News Briefs

Down syndrome indicators in diverse populations

According to a large international study published in the American Journal of Medical Genetics, physical features vary in patients with Down syndrome across diverse populations. The study, led by the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health, used an objective digital facial analysis technology developed by the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Health System to identify the most relevant facial features characteristic in Down syndrome in diverse populations from 12 countries. This study is the first to compare and contrast Down syndrome across diverse populations. It is the first in a series of studies to be used in the NIH’s Atlas of Human Malformation Syndromes in Diverse Populations, a free resource to help clinicians around the world diagnose birth defects and genetic diseases in people of diverse ancestry, and is the first in a series focused on different genetic syndromes.

Read more here.

Link between population health and heart disease

Gerard Martin

Although clinical advances have improved treatments and mortality among patients with cardiovascular disease, heart disease remains the leading cause of death worldwide. Gerard Martin, M.D., cardiologist and medical director of Global Health at Children’s National and Chair of the American College of Cardiology’s Population Health Policy and Promotion Committee shares how cardiologists can improve outcomes by focusing on the link between population health and heart disease in a just-published article in Cardiology.

Read more.

How mindfulness can improve adolescent heart health

Could yoga, meditation, group support, or online video chats improve outcomes for adolescents with cardiac diagnoses? Vicki Freedenberg, Ph.D., R.N., electrophysiology nurse scientist at Children’s National Health System, shared insights from her research using these interventions at the American Heart Association (AHA) Scientific Sessions, held November 12-16 in New Orleans. The AHA Scientific Sessions featured the latest developments in science and cardiovascular clinical practice, including all aspects of basic, clinical, population, and translational science. In her presentation titled “Mindfulness Based Stress Reduction and Group Support Decrease Stress, Anxiety, and Depression in Adolescents with Cardiac Diagnoses: A Randomized Two-Group Study,” Freedenberg presented findings from her study comparing outcomes between cardiac patients who participated in a Mindfulness Based Stress Reduction program, which used meditation, yoga, and group support, and a second group that participated in a clinician-led online video support group with peers. Early results suggest that stress significantly decreased in both groups, and higher baseline anxiety and depression scores predicted lower levels of post-intervention anxiety and depression.

Read more about Children’s National AHA Scientific Sessions speakers.

Advances in 3-D imaging and printing

Laura Olivieri

The emerging field of 3-D printing and 3-D digital displays has the potential to change the way surgeons and cardiologists make decisions. Laura Olivieri, M.D., a cardiologist at Children’s National Health System, shared insights on this topic during the American Heart Association (AHA) Scientific Sessions, held November 12-16 in New Orleans. The AHA Scientific Sessions featured the latest developments in science and cardiovascular clinical practice, including all aspects of basic, clinical, population, and translational science. In her presentation “Cardiovascular Imaging for 3-D,” Dr. Olivieri explained how cardiovascular imaging physicians can “image gently” to create 3-D models while reducing patients’ exposure to radiation and sedation. She also shared best practices for producing 3-D models from magnetic resonance imaging and echocardiograms, which are often underutilized for this purpose.

Read more about Children’s National AHA Scientific Sessions speakers.

Children’s National gastroenterologist honored with Excellence of Healthcare Award

Benny Kerzner, M.D., gastroenterologist and creator of the Division of Gastroenterology, Hepatology, and Nutrition at Children’s National Health System, received the Excellence of Healthcare award from the Crohn’s & Colitis Foundation of America (CFFA) – Greater Washington, D.C. and Virginia Chapters during the organization’s Evening of Hope Gala on November 17, 2016. The award is presented to a medical professional who has positively impacted patient lives and furthered the mission of the CCFA to cure Crohn’s disease and ulcerative colitis and to improve the quality of life of children and adults affected by these diseases.

