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Latest News and Views regarding Neonatology
Discoveries, innovations, studies and other news are appearing constantly on the neonatology horizon. The NICUniversity News and Views section will bring all this data together for you to stay on top of the essential information coming to light in our field.

That process involves you, also. We welcome your submissions and suggestions about current findings or any other newsworthy items you feel would be of interest to our audience. The Steering Committee will review all submissions and publish those chosen on a monthly basis. Please send ideas to: ideas@nicuniversity.org


Modified Recommendations for the Use of Palivizumab for the Prevention of Respiratory Syncytial Virus (RSV) Infections - Posted: October 1st, 2009

Authored By Dan L. Stewart, M.D. -

Dan L. Stewart, M.D.

Dr. Stewart joined the Department of Pediatrics at the University of Louisville School of Medicine in 1988, several years following the completion of his fellowship in Neonatology at this institution.  He initially completed his training in Pediatrics at the Medical College of Virginia.  Previously, Dr. Stewart has served in a variety of capacities, including as chairman of the Department of Pediatrics at East Tennessee State University.  Currently, he is a Professor of Pediatrics and Assistant Director of the Division of Neonatal Medicine.

Remaining active in his advocacy for children, Dr. Stewart has worked with multiple national and international organizations.  Dr. Stewart is a past President of the Kentucky Chapter of the American Academy of Pediatrics and chairs the committee on Pediatric Advocacy in Kentucky.  He is also a board member and past president of the Kentucky Pediatric Society Foundation.  Additionally, Dr. Stewart has worked to promote improvements to neonatal care internationally, and he has traveled extensively in this regard to countries such as Romania, Moldova, and Vietnam.

Having authored over 50 publications and multiple abstracts, Dr. Stewart has pursued a diverse research agenda during his academic career.  Dr. Stewart has particularly focused on innovative work involving extracorporeal membrane oxygenation, inhaled nitric oxide therapies, and high-frequency ventilation.  Dr. Stewart is a frequently invited speaker and has received multiple awards.  Most recently, Dr. Stewart was the recipient of the Marion Downs Award. 

Personally, Dr. Stewart is married to his wife of 35 years and has two grown children.


Gestational age – we do know what we are talking about, don’t we? - Posted: Aug 17th, 2009

Authored By Brian Darlow MD FRACP -

Brian Darlow MD FRACP
Christchurch School of Medicine University of Otago Christchurch New Zealand

Brian Darlow, MD was raised in South-West London, read natural sciences and then medicine at Cambridge University and trained in the UK and New Zealand. He holds the CureKids Chair of Paediatric Research and is Head of the Department of Paediatrics, Christchurch School of Medicine, University of Otago, New Zealand. Dr. Darlow’s clinical work is predominantly as a neonatologist and his research interests have focussed on free-radical disease in the newborn, longer term outcome following preterm birth and unit variations in outcome. He has been the PI or co-investigator on over 12 project grants from the NZ Health Research Council, together with other grants from various funding bodies, and PI and organiser of a number of large multicentre trials involving all level III neonatal units in New Zealand. Dr. Darlow has a number of ongoing international collaborations, has been a member of the Executive of the Australia and New Zealand Neonatal Network since 1994 and is currently Chair of the Network Management Committee. 



Placental Examination - Posted: March 21, 2009

Authored By Dr. Carolyn Salafia & Dr. Jonathan Davis

Dr. Carolyn Salafia
Dr. Carolyn Salafia is Board Certified in Anatomic and Clinical Pathology with subspecialty board in Pediatric Pathology. She has held academic appointments at the Associate and Full Professor levels at Georgetown University Medical Center, Albert Einstein College of Medicine, and Columbia University College of Physicians and Surgeons. Dr. Salafia received her BA from Dartmouth College and an MD from Duke University School of Medicine. Following medical school, she completed a Residency in Anatomic and Clinical Pathology at the Yale-affiliated community hospitals of St Raphael and Danbury Hospital, where she began her long publication history with analyses of the placental pathology underlying complications occurring in a low-risk community based population.

