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World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition 2016

PrintThe 5th World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition (WCPGHAN) was held October 5-8, 2016 in Montreal. This event showcased state of the art science and technology in the field of pediatric gastroenterology, hepatology, and nutrition, as well as presentations and keynote speeches from experts who are leaders in their field.

The conference encompassed nine themes including:

  • IBD
  • Celiac and other GI disorders
  • Neurogastroenterology and motility
  • Endoscopy
  • Hepatology
  • Pancreatology
  • Global health
  • Nutrition and intestinal rehabilitation
  • Transplantation

Several Children’s Hospital of Pittsburgh of UPMC faculty and staff spoke at the conference on a number topics including:

Immune Tolerance and Rejection
Pharmacology (pharmaco-genetics) and immunosuppression: Past, present and future
Patrick McKiernan, MD

Steatorrhea: What if it’s not Cystic Fibrosis
Mark Lowe, MD, PhD

Acute Liver Failure – Pathogenesis and Management
Rob Squires, MD and Anil Dhawan, MD

Mark Lowe, MD PhD


Inflammatory Responses/ Healing in Pancreatic Injury
Sohail Husain, MD

Poster Presentations

Sterile Cerebrosprinal Fluid Ascites: A Rare Complication After Ventriculoperitoneal Shunting
James Squires, Kristen Critelli (fellow)

Clinical Variability Following Partial External Biliary Diversion In Familial Intrahepatic Cholestasis 1 Deficiency
James Squires, Robert Squires, Amy Morris

Children’s Hospital of Pittsburgh of UPMC Part of New Pennsylvania Program to Improve Behavioral Health for Kids

PrintChildren’s Hospital of Pittsburgh of UPMC’s primary care network, Children’s Community Pediatrics (CCP), has been selected by the HealthChoices managed care organizations to take part in a new program to improve behavioral health treatment for children in the state.

Ted Dallas, secretary of the Department of Human Services in Pennsylvania, announced the selection of organizations to administer behavioral health treatment through the new Telephonic Psychiatric Consultation Service Program (TiPS). The announcement was made today at Children’s Hospital, with Dallas joining Christopher Gessner, president of Children’s Hospital, and Abigail Schlesinger, MD, medical director, Community Based Services, Behavioral Science Division of Children’s Hospital.

TiPS is a new program designed to provide real-time resources to physicians seeking consultation and advice for pediatric patients with behavioral health concerns who are served by Medicaid. A physician who uses the TiPS service will have access to a child and adolescent psychiatrist to discuss treatment options and get help linking the child to appropriate treatment if services outside of primary care are deemed necessary.

CCP, through its award-winning behavioral health program, will be manning the hotline to provide telephone consultation to any physician who is prescribing behavioral health medications to kids.

“It is critical that all children, regardless of where they live, have access to quality health care services,” said Dallas. “Access to child psychiatry has been a significant problem nationwide for years. Today’s announcement means that more of our kids will have the services they need, and not just another prescription.”

“Being able to provide behavioral health services in the primary care setting was a vision of ours and something that we’ve been doing for 8 years now,” said Dr. Schlesinger. “We’re excited to partner with the state of Pennsylvania to further enhance families’ ability to access behavioral health services in our region.”

CCP will serve the 26 counties in both the Southwest and Northwest zones. The Children’s Hospital of Philadelphia will serve the Southeast zone and Penn State Children’s Hospital will serve the Northeast and Lehigh/Capital zones.

For more information, visit www.childrenspeds.com.

Children’s Hospital of Pittsburgh of UPMC Earns National Recognition as Patient-Centered Medical Home

PrintChildren’s Hospital of Pittsburgh of UPMC’s Primary Care Center, part of the Division of General Academic Pediatrics, has received Level III Patient-Centered Medical Home (PCMH) Recognition from the National Committee for Quality Assurance (NCQA) for using evidence-based, patient-centered processes that focus on highly coordinated care and long‐term, participative relationships.

