Hard Head Patrols Resume

With the return of summer and bike riding season, the Hard Head Patrol from Children’s Hospital of Pittsburgh is once again hitting the streets. Children’s Director of Trauma and Injury Barbara Gaines says about 70 employee volunteers will be on the streets watching for young bikers without helmets. If they find one the child will be given a coupon to attend one of ten free bike helmet fittings where experts give the juvenile a new helmet and teach them how to properly wear it.

Gaines says every year the emergency room staff admits 150 – 175 kids who suffer head injuries while riding their bikes. She says 85% of those injures could have been prevent if the child would have been wearing a helmet.

The volunteers also hand out rewards for kids wearing their helmets. This year it is a Giant Eagle cookie card. Gaines says it is important to also give an incentive to wear the protective gear.

Last year the hospital handed out 1,700 helmets during the Hard Head summer program and another 1,000 helmets through other efforts. Volunteers also handed out 2,500 reward cards.

Gaines says ay child who comes to a fitting event without a helmet will be given one. She says the coupons simply serve as a good reminder for the kids and their parents.

This summer’s first Hard Head helmet fitting event will be held at the Kohl’s Department store in Robinson from 11:00 a.m. to 2 p.m. A full list of fitting can be found online.

Antibiotics Ease Ear Infection Symptoms in Infants & Toddlers

Alejandro Hoberman, M.D. and a team from the Children’s Hospital of Pittsburgh recently found that antibiotics are an effective treatment for young children diagnosed with acute otitis media, or a middle ear infection. Hoberman’s research is another in a series of trials worldwide that look at the effects of antibiotics on the relief of symptoms and overall recovery, while shielding children against the risk of becoming resistant to drugs.

“Most children in the U.S. with acute otitis media have been treated routinely with antibiotics but there has been concern with antibiotic overuse and clinical practice guidelines have included an option that provides for “watchful waiting” in children older than six months with mild symptoms, reserving antibiotics for children who do not improve with time,” Dr. Hoberman says.

His research looked at a variety of characteristics of ear infections and he studied 291 children between the ages of 6 months and 2 years. The children were randomly assigned to a placebo group and a group that received the antibiotic amoxicillin-clavulanate for 10 days. The study found that at both check points, five days and 10 days, the children who had been given the antibiotics were recovering earlier and symptoms were significantly less intense.

Dr. Hoberman insists that although the findings show that antibiotics can be a great help in the treatment of ear infections, it is still essential for children to have a certain diagnosis of acute otitis media before being treated with drugs. He says that drug resistance in children is still an issue that needs to be accounted for.

“These considerations underscore the need to restrict treatment to children whose illness is diagnosed using stringent criteria,” Dr. Hoberman says. “Provided the diagnosis of acute otitis media is certain we favor treatment of antibiotics for all children under two years of age with acute otitis media.”

Children's Hospital and Pitt School of Medicine Receive $8.2 million Grant from NIH

Researchers at Children’s Hospital and Pitt’s School of Medicine have received an $8.2 million dollar grant to study antibiotic resistance in children.

The most frequent reason to prescribe an antibiotic to a child is acute otitis media—an ear infection. Dr. Alejandro Hoberman, Chief of Academic Pediatrics at Children’s Hospital, says not many new antibiotics are being developed and some children don’t respond to first and second line antibiotics available now. Hoberman says doctors are then stuck with injectable antibiotics or even draining the eardrum, so there are not many options for treating children with ear infections from drug resistant organisms.

600 children will be studied over five years to see if a 5-day course of antibiotics rather than the standard 10-day course can produce the same outcome with less drug resistance.

Pirates Manager Comes with a Cause

When the Pittsburgh Pirates hired Clint Hurdle as their new manager not only were they getting a man with more than two decades experience in professional baseball they also picked up the national celebrity spokesperson for the Prader-Willi Syndrome Association (PWSA). Prader-Willi Syndrome is a rare genetic defect that occurs in about one in every 15,000 births. The illness begins with a newborn typically having a low birth weight and hypotonia (weak muscles) that is so severe that the child cannot suck well enough to get nourishment. Most babies must be kept alive with a feeding tube. The syndrome then “flips” between the ages of two to five when the child never feels “full” leading, if unchecked, to morbid obesity. Other symptoms include short stature if not treated with growth hormones, incomplete sexual development and in some cases, behavior and developmental problems.

Hurdle’s 8-year-old daughter, Madison, was born with Prader-Willi Syndrome. He and his wife have been active with the PWSA for years and he says his daughter’s illness played a small roll in his decision to come to Pittsburgh. “I don’t think it is a coincidence that the only in-patient clinic [for PWS] in the world is in the Children’s Institute here in Pittsburgh,” says Hurdle. He says the Institute has a great support group, “we have reached out to many families throughout the years since the birth of Madison and we have been embraced by many families who have children older.” Hurdle and his family currently live in Denver where he used to coach and says Madison gets great care there but they will soon be looking for a new home in Pittsburgh. “You talk about an easy transition, I know a couple of doctors over there.”

