Georgia Kids First by Augusta University

Kids GEORGIA First SUMMER 2012

A quarterly publication of the Georgia Health Sciences Children’s Medical Center and Department of Pediatrics

Carter Daly, 10, makes a Blizzard® with the help of Dairy Queen store owner Asim Momin at the DQ on Central Avenue during the 2012 Miracle Treat Day on July 26. A portion of the proceeds from the sale of every DQ Blizzard sold on Miracle Treat Day will be donated to the Georgia Health Sciences Children’s Medical Center through the Children’s Miracle Network Hospitals organization. Carter, who has Type 1 diabetes, is under the care of specialists at the GHS Children’s Medical Center.

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From the Chair

Temperatures have soared this summer, and so has the enthusiasm of those at the Georgia Health Sciences Children’s Medical Center who devote their lives to improving the health and well-being of Georgia’s youngest citizens. Our team of health care providers grows more impressive with every passing year, and we are pleased to introduce our new recruits in this edition of Georgia Kids First. Please take a moment to peruse the specialties, research interests and clinical focus areas of the stellar new members of our faculty, along with our 2012-13 pediatric interns. We think you will agree that their extensive expertise and boundless dedication make for a healing environment that rivals that of the best facilities in the world. And don’t overlook the articles in this edition that aim to launch a sunny, successful school year for the backpack-toting set. Immunizations, vision/hearing screenings and healthy sleep habits are among the topics covered to ensure that all of Georgia’s children make the grade this year. On a personal note, I’m pleased to announce that I have been appointed a scientific reviewer for the Neurofibromatosis Research Program for U.S. Department of Defense Congressionally Directed Medical Research Programs. Using my expertise as a pediatric neuro-oncologist, I will serve on two Experimental Therapies and Diagnosis panels reviewing grant applications for drug and device development as well as targeted and gene therapies for neurofibromatosis, the most common genetic disorder affecting the nervous system. I am delighted to be better-positioned than ever to support our most precious resource, our children. And as you’ll see in these pages, I am in excellent company. n

Asthma Screenings Have Area Children Breathing Easy

After 10 children died from asthma in the Augusta area from 200608, the Centers for Disease Control and Prevention recommended more community education in this region. The Georgia Health Sciences Children’s Medical Center responded on several Jennifer Anderson fronts, including teaming with Kohl’s to provide asthma screening and education last spring. This free event was the second in a series of asthma education initiatives funded by a $32,000 grant from the Kohl’s Cares program. “With asthma cases rising in both numbers and severity, we want to do everything we can to provide education for patients and families,” said Jennifer Anderson, CMC Director of Respiratory Care Services. “Our goal is to help patients manage their asthma and prevent adverse events.” A condition affecting about 226,000 children in Georgia, asthma is a lifelong disease that targets the lungs, causing wheezing, breathlessness, chest tightness and coughing. Asthma triggers include smoke, mold, pet dander and air pollution. Although there is no cure, most people can control symptoms and prevent asthma attacks by avoiding triggers and correctly using prescribed medicine. n Respiratory Therapist Lindsay Smith talks to children at a Kohl’s Cares event.

Sincerely,

Bernard L. Maria, M.D./M.B.A. Pediatrician-in-Chief, GHS Children’s Medical Center Ellington Charles Hawes Professor Chair, Department of Pediatrics Georgia Health Sciences University

GEORGIA Kids First

Asthma Treatment at the CMC For more information, call 706-721-3225.

Help Your Child Conquer Bedwetting

If you have young children, chances are you may be dealing with bedwetting. “It is very common,” said Dr. Jeffrey M. Donohoe, a CMC pediatric urologist. “Children’s bladders are smaller, and they tend to be hard sleepers. So, essentially, their brains and bladders have not coordinated how to wake and void.” Risk factors include not getting enough sleep and Dr. Jeffrey M. Donohoe drinking too many fluids in the evening. Occasionally, emotional factors—moving to a new home, starting school or changing family dynamics—may contribute to a child’s bedwetting. “Most children outgrow bedwetting over time,” said Donohoe. “The majority of kids are able to control their bladder at night by age 5 to 7. However, boys may take a little longer than girls, so I usually encourage parents to give it another year or two with boys, and the problem will likely correct itself.” For younger children, reassurance and rewards work best. As children age, they need to learn to motivate themselves and accept responsibility to solve the problem, he said. Children older than age 7 who are motivated to stop wetting the bed may benefit from a bedwetting alarm, Donohoe said. When the alarm goes off, the parent should make sure the child is getting out of bed and going to the bathroom. The alarm system helps train the child to wake and void when necessary. If the alarm system fails after a serious attempt, medication may be a necessary supplement to improve bladder capacity and/or help the kidneys recirculate more urine. Children with daytime problems, such as a slow urinary stream, urinary retention, a urinary tract infection or constipation, should see a doctor. n

To help prevent bedwetting, Donohoe recommends that parents: n Ensure that the child is getting enough sleep. n Limit the child’s fluid intake at night. n Identify and minimize psychological stressors. n Be patient and reassuring with the child. n Keep a diary and be aware of the child’s daytime and nighttime voiding habits.

