecology . . . . . . . . . 39 Graduate Medical Education Fellowship . . . . . . 77 Hematology-Oncology . . . . . . . . . . . . . . . 40 Grants & Contracts . . . . . . . . . . . . . . . . . 80 Hospital Medicine . . . . . . . . . . . . . . . . . 42 2014 was an extraordinary year of growth in clinical services, and achievement in research and education for the faculty and staff of the Department of Pediatrics. 1 Chair’s Summary Dear Colleagues and Friends, It is my pleasure once again to share with you the highlights of a remarkable year for the faculty and staff of the Department of Pediatrics at the University of Connecticut School of Medicine and at Connecticut Children’s Medical Center. As you page through this report, my second as Chair of Pediatrics and Physician-in-Chief, you will see that 2014 was an extraordinary year of growth in clinical services, and achievement in research and education for the faculty and staff of the Department of Pediatrics. On these pages, we are also pleased to highlight the contributions of our exceptional colleagues in Surgical Specialties, Anesthesiology and Radiology. In a year crowned with many honors and awards, several stand out. Two divisions – Endocrinology and Urology – were recognized by US News & World Report for their excellence in clinical care and quality, education, and research. Dr. Jeffrey Hyams, head of our Division of Digestive Diseases, Hepatology, and Nutrition, was honored as the 2014 recipient of the Murray Davidson Award. The Endocrinology Division’s Diabetes Education Program was reaccredited by American Association of Diabetes Educators. Dr. Kathleen Marinelli, from the Division of Neonatology, received the United States Breastfeeding Committee’s Distinguished Service Award and the Academy of Breastfeeding Medicine Board Service Award. She also was named Chair of the Baby-Friendly US NICU Initiative, and elected to the Board of the International Lactation Consultant Association as director of Professional Development. Two major challenges were confronted by our staff this year, and both brought out the very best in us. The outbreak of Ebola led Connecticut Children’s, and in particular Dr. Andrea Benin and my colleagues in the Division of Infectious Diseases, to enhance the medical center’s existing disaster pre- paredness planning, and to focus on safely detecting, isolating, and treating children with possible Ebola infection while minimizing the risk of contamination to staff, patients, visitors, and members of the community. While no cases of Ebola were discovered or diagnosed at Connecticut Children’s, the medical center is now better prepared to deal with circumstances of this kind. The second major challenge affected our colleagues in the Emergency Department, which received its highest number of patients to date, and within that number, an increasing proportion of behavioral and mental health patients. In response to this challenge, the Emergency Department was partially redesigned to incorporate 11 rooms in a sequentially securable area that incorporates safety design features. The division augmented its security presence with the addition of an assigned security officer and an ED safety officer. A new ED social worker evaluates low risk patients with the aim of decreasing the average length of stay of behavioral health patients. Pediatric UME had a highly successful year. The overall satisfaction with the Ambulatory Pediatric clerkship was rated as “excellent” or “good” by more than 92 percent of medical students and more than 91 percent of students rated their Advanced Pediatric Experience (sub-internship) as “excellent” or “good.” Twenty-three percent of the graduating UConn medical school class entered a Pediatric or Pediatric combined residency. All students matched at highly competitive programs including Children’s Hospital of Philadelphia, Cincinnati Children’s Hospital Medical Center, Yale-New Haven Hospital, and UConn School of Medicine/ Connecticut Children’s Medical Center. Our Residency program, under the exemplary direction of Dr. Ed Zalneraitis, continues its progress toward effectiveness in the ACGME’s Next Accreditation System. Our faculty and residents 2 Chair’s Summary instituted the new milestones-based assessments, but found areas that might benefit from a bit of fine-tuning. Changes were made to improve efficacy and efficiency, and these revisions were subsequently presented nationally at the Annual Spring Meeting of the Association of Pediatric Program Directors. Our Fellowship program, overseen by Dr. Paola Palma Sisto, continues to graduate highly trained specialty physicians who are sought after by some of the finest practices in the country. Our fellows have attracted funding for research projects, had numerous presentations accepted at national scientific meetings, and have been recognized through travel grants and awards. Clinically, the Department of Pediatrics and Connecticut Children’s Medical Center continue to lead or participate in a number of national and regional programs. Led by Jeffrey Hyams, MD, the Division of Digestive Diseases, Hepatology and Nutrition is home to the Center for Pediatric Inflammatory Bowel Disease, the largest program in the region between Boston and New York, which currently provides care to over 600 children with Crohn’s disease and ulcerative colitis. The division also continues to be the Clinical Coordinating Center for a $10.4 million grant from the National Institutes of Health to lead the PROTECT Study: Predicting Response to Standardized Pediatric Colitis Therapy. The division also commenced formal collaborative work with Jackson Laboratories to isolate and study intestinal stem cells from children with inflammatory bowel disease. Our colleagues in the burgeoning Division of Hospitalist Medicine, under the exceptional leadership of Anand Sekaran, MD, further standardized best practices via multiple new Clinical Pathways, including both medical and, most recently, surgical diagnoses. For asthma patients, the division has been able to demonstrate reduced length of stay and costs, with no increase in readmissions. Dr. Cynthia Silva, head of the Division of Nephrology, was invited to participate in the prestigious Mid West Pediatric Nephrology Consortium (MWPNC), a multicenter research collaborative aimed at improving knowledge and clinical care for children with renal disorders. Two new multidisciplinary clinics have been added: a chronic renal failure clinic for children with urological malformation; and a clinic for kidney/bladder stones. Connecticut Children’s is the first Nephrology practice in the state to offer such an array of clinics. The Division of Pulmonology welcomed Dr. Jay Kenkare, a certified sleep specialist and member of the American Academy of Sleep Medicine. He led the accreditation of our new 5-bed Pediatric Sleep Laboratory, and has initiated a pediatric sleep clinic at our new multi-specialty medical surgical facility in Farmington. Victor Herson, MD, and the colleagues he supervises as head of the Neonatalogy Division, incorporated the Neonatal Transport Program into Connecticut Children’s Critical Care Transport. They also established the CT Human Milk Research Center under the leadership of Elizabeth Brownell, PhD. The Division of Developmental & Rehabilitation Medicine focused extensive resources on developing the Autism Spectrum Assessment Program (“ASAP”). Under the leadership of Drs. Shailendra Upadhyay and Felice Heller, the CTACH (Connecticut Adult Congenital Heart program) has experienced tremendous growth. Dr. Upadhyay and the members of the division hosted a full day symposium dedicated to the care of adult congenital heart disease patients. At the other end of the age spectrum, our fetal cardiac program, under the leadership of Drs. Alicia Wang and Brooke Davey, partnered with high risk obstetrical services in 3 Chair’s Summary Connecticut to provide advanced imaging for our patients waiting to be born. Our busy Office of Continuing Medical Education accredited a total of 429 hours of instruction to 1,942 individual participants for a total of 24,477 contact hours. Accredited CME offerings include Grand Rounds, regularly scheduled educational series, and Pediatric and Mental Health Lecture series. In all of our endeavors, we are grateful for the support and assistance of the Academic Leadership at the UConn School of Medicine and UConn Storrs, our CEO, Marty Gavin, the Executive Management Team, and the Board of Directors at Connecticut Children’s. I also wish to thank the staff of the Division of Academic Administration. Susan Duckworth led the division for many years with creativity, grace and unfailing good humor. When she retired this year, we welcomed Annamarie Beaulieu, MPH, who previously worked in the Children’s Center for Community Research. Annamarie is off to a great start, and we wish her well in a busy, multi-faceted position. The Department of Pediatrics, the children’s hospital, and I owe an ongoing debt of gratitude to Esperanza Lesmes, Rachel Cunningham, Laurie Papacs, and Theresa George for everything they do to keep things running smoothly. Finally, my sincere thanks goes to Gigi Burke, PhD, who leads the Department of Research at Connecticut Children’s, and her team; Lisa Benson, Director of Grants and Sponsored Programs, and her team; and Justin Radolf, MD, Professor of Medicine and Pediatrics, and Senior Scientific Advisor at Connecticut Children’s, for their combined energy, steadfast support and mentorship of our faculty, and stewardship of our research enterprise. Congratulations to you all for an outstanding year. I look forward to 2015, Sincerely, Juan C Salazar, MD, MPH, FAAP Professor and Chair, Department of Pediatrics Physician-in-Chief, Connecticut Children’s Medical Center 5 Chair’s Summary Dear Colleagues and Friends, It is with great pleasure that we present the sixth annual report from the Department of Pediatric Surgical Subspecialties of Connecticut Children’s Medical Center and the second combined report with the Department of Pediatrics. This report continues to reflect the solid alignment between surgery and pediatrics and the continued multi-disciplinary growth of combined surgical and pediatric programs at Connecticut Children’s Medical Center. Over the last year, the surgical services have continued to experience growth, performing procedures on over 10,000 children with over 1,000 cases performed at our new ambulatory surgery center in Farmington, Connecticut. We continue to aggressively pursue our vision to bring the very best surgical care to the children of the region while simultaneously pursuing our two other core missions: research and education. Some specific highlights from the past year include: • T he first 1,000 ambulatory surgeries were performed at the Connecticut’s Children’s Ambulatory Surgery Center in Farmington. • C onnecticut Children’s Medical Center remains the exclusive site for pediatric surgical subspecialty training for the University of Connecticut School of Medicine surgical residency programs. Annually, dozens of residents from the University of Connecticut and other institutions receive their required pediatric surgical experience at Connecticut Children’s. The Pediatric General Surgery, Pediatric Orthopaedics, and Pediatric Urology programs continue to train the future leaders in surgical subspecialties and have graduated several successful fellows since the last report. We look forward to continued growth of innovative programs and remain focused on providing the highest quality, state-of-the-art care for children of the region. have seen expansion of our full-time faculty through the successful recruitment of some of the “best and brightest” in their respective fields as evidenced by our Neurosurgery recruitment from one of the most prestigious training programs in the nation. Sincerely, I nnovation through research is integral to the mission of the department. We continue to focus efforts on children with solid tumors, premature lung disease, otitis media, injury prevention, and sportsrelated injuries. Several federal grants and inven- Peter J. Deckers MD Endowed Chair of Pediatric Surgery Chief Physician Executive Surgeon-in-Chief Executive Vice President Director, Division of Pediatric Urology Connecticut Children’s Medical Center e •W • tion patents were submitted this year focusing on diagnosis and treatment of these diseases. We also have established research collaborations with Harvard Apparatus working on a new way to engineer esophageal tissue, and the Massachusetts Institute of Technology to improve our ability to diagnose otitis media. Fernando Ferrer, MD, FAAP, FACS 6 The Year’s Highlights HONORS & AWARDS CONFRONTING CHALLENGES Two divisions – Endocrinology and Urology – were named among the best in the nation by the 2014 U.S. News Media Group’s Best Children’s Hospitals rankings. The unprecedented outbreak of Ebola in West Africa, combined with the realities of rapid, global travel, led Connecticut Children’s to enhance its existing disaster preparedness planning to focus on safely detecting, isolating, and treating children with possible Ebola infection. Led by Dr. Andrea Benin, with significant contributions from Dr. Nicholas Bennett and the other members of the Division of Infectious Diseases, the Ebola Taskforce developed clinical pathways, trained over 100 hospital staff members, and remodeled four hospital rooms in the event of having to care for children exposed to or infected with any serious communicable infection. In five short but intense weeks, Connecticut Children’s significantly upgraded its ability to deal with healthcare disasters, including infectious diseases, but with skills and equipment that could be transferred to many other scenarios. Dr. Jeffrey Hyams, head of the Division of Digestive Diseases, Hepatology and Nutrition, was honored as the 2014 Murray Davidson Award recipient. This award is given by the Section on Gastroenterology, Hepatology and Nutrition of the American Academy of Pediatrics and recognizes an outstanding clinician, educator and scientist who has made significant contributions to the field of pediatric gastroenterology and nutrition. The Endocrinology Division’s Diabetes Education Program was reaccredited by the American Association of Diabetes Educators, one of only three programs certified in Connecticut in 2014, and the only one dedicated to the care of children and adolescents with diabetes. 7 The Year’s Highlights In 2014, the Emergency Department of Connecticut Children’s Medical Center treated 56,998 patients, its highest annual volume ever. Although the rate of growth has slowed since 2010, this represents a 30% increase over the last 10 years. The greatest clinical challenge continues to be the increasing number of behavioral/mental health patients. In response to the serious safety issues raised by some of these patients, the Emergency Department underwent a partial redesign and renovation of some physical space. ADVANCES & ACHIEVEMENTS The Division of Digestive Diseases, Hepatology & Nutrition was a leader on both the national and international stages. Its Center for Pediatric Inflammatory Bowel Disease, the largest program in the region between Boston and New York, provided care to over 600 children with Crohn’s disease and ulcerative colitis. The division is the Clinical Coordinating Center for a $10.4 million grant from the National Institutes of Health to lead the PROTECT Study: Predicting Response to Standardized Pediatric Colitis Therapy. The division also commenced formal collaborative work with Jackson Laboratories to isolate and study intestinal stem cells from children with inflammatory bowel disease. The Hospitalist Division further standardized best practice via multiple new clinical pathways, including both medical and, most recently, surgical diagnoses. For asthma patients, the division was able to demonstrate reduced length of stay and costs, with no increase in readmits, and with improvements in preventive care. The department of Radiology saw major replacements and upgrading of imaging equipment. These upgrades support the philosophy of the department as an “Image Gently” and “Step Gently” facility to provide appropriate imaging while reducing the effects of ionizing radiation as much as possible. Video goggles were provided by a donor through the Foundation. They can be worn by a child in the MR unit who can watch a movie while having a lengthy imaging procedure with less dependence on sedation. The Pediatric Cardiothoracic Surgery service, a merged practice including Connecticut Children’s Medical Center and Yale-New Haven Children’s Hospital, now submits data to the Society of Thoracic Surgeons (STS) Congenital Cardiac Surgery Database, which is the largest clinical database for our specialty in the world. The STS Database includes more than 94% of the Congenital Cardiac Surgery programs in North America and serves as an excellent benchmark for our outcomes, which remain significantly better than the national average. NEW SERVICES Dr. Jay Kenkare joined the Division of Pulmonology this year, coming to Connecticut Children’s from Gaylord Sleep Medicine. A certified sleep specialist and member of the American Academy of Sleep Medicine, Dr. Kenkare led the accreditation of the medical center’s new 5-bed Pediatric Sleep Laboratory, with an accompanying increase in sleep studies from 350 to over 800 per year. Dr. Kenkare also initiated a pediatric sleep clinic for the evaluation and treatment of children with respiratory and non-respiratory sleep problems. The Division of Neonatology incorporated the Neonatal Transport Program into Connecticut Children’s Critical Care Transport, and the new program completed its first full year of operations, transporting over 300 newborns throughout the region and state. The Division of Pediatric General & Thoracic Surgery performed the first two gastric sleeves for the treatment of adolescent obesity. This procedure is used for those adolescents with severe obesity, and will complement the laparoscopic band procedure for obesity treatment. The Division of General Surgery spearheaded Connecticut Children’s continued involvement in the American College of Surgeons’ Pediatric National Surgical Quality Improvement Program (NSQIP), which is the first multispecialty program designed to measure and improve the quality of children’s surgical care. The Division of Developmental & Rehabilitation Medicine focused extensive resources on developing the Autism Spectrum Assessment Program (“ASAP”). The surgical services of the Division of Gynecology expanded to include daVinci robotically-assisted minimallyinvasive gynecologic procedures for selected patients at Connecticut Children’s. 8 The Year’s Highlights The Division of Neurosurgery’s collaboration with the Jackson Laboratory Avatar program was successful at animal modeling of several malignant and rare brain tumors, providing an extraordinary study of tumor genomics and chemotherapy response. The division of Nephrology added two new multidisci- plinary clinics: a chronic renal failure clinic for children with urological malformation as well as a clinic for kidney/bladder stones. It is the first Nephrology section in the state to offer such an array of clinics. Pediatric General & Thoracic Surgery instituted rapid access to its clinics with same-day appointments for urgent conditions. 9 Academic Administration After eight years of successful and exemplary leadership, Susan Duckworth retired in May from her role as Director of Academic Administration, and Administrator, Department of Pediatrics. During her tenure, Connecticut Children’s faculty and staff benefited greatly from Susan’s wisdom, dedication and patience. Annamarie Beaulieu, MPH, moved to the Office of Academic Administration from Connecticut Children’s Center for Community Research in May to take on the role of Director and Administrator. As an academic teaching hospital, Connecticut Children’s strives to encourage, support, and recognize the academic activities of its faculty, and support the highest quality Medical Education and Pediatric Fellowship programs. With faculty based at multiple institutions, administration of the Department of Pediatrics, staffed at the University of Connecticut Health Center by Laurie Papacs, Administrative Officer, and Theresa George, Administrative Fiscal Assistant, is comprised of centrally managed academic functions and decentralized business and research management functions. The Office of Academic Administration, in cooperation with the Chair’s Office, staffed at Connecticut Children’s Medical Center, manages academic appointment, promotion, and development activities, merit tracking for both in-residence and affiliated faculty, academic faculty contracts, produces the combined Department of Pediatrics & Pediatric Surgical Specialties Annual Report and the Faculty Resource Guide. The office is staffed by Esperanza Lesmes, Academic Operations Program Manager; with assistance from Deborah Hornblow, per diem editor, and Brian Lesmes, per diem intern, and includes the following areas: Continuing Medical Education (CME): The Office of Continuing Medical Education, supported by Deirdre Palmer, Diane Mouradjian, and Kenneth Spiegelman, MD, accredited a total of 429 hours of instruction to 1,942 individual participants for a total of 24,477 contact hours. Accredited CME offerings include Grand Rounds, and Pediatric, and Mental Health Lecture series. 10 Academic Administration Fellowships: Fellowship coordinators Kathleen Mikulak (who left the department in October), Jack Wakefield and Marianne Gonzalez, supported nine pediatric subspecialty fellowships and 20 fellows. In 2014, the pediatric fellowship programs graduated eight fellows and successfully filled seven of 10 available fellowship positions. In preparation for the 2015 year, coordinators effectively supported recruitment of 148 applicant interviews over 53 days throughout the year. Maintenance of Certification: Eminet Abebe Gurganus, Maintenance of Certification (MOC) Program Manager, collaborated with faculty and community partners to develop four new MOC activities for a total of 12 (five internal and seven community-focused) MOC activities that promote quality improvement efforts within the hospital and serve as a bridge to the community to disseminate the hospital’s excellent quality improvement work to community practitioners. A generous gift from United Healthcare in 2013 enabled the office to begin development of a comprehensive database in support of its MOC activities. Medical Photography: Connecticut Children’s medical photographer, Michael McCarter, supports patient care, research, legal documentation, continuing medical education and public relations efforts with high quality photographic images that enhance our website, publications, research articles and medical records. STAFF Susan Duckworth Director, Academic Administration (retired, May 2014) Annamarie Beaulieu, MPH Director, Academic Administration Laurie Papacs Administrative Officer, Department of Pediatrics University of Connecticut School of Medicine Theresa George Administrative Fiscal Assistant, Department of Pediatrics University of Connecticut School of Medicine Esperanza Lesmes Academic Operations Manager Connecticut Children’s Medical Center Diane Mouradjian Continuing Medical Education Coordinator Deirdre Palmer Continuing Medical Education Coordinator Kathy Mikulak Fellowship Coordinator Marianne Gonzalez Fellowship Coordinator Jack Wakefield Fellowship Coordinator Eminet Gurganus Maintenance of Certification Manager Michael McCarter Medical Photographer 11 Adolescent Medicine During 2014, the Division of Adolescent Medicine transitioned from having a long-term Division Director and offering services and clinical education delivered primarily at St. Francis Hospital to having an Interim Division Director and offering services and clinical education delivered primarily at the Primary Care Center of Connecticut Children’s Medical Center and other community sites. The missions of the Division of Adolescent Medicine are to provide comprehensive healthcare to adolescents between the ages of 13 and 24, to educate health and mental health providers regarding the needs of adolescents, to promote adolescent health in the community, and to advance adolescent health through clinical research. The clinical services provided by the division include the following: • Adolescent Medicine primary care and consultative health • services at the Primary Care Center of Connecticut Children’s Medical Center Detention Health Services: General adolescent health services are provided at three facilities: Broad Street Detention Center, an 88-bed locked facility for both males and females; Washington Street Secure Community Residential Program, an 18-bed locked facility for females; and Grace House, an 8-bed unlocked facility for females Clinical services rendered by our clinical partners while mentoring the pediatric residents on their Adolescent Medicine electives include the following sites: Hartford Job Corps Center: providing primary care health services to adolescents and young adults, under the direction of Medical Director Paul Clarke, MD Westminster School, Simsbury, CT: providing primary care health services to adolescents, under the direction of Medical Director Davis Smith, MD Student Health Services at University of Connecticut, Sports Injury Clinic: under the direction of Director of Medical Services Jeffrey Anderson, MD, FACSM Women’s Ambulatory Health Services, Family Planning and Teen Clinic: under the direction of Amy Nelson, MD • • • • The division offers an Adolescent Medicine Selective, a onemonth ambulatory experience for all second-year pediatric residents. An advanced adolescent medicine elective is tailored to the needs of third-year pediatric residents by request. STAFF Nancy H. Miller, MD Interim Division Director Jeffrey Anderson, MD, FACSM Sudeshna Basu, MD Paul Clarke, MD Amy Nelson, MD Grael O’Brien, MD Davis Smith, MD Elaine Yordan, MD 12 Anesthesiology Drs. Michael Archambault and Carole Lin received subspecialty certification in Pediatric Anesthesiology awarded by the American Board of Anesthesiology this past year. This brings the total to 11 members in the division with subspecialty certification. STAFF The year 2014 was another busy one for the division. We performed over 1,000 surgical procedures at the newly opened Connecticut Children’s Ambulatory Surgery Center in Farmington. We have provided anesthesia services for all surgical subspecialties including cardiac and neurosurgery. We also provide services for radiologic procedures including MRI, MRA CT scans and interventional procedures. For pediatric patients requiring services at Hartford Hospital, we provide anesthesia for nuclear medicine, cardiac MRA and radiation oncology. Dr. Rutkowski and his regional anesthesia team provide support for our sports medicine program both at the main campus and in Farmington. Dr. Archambault is continuing his collaboration with Dr. Kavanaugh in the Division of Otolaryngology to provide simulation-based training for residents in both divisions as well as Operating Room staff. Dr. Biello is working with Dr. Hyams in Gastroenterology on a research project to define optimal doses of propofol in pediatric patients during upper endoscopy. The Divisions of Otolaryngology and Anesthesiology are now participating in a monthly joint airway conference where the most challenging cases are discussed. Dr. Garrison is working on a project looking at acupuncture and its benefit in surgical patients. Dr. McIsaac continues his work on medical devices for austere environments including a surgical cooling vest, chemical protective garments, and a field-deployable fluid generation device. He also serves on the American Society of Anesthesiologists Committee on Trauma and Emergency Preparedness and is the Task force Chair. Dr. Rossetti has been working with Operation Smile and has completed mission trips to Honduras and Malawi this past year. Dr. Kuntz once again has donated his time for trips to Central America. Dr. Mark Indelicato received his MSc in Management and Health Care Administration. Christina Biello, DO Craig Bonanni, MD, FAAP Division Director Michael Archambault, MD Jessica Bland, MD Amy Bouchard, DO, FAAP Marrian Clubb, MD Edward Cortland, MD, FAAP Deanne Daggett, MD John Garrison, MD Mark Indelicato, MD, FAAP Gregory Kernisan, MD Richard Kuntz, MD Carole Lin, MD Anil Mathew, MD, FAAP Joseph McIssac, MD, MS Gerald Piserchia, MD Valerie Rossetti, MD, MPH Gregory Rutkowski, MD Tracy Kunkel, APRN Stephania Kushnir, APRN 13 Cardiology The Division of Pediatric Cardiology at Connecticut Children’s Medical Center continues to serve as a resource for physicians and a source of medical and surgical care for children and adults with all types of cardiac issues. The Division of Pediatric Cardiology works collaboratively with primary care physicians, practitioners, family practitioners and adult-oriented physicians to provide state-of-theart care for all pediatric and adult patients with congenital heart defects and heart rhythm abnormalities. Pediatric Cardiology at Connecticut Children’s continues to evolve. While strengthening our commitment to sub-specialization and research, we are simultaneously growing our community commitments in order to provide cardiology care to the children of Connecticut and the surrounding region. Connecticut Children’s has become a leader in the care of adults with congenital heart disease. Under the leadership of Drs. Shailendra Upadhyay and Felice Heller, the CTACH (Connecticut Adult Congenital Heart program) has experienced tremendous growth. We have continued to reach out and engage our adult care providers and adult hospitals to partner in the care of these patients in an effort to maximize positive outcomes for these patients. Dr. Upadhyay and the members of the division hosted a full day symposium dedicated to the care of adult congenital heart disease patients. We plan to make this an annual event. At the other end of the age spectrum, we also have grown tremendously with our fetal cardiac program. Under the leadership of Drs. Alicia Wang and Brooke Davey, we have partnered with the Obstetrical community and the high risk Obstetrical services in Connecticut to provide advanced imaging for our patients waiting to be born. The care of these high risk children is coordinated with Obstetrics, Neonatology, Cardiology, and Cardiac Surgery services in order to maximize the outcome for these fragile patients. Dr. Davey continues her research on the stress responses of pregnant women with a child diagnosed with a congenital heart defect. Echocardiography and advanced imaging is one of the foundations of pediatric cardiology. The division has continued its excellence in echocardiography and has expanded into 3-dimensional imaging and other forms of advanced imaging. This improved imaging will better demonstrate the unique anatomy of each abnormality and improve the outcome of our patients undergoing open heart surgery and trans-catheter procedures to correct their congenital heart defects. We anticipate that the echocardiography services at Connecticut Children’s will soon become nationally certified by the ICAEL, the certifying agency for echocardiography labs. Our Cardiac MRI program has grown exponentially since its inception, and continues to grow with the increased need for anatomic and physiologic imaging. Due to size and ultrasound imaging limitations, cardiac MRI has become increasingly utilized for our adult patients. We anticipate further growth in Cardiac MRI and other imaging modalities and look forward to further recruitment to help support these initiatives. In contrast to previous eras of cardiology and cardiac surgery care, many patients do not need invasive studies including radiation and only need noninvasive imaging such as echo and MRI prior to their surgery. Under the leadership of Dr. Olga Salazar, the MRI program is a focus of research in pediatric cardiology and collaborative research between pediatric cardiology and pediatric hematology/oncology. Even as we have been growing in our sub-specialization, we have grown our outreach services and look to further expand our presence throughout Connecticut, partnering with community physicians and practitioners. We believe that many cardiology patients can be cared for locally without ever having to make a trip to Connecticut Children’s Medical Center. Therefore, at Connecticut Children’s facilities in Hartford, we have focused on the care of the complex pediatric and adult patients with congenital heart disease in order to maintain and improve the health of these patients. PUBLICATIONS Davey B, Donofrio M, Moon-Grady A, Fifer C, Cuneo B, Falkensammer C, Szwast A, Rychik J. Development and validation of a fetal cardiovascular disease severity scale. Pediatr Cardiol. 