Health Policy

Thousands of children in Florida’s KidCare program over the past five months may have been improperly dropped from the program’s rolls because of a glitch in the state’s computer system, the Daytona Beach News-Journal reports. According to the News-Journal, Rich Robleto — executive director of Florida Healthy Kids, which administers KidCare — said 62,500 children left the program or were terminated from May to October, about 25,000 more than normal.

Child advocates and officials with Florida Healthy Kids said that notices to some families about premium due dates or enrollment renewal were sent late or not at all. In other cases, letters were not properly sent to inform parents that additional documentation was required to maintain coverage. Robleto said that some of the enrollment data may not have transferred properly when the new system was put in place in May. Robleto said eventually, the new system will “significantly improve service.”

Florida Healthy Kids officials have started contacting the families of all 62,500 children, although it is unknown how many children were affected by the problem. The Florida Healthy Kids board recently reinstated some of the policies effective Nov. 1, for at least 30 days, until staff can determine that the cancellations were not caused by the computer problem, Robleto said (Circelli, Daytona Beach News-Journal, 11/5).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

Surgical Information Systems (SIS) has been selected by Nebraska Orthopaedic Hospital to implement SIS Anesthesia, a comprehensive anesthesia information system that incorporates critical patient safety features with an intuitive graphical drag-and-drop interface.

In the current economic environment, hospitals are seeking technology solutions that will help them improve patient safety and realize a quick return on investment. In addition to providing a clean and legible electronic anesthesia record, Nebraska Orthopaedic Hospital chose SIS Anesthesia because of the system’s capacity to increase efficiencies through the reduction of documentation time and cost of customizing charts, as well as optimize financial performance by increasing drug reimbursement and reducing the number of delayed or canceled cases.

“Patient safety and superior care outcomes is the focus at Nebraska Orthopaedic Hospital,” said Nebraska Orthopaedic Hospital CEO, Tom Macy. “We are confident that implementing SIS Anesthesia will positively impact outcomes. Its ease of use and automatic data capture mean physicians will be able to spend more time focused on patient care and less time documenting each case.”

SIS Anesthesia automates Anesthesia Preop and Anesthesia Intraop processes. Information from Anesthesia Preop populates Anesthesia Intraop, so there is no need to re-enter information. When these components are implemented together, the benefits are multiplied as accurate data flows from one component to another, creating an information value chain that ultimately enables better patient care, creates innumerable efficiencies, and helps ease the complexities of anesthesiology.

“We continue to upgrade SIS Anesthesia with even more patient safety features,” said Ed Daihl, CEO at SIS. “Enhanced drug capabilities provide for improved visibility and control of the management of invasive lines, intake and output balance, and medication history. It’s a system that is more powerful than ever and is designed to provide immediate value to hospitals, which is critical during the current economic crisis.”

In addition to providing Nebraska Orthopaedic Hospital with a powerful anesthesia management system, SIS will guide the hospital through an implementation methodology that is both proven and practical. The guiding principles – make implementations easier and control variance to achieve great outcomes every time – provide structure to the project that result in intentional, efficient and consistent outcomes for clients. The SIS Methodology, in combination with training and support through SIS Academy and SIS Central (SIS client portal), offers a total client experience that is unmatched in the industry.

About SIS

SIS provides software solutions that are uniquely designed to add value at every point of the perioperative process. Developed specifically for the complex surgical environment, all SIS solutions – including anesthesia – are architected on a single database and integrate easily with other hospital systems. SIS offers the only surgical scheduling system endorsed by the American Hospital Association (AHA), and a rules-based charging system that has been granted Peer Reviewed status by the Healthcare Financial Management Association (HFMA).

For more information visit our website, SISFirst

About Nebraska Orthopaedic Hospital

Opening its doors in 2004, Nebraska Orthopaedic Hospital is the only Orthopaedic specialty hospital of its kind in the state of Nebraska. Located at 144th and West Center in Omaha, Nebraska Orthopaedic Hospital is a partnership between 27 orthopaedic surgeons and The Nebraska Medical Center. The hospital provides inpatient and outpatient surgical procedures as well as outpatient physical and occupational therapy and MRI. For more information visit our website at neorthohospital.