Donohoe advises that children: n Use the bathroom immediately before going to bed. n Become familiar with their bowel and bladder habits, being honest with their parents about any issues. n Become self-motivated as they mature, assuming responsibility to help correct the problem.

A Healthy, Happy School Year? Check!

a P a a a a a Back to a Scho o l a Preparing your child for another school year requires more than new clothes and school supplies. You should also consider your child’s health needs, according to Dr. Davidson Freeman, a CMC pediatrician. “No matter what grade your child is Dr. Davidson Freeman entering, routine physical examinations, including hearing and vision tests, help ensure that your children are truly ready for school,” Freeman said. Here is a handy back-to-school health checklist: Have your child’s hearing checked. Most states mandate hearing tests for babies and toddlers, but school-age children may not be routinely tested. Clues to hearing loss include listening to the television or music at a very high volume or favoring one ear over the other. If indicated, your pediatrician can recommend an audiologist for an in-depth evaluation.

Have your child’s vision screened. An annual screening is vital to ensure that children can see well enough for schoolwork. A vision problem can likely be corrected, preventing children from falling behind academically. Be sure that glasses or contact lenses are in good condition and that your child’s prescription is current.

Keep shots up to date. Immunizations are necessary to prevent infectious diseases. (See 4 Reasons to Vaccine Your Child page 6.) Your child will not be allowed to attend school without the required immunizations. Vaccines or booster doses for older children that were not required when parents were younger may be needed. To be sure, ask your pediatrician. Investigate possible learning problems. If you suspect that your child is developmentally delayed, including not processing information correctly, speak to a teacher or contact a learning center for advice. A diagnosis usually requires one to two days of professional testing. The sooner you discover a disability, the sooner your child can be taught how to compensate. Inventory your child’s mental health. What’s your child’s behavior like? Are his reactions appropriate in most situations? Is he anxious or apprehensive about school? Children typically need about a month to adjust to change, but factors such as a new school, class bully or new transportation routine may cause ongoing anxiety. If your child seems anxious or unsteady, talk to your pediatrician or a counselor who can help you identify the source of the behavior and work out a solution.

Plan ahead on prescriptions. If your child takes medication for asthma, diabetes or any other chronic condition, make sure you have plenty on hand for home and school. Inform school nurses and teachers of your child’s needs, especially if a school employee will administer medicine. Speak with staff members before school begins and work out a course of action for emergencies. Equip the athlete. Provide all necessary protective equipment for children involved in sports. Children with braces and/or glasses require extra protective measures, even for gym class. Invest in sports frames for the eyes and a mouthpiece to protect dental work. Save time by completing forms and physical exams in the summer, if possible.

Address sleep issues. Is your child having trouble sleeping? Issues such as sleepwalking, insomnia and nightmares can impede school performance. Begin a routine sleep schedule about a month before school begins; the body needs more than just a couple of days to adjust to factors such as earlier bedtimes and fewer hours of daylight. If problems are severe, your pediatrician may recommend a sleep specialist. n

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CMC Patients Benefit from Second-to-None Imaging Modalities

Georgia Health Sciences Health System’s outstanding record in imaging—it is the first facility in the region to receive American College of Radiology accreditation in all advanced imaging modalities—is a particular boon to children. The health system, home of the Children’s Medical Center, participates in the Image Gently campaign, an initiative of the ACR and Alliance for Radiation Safety in Pediatric Imaging to minimize radiation exposure in children. The health system’s high marks in imaging techniques including ultrasound, computed tomography, magnetic resonance imaging, nuclear medicine and positron emission tomography also ensure prompt diagnosis and optimal treatment of conditions such as cancer, seizures, brain bleeds and abscesses. The ACR gold seal of accreditation represents the highest level of image quality and patient safety. It is awarded only to facilities meeting ACR Practice Guidelines and Technical Standards after a peer-review evaluation by board-certified physicians and medical physicists who are experts in the field. Image quality, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs are assessed. The findings are reported to the ACR Committee on Accreditation, which follows up with a comprehensive report the practice can use for continuous improvement.