Her research has focused on the clinical correlation of placental pathology with maternal, fetal and neonatal outcomes, and more recently on the mathematical modeling of placental growth and placental pathology. She has authored approximately over 100 original manuscripts and book chapters and 200 abstracts and received grant awards from the National Institutes of Health, including a K23 Mentored Mid-Career Development Award from the National Institutes of Mental Health, the goals of which were to evaluate our current methods of placental evaluation and develop novel measures that can improve our understanding of how gestational pathology appears to create risk for neurodevelopmental disorders. She was a National Science Foundation sponsored Fellow in 2007, 2008 and 2009 to the Institute of Pure and Applied Mathematics at UCLA, where she has developed a multidisciplinary team that has created a number of novel means to measure and quantitate placental growth and development and its disease states including acute intraamniotic infection.

Dr. Jonathan Davis
Dr. Jonathan Davis is Chief of Newborn Medicine, Director of the Clinical and Translational Research Center and Professor of Pediatrics at the Floating Hospital for Children at Tufts Medical Center. Dr. Davis received his BA from Brandeis University and an MD from McGill University Faculty of Medicine. Following medical school, he completed a Residency in Pediatrics at Boston Children’s Hospital and Harvard Medical School and a Fellowship in Neonatal-Perinatal Medicine at the Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine.

Dr. Davis has worked at the University of Rochester, the State University of New York at Stony Brook and is currently at Tufts University. His research has focused on respiratory disorders of newborn infants, causes of newborn brain injury and oxidant/antioxidant balance in diseases of newborns. He has authored approximately 125 original manuscripts and book chapters and 200 abstracts and received numerous grant awards from the National Institutes of Health, the March of Dimes, the American Lung Association and Private Industry totaling over $10,000,000. Dr. Davis has lectured extensively worldwide including the Vatican Children’s Hospital in Rome, the Pasteur Research Institute in Paris, as well as Canada, Greece, Turkey, Ireland, England, Israel and Japan. He has served on many advisory panels for the NIH (currently Chair of the Eunice Kennedy Shriver Pediatric Sub-Committee at NICHD) and FDA in the US, Medical Research Council in Canada, British Lung Foundation and the National Health Council of Australia. 



Transcutaneous monitoring: back to the future - An important adjunct to care during high frequency oscillatory ventilation - Posted: July 17th, 2008
Reprinted with permission from bloodgas.org

Authored By Sherry E. Courtney, MD MS -

Sherry E. Courtney, MD MS
Department of Pediatrics
Division of Neonatology
Stony Brook University Medical Center
Stony Brook, NY
Email: sherry.courtney@stonybrook.edu

Dr. Courtney received her MD degree from the University of Kansas in 1973.  She completed her pediatric residency and neonatal fellowship at Children’s Mercy Hospital in Kansas City, Missouri in 1979.  Throughout the 1980’s she practiced at Children’s Medical Center, Dayton, Ohio, where she was Director of Newborn Medicine from 1982-1990.  She received her Masters of Science from the University of Michigan in 1991, in clinical research design and statistical analysis.  Throughout most of the 1990’s Dr. Courtney practiced at Cooper Hospital in Camden, New Jersey, where she was Director of Clinical Research for the Department of Pediatrics, and Professor of Pediatrics at Robert Wood Johnson School of Medicine.  Dr. Courtney joined the Department of Pediatrics at Schneider Children’s Hospital on Long Island in 2002, and moved to Stony Brook University Medical Center in 2007 to direct the clinical research and the neonatal fellowship programs there.

Dr. Courtney has been active in clinical research throughout her career.  She has published extensively in the area of neonatal pulmonology, and is especially interested in high frequency ventilation and non-invasive forms of ventilatory support.  She is a Fellow of the American Academy of Pediatrics and a member of the Society for Pediatric Research and the American Thoracic Society.  She is a frequent speaker at national and international conferences on ventilatory support of neonates.


