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RESEARCH ANNUAL REPORTDear FriendsThis has been another exciting year for Children’s of Alabama and the Department of Pediatrics. Ourresearch report details these accomplishments by division.In the Department of Pediatrics, we seek to discover new knowledge to improve the health of thechildren of Alabama, the region and, the world.The clinical advances and research discoveries we describe here have an impact on children’s lives.That impact will be our legacy. We present in this report some early signs of that impact asmeasured by major research accomplishments and publications. In FY 2015, the Department ofPediatrics faculty had over 200 publications, research funding from the NIH of 15 million, and totalresearch funding of 25 million.We aim to build on these successes and expand the size and, importantly, the impact of thisresearch funding in the coming year. We anticipate growth not only in our core areas of significantaccomplishment – virology, therapeutic drug development, and cancer and rheumatology outcomes– but also in newer areas where the recruitment of talented young researchers will ensurecontinued and expanded success.Children’s is the only medical center in Alabama dedicated solely to the care and treatment ofchildren. It is a private, not-for-profit medical center that serves as the primary site of the Universityof Alabama at Birmingham (UAB) pediatric medicine, surgery, psychiatry, research and residencyprograms. Children’s of Alabama built the Benjamin Russell campus, a world class physical facility,three years ago. We are now partnering with Children’s of Alabama to continue to build the worldclass clinical and research programs that belong in this building and that the children of Alabamadeserve.Sincerely,Mitchell B. Cohen, MDKatharine Reynolds Ireland ProfessorChair, Department of PediatricsUniversity of Alabama at BirminghamPhysician in Chief, Children’s of Alabama
RESEARCH ANNUAL REPORTThe UAB Department of Pediatrics at Children's of Alabama is comprised of 16 Subspecialty Divisionseach with a research, educational, and clinical focus. To find research initiatives, areas of clinicalexcellence, educational efforts and learn more about the faculty, click on the division of 16.PEDIATRIC DIVISIONS:Pediatric Allergy & ImmunologyPediatric CardiologyPediatric Critical CarePediatric Emergency MedicinePediatric EndocrinologyPediatric Gastroenterology, Hepatology & NutritionGeneral Pediatrics and Adolescent MedicinePediatric Hematology and OncologyPediatric Hospital MedicinePediatric Infectious DiseasesNeonatologyPediatric NephrologyPediatric NeurologyPediatric Pulmonology and Sleep MedicinePediatric Rehab MedicinePediatric RheumatologyCONTENT PER DIVISION INCLUDES:Pediatric FacultyFeatured ResearchSignificant PublicationsDivision Awards & Recognition
RESEARCH ANNUAL REPORTPEDIATRIC ALLERGY & IMMUNOLOGYPediatric FacultyDr. Prescott AtkinsonDr. Coralie S. HainsDr. Suthida KankirawatanaProfessorAssociate ProfessorAssistant ProfessorFeatured ResearchThe division of Pediatric Allergy and Immunology engages in a broad range of research inprimary immune deficiencies, autoimmunity, and disease-specific pathogens. Current pharyngitisguidelines focus solely on group A β-hemolytic streptococcal infection. European data suggest that inpatients aged 15 to 30 years, Fusobacterium necrophorum causes at least 10% of cases ofpharyngitis; however, few U.S. data exist. In a report in the Annals of Internal Medicine, PrescottAtkinson, M.D., Ph.D., and co-authors demonstrated that Fusobacterium necrophorum-positivepharyngitis occurs more frequently than group A β-hemolytic streptococcal-positive pharyngitis in astudent population drawn from The University of Alabama at Birmingham (UAB), and F.necrophorum-positive pharyngitis clinically resembles streptococcal pharyngitis. These findingssuggest that physicians should