2014 Oct;35(7):1174-80. Epub 2014 May 7. 14 Cardiology FACULTY Derek Obayashi, MD Harris Leopold, MD, Division Chief Olga Toro-Salazar, MD Frederic Bernstein, DO Brooke Davey, MD Felice Heller, MD Seth Lapuk, MD Shailendra Upadhyay, MD Alicia Wang, MD Amy Carlucci Wu, MD Leon Chameides, MD Professor Emeritus 15 Cardiothoracic Surgery The Pediatric Cardiothoracic Surgery service represents a merged practice including Connecticut Children’s Medical Center and Yale-New Haven Children’s Hospital. This joint program provides world-class surgical care to the children and adults of Connecticut born with congenital heart disease. Both programs now submit data to the Society of Thoracic Surgeons (STS) Congenital Cardiac Surgery Database, which is the largest clinical database for our specialty in the world. The STS Database includes more than 94% of the Congenital Cardiac Surgery programs in North America and serves as an excellent benchmark for our outcomes, which remain significantly better than the national average. Our results will now be included in the STS Public Reporting initiative and will be available on both the STS and the Consumer Reports websites when this program is rolled out later this year. The section of Pediatric Cardiothoracic Surgery remains committed to providing cutting-edge care for the congenital heart disease patients in our region. Dr. Mohsen Karimi continues to make strides with the blood conservation program, allowing us to perform transfusion-free open-heart surgery for many of our patients while limiting transfusions for everyone. PUBLICATIONS Poynter JA, Bondarenko I, Austin EH, DeCampli WM, Jacobs JP, Ziemer G, Kirshbom PM, Tchervenkov CI, Karamlou T, Blackstone EH, Walters HL 3rd, Gaynor JW, Mery CM, Pearl JM, Brothers JA, Caldarone CA, Williams WG, Jacobs ML, Mavroudis C; Congenital Heart Surgeons’ Society AAOCA Working Group. Repair of anomalous aortic origin of a coronary artery in 113 patients: a Congenital Heart Surgeons’ Society report. World J Pediatr Congenit Heart Surg. 2014 Oct;5(4):507-14. Kanter KR, Kirshbom PM, Kogon BE. Surgical repair of pulmonary venous stenosis: a word of caution. Ann Thorac Surg. 2014 Nov;98(5):1687-91; discussion 1691-2. Kirshbom PM. Percutaneous device occlusion and minimally invasive surgical repair for perimembranous ventricular septal defect. [invited commentary] Ann Thorac Surg. 2014 Apr;97(4):1406. STAFF Paul Kirschbom, MD Division Chief Mohsen Karimi, MD 16 Child & Adolescent Psychiatry The Division of Child and Adolescent Psychiatry remains a highly vibrant resource within the Department of Pediatrics at the Connecticut Children’s Medical Center. Its tripartite mission is: providing the highest quality of mental health care for children/adolescents and their families in the Greater Hartford area, providing the highest quality of mental health education to trainees and community providers, and expanding the research base within the field of Child and Adolescent Psychiatry and Psychology. At Connecticut Children’s, the division’s services include: a consultation/liaison service that provides inpatient and outpatient evaluation and treatment services of children and adolescents with co-morbid psychiatric and medical conditions; emergency psychiatric assessment, triage and disposition services within the Connecticut Children’s Emergency Department; and psychological services including assessment and psychotherapy, through the Divisions of GI, Endocrinology, Obesity and Weight Management, Hematology/Oncology, and Pain/Rehabilitation. At the Institute of Living, (IOL), clinical services include: individual, group, and family therapies; pharmacotherapy; and diagnostic evaluations. These services are provided through: inpatient units for children and adolescents; the Child and Adolescent Rapid Emergency Services (C.A.R.E.S) unit, a very short-term setting interfacing directly with Connecticut Children’s Emergency Department that focuses on the assessment, stabilization, and disposition of children and adolescents in acute behavioral crisis; the Grace Webb School, a therapeutic educational setting for children and adolescents with co-existing psychiatric and learning difficulties; an outpatient child and adolescent clinic; an Extended Day Treatment Program (TOPS), for older school-aged children; a partial hospital program for children and adolescents; and an Autism Consultation Service. We have become one of the hubs for the new ACCESS-Mental Health CT program, a collaborative educational, consultation and assessment program between primary care providers and child and adolescent psychiatrists. We have continued a descriptive study of our Eating Disorder protocol while also implementing a somatic symptom disorder clinical pathway. Connecticut Children’s and the Institute of Living remain highly active teaching sites for many trainees: Child and Adolescent Psychiatry fellows; General Psychiatry residents; Psychology fellows; Pediatric residents and medical students. PUBLICATIONS Guite JW, Kim S, Chen C-P, Sherker JL, Sherry DD, Rose JB, Hwang W-T. Pain beliefs and readiness to change among adolescents with chronic musculoskeletal pain and their parents before an initial pain clinic evaluation. Clin J Pain. 2014;30(1):27-35. PMCID: PMCPMC 3742695. Guite JW, Kim S, Chen C-P, Sherker JL, Sherry DD, Rose JB, Hwang W-T. Treatment expectations among adolescents with chronic musculoskeletal pain and their parents prior to an initial pain clinic evaluation. Clin J Pain. 2014;30(1):17-26. PMCID: PMCPMC 3742613. Malik S, Caley CF, Azeem MW. Psychopharmacogenomics – a new tool for the prescribing physician. J Pakistan Psychiatric Society. 2014 Jul-Dec; 11(2):12-15. Goyal R, Arroyave A, Malik S. Urticaria and angioedema secondary to methylphenidate exposure in a young child. J Child Adoles Psychopharmacol. 2014;24:1-3. Haney-Caron E, Caprihan A, Stevens MC. DTI-measured white matter abnormalities in adolescents with Conduct Disorder. J Psychiatr Res. 2014 Jan;48(1):111-20. PubMed PMID: 24139595; PubMed Central PMCID: PMC3863548. Dager AD, Jamadar S, Stevens MC, Rosen R, JiantonioKelly RE, Sisante JF, Raskin SA, Tennen H, Austad CS, Wood RM, Fallahi CR, Pearlson GD. fMRI response during figural memory task performance in college drinkers. Psychopharmacology (Berl). 2014 Jan;231(1):167-79. PubMed PMID: 23949205; PubMed Central PMCID: PMC3877735. Tolin DF, Witt ST, Stevens MC. Hoarding disorder and obsessive-compulsive disorder show different patterns of neural activity during response inhibition. Psychiatry Res. 2014 Feb 28;221(2):142-8. PubMed PMID: 24389161; PubMed Central PMCID: PMC3946244. Castelluccio BC, Meda SA, Muska CE, Stevens MC, Pearlson GD. Error processing in current and former cocaine users. Brain Imaging Behav. 2014 Mar;8(1):87-96. PubMed PMID: 23949893; PubMed Central PMCID: PMC3925762. Tyson K, Kelley E, Fein D, Orinstein A, Troyb E, Barton M, Eigsti IM, Naigles L, Schultz RT, Stevens MC, Helt M, Rosenthal M. Language and verbal memory in individuals with a his- 17 Child & Adolescent Psychiatry tory of autism spectrum disorders who have achieved optimal outcomes. J Autism Dev Disord. 2014 Mar;44(3):64863. PubMed PMID: 23982487; PubMed Central PMCID: PMC3948218. STAFF Rosenfeld ES, Pearlson GD, Sweeney JA, Tamminga CA, Keshavan MS, Nonterah C, Stevens MC. Prolonged hemodynamic response during incidental facial emotion processing in inter-episode bipolar I disorder. Brain Imaging Behav. 2014 Mar;8(1):73-86. PubMed PMID: 23975275; PubMed Central PMCID: PMC3944373. J. Craig Allen, MD Kenneth Robson, MD Michal Assaf, MD Carlos Salguero, MD Sudeshna Basu, MD Rosemary Coratola, PsyD, LMFT Troyb E, Orinstein A, Tyson K, Helt M, Eigsti IM, Stevens MC, Fein D. Academic abilities in children and adolescents with a history of autism spectrum disorders who have achieved optimal outcomes. Autism. 2014 Apr;18(3):233-43. PubMed PMID: 24096312. Eric D. Cohen, MD Balodis IM, Grilo CM, Kober H, Worhunsky PD, White MA, Stevens MC, Pearlson GD, Potenza MN. A pilot study linking reduced fronto-Striatal recruitment during reward processing to persistent bingeing following treatment for binge-eating disorder. Int J Eat Disord. 2014 May;47(4):376-84. PubMed PMID: 24729034; PubMed Central PMCID: PMC3986812. Orinstein AJ, Stevens MC. Brain activity in predominantly-inattentive subtype attention-deficit/hyperactivity disorder during an auditory oddball attention task. Psychiatry Res. 2014 Aug 30;223(2):121-8. PubMed PMID: 24953999; PubMed Central PMCID: PMC4120259. Narayanan B, O’Neil K, Berwise C, Stevens MC, Calhoun VD, Clementz BA, Tamminga CA, Sweeney JA, Keshavan MS, Pearlson GD. Resting state electroencephalogram oscillatory abnormalities in schizophrenia and psychotic bipolar patients and their relatives from the bipolar and schizophrenia network on intermediate phenotypes study. Biol Psychiatry. 2014 Sep 15;76(6):456-65. PubMed PMID: 24439302. Robert Sahl, MD Division Head Kim Brownell, MD Julie Goslee, MD Mirela Loftus, MD Daane Logsdon, DO Salma Malik, MD Lynn Mangini, MD Lisa Namerow, MD Jonathan Raub, MD Francisco Ripepi, MD Jessica Guite, PhD Mary Gratton, PhD, LCSW Robert Katz, JD Barbara Rzepski, PhD Melissa Santos, PhD Michael Stevens, PhD Kevin Tsang, PsyD Suzanne Femino, APRN 18 Children’s Center for Community Research (C3R) In 2014, the Children’s Center for Community Research welcomed Administrative Assistant Magdalena Owczarska and Research Associate Kaitlin Flannery to the team. The Children’s Center for Community Research (C3R) is dedicated to improving the health and well-being of children and their families by conducting communitybased collaborative research and programs. C3R works to encourage, facilitate, and provide a mechanism for program dissemination and outcomes assessment of clinical, behavioral and translational research. This research is conducted by investigators with and in community settings including schools, homes, community organizations, hospitals and ambulatory practice settings. Within C3R, research is conducted in three broad areas: Adolescent health, childhood asthma, and childhood obesity. ADOLESCENT HEALTH During the spring of 2014, C3R administered follow-up surveys to 258 Adolescent Adjustment Project (AAP) participants. All of the participants previously were surveyed throughout their high school years and are now in their early 20’s. In the fall of 2014, C3R also administered surveys to a nationwide sample of 600 18-22 year-old youth. Data from these surveys will be used to examine risk and protective factors involved in the development of psychological problems and substance use. During 2014, Dr. Ohannessian collaborated as a Co-investigator with Dr. Yifrah Kaminer from the Psychiatry Department at UConn Health on two NIH-funded projects focusing on treatments for adolescent substance use disorders. Dr. Ohannessian also served as a guest editor of a special issue of the Journal of Youth Development focusing on media use in youth. Finally, an article published in Parenting: Science and Practice, authored by Drs. Ohannessian and De Los Reyes, “Discrepancies in adolescents’ and their mothers’ perceptions of the family and adolescent anxiety symptomatology,” was included in an online collection featuring the most downloaded articles published in Routledge Behavioral Sciences journals in 2014. CHILDHOOD ASTHMA This past year has been a busy time for C3R’s Asthma Center, which entered its third year of collaboration with Hartford Public Schools to pilot the Building Bridges school-based asthma program. Between the 2013-14 and 2014-15 school year, the program expanded from 3 to 10 Hartford elementary schools and has been wellreceived by the community. Funded by the GlaxoSmithKline Foundation and in collaboration with Denver Public Schools and Children’s Hospital of Colorado, the program aims to improve academic performance by decreasing school absences through improved asthma control in inner-city students. During 2014, preliminary data demonstrated that enrollment in the program for one year resulted in an 11.8% decrease in school absences. In 2014, the Easy Breathing© program celebrated 16 years. Easy Breathing© has served over 135,000 children in Connecticut, of whom more than 35,000 have been diagnosed with asthma. In early 2014, Akron Children’s Hospital was trained in the program and began implementing it within the primary care community. Currently, Easy Breathing© is active in 5 states – Ohio, Kansas, Kentucky, Florida, and Vermont. The Easy Breathing© program also initiated a collaboration with a start-up incubator called CoHero. CoHero has developed a metered dose inhaler with a sensor that links to a smartphone app. We currently are working with CoHero to assess the need or desire in the primary care community for this type of technology and are asking pediatricians how they could use this information to better serve their patients. CHILDHOOD OBESITY C3R’s Early Childhood Obesity (ECHO) Prevention Program, funded by NICHD, recruited 58 mother/infant dyads between 6 participating NFN sites in Hartford under the assistance of James Wiley, the program coordinator. The first mother/infant dyad completed the 12-month intervention in December 2014. The Hartford Childhood Wellness Alliance underwent a 360 degree review this past year and created a strategic plan for the next 3 years. More than 35 Alliance partners participated in the strategic planning retreat and the 4 workgroups that were created. The strategic plan was approved by the Alliance at a special meeting in December 2014. Jacqueline Ortiz-Miller, CHW, has been recruited to serve as the new Coordinator of the Hartford Childhood Wellness Alliance. Steps to Growing Up Healthy for childcare centers 19 Children’s Center for Community Research (C3R) wrapped up in December 2014. A training manual for child care center staff has been created and will be rolled out to staff in the spring of 2015. This past year, C3R continued to expand its collaborations with multiple external partners including the University of Connecticut at Storrs, UConn Health, the University of Delaware, the University of Maryland, Pennsylvania State University, the University of New Orleans, Rutgers University, the University of Colorado, Utrecht University in the Netherlands, Nationwide Children’s Hospital, the State of Connecticut Department of Public Health, the City of Hartford Department of Health and Human Services, the Hartford Foundation for Public Giving, and the Community Health Network of CT. PUBLICATIONS Gorin AA, Wiley J, Ohannessian C, Hernandez D, Grant A, Cloutier MM. Steps to Growing Up Healthy: A pediatric primary care based obesity prevention program for young children. BMC Public Health. 2014;14:72-82. Hollenbach JP, Cloutier MM. Implementing school asthma programs: lessons learned and recommendations. J Allergy Clin Immunol. 2014 Dec;134(6):1245-9. Ohannessian CM, Boyd M, Kirsh S, editors. Media and youth development: an overview of issues, theory and research. Special issue. J Youth Dev. 2014;9(1). Rosas-Salazar C, Forno E, Brehm JM, Han Y-Y, AcostaPerez, E, Cloutier MM, et al. Breastfeeding duration and asthma in Puerto Rican children. Pediatr Pulmonol. 2014 Aug 6. Schifano ED, Hollenbach JP, Cloutier MM. Mismatch between asthma symptoms and spirometry - implications for managing asthma in children. J Pediatr. 2014 Nov;165(5):997-1002. Wiley JF, Cloutier MM, Wakefield DB, Hernandez DB, Grant A, Beaulieu A, Gorin AA. Acculturation determines BMI percentile and noncore food intake in Hispanic children. J Nutrition. 144(3):305-10, 2014. STAFF Christine Ohannessian, PhD Director, C3R Michelle Cloutier, MD Director, Asthma Center Jessica Hollenbach, PhD Magdalena Owczarska Autherene Grant Kaitlin Flannery Christine Langton Ohannessian CM. Anxiety and substance use during adolescence. Subst Abuse. 2014;35(4):418-25. Carol Vinick Ohannessian CM, Boyd M, Kirsh S. Media and youth development: an overview of issues, theory, and research. J Youth Dev. 2014;9(1):6-13. Jacqueline Miller-Ortiz Ohannessian CM. A longitudinal examination of the relationship between media use and self-competence during adolescence. J Youth Dev. 2014;9(1):143-156. Ohannessian CM, De Los Reyes A. Discrepancies in adolescents’ and their mothers’ perceptions of the family and adolescent anxiety symptomatology. Parent Sci Pract. 2014;14(1):1-18. James Wiley 20 Community Pediatrics The Division of Community Pediatrics is the largest division at Connecticut Children’s Medical Center. There are 21 active, 20 courtesy, and 90 refer-and-follow members. The division is concerned with issues regarding the advocacy and delivery of healthcare to children in community-based settings and institutions such as office-based practice, well-baby nurseries, community health centers, schools, camps, fostercare adoptive services, etc. Our members provide primary pediatric care to most children from the Greater Hartford area. Members see to well care, sick care, and behavioral health needs of children. Member pediatricians diagnose most chronic diseases of children in our area. Our members work closely with specialists in other divisions to coordinate care for the sickest children in the community. Pediatricians in the division consult with local school systems to address public health and sports medicine issues. Our members serve on a variety of hospital committees, and they provide neonatal care at John Dempsey Hospital, Hartford Hospital, Manchester Memorial Hospital, and Saint Francis Hospital. Members are interviewed by public media including radio, television and newspapers on a wide variety of pediatric and public health care issues of local and national interest, including childhood obesity, school safety and bullying, vaccine advocacy, and changes to guidelines for cold and cough care for young children. tive, to help coordinate care for children with special health care needs; and the creation of collaborative practice models/comanagement guidelines, including migraine headaches, Lyme disease, voiding dysfunctions, premature adrenarche, and concussions. Members are actively involved in ongoing education through Grand Rounds and evening lecture series in pediatrics and child mental health, to promote topics of interest to the community physicians as well as nurse practitioners, physician assistants and school nurses who care for children in the community setting. The division sponsors a lectureship in honor of Christopher O’Connor, MD, that addresses topics of concern to communitybased pediatrics. PUBLICATIONS Feyissa E, Cornell E, Chandhok L, Wang D, Ionita C, Schwab J, Kostyun R, Wilion F, Rubin K. Impact of co-management at the primary-subspecialty care interface on follow-up and referral patterns for patients with concussion. Clin Pediatr. 2015. doi: 10.1177/0009922814566929. STAFF Douglas MacGilpin, MD co-Division Head Division members provide instruction and supervision for student and resident continuity practices as well as the pediatric ambulatory rotation for third year students. In addition to providing rich and varied clinical experiences, members educate students and residents about external issues that influence child health care, such as delivery care models, working with consultants and other professionals to address health care plans for children, coding and other business practicalities in community pediatrics, and time and personal health management. We seek to identify innovative practice styles in health care delivery and opportunities to improve patient education and health outcomes. Larry Scherzer, MD co-Division Head Members engage in many collaborative programs within broader department- and state-based initiatives to provide better care for children. These include the Easy Breathing© Program, which has led to improved health practices and better outcomes for children with asthma; the Medical Home initia- Thomas B. Binder, MD Robert S. Adamenko, MD Luis Alonso, MD Brenda K. Balch, MD Meredith W. Barrows, MD Amy H. Baumer, MD Lucia C. Benzoni, MD Nancy B. Brown, MD David L. Brown, MD 21 Community Pediatrics William Brownstein, MD Brad Jubelirer, MD Chitraleka Ramanan, MD Leon Chameides, MD Professor Emeritus Anjum Khera, MD Cynthia C. Roque, MD Natalie Komaiszko, MD Viviann Rubin, MD Gubbanna S. Kumar, MD Kweku G. Sam, MD Sydney Ladenheim, MD Jennifer Schwab, MD Jerome Lahman, MD Gavin Schwarz, MD Christine Lamoureux, MD John F. Siraco, MD John H. Lavalette, MD Candra L. Smith-Slatas, MD Carol Leicher, MD Daniel L. Spada, MD Deepa Limaye, MD Kenneth N. Spiegelman, MD Foong-Yi Lin, MD Prasad Srinivasan MD Stephen J. Maddox, Jr., MD Martha Sternberg, MD Asha Manaktala, MD Carrie S. Streim, MD Kathleen A. Marinelli, MD Charles Thompson, MD Linda Mathew, MD Robert R. Toscano, MD John Mathews, MD Kerline A. Vassell, MD Bruce McDonald, MD Christopher Veale, MD Louis M. Mendelson, MD Rachna Walia, MD Judith C. Meyers, PhD Ramindra Walia, MD Debora Mihaley-Sobelman, MD Matthew Warren, MD Donald Mordavsky, MD Harry C. Weinerman, MD Sylvia Nash, MD Allison Whitaker, MD Margaret O’Neill, MD Felicia M. Wilion, MD James O’Connor, MD Richard S.K. Young, MD Kathy Pae, MD Robert W. Zavoski, MD Hemant K. Panchal, MD Sophia Zervas-Grant, MD Elizabeth T. Pericat, MD Barbara Ziogas, MD Carolyn Clark, MD Paul Clarke, MD Della M. Corcoran, MD Allison S. Cowl, MD J. Michael Curi, MD Sachin Dhingra, MD Louis DiMauro, MD Leo J. DiStefano, MD Allyson Duffy, MD Nancy S. Dunbar, MD, MPH Jeffrey M. Factor, MD Parvin Fadakar, MD John J. Fote, MD Cecille Freilich, MD Thomas Fromson, MD Richard W. Geller, MD Gregory S. Germain, MD Susan Glasser, MD Dyan Griffin, MD Marshall P. Grodofsky, MD Richard C. Harvey, Jr., MD Hillary S. Hernandez-Trujillo, MD Elizabeth Herz, MD Delbert H. Hodder, MD Peter J. Jannuzzi, MD Ishrat Quadri, MD 22 Pediatric Critical Care The Division of Pediatric Critical Care is dedicated to the delivery of state-of-the-art child and family centered care for critically ill and injured children. The division’s mission is accomplished by a collaborative group that champions a multidisciplinary approach to care, the incorporation of best available evidence into clinical practice, and acquisition of new knowledge through clinical research. Attention to patient safety, continuous performance improvement, and education of physicians, nurses, and other care team members is paramount. Major awards and academic accomplishments among the division members include important contributions to several national societies and both internal and external collaborations: Dr. Christopher Carroll continues to be active in clinical and translational research, collaborating with investigators at Connecticut Children’s, at Jackson Laboratories, and internationally. He continues in leadership roles in major medical organizations including: Associate Editor of two journals: Chest and Journal of Asthma Serves as Chair of the Pediatric Network, Chair of the Scientific Presentation and Awards Committee, Executive Committee of the Council of NetWorks, Member of the Board of Trustees for the CHEST Foundation and Social Media Editor of the American College of Chest Physicians Appointment to the Program and the Planning Committee of the American Thoracic Society Appointment to the Multidisciplinary Critical Care Knowl edge Assessment Program Committee and to the LearnICU Committee of the Society of Critical Care Medicine • • to children, educate Haitian health care personnel, and perform clinical research. He holds monthly videoconferences concerning the care of neonates with residents and staff at Justinien University Hospital in Cap-Haitian, Haiti. He also continues to serve as the Membership Chairperson for the American Academy of Pediatrics Section on International Child Health, and as the SOICHPix Coordinator at the National Conference and Exposition. Dr. Heather Schlott continues activities in the American College of Chest Physicians Pediatric Chest Medicine Network Steering Committee. She also has been the division leader of our extracorporeal membrane oxygenation (ECMO) program, in partnership with Pediatric Surgery and Neonatology physician colleagues, as well as nursing, respiratory therapy, and perfusion team members. This technology provides state-ofthe-art heart and lung support for our most critically ill and injured patients. The program has grown and been extremely successful, with outcomes that exceed national benchmarks. She also led the development and implementation of our continuous renal replacement therapy (CRRT) program, which has grown with excellent clinical results. These capabilities are key components of modern PICU care and specifically crucial to the expansion of our Cardiac Surgery program. • • In further regard to the Cardiac Surgery program, Dr. Kenneth Banasiak has taken a lead role in clinical, educational, and performance improvement aspects of the multidisciplinary process in collaboration with our Cardiology and Cardiac Surgery colleagues. They are implementing clinical pathways that will standardize and streamline the care of post-operative patients. He is also creating a new Critical Care Physiology course for pediatric residents. Dr. Adam Silverman continues his leadership of our Global Healthcare Initiative. The second annual Global Healthcare Fair was held in May of 2014, and the first annual Global Healthcare Film Festival was held in November of 2014. Locally, he continues to support the Global Healthcare Educational Pathway for pediatric residents and organizes the activities of Connecticut Children’s Medical Center staff members who travel to developing countries to help improve the healthcare of children. Dr. Daniel Fisher continues his work with colleagues in the Divisions of Otolaryngology and Pediatric Surgery to hone the activities of the Critical Airway Response Team, which responds to life-threatening emergencies in children with upper airway obstruction. In addition, he continues his leadership in the refinement of the hospital’s recently implemented comprehensive electronic medical record, which has a huge impact on the quality of daily patient care, safety improvement, and clinical research. His efforts also have international impact. Each year, he coordinates multiple groups’ trips to Hospital Bernard Mevs in Port-au-Prince, Haiti, where they directly render clinical care Dr. Leonard Comeau continued his activities to improve the comfort and quality of care for our patients, both in the PICU 23 Pediatric Critical Care and hospital-wide. He is a leader of our developing comprehensive palliative care program. He participates in care delivered by the Sedation Service, and also serves as the leader of the quality and safety oversight activities of the Sedation and Analgesia Committee. He serves as the Chair of the hospital Ethics Committee, which deals with issues related to the appropriateness and decision-making regarding health care for some of our most complicated patients. Dr. Allison Cowl continues her clinical research collaborations with the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) international network, focusing on various aspects of the management of sedation and pain during the care of critically ill children. She is implementing clinical research protocols spurred by results of a national multicenter study of sedation practices in children with severe respiratory failure. She implemented an Advanced Critical Care elective rotation in concert with a new national restructuring of education framework for pediatric residents. Drs. Rosanne Salonia and Aaron Zucker are among leaders of a hospital-wide group that oversees an “early warning system” which focuses attention on patients at risk for clinical deterioration. Dr. Zucker is the Chairperson of the Peer Review Committee, which oversees the Medical Staff’s evaluations of individual physician’s clinical performance and patient outcomes in pursuit of the best and safest care for our patients. blood pressure monitor with Orion/MaxIQ NIBP module. Blood Pressure Monitoring. 2014;19(3):180-2. Carroll CL, Ramachandran P. The intelligent use of digital tools and social media in practice management. Chest. 2014;145(4):896-902. Carroll CL, Sala KA, Fisher D, Zucker AR. Pediatric code events: does in-house intensivist coverage improve outcomes? Pediatr Crit Care. 2014;15(3):250-257. STAFF Aaron Zucker, MD Division Head Kenneth Banasiak, MD Rosanne Salonia, MD Christopher Carroll, MD Heather Schlott, MD Leonard Comeau, MD Adam Silverman, MD Allison Cowl, MD Petronella Stoltz, APRN Daniel Fisher, MD PUBLICATIONS Hymel KP, Armijo-Garcia V, Foster R, Frazier TN, Stoiko M, Christie LM, Harper NS, Weeks K, Carroll CL, Hyden P, Sirotnak A, Truemper E, Ornstein AE, Ming Wang M. Validation of a clinical prediction rule for pediatric abusive head trauma. Pediatrics. 2014;134:e1537-1544. Gupta P, Tang X, Gossett JM, Gall CM, Lauer C, Rice TB, Carroll CL, Kacmarek RM, Wetzel RC. Association of center volume with outcomes in critically ill children with acute asthma: a multicenter analysis. Annals Allergy Asthma Immunol. 2014;113(1):42-47. Carroll CL, Coro M, Cowl A, Sala K, Schramm CM. Transient occult cardiotoxicity in children receiving continuous beta-agonist therapy. World J Pediatr. 2014;10(4):324-9. Lang SM, Giuliano JS, Carroll CL, Eisenfeld L. Neonatal/ infant validations study of the CAS model 740 non-invasive Dr. Adam Silverman at Hospital Bernard Mevs, Port-au-Prince, Haiti 24 Pediatric Dentistry The Division of Pediatric Dentistry provides a full range of primary and specialty dental services for children. Significant expertise is available in the areas of dentofacial growth and development, craniofacial and dental anomalies and pathology, behavior management associated with dental treatment delivery, dental care for children with special health needs, prevention of dental diseases, and dental public health issues affecting children. Services available include restorative dentistry, surgical treatment of oral and perioral hard and soft tissue pathology, dental treatment with procedural sedation, oral rehabilitation under general anesthesia, and treatment of minor orthodontic problems. The division provides quality oral health care in a timely and caring manner. Emphasis is placed on assisting other specialty divisions within Connecticut Children’s Medical Center in managing their patients’ overall health care needs by preventing and treating oral disease. The division also is committed to supporting research activities consistent with the Connecticut Children’s and University of Connecticut School of Dental Medicine institutional missions. The division is currently comprised of 40 members of the dental staff, 28 active, 7 courtesy, and 5 consulting. There are 37 pediatric dentists, one orthodontist, one oral pathologist, and one prosthodontist. Dr. Richard Skinner serves as the Director of the Division of Pediatric Dentistry. During 2014, members of the division completed 618 oral rehabilitation cases in the operating rooms at Connecticut Children’s, representing a 26% increase over the number of cases completed last year. The UConn School of Dental Medicine’s Division of Pediatric Dentistry, headed by Dr. Mina Mina, operates a full-service dental clinic at Connecticut Children’s. The dental clinic is the principle clinical site for the UConn School of Dental Medicine’s Advanced Education Residency Program in Pediatric Dentistry. Dr. Bina Katechia serves as the Residency Program Director, and Dr. Jorge Rabat is the Assistant Residency Program Director. Four residents completed the program in June 2014. All four of them challenged and successfully completed the Qualifying Examination of the American Board of Pediatric Dentistry (ABPD) that same month. All four residents made presentations at the annual meeting of the American Academy of Pediatric Dentistry in May 2014. The current combined first- and second-year resident classes have a total of 12 residents. This represents the culmination of our continued residency program expansion, facilitated by a 5-year $1.8 million HRSA Title VII Grant. In 2014, the Connecticut Children’s dental clinic provided 5,788 outpatient clinical visits. Over 14,200 dental procedures were completed in the clinic, and 88 oral rehabilitation cases were completed in the Connecticut Children’s operating rooms under general anesthesia. A total of 361 patients received procedural sedation during the delivery of dental services in the clinic. The dental clinic also provides a site for the clinical education of UConn Dental Students, UConn Advanced Education in General Dentistry residents, Tunxis Community College Dental Hygiene students, Tunxis Community College Dental Assistant students, Prince Regional Vocational Technical School Dental Assistant students, and Porter and Chester Dental Assistant students. In addition to Drs. Katechia, Mina, Rabat and Skinner, three full-time UConn Pediatric Dentistry faculty serve as attendings in the clinic, including Dr. Deborah Redford-Badwal, the Dental Director of the Connecticut Children’s Craniofacial Disorders Team. The clinic is additionally supported by 6 parttime UConn attending faculty. Oral Surgery support for the clinic is provided by residents and attending faculty from the UConn Oral and Maxillofacial Surgery Residency Program, directed by Dr. David Shafer. The following members of the division received a variety of honors and accolades over the past year. Drs. Monica Cipes and Richard Skinner continued to serve as Consultants to the Examination Committee of the American Board of Pediatric Dentistry. Dr. Ira Greene was re-elected President of the Connecticut Society of Pediatric Dentists. PUBLICATIONS Law CS, Douglass JM, Farman AG, White SC, Zeller GG, Lurie AG, Goske MJ. The image gently in dentistry campaign: partnering with parents to promote the responsible use of Xrays in pediatric dentistry. Pediatr Dent. 2014;36(7):458-9. Sagomonyants K, Mina M. Stage-specific effects of fibroblast growth factor 2 on the differentiation of dental pulp cells. Cells Tissues Organs. 