The Changing Landscape of Neonatology - Posted: April 5th, 2008

Authored By Mark C. Mammel, MD -

Mark C. Mammel, MD
Professor of Pediatrics, Co-director Neonatal-Perinatal Fellowship
University of Minnesota
Director, Infant Diagnostic & Research Center
Children's Hospital - St. Paul, MN
Email: mamme001@tc.umn.edu

Mark Mammel, MD is Professor of Pediatrics and Co-director of the Neonatal-Perinatal Fellowship at the University of Minnesota, and Director of the Infant Diagnostic & Research Center at Children's Hospital - St. Paul. He trained at the University of Minnesota, joining the Children's staff as a neonatologist in 1982. He has never left, in spite of the sometimes miserable weather.  Dr. Mammel's professional interests center on the interaction of the patient and the mechanical ventilator. He has published both laboratory and clinical studies focusing on neonatal respiratory care.  He is a past member of the Perinatal Executive Committee for the American Academy of Pediatrics.  Whenever possible, he seeks out a golf course for reinforcement of his vocational choice.


Respiratory Syncytial Virus Infection and the “Mildly” Preterm Infant - Posted: October 30th, 2007

Respiratory syncytial virus (RSV) is the most important cause of viral lower respiratory tract illness in infants and children worldwide and is responsible for over 125 000 annual hospitalizations in infants in the US alone. Bronchiolitis, pneumonia, apnea, respiratory failure, and death are well known manifestations of severe acute RSV disease. Infant populations at high risk for severe RSV infections include patients with hemodynamically significant congenital heart disease, chronic lung disease, neuromuscular disease, congenital airway abnormalities, and premature birth (especially <35 weeks GA). Currently, mildly preterm infants (32 to <36 week GA) are believed to have better outcomes following RSV infection than infants <32 weeks GA. Since RSV prophylaxis is costly, guidelines do not support prophylaxis in mildly preterm infants. However, published data suggest that current beliefs should be challenged and guidelines changed to include RSV prophylaxis for mildly preterm infants.
Not for CE/CME credit.

Authored By Dr. Howard Panitch -
Howard Panitch, MD

Dr. Howard Panitch has long had an interest in the care of children with complex respiratory problems and those requiring technology assistance. He is the clinical director of the Division of Pulmonary Medicine, the director of the Pediatric Pulmonary Fellowship Training Program and the medical director of the Technology Dependence Center. His research has focused on airway smooth muscle, dynamic airway collapsibility, RSV bronchiolitis pathogenesis and prevention and barriers to transitioning technology dependent children to adult care.

He is the 2002 recipient of the University of Pennsylvania School of Medicine Dean's Award for Excellence in Clinical Teaching at an Affiliated Hospital.


Acute Bilirubin Encephalopathy: Does Intervention Influence Outcome? - Posted: October 30th, 2007

Infants born in the United States and discharged healthy from their birth hospital, continue to de at increased risk for development of severe hyperbilirubinemia and acute bilirubin encephalopathy (ABE). Recognition and identification of subtle neurologic signs in any infant with severe jaundice and/or hyperbilirubinemia are crucial to a successful outcome, with a “crash cart” approach to manage ABE. Current evidence suggests that, in its early and intermediate phases, ABE is reversible with timely, rapid, and effective bilirubin reduction strategies.
Not for CE/CME credit.

Authored By Dr. Vinod K. Bhutani -
Vinod K. Bhutani, MD, PhD

Dr. Vinod K. Bhutani is a professor at  Stanford University School of Medicine in the Department of Pediatrics, Division of Neonatal and Developmental Medicine.  His research interests are Neonatology; newborn jaundice, bilirubin biology and kernicterus prevention; pulmonary physiology, pulmonary functions and neonatal ventilation.