consider F. necrophorum when treating pharyngitis in young adultsand adolescents. Importantly, F. necrophorum can cause a life-threatening illness known asLemierre’s syndrome, further highlighting the importance of this work. See publication.Studies continue on the epidemiology and microbiology of mycoplasma. Mycoplasmapneumoniae is a common pathogen that causes upper and lower respiratory tract infections inpeople of all ages, responsible for up to 40% of community-acquired pneumonias. It also is linked toa wide array of extra-pulmonary infections and autoimmune phenomena. To better understand thephysiology and pathogenicity of this important human pathogen, Dr. Atkinson and colleaguesanalysed 15 strains of M. pneumoniae isolated between the 1940s to 2009 from respiratoryspecimens and cerebrospinal fluid originating from the USA, China, and England. These data indicatethat the M. pneumoniae genome is extraordinarily stable over time and geographic distance acrossthe globe. See publication.Macrolide-resistant Mycoplasma pneumoniae (MRMP) is highly prevalent in Asia and is nowbeing reported from Europe. Few data on MRMP are available in the United States. Dr Atkinsonparticipated in a study that demonstrated high-level MRMP in 13.2% of M. pneumoniae-positivespecimens in the US. See publication.At present the most effective means for detection and strain-typing for M pneumoniae isqPCR, which has limited practicality for widespread, point-of-care use. Dr. Atkinson had previouslydeveloped a sensitive and specific assay for diagnosing M pneumoniae (NA-SERS). In a recent study,they demonstrated that NA-SERS correctly identified M. pneumoniae with a high level of sensitivityand specificity. See publication.Significant PublicationsAnn Intern Med. 2015 Feb 17;162(4):241-7. doi: 10.7326/M14-1305. The Clinical Presentation ofFusobacterium-Positive and Streptococcal-Positive Pharyngitis in a University Health Clinic: A Cross-
RESEARCH ANNUAL REPORTsectional Study. Centor RM, Atkinson TP, Ratliff AE, Xiao L, Crabb DM, Estrada CA, Faircloth MB,Oestreich L, Hatchett J, Khalife W, Waites KB.BMC Genomics. 2015 Aug 16;16:610. doi: 10.1186/s12864-015-1801-0. Comparative genomeanalysis of Mycoplasma pneumoniae. Xiao L, Ptacek T, Osborne JD, Crabb DM, Simmons WL,Lefkowitz EJ, Waites KB, Atkinson TP, Dybvig K.Clin Infect Dis. 2014 Nov 25. pii: ciu944. Pseudomonas aeruginosa in cystic fibrosis patients withG551D-CFTR treated with ivacaftor. Heltshe SL, Mayer-Hamblett N, Burns JL, Khan U, Baines A,Ramsey BW, Rowe SM; on behalf of the GOAL Investigators of the Cystic Fibrosis FoundationTherapeutics Development Network.Emerg Infect Dis. 2015 Aug;21(8):1470-2. doi: 10.3201/eid2108.150273. Macrolide-ResistantMycoplasma pneumoniae, United States. Zheng X, Lee S, Selvarangan R, Qin X, Tang YW, Stiles J,Hong T, Todd K, Ratliff AE, Crabb DM, Xiao L, Atkinson TP, Waites KB.PLoS One. 2015 Jun 29;10(6):e0131831. doi: 10.1371/journal.pone.0131831. Specificity and StrainTyping Capabilities of Nanorod Array-Surface Enhanced Raman Spectroscopy for Mycoplasmapneumoniae Detection. Henderson KC, Benitez AJ, Ratliff AE, Crabb DM, Sheppard ES, Winchell JM,Dluhy RA, Waites KB, Atkinson TP, Krause DC.PLoS One. 2015 Jun 29;10(6):e0131831. doi: 10.1371/journal.pone.0131831. Specificity and StrainTyping Capabilities of Nanorod Array-Surface Enhanced Raman Spectroscopy for Mycoplasmapneumoniae Detection. Henderson KC, Benitez AJ, Ratliff AE, Crabb DM, Sheppard ES, Winchell JM,Dluhy RA, Waites KB, Atkinson TP, Krause DC.Pediatric Allergy & Immunology Awards & RecognitionPrescott Atkinson, M.D. Ph.D, Pediatric Allergy and Immunology, has been appointed vice chair ofthe American Board of Allergy and Immunology.The Accreditation Council for Graduate Medical Education (ACGME) announced the appointment ofPrescott Atkinson, M.D., Ph.D., Pediatric Allergy and Immunology, to the ACGME Review Committeefor Allergy and Immunology.