The three-year recognition is based on standards aligned with joint principles of the Patient-Centered Medical Home, a model of primary care that combines teamwork and information technology to improve care, to improve patients’ experience of care and to reduce costs.

“As the pediatric office for many of Pittsburgh’s underserved children, we are dedicated to providing the highest quality of care to the children in our region who are in need. This national recognition demonstrates our comprehensive approach and ongoing commitment to patient-centered care,” said Stacey Cook, MD, PhD, physician, General Academic Pediatrics, Children’s Hospital. “We provide increased access, implement quality improvement measures and provide continuing outreach to our families each and every day.”

Medical homes foster ongoing partnerships between patients, their families and their personal clinicians, instead of approaching care as the sum of episodic office visits. Each patient’s care is overseen by clinician-led care teams that coordinate treatment across the health care system.

“NCQA Patient-Centered Medical Home Recognition raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients,” said NCQA President Margaret E. O’Kane. “Recognition shows that Children’s Hospital of Pittsburgh of UPMC has the tools, systems and resources to provide its patients with the right care, at the right time.”

NCQA standards are aligned with the joint principles of the Patient-Centered Medical Home established with the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Osteopathic Association.

Children’s Hospital of Pittsburgh of UPMC Ranked in National Top 10 Seven Years in a Row

PrintChildren’s Hospital of Pittsburgh of UPMC, for the seventh consecutive year, has been named to the US News & World Report Honor Roll of America’s Best Children’s Hospitals.

The hospital is ranked seventh on the 2016-17 Honor Roll of America’s Best Children’s Hospitals, which was released today. The Best Children’s Hospitals rankings highlight the top 50 US pediatric hospitals in each of 10 specialties: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; neonatology; nephrology; neurology and neurosurgery; orthopedics; pulmonology; and urology.

“We’re very proud to once again be recognized as one of the top children’s hospitals in the country,” said Christopher Gessner, president, Children’s Hospital. “Patients and families with complex medical conditions and needs increasingly are choosing our hospital because our physicians, nurses, and staff, who are among the leaders in their fields, are committed to providing the highest quality pediatric healthcare in the world every single day.”

The 2016-17 Best Children’s Hospitals rankings will be released online today and also will be published in the U.S. News “Best Hospitals 2017” guidebook, available in September.

US News introduced the Best Children’s Hospitals rankings in 2007 to help families of children with rare or life-threatening illnesses find the best medical care available. The rankings open the door to an array of detailed information about each hospital’s performance.

Children’s tied with one other hospital for seventh place. The 11 hospitals named to US News’ Honor Roll of Best Children’s Hospitals for 2016-17 are:
1. Boston Children’s Hospital
2. Children’s Hospital of Philadelphia
3. Cincinnati Children’s Hospital Medical Center
4. Texas Children’s Hospital, Houston
5. Seattle Children’s Hospital
6. Ann and Robert H. Lurie Children’s Hospital of Chicago
7. Children’s Hospital of Pittsburgh of UPMC
7. Children’s Hospital Los Angeles
9. Children’s Hospital Colorado, Aurora
10. Lucile Packard Children’s Hospital at Stanford, Palo Alto, California
10. Nationwide Children’s Hospital, Columbus, Ohio

Leading International Expert in Metabolic Liver Disease to Direct Hepatology Program at Children’s Hospital of Pittsburgh of UPMC

PrintPatrick McKiernan, MD, a leading expert in metabolic liver disease, has been appointed director of the Pediatric Hepatology Program at Children’s Hospital of Pittsburgh of UPMC, part of the Division of Pediatric Gastroenterology, Hepatology, and Nutrition. Dr. McKiernan will also join the staff of the hospital’s Center for Rare Disease Therapy.

Dr. McKiernan specializes in treating children with inherited metabolic disease and has an interest in developing less invasive therapies to help patients avoid or delay the need for liver transplantation. His research focus covers the clinical aspects of inherited metabolic liver disease, portal hypertension, novel endoscopic techniques, non-invasive markers of hepatic fibrosis, and immunosuppression following liver transplantation. He is actively involved in research on stem cell therapy for metabolic liver diseases and recently was the UK principle investigator on a stem cell study involving children with urea cycle disorders and Crigler-Najjar syndrome.