Surgical Information Systems
sisfirst

The following summarize efforts and events that seek to reduce racial and ethnic health disparities. Asian Liver Center: Stanford University’s Asian Liver Center announced last week that it is expanding its efforts to raise hepatitis B awareness in Asian communities by launching a global initiative, the Asia and Pacific Alliance to Eliminate Viral Hepatitis, AsianWeek reports. In partnership with CDC and the World Health Organization, the new initiative will focus on advocacy, education, vaccination and treatment to reduce the spread of the disease (Pang, AsianWeek, 11/5).

Butler County, Ohio: The Cincinnati Children’s Hospital Medical Center’s Office of Diversity and Multicultural Affairs on Friday will host a cultural competency conference aimed at educating community organizations on how to better serve the Hispanic community, the Oxford Press reports. The conference will include discussions on cultural competency, trauma and pediatrics, health care providers’ role in immigrants’ access to health care, and basic Spanish, according to Danielle Lewis, a spokesperson for the hospital. Butler County has an increasing Hispanic population (Latta, Oxford Press, 11/2).

Solano County, Calif.: The Solano County Health and Social Services Department recently held its first large HIV/AIDS event, which targeted the Hispanic community, the Vallejo Times-Herald reports. The event, which included no-cost HIV tests and offered health information and resources, was a late recognition of Latino AIDS Awareness Day in October (Banes, Vallejo Times-Herald, 10/31).

University of Maryland Eastern Shore: UMES on Tuesday began its Pharmacy and Health Professions e-Health Access program, which in part will aim to reduce health disparities in the black community, the Salisbury Daily Times reports. As part of the program, UMES will hold training sessions at various on- and off-campus locations that teach participants how to use online medical resources to learn about diseases that are prevalent among blacks and how to make lifestyle changes to address the conditions (Salisbury Daily Times, 11/3).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

If the heart becomes diseased during its embryonic/fetal development, it can regenerate itself to such an extent that it is fully functional by birth, provided some of the heart cells remain healthy. Dr. JГ¶rg-Detlef Drenckhahn of the Max DelbrГјck Center for Molecular Medicine (MDC) Berlin-Buch made this discovery together with colleagues from Australia. They were able to demonstrate in female mice that the healthy cells of the heart divide more frequently and thus displace the damaged tissue. “Hopefully, our results will lead to new therapies in the future,” Dr. Drenckhahn said. “With the right signals, a heart that has been damaged – for example through infarction – might be stimulated to heal itself.” Their finding has been published in the current edition of the journal Developmental Cell (Vol. 15)*.

For the heart to be able to beat, it needs energy. If the energy production in the heart cells is disturbed, then the embryo will actually die of heart dysfunction. But if only a portion of the cells is affected, this is not the case: With the aid of the remaining healthy cells, the embryo manages to regenerate the heart.

The scientists switched off a gene (Holocytochrome C synthase, abbreviated Hccs) in the developing hearts of mice – a gene that is essential for energy production. Results showed that the embryos died when all cells in the heart were affected by the defective energy production. However, the animals that still had some healthy myocardial cells survived, and at the time of birth they had a heart that was fully able to function.

The gene Hccs is located on one of the sex chromosomes, the X chromosome. In contrast to male animals who have only one X chromosome, females have two X chromosomes. Some of the altered female mice have an X chromosome with the defective Hccs gene and one with the intact Hccs gene. However, in the cells of the female animals, only one X chromosome is active. Depending on which one is expressed, either healthy or diseased heart cells develop. “At this point in time, the heart of the mice is like a mosaic,” Dr. Drenckhahn said. “Half of the cells are healthy, the other half not.”

Up until birth, the fetal heart manages to improve the ratio of healthy cells to defective cells from the original 50:50 ratio. The defective cells then only comprise ten percent of the entire heart volume. That is possible because the healthy myocardial cells divide much more frequently than the defective cells. Their percentage in the heart increases so that, at the time of birth, the ratio is large enough to allow the heart of the newborn mouse to beat normally. “But even for a while after birth, the heart is capable of compensatory growth of healthy cardiac cells,” Dr. Drenckhahn explained.

