October 22, 2012

UH Rainbow doctors At AAP Discuss Minority Obesity, Perinatal Health, Testicular Cancer And Other Topics

Combating obesity in minorities, looking at improvements in perinatal health in Ohio, and treating rare testicular cancer in adolescents are among the presentations physicians from University Hospitals (UH) Rainbow Babies & Children's Hospital will give at the American Academy of Pediatrics (AAP) 2012 National Conference in New Orleans Oct. 20 to 23. Susanna Briskin, MD, pediatric sports medicine physician at UH Rainbow Babies & Children's Hospital, will present "Overcoming Barriers to Physical Fitness in Minority Populations;" Michele Walsh, MD, Chief, Division of Neonatology, will present "Ohio Perinatal Quality Collaborative-OBs and Neos Working Together To Improve Perinatal Health;" and Jonathan Ross, MD, Chief, Division of Pediatric Urology, will present data from his abstract "Management of the Retroperitoneum in Children and Adolescents with Malignant Germ Cell Tumors of the Testis" at the annual meeting.

"We have recognized the magnitude of the obesity crisis, particularly in minority populations," says Dr. Briskin, who is also Associate Professor of Sports Medicine at Case Western Reserve University School of Medicine. "We are looking at intervening in schools and at home by targeting high-risk groups early, including building daily routines, involving parents, building structured and unstructured playtime, and encouraging walking and biking."

Among high school students, Dr. Briskin found the obesity rate at 18.2 percent for African-Americans and 14.1 percent for Hispanics while it is 11.5 percent for Caucasians. The known health risks of obesity include high blood pressure, heart disease, diabetes and stroke, but there are other non-apparent risks. "A non-obese child is more likely to have increased self-esteem, decreased anxiety and depression, lower teen pregnancies and engage in less risky sexual behavior," says Dr. Briskin.

"The best time to prevent a premature birth is before delivery," says Dr. Walsh, who is a leader in the Ohio Perinatal Quality Collaborative and is Professor of Neonatology at Case Western Reserve School of Medicine. "In Ohio, obstetricians and neonatologists have collaborated in a ground-breaking way to increase the number of babies born at 39 weeks or more. These efforts have led to over 24,000 infants who have avoided premature birth. Ohio is receiving great recognition for these efforts."

In her presentation, "Ohio Perinatal Quality Collaborative-OBs and Neos Working Together to Improve Perinatal Health," Dr. Walsh found Ohio ranked 18th in preterm birth rate at 13.3 percent and 14th in infant mortality rate at 7.8 percent. Under her direction, Ohio obstetricians have reduced scheduled births before 39 weeks by 60 percent after data suggested a higher risk associated with births before 39 weeks of gestation.

In Ohio, more than 26,000 births have moved from prior to the due date to full term (39 to 41 wks) with approximately 400 Neonatal Intensive Care Unit admissions avoided and approximately $10 million in annual Ohio health care savings. Meanwhile, neonatologists have reduced late onset infections in pre-terms from 22 to 29 weeks by 50 percent by educating all pregnant women of the benefits of human milk and encouraging kangaroo care among other practice changes.

Dr. Ross' study describes the findings in retroperitoneal surgery (in the abdomen) for metastatic disease in children and adolescents with testicular cancer and helps to begin to define how retroperitoneal disease should be handled in these patients. "These are rare tumors and so there is little data guiding their management in these age groups, which is why we're excited by our research," said Dr. Ross, who is a Professor of Urology at Case Western Reserve School of Medicine. The abstract is also one of seven the AAP has nominated for "Best Clinical Research Abstract."

Dr. Walsh will also present the Neonatal Education Award to Richard Martin, MD, the Drusinski-Fanaroff Chair in Neonatology, UH Babies & Children's Hospital. The Neonatal Education Award is given annually by the Section on Perinatal Pediatrics of the American Academy of Pediatrics to an individual for recognition of outstanding contributions in Neonatal-Perinatal Medicine for health care students, professionals, or lay public.

An internationally renowned neonatolgoist, Dr. Martin has authored/co-authored nearly 130 peer-reviewed articles, has written more than 60 chapters, and edited several monographs and text books, the most prominent of which is Neonatal/Perinatal Medicine (now in its 8th edition) that he co-edits with Drs. Avroy Fanaroff and Walsh. He has been a member of the HED-1 Study Section of the National Institutes of Health, and currently serves on the Editorial Boards of Acta Pædiatrica, Journal of Applied Physiology and Biology of the Neonate.

Dr. Martin's laboratory has focused much of its attention on the biologic basis for apnea of prematurity and its management, employing state-of-the-art biologic tools, and clinical trials for new ventilatory and pharmacologic clinical strategies. In addition, his work has been concentrated on the development of airway function in health and disease, and the roles of lung and airway injury in the development of later respiratory morbidities such as wheezing disorders in children born prematurely. Additional research interest includes nitric oxide activity as it pertains to lung injury and its use in modulating airway contraction. His research has been funded continuously by the National Institutes of Health for over 20 years.

Dr. Walsh will present Oct. 20 during the morning session. Dr. Briskin's presentation is 7a.m. on Oct. 21. Dr. Ross will present Oct. 20 at 11:50 a.m. and a link to his abstract is at: https://aap.confex.com/aap/2012/webprogrampress/Paper15832.html


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