Postdoctoral researcher receives Urology Care Foundation Research Scholar Award

Evaristus Mbanefo, Ph.D., M.S., M.Sc., a postdoctoral researcher at Children’s National Health System, was awarded the 2017 Urology Care Foundation Research Scholar Award in recognition of his potential for a successful career in urology research. Mbanefo’s project, “Therapeutic Exploitation of Interleukin-4-Inducing Principle from Schistosoma Mansoni Eggs: A Urogenital Parasite-Derived Host Immunomodulatory Protein for Hemorrhagic Cystitis and Bladder Hypersensitivity,” was among 70 applications for the highly competitive annual award. He works in the lab run by Michael H. Hsieh, M.D., Ph.D., Director of the Clinic for Adolescent and Adult Pediatric Onset Urology (CAPITUL) at Children’s National.

Thrasher Research Fund supports Zika virus neurologic outcomes study

The Thrasher Research Fund will fund a Children’s National project, “Neurologic Outcomes of Apparently Normal Newborns From Zika Virus-Positive Pregnancies,” as part of its Early Career Award Program, an initiative designed to support the successful training and mentoring of the next generation of pediatric researchers.

The project was submitted by Sarah B. Mulkey, M.D., Ph.D., a fetal-neonatal neurologist who is a member of the Congenital Zika Virus Program at Children’s National. During the award period, Dr. Mulkey will be mentored by Adre du Plessis, M.B.Ch.B., director of the Fetal Medicine Institute, and Roberta L. DeBiasi, M.D., M.S., chief of the Division of Pediatric Infectious Diseases. Drs. du Plessis and DeBiasi co-direct the multidisciplinary Zika program, one of the nation’s first.

In the award letter, the fund mentioned Children’s institutional support for Dr. Mulkey, as demonstrated by the mentors’ letter of support, as “an important consideration throughout the funding process.”

Doctors working together to find treatments for autoimmune encephalitis

Children’s and Regeneron partner in exome sequencing study

Children’s National, in partnership with the Regeneron Genetics Center (RGC, a subsidiary of Regeneron Pharmaceuticals, Inc.), has announced the launch of a major three-year research study that will examine the links between undiagnosed disease and an individual’s genetic profile.

The program, directed by Children’s National Geneticist Carlos Ferreira Lopez, M.D., and coordinated by Genetic Counselor Lindsay Kehoe, hopes to include as many as 3,000 patients in its initial year and even greater numbers in the following two years.

During the course of the study, RGC will conduct whole exome sequencing (WES) to examine the entire protein-coding DNA in a patient’s genome. Children’s National geneticists will analyze and screen for certain findings that are known to be potentially causative or diagnostic of disease. Children’s National scientists and providers will confirm preliminary research findings in a lab certified for Clinical Laboratory Improvement Amendments (CLIA), per federal standards for clinical testing, and refer any confirmatory CLIA-certified cases to appropriate clinicians at Children’s National for further care.

According to Marshall Summar, M.D., Chief of Genetics and Metabolism at Children’s National, the WES study could finally provide patients and their families with the medical answers they have been looking for, allowing for treatment appropriate to their specific genetic condition.

Because pediatric diseases can often elude diagnosis, they can pose a number of detrimental effects to patients and their families, including treatment delays, multiple time- and cost-intensive tests, and stress from lingering uncertainty regarding the illness. With this genomic data, Regeneron will be able to utilize findings to continue its efforts to improve drug development.

Since its inception in 2014, the RGC has strategically partnered with leading medical institutions to utilize human genetics data to speed the development and discovery of new and improved therapies for patients in need.

Children’s National spin-off ReveraGen announces agreement with actelion for Duchenne Muscular Dystrophy treatment

Earlier this month, ReveraGen BioPharma announced an exclusive option agreement with Actelion Ltd for lead compound vamorolone, a non-hormonal steroid modulator that is primarily used for the treatment of Duchenne Muscular Dystrophy (DMD). ReveraGen, the first Children’s National private spin-off company, is engaged in the discovery and development of proprietary therapeutic products for neuromuscular and inflammatory diseases.