Later the heart loses this ability. Thus, after approximately one year, some of the mice (13 percent) died of myocardial insufficiency and almost half developed arrhythmia. Why only some of the mice develop heart problems is still unclear. The scientists, therefore, want to inactivate the gene in adult mice as well in order to investigate its influence.

Furthermore, they want to identify the embryonic/fetal signal substances that stimulate healthy cells to proliferate and inhibit diseased cells. The scientists hope that, in the future, these signal substances may help stimulate the body’s own repair mechanisms of the heart, for example after a heart attack or in the case of heart insufficiency.

In 2007 Dr. Drenckhahn received the Oskar Lapp Prize for his research on the repair of the fetal heart.

*Compensatory growth of healthy cardiac cells in the presence of diseased cells restores tissue homeostasis during heart development

Jörg-Detlef Drenckhahn1,2,3, Quenten P. Schwarz2,9, Stephen Gray1, Adrienne Laskowski4, Helen Kiriazis5, Ziqiu Ming5, Richard P. Harvey6, Xiao-Jun Du5, David R. Thorburn4,7 and Timothy C. Cox1,2,8

1 – Department of Anatomy & Developmental Biology, Monash University, Wellington Road, Clayton VIC 3 – 800, Melbourne, Australia
2 – School of Biomedical & Molecular Science, University of Adelaide, North Terrace, Adelaide SA 5005, Adelaide, Australia
3 – Max-DelbrГјck Center for Molecular Medicine, Robert-RГ¶ssle-StraГџe 10, 13125 Berlin, Germany
4 – Murdoch Children’s Research Institute, Royal ChildrenВґs Hospital, Flemington Road, Parkville VIC 3052, Melbourne, Australia
5 – Baker Heart Research Institute, Commercial Road, Melbourne VIC 3004, Melbourne, Australia
6 – Victor Chang Cardiac Research Institute, Victoria Street, Darlinghurst NSW 2010, Sydney, Australia
7 – Department of Paediatrics, University of Melbourne, Parkville VIC 3052, Melbourne, Australia
8 – Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA

Max DelbrГјck Center for Molecular Medicine (MDC) Berlin-Buch
Robert-Rössle-Str. 10¸13125 Berlin, Germany
mdc-berlin.de/en

Member of the Hermann von Helmholtz Association of National Research Centres

Todd Landry, director of the Division of Children and Family Services for the Department of Health and Human Services, said a 13-year-old Michigan boy was left at Creighton University Medical Center through LB 157, Nebraska’s “safe haven” law, on October 13.

“We now have our second case where a child from another state has been left at a Nebraska hospital,” Landry said. “We have made a formal report of the abandonment to the Michigan Department of Human Services.”

Landry said the department is working with Michigan officials and the Douglas County Attorney’s office to resolve this situation as quickly as possible. The Department has also been in contact with the boy’s family since the child was dropped off.

This is the 10th instance of use of LB 157 and the 18th child left at a hospital under the law since September 13. LB 157 went into effect on July 18.

More information about Nebraska’s safe haven law, as well as information about local resources for families, can be found on the Department’s Website.

DHHS offices can also provide information about options and resources. To find your local DHHS office, go to www.dhhs.ne/map/mapindex.htm.

These days most children born with congenital heart disease live well into adulthood, thanks to innovative surgical, interventional and medical treatments. That means that not only are cardiologists caring for a growing number of adults with repaired heart defects, but the resulting cardiac anatomy and physiology are often much more complex than in the past.

To assist cardiologists in making everyday clinical decisions for this challenging group of patients – and in knowing when to refer patients to specialists with expertise in congenital heart disease – the American College of Cardiology and the American Heart Association have jointly released a comprehensive set of practice guidelines on the management of adults with congenital heart disease (CHD).