Robert Nicholls is a professor and genetic researcher at the Childrens Hospital of Pittsburgh. He has been studying PWS for nearly a quarter of a century. “Were making great strides in understanding the genetic basis, but its very complex. Prader-Willi Syndrome is not due to loss of function of a single gene, which many conditions like cystic fibrosis and others are, but there are new cellular models there are animal models,” says Nicholls. Nicholls says he works closely with many doctors and patients at both his hospital and at the Children’s Institute. He says it does not seem like the syndrome is increasing or decreasing, nor does it seem to discriminate between males and females or among races. He notes that most cases are in developed countries like the US, England and Germany but he notes that in most third-world and developing nations children with PWS never make it out of infancy. Those who make it out of infancy and are being treated can live into their 60’s and beyond. “When diagnosis was late, meaning by the 20’s or 30’s, and individuals had already become severely obese, then it is a life threatening condition,” says Nicholls.

Grant Will Train Pediatricians for Poor Areas

Children’s Hospital has picked up a $1.9 million grant to train medical students to become primary care pediatricians in medically underserved neighborhoods.

Children’s Residency Program Director Dena Hofkosh says many areas in and around Pittsburgh are in need of primary care pediatricians, as well as family doctors. She says this is especially true of both urban and rural low-income areas.

The 5-year program will add two doctors per year for the three-year training course. Hofkosh says the doctors will not only get the traditional academic training of residency, but also hands-on experience in community primary care centers.

Hofkosh says this will be Children’s Hospital’s first attempt to target pediatrician training specifically for high-need areas.

Funding for the grant comes from the U.S. Department of Health and Human Services, by way of the Affordable Care Act.

New Children's Hospital Study

A new study published in the September issue of The Journal of Clinical Investigation says Vitamin D might be used to treat and prevent severe allergic response to Aspergillus Fumigatus, a common airborne mold. While the mold does not cause serious symptoms in the majority of people who inhale it, for people with cystic fibrosis, it can cause a severe allergic response.

The research team was led by Dr. Jay Kolls, a lung disease researcher at Children's Hospital who works at Louisiana State University. They studied patients who had infections and had developed severe allergies and some who had not. Vitamin D helped those who had cystic fibrosis.

Kolls says this research might make treating the allergies a lot easier than with the strong medications commonly prescribed.

The researchers are now moving into clinical trials. This new research add to previous evidence that vitamin D may play a critical role on immune responses and allergic diseases.

Children's Hopsital to Host Program About Tourette's Syndrome

On Saturday Morning, the hospital will host a panel discussion about Tourette syndrome. The event will be followed by an informational session held by the Tourette Syndrome Association.

Dr. Keith Coffman, co-director of the Tourette and Movement Disorder clinic at the hospital is one of the panelists. He says the most noticeable symptom of Tourette Syndrome is involuntary movement which includes outbursts, sniffling and other such tics. It is more likely to occur in males than females and is often more prevalent in childhood than in adulthood. It often co-occurs with other disorders such as attention deficit hyperactivity disorder or obsessive-compulsive disorder.

The event will be held from 9 to 12 and is free and open to the public.

Child Abuse Skyrocketed During This Recession

According to a multi-center study led by Children's Hospital of Pittsburgh, the number of cases of abusive head trauma, formerly known as "shaken baby syndrome," increased signficantly since the beginning of the recession.
Lead researcher, Dr. Rachel Berger, a child abuse specialist and researcher at Children’s Hospital’s Child Advocacy Center, says they studied 512 patients with abusive head trauma ranging in age from 9 days to 6 years. Dr. Berger says
the number of cases of abusive head trauma rose from six per month before Dec. 1, 2007, to 9.3 per month after that date.
"it coincided with the economic recession, and that it’s not a phenomenon isolated to our region but happening on a much more widespread level. This suggests we may need to dramatically increase our child abuse prevention efforts now and in future times of economic hardship.”

Of the children studied, 63 percent had injuries severe enough that they had to be admitted to intensive care units, and 16 percent died. Dr. Berger said that in 2008, more patients at Children’s Hospital of Pittsburgh died from abusive head trauma than from non-inflicted brain injury.
In addition to Pittsburgh, the patients were treated at pediatric hospitals in Cincinnati, Columbus and Seattle. Results of the study are being presented by Dr. Berger today at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia.

