Adre du Plessis, MBChB, treats boy without cerebellum
Chase Britton of Buffalo, NY, has a puzzling condition that has been dubbed a medical mystery by Adre du Plessis, MBChB, chief of fetal and transitional medicine at Children’s National. The 3-year-old boy was born missing two very important components of the brain – the cerebellum and pons. The cerebellum is responsible for things like balance, coordination of movement, motor control, and emotional function, while the pons helps to automatically regulate some of the body’s basic functions, such as sleeping, breathing, and swallowing. Dr. du Plessis has been working with Chase for the past two years, and calls his patient’s diagnosis a “mystery.”
Despite being born with critical parts of the brain missing, Chase can do many things that doctors say he should not be able to do. He stands up by himself with the help of nearby furniture and he walks with assistance from a walker. He also is able to sign and has a vocabulary of roughly 75 words that continues to grow. He laughs and is in the process of being potty trained. Dr. du Plessis shares, “He clearly is doing much better than we would have expected based on conventional wisdom.”
Dr. Teach was one of eight investigators, led by William Busse, MD, the principal investigator of the Inner City Asthma Consortium (ICAC), a nationwide clinical trials network supported by the National Institute of Allergy and Infectious Diseases, part of the NIH. Additional support for this research was provided by the NIH National Center for Research Resources and Novartis Pharmaceuticals Corporation. The study was conducted in eight U.S. cities
“This Consortium is an important force in defining best practices in asthma care for at-risk children and adolescents across multiple institutions and regions,” said Dr. Teach. “Through our collaborations, we can be more certain that specific institutional and regional factors are not affecting our findings. The goal is to advance universal best practices.”
The study enrolled 419 children and youths, ages 6 to 20 years old, diagnosed with moderate to severe allergic asthma lasting more than one year. The children were from Boston, Chicago, Cleveland, Dallas, Denver, New York, Tucson, Ariz. and Washington, DC. Nearly all were minorities, including African Americans (60 percent) and Hispanics (37 percent). The study goal was to determine if adding omalizumab to NIH guidelines-based asthma therapy reduced the number of days that participants experienced any asthma-related symptoms. Another goal was to find out if the addition of omalizumab could also reduce the number of severe asthma attacks. Half of the participants were assigned at random to receive omalizumab, and the other half a placebo.
“The spike in asthma attacks in the fall, which is associated with colds and other viral airway infections, disappeared in the kids in the omalizumab group,” said Dr. Busse. “Because the drug specifically targets IgE, which is the antibody responsible for allergies, our observations show the possible interplay between allergies, respiratory viruses and IgE in provoking asthma attacks.”
Seasonal asthma attacks can cause children and teens to miss school, particularly in the fall and spring. Additionally, many hospital emergency departments see a spike in visits with severe seasonal asthma flare ups.
“If the ICAC now collaborates in refining indications for use of this drug, we may find the optimal way to use this therapy to reduce emergency department visits and to improve these kids’ quality of life,” said Dr. Teach. “This is what we mean by translational research – we moved this drug from the laboratory to the patients, found important impacts on kids’ lives, and now will work further to develop the best applications. The next step for the ICAC is to focus more closely on the role of omalizumab in reducing fall exacerbations of asthma.”
Adré du Plessis, MBChB Chief, Division of Fetal and Transitional Medicine
Adré du Plessis, MD, joins Children’s National from Children’s Hospital Boston, where he developed and directed the Critical Care Neurology and Fetal-Neonatal Neurology programs within the Department of Neurology. These were the first such programs of their kind anywhere, and continue to be the largest in the United States and abroad. He is one of the world’s leading experts on the neurology of the fetal brain, and has been charged with bringing together existing and new fetal medicine programs at Children’s National.
David Jacobsohn, MD Chief, Division of Blood and Marrow Transplantation
David Jacobsohn, MD, joins Children’s National from Children’s Memorial Hospital in Chicago, where he served as a member of the Stem Cell Transplant Program staff and as the Director of the Chronic Graftversus-Host Disease Clinic. He has lectured widely on GvHD/BMT in Europe, Latin America, and the United States.