The guidelines – the first of their kind in the United States – appear in the December 2, 2008, issue of the Journal of the American College of Cardiology (JACC) and the December 2, 2008, issue of Circulation. They were published online on November 7, 2008.

“Adult cardiologists have never before been presented with patients who have such complex congenital heart disease, because in the past, most of these patients did not survive to adulthood,” said Roberta G. Williams, M.D., co-chair of the guidelines writing committee. “These guidelines are an important component of a multi-pronged strategy to provide appropriate care for adults with congenital heart disease.” Dr. Williams is chair of pediatrics at the Keck School of Medicine of the University of Southern California and vice president for pediatric and academic affairs for Childrens Hospital Los Angeles.

Congenital heart defects can be relatively simple – a small, repairable hole between the left and right sides of the heart, for example. But many forms of CHD are much more complex. A baby may be born with only one ventricle (the lower chambers of the heart; normally there are two). Or the two large arteries that carry blood away from the baby’s heart may be switched, so that blood does not flow through the lungs and pick up oxygen before being pumped to the rest of the body. Heart valves may be misshapen or narrowed. There are many other types of congenital heart defects, and many variations of each, making congenital heart disease one of the most challenging areas of cardiology.

Over the years, cardiac surgeons and interventional cardiologists have become highly skilled at repairing heart defects. That doesn’t mean that all children who have undergone surgical procedures are completely cured, however. “That’s a common misconception,” said Carole A. Warnes, M.D., co-chair of the guidelines writing committee, a professor of medicine at the Mayo Clinic in Rochester, MN, and director of Mayo’s adult congenital heart disease clinic. “Some patients leave their pediatric cardiologist and think they don’t need to see a physician anymore, and others are seen by a cardiologist with no training in congenital heart disease. We really need to focus on how to better care for this population.”

In reality, nearly all patients need follow-up throughout adult life. Some will eventually need additional surgery to correct complications that arise over time. Most will need guidance on how their heart condition affects the important milestones of adulthood, such as employment, pregnancy and physical activity.

Without ongoing care and follow-up by a physician with training in congenital heart disease, the results can be tragic. Worsening of a leaky heart valve may be overlooked until the patient is in heart failure, making surgery highly risky or even impossible. A young woman may be told she cannot have children, when in fact, pregnancy might be possible if managed at a center with expertise in congenital heart disease. A seemingly routine appendectomy may turn into a life-threatening crisis.

To help avoid such problems, the guidelines provide comprehensive information on the clinical features, diagnosis, and medical, surgical and interventional therapy of a range of congenital heart defects. They also point out common problems and pitfalls, highlight key issues to look for during follow-up, and make recommendations on genetic testing, pregnancy, contraception and physical activity.

In addition, the guidelines call for:
Coordination of the ongoing care of patients through regional centers of excellence with expertise in adult congenital heart disease;

Individual and family counseling, including the early education of children on their heart condition and what to do to stay healthy;

A formal transition process to help teenagers and young adults cross the bridge from their pediatric cardiologist to an adult cardiologist;

Outreach and education programs to bring patients back into the healthcare system if they are no longer receiving appropriate care and follow-up;

Education about the risks of infection of the inner lining of the heart or the heart valves posed by dental procedures, tattoos, body piercings, and other procedures that may introduce bacteria into the bloodstream;

Thorough clinical evaluation of patients before noncardiac surgery or any procedure requiring anesthesia or sedation, coordinated through a regional center of excellence;

Counseling about safe contraception;

Consultation before pregnancy, including genetic counseling, so that patients understand the risks to both mother and baby.

The guidelines were developed in collaboration with the American Society of Echocardiography, Canadian Cardiovascular Society, Heart Rhythm Society, International Society for Adult Congenital Cardiac Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.

“We benefited from the diverse experience of adult cardiologists, pediatric cardiologists, cardiac surgeons, advanced practice nurses, and multiple institutions across the country,” Dr. Williams said. “It represents a wonderful collaboration.”

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About the American College of Cardiology (ACC):

The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The College is a 36,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. For more information visit acc/.