2014;199(5-6):311-28. 25 Pediatric Dentistry doi:10.1159/000371343. Epub 2015 Mar 25. STAFF Sagomonyants K, Mina M. Biphasic effects of FGF2 on odontoblast differentiation involve changes in the BMP and Wnt signaling pathways. Connect Tissue Res. 2014 Aug;55 Suppl 1:53-6. doi:10.3109/03008207.2014.923867. Richard Skinner, DMD Division Head Mirucki CS, Abedi M, Jiang J, Zhu Q, Wang Y-H, Safavi KE, Clark RB, Nichols FC. Biological activity of Porphyromonas endodontalis complex lipids. J Endod. 2014;40(9):1342-8. PMID: 25146013. Cristian Brutten, DDS Jorge Rabat, DDS Joanna Douglass, BDS, DDS Deborah Redford-Badwal, DDS, PhD Ira Greene, DDS Moises Y. Salas, DDS, MPH Bina Katechia, DDS, MSc Cristina Santos-Tomas, DDS Glenn Koehler, DDS Gary Schulman, DDS Mina Mina, DMD, MSD, PhD Yu-Hsiung Wang, DDS, PhD Lawrence Lee, DDS Paulete Chung, RDH Antonio Lepore, Jr, DDS 26 Developmental & Rehabilitation Medicine The division’s mission is: 1) to provide comprehensive and compassionate diagnosis and management for children with neurodevelopmental and behavioral problems that range from normative deviations to rare disorders; 2) to teach healthcare professionals about these problems; 3) to add to existing knowledge by researching relevant questions in the field; and, 4) to offer advocacy and to support public policy development. The Division of Developmental and Rehabilitation Medicine is composed of a diverse faculty - Developmental-Behavioral Pediatrics (DBPeds) and Physical Medicine and Rehabilitation (PM&R) – who practice at a number of sites throughout the state. NEW STAFF Developmental-Behavioral Pediatrician Thyde Dumont-Mathieu, MD, joined the division August 1, 2014. She brings 15 years experience and particular interests in autism and health care access disparities. She has long-term research relationships with the Psychology Department at UConn (Storrs), and this has been a beautiful fit to support the division’s autism research collaboration with UConn Health Center (Farmington) and the Jackson Laboratories. In addition to her Developmental Pediatrics practice, she has assumed leadership for the Comprehensive Down Syndrome Program. This provides consultation to primary care providers, pediatric subspecialists, and families on the overall health and developmental needs of children with Down syndrome. Division clinical services occur in a number of settings – outpatient, inpatient, and community-based (e.g., schools, CT Birth to Three system, and other agencies). We provide direct consultation and clinical care. The division has focused extensive resources on developing the Autism Spectrum Assessment Program (“ASAP”). We have established a collaboration between DBPeds and Neurology (i.e. the “Neurogenetics ASAP program”) that provides a direct line from the autism diagnosis in DBPeds to standard-of-care clinical and laboratory evaluation. This also provides access for all patients to our research collaborations. GOALS FOR 2015 • Recruit a second pediatric physiatrist to support expand• • • • ing the inpatient service, as well as the clinics at satellite locations Pursue CARF (the Commission on Accreditation of Rehabilitation Facilities) accreditation for the Rehabilitation Service Seek funding for CBIF (Connecticut Bioscience Innovation Fund) genetics grant, the goal of which is to assess whether the “AllSeq” platform is a good mechanism for bringing additional genetic insights into clinical practice for people with autism Possible research collaboration on autism and breastfeeding – Ruth Lucas, PhD Collaborate with the sedation team to help children with autism and other developmental disabilities to prepare for medical procedures. This will have organization-wide impact and has “standard of care”-altering potential. The division’s research includes: Early Detection of Pervasive Developmental Disorders. PI: Fein, D. Co-Investigators: Barton M, Green J, Dumont-Mathieu T, Stone W, and Robins D. April 1, 2009 thru March 31, 2014. Funded by: the National Institute of Child Health & Human Development Multidisciplinary “ARC” initiative between CT Children’s Medical Center, UConn Health Center and the Jackson Laboratory: Neuronal Synaptic and Circuit Dysfunction in the Autism Spectrum Disorders. Dr. Milanese is one of the principal investigators. 2013-2018. Funded by: Institute for Systems Genomics • • PUBLICATIONS Herlihy LE, Brooks B, Dumont-Mathieu T, Barton ML, Fein D, Chen Chi-Ming, Robins DL. Standardized screening facilitates timely diagnosis of autism spectrum disorders in a diverse sample of low-risk toddlers. J Dev Behav Pediatr. 2014 Feb-Mar; 35(2):85-164,S1-S15. O’Brien JE, Dumas HM, Nash CM, Burke SA, Holson DC, Mast J, Pelegano J, Simpser EF, Traul C, Whitford K. Pediatric post-acute care hospital transitions: an evaluation of current practice. Hosp Pediatr. 2014 Jul;4(4):217-21. doi: 10.1542/hpeds.2013-0105. 27 Developmental & Rehabilitation Medicine Robins DL, Casagrande K, Barton ML, Chen C, DumontMathieu T, Fein D. Validation of the Modified Checklist for Autism in Toddlers 2014 – revised with follow-up (M-CHATR/F). Pediatrics. 2014. FACULTY Ann Milanese, MD Division Head Mark Greenstein, MD Paul Dworkin, MD Edwin Cruz-Zeno, MD John Pelegano, MD Thyde Dumont-Mathieu, MD Sarah Schlegel, MD 28 Digestive Diseases, Hepatology, & Nutrition The Division of Digestive Diseases, Hepatology, and Nutrition is committed to cutting edge and innovative clinical care of infants, children and adolescents, pioneering clinical, translational, and basic research, and the education of the next generation of physicians. dents who spend three years receiving their sub-specialty training. The great depth in our pediatric surgical and radiology programs as well as the great variety of clinical disorders and the intimate involvement of our faculty in education makes our fellowship program particularly attractive. In 2014, the division, small by the standards of other children’s hospitals, was a leader on both the national and international stages. Our Center for Pediatric Inflammatory Bowel Disease, the largest program in the region between Boston and New York, currently provides care to over 600 children with Crohn’s disease and ulcerative colitis. We are the Clinical Coordinating Center for a $10.4 million grant from the National Institutes of Health to lead the PROTECT Study: Predicting Response to Standardized Pediatric Colitis Therapy. This five-year effort coordinates the resources of 28 leading pediatric IBD centers in North America to study newly diagnosed children with ulcerative colitis. PROTECT, along with the Crohn’s and Colitis Foundation of America (CCFA) RISK stratification study of 1,200 newly diagnosed children with Crohn’s disease, has squarely placed Connecticut Children’s at the epicenter of pioneering research in pediatric inflammatory bowel disease. We commenced formal collaborative work with Jackson Laboratories to isolate and study intestinal stem cells from children with inflammatory bowel disease. Dr. Wael Sayej of the division has also entered into collaboration with Jackson Laboratories to study esophageal stem cells as part of his work in elucidating the mechanisms of disease in eosinophilic esophagitis. Dr. Zev Davidovics has directed our fecal transplant team for the treatment of refractory Clostridium difficile infection. Dr. Jeffrey Hyams, Division Head, was the winner of the American Academy of Pediatrics 2014 Murray Davidson Award. Our Multi-disciplinary Intestinal Rehabilitation Team (IRT) is the only one of its kind in the state. Co-directed by Drs. Karan Emerick and Zev Davidovics, this group focuses on the care of children with intestinal failure of all causes. Our Center for Pediatric Liver Care, directed by Dr. Karan Emerick, provides care to children with a large range of hepatic disorders ranging from chronic hepatitis B and C, metabolic liver disease, non-alcoholic fatty liver disease (NAFLD), autoimmune disease, and acute and chronic liver failure. It provides pre- and post-transplant care to 40 children. Our fellowship program under Dr. Sayej has benefited from the recruitment of highly qualified graduating pediatric resi- PUBLICATIONS Walters TD, Kim M, Denson LA, Griffiths AM, Dubinsky M, Markowitz J, Baldassano R, Crandall W, Rosh J, Pfefferkorn M, Otley A, Heyman MB, Leleiko N, Baker S, Guthery SL, Evans J, Ziring D, Kellermayer R, Stephens M, Mack D, OlivaHemker M, Patel AS, Kirschner B, Moulton D, Cohen S, Kim S, Liu C, Essers J, Kugathasan S, Hyams JS. Increased effectiveness of early therapy with anti-tumor necrosis factor-α vs an immunomodulator in children with Crohn’s disease. Gastroenterology. 2014;146:383-91. Gevers D, Kugathasan S, Denson LA, Vázquez-Baeza Y, Van Treuren W, Ren B, Schwager E, Knights D, Song SJ, Yassour M, Morgan XC, Kostic AD, Luo C, González A, McDonald D, Haberman Y, Walters T, Baker S, Rosh J, Stephens M, Heyman M, Markowitz J, Baldassano R, Griffiths A, Sylvester F, Mack D, Kim S, Crandall W, Hyams J, Huttenhower C, Knight R, Xavier RJ. The treatment-naive microbiome in new-onset Crohn’s disease. Cell Host Microbe. 2014;15:382-92. Minar P, Haberman Y, Jurickova I, Wen T, Rothenberg ME, Kim MO, Saeed SA, Baldassano RN, Stephens M, Markowitz J, Rosh J, Crandall WV, Heyman MB, Mack DR, Griffiths AM, Baker SS, Hyams JS, Kugathasan S, Denson LA. Utility of neutrophil Fcγ receptor I (CD64) index as a biomarker for mucosal inflammation in pediatric Crohn’s disease. Inflamm Bowel Dis. 2014;20:1037-48. Hyams JS. Standardized recording of parameters related to the natural history of inflammatory bowel disease: from Montreal to Paris. Dig Dis. 2014;32:337-44. Sunseri W, Hyams JS, Lerer T, Mack DR, Griffiths AM, Otley AR, Rosh JR, Carvalho R, Grossman AB, Cabrera J, Pfefferkorn MD, Rick J, Leleiko NS, Hitch MC, Oliva-Hemker M, Saeed SA, Kappelman M, Markowitz J, Keljo DJ; Pediatric Inflammatory Bowel Disease Collaborative Research 29 Digestive Diseases, Hepatology, & Nutrition Group. Retrospective cohort study of methotrexate use in the treatment of pediatric Crohn’s disease. Inflamm Bowel Dis. 2014;20:1341-5. Haberman Y, Tickle TL, Dexheimer PJ, Kim MO, Tang D, Karns R, Baldassano RN, Noe JD, Rosh J, Markowitz J, Heyman MB, Griffiths AM, Crandall WV, Mack DR, Baker SS, Huttenhower C, Keljo DJ, Hyams JS, Kugathasan S, Walters TD, Aronow B, Xavier RJ, Gevers D, Denson LA. Pediatric Crohn’s disease patients exhibit specific ileal transcriptome and microbiome signature. J Clin Invest. 2014;124:3617-33. Hyams JS. Biologics in pediatric Crohn’s disease: is it time to move to an earlier therapeutic approach? Expert Rev Clin Immunol. 2014;10:1423-6. Walters TD, Hyams JS. Can early anti-TNF-α treatment be an effective therapeutic strategy in children with Crohn’s disease? Immunotherapy. 2014;6:799-802. Rosh JR, Hyams JS. Pediatric UC drug development: a GREAT idea now needs a GRAND conversation. J Pediatr Gastroenterol Nutr. 2014;58:677-8. Arbuckle RA, Carson RT, Abetz-Webb L, Hyams J, Di Lorenzo C, Lewis BE, Gargon E, Kurtz C, Shiff SJ, Johnston JM. Measuring the symptoms of pediatric constipation and irritable bowel syndrome with constipation: expert commentary and literature review. Patient. 2014;7:343-64. Zeisler B, Hyams J. Transition of management in adolescents with IBD. Nat Rev Gastroenterol Hepatol. 2014;11:109-15. BOOK CHAPTERS Zeisler B, Sylvester FA. Protein losing enteropathy. In: Practical algorithms in pediatric gasteroenterology. Shaoul R, editor. (Practical algorithms in pediatrics. Hochberg Z, series editor.) Haifa; 2014. Zeisler B, Sylvester FA. Gasterointestinal polyps. In: Practical algorithms in pediatric gasteroenterology. Shaoul R, editor. (Practical algorithms in pediatrics. Hochberg Z, series editor.) Haifa; 2014. Hyams J. The natural history of ulcerative colitis. In: Pediatric inflammatory bowel disease. 2nd ed. New York: Springer. STAFF Jeffrey Hyams, MD Division Head Zev Davidovics, MD Karan Emerick, MD Franziska Mohr, MD Wael Sayej, MD Francisco Sylvester, MD Bella Zeisler, MD Donna Zeiter, MD Kristin Phillip, APRN Heidi Sweeney, APRN 30 Emergency Medicine The Division of Emergency Medicine is committed to a continuous quality improvement process, and we have improved our efficiency, the safety of our healthcare delivery system and ultimately our patient satisfaction. In 2014, the Emergency Department of Connecticut Children’s Medical Center treated 56,998 patients, our highest annual volume ever. Although the rate of growth has slowed since 2010, this represents a 30% increase over the last 10 years. The greatest clinical challenge continues to be the increasing number of behavioral/mental health patients. In response to the serious safety issues raised by some of these patients, the Emergency Department underwent a partial redesign and renovation of some physical space. Eleven rooms were built in a sequentially securable area that incorporates safety design features, such as anti-ligature door handles and bathroom features. Seven of them were designed to be convertible to accommodate the evaluation of medical patients with the ability to secure medical equipment behind a garage type door. Security presence has been augmented with expanded coverage by an assigned security officer and an ED Safety Officer. The addition of an ED social worker who evaluates low risk patients has decreased the average length of stay for our behavioral health patients. Solutions to the behavior/mental health crisis extend beyond Connecticut Children’s Medical Center. Dr. Steve Rogers, Emergency Mental Health and Psychiatric Services Coordinator for the division, has been partnering with DCF and Behavioral Health Partners to entrain other state resources. Dr. John Peng served on the Connecticut Hospital Association’s Subcommittee for Mental Health to develop recommendations to the state legislature to improve health outcomes and reduce unnecessary use of the emergency department. In April of 2014, we went live with a new electronic medical record. Implementation was successful with return to baseline key process indicators within 4 weeks despite a record patient volume during that month. Other initiatives include an Excellence Delivered campaign to reinforce service behaviors to improve the patient experience and satisfaction. As part of the drive to improve efficiency, direct bedding was implemented. This has decreased our arrival-to-provider time. Pathways for asthma and gastroenteritis/dehydration were implemented. Improving our time metrics in the treatment of sepsis has been a focus with the development of a sepsis alert and standardized approach. Our faculty has been joined by Eric Hoppa, MD, a former resident of the University of Connecticut pediatric residency program who completed a fellowship in pediatric emergency medicine at Boston Children’s Hospital. Dr Hoppa worked for several years as an attending physician at Cohen Children’s Medical Center and also served as Director of Pediatric Emergency Medicine at one of their community affiliates. We have also had the addition of 3 physician assistants: Lisa Tryon PA-C, Leila Rebai, PA-C, and Lauren Christofori, PA-C. Carol Erickson, APRN, has taken over the leadership role for the advanced practitioners. Members of the Division of Emergency Medicine continue to be highly involved in leadership and committees at Connecticut Children’s with participation by the division in over 35 hospital committees. Dr. Jim Parker is the Chairperson for EMS-C for the State of Connecticut and vice chair of the North Central Region Medical Advisory Council. Dr. Michael Soltis serves on the state’s Child Fatality panel and the Abusive Head Trauma working group. On a regional and national level, Dr. Steven Rogers completed a 3-year term as the American Academy of Pediatrics Chair of the Committee for the Future for the Section on Emergency Medicine. He continues to serve on the Executive Board of the Eastern Society for Pediatric Research and as the program chairperson for the Injury Free Coalition for Kids. He also continues to be on the editorial boards and act as a reviewer for multiple journals and national conferences. Education and research continue to be part of our mission. The faculty taught and mentored pediatric residents, emergency medicine residents, family practice residents, medical students, dental students and advanced practitioner students. Under the leadership of Dr. John Brancato, who also functions as associate division head, our fellowship program has continued to successfully recruit talented fellows. Dr. Matt Laurich has undertaken the associate fellowship director position. An undergraduate research assistant program that was developed by Dr. Sharon Smith and taught by our faculty supports the research productivity of our division. Research projects covering topics such as violence prevention, appendicitis, ultrasound-guided IV placement, lethal means restriction, nutrition and asthma are ongoing. Dr. Smith is also the Director of PALS for the institution. The Trauma program underwent a successful re-verification by the American College of Surgeons for designation as a Level 1 Pediatric Trauma Center. The Emergency Department 31 Emergency Medicine is seeking to have all Level I Trauma patients be transported to and evaluated directly at Connecticut Children’s. Dr. Parker is Medical Director of the Transport program, which is planning to transition to a nurse-led team. They have acquired a Connecticut Children’s ambulance cobranded with AMR and will be building another medical transport vehicle. ioral health patients in the pediatric emergency department. J Trauma Acute Care Surg. 2014 Oct;77(3 Suppl 1):S23-8. Two of our staff members were the recipients of notable awards. Eric Hoppa received the McNeill Teaching Award from the Pediatric Residents for November 2014. Lana Friedman was given the Pediatric Emergency Medicine Teaching Award from the Department of Emergency Medicine at Hartford Hospital in June of 2014. Kohn C, Saleheen H, Borrup K, Rogers S, Lapidus G. Correlates of drugs use and driving among undergraduate college students. Traffic Inj Prev. 2014;15(2):119-24. PUBLICATIONS Sturm JJ, Hirsh D, Weselman B, Simon HK. Reconnecting patients with their primary care provider: an intervention for reducing nonurgent pediatric emergency department visits. Clin Pediatr. 2014. Rogers SC, DiVietro S, Brinkley A, Kaminer Y, Lapidus G. Restricting youth suicide: a pilot descriptive study of behav- Rogers SC, Chun TH. Flood of pediatric mental health patients strains emergency department resources. AAP NEWS. 2014;35(6):1. Chicaiza H, Hellstrand K, Lerer T, Smith SR*, Sylvester F. Potassium hydroxide: an alternative reagent to perform the Modified Apt Test. J Peds. 2014 Sep;165(3):628-30. 32 Emergency Medicine BOOK CHAPTERS PEER-REVIEWED E-PUBLICATION Rogers SC, Cohen-Abbo A. Mononucleosis. In: Rosen & Barkin’s 5-minute emergency medicine consult. 5th ed. Wolters Kluer; 2014. p. 714-5. Sherman JM, Sheppard P, Hoppa E, Krief W, Avarello J. Let us use LET: a quality improvement initiative. Pediatr Emerg Care. 2014 Dec 3. [Epub ahead of print] Per Diem Attending Kay Hesse, MD PA/APRN Ann Gorjanc, PA Sandra Johnson, MD Gary Lapidus, PA-C, MPH Seth Lotterman, MD Josh Freund, PA-C Sarah Orlando, PA Zoe Casey, MD Pediatricians Christine Cornachio, MD Lana Friedman, MD David Marcello, MD Andrew Heggland, MD Marissa Smith, MD Christopher Scheinberg, APRN Eric Hoppa, MD, FAAP Sarah-Jo Stimpson, MD Meg Seitz, PA-C, MS Matt Laurich, MD Per Diem Pediatricians Brenda Balch, MD Lauren Christofori, PA-C STAFF Attendings John Peng, MD Division Head John Brancato, MD James Parker, MD Carla Pruden, MD Steven Rogers, MD Michael Soltis, MD Adam Silverman, MD Sharon Smith, MD Jesse Sturm, MD Kristin Welch, MD James Wiley II, MD Meredith Barrows, MD Glenda Nouman, DO Charles Thompson, MD Kate Pesce, APRN Carol Erickson, APRN Leila Rebai, PAC, MS Lisa Tryon, PA Nancy Trout, MD Per Diem PA/APRN Keri McGeary, PA-C Elizabeth Smith, MD Kathleen O’Leary, APRN Richard Pierce, MD Dave Parrotti, PA Nicole Frost, APRN 33 Pediatric Endocrinology & Diabetes The division was recognized by the U.S. News Media Group (U.S. News & World Report) again in 2014 as one of the top programs in the country for endocrinology and diabetes. Our Diabetes Education Program was reaccredited by the American Association of Diabetes Educators, one of only three programs certified in Connecticut in 2014, and the only one dedicated to the care of children and adolescents with diabetes. This attests to the high quality and standards that our staff of diabetes educators, including registered dietitians, nurse, social worker, nurse practitioners and physicians under the able leadership of Dr. Cem Demirci provide to over 1,200 children with type 1 and type 2 diabetes and their families. With the growth of faculty, staff and clinical programs over the past several years, the division’s space challenges were completely met by our relocation to the new Connecticut Children’s Medical/Surgical Center at 505 Farmington Avenue in Farmington, CT, in September 2014. Our new clinical area now offers bright, colorful, comfortable patient and family rooms for our out-patient programs, 10 large examination rooms, and adequate offices and conference space for faculty, staff, fellows, residents, and medical students. Our patients and families especially appreciate easy access and parking as well as the welcoming environment created by a larger waiting area where art created by local school children decorates the walls. While the primary home of the division is now in Farmington, the division continues to care for hospitalized patients on the Hartford campus of Connecticut Children’s Medical Center and at our office at 85 Seymour Street for children who are enrolled in our weight management program and families with limited ability to travel to Farmington. This year has brought a number of changes in the leadership of the division. Dr. Karen Rubin stepped away from her position as division head (2008-2014), while remaining clinically active in the division, in order to devote the majority of her efforts to expanded departmental roles as Associate Chair for Clinical Affairs and a new appointment as the Chief Innovation Officer at Connecticut Children’s. Dr. Susan Ratzan, a founding member of the division and former division head, was named interim division head while a national search for a new division head was announced on October 1, 2014. Dr. Paola Palma Sisto was named Clinical Director, a formal leadership role in the new alignment of divisions and restructuring of Connecticut Children’s Specialty Group. Dr. Elizabeth Es- trada was promoted to Professor of Pediatrics, University of Connecticut School of Medicine. She has been the Director of the Pediatric Obesity Center for Treatment, Research and Education, and a valued member of the division for 18 years. She and her husband, Dr. Francisco Sylvester, Division of Digestive Diseases, Hepatology & Nutrition, were co-recruited to join the faculty of the Department of Pediatrics at the University of North Carolina, and we are grateful for their years of contributions to Connecticut Children’s Medical Center. Our fellowship training program has successfully recruited well-qualified trainees each year and all graduates have moved on to clinical academic positions. Dr. Palma Sisto assumed the Directorship of the Pediatric Endocrine Fellowship with the departure of Dr. Estrada. Dr. Palma Sisto also is the Director of Fellowships for the Department of Pediatrics, overseeing 6 medical to assure that all fellowships at Connecticut Children’s meet ACGME requirements. Division members provide leadership in a number of clinical and research collaborations including the following: Drs. Rubin and Palma Sisto co-direct the Thyroid Center, a multidisciplinary, coordinated program with Surgery, Radiology, Pathology, and Nuclear Medicine for the evaluation and treatment of children with thyroid nodules and thyroid cancer. Dr. Riba-Wolman directs the Endocrine Late Effects Clinical Program in the monthly STAR program in the Oncology division for long-term survivors of childhood cancer. Dr. Priya Phulwani is the Endocrine Director of the multidisciplinary (Genetics, Urology, Psychiatry) program for youth with disorders of sexual development and gender dysphoria. Melissa Santos, PhD, Clinical Director of the Pediatric Obesity Center, received a CICATS Pre-K award to support her development in clinical and translational obesity research. She is collaborating with Jackson Labs at the University of Connecticut Health Center on a proposed study of the epigenetics of obesity. Dr. Nancy Dunbar, in addition to directing our Bone Health Program, is a member of the I-91 Global Health Group and volunteered in Haiti through the non-profit organization, Crudem, to develop a pediatric diabetes program and provide endocrine consultation to a local pediatrician. The program now supports 30 Haitian children with diabetes including medical and surgical care, insulin, and other diabetes supplies. Dr. Christine Trapp is enrolled in the Masters in Clinical and Translational Research at the University of Connecticut Health Center to gain additional skills to support her research in obesity prevention under the mentorship of Dr. Michele Cloutier. 34 Pediatric Endocrinology & Diabetes STAFF The division is looking forward to our full integration into Care Navigator (EHR) for our ambulatory practice in the fall of 2015. Our Physician Builder, Dr. Rebecca Riba-Wolman, has worked tirelessly with the Care Navigator team and members of the division to ensure that our specific practice and clinical goals will be achieved and our transition a smooth one. Susan Ratzan, MD Interim Division Head (10/1/14 - ) PUBLICATIONS Cem Demirci, MD Alvarez-Perez JC, Ernst S, Demirci C, Casinelli GP, MelladoGil JM, Rausell-Palamos F, et al. Hepatocyte Growth Factor/ c-Met Signaling is required for β-cell regeneration. Diabetes. 2014; 63(1):216-23. Nancy Dunbar, MD Karen Rubin, MD Division Head (1/1/14 – 9/30/14) Elizabeth Estrada, MD (through October 2014) Nilsson O, Guo MH, Dunbar N, Popovic J, Flynn D, Jacobsen C, et al. Short stature, accelerated bone maturation and early growth cessation due to heterozygous aggrecan mutations. J Clin Endocrine Metab. 2014:99(8):E1510-8. Paola Palma Sisto, MD Estrada E, Eneli I, Hampl S, Mietus-Snyder M, Mirza N, Rhodes E, et al. Children’s Hospital Association Consensus statements for co-morbidities of childhood obesity. Child Obes. 2014 Aug. Christine Trapp, MD Haemer M, Grow H, Fernandez C, Lukasiewicz G, Rhodes E, Shaffer L, Sweeney B, Woolford S, Estrada E. Addressing prediabetes and type 2 diabetes in childhood obesity treatment: summary of research and current practice. Child Obes. 2014 Aug. Palma Sisto PA, Heneghan MK. Endocrinology. In: Marcdante K, Kliegman RM, Behrman RE, editors. Nelson’s essentials of pediatrics. 