Under the terms of the license agreement, Actelion and ReveraGen will partner to research and co-develop the novel compound vamorolone, which holds the potential to preserve muscle function and prolong ambulation in DMD patients, without some of the side effects that are commonly associated with glucocorticoid therapy. Those commonly associated include growth stunting and immune suppression, which can pose significant challenges for very young patients.

ReveraGen completed Phase I clinical trials for vamorolone in late 2015, and a Phase IIa program is currently underway to investigate the safety and efficiency of vamorolone in male DMD patients between four and seven years of age who have not taken deflazacort or prednisone. A Phase IIb program is also in early planning stages.

ReveraGen Co-Founder and CEO Eric Hoffman, PhD, has worked on DMD since the late 1980’s and has led his own research group for nearly 20 years at Children’s National. He co-founded ReveraGen back in 2008 with John McCall, PhD and Kanneboyina Nagaraju, PhD, DVM, before being named CEO in 2014. Children’s National maintains a 38 percent stake in ReveraGen.

Brain tumor expert from Children’s National speaks at Society for Neuro-Oncology’s scientific meeting and Education Day

Roger Packer

Roger Packer, M.D., Senior Vice President for the Center of Neuroscience and Behavioral Medicine and Director of the Brain Tumor Institute at Children’s National Health System, will be speaking at the 21st Annual Meeting and Education Day of the Society for Neuro-Oncology. From November 17-20, 2016, the conference will gather neuro-oncologists, medical oncologists, adult and pediatric neurosurgeons, pediatric neuro-oncologists, neuroradiologists, neuropathologists, radiation oncologists, neuropsychologists, and epidemiologists from across the country to discuss the future of neuro-oncology. Dr. Packer will be sharing his expertise in treating neurofibromatosis and pediatric brain tumors. He also will be part of a working group to discuss guidelines for response assessment in PDCT-13 medulloblastoma and other leptomeningeal seeding tumors.

2016 Neurobiology of Disease in Children Symposium: neurofibromatosis features Children’s National expert

Roger Packer, M.D., Senior Vice President for the Center of Neuroscience and Behavioral Medicine and Director of the Gilbert Neurofibromatosis Institute at Children’s National Health System, was an invited speaker at the 2016 Neurobiology of Disease in Children Symposium: Neurofibromatosis (NF). This conference brought together experts from around the world to discuss the newest developments in the understanding and treatment of children with NF. While at the conference, which was held on October 26, 2016, Dr. Packer gave an update of the Department of Defense-sponsored Neurofibromatosis Clinical Trial Consortium. The Neurofibromatosis Clinical Trials Consortium, of which Dr. Packer is the group chair, was established by the Department of Defense Neurofibromatosis Research Program to develop and perform clinical trials for the treatment of NF complications in children and adults.

Read more about the symposium.

Brain Tumor Institute Director Speaks at Coalition against Childhood Cancer Meeting

Roger Packer, MD, Senior Vice President for the Center of Neuroscience and Behavioral Medicine and Director of the Brain Tumor Institute at Children’s National Health System, was an invited speaker at the Coalition Against Childhood Cancer meeting at Cold Springs Harbor Laboratory on October 31 and November 1, 2016. This international conference was a unique collaborative effort between multiple foundations, the National Cancer Institute, and industry experts to develop a new path forward for the treatment of childhood cancer. Dr. Packer spoke on “Pediatric Brain Tumors: Where Are We Now” and shared his expertise in treating pediatric brain tumors and what he hopes the future of pediatric brain tumor research will look like. Pediatric brain tumors recently surpassed leukemia as the most deadly form of childhood cancer.

Efficacy of family-centered advanced care planning for adolescents with HIV and their families

Led by experts at Children’s National Health System and the Adolescent Palliative Care Consortium, a new study published in Pediatrics reports that pediatric advanced care planning (pACP) can provide a positive environment for adolescents with Human Immunodeficiency Virus (HIV) and their families to discuss end of life care. Being born with HIV increases an adolescent’s risk of dying from an opportunistic infection or chronic illness, underscoring the need for pACP and the significance of this research.