ACR-accredited facilities are characterized by: n A hospital, clinic or health center that has voluntarily completed a rigorous review process to ensure nationally accepted standards. n Personnel well-qualified through education and certification to perform and interpret medical images and administer radiation therapy treatments. n Equipment appropriate for a given test or treatment, and a facility that meets or exceeds quality assurance and safety guidelines. n

Reaccreditation Reflects Optimal Standards in Cancer Care

The Georgia Health Sciences University Cancer Center has been granted three-year accreditation with commendation by the American College of Surgeons Commission on Cancer. The center met standards in all 35 quality-of-care measures in eight areas judged important by the commission, and it was awarded commendation in seven of those areas: cancer committee leadership, data management and cancer registry, clinical management, research, community outreach, professional education and staff support and quality improvement. Accreditation follows an onsite evaluation by a physician Dr. Samir Khleif surveyor. Approval reflects voluntary commitment to the highest-quality cancer care and a rigorous self-evaluation and review process. “Commission approval signifies that our program ensures patients have access to comprehensive care, including a range of state-of-the art services and equipment; a multispecialty team approach to coordinate the best treatment options; information about ongoing clinical trials and new treatment options; access to cancer-related information, education and support; and most importantly, excellence in quality care,” said Dr. Samir Khleif, Director of the Cancer Center. The GHS Cancer Center has the only dedicated inpatient oncology unit in the Augusta area. A two-story, $31 million dollar freestanding outpatient facility opened in 2010. “Our accreditation ensures that our cancer program is offering the highest-quality patient-centered care right here in the CSRA,” said Dr. Jim Kruse, Assistant Professor of Surgical Oncology and Chair of the GHS Cancer Committee. “Our program is committed to continuous improvement in a multidisciplinary fashion.” n

4 Reasons to Vaccinate Your Child

From car seats and baby gates to bicycle helmets and football pads, there are numerous ways to protect children as they grow. One of the most important is getting them vaccinated, says Dr. Dennis Murray, Infectious Diseases Chief at the Georgia Health Sciences Children’s Dr. Dennis Murray Medical Center. “Many life-threatening diseases are not seen today in the United States because of the development and implementation of vaccines,” says Murray. “Polio and smallpox are examples. Other diseases like measles have been dramatically decreased.” “Many life-threatening Still, more than 900,000 American diseases are not seen today children are not fully in the United States because immunized, according of the development and to the U.S. Centers for Disease Control and implementation of vaccines. Prevention. Polio and smallpox are examples. As the new school Other diseases like measles have year approaches, Murray urges parents to been dramatically decreased.” understand the value of immunizations and to be sure their children’s shots are up to date.

He cites four main reasons: n Immunizations can save your child’s life. Advances in medical science enable your child to be protected against more diseases than ever before. Some potentially fatal diseases have been eliminated completely and others are close to being gone – primarily due to safe and effective vaccines. n Immunizations protect others you care about. Serious vaccine-preventable diseases still occur, striking groups such as infants who have not yet been fully immunized and those unable to receive vaccinations due to allergies, illness, weakened immune systems or other reasons. Full immunization in the general population is important to prevent the spread of diseases to vulnerable friends and loved ones. n Immunizations can save time and money. A child with a vaccine-preventable disease will likely be kept out of school or daycare. Likewise, a prolonged illness can take a financial toll because of lost time at work, medical bills and/or long-term disability care. Immunization is a good investment and usually covered by health insurance plans. For those without insurance or the underinsured, ask your health care provider about the Vaccines for Children program, a federally funded program that provides free vaccines to children. n Vaccinations are safe and effective. Vaccines are recommended only after a long and careful review by scientists and health care professionals. The side effects of vaccines (potential pain, redness or tenderness at the injection site) are minimal compared to the pain, discomfort and trauma of the diseases these vaccines prevent. Studies repeatedly debunk the link of vaccines to autism, sudden infant death syndrome, immune dysfunction or asthma—findings supported by groups including the American Academy of Pediatrics, Institute of Medicine, National Institutes of Health and CDC.

Murray stresses the importance of immunizations both in well-child care and for periodic updating in adults. For more information, visit cdc.gov/vaccines or talk to your pediatrician. n GEORGIA Kids First

Welcome, New Pediatrics Faculty

Top Docs

Editor’s note: The following faculty members have joined the Children’s Medical Center in the past two years:

University of South Carolina. His interests include asthma and pneumonia in pediatric patients.

Dr. Catalina Bazacliu, Assistant Professor of Pediatrics, earned her medical degree from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania and completed a neonatalperinatal medicine fellowship at the University of Buffalo. She researches function and fetal programming of cardiovascular diseases.