7th edition. Philadelphia: WB Saunders; 2014. Rubin K. Optimizing management of patients with Turner syndrome in transition to adulthood and corresponding Q&A assessment. American College of Endocrinology Self-Assessment Program in Endocrinology and Metabolism (ASAP), 2014. Priya Phulwani, MD Rebecca Riba-Wolman, MD Melissa Santos, PhD Karen Bucci, APRN Nancy Paulhus-Orkin, APRN 35 General Pediatrics The Division of General Pediatrics is committed to fostering the health and well-being of children, families and communities. To realize this mission, we provide exceptional clinical care in partnership with families, teach evidence-based clinical pediatrics to the next generation of pediatric health care providers, and pursue original research and vigorous advocacy around issues important to children, families and the public. All of our activities place special emphasis on caring for children with special health care needs, including disadvantaged children, children growing up in low-income families, and children with complex and chronic medical conditions. The Division of General Pediatrics continues to provide the majority of pediatric primary care to Hartford’s children through the ambulatory and primary care clinics at Connecticut Children’s Medical Center, Saint Francis Hospital and Medical Center, and the Burgdorf/Bank of America Health Center. Members of the division provide ambulatory care to infants, children and adolescents, and inpatient care for newborns and children with lead poisoning and suspected abuse or neglect. Our ambulatory services include health supervision, behavioral health care, chronic disease management, and urgent care using a Medical Home model. The division houses innovative, community-wide clinical programs such as the Hartford Regional Lead Treatment Center, the Reach Out and Read literacy program, and the Suspected Child Abuse and Neglect (SCAN) program. Under the direction of Nina Livingston, MD, the SCAN program provides medical and social work diagnostic consultations for concerns of child abuse and neglect to all Connecticut Children’s inpatient services. Outpatient and telephone consultations also are available when there is concern for possible child abuse or neglect. Division faculty have gained regional and national prominence for clinical research, education, and program development in the fields of injury epidemiology and prevention, child behavior and development, culturally effective health care, emergent literacy promotion and development of Medical Home-based systems of care for children and youth with special health care needs. The largest clinical site of the division, the Primary Care Center at Connecticut Children’s, moved to a new site in April 2014. This new larger, community-based center, located ½ mile from the medical center, is more accessible to the Cen- ter’s patients and has been designed to better accommodate electronic medical records, and to enhance operational flow and capacity. In 2014, the division also successfully recruited three new faculty members; the division’s first Adolescent Medicine subspecialist, Dr. Nancy Miller, and Dr. Patricia Garcia, to the Primary Care Center at Connecticut Children’s Medical Center, and Dr. Norrell Atkinson to the SCAN program. The year 2014 was also marked by the retirement of Dr. Frederick Bogin, Medical Director of the Pediatric Clinic at St. Francis Hospital and Medical Center, and Dr. Chitraleka Ramanan, former director of the Pediatric Clinic at the University of Connecticut Health Center. Drs. Bogin and Ramanan each spent more than 30 years caring for the underserved children of Connecticut and training the next generation of pediatricians. Faculty members at division sites play a central role in education in the University of Connecticut system by providing the majority of pediatric primary care and newborn nursery educational experiences for medical students and residents in the region. Other rotating learners from UConn and other institutions include dental residents, child psychiatry fellows, and students from nurse practitioner, physician assistant and medical assistant programs. Members of the SCAN program also are highly involved in educational efforts within the UConn system, including required and elective resident rotations, lectures, Grand Rounds, and community provider education. Division members serve on a wide variety of hospital, university and state committees. Membership on national committees includes the National Center for Culture Competence Advisory Group (Alberto Cohen-Abbo, MD) and the Society for Pediatric Dermatology Education Committee (Keri Wallace, MD). Research interests in the division include health literacy, cultural competence, immunization, obesity, and quality of life measures in children. Division members collaborate in the Asthma Center’s Easy Breathing© program, the Steps to Growing Up Healthy study (obesity prevention for 2- to 4-year-olds) and the co-management pilot protocols with Connecticut Children’s Medical Center pediatric subspecialists. Patricia Joyce, MD, continues her work with the REACH (Resident Education in Advocacy and Community Health) pathway and community/advocacy education for all residents, working in collaboration with Connecticut Childrens’ Office for Community Child Health and its Office of Govern- 36 General Pediatrics ment Relations, as well as the Center for Children’s Advocacy, Connecticut Voices for Children, Office of the Child Advocate, Help Me Grow, the Hartford Department of Health and Human Services, Child Health Development Institute, and the Department of Children and Families. Residents enrolled in the REACH pathway completed a Resident CATCH Grant funded project called Healthy Habits for Healthy Hartford Children. Dr. Wiley continues her advocacy work in the area of emergent literacy and serves as Medical Director of Reach Out and Read Connecticut. Melissa Held, MD, and Patricia Joyce, MD, continue to modify aspects of the Ambulatory Pediatrics Clerkship to further improve upon this highly regarded experience. Through the use of brief structured clinical observations during the clerkship, every medical student is directly observed and receives feedback from a faculty member about his or her clinical skills a minimum of six times. STAFF Dr. Anton Alerte continues to serve as Director of UConn’s Clinical Medicine course, and has established a new program for fourth year students focused on their teaching skills. He also continues in his roles as Vice President of the CT Chapter of the American Academy of Pediatrics and Chair of the Chapter’s Committee on Foster, Kinship and Adoption Care. This committee received a grant from the AAP in 2014 to improve collaboration between practitioners and DCF in the state. Grael O’Brien, MD, serves as site director for the CORNET (Continuity Clinic Research Network) of the Academic Pediatric Association. This year she received a grant from the CDC in support of an Adolescent Reproductive Health Care Training Project. Jennifer Haile, MD PUBLICATIONS Grael O’Brien, MD Rogers S, Cohen-Abbo A. Mononucleosis. In: Schaider J, et al, editors. Rosen & Barkin’s 5-minute emergency medicine consult. 5th ed. Wolters Kluwer; 2014. Catherine Wiley, MD Division Head Anton Alerte, MD Chitraleka Ramanan, MD Norrell Atkinson, MD (SCAN) Laurie Scheiner, MD Frederick Bogin, MD Christina Cefaloni, MD Alberto Cohen-Abbo, MD Patricia Garcia, MD Susan Glasser, MD Patricia Joyce, MD Jaye Ladinsky, MD Molly Senn-McNally, MD Hilda Slivka, MD Elizabeth C. Smith, MD Jody Terranova, DO Nancy Trout, MD Keri Wallace, MD Jessica Zimmerman, MD Darlene Abbate, APRN Dorien Barnett, APRN Nina Stuart Livingston, MD, FAAP Meredith Brown, PA-C Margaret McLaren, MD, MB. BCh Monica Joyce-Montaudy, APRN Lisa Menillo, MD Kathleen Laurie Kelliher, PA-C Joseph Newell, MD Priscilla Malloy, APRN Dianne Powers, APRN 37 Pediatric General & Thoracic Surgery The mission of the Pediatric General and Thoracic Surgery Division is to provide the highest quality, family centered surgical care. One new initiative implemented this year is rapid access to our clinics with same-day appointments for urgent conditions. EXPANSION The Division of Pediatric General and Thoracic Surgery performs a full range of clinical services for patients from newborns to young adults, and includes prenatal consults, the treatment of congenital anomalies, enteral access, pediatric gynecology, and surgical oncology. Connecticut Children’s is an American College of Surgeons-verified Level I Pediatric Trauma Center. We currently have satellite offices in Farmington and Danbury, and we are performing surgeries at the Ambulatory Surgery Center in Farmington. The mission of the division is to continue to provide the highest quality of care for children in Connecticut. This includes easy patient access for subspecialty consultation as well as enhancing care of children through innovative surgical techniques and instrumentation. This year we performed the first two gastric sleeves for the treatment of adolescent obesity. This procedure is used for those adolescents with severe obesity and will complement the laparoscopic band procedure for obesity treatment. EXCITING INITIATIVES: QUALITY IMPROVEMENT & MULTIDISCIPLINARY PROGRAMS Connecticut Children’s continues to be involved in the American College of Surgeons’ Pediatric National Surgical Quality Improvement Program (NSQIP), which is the first multi-specialty program designed to measure and improve the quality 38 Pediatric General & Thoracic Surgery of children’s surgical care. Dr. Brendan Campbell is the Surgeon Champion for the NSQIP Program, and over this past year, implementation of a standardized pathway for appendicitis was accomplished. STAFF The Division of Pediatric General & Thoracic Surgery continues to drive several multi-disciplinary services aimed at facilitating and improving patient care and experience. Through the Multidisciplinary Thyroid Group, children with thyroid diseases are able to be evaluated simultaneously by a surgeon as well as an endocrinologist. Over this past year, the team has evaluated over 48 patients with a wide range of thyroid pathology. Michael Bourque, MD, FACS PUBLICATIONS Sherry Blair, APRN Mondrinos MJ, Jones PL, Finck CM, Lelkes PI. Engineering de novo assembly of fetal pulmonary organoids. Tissue Eng Part A. 2014 Nov;20(21-22):2892-907. Nicole Boone, PA Vadasz S, Jensen T, Moncada C, Girard E, Zhang F, Blanchette A, Finck C. Mid to late gestational age amniotic fluid stem cells and lung bioengineering. J Pediatr Surg. 2014;49(11)155463. Kelly Henri, APRN Finck CM, Jensen T. Bioengineering distal airways. Stem cells, tissue engineering and regenerative medicine. Elsevier; 2014. pp. 353-72. Abby Theriaque, APRN Campbell BT, Herbst KW, Briden KE, Neff S, Ruscher KA, Hagadorn JI. Inhaled nitric oxide use in neonates with congenital diaphragmatic hernia. Pediatrics. 2014;134:e420e426. Mazotas I, Toal M, Borrup K, Saleheen H, Hester AL, Copeland D, Danielson PD, DeRoss A, Lapidus G, Bentley G, Thaker S, Campbell BT. A prospective, multi-institutional study of pediatric all-terrain vehicle crashes. J Trauma Acute Care Surg. 2014;77:103-8. Markush D, Briden KE, Chung M, Herbst KW, Lerer TJ, Neff S, Wu AC, Campbell BT. Effect of surgical subspecialty training on patent ductus arteriosus ligation outcomes. Pediatr Surg Int. 2014;30:503-9. Misra MV, Tsai A, Valdez T, Campbell BT. Thoracoscopic resection of a bronchogenic cyst located at the thoracic inlet. J Laparoendosc Adv Surg Tech B, Videoscopy. 2014 Nov. Christine Finck, MD, FACS Division Head Brendan Campbell, MD, MPH, FACS Meghna Misra, MD Christine Rader, MD Richard Weiss, MD, FACS Jessica Cooper, APRN Jeanette Rybski, APRN Nicole Terenzoni, APRN 39 Pediatric & Adolescent Gynecology The members of the Division of Gynecology at Connecticut Children’s Medical Center continue to provide state-of-theart pediatric and adolescent gynecology consultative services in office, operating room, emergency room, and inpatient settings. The clinical services provided include specialty care in all areas of medical and surgical gynecologic care. These include reproductive health issues, vulvar and vaginal infections in children and adolescents, management of abnormal uterine bleeding and pelvic pain, adolescent endometriosis, congenital abnormalities of the reproductive tract, ovarian cysts and masses, and adolescent hormonal and contraceptive issues. Our team of gynecologists provides 24/7 coverage of the Connecticut Children’s Medical Center’s Emergency Room, operating room, and in-patient floors. Our surgical services have expanded in 2014 to include daVinci robotically assisted minimally-invasive gynecologic procedures at Connecticut Children’s for selected patients. Dr. Frederick Rau performed a robotically-assisted laparoscopic excision of a congenital uterine anomaly with preservation of future fertility. Office evaluations of pediatric and adolescent patients are done at the Gynecology and Obstetrics Division of Physicians of Women’s Health by Dr. Frederick Rau, Division Director, and Drs. Emily Rosenbush, Kerrie Henry, Catherine Graziani, Kelley Sturrock, Erin Pickett, and Elizabeth Purcell at locations in Hartford, Farmington, Glastonbury and Rocky Hill. Our extensive range of pediatric and adolescent-friendly gynecologists has improved the ability of community physicians to refer families for age-appropriate gynecologic care. Our physicians are members of the North American Society for Pediatric and Adolescent Gynecology, an international organization dedicated to the gynecologic care of children and teenagers. Our physicians collaborate at Connecticut Children’s Medical Center with the University of Connecticut School of Medicine Obstetrics/Gynecology and Pediatrics residents and medical students for in-patient, emergency room and operating room patient care. Our physicians emphasize a supportive and minimally intrusive strategy while seeing children, adolescents and families. For 2015-2016, the division will maintain and improve our patient’s access to superior specialty care in pediatric and adolescent gynecology to promote reproductive health and wellness for our community’s children and teenagers. STAFF Frederick J. Rau, MD Division Director Catherine Graziani, DO Kerrie Henry, MD Erin Pickett, MD Elizabeth Purcell, MD Ellen Robinson, MD Emily Rosenbush, MD Kelley Sturrock, MD 40 Hematology-Oncology We improve the lives of children with cancer and blood disorders by delivering high quality family-centered academic health care. We continuously improve what we do through discovery and partnerships. We have three broad areas of focus: Quality & Safety, Service & Access, and Research & Teaching. This year, the Division of Hematology/Oncology has continued to excel in our ability to provide the highest quality of care with our focus on standardized approaches when appropriate; we encourage the development of specific areas of expertise among our faculty, and we are supported by a talented group of advanced practitioners and nurses as a key component of our service model. This past year, Dr. Kerry Moss was appointed as the Director of the Palliative Care program. She has furthered our ability to care for patients and families in need within Hematology/Oncology and throughout Connecticut Children’s Medical Center. Dr. Michael Isakoff initiated a national clinical trial for patients with relapsed/refractory Osteosarcoma. We continued the alignment of our advanced practitioner staff to provide continuous, streamlined, and patient-centered care in both inpatient and outpatient facilities. In the upcoming year, our biggest initiative will align the organization’s focus on effective and safe care, as we develop a care team model which emphasizes continuous improvement initiatives setting the national standards for patient safety and care delivery in pediatric hematology-oncology. We are humbled by our high commendations from patients and families, a testament to our continued striving for a family-centered approach to care delivery. We are supported by our two active family advisory boards for Sickle Cell Disease and Cancer Care. We provide comprehensive care using a team approach to treat children and young adults with cancer, including recurrent and refractory cancer, hemostasis and thrombotic problems, red cell disorders, and other hematological diseases. Our comprehensive Advanced Cancer Care Program is continuing to expand with increased regional, national and international referrals to our Center for Advanced Therapeutics Program for the Phase 1 and 2 therapies. Our research efforts continue to expand. Our Children’s Oncology Group participation, under the leadership of Michael Isakoff, MD, is one of the highest in the country. Division CoDirector Nehal Parikh, MD, has developed the Center for Advanced Therapeutics into a program of national significance through local and national collaborations. We are members of two national consortiums (Sunshine Project and Neuroblastoma Medulloblastoma Translational Research Consortium) bringing novel Phase 1 and Phase 2 treatments to children with relapsed and refractory cancers. Dr. Parikh was a recipient of St. Baldrick’s Infrastructure grant to further build this program. We have continued to expand our partnership with Jackson Laboratories to develop a personalized approach to cancer therapeutics. Under the leadership of Dr. Michael Isakoff, the Adolescent and Young Adult Program, supported by the Nascembini Foundation and the Reid R. Sacco Adolescent and Young Adult Cancer Alliance, has collaborated and expanded our consultation for young adults at Hartford Hospital, St. Francis Medical Center, and UConn Health Center. Additionally, Dr. Isakoff has received support from Lea’s Foundation for Leukemia Research to support the opening of clinical trials focused on the area of leukemia and lymphoma. Dr. Andrea Orsey is leading the way in implementing an exercise program to improve the quality of life for children undergoing cancer treatments. This past year, she was awarded CHIP UConn/UCHC seed funding for a pilot yoga intervention project to improve pediatric cancer patient’s quality of life. Dr. Orsey also has been appointed as the cochair of the subcommittee in Global Health initiative within the America Society of Pediatric Hematology/Oncology. Dr. Donna Boruchov’s expertise and state grant funding for our sickle cell patients has guided regional standards for exceptional care. Dr. Boruchov also has received grant funding for participation in nationwide genotyping and repository of our hemophilia patients. Our newest member of the division, Natalie Bezler, MD, was awarded a Hyundai Young Investigator Award for her research in health literacy. PUBLICATIONS Andemariam B, Owarish-Gross J, Grady J, Boruchov D, Thrall RS, Hagstrom JN. Identification of risk factors for an unsuccessful transition from pediatric to adult sickle cell disease care. Pediatr Blood Cancer. 2014 Apr;61(4):697-701. Armstrong AE, Gillan E, DiMario FJ Jr. SMART syndrome (stroke-like migraine attacks after radiation therapy) in adult and pediatric patients. J Child Neurol. 2014 Mar; 29(3):336-41. Robison NJ, Campigotto F, Chi SN, Manley PE, Turner CD, Zimmerman MA, Chordas CA, Werger AM, Allen JC, Goldman 41 Hematology-Oncology S, Rubin JB, Isakoff MS, et al. A phase II trial of a multiagent oral antiangiogenic (metronomic) regimen in children with recurrent or progressive cancer. Pediatr Blood Cancer. 2014 Apr;61(4):636-42. Cortezzo DE, Sanders MR, Brownell EA, Moss K. End-of- life care in the neonatal intensive care unit: experiences of staff and parents. Am J Perinatol. 2014 Dec 17. Fuentes S, Parikh N. Neuroblastoma. In: Stefan and Rodriguez-Galindo, editors. Pediatric hematology-oncology in countries with limited resources. 1st ed. New York: Springer; 2014. p. 337-53. STAFF Natalie Bezler, MD Taryn Hamre, APRN Michael Isakoff, MD Division Co-director Donna Boruchov, MD Kerri McGeary, PA-C Kerry Moss, MD Kathleen O’Leary, APRN Eileen Gillan, MD Hilarie Orton, PA-C Arnold Altman, MD Professor Emeritus Megan Coco, APRN Emily Peluso, APRN Christine Eaccarino, APRN Kimberly Ramjattan, PNP-BC Andrea Orsey, MD Karina Engelke, APRN Katherine Steven, APRN Nehal Parikh, MD Division Co-director Sarah Wentworth, APRN 42 Hospital Medicine The Division of Hospital Medicine is committed to providing exceptional, value-based care to hospitalized children and their families. We value educational excellence, strong collaborations, and continued contributions to the advancement of our field. Pediatric Hospital Medicine is the fastest growing specialty within Pediatrics and our division has continued to grow at a rapid pace. We provide general inpatient pediatric care at Connecticut Children’s Medical Center in Hartford, as well as at our 12-bed satellite unit at St. Mary’s Hospital in Waterbury, CT. Our patient volume has grown over 50 percent in the past five years (2009 to 2013). We continue to partner with primary care groups to assume the care of their inpatients – 96 percent of general pediatric inpatients are now cared for by the hospitalist service. This year we were thrilled to welcome back David Marcello, MD. He returned as a full-time member of the division after a period of time spent developing the Connecticut Children’s Sedation Program. We also continue to oversee a highly proficient group of APRNs and PAs who provide outstanding care and have also led in the development of many of our new clinical pathways. Clinical accomplishments during the past year were numerous. We strengthened our new Co-management Program in which we provide medical expertise in the care of complex surgical patients. This role has improved communication and family satisfaction, and led to a 20-fold increase in our consult volume in two years. We continue to track discrete quality metrics in the division. Our physicians were able to call the primary care provider at discharge over 95 percent of the time and completed a full asthma home treatment plan over 93 percent of the time, putting us in the top quartile nationally. Our new system for early recognition of high patient acuity has expanded, with 300 PICU-level team activations in 2014. We have further standardized best practice via multiple new Clinical Pathways, including both medical and, most recently, surgical diagnoses. For our asthma patients, we have been able to demonstrate reduced length of stay and costs, with no increase in readmits, and with improvements in preventive care. This is perhaps the best example of how as hospitalists we can improve value, which will be increasingly important as health care systems evolve. Education of the next generation of pediatric providers remains an important part of our mission. Our faculty members continue to excel in this area. Dr. Kathy Kalkbrenner earned the prestigious overall Faculty Teaching Award, given to the faculty member who has had the greatest positive impact on the learning of pediatric residents. Dr. David Marcello was also honored with a teaching award for his excellent skills in education. Members of the division continue to share their work on a national level. Division Head Dr. Anand Sekaran presented a talk on hospitalist co-management of neurosurgery patients at the Pediatric Academic Society. Dr. Sekaran was joined by Drs. Waynik and Skurkis as they led a workshop to teach faculty from around the country how to create and implement Clinical Pathways in their own institutions. Our APRN group was nationally visible as well, as Grace Hong presented her work on a community-acquired pneumonia pathway at the National Pediatric Nurse Practitioner Annual Meeting. Physician Assistant Kara Denz presented our new Urinary Tract Infection pathway at the national PA meeting. We take great pride in sharing our work and in helping others to improve along with us. As hospitalists, we continue to evolve in how we provide value, educate trainees, and improve care. Our goal is to not only measure our performance against national standards but to be at the top of those increasingly recognized benchmarks. Yet as we continue to grow, we strive to maintain our greatest core value of putting patients and families first in all we do. PUBLICATIONS Waynik I, (contributing member of the Pediatric Research in Inpatient Settings Network collaborators). Comparative effectiveness of intravenous vs. oral antibiotics for post-discharge treatment of acute osteomyelitis in children. JAMA Pediatr. 2014 Dec 15. doi:10.1001/jamapediatrics.2014.2822. [Epub ahead of print] FACULTY Anand Sekaran, MD Division Head Richard Johnson, MD Kathy Kalkbrenner, MD David Marcello, MD 43 Hospital Medicine Marta Mieczkowska, MD MacDara Tynan, MD Jill Herring, APRN Chris McDermott, MD Ilana Waynik, MD Grace Hong, APRN Christine Skurkis, MD Basia Adams, APRN (Leader) Samantha Lee, APRN Catherine Sullivan, MD Kara Denz, PA-C 44 Human Genetics The Division of Human Genetics resides jointly in the Department of Genetics and Genome Sciences as well as the Department of Pediatrics. The mission of the division is to provide high quality, timely and state-of-the-art genetic consultations, counseling, and treatment for patients from the prenatal period throughout childhood and into adulthood. This care over the lifespan is provided by clinical geneticists, genetic counselors and a part-time metabolic dietician (2.0 FTE clinical geneticists, 2.0 full-time prenatal genetic counselors, 1.8 hereditary cancer genetic counselors, 1.0 “teratogen” counselor, and 0.4 metabolic dietician) at two campuses. The clinical/administrative/academic offices this year moved to the UConn campus at 263 Farmington Ave., Farmington, Connecticut, where children and adults are seen in a general genetics clinic, and where prenatal and hereditary cancer patients receive genetic counseling. MotherToBabyCT has moved to 195 Farmington Ave., Farmington. At our site for Connecticut Children’s, children are seen in our outpatient clinic at 11 South Road, Farmington. A full-service cytogenetics laboratory run by Dr. Peter Benn at John Dempsey Hospital provides testing for internal and external patients. Patients with metabolic disease identified through the DPH Newborn screening program, as well as children diagnosed at a later age, are seen in our UConn office in conjunction with our metabolic dietician. There have been no major changes in the scope of patients seen. However, increased use of non-invasive prenatal genetic testing continues to increase the number of patients being seen by the prenatal service, and frequently updated test offerings for patients with hereditary cancers has increased the patient numbers being seen and evaluated by the hereditary cancer counseling program. MotherToBabyCT, our teratogen counseling program, is expanding its coverage throughout the state. Collaborations with Connecticut Children’s Medical Center, Department of Public Health Newborn Screening Program, UConn’s Maternal–Fetal-Medicine program, and Neag Cancer Center are robust and active. A $225,000 Department of Public Health annual contract helps to support the newborn screening/metabolic and MotherToBabyCT programs. The division’s educational mission begins in the first year of medical school and goes through postgraduate fellowship. We have an active medical genetics fellowship, including a two-year post-residency fellowship and one of only 16 combined pediatric-medical genetics residency programs nationally. There are also student, resident, fellow, and genetic counseling learners who spend a month’s rotation in genetics. In addition, one pediatric resident arranged a weekly longitudinal rotation. The year 2014 was a busy one for Dr. Benn who delivered invited presentations to international audiences at conferences in Portugal, Italy, India, Australia and New York. Benn serves as a reviewer for 10 publications including The American Journal of Medical Genetics, The American Journal of Obstetrics and Gynecology, Genetics in Medicine, and Prenatal Diagnosis. He is a member of the board of the International Society for Prenatal Diagnosis. The division’s genetic counselors received the following recognition: Brittany Gancarz, MS, CGC, received UConn’s Touchstone Innovation Award for her work in the area of perinatal palliative care. Sharon Lavigne, MS, was an invited speaker at the annual Teratology Course at Harvard’s Mass General Hospital. The division’s teratogen counseling program, MotherToBabyCT, received a grant entitled “Reproductive and Environmental Health Network” through HRSA. Robin Schwartz, MS, CGC, is co-chair of the Education and Workforce Development, Genetic Advisory Committee at the CT Department of Public Health. NEW/ONGOING COLLABORATIONS Sally Rosengren, MD, is a co-investigator for an Affinity Research Collaborative project, whose goals are to look at specific clinical, historical, genetic, and functional aspects of autism. This project was funded in July 2013 by the Institute for Systems Genomics for five years. Other agencies participating in this ARC include Connecticut Children’s Medical Center and Jackson Laboratories. Robin Schwartz and Jennifer Stroop, CGCs, are both col- 45 Human Genetics laborating investigators in the CICATS project, “Determining clinical significance of mismatch repair variants,” with PI Chris Heinen, PhD. Drs. Rosengren and Joseph Tucker are active members of the GUPPE program, and along with the Urology, Psychiatry, Psychology and Endocrinology divisions at Connecticut Children’s, they provide multidisciplinary care for children with disorders of sexual development. PUBLICATIONS BOOK CHAPTER Benn P. Debate: Screening in recurrent pregnancy loss: nonspecific testing is insufficient. In: Carp H, editor. Recurrent pregnancy loss: causes, controversies and treatment. 2nd ed. CRC Press. 2014. STAFF Sally Rosengren, MD Division Head Benn P, Cuckle H. Theoretical performance of non-invasive prenatal testing for chromosome imbalances using counting of cell-free DNA fragments in maternal plasma. Prenat Diagn. 2014;34:778-83. Peter Benn, PhD Chapman AR, Benn PA. Noninvasive prenatal testing for early sex identification: a few benefits and many concerns. Perspect Biol Med. 2014;56:530-47. Sharon Lavigne, MS Dar P, Curnow KJ, Gross SJ, Hall MP, Stosic M, Demko Z, Zimmermann B, Hill M, Sigurjonsson S, Ryan A, Banjevic M, Kolacki PL, Koch SW, Strom CM, Rabinowitz M, Benn P. Clinical experience and follow-up with large scale single-nucleotide polymorphism-based noninvasive prenatal aneuploidy testing. Am J Obstet Gynecol. 2014;211:527.e1-527.e17. Joseph Tucker, MD Alicia Craffey, MS Ginger Nichols, MS Robin Schwartz, MS Brittany Gancarz, MS Jennifer Stroop, MS FACULTY EMERITUS Robert Greenstein, MD 46 Infectious Diseases & Immunology In 2014, the Division of Infectious Diseases and Immunology had their busiest year yet, with consistent growth in inpatient and outpatient consultations, while leading the hospital response to the threat of Ebola in West Africa. The division continued this year in its mission to provide the best possible care to children in Connecticut suffering from infectious diseases and immune deficiencies. In addition to providing care at Connecticut Children’s Medical Center, our members provided educational outreach across the state, and successfully advocated for an expansion in the state vaccination program to properly serve children with immune deficiencies. The unprecedented outbreak of Ebola in West Africa, combined with the realities of rapid, global travel, led Connecticut Children’s to enhance its existing disaster preparedness planning to focus on safely detecting, isolating, and treating children with possible Ebola infection. Led by Dr. Andrea Benin, with significant contributions from Dr. Nicholas Bennett and the other members of the division, the Ebola Taskforce developed clinical pathways, trained over 100 hospital staff members, and remodeled four hospital rooms in the event of having to care for children exposed to or infected with any serious communicable infection. In five short but intense weeks, we significantly upgraded our ability to deal with health care disasters, including infectious diseases, but with skills and equipment that could be transferred to many other scenarios. Clinical growth was assisted by the addition of Dr. Thomas Murray MD, PhD, also of Quinnipiac University School of Medicine, who brings to the division his experience and training in clinical microbiology, as well as pediatric infectious diseases. Dr. Murray is involved with research collaborations with Pediatric Pulmonology at Connecticut Children’s, and is the director of the Capstone longitudinal research experience at Quinnipiac. The division of Infectious Diseases and Immunology was the first of two clinical divisions to mentor students as part of that experience. We continue to provide comprehensive care, supported by the Ryan White program, for HIV-infected youth and HIV-exposed children and neonates. This year saw several referrals from new overseas adoptions, where we were ideally placed to provide comprehensive care including diagnosis and treatment of parasitic diseases, advice on vaccine requirements, and to adapt treatment regimens to the United States’ equivalents. The Antimicrobial Stewardship Program, led by Dr. Bennett and Jennifer Girotto, PharmD, expanded its remit by becoming one of only two programs in the United States to offer a one-year pharmacy residency in pediatric infectious diseases. This not only enhanced our ability to provide effective stewardship guidance to the clinicians at Connecticut Children’s, and further our research efforts, but will provide a lasting contribution to the national effort to improve antibiotic use in pediatric medicine. The division continues to publish cutting-edge research, funded by NIH R01 and R03 grants held by Dr. Salazar, as well as clinical reports and reviews. ACTIVE GRANTS R0-1 AI090166 NIAID – Phagosomal signals shape inflammatory responses to Borrelia burgdorferi. Direct amount per year $315,000. (Active: 07/15/2011- 6/30/2016) PI: Dr. Juan Salazar. R03 TW00972 – Mechanisms of immune evasion in human syphilis. (Active: 3/1/2013-11/30/2015) Co-PI: Dr. Juan Salazar. Colciencias Grant (Colombian National Institute of Sciences) – Natural killer cells in syphilis infection. (Active 2/1/201312/31/2014) Co-PI: Dr. Juan Salazar. AI-29735 NIH RpoS regulation of Borrelia burgdorferi genes in vivo. (Active 2/1/2013-1/31/2018) Co-Invest: Dr. Caimano. PUBLICATIONS Bennett N. Pneumocystis jirovecii pneumonia prophylaxis for HIV-exposed neonates. Res Rep Neonatol. 2014;Apr;4:71–4. Brandt KS, Patton TG, Allard AS, Caimano MJ, Radolf JD, Gilmore RD. Evaluation of the Borrelia burgdorferi BBA64 protein as a protective immunogen in mice. Clin Vaccine Immunol. 2014;21(4):526-33. PMID: 24501342. Caimano MJ, Sivasankaran SK, Allard A, Hurley D, Hokamp K, Grassmann AA, Hinton JC, Nally JE. A model system for studying the transcriptional and physiological changes associated with mammalian host-adaption by Leptospira interrogans serovar Copenhageni. PLoS Pathog. 2014;10(3):e1004004. PMID 24626166. 47 Infectious Diseases & Immunology Cervantes JL, Hawley KL, Benjamin SJ, Weinerman B, Luu SM, Salazar JC. Phagosomal TLR signaling upon Borrelia burgdorferi infection. Front Cell Infect Microbiol. 