Read more here.

eKare wins Washington Business Journal 2106 Innovation Award

eKare, Inc., a spin-off company out of the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National, was selected as a Washington Business Journal 2016 Innovation Award honoree for their 3D wound assessment technology.

eKare’s inSight is a cost efficient solution that enables healthcare providers to take accurate and reliable measurements of wounds using a technology that is built on top of an iPad. The co-founder, Kyle Wu, M.D., a former Joseph E. Robert Jr. Fellow, worked with engineers and clinicians from the Sheikh Zayed Institute to develop the technology because he was frustrated with the primitive and subjective nature of standard wound measurement practices, which involve using a disposable ruler to measure the wound length/width and a Q-tip inserted in the wound to determine its depth.

In 2014, eKare spun off from the Sheikh Zayed Institute and, by November 2015, launched its product.

The Washington Business Journal Innovation Awards honor the most innovative people, places, and products in Greater Washington. eKare was one of the 15 honorees in the inaugural Innovation Awards.

McGill honors Children’s director of Developing Brain Research Lab

Catherine Limperopoulos

McGill Publications has awarded Catherine Limperopoulos, Ph.D., director of the Developing Brain Research Laboratory at Children’s National Health System, with a Medicine Alumni Global Award. She is receiving the School of Physical & Occupational Therapy Alumni Award of Merit. This award is given annually.

Children’s National emergency medicine specialists win best abstract

Lenore Jarvis, M.D., an Emergency Medicine Specialist at Children’s National Health System, won Best Abstract in the Section of Emergency Medicine at the American Academy of Pediatrics 2016 National Conference. Monika Goyal, MD, MSCE, also an Emergency Medicine Specialist at Children’s, is senior author of the study.

The abstract, titled Postpartum Depression Screening in a Pediatric ED, explored the topic through an investigation of the prevalence of postpartum depression positive screens, factors associated with them, and the frequency of screenings and the impact they have.

The research findings may help with future efforts to support mothers with infants who use the emergency department.

At AAP: addressing the needs of children living in poverty

Lanre Omojokun Falusi, M.D., F.A.A.P., a pediatrician at Children’s National Health System and Associate Medical Director for Municipal and Regional Affairs at Child Health Advocacy Institute (CHAI), will tell attendees of the American Academy of Pediatrics 2016 National Conference that “poverty really is a public health issue.”

For any child, and particularly children living in poverty, adverse experiences during childhood are linked to health conditions that can linger for much of their adult lives.

While pediatricians are challenged by high case loads, Dr. Falusi believes that there is a place within the doctor visit for a discussion about such social determinants of health. Team-based care provides an opening for such conversations.

In some cases, pediatricians may feel out of their element. “It’s a very natural feeling: The best interventions to alleviate poverty are not the issues that doctors are used to working on,” she says. On the other side of the continuum are clinicians who try to take a lion’s share of the load.  “Many pediatricians trained in hospitals that are very work-focused, and even I still fight the urge of saying ‘I myself need to fix this. It’s my job to make their health better.’ ”

But social workers, who are trained in identifying such resources, and nurses are also integral members of the healthcare team. It would be equally natural for a referral to a food pantry or an application for the Supplemental Nutrition Assistance Program to come from these team members.

It’s a shift in mentality, refocusing on the patient’s broader needs that may impact health, rather than the narrow symptoms caused by those health concerns.

AAP 2016 presentation:
Saturday, October 22, 2016

  • I1161- “Place Matters: Addressing the Needs of Children in Poverty in Rural and Urban Settings” 4 p.m. to 5:30 p.m.

AAP presentations on feeding disorders

Irene Chatoor, M.D., vice chair of the Department of Psychiatry and Behavioral Sciences at Children’s National Health System, specializes in helping children work through their food anxieties and encourages parents to set aside dedicated time for family meals. That’s expertise she will share with peers at the American Academy of Pediatrics 2016 National Conference.