Dr. James Holcomb, Associate Professor of Pediatrics, earned his medical degree from Ohio State University and completed a neonatalperinatal medicine fellowship at Emory University Affiliated Hospitals. He specializes in neonatology and served as the Medical Director of the Northeast Georgia Medical Center Neonatal Intensive Care Unit before joining the CMC.

Three members of the CMC team are among the 15 GHSU physicians included in the prestigious list of America’s Top Doctors, a national patient reference guide published by Castle Connolly Medical Ltd. The book, now in its 11th edition, identifies the top 1 percent of physicians in the nation, helping patients find recognized specialists in any given medical field. GHSU physicians have made the list for more than a decade.

Dr. Albert Copeland Jr., Assistant Professor of Pediatrics, earned his medical degree and Ph.D. in human physiology and endocrinology from GHSU. He completed a pediatric critical care fellowship at Vanderbilt University Medical Center and a neonatology fellowship at Louisiana State University. His research and clinical interests include streptozotocin-induced diabetes. Dr. Christopher Edwards, Assistant Professor of Pediatrics, earned his medical degree from the University of Missouri-Kansas City and completed a pediatrics residency at C.S. Mott Children’s Hospital at the University of Michigan. He has studied the effects of circumcision on newborn feeding and the effects on driving of new parents’ sleep deprivation. Dr. Daniel Heine, Assistant Professor of Pediatrics, earned his medical degree from Louisiana State University. Dr. Daniel Heine, Assistant Professor of Pediatrics, earned his medical degree from Louisiana State University and completed a pediatrics residency at the Medical

Dr. Anthony Moretti, Assistant Professor of Pediatrics, earned his medical degree from Rush Medical College and completed pediatric critical care medicine fellowships at Holtz Children’s Hospital in Miami and UCLA-Harbor Medical Center. He was included among “America’s Top Pediatricians” in 2010 by the Consumers’ Research Council of America. Dr. Cindy Neunert, Assistant Professor of Pediatrics, earned her medical degree from Eastern Virginia Medical School and earned a master’s degree in clinical science with distinction from the University of Texas Southeastern Medical Center, where she also completed a pediatric hematology/oncology fellowship. She is certified by the American Board of Pediatrics and studies sickle cell disease.

Welcome, 2012-13 Pediatric Interns Dr. Kevin Allen Jr. Dr. Jessica Corral Dr. Maya Fields Dr. Joshua Fife Dr. George Hsu Dr. James Krulisky Dr. George Lazari Dr. Steven Ma

Dr. Tara Moon Dr. Maria Panglao Dr. Emily Pierce Dr. Tanisha Powell Dr. Freda Singletary Dr. Robert Tillman Dr. Kevin Wellbaum Dr. Jamie Wolf n

Dr. Dennis R. Ownby, Pediatric Allergy and Immunology: Ownby is Professor of Pediatrics and Medicine, and Head of the Section of Allergy, Immunology and Rheumatology. He treats asthma and food allergies in children and adults and has identified risk factors for childhood asthma and allergies. Dr. Sandra G. B. Sexson, Child and Adolescent Psychiatry: Sexson is Professor and Chief of the Division of Child, Adolescent and Family Psychiatry in the Department of Psychiatry and Health Behavior. She specializes in psycho-social aspects of children and adolescents with chronic diseases such as diabetes, cystic fibrosis and cancer. She researches pediatric oncology, attention deficit/ hyperactivity disorder and school continuity for ill children. She is a national leader in psychiatric education. Dr. Jack C. Yu, Pediatric Plastic Surgery: Yu is the Milford B. Hatcher Professor of Surgery and Chief of the Section of Plastic Surgery. He treats cleft lip and palate and craniosynostosis as well as aesthetic surgeries such as facelift, blepharoplasty, lip augmentation and rhinoplasty. He researches stem cell therapy and oscillating stimulation of the musculoskeletal system to treat age-related bone and muscle loss. n

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Broadcast celebrates $787,400 in donations

Patients and families from all over the Southeast shared their experiences at the CMC during the 2012 Children’s Miracle Network Hospitals Celebration, a telethon that was broadcast live from the hospital lobby June 3 on WRDW-TV Channel 12. The event celebrated the $787,400-plus in donations contributed by businesses, organizations and individuals to benefit programs and services at the CMC, the area’s only children’s hospital. The CMC has been a beneficiary of Children’s Miracle Network proceeds since 1986. Donations have helped fund the many resources needed to enhance and maintain the quality of care children receive – everything from bandages to precision surgical instruments. n

For more information or to make a donation, call 706-721-4004 or visit giving.georgiahealth.edu.