About the American Heart Association (AHA):

Founded in 1924, the American Heart Association is the nation’s oldest and largest voluntary health organization dedicated to building healthier lives, free of heart disease and stroke. These diseases, America’s No. 1 and No. 3 killers, and all other cardiovascular diseases claim nearly 870,000 lives a year. In fiscal year 2006 the association invested more than $554 million in research, professional and public education, advocacy and community service programs to help all Americans live longer, healthier lives. To learn more, visit americanheart.

Source: Amanda Jekowsky

American College of Cardiology

Elementary school students will eat more whole grains when healthier bread products are gradually introduced into their school lunches, a new University of Minnesota study shows.

Whole grain breads are strongly recommended as part of a healthy diet, but children and pre-teens won’t always eat them. For this study, researchers from the university’s department of food science and nutrition monitored how much bread students threw away, and whether that amount increased as the percentage of whole-grain flour in the bread and rolls was gradually increased.

The study included meals fed to kindergartners through sixth-graders at two Hopkins, Minn., elementary schools over the course of a school year. Red and white whole-grain flour was added incrementally to products, but students showed no strong preference for either type of flour. Students didn’t throw away more bread products until the percentage of whole-grain flour in the bread and rolls reached about 70 percent.

The research is important because it shows that a gradual approach to improving children’s overall diets can be successful both for parents and school food-service workers, said Len Marquart, one of the study’s authors and an associate professor at the university.

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The study will be published in the fall 2008 issue of the Journal of Child Nutrition and Management. Marquart’s collaborators on the survey were professor Marla Reicks and graduate students Renee Rosen and Leila Sadeghi.

Source: Patty Mattern

University of Minnesota

In the last decade, biomedical and research breakthroughs, notably in genetics and stem cells, have helped transform the care of children, improving diagnosis and treatment for numerous diseases. On Nov. 8 and 9, Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center will host a conference at the Grand Hyatt New York, titled “Innovations in Pediatric Medicine,” to exchange the latest advances in genetics, stem cell therapy, and childhood disease treatment.

The continuing medical education (CME) conference will feature lectures by international leading authorities in pediatric care in congenital and primary immunodeficiencies, gene therapy in children, the genetic basis for common childhood infections and a rational approach to pediatric emergency care during unplanned national or regional disasters.

“Medical breakthroughs have greatly increased the range of treatment options for pediatric diseases, which is why we are thrilled to bring together medical professionals who are on the frontline of pediatric care for this opportunity of learning the latest progress and the sharing of best practices,” says the conference’s course director, Dr. Mitchell Cairo, director of pediatric blood and marrow transplantation at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and professor of pediatrics, medicine and pathology at Columbia University College of Physicians and Surgeons.

A brief listing of speakers and topics is below. For the complete two-day conference program, visit: nyp/pdf/innovations_cme_schedule.pdf.

Saturday, Nov. 8
Plenary I
Bench to Bedside Genetics: A Pediatrician’s Viewpoint

Moderator:
Dr. Gerald M. Loughlin, Phyllis and David Komansky Center for Children’s Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and Weill Cornell Medical College

8:00 – 8:45 a.m.
Newborn Screening for Inborn Errors of Metabolism
Dr. Piero Rinaldo, Mayo Clinic College of Medicine, Rochester, Minn.

8:45 – 9:15 a.m.
Prenatal Pediatrics: How Analysis of Fetal Nucleic Acids in Maternal Blood Provides Novel Opportunities to Improve Newborn Care
Dr. Diana W. Bianchi, Tufts University School of Medicine and the Floating Hospital for Children

9:15 – 9:45 a.m.
Early Diagnosis of Primary Immunodeficiencies
Dr. Jennifer M. Puck, University of California, San Francisco

10:15 – 10:45 a.m.
Current Status of Gene Therapy in Children
Dr. Alain Fischer, Descartes University Hospital Necker-Enfants Malades, Paris, France

10:45 – 11:15 a.m.
Molecular Physiology of the Control of Body Weight
Dr. Rudolph L. Leibel, Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center