“Dr. McKiernan is among the world’s leading physician-scientists with expertise in pediatric hepatology, specifically inherited metabolic disease,” said Mark Lowe, MD, PhD, chief of the Division of Pediatric Gastroenterology, Hepatology and Nutrition at Children’s Hospital. “His appointment enhances Children’s ability to provide care for children from around the world with complex metabolic conditions in need of the highest level of care.”

Dr. McKiernan also has a special interest is tyrosinemia, an inherited disorder caused by an enzyme deficiency that can lead to life-threatening liver and kidney failure. In a study published in 2014, Dr. McKiernan and his colleagues found that children whose tyrosinemia was identified at birth through newborn screening and started on the drug nitisinone developed normally and showed no signs of liver or kidney disease.

Dr. McKiernan comes to Children’s from Birmingham Children’s Hospital in the United Kingdom, where he was a hepatologist in the liver unit since 1994. He trained in medicine and pediatrics at Queen’s University in Belfast.

Dr. McKiernan is a member of the British Medical Association, British Society of Pediatric Gastroenterology, Hepatology and Nutrition, British Association for the Study of the Liver, and American Association for the Study of Liver Diseases. He also is an associate professor at the University of Pittsburgh School of Medicine.
As an international expert in metabolic disease, Dr. McKiernan is part of the Center for Rare Disease Therapy at Children’s, an integrated team of experts who have developed innovative therapies to treat a multitude of rare diseases.

Children’s has performed more than 330 liver transplants for patients with metabolic disease, which is more than any other center, including adult facilities. In addition, Children’s is a leading center for liver transplantation as a therapeutic option for children with maple syrup urine disease (MSUD). Children’s developed the first liver transplant protocol for MSUD in 2004 and since then has successfully performed more liver transplants in patients with MSUD than any other center in the world with 100 percent patient and graft survival.

For more information on Dr. McKiernan and the Pediatric Hepatology Program at Children’s Hospital of Pittsburgh of UPMC, please visit www.chp.edu/hepatology.

New Placenta Model Could Reveal How Birth Defect-Causing Infectious Agents Cross From Mother to Baby

Researchers at the University of Pittsburgh and Magee-Womens Research Institute (MWRI) have devised a cell-based model of the human placenta that could help explain how pathogens that cause birth defects, such as Zika virus, cross from mother to unborn child. The findings were published today in Science Advances.

The placenta is a complex and poorly understood organ that anchors the developing fetus to the uterus, nourishes the baby, and provides a barrier to the spread of microorganisms from an infected mother to the fetus, explained senior investigator Carolyn Coyne, PhD, associate professor of microbiology and molecular genetics at Pitt School of Medicine and a member of the MWRI.

“The human placenta is unique and unlike that of other many other placental mammals,” she said. “With our new model in the research toolkit, we and other scientists hope to advance our knowledge of the placenta, examine its function , and learn how it can prevent most, but not all, maternal infections from causing problems for the baby.

Researchers currently can obtain and study placental cell lines, but such cells do not fuse spontaneously to form the characteristic structure of the human organ. Some scientists study cells, called primary human trophoblasts, that are isolated from placentas obtained after childbirth, but such cells do not divide, can be more difficult to obtain, and are more difficult to genetically manipulate to learn about biochemical pathways that have a role in placental function, Dr. Coyne said.

Dr. Coyne’s team took a different approach: They cultured a human placental trophoblast cell line in a microgravity bioreactor system developed by NASA. The trophoblasts along with blood vessel cells were added to small dextran beads that were then spun around in a container filled with cell culture fluid, creating shear stress and rotational forces to better mimic the environment at the maternal-fetal interface than static cell-culture systems.

As a result, the cells fused to form syncytiotrophoblasts, and thus more closely resemble the primary cells lining the outermost layer of the tree-like or villous structure of the human placental tissue. Next, the researchers tested the functional properties of their model by exposing it to a virus and to Toxoplasma gondii, a parasite found in cat feces that can lead to fetal infection, causing miscarriage, congenital disease and/or disability later in life.