2014 May 20;4:55. Feder HM Jr. Lyme disease. N Engl J Med. 2014 Aug 14;371(7):683-4. Fornari A, Murray TS, Menzin AW, Woo VA, Clifton M, Lombardi M, Shelov S. Mentoring program design and implementation in new medical schools. Med Educ Online. 2014;19:24570. doi:10.3402/meo.v19.24570. Held M, Burke G, Zalneraitis E. Pediatric residency program hand-over: before and after the ACGME requirement. Acad Pediatr. 2014 Nov/Dec;14(6):610-15. Kassam Z, Murray TS. Navigating the pediatric microbiome: emerging evidence and clinical implications. Curr Pediatr Rep. 2014. doi:10.1007/s40124-014-0040-1. Kulkarni M, Tichy A, Pyka J, Murray T, Hodsdon M, Peaper D. 2014. Use of imipenem to detect KPC, NDM, OXA, IMP, and VIM carbapenemase activity from gram negative rods in 1 hour using LC-MS/MS. J Clin Microbiol. 2014;52:2500-5. Libardo MD, Cervantes JL, Salazar JC, Angeles-Boza AM. Improved bioactivity of antimicrobial peptides by addition of amino-terminal copper and nickel (ATCUN) binding motifs. ChemMedChem. 2014 Aug;9(8):1892-901. Miller KA, Motaleb MA, Liu J, Caimano MJ, Miller MR, Charon NW. Initial characterization of the Flg hook high molecular weight complex of Borrelia burgdorferi. PLoS One. 2014;9(5):e98338. PMID 24859001. Rogers S, Cohen-Abbo A. Mononucleosis. Rosen & Barkin’s 5-minute emergency medicine consult. Salazar JC, Cahn P, Della Negra M, De Aquino MZ, Robinson PA, Jelaska A, Mikl J. Efficacy and safety of tipranavir coadministered with ritonavir in HIV-1-infected children and adolescents: 5 years of experience. Pediatr Infect Dis J. 2014 Apr;33(4):396-400. Somily AM, Habib HA, Absar MM, Arshad MZ, Manneh K, Al Subaie SS, Al Hedaithy MA, Sayyed SB, Shakoor Z, Murray TS. ESBL Producing Escherichia coli and Klebsiella pneumoniae at a tertiary care hospital in Saudi Arabia. J Infect Dev Ctries. 2014;8:1129-36. doi:10.3855/jidc.4292. PMID: 25212077. Somily AM, Al-Subiae SS, BinSaeed AA, Torchyan A, Alzamil F, Al-Aska AI, Al-Khattaf FS, Khalifa LA, Al-Thawadi SI, Alaidan W, Al-Ahdal MN, Al-Qahtani AA, Murray TS. Extended spectrum beta-lactamase producing Klebsiella pneumoniae outbreak in the neonatal intensive care unit of a teaching hospital, does vancomycin have role? Am J Infect Cont. 2014;42:277-82. Sweet L, Held M. Paeditricians in training: a global child health elective curriculum. MedEdPublish. 2014;3:35. Valdez TA, Marvis K, Bennett NJ, Lerer T, Nolder AR, Buchinsky FJ. Current trends in perioperative antibiotic use: a survey of otolaryngologists. Otolaryngol Head Neck Surg. 2014 Oct 10. Xu H, Sobue T, Thompson A, Xie Z, Poon K, Ricker A, Cervantes J, Diaz PI, Dongari-Bagtzoglou A. Streptococcal coinfection augments Candida pathogenicity by amplifying the mucosal inflammatory response. Cell Microbiol. 2014 Feb;16(2):214-31. STAFF Juan C. Salazar, MD, MPH Division Head Nicholas Bennett, MBBChir, PhD Andrea Benin, MD Alberto Cohen-Abbo, MD Henry M. Feder, Jr., MD Melissa Held, MD Hillary Hernandez-Trujillo, MD Thomas Murray, MD, PhD Gavin Schwarz, MD Jennifer Girotto, PharmD 48 Neonatology The Division of Neonatology directs one of the largest and most diverse clinical services in New England and is the perinatal regional center for northern Connecticut. The Division of Neonatal-Perinatal Medicine includes faculty at five major sites: Connecticut Children’s Medical Center (Hartford), Connecticut Children’s Medical Center at the University of Connecticut Health Center (UCHC)/John Dempsey Hospital (JDH), St. Francis Hospital and Medical Center (SFHMC), the Hospital of Central Connecticut (THOCC), and Eastern Connecticut Health Network (ECHN). Faculty members work collaboratively across sites to achieve goals in quality of care, education, training, and research. In support of this multi-site program, Dr. David Sink was appointed site director at the Connecticut Children’s NICU at UCHC. As the regional perinatal center, the division provides clinical leadership and outreach education for hospitals throughout Connecticut. The neonatal transport program was incorporated into Connecticut Children’s Critical Care Transport and completed its first full year of operations transporting over 300 newborns throughout the region and state. Neonatal transports are performed by NICU-specific staff providing service to referring hospitals throughout Connecticut. The neonatal follow-up program provides transitional short-term medical follow-up and neurodevelopmental follow-up for high risk infants from all NICUs in the region. The CT Perinatal Collaborative was launched this year under the leadership of Dr. Marilyn Sanders, in collaboration with the Yale Division of Neonatology and the CT March of Dimes. The collaborative works with all birthing hospitals in the state to improve care for all newborns. The focus for its first year is on improving breastfeeding initiation rates and reducing necrotizing enterocolitis. The CT Human Milk Research Center was established under the leadership of Elizabeth Brownell, PhD, and has several active research projects and publications. The division held its second bi-annual Neonatal–Perinatal Research Day. This year’s program’s focus was on necrotizing enterocolitis featuring presentations by local and invited investigators as well as 25 research posters encompassing a variety of topics in neonatal-perinatal medicine. Dr. Kathleen Marinelli received the United States Breastfeeding Committee Distinguished Service Award and the Academy of Breastfeeding Medicine Board Service Award. She was also named Chair of the Baby-Friendly US NICU Initiative and elected to the Board of the International Lactation Consultant Association as Director of Professional Development. PUBLICATIONS Hagadorn JI, Salikooti S, Pappagallo M, AriasCamison J, Alba J, Herson V, et al. Postpartum triage, services provided, and length of stay for infants born at 35 weeks gestation. Am J Perinatol. 2014 Dec 23. [Epub ahead of print] Brownell EA, Hagadorn JI, Lussier MM, Lerer TJ, Herson VC, Howard CR, et al. Optimal periods of exclusive breastfeeding associated with any breastfeeding duration through one year. J Pediatr. 2015 Mar;166(3):566-570.e1. doi: 10.1016/j.jpeds.2014.11.015. Epub 2014 Dec 16. Hagadorn JI, Brownell EA, Lussier MM, Parker MG, Herson VC. Variability of criteria for pasteurized donor human milk use: a survey of U.S. neonatal ICU medical directors. JPEN J Parenter Enteral Nutr. 2014 Sep 29. doi: 10.1177/0148607114550832. [Epub ahead of print] Campbell BT, Herbst KW, Briden KE, Neff S, Ruscher KA, Hagadorn JI. Inhaled nitric oxide use in neonates with congenital diaphragmatic hernia. Pediatrics. 2014 Aug;134(2):e420-6. doi: 10.1542/peds.2013-2644. Epub 2014 Jul 14. Brownell EA, Lussier MM, Esposito P, Briere CE, Herson VC, Hagadorn JI, et al. Patterns and predictors of donor human milk non-consent in the neonatal ICU. Breastfeed Med. 2014 Oct;9(8):393-7. doi: 10.1089/bfm.2014.0044. Epub 2014 Jul 9. Marinelli KA, Lussier MM, Brownell E, Herson VC, Hagadorn JI. The effect of a donor milk policy on the diet of very low birth weight infants. J Hum Lact. 2014 Apr 18;30(3):310-316. [Epub ahead of print] Brownell EA, Lussier MM, Hagadorn JI, Herson VC, Marinelli KA. Authors’ response to “a letter to the editor regarding ‘donor human milk bank data collection in North America: an assessment of current status and future needs’ from the human milk banking association of North America.” J Hum Lact. 2014 May;30(2):243. 49 Neonatology Ruiz TL, Trzaski JM, Sink DW, Hagadorn JI. Transcribed oxygen saturation vs. oximeter recordings in very low birth weight infants. J Perinatol. 2014 Feb;34(2):130-5. Brownell EA, Lussier MM, Hagadorn JI, McGrath JM, Marinelli KA, Herson VC. Independent predictors of human milk receipt at neonatal intensive care unit discharge. Am J Perinatol. 2014 Nov;31(10):891-8. Brownell EA, Lussier MM, Herson VC, Hagadorn JI, Marinelli KA. Donor human milk bank data collection in North America: an assessment of current status and future needs. J Hum Lact. 2014 Feb;30(1):47-53. Lang SM, Giuliano JS Jr, Carroll CL, Rosenkrantz TS, Eisenfeld L. Neonatal/infant validation study of the CAS model 740 noninvasive blood pressure monitor with the Orion/MaxIQ NIBP module. Blood Press Monit. 2014 Jun;19(3):180-2. Meigh L, Hussain N, Mulkey DK, Dale N. Connexin26 hemichannels with a mutation that causes KID syndrome in humans lack sensitivity to CO2 Elife. 2014 Nov 25;3:e04249. Shamshirsaz AA, Ravangard SF, Ozhand A, Haeri S, Shamshirsaz AA, Hussain N, et al. Short-term neonatal outcomes in diamniotic twin pregnancies delivered after 32 weeks and indications of late preterm deliveries. Am J Perinatol. 2014 May;31(5):365-72. Selvaraju V, Parinandi NL, Adluri RS, Goldman JW, Hussain N, Sanchez JA, et al. Molecular mechanisms of action and therapeutic uses of pharmacological inhibitors of HIF-prolyl 4-hydroxylases for treatment of ischemic diseases. Antioxid Redox Signal. 2014 Jun 1;20(16):2631-65. Hussain N, Shamshirsaz AA, Haeri S, Ravangard SF, SangiHaghpeykar H, Gandhi M, et al. Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies. J Matern Fetal Neonatal Med. 2014 Apr;27(6):552-6. Wight N, Marinelli KA. ABM clinical protocol #1: guidelines for blood glucose monitoring and treatment of hypoglycemia in term and late-preterm neonates, revised 2014. Academy of Breastfeeding Medicine. Breastfeed Med. 2014 May;9(4):173-9. Evans A, Marinelli KA, Taylor JS. ABM clinical protocol #2: Guidelines for hospital discharge of the breastfeeding term newborn and mother: “The going home protocol,” revised 2014. Academy of Breastfeeding Medicine. Breastfeed Med. 2014 Jan-Feb;9(1):3-8. Cortezzo DE, Sanders MR, Brownell EA, Moss K. Endof-life care in the neonatal intensive care unit: experiences of staff and parents. Am J Perinatol. 2014 Dec 17. Brownell EA, Lussier MM, Dozier AM, Howard CR, Fisher SG, Duckett JW, et al. The discordance between planned use and actual receipt of immediate postpartum depot medroxyprogesterone among low-income women. Breastfeed Med. 2014 Jul-Aug;9(6):290-3. Dozier AM, Nelson A, Brownell EA, Howard CR, Lawrence RA. Patterns of postpartum depot medroxyprogesterone administration among low-income mothers. J Womens Health (Larchmt). 2014 Mar;23(3):224-30. Dozier AM, Brownell E, Guido J, Yang H, Howard CA, Doniger A, et al. Adapting the pregnancy risk assessment monitoring survey to enhance locally available data: methods. Matern Child Health J. 2014 Jul;18(5):1196-204. Smith AL, Hill CA, Alexander M, Szalkowski CE, Chrobak JJ, Rosenkrantz TS, et al. Spatial working memory deficits in male rats following neonatal hypoxic ischemic brain injury can be attenuated by task modifications. Brain Sci. 2014 Apr 2;4(2):240-72. Rhein LM, Dobson NR, Darnall RA, Corwin MJ, Heeren TC, Poets CF, et al, Caffeine Pilot Study Group (Rosenkrantz T). Effects of caffeine on intermittent hypoxia in infants born prematurely: a randomized clinical trial. JAMA Pediatr. 2014 Mar;168(3):250-7. Smith AL, Alexander M, Rosenkrantz TS, Sadek ML, Fitch RH. Sex differences in behavioral outcome following neonatal hypoxia ischemia: insights from a clinical meta-analysis and a rodent model of induced hypoxic ischemic brain injury. Exp Neurol. 2014 Apr;254:54-67. Alexander M, Garbus H, Smith AL, Rosenkrantz TS, Fitch RH. Behavioral and histological outcomes following neonatal HI injury in a preterm (P3) and term (P7) rodent model. Behav Brain Res. 2014 Feb 1;259:85-96. Mourani PM, Kinsella JP, Clermont G, Kong L, Perkins AM, 50 Neonatology Weissfeld L, et al, Prolonged Outcomes After Nitric Oxide (PrONOx) Investigators (Pappagallo M). Intensive care unit readmission during childhood after preterm birth with respiratory failure. J Pediatr. 2014 Apr;164(4):749-755. Alur P, Bollampalli V, Bell T, Hussain N, Liss J. Correlation of caffeine concentrations with short term outcomes in premature infants of ≤ 29 weeks gestation. J Perinatol. 2014 Dec 18. doi: 10.1038/jp.2014.226. [Epub ahead of print] STAFF Victor C. Herson, MD Division Head Amir LH, Academy of Breastfeeding Medicine Protocol Committee (Marinelli K, Bunik M, Noble L, Brent N, Grawey AE, Holmes AV, Lawrence RA, Seo T). ABM Clinical Protocol #14: Mastitis, revised March 2014. Breastfeed Med. 2014;9(5):239-243. BOOK CHAPTER Hussain N. Epigenetics in childhood health and disease. In: Maulik N, Karagiannis T, editors. Molecular mechanisms and physiology of disease: implications for epigenetics and health. New York: Springer; 2014. p. 1-62. John R. Raye, MD (retired, honorary staff) Ted S. Rosenkrantz, MD Jose Arias-Camison, MD Saritha Salikooti, MD Tina Rita Bafumi, MD (Middlesex) Marilyn Sanders, MD Fadel Balawi, MD (SFHMC) Shikha Sarkar, MD Hema DeSilva, MD Professor Emeritus David Walker Sink, MD Leonard I. Eisenfeld, MD James Hagadorn, MD Jennifer Trzaski, MD Aniruddha Vidwans, MD Leslie I. Wolkoff, MD Bernadette A. Hillman, MD (THOCC) Rebecca Beebe, PhD Naveed Hussain, MBBS, DCH Jacqueline McGrath, PhD Carla Jacobson-Kiel, MD Sabrina Colangelo, PA-C Shabnam Lainwala, MD Shivani Desai, PA-C Kathleen Marinelli, MD James Gerace, PA Adam Matson, MD Kristen Moore, PA Arpana Mohnani, MD (THOCC) Jessica Simao, PA Indira Panthagani, MD Jessica Cauchon, APRN Mariann Pappagallo, MD Lucia Onofrio, PA-C Angela Boisseau, APRN Mary Brennan-Centrella, APRN Stephanie Capps, APRN Karen Cleveland, APRN Jill Herr, APRN Lindsay Leighton, APRN Michelle Letendre, APRN Jennifer Long, APRN Stephanie McGuire, APRN Suanne Menick, APRN Karen O’Brien, APRN Terry Poppiti, APRN Christine Raymond, APRN Megan Richardson, APRN Stacey Rubin, APRN Patricia Trehey, APRN Lindsay Tucker, APRN Alyssa Weiss, APRN Erin Vlahakis, APRN Mary Young, APRN Allyson Dacruz, PA-C 51 Neonatology Corey Champeau, PA-C Karen Cleaveland, APRN Wendy Petow, APRN Brian Landry, PA-C Anna Camacho, APRN Karen Pietruszkiewicz, APRN Kristen Moore, PA-C Nicole Duguay, APRN Laura Pittari, APRN Stacy Voegeli, PA-C Maria Haar, APRN Christine Raymond, APRN Margaret Wilber, PA-C Nick Markey, APRN Babette Sternat, APRN Kim Oski, APRN Claudia Wittenzellnew, APRN 52 Nephrology This was an exciting year as the division has seen significant changes with the successful recruitment of a third fulltime nephrologist, Dr. Samriti Dogra, as well as a part-time renal dietitian, Kyle Lamprecht, MS, RD, CD-N. These additions increased capacity to treat children with renal diseases from across the state. Volume was up significantly, specifically renal transplantation, which saw the successful transplant of five patients in an 18-month span. The leadership of the division has come under structure change as well. We are excited to report that Dr. Cynthia Silva was promoted to Division Head. As the Division of Nephrology continues to grow, the greater goal is to move toward a service line blending Urological and Renal services under the same structure. To this end, the division rolled out a multidisciplinary clinic aimed at caring for children with complex urological malformations and chronic renal failure as well as kidney stone patients. Two new multidisciplinary clinics were added this past academic year; a chronic renal failure clinic for children with urological malformation as well as a clinic for kidney/bladder stones. We are the first Nephrology section in the state to offer such an array of clinics, which involve board-certified Nephrologists, Urologists, Pediatricians, dietitians, mid-levels and social workers. Drs. Mason, Silva and McDonald are all board-certified Pediatric Nephrologists. Dr. Bruce McDonald re-started providing renal services at our Shelton location this year, which was a divisional goal in 2013. The Shelton satellite has increased services to our patients in Fairfield County and yielded an increased referral base, which now also includes New Haven County. The division is pushing forward to expand services in other areas, and plans for Dr. Mason to see patients in our Farmington location are well underway. The division increased care for more than 3,000 outpatient visits as well as increasing in-patient volumes. The visits were comprised of pre-transplant, post-transplant, inpatient and outpatient consults as well as acute and chronic dialysis. The division continues to work closely with the ICU on a regular basis to provide continuous veno-venous hemodialfiltration for our sickest patients. Dr. Silva was invited to participate in the prestigious Mid West Pediatric Nephrology Consortium (MWPNC), which is a multicenter research collaborative aimed at improving knowledge and clinical care for children with renal disorders. The division has multiple IRB-approved research studies active at this time as well as joint research collaborative with the Division of Urology. As we look forward to the upcoming year, we expect roll out of our Nephrology-Urology service line. We also hope to cohort these patients during their in-patient experience for improved clinical outcomes as well as patient satisfaction. We also will continue our extensive research portfolio and move from IRB-approved research to funded studies. PUBLICATIONS Koraishy FM, D’Alessandri-Silva C, Mason S, Wu D, Cantley LG. Hepatocyte growth factor (Hgf) stimulates low density lipoprotein receptor-related protein (Lrp) 5/6 phosphorylation and promotes canonical Wnt signaling. J Biol Chem. 2014 May 16;289(20):14341-50. Mason S, Hader C, Marlier A, Moeckel G, Cantley L.G. Met activation is required for early cytoprotection after ischemic kidney injury. J Am Soc Nephrol. 2014 Feb;25(2):329-37. Riemenschneider M, Makari J, Rochon C, Ferrer F, D’Alessandri-Silva C. Mass in failed renal allograft. Pediatr Nephrol. Epub ahead of print: 2014 Sept 4. Thangada S, Shapiro LH, D’Alessandri-Silva C, Yamase H, Hla T, Ferrer FA. Treatment with the Immunomodulator FTY720 (Fingolimod) significantly reduces renal inflammation in murine unilateral ureteral obstruction. J Urol. 2014 Mar 25. BOOK CHAPTER D’Alessandri-Silva C, Dorsey K. Week 38: enuresis. Yale Primary Care Pediatrics Curriculum. 6th ed. 2012. STAFF Cynthia D’Alessandri-Silva, MD, FAAP Division Head Samriti Dogra, MD Bruce McDonald, MD, FAAP Sherene Mason, MD, FAAP, MBA Molly Band, PA-C 53 Pediatric Neurology The main mission of the Division of Neurology is to provide the best available care for children with various neurological diseases. in predicting outcomes following seizures in the neonatal period. We practice according to the latest care guidelines and employ state-of-the-art diagnostic technologies and treatments. The neurology faculty consists of experts in the fields of epilepsy, electrophysiology, neurocutaneous diseases, neurogenetics and neuromuscular diseases. We collaborate with most of the other specialties at Connecticut Children’s. Our faculty members and nurses participate in various national and international conferences. Another important part of our academic activity is to educate residents and medical students. The division is actively involved in clinical research in autism, epilepsy, tuberous sclerosis, and neuromuscular diseases. Dr. Louisa Kalsner (principal investigator) and Dr. Gyula Acsadi (co-investigator) are in a collaborative research program on autism founded by the joint UConn and Jackson Laboratory ARC Program. Dr. DiMario conducts a multicenter clinical study on Tuberous Sclerosis. Dr. Acsadi has collaborated with Sylvia Õunpuu and Dr. Kristan Pierz of the Center of Motion Analysis to evaluate the gait patterns of CMT patients. Dr. Acsadi participates in the Tone Management program that helps to treat patients with spasticity. Dr. Jennifer Madan Cohen has collaborated with Neurosurgery and Hartford Hospital’s adult epilepsy program to evaluate patients with intractable focal epilepsy for epilepsy surgery. MAJOR ACCOMPLISHMENTS PUBLICATIONS Dr. Francis DiMario was an invited speaker at the Joint Annual Conference of Indian Epilepsy Association & Indian Epilepsy Society, Kolcata, India, and at the Annual National Conference for Public Responsibility in Medicine and Research (PRIM&R), Baltimore, MD. Armstrong AE, Gillan E, DiMario FJ Jr. SMART syndrome (stroke-like migraine attacks after radiation therapy) in adult and pediatric patients. J Child Neurol. 2014 Mar;29(3):336-41. AWARDS Dr. Richard Young has received the “Meritorious Service Award” from the U.S. Army. RECRUITMENTS/DEPARTURES The Pediatric Neurology Division has recruited two new neurology specialists, Drs. Mark L. Schomer and Christine Matarese, whose expertise includes Epilepsy and Clinical Neurophysiology. Dr. Cristian Ionita accepted a position at Seattle Children’s Hospital. EXPANSION In September 2014, the division’s main office and clinic was relocated to the new ambulatory building located in Farmington. The Connecticut Children’s hospital clinic was relocated to 85 Seymour in Hartford. COLLABORATIONS Since arriving at Connecticut Children’s, Dr. Schomer has helped to establish a multi-institutional EEG database, with collaborators at Boston Children’s Hospital and Columbia Medical Center, with the goal of finding factors that may help Held MR, Burke GS, Zalneraitis E. Pediatric residency program handover: before and after the ACGME requirement. Acad Pediatr. 2014 Nov-Dec;14(6):610-5. Kissel JT, Elsheikh B, King WM, Freimer M, Scott CB, Kolb SJ, Reyna SP, Crawford TO, Simard LR, Krosschell KJ, Acsadi G, Schroth MK, D’Anjou G, LaSalle B, Prior TW, Sorenson S, Maczulski JA, Swoboda KJ; Project Cure Spinal Muscular Atrophy Investigators Network. SMA valiant trial: a prospective, double-blind, placebo-controlled trial of valproic acid in ambulatory adults with spinal muscular atrophy. Muscle Nerve. 2014 Feb;49(2):187-92. BOOK CHAPTERS DiMario FJ. Tuberous sclerosis complex. In: E-Pocrates. London, England: BMJ. Revision and update, June 2014. Acsadi G. In: Greenamyer T, editor. Medlink neurology. Arbor Publ. updated 2014. 1. A csadi, G: The Chediak-Higashi syndrome 2. Acsadi, G: Congenital muscular dystrophy: Merosin deficient form 3. A csadi, G: Duchenne muscular dystrophy 4. A csadi, G: Becker muscular dystrophy 5. Acsadi, G: Severe autosomal recessive congenital muscular dystrophy 54 Pediatric Neurology STAFF Cristian Ionita, MD Gyula Acsadi, MD Division Head Mark Schomer, MD Francis J. DiMario, Jr, MD Louisa Kalsner, MD Jennifer Madan Cohen, MD Richard Young, MD Edwin Zalneraitis, MD Brenda Cowan-Frautschy, APRN 55 Pediatric Neurosurgery Our Pediatric Neurosurgery program successfully recruited Dr. Markus Bookland in 2014 following his fellowship training at Emory University in Atlanta. Dr. Bookland’s clinical practice specializes in the surgical management of brain tumors and minimally invasive procedures. He maintains an active research laboratory at the University of Connecticut School of Medicine where he continues investigations of malignant glioma and 3-D neural networking. Our collaboration with the Jackson Laboratory Avatar program has been successful at animal modeling of several malignant and rare brain tumors, providing an extraordinary study of tumor genomics and chemotherapy response. Our spine deformity program has been successful at complex cranial-cervical junction fusion in very young children using high molecular weight polyethylene cables to enhance rigid internal fixation. The spina-bifida program treated a record number of new children in 2014 born with congenital spine malformations. Our operating room is fully equipped with an intraoperative CT scanner, neuro-physiological and EEG monitoring, brain mapping, CO2 laser, and brain-lab navigation image guidance. Our multi-institutional study of children with craniosynostosis identified improved neurodevelopmental milestones following cranioplasty completed when less than 6 months of age. A cognitive advantage was demonstrated following open expansions compared to minimally invasive procedures followed by helmet use. Working closely with the faculty from the Division of Neurology, there has been considerable growth in the epilepsy surgery program. A record number of temporal lobe resections with intraoperative EEG monitoring were completed. We maintain collaborations with the neuro-oncology program, cranio-facial center and our endoscopic sinus surgeons. PUBLICATIONS Hashim P, Patel A, Yang J, Travieso R, Terner J, Losee J, Pollack I, Kanev P, Jane J Sr, Jane J Jr, Mayes L, Duncan C, Bridgett DJ, Persing J. The effects of whole vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis. J Plast Reconstr Surg. 2014;134(3):491-501. Epub 2014 May 6. Patel A, Yang J, Hashim P, Travieso R, Terner J, Mayes L, Kanev P, Duncan C, Jane J Jr, Jane J Sr, Pollack I, Losee J, Bridgett D, Persing J. The impact of the Age of Surgery on long-term neuropsychological outcomes in sagittal craniosynostosis. J Plast Reconstr Surg. 2014;134(4):608e-617e. Sarda S, Bookland M, Chu J, Shoja M, Miller M, Reisner S, Yun P, Chern N. Return to system within 30 days of discharge following pediatric non-shunt surgery. J Neurosurg Pediatr. 2014 Dec;14(6):654-61. Chern J, Bookland M, Tejedor-Sojo J, Riley J, Tubbs R, Reisner A. Return to system within 30 days of discharge following pediatric shunt surgery. J Neurosurg Pediatr. 2014 Dec;3(3):525-31. STAFF Paul Kanev, MD Division Chief Jonathan Martin, MD Markus Bookland, MD, FAANS Gary Spiegel, MD Belachew Tessema, MD Katie Kellerman, M.Hs, PA-C Petronella Stoltz, APRN, DNP 56 Orthopaedic Surgery The Orthopaedic Division continues to grow both clinically and academically. An all-star team ranging from surgeons to sports trainers to engineers provides quality care for the full spectrum of orthopaedic conditions to improve the quality of health for members of our community. The Orthopaedic Division consists of three services: the pediatric orthopaedic service, a sports medicine service (Elite Sports Medicine), and the Center for Motion Analysis (CMA). The pediatric orthopaedic service has seven fellowship-trained pediatric orthopaedic surgeons, two physicians’ assistants, and one advanced-practice registered nurse. Together, our services provide the full spectrum of care for children and young adults with orthopaedic conditions such as scoliosis and spinal deformities, limb deformity, congenital dislocated hips, clubfeet, congenital hand deformities, children’s fractures, sports injuries, as well as neuromuscular conditions such as cerebral palsy, spina bifida and muscle diseases. Residents are taken through a core curriculum of pediatric orthopaedic topics to supplement their clinical and surgical experience. An ACGME-accredited pediatric orthopaedic fellowship helps train the next generation of subspecialists. Journal clubs for the entire clinical staff keep the team up to date on the latest literature and promote a cohesive environment for the care team. Departmental and interdisciplinary conferences with radiology and neurosurgery promote multi-specialty collaboration. Dr. Kristan Pierz now serves as editor of the POSNA Resident Review, an important educational asset for surgeons-intraining. The sports medicine service (Elite Sports Medicine) continues to grow under the guidance of four physicians, two physicians’ assistants, and two athletic trainers. This group provides outstanding care for young athletes with injuries and oversees impressive sports injury prevention and concussion programs. The CMA continues to expand its scope of practice, both clinically and in the area of research. In June of 2014, the Center for Motion Analysis hosted the 24th annual gait course entitled: Clinical Gait Analysis: A Focus on Interpretation, which was attended by 85 medical providers from all over the world. This AMA Category 1 course was 3½ days in length and included the following faculty: Sylvia Õunpuu MSc, Kristan Pierz, MD, Jeffrey Thomson, MD, Janet Zahradnik, MD, Philip Mack, MD, Matthew Solomito, MS, and Erin Garibay, MS. Research in the CMA currently includes multiple collaborations includ- ing outcomes for patients with cerebral palsy with the Functional Assessment Research Group with 6 other children’s hospitals, research on concussion with CHLA and University of Oregon, and in pain management in young adult females with Cincinnati Children’s Hospital. Funded research also includes analysis of orthopaedic surgical outcomes using motion analysis techniques in patients with Charcot-Marie-Tooth and recurrent clubfoot deformity as well as evaluation of return-to-sport decision-making following ACL reconstruction. Our research program, under the direction of Matthew Solomito, has been increasingly busy. Our three services have 47 active IRB studies underway with over 30 additional projects in progress. Collaboration in multicenter studies gives us access to the latest protocols for difficult diseases. Grants from Major League Baseball, Centers for Disease Control, and POSNA help us provide evidence-based guidelines for topics such as ideal pitching mechanics and return-to-play after ACL reconstruction. Summer research programs educate college and medical students on the scientific process. The Orthopaedics Division continues to benefit from the generosity of Geno Auriemma’s Fore the Kids charity golf tournament, which is co-chaired by Mr. Brien Beakey and Mr. Joe Campanisi. This year we expect another successful tournament, which will result in over $1 million dollars being raised over 10 years. PUBLICATIONS Presciutti SM, Karukanda T, Lee M. Management decisions for adolescent idiopathic scoliosis significantly affect patient radiation exposure. Spine J. 2014;14(9):1984–1990. doi:10.1016/j. spinee.2013.11.055. Davis RB III, Õunpuu S, DeLuca PA. Analysis of gait. In: DR Peterson and JD Bronzino, editors. Biomechanics: principles and practices. Boca Raton: CRC Press; 2014 Dec. p. 5:1-13. Talusan PG, Milewski MD, Wall EJ. Osteochondritis dissecans of the talus in athletes. Clin Sports Med. 2014. Milewski MD, Skaggs DL, Bishop GA, Pace JL, Ibrahim DA, Wren TAL, Barzdukas A. Sleep deprivation is associated with increased risk of sports injuries in adolescent athletes. J Pediatr Orthop. 2014. Reach JS, Perez JL, Milewski MD, Talusan PG. Anterior ankle impingement syndrome. J Am Acad Orthop Surg. 2014. 57 Orthopaedic Surgery Chu A, Chaudhry S, Sala D, Atar D, Lehman W. Calcaneocuboid arthrodesis for recurrent clubfeet: what is the outcome at 17-year follow-up? J Child Orthop. 2014(8):43-48. Chaudhry S, Phillips D, Feldman D. Legg-Calvé-Perthes Disease: an overview with recent literature. Bull Hosp Jt Dis. 2014;72(1). BOOKS Milewski MD, Nissen CW, editors. Osteochondritis dissecans: diagnosis and treatment options for athletes: an issue of clinics in sports medicine. Philadelphia: Elsevier; 2014 Apr. BOOK CHAPTERS Pensak MJ, Lee MC, Bayron JA, Thomson JD. Utility of early post-operative radiographs after posterior spinal fusion for adolescent idiopathic scoliosis. Spine. 2014 Apr 10. Nissen CW. Knee injuries in skeletally immature athletes. In: Miller M, Thompson S, editors. DeLee & Drez’s Orthopaedic Sports Medicine. Elsevier; 2014 Apr. O’Malley M, Solomito MJ, Milewski MD. The association of tibial slope and ACL rupture in skeletally immature patients. J Arthroscop Rel Surg. 2014. STAFF Kostyun RO, Milewski MD, Hafeez I. Sleep disturbance and neurocognitive function during the recovery of a sport-related concussion in adolescents. Am J Sports Med. 2014. Sonia Chaudhry, MD Janet Zahradnik, MD Imran Hafeez, MD Amy Shannon, APRN Rethlefesen SA, Nguyen DT, Wren TA, Milewski MD, Kay RM. Knee pain and patellofemoral symptoms in patients with cerebral palsy. J Pediatr Orthop. 2014. Mark C. Lee, MD Bruce E. Bowman, PA-C Philip W. Mack, MD Nicole Cohle, PAC Matthew D. Milewski, MD Sylvia Õunpuu, MSc Carl W. Nissen, MD Marta Jablonski, PA-C Kristan Pierz, MD Kevin Fitzsimmons, PA-C David Wang, MD AJ Ricciuti, PA-C Solomito M, Garibay E, Woods J, Õunpuu S, Nissen C. Evaluation of wrist and forearm motion in college-aged baseball pitchers. Sports Biomech. [published online] 2014 Sep 9; doi:10. 1080/14763141.2014.955523. Matava M, Arciero R, Baumgarten K, Carey J, DeBerardino T, Hame S, Hannafin J, Miller B, Nissen C, Taft T, Wolf B, Wright R. The MARS Group. Multirater agreement of the causes of ACL reconstruction failure: a radiographic and video analysis of the MARS Cohort. Am J Sports Med. 2014 Dec. Keller TC, Tompkins M, Economopoulos K, Milewski MD, Gaskin C, Brockmeier S, Hart J, Miller MD. Tibial tunnel placement accuracy during anterior cruciate ligament reconstruction: independent femoral versus transtibial femoral tunnel drilling techniques. Arthroscopy. 