11:15 – 11:45 a.m.
Panel Discussion with Q&A

Plenary II
The Future of Stem Cell Therapy in Children

Moderator:
Dr. Mitchell Cairo, Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center

12:30 – 1:15 p.m.
Stem Cell Therapeutics for Childhood Neurological Diseases
Dr. Evan Snyder, University of California, San Diego

1:15 – 1:45 p.m.
Prenatal Stem Cell Transplantation – The Virtues of Tolerance
Dr. Alan W. Flake, Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine

1:45 – 2:15 p.m.
Applying Embryonic and Cord Blood Stem Cell Research to Children
Dr. Mervin C. Yoder, Indiana University School of Medicine

2:30 – 3:00 p.m.
Bioethical Challenges for Stem Cell Therapy in Children
Dr. Ruth L. Fischbach, Columbia University Medical Center

3:00 – 3:30 p.m.
Molecular Characterization of Normal and Leukemic Stem Cells
Dr. David A. Williams, Children’s Hospital of Boston and Harvard Medical School

3:30 – 4:00 p.m.
Panel Discussion with Q&A

Sunday, Nov. 9
Plenary III
Advances in Childhood Diseases

Moderator:
Dr. Charles L. Schleien, Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center

8:15 – 9:00 a.m.
Advances in the Genetic Pathogenesis of Common Childhood Infectious Diseases
Dr. Margaret K. Hostetter, Yale-New Haven Children’s Hospital

9:00 – 9:30 a.m.
Neonatal and Infant Nutrition and Iron Metabolism
Dr. Michael K. Georgieff, University of Minnesota

9:30 – 10:00 a.m.
Care of Children and Families in the Neonatal Intensive Care Unit
Lori Armstrong, R.N., Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center

10:30 – 11:00 a.m.
Pediatric Disaster Medicine
Dr. Gary R. Fleisher, Children’s Hospital of Boston and Harvard Medical School

11:00 – 11:30 a.m.
Recent Advances in the Pathophysiology and Treatment of Childhood Asthma
Dr. Robert F. Lemanske Jr., University of Wisconsin School of Medicine and Public Health

11:30 a.m. – 12:00 p.m.
Advances in Childhood Cancer: 50 Years of Progress
Dr. Gregory H. Reaman, George Washington University School of Medicine

12:00 – 12:30 p.m.
Prevention and Treatment of Sexually Transmitted Diseases in Adolescents
Dr. Lawrence Stanberry, Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center

12:30 – 1:00 p.m.
Panel Discussion and Q&A

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit cumclumbia.edu/.

Morgan Stanley Children’s Hospital of NewYork-Presbyterian

Ranked by U.S.News & World Report as one of the top children’s hospitals in the country, Morgan Stanley Children’s Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics — including the most complex neonatal and critical care, and all areas of pediatric subspecialties — in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation’s premier children’s hospitals, Morgan Stanley Children’s Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is Manhattan’s only hospital dedicated solely to the care of children and the largest provider of children’s health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children’s Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide. For more information, visit nyp/.

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Source: Belinda Mager

New York- Presbyterian Hospital/Columbia University Medical Center

The American Academy of Pediatricians on Monday issued a new recommendation that children receive 400 international units of Vitamin D daily — twice the amount previously recommended, the AP/New York Times reports. The new recommendation is based on a growing body of research that the vitamin may reduce the risk of cancer, diabetes and heart disease, among other benefits (AP/New York Times, 10/13). Darker-skinned children have a greater risk of vitamin D deficiency than other children because they do not absorb vitamin D as easily through the skin. Sunlight enables the skin to synthesize vitamin D (Kaiser Health Disparities Report, 8/27).