“We found that the syncytiotrophoblasts formed in our system recapitulated the barrier properties of the naturally occurring cells and they resisted infection by a model virus and three genetically different strains of Toxoplasma,” said co-investigator Jon P. Boyle, PhD, associate professor of biological sciences at Pitt. “With this model, we can experiment with different biological factors to see what might allow an infectious agent to get through the placental barrier to the fetus.”

Understanding the placenta might one day lead to ways to prevent fetal damage from the so-called TORCH infections: toxoplasmosis, rubella, cytomegalovirus, herpes and HIV, he added.

The researchers are beginning to use their model to test whether Zika virus, and other pathogens associated with congenital disease, can infect placental cells and/or cross the placental barrier.

Research team members include Cameron McConkey, BS, Elizabeth Delorme-Axford, PhD, and Yoel Sadovsky, MD, all of the University of Pittsburgh; Cheryl A. Nickerson, PhD, of Arizona State University; and Kwang Sik Kim, MD, of Johns Hopkins University.

The project was funded by National Institutes of Health grants AI081759 and HD075665 and the Burroughs Wellcome Fund.

Nephrotic Syndrome Symposium

Nephrotic Syndrome: Clinical Challenges and Evidence-based Management
May 12, 2016 – 9:00 a.m. to 6 p.m.
Children’s Hospital of Pittsburgh of UPMC
4401 Penn Ave.
Pittsburgh, PA 15224

Please join us for this one day event will engage glomerular kidney disease researchers, clinicians, other healthcare professionals and patient families. This event promises to foster new collaborations, close the gaps between research and clinical care and form common research agendas.

Course Directors
Agnieszka Swiatecka-Urban, MD
Children’s Hospital of Pittsburgh of UPMC,
University of Pittsburgh School of Medicine

Hoda Kaldas, MD
University of Pittsburgh

To view the Save the Date flyer, click here.
For more information or to register, click here.


Chief of Hematology/Oncology at Children’s Hospital of Pittsburgh of UPMC Selected for Pediatric Cancer MoonShot Consortium

PrintLinda McAllister-Lucas, M.D., Ph.D., chief of the Division of Pediatric Hematology/Oncology at Children’s Hospital of Pittsburgh of UPMC, has been selected as a member of the prestigious Pediatric Cancer MoonShot Consortium.

The announcement was made at the Cancer MoonShot 2020 press conference held this week in Phoenix.

Dr. McAllister-Lucas is an internationally recognized expert in lymphoma whose research has provided new insights into the molecular basis of these types of cancers.

The Cancer MoonShot 2020 Program is a cancer collaborative initiative seeking to accelerate the potential of combination immunotherapy as the next-generation standard of care for cancer patients. This group aims to explore a new paradigm in cancer care by initiating randomized Phase II trials involving 20,000 patients with 20 tumor types within the next 36 months. These findings will inform Phase III trials and the aspirational “moonshot” to develop effective, vaccine-based immunotherapies to combat cancer by 2020.

The newly formed consortium will focus on bringing the promise of immunotherapy to children diagnosed with the disease. The group will seek to apply the most comprehensive diagnostic testing available—whole genomic and proteomic analysis—and leverage proven and promising combination immunotherapies and clinical trials under the QUantitative, Integrative Lifelong Trial (QUILT) Program within the Cancer MoonShot 2020 mission.

“Less than 1 percent of cancers in the United States occur in pediatric patients. And yet, the loss of years and quality of life to pediatric cancer is huge,” said Dr. McAllister-Lucas, also an associate professor of pediatrics at the University of Pittsburgh School of Medicine. “The Cancer MoonShot 2020 will pour resources into research investigating the cause, the diagnosis and the treatment of pediatric cancers. This MoonShot will start a new era of hope for our patients and their families, and will lead the way toward more effective, less toxic treatments, and higher quality, longer lives for children with cancer.”