RESEARCH ANNUAL REPORTPEDIATRIC CARDIOLOGYPediatric FacultyDr. Yung R. LauDr. Jeffery Alten CVICUDr. Santiago Borasino CVICUDr. Wally F. CarloDr. Edward V. ColvinDr. Kimberly Jackson CVICUDr. Walter H. JohnsonDr. Yuvraj Kalra CVICUDr. Mark LawDr. William S. McMahonDr. F. Bennett PearceDr. Leslie Rhodes CVICUDr. Robb L. RompDr. Hayden Zaccangi CVICUProfessorProfessorAssociate ProfessorAssociate ProfessorProfessorAssistant ProfessorProfessorAssistant ProfessorAssociate ProfessorProfessorProfessorAssistant ProfessorAssociate ProfessorAssistant ProfessorFeatured ResearchThe division of Pediatric Cardiology and the section of Cardiovascular Intensive Care featureone of the nation’s only comprehensive pediatric cardiac intensive care unit repositories forbiological samples from patients. With the approval of the UAB Institutional Review Board, blood,urine, chest tube samples, and peritoneal and other samples are stored from every consentingcardiac surgery patient, and annotated with clinical details. Pilot data from this valuable resourcewill lay the foundation for translational research grant proposals and multi-center researchcollaborations in the years to come.Division members presented 15 oral and poster presentations at scientific conferences, andreceived four conference abstract awards.The division was the lead institution for the first multicenter evaluation of nutritionalrequirements and approaches, along with associated outcomes, following neonatal cardiac surgery.See publication.Significant PublicationsCirc Arrhythm Electrophysiol. 2015 Feb 24. pii: CIRCEP.114.002217. Catecholaminergic PolymorphicVentricular Tachycardia in Children: An Analysis of Therapeutic Strategies and Outcomes from anInternational Multicenter Registry. Roston TM, Vinocur JM, Maginot KR, Mohammed S, Salerno JC,Etheridge SP, Cohen M, Hamilton RM, Pflaumer A, Kanter RJ, Potts JE, LaPage MJ, Collins KK,Gebauer RA, Temple JD, Batra AS, Erickson C, Miszczak-Knecht M, Kubuš P, Bar-Cohen Y, Kantoch M,Thomas VC, Hessling G, Anderson C, Young ML, Cabrera Ortega M, Lau YR, Johnsrude CL, Fournier A,Kannankeril PJ, Sanatani S.
RESEARCH ANNUAL REPORTJAMA. 2015 Jan 27;313(4):379-89. doi: 10.1001/jama.2014.18399. Protocolized sedation vs usualcare in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinicaltrial. Curley MA, Wypij D, Allen GL, Angus DC, Asaro LA, Ascenzi JA, Bateman ST, Borasino S, BowensCD, Bysani G, Cheifetz IM, Cowl AS, Dodson BL, Faustino EV, Fineman LD, Flori HR, Franck LS, GedeitRG, Grant MJ, Harabin AL, Haskins-Kiefer C, Hertzog JH, Hutchins L, Kirby AL, Lebet RM, Matthay MA,McLaughlin GE, Natale JE, Oren PP, Polavarapu N, Schneider JB, Schwarz AJ, Shanley TP, Simone S,Singer LP, Sorce LR, Truemper EJ, Vander Heyden MA, Watson R, Wells CR.J Am Heart Assoc. 2014 Nov 25;3(6). pii: e001493. doi: 10.1161/JAHA.114.001493. Cardiovascularmanifestations of tuberous sclerosis complex and summary of the revised diagnostic criteria andsurveillance and management recommendations from the international tuberous sclerosis consensusgroup. Hinton RB, Prakash A, Romp RL, Krueger DA, Knilans TK.J Thorac Cardiovasc Surg. 2014 Dec;148(6):2517-23.e1. doi: 10.1016/j.jtcvs.2014.07.075. The modernFontan operation shows no increase in mortality out to 20 years: a new paradigm. Dabal RJ, KirklinJK, Kukreja M, Brown RN, Cleveland DC, Eddins MC, Lau Y.N Engl J Med. 2015 May 14;372(20):1898-908. doi: 10.1056/NEJMoa1411480. Therapeutichypothermia after out-of-hospital cardiac arrest in children. Moler FW, Silverstein FS, Holubkov R,Slomine BS, Christensen JR, Nadkarni VM, Meert KL, Clark AE, Browning B, Pemberton VL, Page K,Shankaran S, Hutchison JS, Newth CJ, Bennett KS, Berger JT, Topjian A, Pineda JA, Koch JD, SchleienCL, Dalton HJ, Ofori-Amanfo G, Goodman DM, Fink EL, McQuillen P, Zimmerman JJ, Thomas NJ, vander Jagt EW, Porter MB, Meyer MT, Harrison R, Pham N, Schwarz AJ, Nowak JE, Alten J, Wheeler DS,Bhalala US, Lidsky K, Lloyd E, Mathur M, Shah S, Wu T, Theodorou AA, Sanders RC Jr, Dean JM;THAPCA Trial Investigators.Cardiol Young. 2015 Dec;25(8):1593-601. doi: 10.1017/S1047951115002474. Perioperative feedingmanagement of neonates with CHD: analysis of the Pediatric Cardiac Critical Care Consortium (PC4)registry. Alten JA, Rhodes LA, Tabbutt S, Cooper DS, Graham EM, Ghanayem N, Marino BS, FigueroaMI, Chanani NK, Jacobs JP, Donohue JE, Yu S, Gaies M.Cardiology Awards & RecognitionWilliam S. McMahon, M.D., and Mark Law, M.D., Pediatric Cardiology, were recently certified toimplant a new device used for closure of patent ductus arteriosus (PDA). This new device, specificallydesigned for percutaneous PDA closure, facilitates non-surgical closure of PDA in infants andchildren.