Evidence-Based Medicine and Clinical Research —An Uneasy Partnership - Posted: May 22nd, 2007

Evidence-based medicine is an exciting concept, but there is a risk of it being interpreted with too narrow a focus on clinical trial synthesis and systematic review of published clinical trial information. Often, the research studies needed to answer the question posed have simply not been done, or the research has failed to demonstrate a strong conclusion. This will continue to be the case; both as new treatments emerge, and is especially true in the specialty of neonatology. In order to optimally treat patients in a situation where no evidence-based answer exists we need to find a way to practice “non-evidence-based medicine. The challenges faced by potential researchers, both in obtaining training and funding underscore the need to avoid depending entirely on evidence-based medicine for clinical decision making.
Not for CE/CME credit.

Authored By Dr. Malcolm Chiswick -
Malcolm Chiswick, MD, FRCP [Lond], FRCPCH, DCH

Malcolm Chiswick graduated in medicine at the University of Newcastle upon Tyne in 1965 and was trained in pediatrics in London and Manchester. In 1975, he was appointed Consultant Pediatrician at St. Mary's Hospital for Women and Children, Manchester, where he developed the Neonatal Medical Unit as a referral center for the care of critically ill newborn infants.

In 1992, he was made Professor of Child Health and Pediatrics at the University of Manchester. He has published widely on the influence of perinatal events on neurodevelopmental outcome. From 1987 to 1999 he was Editor of Archives of Disease in Childhood.

In 2002, Professor Chiswick became Medical Director of Central Manchester and Manchester University Children's Hospitals NHS Trust. He is currently President of the British Association of Perinatal Medicine.



Neonatal Hypothermia - What are we waiting for? - Posted: August 2nd, 2006

With the publication of three randomized controlled trials demonstrating modest beneficial effects of hypothermia for treatment of hypoxic-ischemic encephalopathy in the term or near-term neonate in 2005, neonatal clinicians must confront several questions: Does hypothermia "work"? Should our NICU use hypothermia, or refer potentially eligible infants to a center that offers hypothermia? How should they be cooled? Is cooling safe? Who should be cooled, or not cooled? This commentary addresses each of those questions in a way that may help practitioners to make an informed judgment.
Not for CE/CME credit.

Authored By Dr. John Barks -
John Barks M.D John Barks M.D. is an Associate Professor of Pediatrics at the University of Michigan, where he has been on the faculty of the Division of Neonatal-Perinatal Medicine of C.S. Mott Children’s Hospital since 1990.  He is a graduate of Queen’s University in Kingston, Canada, and did his Pediatric Residency at the I.W. Killam Hospital for Children in Halifax and at the Hospital for Sick Children, in Toronto.  His fellowship training was at the Hospital for Sick Children, Toronto and at the University of Michigan. Dr. Barks was a site co-investigator in the Cool Cap randomized trial and has participated in the Cool Cap continued access protocol since December 2003.  In his laboratory research he has investigated mechanisms of hypoxic-ischemic brain injury and strategies for enhancing recovery from neonatal brain injury.


The Physician as a Defendant in Malpractice Lawsuits: Do's and Don'ts - Posted: November 10th

Physicians who are faced with their first malpractice suit are poorly prepared for the confrontational nature of the litigation process. The emotional impact of the allegations can be devastating and the insurance company frequently is more concerned about minimizing the cost than protecting the reputation of the defendant. The three most important aspects of malpractice litigation are preparation, preparation and preparation.
Not for CE/CME credit.

The Cause and Prevention of Human Birth Defects: How are we doing? - Posted: December 9th

In 1910, 4% of infants who died in the first year of life died of congenital malformations. In the year 2000, 25% of infant deaths were due to congenital malformations which are due to both genetic diseases and environmental agents. But the largest category is still labeled as unknown. However, we are making progress in increasing our ability to make etiologic diagnoses. The advances of the last 50 years in this field are astounding and will be discussed.

News and Views Chair:
Steven M Donn, MD
Professor of Pediatrics
Director, Neonatal-Perinatal Medicine
University of Michigan Health System
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