“I also want to help pediatricians to differentiate between toddlers who ‘no-no-NO’ to the few foods they don’t like – which is OK – and children whose food selection is quite limited,” she says. “They need to be aware of red flags, like a child who spits out food, gags, or grimaces in response to certain foods or refuses to eat other foods that may look similar or that have the same texture as the aversive foods.”

Their limited may lead to nutritional problems, and also may have emotional consequences, according to a 2015 article published in Pediatrics for which Dr. Chatoor was senior author.

This makes parents increasingly anxious, and they often try all kinds of distractions to get their child to eat. Dr. Chatoor has described this feeding disorder as infantile anorexia. Interestingly, research has shown that families who eat together at regular times help their children to outgrow their feeding problems.

AAP 2016 presentations:
Saturday, October 22, 2016
• F1069- “Food Refusal: From Picky Eating to Feeding Disorders”
9:30 a.m. to 10:15 a.m.

Sunday, October 23, 2016
• F2012- “Food Refusal: From Picky Eating to Feeding Disorders”
7:30 a.m. to 8:15 a.m.

Urology research team wins best basic science award

Parasites have developed ingenious strategies to change their host’s biology. A research team led by Michael H. Hsieh, M.D., Ph.D., Director of the Clinic for Adolescent and Adult PedIatric OnseT UroLogy (CAPITUL) at Children’s National, turned the tables on the pesky parasites by using their proteins to provide therapeutic benefits. The team’s paper, “Therapeutic Exploitation of IPSE, a Urogenital Parasite-Derived Host Modulatory Protein, for Chemotherapy-Induced Hemorrhagic Cystitis and Bladder Hypersensitivity,” won the “Best Basic Science” award–a coveted national honor–during the Pediatric Urology Fall Congress in September. “Our work represents the first time that a uropathogen-derived host modulatory molecule has been therapeutically exploited in bladder disease models,” Dr. Hsieh and co-authors write.

Denice Cora-Bramble among the Washington Business Journal Women Who Mean Business

Denice Cora-Bramble, M.D., M.B.A., Chief Medical Officer and Executive Vice President of Ambulatory and Community Health Services at Children’s National Health System, was named to the 2016 list of Women Who Mean Business by the Washington Business Journal. Dr. Cora-Bramble was among a select group of Washington, DC, metropolitan area women who were honored Oct. 13 for having made a significant impact on their community, using their leadership skills and professional accomplishments to break down barriers.

At Children’s National, Dr. Cora-Bramble oversees all regional ambulatory clinical operations including seven pediatric subspecialty regional outpatient centers, two emergency departments, six general pediatrics health centers, 12 pediatric practices, three mobile medical units, as well as nursing services in DC Public Schools and Public Charter Schools. She also has direct responsibility for the Children’s Health Network, which includes more than 1,400 providers in the mid-Atlantic region.

“I am honored to work along-side Dr. Cora-Bramble on a daily basis, and it comes as no surprise to me that she’s being recognized as one of the Washington Business Journal’s Women Who Mean Business. As one of our two Chief Medical Officers, Dr. Cora-Bramble is a crucial component of this organization, and I am so proud to see her honored for her leadership and commitment to our patients,” said Kurt Newman, M.D., President and CEO of Children’s National.

Dr. Cora-Bramble has worked at Children’s National for 14 years in various roles, including overseeing the Diana L and Steven A. Goldberg Center for Community Pediatric Health before she took on the role of Chief Medical Officer of Ambulatory and Community Health Services in 2013. She is a Professor of Pediatrics at the George Washington University School of Medicine and Health Sciences and a Diplomate of the American Board of Pediatrics.

Dr. Cora-Bramble completed her medical and pediatric residency training at Howard University and a Master in Business Administration with a concentration in Medical Services Management from Johns Hopkins University. She has held several leadership positions at the George Washington University Medical Center and the U.S. Department of Health and Human Services.