2014 Jun 4. pii: S0749-8063(14)00282-5. Milewski MD, Nissen CW. Preface. Clin Sports Med. 2014 Apr;33(2):xiii-xiv. Economopoulos KJ, Milewski MD, Hanks JB, Hart JM, Diduch DR. Radiographic evidence of FAI in athletes with sports hernias. Sports Health. 2014 Mar;6(2):171-7. Jeffrey D. Thomson, MD Division Head 58 Otolaryngology Since the founding of the division in 1999, we have had significant growth. What started as a one-surgeon practice in September 1999 is now the state’s largest group of fellowship-trained pediatric otolaryngologists that includes Drs. Valerie Cote, Christopher Grindle, Katie Kavanagh, Nicole Murray, Scott Schoem and Tulio Valdez. To expand our capacity and improve our care for patients, we have two current advanced practitioners, Rebecca Strong, APRN, and Meaghan Krajewski, APRN. Christine Harrington, PA-C, joins our practice in mid-April from National Children’s in Washington, D.C. We are starting the process toward fellowship accreditation in pediatric otolaryngology. The field of otolaryngology – head and neck surgery – has expanded widely over the past decade with improvements in surgical care, refinement and miniaturization of instrumentation, use of minimal incision surgery, and advancement of endoscopic techniques replacing traditional open surgical techniques. This has revolutionized management of sinus disease and airway disorders. Technologic advancements in cochlear implantation have enabled children who are deaf to develop excellent speech and integrate into mainstream society. Currently, the division has thriving sub-specialty clinics in voice and swallowing disorders, and cochlear implantation. In collaboration with the divisions of Pulmonary Medicine and Digestive Diseases, we have expanded the scope of the multidisciplinary Connecticut Children’s Airway Team. The Division of Otolaryngology participates with General Surgery and Endocrinology on the Pediatric Thyroid center. Patients and families appreciate the improved time efficiency of combined office appointments and operative procedures. In addition, the division is involved in several new collaborations: MIT Spectroscopy Laboratory, the UConn Computer Science Department, and with Anesthesiology instructing residents via medical simulation. PUBLICATIONS Cote V, Prager JD. Iatrogenic phenol injury: a case report and review of medication safety and labeling practices with flexible laryngoscopy. Int J Pediatr Otorhinolaryngol. 2014 Oct;78(10):1769-73. doi: 10.1016/j.ijporl.2014.07.007. Epub 2014 Jul 12. Grindle CR. Pediatric hearing loss. Pediatr Rev. 2014 Nov;35(11):456-63; quiz 464. doi: 10.1542/pir.35-11-456. Marom T, Joseph RA, Grindle CR, Shah UK. Tracheotomy after laryngotracheopasty: risk factors over 10 years, J Pediatr Surg. 2014 Aug;49(8):1206-9. doi: 10.1016/j.jpedsurg.2013.11.065. Epub 2013 Nov 28. Lawrason Hughes A, Murray N, Valdez TA, Kelly R, Kavanagh K. Development of the Connecticut Airway Risk Evaluation (CARE) system to improve handoff communication in pediatric patients with tracheotomy. JAMA Otolaryngol Head Neck Surg. 2014 Jan; 140(1):29-33. Schoem SR, Rosbe K. Aerodigestive foreign bodies and caustic ingestion. In: Cummings, et al, editors. Textbook on otolaryngology – head and neck surgery. 2014. Schoem SR, Bennett N, Johnson K. Complications of otitis media. In: Infectious diseases in pediatric otolaryngology – a practical guide. Springer; 2015. Chandy BM, Valdez TA, Lim M. Invasive fungal sinusitis in immunocompromised pediatric patients. Multi-resistant infections. In: Pediatric otolaryngology XIII IAPO manual of pediatric otolaryngology. San Paulo: Rettec Artes Graficas; 2014. p34-7. Valdez TA, Pandey R, Spegazzini N, Longo K, Roehm C, Dasari RR, Barman I. Multiwavelength fluorescence otoscope for video-rate chemical imaging of middle ear pathology. Analyt Chem. 2014;86:10454-60. STAFF Scott Schoem, MD Division Head Valerie Cote, MD, FRCSC Rebecca Strong, APRN Christopher Grindle, MD Meaghan Krajewski, APRN Katie Kavanagh, MD Christine Harrington, PA-C Nicole Murray-Posner, MD Tulio Valdez, MD 59 Pain & Palliative Medicine Our mission is to utilize our multidisciplinary expertise to alleviate pain and stress in children afflicted with acute, chronic or terminal illness. Connecticut Institute for Clinical and Translational Science: Sickle Cell Hemoglobinopathies and Bone Health 1/1/146/30/15 Zempsky Co-I Highlighting our year has been the addition of new faculty members Kalyani Raghavan, MD, who was the Director of Pediatric Sedation at Children’s Hospital of Michigan. Dr. Raghavan will support our efforts in Acute Pain and Sedation. She also plans to develop a therapeutic yoga program at Connecticut Children’s. Drs. Kathy Kalkbrenner and Jessie Sturm from the Divisions of Hospitalist Care and Emergency Medicine respectively have joined the division on a part-time basis to provide Sedation Services. Connecticut Institute for Clinical and Translational Science: Genotypic Determinants of RBC Adhesion and Pain Severity in Sickle Cell Disease 1/1/14-6/30/15 Zempsky Co-I Other important highlights and milestones for the division for 2014 included: Jessica Guite, PhD, was promoted to Associate Professor in the Department of Pediatrics Renee Manworren, RN, PhD, was named to the Board of Directors of the American Pain Society Ana Verissimo, MD, published her first book A Guide to Integrative Pediatrics for the Healthcare Professional William Zempsky, MD, published his first book the Oxford Textbook of Paediatric Pain William Zempsky, MD, received three new grants to support his research in pain and sickle cell disease • • • • • NEW GRANTS Donaghue Foundation Research Relevant and Ready: SEED Greater Understanding of Sickle Cell Disease 4/1/1410/1/15 Zempsky PI PUBLICATIONS Guite JW, Kim S, Chen C-P, Sherker JL, Sherry DD, Rose JB, Hwang W-T. Pain beliefs and readiness to change among adolescents with chronic musculoskeletal pain and their parents before an initial pain clinic evaluation. Clin J Pain. 2014;30(1):27-35. PMCID: PMCPMC 3742695. Guite JW, Kim S, Chen C-P, Sherker JL, Sherry DD, Rose JB, Hwang W-T. Treatment expectations among adolescents with chronic musculoskeletal pain and their parents prior to an initial pain clinic evaluation. Clin J Pain. 2014;30(1):17-26. PMCID: PMCPMC 3742613. Samuels J, Manworren RCB. Determining the value of post-operative pain management using timed electronic data. Nurs Econ. 2014;32(2):80-88, 98. Jain G, Mahendra V, Singhal S, Dzara K, Pilla TR, Manworren R, Kaye AD. Long-term neuropsychological effects of opioid use in children: a descriptive review. Pain Physician. 2014;17:109-18. Drew D, Gordon D, Renee L, Morgan B, Swensen H, Manworren RCB. The use of “as-needed” range orders for opioid analgesics in the management of pain: a consensus statement of the American Society of Pain Management Nurses and the American Pain Society. Pain Manag Nurs. 2014;15(2):551-4. Sanghamitra MM, Verissimo AM. A guide to integrative pediatrics for the healthcare professional. Houston, TX: Springer Briefs in Public Health; 2014. Zempsky WT, O’Hara EA, Santanelli JP, New T, Smith-Whitley K, Casella J, Palermo TM. Development and validation of the youth acute pain functional ability questionnaire (YAPFAQ). J Pain. 2014 Dec;15:1319-27. Bromberg MH, Schechter NL, Nurko S, Zempsky WT, Schanberg LE. Persistent pain in chronically ill children without detectable disease activity. Pain Manag. 2014 May;4(3):211-9. 60 Pain & Palliative Medicine Mcgrath PJ, Stevens BJ, Walker SM, Zempsky WT, editors. Oxford textbook of paediatric pain. United Kingdom: Oxford University Press; 2014 Zempsky WT. Topical anesthetics and analgesics. In: Oxford textbook of paediatric pain. STAFF William T. Zempsky, MD, MPH Division Head Len Comeau, MD Kalyani Raghavan, MD Mcgrath PJ, Stevens BJ, Walker SM, Zempsky WT, editors. United Kingdom: Oxford University Press; 2014. p.486-94. J. Michael Connors, MD Jessie Sturm, MD Jessica Guite, PhD Ana Verissimo, MD Stevens BJ, Zempsky WT. Prevalence and distribution of pain in children. In: Oxford textbook of paediatric pain. Kathy Kalkbrenner, MD Kim Kempner, APRN Kim Kempner, APRN Renee Manworren, PhD, APRN Mcgrath PJ, Stevens BJ, Walker SM, Zempsky WT, editors. United Kingdom: Oxford University Press; 2014. p.12-19. Kerry Moss, MD 61 Pathology In 2014, the Department of Pathology and Laboratory Medicine continued its mission of providing the highest quality laboratory services through excellence, innovation, integrity and concern for quality care provided to patients. Dr. Rebecca Williams recently resigned from the pathology division of the department due to illness and shortly thereafter succumbed to that illness. This was a significant loss to the department since Dr. Williams had served with nationally recognized distinction as the Residency Program Director for 13 years. Dr. Fiel-Gan has assumed the Program Director role. In the fall, the department added Dr. Anshu Trivedi. Dr. Trivedi recently completed her training in the department and spent the past year doing a fellowship in liver pathology. Although the majority of the members within the department provide services in Anatomic Pathology, there is a wide range of subspecialization within that division of the department. The current MD/PhD staff in Anatomic Pathology have subspecialization in neuropathology (3), cytopathology (8), pediatric pathology (1), molecular pathology (1), and dermatopathology (1). Additional members within AP have specialty skills in organ systems for which there is no board certification. These include breast pathology, GI pathology, GU pathology, Gyn pathology, pulmonary pathology, head and neck pathology, and soft tissue tumors. Additionally there are six members of the department board certified in topathology providing support in Hematology and Hematopathology. Two staff members provide support in Transfusion Medicine. One is board certified in Transfusion Medicine and the other has specialty expertise in Coagulation. There is one PhD board-certified member in each of the following disciplines: Microbiology, Chemistry, Molecular Pathology/Cytogenetics, and Immunopathology. Evolving applications of molecular diagnostics to neoplastic and non-neoplastic diseases has put demands on the division of Cytogenetics and Molecular Diagnostics. The recent alliance with MSKCC also has had an impact on molecular diagnostics. It is anticipated that diagnostic and therapeutic applications for malignant diseases will continue to expand. To remain on the cutting edge of these applications in our division of Molecular Diagnostics, a request was made for acquisition of equipment for next generation sequencing. The needed equipment will be arriving in FY2015. The department’s 12 residencies in Anatomic Pathology and 5 fellowship positions continue to be filled with highly qualified individuals. Graduates of the Educational Program have continued to be successful in obtaining highly desirable fellowships on completion of their residency training program in Pathology at Hartford Hospital or have gone on to find attractive positions in the clinical practice of Pathology. The residency program continues as a Hartford Hospital-only program that is not integrated with the University of Connecticut. The program does rely on the university, however, for training residents in Renal Pathology and Electromicroscopy. Now that the department has recruited a dermatopathologist, the program no longer relies on training in Dermatopathology at the university. PUBLICATIONS Glazewaski L, Maldonado Y, Hamilton P, Aslanzadeh J. Comparison of ZEUS ELISA™ Borrelia VlsE-1/pepC10 IgG/ IgM test to the Immunetics C6 Peptide ELISA for detection of antibody response to B. burgdorferi infection. 114th Annual Meeting of the American Society for Microbiology; 2014. Tetreault J, Smally AJ, Hamilton P, Aslanzadeh J. Reliability of rapid strep antigen test on throat samples collected by the BD ESwab for laboratory diagnosis of acute pharyngitis in adult patient population. 114th Annual Meeting of the American Society for Microbiology; 2014. Araneta III RN, Aslanzadeh J, Ratkiewicz I, Chamberlain B, Voytek T. Evaluation of the Gen-Probe APTIMA HPV 16, 18/45 Genotype Assay® in women with high-risk HPV infections. 30th Annual Clinical Virology Symposium and Annual Meeting of the Pan-American Society for Clinical Virology; 2014. Cartun RW. Negative reagent controls in diagnostic immunohistochemistry: do we need them? An evidence-based recommendation for laboratories throughout the world. [editorial] App Immunohistochem and Mole Morph. 2014 Mar. Trivedi A, Cartun RW, Ligato S. Immunohistochemical expression of IMP3 in superficially invasive pT1 esophageal adenocarcinoma (EAC) is associated with lymphovascular invasion (LVI) and can help in the risk stratification of these patients. Path – Res and Prac. 2014 Jan. 62 Pathology Ciesielski T. Human case of Eastern equine encephalitis – Connecticut 2013. Conn Epidemiol. 2014 Jul; V34(3):9-10. Vafaii P, DiGiuseppe JA. Detection of B-cell populations with monotypic light chain expression in cerebrospinal fluid specimens from patients with multiple sclerosis by polychromatic flow cytometry. Cytometry Part B (Clin Cytom). 2014;86B:106-10. Abarzua-Cabezas F, Earle J, Meraney A. Angiosarcoma of the corpora cavernosa. Int J Urol. 2014, Jun;21(6):622-3. doi:10.1111/iju.12385. [Epub 2014 Jan 9] Doss M, Araneta R 3rd, Fiel-Gan M, Edelheit B. Cranial nerve VI palsy as an initial presentation of necrotizing sarcomatoid granulomatosis in a 14-year-old female: case report and literature review. Semin Arthritis Rheum. pii: S00490172(14)00166-8. doi:10.1016/j.semarthrit.2014.07.004. [Epub ahead of print. 2014 Jul 17] Khutti S, Burghart J, Newcomb P, Mandavilli S. PAX-8 immunohistochemical staining in mucinous neoplasms involving ovary; a critical evaluation including comparison of monoclonal versus polyclonal antibodies. Arch Path Lab Med. 2014 Sep. Feder HM, Liu J, Rezuke WN. Kikuchi disease in Connecticut. J Peditr. 2014;164:196-200. Zhou Q, Wang L, Tannenbaum S, Ricci Jr. A, DeFusco P, Hegde P. Pathologic response prediction to neoadjuvant chemotherapy utilizing pre-treatment near-infrared imaging parameters and tumor pathologic criteria. Breast Cancer Res. 2014;16:456. Gipson KE, Rosinski DJ, Schonberger RB, Kebera C, Mathew ES, Nichols F, Dyckman W, Courtin F, Sherburne B, Bordey AF, Gross JB. Elimination of gaseous microemboli from cardiopulmonary bypass using hypobaric oxygenation. Ann Thoracic Surg. 2014 Mar; 97(3):879-86. Levine C, Trivedi A, Thung SN, et al. Severe ductopenia and cholestasis from Levofloxacin drug induced liver injury. A case report and review. Semin Liver Dis. 2014;34(02):246-51. Marti J, Trivedi A, et al. Calcified teleangiectatic hyperplastic nodule associated with vascular malformation in a child. A case report. Fetal Pedi Path. doi:10.3109/15513815.2014 .970264. BOOK CHAPTERS Borowitz MJ, DiGiuseppe JA. Acute lymphoblastic leukemia/lymphoblastic lymphoma. In: Orazi A, Weiss LM, Foucar K, Knowles DM, editors. Knowles’ neoplastic hematopathology, 3rd ed. Lippincott, Williams & Wilkins; 2014. p. 1019-29. STAFF William T. Pastuszak, MD Department Chief Jaber Aslanzadeh, PhD Srinivas Mandavilli, MD Margaret Assaad, MD Laila Mnayer, MD Fabiola Balarezo, MD Richard Muller, MD Richard Cartun, PhD William Rezuke, MD Joseph DiGiuseppe, MD, PhD Andrew Ricci, MD Jonathan Earle, MD Zendee Elaba, MD Mary Fiel-Gan, MD Marilyn Kritzman, MD Lisa Laird, MD Saverio Ligato, MD Gregory Makowski, PhD Bela Mandavilli, MD Donna Rose, MD Peter Shen, MD Bradford Sherburne, MD Sara Song, MD Anshu Trivedi, MD Dean Uphoff, MD Terry Voytek, MD 63 Plastic Surgery Dr. Charles Castiglione was selected as Physician of the Year for Connecticut Children’s, and was a Finalist for the Hartford Healthcare Heroes Award. He was also President of the New England Society of Plastic and Reconstructive Surgeons for 2013-2014. Dr. Alan Babigian is now Vice President of the NESPRS, and Dr. Orlando Delucia is the President of the Connecticut Society of Plastic and Reconstructive Surgeons. The Plastic Surgery Department provides clinical services at the Connecticut Children’s Medical Center and at Hartford Hospital. Our surgical volume has remained stable, and includes all types of plastic and reconstructive procedures. Our plastic surgeons frequently collaborate with other surgical specialists, providing state-of-the-art multidisciplinary surgical care. Common surgical procedures performed include: complex wound closures including flaps and grafts, craniofacial reconstruction, craniofacial fracture repair, cleft lip/palate reconstruction, breast surgery/reconstruction, body contouring, skin/soft tissue tumor excision/repair, upper extremity/hand surgery/reconstruction, and cosmetic surgery/non-surgical cosmetic procedures. The multidisciplinary Craniofacial Team at Connecticut Children’s, co-directed by Dr. Charles Castiglione of Plastic Surgery and Dr. Paul Kanev of Pediatric Neurosurgery, remains a center of excellence. The team provides comprehensive evaluation and treatment for patients of all ages with congenital or acquired deformities of the head and neck. Active team members come from many disciplines, including Plastic Surgery, Pediatric Neurosurgery, Pediatric Otolaryngology, Pediatric Dentistry, Orthodontics, Oral and Maxillofacial Surgery, Pediatric Development, Social Work, and Speech and Language Pathology. Surgeries for cleft lip and palate are most common. Craniosynostosis reconstruction, performed by Dr. Castiglione of Plastic Surgery, and Drs. Kanev, Jonathan Martin, and Markus Bookland of Pediatric Neurosurgery, are also common. In addition, the multidisciplinary Craniofacial Trauma Team, under the leadership of Drs. Castiglione and Norman Cavanagh, provides cutting edge treatment for all craniomaxillofacial injuries at both Connecticut Children’s and Hartford Hospital. Dr. Brian Allen joined the Plastic Surgery Department at Connecticut Children’s, Hartford Hospital, and THOCC. After completing a full general surgery residency at UConn, Dr. Al- len later spent three years training in Plastic Surgery at the renowned program at Emory University. He is fully trained in all aspects of Plastic Surgery including general Pediatric Plastic Surgery. Four plastic surgeons, Drs. Duff Ashmead, Alan Babigian, David Bass, and Steven Smith, are fellowship-trained hand surgeons, and perform all types of upper extremity and hand surgery. This includes trauma surgery, and reconstruction for acquired and congenital deformities. These surgeons also provide the majority of coverage for hand call at Hartford Hospital and Connecticut Children’s. Plastic surgeons are very involved in volunteer activities, including surgical mission trips. Drs. Babigian and Castiglione are consultants for Iraq Star, providing surgical care to injured veterans of the Iraq and Afghanistan wars. Dr. Bass continues to make frequent mission trips to South America. Drs. Babigian and Castiglione traveled to Latacunga, Ecuador, and performed many surgeries, including burn reconstruction, hand surgery, ear reconstruction, and cleft lip/palate surgeries. Finally, Dr. Castiglione serves on the Medical Advisory Board of the Jorge Posada Foundation, a foundation supporting the treatment of congenital craniofacial deformities. Education is a large component of the Plastic Surgery Department’s activities. Residents from General Surgery, Orthopedic Surgery, Urology, ENT, OMFS (UConn and St Raphael’s), and Emergency Medicine rotate on the service. Medical students also elect rotations on Plastic Surgery. Active teaching occurs during daily patient rounds, in the clinic/office setting, in the ER, in the OR, and during planned teaching conferences. Several residents and medical students also have expressed interest in a career in Plastic Surgery, and two residents matched at premier plastic surgery residency programs this year. This brings the total to 44 of our residents and students who have moved on to Plastic Surgery since 1988 when Dr. Castiglione began practicing here. Several residents and medical students are involved in research projects with Drs. Babigian and Castiglione. Drs. Babigian and Castiglione have had several publications this year, and have presented papers locally, regionally, and nationally. Dr. Castiglione is the Plastic Surgery editor for Connecticut Medicine: The Journal of the Connecticut State Medical Society, and a reviewer for both The American Journal of Cosmetic Surgery and Craniomaxillofacial Trauma & Reconstruction. Some department 64 Plastic Surgery members are involved in local, regional and national professional societies. Drs. Castiglione and Delucia are members of the Executive Council of the Connecticut Society of Plastic and Reconstructive Surgeons, and Dr. Delucia is President. Drs. Babigian and Castiglione are members of the Executive Council of the New England Society of Plastic and Reconstructive Surgery, and Dr. Castiglione was the 2013-2014 Society President, while Dr. Babigian has become the Vice President. PUBLICATIONS Ferneini E, Castiglione C, Forte P, Tinsley J, Wrubel J. Medical malpractice reform: exploring opportunities for improvement. Conn Med. Jan 2014;78(1):41-5. Ferneini E, Castiglione C, Forte P, Tinsley J, Wrubel J. Medical malpractice reform: more choices for improvement. Conn Med. Feb 2014;78(2):95-8. STAFF Charles L. Castiglione, MD, MBA, FACS, Division Chief Brian Allen, MD Duffield Ashmead, MD Alan Babigian, MD David Bass, MD Norman Cavanagh, MD, DMD Alex Cech, MD Orlando Delucia, MD Steven Smith, MD Mindi Cieck, APRN Mary Eileen Auclair, PA-C Paul Christopher Polzella, PA-C 65 Pulmonary Medicine The Division of Pulmonary Medicine strives to be a comprehensive regional resource for pediatric pulmonary disease, with commitments to expert patient care, professional and patient education, and clinical and basic research. This year’s highlight was the recruitment of a sleep specialist, Dr. Jay Kenkare, and opening of an accredited Pediatric Sleep Laboratory. The Division of Pulmonary Medicine provides care for infants, children and adolescents with a variety of pulmonary diseases including asthma, apnea, bronchopulmonary dysplasia, cystic fibrosis, interstitial lung disease, neuromuscular disease, respiratory sleep disorders, and chronic respiratory failure. The division oversees a state-of-the-art pulmonary function laboratory that is capable of performing spirometry, body plethysmography, impulse oscillometry, methacholine challenge, cardiorespiratory adaptation, and exercise provocation testing in children. Simple spirometry and bronchodilator assessment also are performed at our satellite clinics. Dr. Jay Kenkare joined the division this year, coming to us from Gaylord Sleep Medicine. A certified sleep specialist and member of the American Academy of Sleep Medicine, Dr. Kenkare led the accreditation of our new 5-bed Pediatric Sleep Laboratory, with an accompanying increase in sleep studies from 350 to over 800 per year. Dr. Kenkare also has initiated a pediatric sleep clinic for the evaluation and treatment of children with respiratory and non-respiratory sleep problems. Our Central Connecticut Cystic Fibrosis Center continues to be one of the Top 10 CF centers in the country based on combined pulmonary and nutritional outcomes. Its director, Dr. Craig Lapin, continued to serve as the Pediatric Program Directors’ Representative to the Cystic Fibrosis Foundation’s Center Director Committee, as well as being a member of the Cystic Fibrosis Foundation Guidelines Steering Committee, and of the Cystic Fibrosis Foundation’s Data Safety Monitoring Board. He co-chaired the Physician Grand Rounds and a workshop on the E-Patient Experience at the 2014 NACFC. Center Co-director, Dr. Melanie Collins, co-chaired a symposium on Care of the Young Child with CF at 2014 NACFC. The center remains part of the CF Therapeutic Development Network. Our Pediatric Pulmonary Fellowship program graduated one fellow in June 2014 and has a second fellow completing training this year. Members of the division also contributed to the education of medical students and residents, respiratory therapists, and nursing APRN students from Yale. Dr. Craig Schramm continued to serve on the Pediatric Chest Medicine Network Steering Committee of the American College of Chest Physicians and as a member of the University Center for Excellence in Developmental Disabilities at the University of Connecticut Health Center. Our certified asthma educator, Rosalyn Bravo, APRN, served as the Program Chair of the Connecticut chapter of the National Association of Pediatric Nurse Practitioners. Clinical collaborations included a Sickle Cell Pulmonary Clinic with Hematology-Oncology and an Aerodigestive Clinic with ENT and Gastroenterology. Clinical research projects conducted over the past year included comparison of impulse oscillometry with clinical asthma scores and participation in multi-center trials involving ivacaftor and lumacaftor in children with cystic fibrosis. Collaborative research projects focused on clinical obesity with Endocrinology, clinical asthma research with Intensive Care Medicine, microbiological research in cystic fibrosis with Quinnipiac Medical School, and weaning of supplemental oxygen in infants with bronchopulmonary dysplasia with Boston Children’s Hospital. Additional basic science research addressed mechanisms of airway immunological tolerance with the Department of Immunology and microRNA expression in asthmatic airways with the Jackson Laboratory for Genomic Medicine in Farmington. PUBLICATIONS Carroll CL, Coro M, Cowl A, Sala KA, Schramm CM. Transient occult cardiotoxicity in children receiving continuous beta-agonist therapy. World J Pediatr. 2014 Nov;10(4):324-9. Lodha A, Sauve R, Bhandari V, Tang S, Christianson H, Bhandari A, Amin H, Singhal N. Need for supplemental oxygen at discharge in infants with bronchopulmonary dysplasia is not associated with worse neurodevelopmental outcomes at 3 years corrected age. PLoS ONE 2014 Mar 19;9(3):e90843. Natarajan P, Guernsey LA, Schramm CM. Regulatory B cells in allergic airways disease and asthma. Methods Mol Biol. 2014 July;1190:207-25. Simoneau T, Bazzaz O, Sawicki GS, Gordon C. Vitamin D status in children with cystic fibrosis. Associations with inflammation and bacterial colonization. Ann Am Thorac Soc. 2014 Feb;11(2):205-10. 66 Pulmonary Medicine STAFF Umit Emre, MD Craig Schramm, MD, Division Head Jay Kenkare, MD Anita Bhandari, MD Melanie Sue Collins, MD Craig Lapin, MD Tregony Simoneau, MD Rosalynn Bravo, APRN 67 Radiology The Division of Radiology provides a full spectrum of imaging services as well as minimally invasive image-guided therapy to all clinical divisions at Connecticut Children’s Medical Center. The department is an “Image Gently” facility using strategies to minimize radiation to our patients while utilizing best practice standards and appropriateness criteria to best evaluate children. Imaging modalities range from computed radiography and digital radiography to complex magnetic resonance imaging. The department is accredited through the American College of Radiology in Ultrasound, CT and MRI. Nuclear Medicine services are provided through collaboration with Hartford Hospital. Image guided therapies are provided through collaboration with physicians from Jefferson Radiology and Hartford Hospital in Interventional Radiology and Interventional Neuroradiology. With collaboration and support from the Divisions of Anesthesia and Sedation Services, more image-guided procedures are being performed on site at Connecticut Children’s Medical Center allowing for less disruption of care in a safer environment. The department of Radiology has seen major replacements and upgrading of imaging equipment. In 2014, a new digital radiography room was installed for the Emergency Department, which allows better plain film imaging with approximately 40% dose reduction. Three new Siemen’s ultrasound units were purchased and put into service allowing for superior imaging in a modality that is well suited to our pediatric population. A new Siemen’s flat panel fluoroscopy unit was installed allowing for significant radiation dose reduction with improved image quality. These upgrades support the philosophy of the department as an “Image Gently” and “Step Gently” facility to provide appropriate imaging while reducing the effects of ionizing radiation as much as possible. Video goggles were provided by a donor through the Foundation. They can be worn by a child in the MR unit who can watch a movie while having a lengthy imaging procedure with less dependence on sedation. Dr. Moote is collaborating with Dr. Jeffrey Hyams in the Division of Gastrointestinal Diseases to support multicenter grant-funded research evaluating the impact of MR imaging of children with inflammatory bowel disease. Dr. Baldwin is involved in a COG multicenter collaborative assessing impact of pulmonary nodule detection in patients with sarcoma. The Division of Radiology provides resident education in Pediatric Radiology to radiology residents from the University of Connecticut Health Center, Hartford Hospital, and the Hospital of St. Vincent’s in Bridgeport, CT. Pediatric residents and medical students from the University of Connecticut attend elective rotations in the department. The radiology attendings provide didactic lectures to the radiology and pediatric residents as well as case review sessions. Teaching and clinical care conferences are held in collaboration with Divisions of Pulmonary Medicine, Digestive Diseases, Endocrinology, General Surgery, Hematology-Oncology, Orthopedic Surgery, and Urology, as well as the NICU and PICU. Work conferences are provided weekly to the Pediatric House Staff. PUBLICATIONS Garcia CM, Boe S, Coughlin B, O’Sullivan DM, Moote D, O’Loughlin MT. The impact of enteric contrast on radiologist confidence in intravenously enhanced MDCT of the abdomen and pelvis: a randomized controlled trial. Adv Comput Tomogr. 2014 June;3:18-23. 68 Radiology BOOK CHAPTER STAFF Shah RP, Hallisey MJ. Venous angioplasty and stents. In: Handbook of interventional radiologic procedures, 5th ed. Little, Brown & Co. R. Timothy Brown, MD Division Head Michael Baldwin, MD W. Steven Poole, MD Frederick U. Conard, MD Ron Rosenberg, MD Michael Hallisey, MD Margaret Szerejko, MD Josh Kallen, MD Greg Wrubel, MD Michael Thomas O’loughlin David Zimmerman, MD Douglas Moote, MD Patrick Deegan, PA 69 Research The four faculty members of the Division of Research conduct high quality clinical/translational research and clinical trials, and prepare proposals for external funding to advance the overall research enterprise of Connecticut Children’s Medical Center. They are assisted in this work by more than 30 professionals, including an expert group of master’s prepared research associates and divisional research managers, certified study coordinators and skilled sponsored-program administrators and analysts. The division also manages a unique Investigator Support program for new and established investigators that has yielded 6 NIH Mentored Scientist (K) awards and a 60% R01 funding rate. Highlights of 2014 include the promotion of Dr. Georgine Burke to the rank of Professor in the School of Medicine and appointment to the editorial board of Inflammatory Bowel Diseases. Dr. Elizabeth Brownell joined the editorial review board of the Journal of Human Lactation, was appointed to the national Baby-Friendly NICU Task Force, and served as Co-Chair of the Maternal Child Health Data and Epidemiology Committee of the American Public Health Association. PUBLICATIONS Brownell EA, Hagadorn JI, Lussier MM, Goh G, ThevenetMorrison KN, Lerer TJ, Herson VC, Howard, CR. Optimal periods of exclusive breastfeeding to predict any breastfeeding duration through one year. J Pediatr. [in press] (Epub ahead of print Dec. 16, 2014. doi:http://dx.doi.org/10.1016/j. jpeds.2014.11.015.) Valdez TA, Marvin K, Bennett NJ, Lerer T, Nolder AR, Buchinsky FJ. Current trends in perioperative antibiotic use: a survey of otolaryngologists. Otolaryngol Head Neck Surg. [in press] (Epub ahead of print Oct 10, 2014. doi:10.1177/0194599814554551.) Goyal A, Hyams JS, Lerer T, Leleiko NS, Otley AR, Griffiths AM, Rosh JR, Cabrera JM, Oliva-Hemker MM, Mack DR, Rick JN, Pfefferkorn MD, Carvalho R, Grossman AB, Hitch MC, Sudel B, Kappelman MD, Saeed SA, Faubion WA, Schaefer ME, Markowitz JF, Keljo DJ. Liver enzyme elevations within three months of diagnosis of inflammatory bowel disease and the likelihood of liver disease. J Pediatr Gastroenterol Nutr. 2014;59:321-3. Sunseri W, Hyams JS, Lerer T, Mack DR, Griffiths AM, Otley AR, Rosh JR, Carvalho R, Grossman AB, Cabrera J, Pfefferkorn MD, Rick J, Leleiko NS, Hitch MC, Oliva-Hemker M, Saeed SA, Kappelman M, Markowitz J and Keljo DJ. Retrospective cohort study of methotrexate use in the treatment of pediatric Crohn’s disease. Inflamm Bowel Dis. 2014;20:1341-5. Chicaiza H, Hellstrand K, Lerer T, Smith S, Sylvester F. Potassium hydroxide: an alternative reagent to perform the modified Apt Test. J Pediatr. 