Orphans Headed Home

At least seven of the 54 orphans from a Port-au-Prince orphanage run by two Ben Avon sisters are with their adoptive families.
Catrina and Nathan Brock of Georgia had been trying to adopt Dania for over four years. Last week a devastating earthquake struck Haiti. In its aftermath, the U.S. is waiving visa requirements on humanitarian grounds for Haitian children already in the pipeline for adoption. As part of the first wave of those adoptions, seven-year-old Dania arrived in Pittsburgh on Tuesday. Wednesday her adoption became final.
Catrina Brock says the earthquake’s effects on their daughter are obvious.
"I think she’s a sensitive child and this is an experience that has marked her in some way. I can tell from meeting her this time, she’s more subdued and a little more sullen," she said.
As happy as the Brocks are to be with their daughter they say the situation in Haiti doesn’t fully allow them to be happy.
Dania lived in an orphanage run by two local sisters. They appealed for help resulting in a rescue mission that included Governor Rendell.
Another child, Jimmy, age 11, was adopted by Brian and Debbie Lepp of Washington state. They had been trying to adopt him for over 2 years. They spoke with reporters on Wednesday.
The remaining 47 orphans are in the custody of the U.S. Bureau of Citizenship and Immigration Services. Within a week they may be with their adoptive families or placed in foster care.

Surplus Hospital Equipment goes International for Reuse

When imagining a hospital, one may visualize an emergency room, crowded with patients waiting in chairs, and receptionists fingering through medical files behind desks or in filing cabinets. However, this is not necessarily the case for hospitals in developing countries. Global Links Deputy Director Angela Garcia says the kinds of equipment that the old Children's Hospital in Oakland have in surplus, like waiting room chairs, filing cabinets, and desks, are sometimes limited or nonexistent in hospitals in countries like Bolivia, Guatemala, Honduras and other developing countries. She expects between 25 to 30 truckloads of this basic but essential equipment to be refurbished and sent to places where it is needed.

New Playroom at Children's Hospital

A new Austin’s playroom at Children’s Hospital of Pittsburgh UPMC opens Friday.

The playroom is part of the Mario Lemieux’s Foundation Playroom Project that funds playrooms in hospitals named after the former Penguin’s star’s son. But unlike many of their playrooms this one is not for the siblings of the sick child. "Its for sick patients who will come down from their room just to escape, just to be a child for a little while,'' said Foundation Director Nancy Angus.

There are thirteen such playrooms in the hospital. Its the largest of the playrooms and is accessible through public spaces so it can be used by patients throughout the building.
The other playrooms are in wards or aimed at specific populations like teens.

Denise Esposto runs the playrooms at the hospital. "We know that if children are encouraged to get out of bed and play that it also helps with their recovery so its one of our jobs to keep children on the track developmentally," she said.

The playroom is filled with toys, books, computers, TVs and a fish tank.

Induced Hypothermia for Newborns with Brain Injury

Neonatologists at UPMC have developed an induced hypothermia protocol to help newborns who are suffering from a brain injury known as hypoxic ischemic encephalopathy (HIE) due to a lack of blood flow and oxygen to the brain. HIE occurs in 1 to 2 of every 1,000 infants and has a 40% fatality rate. In addition, 40% of the survivors suffer severe long-term disabilities.
Dr. Richard Telesco, a neonatologist at UPMC who developed the protocol, says they've known for many years that hypothermia can reduced the energy demands of the body and therefore protect the brain, but not until now could they do it safely. Dr. Telesco says the newborn must be cooled to 92.3 degrees for 72 hours, and the process must begin within 6 hours or the damage to the brain could be too catastrophic. Dr. Telesco says without the whole-body cooling, restoring the blood flow can actually create toxins as the blood goes to damaged brain cells and increases brain swelling. He says the key after the 72 hours of hypothermia is to slowly warm the infant.
Telesco says they have a neonatal transport team that can fly or drive to pick up the endangered infant and being the process on site and continue it during transport till the baby is placed in a cooling unit at Children's Hospital or Magee Hospital.

Hospital Move Finished

The new Children's Hospital in Pittsburgh's Lawrenceville section officially opened yesterday afternoon following a 7 hour move of 152 patients from the old facility in the Oakland neighborhood. Spokesman Mark Lukasiak says the patient move began about 7 a.m. Saturday and involved a team of 275 nurses, doctors, administrators, staff plus EMS personnel. More than 40 ambulances from communities in Allegheny, Beaver and Washington counties transported the patients. The new $625 million Children's Hospital complex includes a 9-story 296-bed hospital, a 10-story research center, medical building and 3 parking garages.