Judith Owens, MD, MPH, is the new director of Sleep Medicine at Children’s National. She is an internationally recognized authority on children and sleep. She chairs the pediatric section of the American Academy of Sleep Medicine, and her research interests include the neurobehavioral and health consequences of sleep problems in children, pharmacologic treatment of pediatric sleep disorders, and cultural and psychosocial issues that impact sleep. Dr. Owens is co-author of “Take Charge of Your Child's Sleep: The All-in-One Resource for Solving Sleep Problems in Kids and Teens” for parents and “A Clinical Guide to Pediatric Sleep” for healthcare professionals. She also is a founding member of the Board of Directors of the Society of Behavioral Sleep Medicine.
Craig Peters, MD, is chief of Surgical Innovation, Technology, and Translation in the Joseph E. Robert, Jr., Center for Surgical Care, and a principal investigator for the Bioengineering Initiative in the Sheikh Zayed Institute for Pediatric Surgical Innovation. Dr. Peters came from the University of Virginia where he was chief of Pediatric Urology. He has extensive experience with treatment of pediatric urologic problems, developing minimally invasive surgical techniques, including robot-assisted procedures.
Zena Quezado, MD, is an internationally renowned pediatric anesthesiologist. In addition to her role as an anesthesiologist, she is director of the Pain Neurobiology Lab at the Sheikh Zayed Institute for Pediatric Surgical Innovation. Prior to joining Children’s, Dr. Quezado was a chief of Anesthesia and Surgical Services at the National Institutes of Health. An active researcher, Dr. Quezado has published more than 50 peer-reviewed manuscripts in clinical and scientific medical journals. Gary F. Rogers, MD, JD, MBA, MPH Chief, Plastic and Reconstructive Surgery
Gary F. Rogers, MD, JD, MBA, MPH, joins Children’s National as the chief of Plastic and Reconstructive Surgery, from Children’s Hospital Boston. He has contributed to the invention of two patented devices to treat deformational plagiocephaly. His clinical interests include hand/wrist trauma, craniofacial surgery (including facial trauma and reconstruction), and ear construction.
Nabile Safdar, MD, is a radiologist who specializes in musculoskeletal imaging. He is one of a dozen radiologists who is fellowship trained in imaging informatics. He also is a principal investigator in the Sheikh Zayed Institute for Pediatric Surgical Innovation. Dr. Safdar’s research includes optimizing computer interfaces for communication, measuring and improving the factors that affect radiologist performance, and computer aided diagnosis.
Venkat R. Shankar, MD, MBA Chief, Division of Respiratory Care
Venkat R. Shankar, MD, MBA, joins Children’s National from St. Christopher’s Hospital for Children in Philadelphia where he was chief of Pediatric Critical Care. Dr. Shankar also is an attending physician in the PICU and CICU. His research interests include extracorporeal membrane oxygenation (ECMO), status asthmaticus, congenital heart disease, and procedural sedation.
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Visit our booth (#929) to receive a free tote bag, and to learn more about the Sheikh Zayed Institute for Pediatric Surgical Innovation.
Back to Top Other News from the PAS Meeting
Children’s National resident, Hanna Kim has been awarded an APA Research Award for Best Abstract by a Resident, based on her abstract entitled, “Have Accreditation Council for Graduate Medical Education Duty Hour Limits Made a Difference? A Re-Examination of Resident Sleep, Mental Health, Education, and Safety Seven Years Later.”
She will be awarded an honorarium on Sunday, May 1, 2011 at the APA Membership Meeting, from 3:45-5:45 p.m. at the PAS meeting. A plaque will also be given at the APA Research Committee Meeting from 11:00 a.m.-12:30 p.m. at the Sheraton Denver Downtown in the Governor’s Square Room 10 that same day. Please come out and support your colleague!
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The 2010 Children’s National Medical Center Annual Report from Children’s Research Institute is now available!