2014;165:628-30. Markush D, Briden KE, Chung M, Herbst KW, Lerer TJ, Neff S, Wu AC, Campbell BT. Effect of surgical subspecialty training on patent ductus arteriosus ligation outcomes. Pediatr Surg Int. 2014;30:503-9. Cortezzo DM, Sanders M, Brownell E, Moss K. End-of-life care in the neonatal intensive care unit: experiences of staff and parents. Am J Perinatol. 2014 Dec 17. [Epub ahead of print] Hagadorn JI, Brownell EA, Lussier MM, Parker MGK, Herson VC. Variability of criteria for pasteurized donor human milk use: a survey of US neonatal ICU medical directors. JPEN J Parenter Enteral Nutr. 2014 Sep 29. [Epub ahead of print] Brownell EA, Lussier MM, Bielecki D, Proulx TA, Esposito P, Briere CE, Herson VC, Hagadorn JI. Patterns and predictors of donor human milk non-consent in the neonatal ICU. Breastfeed Med. 2014 Oct; 9:393-7. Dozier AM, Brownell EA, Guido J, Yang H, Howard CA, Doniger A, Ossip D, Lawrence R. Adapting the pregnancy risk assessment monitoring survey to enhance locally available data: methods. Matern Child Health J. 2014 Jul; 18(5):1196204. Brownell EA, Lussier MM, Dozier AM, Howard CR, Fisher SG, Duckett JW, Lawrence RA, Fernandez ID. The discordance between planned use and actual receipt of immediate postpartum depot medroxyprogesterone among low-income women. Breastfeed Med. 2014 Jun; 9:290-3. Marinelli KA, Lussier MM, Brownell EA, Herson VC, Hagadorn JI. The effect of a donor milk policy on the diet of very low birth weight infants. J Hum Lact. 2014 Apr 18. [Epub ahead of print] 70 Research Dozier AM, Nelson A, Brownell EA, Howard CR, Lawrence RA. Patterns of postpartum depot medroxyprogesterone administration among low-income mothers. J Womens Health (Larchmt). 2014 Mar; 23(3):224-30. Sylvester F, Draghi A, Marina A, Marina F, Wang Z, Vella A. A distinct colonic mucosal cytokine signature in new onset, untreated pediatric Crohn’s disease. J Pediatr Gastroenterol Nutr. 2014. PMID: 25000355. Brownell EA, Lussier MM, Hagadorn JI, McGrath JM, Marinelli KA, Herson VC. Independent predictors of human milk receipt at neonatal intensive care unit discharge. Am J Perinatol. 2014 Nov; 31(10):891-8. Bühlmann P, Gertheiss J, Hieke S, Kneib T, Ma S, Schumacher M, Tutz G, Wang CY, Wang Z, Ziegler A. Discussion of “The evolution of boosting algorithms” and “Extending statistical boosting.” Methods Inf Med. 2014 Nov 14; 53(6):436-45. PMID: 25396219. Brownell EA, Lussier MM, Herson VC, Hagadorn JI, Marinelli KA. Donor human milk bank data collection in North America: an assessment of current status and future needs. J Hum Lact. 2014 Feb; 30(1):47-53. Wang Z, Ma S, Ching-Yun Wang C-Y, Zappitelli M, Devarajan P, Parikh C. EM for regularized zero inflated regression models with applications to postoperative morbidity after cardiac surgery in children. Stat Med. 2014;33(29):5192-208. http://dx.doi.org/10.1002/sim.6314. Wang Z. mpath: Regularized linear models. R package version 0.1-14. 2014. http://cran.r-project.org/package=mpath. STAFF Georgine Burke, PhD Division Director Elizabeth Brownell, PhD Jill Popp, PhD Trudy Lerer, MS Min Tang Schomer, PhD Kathleen McKay, PhD Zhu Wang, PhD 71 Rheumatology The Division of Rheumatology is the largest such program in the state, taking pride in our ability to be accessible to all corners of the state. In 2013, referrals were received from 151 of the 169 towns in Connecticut. The division is looking to expand and increase its academic standings. With that in mind, the division recruited an outstanding young physician, Dr. Heather Tory, who will be splitting her time between rheumatology and patient safety/quality, which will include ongoing research as well. Rheumatology is also excited about recruiting a senior scientist, Dr. Virginia Pascual, who has an international reputation in the field of genomics in autoimmune disease, such as systemic lupus, juvenile idiopathic arthritis, and Kawasaki disease. She has demonstrated that blood gene expression profiling is a valid approach to understanding the pathogenesis of human systemic autoimmune diseases. The mission of the division is to provide the best clinical care possible to children with rheumatic disease, teach trainees the basics of the field, and to enroll patients in clinical trials or collaborative research projects when applicable. The addition of Dr. Pascual will herald a new era of basic science research at the University of Connecticut in the Division of Pediatric Rheumatology. We continue to run a high-volume practice; during 2014, we saw the following number of patients: 1) New outpatients – 805 (additional 47 new patients at Shriner’s satellite) 2) Follow-up visits – 1,850 (additional 194 follow-up patients at Shriner’s) 3) Inpatient admissions - 27 4) Inpatient consults - 37 5) Joint aspirations - 82 Rheumatology collaborates with the sedation service around procedures, orthopaedics for overlapping disorders, GI for infusions and drug toxicities, hematology for disorders that span both specialties, nephrology for lupus and vasculitis, infectious disease for Lyme disease, and the pain service for children with amplified pain disorders, such as fibromyalgia. The division fully utilizes the resources of the hospital, since many of the patients have multi-system disease or complex psycho-social problems. The division provides critical education to trainees, since the outpatient rotation is often the only exposure pediatric residents have with rheumatic disease. Eleven of the 13 blocks were subscribed by pediatric residents or fourthyear medical students on elective. Space permitting, we occasionally accommodate outside residents, third-year medical students, and even physician assistant students. We have an arrangement with the Division of (adult) Rheumatology at the University of Connecticut Health Center to provide their fellows with pediatric training. FACULTY Lawrence Zemel, MD Division Head Barbara Edelheit, MD Heather Tory, MD 72 Transplant Surgery This year has been a very busy and productive one for the Division of Transplant at Connecticut Children’s. Working closely with the Division of Nephrology, the pediatric kidney transplant programs continue to grow, and successful kidney transplants have been performed. Our multidisciplinary approach has allowed us to successfully offer transplants to more pediatric patients. The program is recognized by UNOS. We were named a Center of Excellence for Anthem and Aetna, attesting to the quality of our program. The Transplant Division has a strong quality program. Each program has a quality indicator dashboard as well as a Process Improvement dashboard which tracks PI projects such as revisions of policies, decreasing infections, developing algorithms to improve patient care. Matthew Brown, MD STAFF Patricia Sheiner, MD, FACS Division Director Anne Lally, MD Caroline Rochon, MD Brian Shames, MD 73 Urology Again this year, U.S. News & World Report chose Connecticut Children’s Medical Center as one of the 50 top-ranked centers for children with serious urological conditions. Our ACGME-accredited fellowship program in pediatric urology continues to attract and train top candidates in our field. Our first fellow, Miriam Harel, has joined Connecticut Children’s as a faculty member. She continues her work in basic science research. Her work with Drs. Ferrer and Shapiro was recognized with the basic science research prize at the Pediatric Urology Fall Congress. Dr. Harel now leads the urological care in our specialty clinic for patients with posterior urethral valves (PUV). Our second fellow, Liza Aguiar, is working on her Master’s Degree in Clinical and Translational Research at the University of Connecticut. In July 2015, she will join the faculty at Brown University. Our third fellow, Paul Smith III, is busy with training in his clinical year. Next year, his focus will be on urodynamic evaluation in children. Our next fellow, Gina Smith, will come to us from the residency program at Medical College of Wisconsin. She joins the team in July 2015. Pediatric Urology continues to develop the combined service line with Pediatric Nephrology. The service line remained busy with over 12,500 patient visits and over 1,000 operative cases performed. We led Connecticut in volume of pediatric kidney transplantations. Our service line provides joint clinic visits at both the Hartford and Farmington offices. We expanded our combined research endeavors in stone disease and patients with posterior urethral valves. We continue to enhance the specialty clinics at Connecticut Children’s Medical Center. These include: GUPPE clinic for patients with disorders of sexual development, ROCKS clinic for patients with kidney stones, PUV clinic for patients with posterior urethral valves, MVP (Managing Voiding Problems) clinic for patients with bladder and bowel dysfunction, and Prenatal clinic for patients with known fetal urological abnormalities. Our prenatal program has established care for patients at University of Connecticut, Hartford Hospital, and Danbury Hospital. In 2015, we plan an expansion of services in more satellite locations. We will expand our didactic conferences and integrate joint teleconferences with providers beyond Connecticut. PUBLICATIONS Hamilton TE, Barnhart D, Gow K, Ferrer F, Kandel J, Glick R, Dasqupta R, Naranjo A, He Y, Gratias E, Geller J, Mullen E, Ehrlich P. Inter-rater reliability of surgical reviews for AREN03B2: A COG renal tumor committee study. J Ped Surg. 2014;49(1):154-8. Thangada S, Shapiro LH, Silva C, Yamase H, Hla T, Ferrer FA. Treatment with the immunomodulator FTY720 (Fingolimod) significantly reduces renal inflammation in murine unilateral ureteral obstruction. J Urol. 2014;191(5):1508-16. Ferrer FA, Herbst KW, Fernandez C, Khanna G, Dome JS, Mullen EA, Geller JI, Gratias E, Shamberger R, Ritchey M, Ehrlich PF. Feasibility of using CT volume as a predictor of specimen weight in a subgroup of patients with low risk Wilms tumors registered on COG study AREN03B2: implications for central venous catheter placement. J Ped Urol. 2014;10(5):969. Mullen EA, Geller JI, Gratias EJ, Perlman EJ, Ehrlich PF, Khanna G, Naranjo A, He Y, Hamilton TE, Ferrer FA, Glick RD, Gow KW, Barnhart DC, Kandel JJ, Dasgupta R, Hoffer FA, Servaes S, Fernandez CV, Grundy PE, Dome J. Realtime central review: a report of the first 3,000 patients enrolled on the Children’s Oncology Group Renal Tumor Biology and Risk Stratification protocol AREN03B2. J Clin Oncol. 2014;32(15):10000. Ferrer F. [editorial comment] J Urol. 2104. Li MH, Harel M, Hla T, Ferrer F. Induction of chemokine (CC motif) ligand 2 by sphingosine-1-phosphate signaling in neuroblastoma. J Ped Surg. 2014;49(8):1286-91. Harel M, Makari JH. Paratesticular inflammatory myofibroblastic tumor in a pediatric patient. Case Rep Urol. 2014; Article ID 303678. Markush D, Briden KE, Chung M, Herbst KW, Lerer TJ, Neff S, Campbell BT. Effect of surgical subspecialty training on patent ductus arteriosus ligation outcomes. Ped Surg Intl. 2014 May; 30(5):503. Mason MD, Herndon CA, Herbst KW, Poston TL, Brandt EJ, Peters CA, Corbett ST. Proctor environment facilitates faculty training in pediatric robotic-assisted laparoscopic pyeloplasty. J Robotic Surg. 2014 Dec:8(4):365-9. 74 Urology Herbst KW. [commentary] Emergency room visits and readmissions after pediatric urologic surgery. J Ped Urol. 2014 Aug; 10(4):716. Campbell BT, Herbst KW, Briden KE, Neff S, Ruscher KA, Hagadorn JI. Inhaled nitric oxide use in neonates with congenital diaphragmatic hernia. Pediatrics. 2014 Aug; 134(2):e420-e6. Herbst K, Corbett ST, Lendvay TS, Caldamone AA. Recent trends in the surgical management of primary vesicoureteral reflux in the era of dextranomer/hyaluronic acid. J Urol. 2014 May:191(5):1628-33. Morrison K, Herbst K, Herndon CD. Pain management practice patterns for common pediatric urology procedures. Urology. 2014 Jan;83(1):206-10. Smith PP, Chalmers DJ, Feinn RS. Does defective volume sensation contribute to detrusor underactivity? Neurourol Urodyn. 2014 Sep 14. doi:10.1002/nau.22653. [Epub ahead of print] PubMed PMID: 25220925. Moody BJ, Liberman C, Zvara P, Smith PP, Freeman K, Zvarova K. Acute lower urinary tract dysfunction (LUTD) following traumatic brain injury (TBI) in rats. Neurourol Urodyn. 2014 Sep;33(7):1159-64. doi:10.1002/nau.22470. Epub 2013 Aug 29. PubMed PMID: 24038177. Wolff GF, Kuchel GA, Smith PP. Overactive bladder in the vulnerable elderly. Res Rep Urol. 2014 Oct 3;6:1318. doi:10.2147/RRU.S41843. eCollection 2014. Review. PubMed PMID: 25328867. Smith PP, Tyagi P, Kuchel GA, Pore S, Chermansky C, Chancellor M, Yoshimura N, Levanovich P. Advanced therapeutic directions to treat the underactive bladder. Int Urol Nephrol. 2014 Sep;46 Suppl 1:35-44. doi:10.1007/s11255-0140809-8. Epub 2014 Sep 20. PubMed PMID: 25238893. Tyagi P, Smith PP, Kuchel GA, de Groat WC, Birder LA, Chermansky CJ, Adam RM, Tse V, Chancellor MB, Yoshimura N. Pathophysiology and animal modeling of underactive bladder. Int Urol Nephrol. 2014 Sep;46 Suppl 1:11-21. doi:10.1007/ s11255-014-0808-9. Epub 2014 Sep 20. PubMed PMID: 25238890. BOOK CHAPTER Ramachandra P, Ferrer FA. Pediatric renal tumors. In: Pediatric urology for the primary care physician. New York: Springer; 2014. STAFF Fernando Ferrer, MD FAAP FACS Division Chief Jill Bernstein, MD, FAAP Miriam Harel, MD Christina Kim, MD, FAAP John Makari, MD, FAAP, FACS Eric Nelson, MD Phillip Smith, MD Katherine Herbst, MSc 75 Graduate Medical Education Residency As part of the program’s progress toward effectiveness in the Next Accreditation System, the Pediatric Residency Program revised its milestones-based assessments. During the inaugural application of this approach, it became apparent that there was less narrative description, proportionate to the number of areas of subcompetence assessed. There was a need for faculty and residents to better understand the rationale for the level of progress determined. As a result, faculty members for each resident activity were made responsible for many fewer areas of subcompetence about which to assess the milestone levels reached, with the expectation that the evaluations would provide more description of the performance that led to the assignment of the milestone rating determined. Residents indicated that the revised evaluations, providing more performance description, were more useful for their understanding the basis of their assessments, in knowing what to do to reach the next level in their progression for each area of subcompetence and in using the information in formulating their Individualized Learning Plans. Faculty members felt the revised assessments improved on the accuracy and usefulness the judgments made. The results of the program changes were presented nationally at the Annual Spring Meeting of the Association of Pediatric Program Directors. The restructuring of the curriculum, including the six rotationequivalent transitional experience, entered its second year. Residents and faculty were adapting to the process, and the built-in flexibility was greatly appreciated. The concentration/ pathway approach is serving its purpose of promoting resident career preparation for the spectrum of possibilities in the time frame needed for career decisions. The Ambulatory Pediatrics Pathway was selected to be presented nationally at the Annual Spring Meeting of the Association of Pediatric Program Directors by Drs. Terranova and Wallace, and it was very well received. Dr. Sharon Smith has implemented her research curriculum as a resource to the pathways, and there has been a marked increase in resident participation in research, as needed for most pathways. PL-1s Emily Biddick, MD Abigail Bosk, DO Crista Cerrone, MD The new governance structure for the program, which includes a Program Evaluation Committee (PEC) of core faculty leaders and elected residents to assess the program and make recommendations to the Program Director and Chair regarding changes for the program, has gotten off to a strong start under the leadership of Co-Chairs and Associate Program Directors Drs. Skurkis and Smith. They succeeded in addressing all of the program improvement projects for their first year, and are at work planning for next year’s improvements. The Clinical Competence Committee (CCC), under the leadership of Associate Program Director Dr. Mark Greenstein, reviewed the applicants for the resident selection process for this year’s Match, while conducting regular reviews of resident progress using the milestone-based assessments of resident performance in the identified areas of sub-competence. The CCC was instrumental in further refining the evaluation forms to include fewer areas of subcompetence and expanding the descriptive components. The work of CCC in the summative milestone assessments during the past year has been very successful, based on the lessons learned and changes made. The program continued to successfully recruit high quality residents, and the graduates again obtained outstanding positions for the next steps in their careers. The program first-attempt pass rate on the American Board of Pediatrics certifying examination has increased once again, and it is safely above average in meeting the required rate for accreditation. Participation in quality improvement continues both in resident continuity experience and in the fabric of Connecticut Children’s quality and safety efforts. Resident participation research continues to increase as well, and we expect even more participation with the new opportunities related to pathway requirements for research. Next year, we intend to further develop our training efforts for residents to learn ways to increase their ability to have sustained wellbeing with career success and longevity, without sacrificing their personal well-being. Elizabeth Chasse, MD, MPH Katie Clouthier, DO Sarah Germani, DO Jillian Gormley, DO Tuhina Joseph, DO, MS Annamarie Koller, DO Selena Levine, DO Katrina Loh, MD 76 Graduate Medical Education Residency David Muccino, MD, MPH Shannon Oteri, DO Carolina Quintana, MD John Ramirez, MD Amanda Silverio, MD Kaitlin Strumph, DO Whitney Trompeter, MD Christine Yang, MD Nancy Yip, DO, MS PL-2s Caroline Adegite, MD Alyson Baker, MD William Brucker, MD Mary Ann De Banate, MD Mona Doss, DO Mark Gilroy, DO Megan Griffiths, MD Kunal Gupta, MD Jane Im, MD Rose Lee, MD Laura McKay, MD Adam Pascoe, MD Alisha Philip, MD Brenda Prindle, MD Louis Rigos, DO Melanie Rudnick, MD Jessica Shui, MD Vaka Sigurjonsdottir, MD Kristopher Teti, MD Sussi Vivar, MD PL-3s Rena Aroesty, MD Jennifer Berrick, MD Jennifer Dorr, DO, MPH Rebecca Frontz, DO Serwa Gyamfi, MD Frank Han, MD Lauren Jeffries, DO Thomas Kennedy, MD Paula Lucuara Revelo, MD Sumith Madhavarapu, DO Laurie Malia, DO Nicholas Matarazzo, MD Wallis Molchen, DO Molly Naples, MD Anna Weingarten, DO Christine Pulice, DO Aaron Slaiby, DO Ginnie Taylor, MD Carolyn Vitale, MD Christen Vogel, MD Chief Residents Ruby Bartolome, DO Clare O’Keefe, DO Candice Sheldon, MD 77 Graduate Medical Education Fellowship The University of Connecticut School of Medicine-sponsored graduate medical education (fellowship) programs at Connecticut Children’s Medical Center continue to graduate very well trained specialty physicians who enter practice throughout the country. Our fellows continue to be awarded funding for exciting research projects, with numerous accepted presentations at national scientific meetings, and travel grants and awards received. The success of our Fellowship programs would not be possible without the dedication and tireless efforts of our Fellowship Coordinators: Kathy Mikulak, Jack Wakefield, and Marianne Gonzalez. ENDOCRINOLOGY Led by Dr. Elizabeth Estrada, the program continued to graduate fellows into academic programs. Fellows have had a 100% pass rate at first attempt on the pediatric endocrinology board. They also are engaged in meaningful research experiences mentored by well-published, NIH-funded investigators in basic and translational research. Our fellows continue to receive travel grants to attend national meetings to present their work. Dr. Hector Granados graduated from the program in 2014. He gave a platform presentation on his work at the Pediatric Academic Societies annual meeting. He also has received travel grants to national meetings to present his research. His work was titled “Type 1 Diabetes, Gut Bacteria and Immune Connections.” Dr. Sasi Penukonda is currently working on “Vanilloid Receptor 1 as regulator of gut immunity,” preliminary results of which were presented at the American Association of Immunologists Annual Meeting in May 2014 in Pittsburgh, PA. Dr. Sunitha Sura is currently studying the genetic link between HDL cholesterol and subclinical atherosclerosis. Her project involves studying Lymphocyte Activation Gene (LAG)-3 which is an important immune modulator that mediates the association of Scavenger receptor-B1 genetic variant, rs10846744, with subclinical atherosclerosis and incident cardiovascular disease. The fellowship is now led by Drs. Paola Palma Sisto and Rebecca Riba-Wolman, who have been active with the national pediatric endocrine fellowship group on new assessment tools for the ACGME’s Next Accreditation System requirements for fellowship. EMERGENCY MEDICINE Led by Dr. John Brancato, the Pediatric Emergency Medicine Fellowship is now in its 14th year. The program welcomed two excellent fellows in July: Kathryn Kasmire, MD, who joined Connecticut Children’s from St. Christopher’s Hospital for Children in Philadelphia, and our own resident Karl Hellstrand, DO. The program also matched an excellent candidate, Hannah Sneller, MD, who will join Connecticut Children’s in July 2015 from Stony Brook Long Island Children’s Hospital. Two of the program’s fellows, Henry Chicaiza, MD, and Talia Brooks, MD, presented at the Pediatric Academic Societies meeting in Vancouver and at the Eastern Society for Pediatric Research. Dr. Chicaiza’s two posters were on the use of KOH as an alternative reagent for the modified Apt test, and physical exam and patient historical factors associated with pneumonia. Dr. Brooks presented on features of patients who present to the Emergency Department with back pain. Dr. Chicaiza joined another of our recent graduates, Jeffrey Chen, MD, at Stony Brook University on Long Island. Nationally, Dr. Brancato has been working with a subgroup of the pediatric EM fellowship directors’ group to explore ways of increasing fellowship pursuit by Emergency Medicine residency graduates. UROLOGY Led by Dr. Christina Kim, the Pediatric Urology Fellowship Program continues to recruit and train excellent surgeons in a very competitive field. In 2014, 20% of the fellowship programs did not initially match a candidate. We have proudly matched top candidates at Connecticut Children’s since our program’s inception. Our first fellow, Miriam Harel, joined Connecticut Children’s as a faculty member. In the past year, she continued her work in Dr. Ferrer’s laboratory with a focus on renal tumor growth in mice. She presented multiple abstracts on clinical outcomes at the New England American Urological Association meeting and the Fall Congress for Pediatric Urology. Her laboratory work was recognized with the Basic Science Prize at the Fall Congress for Pediatric Urology. 78 Graduate Medical Education Fellowship Her publications include: Li MH, Harel M, Hla T, Ferrer F. Induction of chemokine (CC motif) ligand 2 by sphingosine-1-phosphate signaling in neuroblastoma. J Ped Surg. 2014;49(8):1286-91. Harel M, Makari JH. Paratesticular inflammatory myofibroblastic tumor in a pediatric patient. Case Rep Urol. 2014; Article ID 303678. Our second fellow, Liza Aguiar, is working on her Master’s Degree in Clinical and Translational Research at the University of Connecticut. On a regional and national platform, she presented a multi-institutional experience of robotic bilateral ureteral reimplantations. Specifically, she presented at the New England American Urological Association meeting and the Pediatric Urology Fall Congress meetings. Additionally, she has an accepted publication: A case of high grade transitional cell carcinoma of the bladder in a pediatric patient with Turner syndrome. Urology. In July 2015, she will join the pediatric urology faculty at Brown University. Our third fellow, Paul Smith III, has been busy with his clinical training. Next year, he will focus on pediatric urodynamic evaluations. Dr. Philip Smith will serve as his primary mentor for this clinical training. Paul will also focus on outcomes research in the field of bladder and bowel dysfunction. We are excited to welcome our next fellow, Gina Smith. Gina is completing her residency training at Medical College of Wisconsin. She will join us in July 2015. NEONATAL-PERINATAL MEDICINE Led by Drs. James Hagadorn and Jennifer Trzaski, the fellowship program in Neonatal-Perinatal Medicine continued its track record of academic accomplishment and scholarly productivity. Senior fellows Arvin Bundhoo and Soji Vargheses are both on track to complete the fellowship program successfully. Dr. Bundhoo published his fellowship research as first author in Clinical & Experimental Allergy, with Dr. Adam Matson as research mentor and senior author. Dr. Varghese is finalizing his research for submission for peer-review in collaboration with mentors Dr. Naveed Hussain, Dr. Mariann Pappagallo, and Dr. Elizabeth Brownell. Junior fellow Tristan Lindberg presented his research to the Eastern Society for Pediatric Research in Philadelphia and to the annual BY- CONN (Brown/Yale/UConn) meeting, and will present to the Pediatric Academic Societies in San Diego in April 2015. Meanwhile, first-year fellow Kendall Johnson passed her pediatric boards and is now board-certified in that specialty. The program continues to match well, and will welcome two strong incoming fellows this July: Maushami Assad, MD, MPH, who is completing her pediatric residency at Sinai Hospital in Baltimore, and Susan Pitts, MD, a pediatric resident at the Oklahoma State University Center for Health Sciences in Tulsa. ORTHOPAEDICS Led by Dr. Mark Lee, the Orthopaedics fellowship is relatively new and was just accredited in 2013. The first fellow, Ali Maziad, has been part of the program since August of 2013 and will be going on to an additional spine fellowship in August. He is currently completing two research projects on operating room efficiency for elbow fractures, and pelvic fixation in neuromuscular scoliosis. Ali received a first place award for case presentations at the IEP (Spine Interactive Educational Program) Fellows & Young Surgeons’ Annual meeting in November 2013. The program has filled the 2015 spot, and Dr. Lee and his colleagues are excited to train another Pediatric Orthopaedist for future practice. GASTROENTEROLOGY Led by Dr. Francisco Sylvester and Dr. Wael Sayej, the fellowship program in Pediatric Gastroenterology, Hepatology and Nutrition has had four fellows since it started four years ago. Dr. Sayej became the program director as of August 2014 after the departure of Dr. Sylvester. The program graduated its first fellow, Dr. Johanna G. Palmadottir, in June 2014. Dr. Palmadottir has accepted a position as assistant professor of pediatrics at the Medical University of South Carolina in Charleston. Dr. Palmadottir presented her work on the effect of colitis in muscle stem cells at Digestive Diseases Week, the annual meeting of the American Gastroenterological Association in May 2014 in Chicago. Dr. Palmadottir won first prize in the Connecticut Children’s Fellows Research competition in 2013. The program will be graduating its second fellow, Dr. Ajay Rana, in June 2015. Dr. Rana has accepted a position with Eastern Maine Medical Center, Bangor, ME. Dr. Rana is in the process of completing his Masters in Clinical Investigation, and several projects that he has carried on over the past 18 months. We are expecting our fifth fellow, Dr. Angela Pressley-Wallace, to start in July 2014. She is currently completing her pediatric residency at Arkansas Children’s Hospital, University of Arkansas, Little Rock, AR. 79 Graduate Medical Education Fellowship She completed her medical education at Louisiana State University School of Medicine in New Orleans. PULMONOLOGY Led by Dr. Anita Bhandari, the Pediatric Pulmonary Fellowship currently has one fellow, Dr. Anne MacLaughlin, a thirdyear fellow. Her abstract titled “Asthma control scores correlate better with small airway than large airway dysfunction,” has been accepted for poster presentation at the American Thoracic Society Meeting in Denver, CO, in May. Dr. Michael Blechner graduated in June 2014 and is pursuing a Pediatric Sleep Fellowship at the Children’s Hospital of Philadelphia. As a third year fellow, he presented a poster at the American Thoracic Society meeting in San Diego in May 2014 titled “Genotype predisposes African-American children to more severe bronchiolitis.” SURGERY Led by Dr. Christine Finck, the fellowship program in Pediatric General Surgery began in July 2011, and its first fellow, Dr. Kimberly Ruscher, successfully began practicing in Eugene, OR. She had several presentations during her fellowship and was responsible for developing congenital diaphragmatic hernia surgical guidelines. The program’s new fellow, Dr. Anthony Tsai, has a strong interest in innovation and minimally invasive surgery. GENETICS Led by Dr. Joseph Tucker, the Pediatric Genetics fellowship, which was first accredited in 1997, has graduated two fellows. The most recent graduate, Jennifer Gannon, completed her fellowship training in June of 2013. Future development of the program involves plans to expand to allow for a fouryear combined Pediatrics and Genetics training program, and collaboration with Jackson Laboratories now located on the campus of the University of Connecticut School of Medicine. FELLOWS Gasteroenterology Pulmonology Endocrinology Johanna Palmadottir, MD Michael Blechner, MD Hector Granados, MD Ajay Rana, MD Anne McLaughlin, MD Sasi Penukonda, MBBS Jasmeet Mokha, MBBS Sunitha Sura, MBBS Victoria Grossi, DO Shrinkhala Srivastava, MD General Surgery Anthony Tsai, MD Neonatology Emergency Medicine DonnaMarie Cortezzo, MD Urology Henry Chicaiza, MD Jeffrey Bartlett, DO Miriam Harel, MD Talia Brooks, MD Soji Varghese, MD Liza Aguiar, MD Danielle Federico, MD Arvin Bundhoo, MD Paul “Trey” Smith, MD Karl Hellstrand, DO Tristan Lindberg, MD Kathryn Kasmire, MD Kendall Johnson, MD Orthopaedics Ali Maziad, MD 80 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Altman, Arnold Leas’s Foundation for 5/1/14 Leukemia Research, Inc. Leukemia Research Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract n/a n/a n/a n/a n/a 180821 Bennett, Nicholas A Multicenter, Cubist Randomized, Pharmaceuticals, Inc Double-blinded Comparative Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Daptomycin Versus Active Comparator in Pediatric Subjects With Acute Hematogenous Osteomyelitis Due to Gram-Positive Organisms 1/1/14 12/31/14 $7,250.00 2 of 3 n/a n/a 180825 Bennett, Nicholas Randomized, Biota Scientific Mgmt Parallel Dose, Pty Ltd Phase 1/2 Safety and Pharmacokinetics Study of Inhaled Laninamivir Octanoate TwinCaps® Dry Powder Inhaler in Children with Naturally Acquired Influenza A or B 1/15/14 12/31/14 $14,095.68 1 of 2 n/a n/a 180283 Bezler, Natalie Health Literacy & Hyundai Hope on Patient Outcomes Wheels After Bone Marrow Transplantation 12/1/14 12/31/14 $75,000.00 1 of 1 n/a n/a 3/15/14 n/a n/a n/a n/a Borrup, Kevin Road Safety Program Kohl’s n/a 179371 Boruchov, Donna Public Health “DHHS/CDC/ATHN Surveillance for (UMASS)” the Prevention of Complications of Bleeding & Clotting Disorders 9/30/14 12/31/14 $24,471.00 1 of 1 n/a n/a 179636 Boruchov, Donna Sickle Cell CT/DPH Disease Program 7/1/14 12/31/14 $101,348.00 2 of 3 n/a n/a 179639 Boruchov, Donna CT Sickle Cell Consortium “CT/DPH (Hosp for Special Care)” 7/1/14 12/31/14 $19,051.00 1 of 1 n/a n/a 180265 Boruchov, My Life Our DonnaFuture Biogen Idec/ATHN 1/1/14 12/31/14 $3,500.00 1 of 2 n/a n/a 180274 Boruchov, Data Quality DonnaCounts ATHN 7/1/14 12/31/14 $17,500.00 2 of 2 n/a n/a 81 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180800 Boruchov, Donna A Phase I/III CSL Behring, LLC Open Label, Multicenter, Crossover Safety, Efficacy and Pharmacokinetic Study of Recombinant Coagulation Factor VIII (rFVIII) Compared to Recombinant Human Antihaemophilic Factor VIII (rFVIII; INN: octocog alfa) in Subjects with Hemophilia A, and a Repeat PK, Safety and Efficacy Study (Part 3) 1/1/14 12/31/14 $32,852.12 2 of 2 n/a n/a 180812 Boruchov, Donna H7T MC TADO Eli Lilly Phase 3, Doubleblind, Randomized, Efficacy and Safety Comparison of Prasugrel and Placebo in Pediatric Patients with Sickle Cell Disease. 