The new recommendation, which will appear in the November issue of the journal Pediatrics, states that Vitamin D supplements should be given to breastfed or partially breastfed infants, beginning in the first few days of life; all non-breastfed infants and children who consume less than one liter of vitamin D-fortified formula or milk per day; and adolescents who do not receive 400 IU of the vitamin daily through food. Vitamin D researcher Catherine Gordon, director of the bone health program at Children’s Hospital Boston, said, “I don’t know of another vitamin that has effects on multiple tissues like Vitamin D,” adding, “As pediatricians, we’re still doing research on health outcomes … later in life like osteoporosis, cancer risk and risk of developing multiple sclerosis. But there are compelling data in adults suggesting an association” (Hopper Oberholzer, Boston Globe, 10/13).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

On Nov. 8 and 9, Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center hosted an “Innovations in Pediatric Medicine” conference at the Grand Hyatt New York, which featured lectures by international leading authorities in pediatric biomedical research, genetic findings and stem cell therapy breakthroughs.

Key topics included discoveries about congenital and primary immunodeficiencies; gene therapy in children; and the genetic basis for common childhood infections. In addition, there was a unique presentation on pediatric emergency care during disasters and the lessons learned from Hurricane Marilyn on St. Thomas; the 2001 attack on the World Trade Center in New York; the 2003 earthquake in Bam, Iran; and Hurricane Katrina.

“Medical breakthroughs have greatly increased the range of treatment options for pediatric diseases, making it vital to bring together medical professionals who are on the frontline of pediatric care for this opportunity to learn the latest progress and to share best practices,” said the conference’s course director, Dr. Mitchell Cairo, director of pediatric blood and marrow transplantation at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and professor of pediatrics, medicine and pathology at Columbia University College of Physicians and Surgeons.

Listed below are some key presentations by leaders in their field:
Dr. Alain Fischer of Descartes University Hospital Necker-Enfants Malades, Paris, France, discussed gene therapy for inherited disorders based on research on the treatment of severe combined immunodeficiency. Introducing genes into bone marrow stem cells led to sustained correction of the disease for almost 10 years, providing evidence that the approach can be effective and could be used to treat other genetic diseases of blood cells. One challenge is the viral vector used to introduce the gene has been linked to cancer. In response, new vectors are being designed.

Dr. Gary Fleisher of the Children’s Hospital Boston and Harvard Medical School presented a framework for planning for disaster management, highlighting unique pediatric aspects. He discussed the conditions likely to be encountered by providers arriving in the first 24 to 72 hours and the skills necessary for success. In terms of response teams, Dr. Fleisher described the structure of PST-1 (Pediatric Specialty Team-1), the first team developed by the NDMS (National Disaster Medical System) dedicated to treating children in disasters. He shareed lessons learned from Hurricane Marilyn on St. Thomas; the 2001 attack on the World Trade Center in New York; the 2003 earthquake in Bam, Iran; and Hurricane Katrina.

Dr. Margaret K. Hostetter of Yale-New Haven Children’s Hospital presented on advances in the genetic origins of common childhood infections, focusing on newly discovered genes that are linked to early onset staphylococcal infection, recurrent pneumococcal infections, and rarer disorders such as Bruton’s agammaglobulinemia, hyper IgE syndrome, chronic granulomatous disease and severe combined immunodeficiency.

Dr. Jennifer M. Puck of the University of California, San Francisco, presented evidence that early diagnosis of primary immunodeficiencies is critical for optimal treatment. The challenge is that these disorders are rare and hard detect until serious complications have developed; a life-threatening situation usually has to occur before a correct diagnosis was made. As a solution, Dr. Puck suggests that all newborns be screened for severe combined immunodeficiencies, with the goal of improving timely diagnosis and outcomes. Her laboratory has developed a screening test that can be done on the dried blood spots routinely used for screening for other serious conditions.

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Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit cumclumbia.edu.

Morgan Stanley Children’s Hospital of NewYork-Presbyterian

Ranked by U.S.News & World Report as one of the top children’s hospitals in the country, Morgan Stanley Children’s Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics — including the most complex neonatal and critical care, and all areas of pediatric subspecialties — in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation’s premier children’s hospitals, Morgan Stanley Children’s Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is Manhattan’s only hospital dedicated solely to the care of children and the largest provider of children’s health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children’s Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide. For more information, visit nyp/.

Source: Belinda Mager

New York- Presbyterian Hospital/Columbia University Medical Center