Dr. McAllister-Lucas is one of 10 members from various academic centers across the United States to be included in the consortium. Other centers include: Ann & Robert H. Lurie Children’s Hospital of Chicago; Children’s Healthcare of Atlanta, Aflac Cancer & Blood Disorders Center; Children’s Hospital of Orange County; Children’s Hospital of Philadelphia; Duke Department of Pediatrics – Duke University School of Medicine; Floating Hospital for Children at Tufts Medical Center; Huntsman Cancer Institute at the University of Utah and Intermountain Primary Children’s Hospital; Phoenix Children’s Hospital; and Sanford Health.

The Division of Pediatric Hematology/Oncology at Children’s provides diagnosis, treatment and follow-up for children, adolescents and young adults with cancer and blood disorders. The division is the largest, most comprehensive pediatric cancer and blood disease center in western Pennsylvania, eastern Ohio and northern West Virginia and has been a member of the Children’s Oncology Group, a multi-institutional pediatric cancer research organization sponsored by the National Cancer Institute, since 1961.

For more information on Dr. McAllister-Lucas, visit www.chp.edu.

Officials Announce New Chair of Pediatrics at Pitt and Scientific Director of Children’s Hospital of Pittsburgh of UPMC

PrintTerence S. Dermody, MD, has been named the new chair of the Department of Pediatrics at the University of Pittsburgh School of Medicine and physician-in-chief and scientific director at Children’s Hospital of Pittsburgh of UPMC.

Dr. Dermody will officially begin on June 1. He joins Children’s Hospital from Vanderbilt University, where he is the Dorothy Overall Wells Professor of Pediatrics, director of the Division of Pediatric Infectious Diseases, and director of the Medical Scientist Training Program at Vanderbilt University School of Medicine. He also is a professor of pathology, microbiology and immunology at Vanderbilt.

“Terry Dermody is a world renowned researcher, compassionate physician, visionary leader and just an all-around first class person,” said Christopher Gessner, president, Children’s Hospital. “We are thrilled that he will be joining our team as we continue to grow our clinical and research programs and make Children’s the place to be for pediatric physicians and physician scientists to launch and build their careers.”

Dr. Dermody is a virologist with interests in viral pathogenesis and vaccine development. He has focused mainly on reovirus, an important experimental model for studies of viral encephalitis in infants, and on chikungunya virus, an arthropod-borne virus that causes epidemics of febrile arthritis.

The work in Dr. Dermody’s lab has encompassed several inter-related themes including the structural basis of viral attachment and cell entry, mechanisms of genome replication and packaging, patterns of cell signaling and gene expression occurring in response to viral infection, mechanisms of virus-induced apoptosis and its significance in the viral life cycle, and the role of viral receptor distribution and utilization in disease pathology. Currently, the lab is developing viral vectors for oncolytic and vaccine applications.

“Dr. Dermody came highly recommended by leaders in our Department of Pediatrics,” noted Arthur S. Levine, M.D., senior vice chancellor for the health sciences and John and Gertrude Petersen Dean of Medicine, University of Pittsburgh. “His academic interests, which included running Vanderbilt’s M.D./Ph.D. training program, are unusually broad. An exceptional physician and scientist, he will be an asset to our faculty, residents and students.”

“I am honored to be able to join the team in Pittsburgh and be a part of this world-class pediatric facility dedicated to improving the lives of children,” said Dr. Dermody. “I am eager to begin and have the opportunity to work with the talented physicians and scientists at Children’s Hospital. I feel honored and humbled to have this opportunity.”

Dr. Dermody succeeds David H. Perlmutter, M.D., who recently left Children’s to become executive vice chancellor for medical affairs and dean of medicine at Washington University in St. Louis.

Dr. Dermody received his bachelor’s degree from Cornell University in 1978, and his medical degree from Columbia University in 1982. He completed an internal medicine residency at Presbyterian Hospital in New York in 1985 and fellowships in infectious diseases and molecular virology at Brigham and Women’s Hospital and Harvard Medical School in 1988.