Children's Ready to Move

Children’s Hospital of Pittsburgh is gearing up for its big move. Starting at 6:00 Saturday morning the Emergency Department at the Oakland facility will close and all new emergency cases will be taken at the new hospital in Lawrenceville. Starting at 7:00am, every patient in the hospital will be put into ambulances and moved to the new building. Children’s Vice President for medical affairs Steven Docimo says 40 ambulances from around the region will be used with the goal of having all the patients moved in 8-12 hours. He says no streets will be closed but Pittsburgh Police officers will be posted at key intersections to make sure traffic moves smoothly. Docimo says the hospital has been trying to lower its census over the last few weeks. They have stopped scheduling elective surgeries and each department has had a census reduction plan in place. The goal was to have just 150 patients in the hospital at the time of the move. Docimo says as of Friday morning there were 190 in-patients and it looks like the number Saturday morning will be closer to 160. He says the increase is due to a recent up tick in emergency room admissions. Docimo says over the last few months Saturday morning census counts have ranged from 220 to 250.

Children's Hospital Brings Renowned Asthma Researcher

Children's Hospital of Pittsburgh named Dr. Fernando Holguin as clinical director of the new Pediatric Environmental Medicine Program. Dr. Holguin and his team are to initiate a long-term research study later this year. The research will begin by pinpointing regional communities that have asthma problems and studying environmental risk factors that might impact asthma in those regions. Dr. Holguin says asthma is very complex, and a variety of environmental factors could cause it, including air pollution, pest infestations, and possibly, childhood obesity. Once risks are identified, he says research will then focus on developing education and treatment strategies for those communities.

Dr. Holguin comes to Pittsburgh from Emory University and the Centers for Disease Control and Prevention in Atlanta, where he was the director of Emory's Asthma Translational Research Program.

Children's Launches Public Phase of Campaign

Children's Hospital of Pittsburgh has raised $65 million toward its $100 million fundraising goal. Today, it took its capital campaign public. Some of the hospital's young patients attended today's kickoff ceremony, including six-year-old Acacia Puelo of New York. She received a multi-organ transplant at Children's as a newborn after 98% of her small intestine had to be removed. Today, Children's CEO Roger Oxendale says Acacia is healthy, and you would never know by looking at her that she had the life-saving surgery.

Oxendale says it's hard to know whether the slow economy will put a damper on the capital campaign. Children's hopes to raise another $15 million for the campaign by the end of June.

New Children's Research Center complete

With the first phase of the new Children's Hospital complete, its research center will soon begin the move from Oakland to Lawrenceville. Children's Hospital Scientific Director Dr. David Perlmutter says the center will help conserve research dollars by being accommodating to changes.

The state-of-the-art building doubles the size of the Oakland facility with more than 300,000 square feet of space. Perlmutter says researchers will begin to move in as soon as next week, and the center is scheduled to fully open in May.

Genetic Mutations may have link to Transplant Rejection in Patients

Transplant rejection may be linked to a genetic mutation found in some recipients, according to a recent study at Children's Hospital. Principal Investigator Dr. Rakesh Sindhi says these mutation can better predict who will experience rejection before having a transplant. These are all genes that "you and I carry," Sindhi explains, but certain ones may prove to have this correllation.

In the future, these predictions will provide more personalized anti-rejection treatment for patients. Those who carry the mutation will receive heavier medication does, while others who do not will receive the normal amount. Once more studies are done on genetic mutation, and FDA has approval of the technique, Sindhi says doctors can begin practicing the new treatment.

Children's Researches Severe Asthma

A new program at Children's Hospital of Pittsburgh of UPMC aims to find better treatments for severely asthmatic children who do not have a medication that works for them.

It is one of two children's centers in the nation that have this kind of research program. The other is at Emory Hospital in Atlanta.

Dr. Shean Aujla, a pulmonologist at Children's, said there have been few studies on severely asthmatic children. She said it is important because these children end up missing more school and having more visits to the emergency room because of ineffective medications. Sometimes children even die from the condition.

"Most of the studies in severe asthma and what we know about severe asthma are in adults," Dr.Aujla says.

Five to 10 percent of asthmatic children are classified as having severe asthma, Aujla said.

Hard Head Patrol Promotes Helmets

For the 4th year Children's Hospital of Pittsburgh will begin its Hard Head Patrol this summer. The program aims at encouraging children to wear helmets when participating in wheeled activities such as biking, skateboarding, or in-line skating. Local community volunteers run the reward-based program by giving out free lunch coupons to children they see wearing helmets and giving out coupons for a free helmet to those who are not wearing one. Hospital Injury Prevention Coordinator Chris Vitale says the entire community needs to work to promote helmet-wearing not just the parents of children. A helmet law was also enacted in 1995 requiring that all children under 12 wear a helmet while riding a bike. Last summer more than 125 certified Hard Head volunteers handed out 1,020 helmets, 293 coupons for helmet fittings, and 3,400 free lunch coupons to kids wearing helmets properly.