RESEARCH ANNUAL REPORTPEDIATRIC CRITICAL CAREPediatric FacultyDr. Margaret WinklerDr. Mark BuckmasterDr. Leslie HayesDr. Michele KongDr. Priya PrabhakaranDr. Stephen RobertDr. Chrystal RutledgeDr. Will SasserDr. Nancy TofilProfessorAssociate ProfessorAssociate ProfessorAssistant ProfessorAssociate ProfessorAssistant ProfessorAssistant ProfessorAssistant ProfessorAssociate ProfessorFeatured ResearchA major research interest within Pediatric Critical Care Medicine involves approaches anddecisions for acute pediatric traumatic brain injuries (TBI). The investigators are measuring standardpractices across the various sites, performing outcomes testing, and determining which therapiesare associated with the best outcomes. Completion of this study will provide evidence for change inclinical practices, provide evidence for new Level II recommendations for future guidelines, and leadto improved research protocols that would limit variability in treatment of TBI.The study known as Age of Blood (used for transfusion) in Children (ABC) in PediatricIntensive Care Units (PICU) is a double blind, randomized controlled trial at multiple internationalcenters, which compares the clinical consequences of red blood cell (RBC) storage duration forcritically ill children to determine whether the transfusion of RBCs of reduced storage durationimproves outcomes. The ABC PICU trial will compare development of new or progressive multipleorgan dysfunction syndrome in critically ill children transfused with RBCs stored for less than eightdays or with standard issue RBCs. This is a unique collaboration between Children’s of Alabama andUAB Pediatric Intensive Care Unit (PICU), blood bank, and the research team in a partnership thatultimately has significant likelihood of benefitting our patients. This study is funded by the NationalHeart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health and by the CanadianInstitutes of Health Research.Among other research highlights of the division is the prospective clinical trial ofazithromycin treatment in RSV-Induced Respiratory Failure in Children, which is funded by the UABCenter for Clinical and Translational Science (CCTS) with Michele Kong, M.D., as the principalinvestigator.Additionally, Pediatric Critical Care has a research focus on Genetic Epidemiology of LifeThreatening Influenza in Children.Significant PublicationsAm J Respir Cell Mol Biol. 2015; Jul 29. Toll-Like Receptor 4 Engagement Mediates ProlylEndopeptidase Release from Airway Epithelia via Exosomes. Szul T, Bratcher PE, Fraser K, Kong M,Tirouvanziam R, Ingersoll S, Sztul E, Rangarajan S, Blalock JE, Xu X, Gaggar A.
RESEARCH ANNUAL REPORTOncotarget. 2014 Oct 31. GLI inhibitor GANT-61 diminishes embryonal and alveolarrhabdomyosarcoma growth by inhibiting Shh/AKT-mTOR axis. Srivastava RK, Kaylani SZ, Edrees N, LiC, Talwelkar SS, Xu J, Palle K, Pressey JG, Athar M.Pediatrics. 2015 Sep 7. pii: peds.2014-3722. A Novel Use of Methylene Blue in the Pediatric ICU.Rutledge C, Brown B, Benner K, Prabhakaran P, Hayes L.Resuscitation. 2014 Nov 26. pii: S0300-9572(14)00835-1. doi: 10.1016/j.resuscitation.2014.11.015.Perception of CPR Quality: Influence of CPR Feedback, Just-in-Time CPR Training and Provider Role.Cheng A, Overly F, Kessler D, Nadkarni VM, Lin Y, Doan Q, Duff JP, Tofil NM, Bhanji F, Adler M,Charnovich A, Hunt EA, Brown LL; for the International Network for Simulation-based PediatricInnovation, Research, Education (INSPIRE) CPR Investigators.Viruses 2015; 7(8): 4230-4253. Matrix Metalloproteinase-9 Mediates RSV Infection in vitro and invivo. Kong M, Whitley R, Peng N, Oster R, Schoeb TR, Sullender W, Ambalavanan N, Clancy A, GaggarA, Blalock JE.Division Awards & RecognitionMichele Kong, M.D., Pediatric Critical Care, received the Junior Faculty 2015 Dean's ExcellenceAward in Service, University of Alabama at Birmingham.