He has authored or co-authored more than 200 articles, reviews and chapters about his research, which is supported by grants from the National Institutes of Health (NIH) and the Lamb Foundation. He currently holds five NIH grants, and his research has been continually funded by the NIH since 1987.

He has been recognized for his research accomplishments with the Ernest W. Goodpasture Faculty Research Award, the Grant W. Liddle Award for Leadership in the Promotion of Scientific Research, and an NIH MERIT Award. He is a past president of the American Society for Virology, past chair of the AAMC GREAT Group M.D./Ph.D. Section Steering Committee, and current chair of the Virology Division of the International Union of Microbiological Societies.

For more information on Dr. Dermody and Children’s Hospital of Pittsburgh of UPMC, visit www.chp.edu.

- See more at: http://www.chp.edu/news/011116-new-pediatrics-chair#sthash.Wr8mpdQv.dpuf

Children’s Hospital of Pittsburgh of UPMC Gastroenterologist Receives Prestigious Murray Davidson Award

PrintThe American Academy of Pediatrics (AAP) has awarded Robert H. Squires, M.D., director of pediatric hepatology, a program of the Division of Pediatric Gastroenterology, Hepatology, and Nutrition at Children’s Hospital of Pittsburgh of UPMC, its 2015 Murray Davidson Award. The award was presented on Oct. 9 at the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) in Washington, D.C.

The award recognizes an outstanding clinician, educator and scientist who has made significant contributions to the field of pediatric gastroenterology, hepatology and nutrition.

“I am humbled that my colleagues consider me to be deserving of an award that includes my heroes in the field of pediatric gastroenterology, hepatology and nutrition,” said Dr. Squires, also professor of pediatrics at the University of Pittsburgh School of Medicine. “While given to an individual, this very special award is a testament to my fortunate encounters with strong mentors, colleagues and patients; and to my wonderfully supportive and accomplished family.”

Dr. Squires is the principal investigator for the multi-center, multi-national National Institutes of Health-sponsored pediatric acute liver failure study group; the site principal investigator for the Childhood Liver Disease Research Network; and was the principal investigator for the Pediatric Intestinal Failure Consortium.

“Dr. Squires embodies the qualities celebrated by the Murray Davidson Award,” said Mark E. Lowe, M.D., Ph.D., director, pediatric gastroenterology, hepatology and nutrition, Children’s Hospital. “I can’t think of a more deserving awardee. We are fortunate to have him helping care for the children of western Pennsylvania.”

Dr. Squires served as chair of the AAP Section on Gastroenterology, Hepatology and Nutrition and was an executive council member of NASPGHAN. He has published over 70 peer-reviewed articles in major journals, 47 in the past 10 years.

“Dr. Squires is a physician with a stable internal compass that has always directed him to serve the health care needs of children in the broadest sense,” said David Keljo, M.D., Ph.D., director, Inflammatory Bowel Disease Center, Children’s Hospital. “He has consistently worked to ensure the best possible clinical care for children, displaying great character while leading the way. It was a privilege to nominate him.”

The Division of Pediatric Gastroenterology, Hepatology and Nutrition at Children’s is ranked second in the country by U.S. News & World Report’s 2015-16 Best Children’s Hospital specialty ranking for pediatric gastroenterology and GI surgery. The division consists of experts in general clinical pediatric gastroenterology, pediatric hepatology, and a broad range of specialty areas, including abdominal pain, acute and chronic pancreatitis, constipation, diarrhea, eosinophilic disorders, feeding disorders, gastroesophageal reflux and esophagitis, gastrointestinal bleeding, Inflammatory Bowel Disease Center, intestinal failure (short-bowel), irritable bowel syndrome, motility disorders, Liver Clinic, liver diseases and transplantation, metabolic disorders affecting the liver or intestines, poor growth, small bowel transplantation and ulcer disease. The division also provides a full range of diagnostic procedures and treatments related to the gastrointestinal tract, liver and pancreas.

For more information on Dr. Squires and Children’s Hospital of Pittsburgh of UPMC, visit www.chp.edu.

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