1/1/14 12/31/14 $11,410.00 2 of 2 n/a n/a 180819 Boruchov, Donna Single-Dose Bristol Myers Squibb Study to Evaluate the Pharmacokenetics, Pharmacodynamics, Safety, and Tolerability of Apixaban in Pediatric Subjects at Risk for a Venous or Arterial Thrombotic Disorder 1/1/14 12/31/14 $9,250.00 2 of 2 n/a n/a 180827 Boruchov, Donna A Phase III Open CSL Behring, LLC Label, Multicenter, Extension Study to Assess the Safety & Efficacy of Recombinant Coagulation Factor VII CSL627 in Subjects with Severe Hemophilia A 10/27/14 12/31/14 $100.00 2 of 3 n/a n/a 1/1/14 n/a n/a n/a n/a n/a 6/1/14 n/a n/a n/a n/a n/a Brock, Karen Safe Kids Project Epic Brock, Karen Safe Kids Project Connecticut Elks Association 82 Grants & Contracts CC# Start Date of Reported Award End Date of Reported Award Amount of Total Award 179330 Cloutier, Early Childhood DHHS/NIH/NICHD MichelleObesity Prevention: Building Healthier Families and Communities 1/1/14 12/31/14 $194,548.00 2 of 2 UCHC $37,966.00 179637 Cloutier, DPH - Easy CT/DPH MichelleBreathing Program 2014-15 7/1/14 12/31/14 $250,000.00 2 of 3 UCHC $6,299.00 180261 Cloutier, Michelle 1/1/14 12/31/14 $380,597.00 1 of 2 UCHC $94,630.00 7/1/14 6/30/15 n/a 6 of 6 CCMC is prime $6,299.00 Cloutier, Early Childhood DHHS/NIH MichelleObesity Prevention: Building Healthier Families and Communities 4/1/14 3/31/15 n/a 2 of 2 CCMC is prime $37,966.00 Cloutier, Building Bridges: GSK MichelleAdvancing Education by Improving Asthma Management in Inner City Children 1/1/14 12/31/14 n/a 2 of 3 CCMC is prime $59,499.00 180263 Cloutier, Michelle 1/1/14 12/31/14 $179,991.05 1 of 2 n/a n/a 179256 Demirci, Cem Type 1 Diabetes DHHS/NIH/NIDDK TrialNet (Univ South Florida) 7/1/14 12/31/14 $3,165.00 4 of 5 n/a n/a 180814 DiMario, Francis 1/1/14 12/31/14 $17,535.69 2 of 2 n/a n/a 179370 Dumont- Early Detection of “DHHS/NIH (UCONN 9/1/14 Mathieu,Pervasive Storrs)” ThydeDevelopmental Disorders 12/31/14 $10,467.00 1 of 1 n/a n/a Principal Award Title Investigator Funding Source (Primary/Secondary) Building Bridges: “Glaxo Smith Kline Advancing (Univ of Colorado)” Education by Improving Asthma Management in Inner City Children Cloutier, Easy Breathing MichelleProgram DPH Easy Breathing CHNCT Training & Consulting 13-14 A Three-arm, Novartis Randonmized, Pharmaceuticals Corp Double-blind, Placebo-controlled Study of the Efficacy and Safety of Two Trough-ranges of Everolimus as Adjunctive Therapy in Patients with Tuberous Sclerosis Complex (TSC) Who Have Refractory Partialonset Seizures Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 83 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award 179638 Dworkin, Regional Care PaulCoordination Community Collaborative CT/DPH 7/1/14 12/31/14 $20,000.00 1 of 3 n/a n/a 179644 Dworkin, Paul Maternal Child Health Blueprint “CT/DPH (City of Hartford)” 7/1/14 12/31/14 $10,000.00 1 of 2 n/a n/a 180271 Dworkin, Paul Use of a National WK Kellogg Fdn Affiliate Network to Diffuse System Innovation to Promote Vulnerable Children’s Optimal Healthy Development 7/1/14 12/31/14 $246,483.00 1 of 3 n/a n/a 180282 Dworkin, Paul Meeting the Lego Children’s Fund Needs of CT’s Young Children by Spreading the Impact of MidLevel Developmental Assessment & Strengthening the Help Me Grow System 9/22/14 12/31/14 $250,000.00 1 of 2 n/a n/a Dworkin, Paul Office for Berthe M. Cote Community Child Foundation Health Educating Practices in the Community 6/1/14 n/a n/a n/a n/a n/a Dworkin, Paul Office for Community Child Health - New Britain Healthy Homes n/a n/a n/a n/a n/a 1/1/14 12/31/14 per patient 5 of 6 n/a n/a Clinical Accuracy CAS Medical Systems 1/1/14 Evaluation of the CAS Model 740 Non-Invasive Blood Pressure Monitor (Intraarterial Method). Neonatal/Infant Study. 12/31/14 $5,300.40 3 of 3 n/a n/a Stanley Black & Decker 8/31/14 180758 Edelheit, A Longterm Abbott Laboratories BarbaraMulticenter Longitudinal Postmarketing Observational Registry of Humira (Adalimumab) in Children with Active JIA. Phase 1. 180791 Eisenfeld, Leonard Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 84 Grants & Contracts CC# Principal Award Title Investigator Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180740 Emerick, Evaluation of the Bristol Myers Squibb KaranPharmacokinetics, Safety, Tolerability and Efficacy of Entecavir in Pediatric Subjects with Chronic Hepatitis B Virus Who Are HB3AG -Positive 1/1/14 12/31/14 $5,107.19 6 of 7 n/a n/a 180780 Emerick, Karan A Comparative Bristol Myers Squibb Study of the Antiviral Efficacy and Safety of Entecavir (ETV) versus Placebo in Pediatric Subjects with Chronic Hepatitis B Virus Infection 1/1/14 12/31/14 $22,770.98 5 of 6 n/a n/a 179246 Estrada, Elizabeth Studies to Treat or DHHS/NIH/NIDDK 1/1/14 Prevent Pediatric (George Washington U) Type 2 Diabetes (George Washington U) 12/31/14 $1,820.00 4 of 5 n/a n/a 180639 Estrada, Elizabeth KIGS 180707 Estrada, Tercica Registry ElizabethAgreement (MS 305) Funding Source (Primary/Secondary) Pfizer, Inc. 1/1/14 12/31/14 $4,433.31 11 of 12 n/a n/a Tercica, Inc. 1/1/14 12/31/14 $1,846.07 7 of 8 n/a n/a 180786 Estrada, Elizabeth Colesevelam Oral Daiichi Sankyo, Inc. Suspension as Monotherapy or Add-On to Metformin Therapy in Pediatric Subjects with Type 2 Diabetes Mellitus 1/1/14 12/31/14 $16,465.30 4 of 5 n/a n/a 179359 Ferrer, Fernando Sphingosine-1- Phosphate Pathway Based Therapy for Neuroblastoma 7/1/14 12/31/14 $335,040.00 3 of 3 CCMC $68,364.00 n/a n/a n/a n/a Ferrer, Neuroblastoma FernandoResearch 179358 Finck, Christine DHHS/NIH/NCI (UCHC) The Seraph Foundation 6/1/14 n/a Optimal Derivation DHHS/NIH/NHLBI of Murine (UCHC) Embryonic Distal Airway Stem Cells 7/1/14 12/31/14 $336,875.00 3 of 3 CCMC $109,159.00 180701 Greenstein, Hunter Outcome Shire Human Genetic RobertSurvey Therapies 1/1/14 12/31/14 per patient 7 of 7 n/a n/a 85 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180779 Hagadorn, James Phase III, Inhaled INO Therapeutics, LLC 1/1/14 Nitric Oxide for the Treatment of Bronchopulmonary Dysplasia (BPD) in Pre-term Infants Requiring Mechanical Ventilation or Positive Pressure Support on Days 5 - 14 After Birth 12/31/14 $2,250.00 5 of 5 n/a n/a 180804 Heller, Felice Adult Congenital Actelion Pharma USA 1/1/14 Heart Disease Enhancement Clinical Research Initiative 12/31/14 $5,250.00 2 of 3 n/a n/a 180799 Hussain, Naveed A Phase 3 Astella Pharma Global 1/1/14 Randomized, Development Double-blind, Multicenter Study to Compare the Efficacy and Safety of Micafungin Versus Amphotericin B Deoxycholate for the Treatment of Neonatal Candidiasis 12/31/14 $3,760.00 n/a n/a 179296 Hyams, Jeffrey Predicting DHHS/NIH/NIDDK Response to Standard Pediatric Colitis Therapy: The PROTECT study 1/1/14 12/31/14 $2,311,223.00 3 of 5 UCHC $6,671.00 1/1/14 12/31/14 $3,841.87 n/a n/a n/a 180725 Hyams, A Multicenter, Janssen Services, LLC 1/1/14 JeffreyProspective, Long-term, Observational Registry of Pediatric Patients with Inflammatory Bowel Disease 12/31/14 $280,683.11 6 of 7 n/a n/a 180727 Hyams, Jeffrey 12/31/14 $1,483.38 6 of 7 n/a n/a 180627 Hyams, A Multicenter Centocor JeffreyInternational Observational Study of the Long-term Safety of Infliximab (Remicade) Results - UC Janssen Services, LLC 1/1/14 Long-term - A Multicenter International Study of the Long-term Safety of Infliximab (REMICADE) in Ulcerative Colitis 2 of 3 86 Grants & Contracts CC# Principal Award Title Investigator Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract Predicting The Hospital for Sick Response to Children Intravenous Corticosteroid Therapy in Pediatric Patients with Ulcerative Colitis 1/1/14 12/31/14 $8,727.20 n/a n/a n/a 180753 Hyams, Investigative Elan Pharmaceuticals JeffreyNatalizumab Through Further Observational Research and Monitoring Phase IV Registry 1/1/14 12/31/14 $6,863.40 5 of 6 n/a n/a 180756 Hyams, Jeffrey Risk Stratification CCFA (Emory U) and Identification of Immunogenetic and Microbial Markers of Rapid Disease Progression in Children with Crohn’s Disease 1/1/14 12/31/14 $21,390.43 5 of 6 n/a n/a 180765 Hyams, Jeffrey Phase 2, Open UCB, Inc. Label, Multicenter Study to Assess the Safety and Efficacy of Certolizumab Pegol in Children and Adolescents with Active Crohn’s Disease 1/1/14 12/31/14 $11,689.80 5 of 6 n/a n/a 180777 Hyams, Jeffrey A Multidisciplinary CCFC (Mt. Sinai Hosp) 1/1/14 Human Study on the Genetic, Environmental, and Microbial Interactions That Cause IBD 12/31/14 $87,201.79 4 of 10 n/a n/a 180795 Hyams, Jeffrey A Phase 1, Shire Pharmaceuticals, 1/1/14 Multicenter, Open Inc. Label Study to Determine the Safety and Pharmacokinetics of MMX Mesalamine Following Administration in Children and Adolescents With Ulcerative Colitis 12/31/14 $8,139.97 2 of 3 n/a n/a 12/31/14 $20,071.64 2 of 3 n/a n/a 180750 Hyams, Jeffrey 180808 Hyams, The ImageKids JeffreyStudy Funding Source (Primary/Secondary) Shaare Zekek Medical 1/1/14 Ctr 87 Grants & Contracts CC# Principal Award Title Investigator 180815 Hyams, Jeffrey Funding Source (Primary/Secondary) A Phase 1b Open Janssen Research & Label Study to Development LLC Assess the Safety and Pharmacokinetics of Subcutaneously Administered Golimumab, a Human anti-TNFα Antibody, in Pediatric Subjects With Moderately to Severely Active Ulcerative Colitis Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 1/1/14 12/31/14 $45,432.94 2 of 3 n/a n/a 180830 Hyams, Serum - Derived JeffreyBovine Immunoglobulin Entera Health 11/14/14 12/31/14 $25,000.00 1 of 2 n/a n/a 179356 Isakoff, Michael National Clinical Trials Network Grant “DHHS/NIH/NCI (CHOP)” 3/1/14 12/31/14 $10,000.00 1 of 1 n/a n/a 179357 Isakoff, Michael Per Case Reimbursement DHHS/NIH/NCI/ COG (CHOP) 1/1/14 12/31/14 $20,550.00 1 of 2 n/a n/a 179374 Isakoff, Michael Study Chair National Clinical Trials Network Grant “DHHS/NIH/NCI (CHOP)” 4/11/14 12/31/14 $7,500.00 na na 180213 Isakoff, Michael multiple studies COG (CHOP) 1/1/14 12/31/14 $41,500.00 1 of 2 n/a n/a 180213 Isakoff, Michael A Dose Jazz Pharmaceutical/ Confirmation and COG (CHOP) Pharmacokinetic Study of Asparec (pegcrisantaspase) Administered as Intravenous (IV) Infusion in Children and Young Adults with Acute Lymphoblastic Leukemia (ALL)/ Lymphoblastic Lymphoma (LBL) Following Hypersensitivity to Pegaspargase (Oncaspar) 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 180213 Isakoff, Michael A Phase II Millenium 1/1/14 Randomized Trial Pharmaceuticals/COG for Patients with (CHOP) de novo AML Using Bortezomib (NSC# 681239) and Sorafenib (BAY 43-9006, NSC# 724772) for Patients with High Allelic Ratio FLT2/ITD 12/31/14 pp/private 1 of 2 n/a n/a 1 of 1 88 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180213 Isakoff, Michael A Phase II Study Pfizer Inc/COG of Sunitinib in (CHOP) Recurrent or Progressive Brain Tumors in Pediatric and Young Adult Patients 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 180213 Isakoff, Michael A Phase 2 Trial of Glaxosmithkline, LLC/ 1/1/14 Pazopanib NSC COG (CHOP #737754, IND #65747 in Children with Refractory Solid Tumors 12/31/14 pp/private 1 of 2 n/a n/a 180213 Isakoff, Michael Intergroup Trial for Hoffman-La Roche Children or LTD/COG (CHOP) Adolescents with B-Cell NHL or B-AL: Evaluation of Rituximab Efficacy and Safety in High Risk Patients LTD/COG (CHOP) 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 180213 Isakoff, Michael A Phase 2 Bristol Myers Squibb/ Multicenter COG (CHOP) Historically Controlled Study of Dasatinib Added to Standard Chemotherapy in Pediatric Patients with Newly Diagnosed Philadelphia Chromosome Positive Accute Lymphoblastic Leukemia 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 180250 Isakoff, Michael multiple studies Moffitt 1/1/14 12/31/14 $16,399.00 2 of 2 n/a n/a 180250 Isakoff, Michael A Phase I Trial of Moffitt Dose Escalation of Metformin in Combination with Vincristine, Irinotecan, and Temozolomide in Children with Relapsed or Refractory Solid Tumors 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 180250 Isakoff, Michael Phase I, Traditional Moffitt 3+3, Trial of PO Sorafenib and Topotecan in Refractory or Recurrent Pediatric Solid Malignancies 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 89 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract Moffitt 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 180250 Isakoff, Michael A Phase I Window, Moffitt Dose Escalating and Safety Trial of Metformin in Combination with Induction Chemotherapy in Relapsed Refractory Acute Lymphoblastic Leukemia: Metformin with Induction Chemotherapy of Vincristine, Dexamethasone, Doxorubicin, and PEG-asparaginase (VLPD) 1/1/14 12/31/14 pp/private 1 of 2 n/a n/a 180797 Isakoff, Michael A Phase II Study COG (CHOP) of Sunitinab in Recurrent or Progressive Brain Tumors in Pediatric and Young Adult Patients 1/1/14 12/31/14 per patient 2 of 2 n/a n/a Isakoff, Michael Hematology/ Oncology Clinical Trials 6/30/14 n/a n/a n/a n/a n/a Isakoff, Michael Hematology/ CureSearch for Oncology Clinical Children’s Cancer Trials 1/15/14 n/a n/a n/a n/a n/a Isakoff, Michael Adolescent & Reid R. Sacco AYA Young Adult (AYA) Cancer Alliance Cancer Program 1/31/14 n/a n/a n/a n/a n/a n/a n/a n/a 180250 Isakoff, Personalized MichaelMedicine: Pediatric Total Cancer Care Protocol AFLAC Lapidus, Safe Kids GaryWorldwide Safe Kids Worldwide 9/10/14 n/a n/a 180262 Lapin, Craig Therapeutic Development Center 2014 Cystic Fibrosis Therapeutic Fdn 1/1/14 12/31/14 $65,957.00 1 of 1 n/a n/a 180272 Lapin, Craig CF Center CF Fdn Therapeutics Support - Nurse & Nutritionist 7/1/14 12/31/14 $47,035.00 1 of 1 n/a n/a 180770 Lapin, Craig 1/1/14 12/31/14 $4,500.00 4 of 5 n/a n/a Controlled Trial of Novartis Two Adherence Pharmaceuticals Corp Promotion (Univ Miami) Interventions for Cystic Fibrosis, [I Change Adherence and Raise Expectations (ICARE)] 90 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180788 Lapin, Craig A Phase 3, MPEX Multicentered, Pharmaceuticals, Inc. Multinational, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of MP-376 in Stable Cystic Fibrosis Patients 1/1/14 12/31/14 per patient 3 of 4 n/a n/a 180789 Lapin, Craig A Phase 3, Open MPEX Label, Randomized Pharmaceuticals, Inc. Trial to Evaluate the Safety and Efficacy of MP-376 Inhalation Solution (Aeroquin) Versus Tobramycin Inhalation Solution (TIS) in Stable Cystic Fibrosis Patients 1/1/14 12/31/14 $6,496.51 3 of 4 n/a n/a 180796 Lapin, Craig A Phase 3, Vertex Pharmaceuticals 1/1/14 Randomized, Double-blind, Placebo-controlled, Parallel Group Study to Evaluate the Efficacy and Safety of Ivacaftor in Subjects with Cystic Fibrosis Who Have the R117H-CFTR Mutation 12/31/14 $17,057.28 2 of 3 n/a n/a 180801 Lapin, Craig A Long-term Seattle Children’s Hosp 1/1/14 Prospective Observational Safety Study of the Incidence of and Risk Factors for Fibrosing Colonopathy in US patients with Cystic Fibrosis Treated with Pancreatic Enzyme Replacement Therapy 12/31/14 $4,025.60 2 of 3 n/a n/a 91 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180803 Lapin, Craig A Phase 3, Vertex Pharmaceuticals 1/1/14 Two-arm, Rollover Study to Evaluate the Safety of Long-term Ivacaftor Trreatment in Subjects 6 Years of Age and Older with Cystic Fibrosis and a Non-G551D CFTR Mutation 12/31/14 $40,237.69 2 of 3 n/a n/a 180805 Lapin, Craig An Open Label Hartford Hosp Study to Assess the Population Pharmacokinetics, Safety, and Practicality of Administering Meropenem as a Prolonged Infusion to Cystiic Fibrosis Children Admitted With an Acute Pulmonary Exacerbation 1/1/14 12/31/14 $27,761.74 2 of 3 n/a n/a 180811 Lapin, Craig A Phase 3, Vertex Pharmaceuticals 1/1/14 Randomized, Double-blind, PlaceboControlled, Parallel Group Study to Evaluate the Efficacy and Safety of Lumacaftor in Combination with Ivacaftor in Subjects Aged 12 Years and Older With Cystyc Fibrosis, Homozygous for the F508delCFTR Mutation 12/31/14 $11,745.02 2 of 3 n/a n/a 180816 Lapin, Craig A Point-Prevalence AbbVie, Inc; Aptalis Study to Evaluate Pharma, Inc; Janssen the Prevalence of Research & Antibodies to Development LLC Selected Porcine Viruses in Patients with Cystic Fibrosis Who Are Receiving Porcine -Derived Pancreatic Enzyme Replacement Therapy: A Harmonized Protocol Across Sponsors 12/31/14 $14,881.00 2 of 3 n/a n/a 1/1/14 92 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180820 Lapin, Craig A Phase 3, Vertex Pharmaceuticals 1/1/14 Rollover Study to Evaluate the Safety and Efficacy of Longterm Treatment With Lumacaftor in Combination With Ivacaftor in Subjects Aged 12 Years and Older With Cystic Fibrosis, Homozygous or Heterozygous for the F508delCFTR Mutation 12/31/14 $31,255.55 2 of 3 n/a n/a 179349 Livingston, Nina SCAN Pediatrician “DHHS/ACF - Federal (CT/DCF)” 7/1/14 12/31/14 $220,500.00 1 of 1 n/a n/a 179366 Livingston, Nina SCAN St. Francis “Nat’l Children’s Alliance 8/7/14 Service Agreement (St Francis Hosp)” 12/31/14 $39,600.00 1 of 1 n/a n/a 179635 Livingston, Nina SCAN Pediatrician CT/DCF 7/1/14 12/31/14 $241,338.00 1 of 1 n/a n/a 179645 Livingston, Nina CAP’s Careline Support Network Pilot Program 12/22/14 12/31/14 $52,329.00 1 of 1 n/a n/a Livingston, Nina Direct Services – VOCA - Justice Dept. Child Abuse Program 7/1/13 6/30/14 $255,390.00 3 of 3 n/a n/a Livingston, Nina Direct Services – Dept. of Children & Victims of Abuse Families 7/1/13 6/30/14 $195,140.00 2 of 3 n/a n/a Livingston, Nina Children’s Center Ensworth Foundation Program Support 1/1/14 12/31/14 $10,000.00 1 of 1 n/a n/a 7/1/13 6/30/14 $127,100.00 1 of 5 n/a n/a Livingston, Child Sexual NinaAbuse CT/DCF CT Dept. of Public Health Livingston, Nina Sexual Abuse Office of Victim 10/1/13 Exams/Interviews Services - Justice Dept. 9/30/14 $210,458.00 1 of 1 n/a n/a Livingston, Nina Children’s Center National Children’s Program Support Alliance 12/31/14 $20,000.00 1 of 1 n/a n/a Livingston, Child Protection/ The Lane Construction 2/1/14 NinaSCAN Corp. n/a n/a n/a n/a 179343 Makari, John 12/31/14 $10,520.00 2 of 5 n/a n/a Short-term Outcomes of Interventions for Reproductive Dysfunction 1/1/14 DHHS/NIH/NICHHD 5/1/14 (Univ of Oklahoma) n/a 93 Grants & Contracts CC# Principal Award Title Investigator 180798 Makari, John Funding Source (Primary/Secondary) A 12-Week, Pfizer, Inc. Randomized, Open Label, Active Comparator Period Followed by a 12-Week Safety Extension Period to Evaluate the Safety and Efficacy of Fesoterodine in Subjects Ages 6 to 16 Years and >25 kg w McGrath, Nursing Research Acorn Alcinda Jacqueline Foundation, Inc. Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 1/1/14 12/31/14 $15,500.00 2 of 2 n/a n/a 3/15/14 Menillo, Lisa Hartford Regional CT Dept. of Public Lead Treatment Health Center 7/1/13 6/30/14 $180,286.00 3 of 3 CCMC $21,438.00 179367 Ohannessian, Adaptive “DHHS/NIH/NIDA Christine Treatment for (UCHC)” Adolescent Cannabis Disorder 8/1/14 12/31/14 $21,826.00 1 of 1 n/a n/a 179368 Ohannessian, Treatment of “DHHS/NIH/NIDA Christine Co-Occuring (UCHC)” Alcohol Use Disorder & Depression/ Anxiety Disorders 8/1/14 12/31/14 $7,275.00 1 of 1 n/a n/a 179319 Orsey, Andrea SunCoast CCOP DHHS/NIH/NCI Research Base at (Univ South Florida) the University of South Florida 1/1/14 12/31/14 $10,000.00 1 of 2 n/a n/a 180273 Orsey, Andrea Pilot Yoga “UCONN Storrs Intervention - (UCHC)” Peds Cancer Patients Sleep & Life Quality and Parents Well Being 7/1/14 12/31/14 $13,483.00 1 of 1 n/a n/a 180792 Orsey, Andrea An Open-Label, Purdue Pharma LP Multicenter Study of the Safety of Twice Daily Oxycodone Hydrochloride Controlled-release Tablets in Opioid Experienced Children from Ages 6 to 16 Years Old 1/1/14 12/31/14 $144,909.41 3 of 4 n/a n/a 180206 Parikh, Nehal 1/1/14 12/31/14 $41,000.00 4 of 5 n/a n/a Neuroblastoma and Medulloblastoma Translational Research Consortium Van Andell Institute 94 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180206 Parikh, Nehal Molecular Analysis Neuroblastoma and 1/1/14 of Pediatric Tumors Medulloblastom with Establishment Translational Research of Tumor Models in Consortium (Spectrum a Biology Study Health) 12/31/14 pp/private 5 of 6 n/a n/a 180206 Parikh, Nehal A Feasibility Trial Using Molecular- Guided Therapy for the Treatment of Patients with Refractory or Recurrent Neuroblastoma Neuroblastoma and 1/1/14 Medulloblastoma Translational Research Consortium (Spectrum Health) 12/31/14 pp/private 5 of 6 n/a n/a 180206 Parikh, Nehal A Phase I Trial for Neuroblastoma and 1/1/14 Refractory or Medulloblastom Relapsed Translational Research Neuroblastoma Consortium (Spectrum with DFMO Alone Health) and in Combination with Etoposide 12/31/14 pp/private 5 of 6 n/a n/a 180206 Parikh, Nehal A Feasibility Trial Neuroblastoma and 1/1/14 Using Molecular- Medulloblastoma Guided Therapy for Translational Research the Treatment of Consortium (Spectrum Patients with Health) Relapsed and Refractory Childhood Cancer 12/31/14 pp/private 5 of 6 n/a n/a 180206 Parikh, Nehal A Phase II Neuroblastoma and 1/1/14 Preventative Trial Medulloblastom of DFMO as a Translational Research Single Agent in Consortium (Spectrum Patients with High Health) Risk Neuroblastoma in Remission 12/31/14 pp/private 5 of 6 n/a n/a 180206 Parikh, Nehal A Phase I/II Trial of TPI 287 in Patients with Refractory or Recurrent Neuroblastoma or Medulloblastoma Neuroblastoma and 1/1/14 Medulloblastom Translational Research Consortium (Spectrum Health) 12/31/14 pp/private 5 of 6 n/a n/a 180206 Parikh, Nehal A Phase I/II Trial of Irinotecan and Temozolomide Compared to Ininotecan and Temozolomide in Combination with TPI 287 in Patients with Refractory or Early Relapsed Neuroblastoma Neuroblastoma and 1/1/14 Medulloblastom Translational Research Consortium (Spectrum Health) 12/31/14 pp/private 5 of 6 n/a n/a 95 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180206 Parikh, Nehal Molecular-guided Therapy for the Treatment of Patients with Relapsed and Refractory Childhood Cancers Neuroblastoma and 1/1/14 Medulloblastoma Translational Research Consortium (Spectrum Health) 12/31/14 pp/private 5 of 6 n/a n/a 180206 Parikh, Nehal A Phase I/II Trial of DFMO in Combination with Bortezomib in Patients with Relapsed or Refractory Neuroblastoma Neuroblastoma an 1/1/14 Medulloblastoma Translational Research Consortium (Spectrum Health) 12/31/14 pp/private 5 of 6 n/a n/a 180224 Parikh, Nehal Clinical Trial of Dell (Van Andell Molecular-GuidedInstitute) Therapy for the Treatment of Patients with Refractory or Recurrent Neuroblastoma 1/1/14 12/31/14 $25,000.00 3 of 3 n/a n/a 180281 Parikh, Nehal Advanced Therapeutics Program Infrastructure 10/1/14 12/31/14 $50,000.00 1 of 1 n/a n/a 180728 Parikh, Nehal A Multi-Center, Grifols Prospective, Open Label, Clinical Trial to Assess the Safety and Efficacy of a New Intravenous Immune Globulin (IGIV31 Grifols 10%) in Patients with Idiopathic (Immune) Thrombocytopenic Purpura 1/1/14 12/31/14 $107.00 6 of 7 n/a n/a DHHS/OS (CT/DPH) 7/1/14 12/31/14 $20,000.00 2 of 3 n/a n/a 1/1/14 12/31/14 $14,454.58 10 of 11 n/a n/a 1/1/14 12/31/14 $28,925.66 1 of 1 n/a n/a 179353 Parker, Public Health JamesPreparation 2014-2015 180650 Ratzan, Susan St Baldricks Fdn An Observational Nordotropin Study (Registry) Assessing Treatment Outcomes and Safety for Children and Adults Who Are Prescribed Norditropin (Human Growth Hormone) 180645 Rosengren, RKIGS Sally Pharmacia 96 Grants & Contracts CC# Principal Award Title Investigator 180631 Rubin, Karen Funding Source (Primary/Secondary) The Genetics and Eli Lilly Neuroendocrinology of Short Stature International Study Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 1/1/14 12/31/14 $2,036.00 n/a n/a 180717 Rubin, Karen Girls Turner Syndrome Eli Lilly 1/1/14 12/31/14 $6,099.31 7 of 12 n/a n/a 179347 Salazar, Juan Ryan White A 2014-2015 “DHHS/HRSA/City of 3/1/14 Hartford (UCHC)” 12/31/14 $119,066.00 1 of 1 CCMC $52,632.00 DPH 4/1/14 3/31/15 $90,000.00 4 of 6 X X 179363 Salazar, Juan Ryan White D “DHHS/HRSA 2014-2015(UCHC)” 8/1/14 12/31/14 $331,902.00 1 of 1 CCMC $16,962.00 179364 Salazar, Juan 7/1/14 12/31/15 $36,372.00 1 of 1 n/a n/a 1/1/14 12/31/14 $128,335.00 2 of 4 X X Salazar, Juan Ryan White B Mechanism of DHHS/NIH/NIAID Impaired (UCHC) Mycobacteria Sensing by TLR2 & TLR4 Polymorphic Variants Salazar, Juan CT DPH HIV DPH Prevention Interventions 2012 Salazar, Juan Hartford Teenage DHHS/City of Hartford 10/1/14 Pregnancy Prevention Initative (HTPPI) 9/30/15 $24,700.00 3 of 3 X X 180270 Salazar, Olga ARC - Use of Diversity Outbred Mice to Study Cardiotoxicity of Chemo 3/1/14 12/31/14 $8,474.00 1 of 2 n/a n/a 180292 Salazar, Olga The Role of Maximillian Hoffman Aerobic Exercise Fdn to Modulate Cardiotoxicity in Long-Term Cancer Survivors 12/16/14 12/31/14 $50,000.00 1 of 2 n/a n/a 180267 Sanders, Statewide Quality March of Dimes MarilynImprovement Collaborative 5/1/14 12/31/14 $5,000.00 1 of 1 n/a n/a 180280 Sanders, Statewide March of Dimes MarilynNeonatal/Perinatal Quality Improvement Collaborative 10/1/14 12/31/14 $10,000.00 1 of 1 n/a n/a 12/31/14 $35,367.00 1 of 3 n/a n/a Jackson Labs 180268 Santos, CICATS Pain & CT Institute for Clinical 7/1/14 Melissa Weight Treatment & Translational Science (CICATS) 97 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award 180824 Schoem, A Prospective, Otonomy, Inc ScottRandomized, Double-blind, Sham-controlled, Multicenter, Phase 3 Study of OTO-201 Given as a Single Intratympanic Injection for Intra operative Treatment of Middle Ear Effusion in Pediatric Patients Requiring Tympanostomy Tube Replacement 1/16/14 12/31/14 $81,881.96 1 of 2 n/a n/a 179375 Silva, Cynthia Pediatric “DHHS/NIH/NIAID Glomerula (Nationwide Children’s BiomarkersHospital)” 6/1/14 12/31/14 $9,705.00 1 of 1 n/a n/a 179355 Skinner, Dental Clinic DHHS/HRSA (UCHC) 7/1/14 RichardHRSA Postdoctoral Training in General, Pediatrc and Public Health Dentistry and Dental Hygiene 14-15 12/31/14 $48,997.00 1 of 1 n/a n/a 179640 Slivka, Hilda Childhood Lead CT/DPH Poisoning Program 9/1/14 12/31/14 $180,286.00 1 of 1 n/a n/a Sylvester, Francisco Predicting NIH Response to Standard Pediatric Colitis Therapy: The PROTECT study 5/1/14 4/30/15 CCMC is prime $6,671.00 Sylvester, Francisco Intestinal Gamma NIH/Oregon Health & 7/1/13 -Delta T Cell Science University Mucosal Responses in Human Crohn Disease (MIST) CCMC $40,388.00 6/30/15 Year# of # of Award Years 3 of 5 $174,253.00 NCE Subcontract to Amount of UCHC/CCMC? Subcontract 98 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 1/1/14 12/31/14 $7,376.96 2 of 3 n/a n/a Patient Centered 1/1/14 Outcomes Research Inst/Children’s Hospital of Philadelphia 12/31/14 $3,066.00 n/a n/a 12/31/14 per patient 3 of 4 n/a n/a 180810 Valdez, Tulio A Multicenter, Salvat Randomized, Double-blind Clinical Trial to Assess the Efficacy and Safety of Ciprofloxacin 0.3% plus Fluocinolone Acetonide 0.025% Otic Solution Compared to Ciprofloxacin 0.3% Otic Otic Solution and to Fluocinolone Acetonide 0.025% Otic Solution in the Treatment of Acute Otisis Media with Tympanostomy Tubes (AOMT) in Pediatric Patients 180822 Waynik, Ilana Pediatric Intravenous Versus Oral Antibiotic Theory (PIVVOT) 180826 Weiss, Richard Hirschsprung Johns Hopkins U Disease Research Collaborative (HDRC Study) Yordan, Elaine Adolescent Medical and Mental Health State of CT – Judicial 7/1/13 Branch, Broad Street 6/30/14 $467,000.00 4 n/a n/a Yordan, Elaine Adolescent Medical and Mental Health State of CT - Judicial Branch - Washington Street & Grace/CRP 6/30/14 $220,000.00 4 n/a n/a 180251 Zemel, Lawrence CARRA Registry Arthritis Fdn (Duke U) 1/1/14 12/31/14 per patient 1 of 2 n/a n/a 180742 Zemel, A 12-Week Roche Laboratories, Inc. 1/1/14 LawrenceRandomized, Double-blind, Placebo controlled, Parallel Group, Two-Arm Study to Evaluate the Efficacy and Safety of Tocilizumab in Patients with Active Juvenile Idiopathic Arthritis: with 92-Week Single Arm Open Label Extension to Examine the Long-term Use of Tocilizumab 12/31/14 $47,050.32 5 of 6 n/a n/a 7/16/14 7/1/13 99 Grants & Contracts CC# Principal Award Title Investigator Funding Source (Primary/Secondary) Start Date of Reported Award End Date of Reported Award Amount of Total Award Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract 180794 Zemel, Lawrence Phase 3, Multi- UCB, Inc. center, Open Label Study to Assess the Pharmacokinetics, Safety and Efficacy of Certolizumab Pegol in Children and Adolescents with Moderately to Severely Active PolyarticularCourse Juvenile Idiopathic Arthritis 1/1/14 12/31/14 $27,968.10 1 of 2 n/a n/a 180813 Zemel, Lawrence A Phase 3 Bristol-Meyers Squibb 1/1/14 Multicenter, Open Label Study to Evaluate Pharmacokinetics, Efficacy and Safety of Abatacept Administered Subcutaneously (SC) in Children and Adolescents with Active Polyarticular Juvenile Idiopathic Arthritis (pJIA) and Inadequate Response (IR) to biologic or non biologic Disease Modifying Antirheumatic Drugs (DMARDs) 12/31/14 $28,560.76 1 of 2 n/a n/a 180817 Zemel, Lawrence An Phase Ib Open Genentech Label Multicenter Study to Investigate Pharmacokinetics, Pharmacodynamics, and Safety of Tocilizumab Following Subcutaneous Administration in Patients with PolyarticularCourse Juvenile Idiopathic Arthritis 12/31/14 $10,750.00 1 of 2 n/a n/a 1/1/14 100 Grants & Contracts CC# Principal Award Title Investigator Start Date of Reported Award End Date of Reported Award Amount of Total Award 1/1/14 12/31/14 $11,663.84 1 of 2 n/a n/a 180264 Zempsky, SCD Pain Control Donaghue Fdn WilliamWeb-based Educational Initiative 3/1/14 12/31/14 $55,000.00 1 of 2 n/a n/a 180275 Zempsky, William Inpatient Massage Long Fdn Therapy Program 5/12/14 12/31/14 $7,500.00 1 of 1 n/a n/a 180802 Zempsky, William An Open Label Purdue Pharma, LP Multicenter Study of the Safety, Pharmacokinetics, and Efficacy of Buprenorphine Transdermal System (BTDS) Opiod Analgesia for Moderate to Severe Pain 1/1/14 12/31/14 $6,250.00 1 of 2 n/a n/a 180818 Zemel, Lawrence Funding Source (Primary/Secondary) A Phase Ib Open Genentech Label Multicenter Study to Investigate Pharmacokinetics, Pharmacodynamics, and Safety of Tocilizumab Following Subcutaneous Administration in Patients with Systemic Juvenile Idiopathic Arthritis Year# of # of Award Years Subcontract to Amount of UCHC/CCMC? Subcontract Connecticut Children’s Medical Center is a nationally recognized, 187-bed not-for-profit children’s hospital serving as the primary teaching hospital for the Department of Pediatrics at the University of Connecticut School of Medicine. Named among the best in the nation in the annual U.S. News & World Report “Best Children’s Hospitals” rankings, Connecticut Children’s is the only free-standing children’s hospital in Connecticut that offers comprehensive, world-class health care to children. Our pediatric services are available at Connecticut Children’s Medical Center in Hartford and at Saint Mary’s Hospital in Waterbury, with neonatal intensive care units at Hartford Hospital and the University of Connecticut Health Center, along with a state-of-the-art ambulatory surgery center, five specialty care centers and 11 other locations across the state. Connecticut Children’s has a medical staff of nearly 1,100 practicing in more than 30 specialties. 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