RESEARCH ANNUAL REPORTPEDIATRIC EMERGENCY MEDICINEPediatric FacultyDr. Peter GlaeserDr. Mark BakerDr. Steven T. BaldwinDr. Judson BarberDr. David W. BernardDr. Teresa CocoDr. Catherine CotneyDr. Valerie DavisDr. Orooj FasiuddinDr. Pallavi GhoshDr. Terry HopeDr. Nicole JonesDr. Ann KlasnerDr. Patricia LaBordeDr. Florence LeeDr. Erica LiebeltDr. Laurie MarzulloDr. Heather MitchellDr. Kathy W. MonroeDr. Michele H. NicholsDr. Melissa PetersDr. Christopher PruittDr. Paul SchneiderDr. Annalise SorrentinoDr. Marjorie Lee WhiteProfessorAssociate ProfessorProfessorProfessorProfessorAssociate ProfessorInstructorAssistant ProfessorInstructorAssistant ProfessorInstructorAssistant ociate ProfessorAssistant ProfessorProfessorProfessorAssociate ProfessorAssistant ProfessorAssistant ProfessorProfessorAssociate ProfessorFeatured ResearchMarjorie Lee White, M.D., and colleagues in the division of Pediatric Emergency Medicinehave developed a significant research program involving the UAB Simulation Center. An example ofthis is the Impact of Just-in-Time and Just-in-Place Simulation on Intern Success with Infant LumbarPuncture, published in Pediatrics. This prospective study enrolled pediatric and emergency medicineinterns from 2009 to 2012 at 34 centers and included review of 436 infant lumbar punctures (LPs).The study explored the impact of just-in-time and just-in-place training (JIPT) on pediatric interns’infant LP success. JIPT produced improved early stylet removal and pain control. See publication.Building upon research in education and training, Dr. White also co-authored in AcademicMedicine a six-step pedagogical framework for procedural skills training composed of the followingparameters: Learn, See, Practice, Prove, Do, and Maintain. Evidence in support of each componentof the framework contributes to a potential paradigm shift in procedural skill training. Seepublication.
RESEARCH ANNUAL REPORTA JAMA Pediatrics publication titled, “Improving Cardiopulmonary Resuscitation with a CPRFeedback Device and Refresher Simulations,” studied the effects of cardiopulmonary resuscitation(CPR) on hemodynamics, survival, and neurological outcomes following pediatric cardiopulmonaryarrest (CPA). Again using novel and practical technology, JIT training was found to improvecompliance with American Heart Association guidelines for CPR that are associated with betteroutcomes. See publication.Significant PublicationsAcad Med. 2015 Apr 15. Learn, See, Practice, Prove, Do, Maintain: An Evidence-Based PedagogicalFramework for Procedural Skill Training in Medicine. Sawyer T, White M, Zaveri P, Chang T, Ades A,French H, Anderson J, Auerbach M, Johnston L, Kessler D.JAMA Pediatr. 2014 Dec 22. doi: 10.1001/jamapediatrics.2014.2616. Improving CardiopulmonaryResuscitation With a CPR Feedback Device and Refresher Simulations (CPR CARES Study): ARandomized Clinical Trial. Cheng A, Brown LL, Duff JP, Davidson J, Overly F, Tofil NM, Peterson DT,White ML, Bhanji F, Bank I, Gottesman R, Adler M, Zhong J, Grant V, Grant DJ, Sudikoff SN, MarohnK, Charnovich A, Hunt EA, Kessler DO, Wong H, Robertson N, Lin Y, Doan Q, Duval-Arnould JM,Nadkarni VM; for the International Network for Simulation-Based Pediatric Innovation, Research, &Education (INSPIRE) CPR Investigators.Pediatrics. 2015 Apr 13. pii: peds.2014-1911. PMID: 25869377. Impact of Just-in-Time and Just-inPlace
The UAB Department of Pediatrics at Children's of Alabama is comprised of 16 Subspecialty Divisions each with a research, educational, and clinical focus. To find research initiatives, areas of clinical . Pediatric Cardiology 3. Pediatric Critical Care 4. Pediatric Emergency Medicine 5. Pediatric Endocri
