December 2004
This edition:
Letter from the Chair
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L. Lyndon Key, MD
Professor and Chairman
Department of Pediatrics |
With great pride and joy, I report to you that the Children's Research Institute will be named after Charles P. Darby Jr., MD. Our campaign raised more than $200,000 (more than $100,000+ from the faculty and $100,000 from anonymous donors). Along with the $31,000 that the faculty gave at the time of the groundbreaking ceremony, we have given a total contribution of more than $231,000. This contribution is something that we can be proud of, and it will pay dividends for years to come. Indeed, there is no better way to attract philanthropy to our department than to demonstrate our commitment to support the mission of our Children's Hospital.
This also marks the completion of Dr. Darby's plan for establishing MUSC's Children's Hospital.
Dr. Darby envisioned:
- A free-standing Children's Hospital that would provide an excellent staff of sub-specialists capable of providing world-class care for the children of South Carolina
- A first-class educational program to train future pediatricians
- A research program that would increase knowledge about pediatrics and standards of treatment for children, while also attracting the best physicians and researchers
Dr. Darby has spent many days away from his family, convincing politicians and donors to support this dream. He has recruited an outstanding faculty and has been instrumental in the establishment of a first rate children's hospital. With the completion of the Children's Research Institute, Dr. Darby's vision has come to fruition with a Children's Hospital of more than 165 beds, an educational program that trains 150 medical students and 46 residents, one of only 15 children's research centers in the nation, and the most comprehensive in the Carolinas.
Today I wish to thank the faculty and staff in the Department of Pediatrics and the Children's Hospital for their dedication to excellence, generosity, and tireless effort to help children in South Carolina and across the nation.
South Carolina is a better place for children to live because of the dedication and vision of Dr. Charles P. Darby. On February 10, we will celebrate the opening of the CRI and honor the career of the man who envisioned this wonderful facility.
This is a time to be proud of what we have accomplished, and to rededicate ourselves to strive for excellence in all that we do to provide the best possible care for children.
Sincerely,
L. Lyndon Key, MD
Chair, Department of Pediatrics
The Man Behind the Vision
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Charles P. Darby, MD
Executive Director
Center for Children's Advocacy |
Charles P. Darby, MD has devoted his entire professional career to improving
the state of pediatric health in South Carolina. He joined MUSC's Department
of Pediatrics in 1962 and provided leadership as chairman of the department for
more than 20 years. He was the driving force behind the opening of the
Children's Hospital in 1987 and has been instrumental in making the
Children's Research Institute a reality. The establishment of both the
Children's Hospital and the CRI was the culmination of 20+ years of
planning, fundraising and constant public education to gain legislative
approval. He has recruited outstanding physicians, scientists and other
health care professionals to staff both facilities and under his leadership
the Children's Hospital and the Department of Pediatrics grew to be
respected throughout the region, state and nation. In his honor and for his
commitment to all the children within the state of South Carolina beyond we
are pleased to announce that the Children's Research Institute will be
formally known as the Charles P. Darby Children's Research Institute.
More about Dr. Darby
News from the Medical Director
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J. Philip Saul, MD
Medical Director
Director, Pediatric Cardiology |
The most important cause of iatrogenic (hospital-acquired) morbidity is infection. This issue is perhaps most pertinent in children's hospitals because it turns out that the smallest premature babies are the most at risk. In fact, by the time most premature babies "graduate" from a neonatal intensive care unit, they may have nearly a 100% chance of having at least one hospital acquired infection. As we all know, the immune system of these developing children is the least equipped to handle such infections, leading to a reliance on the strongest antibiotics, with all their potential side effects. The good news is that working together we can have an impact on this important problem. Our neonatologists and NICU staff have instituted a broad program of infection control, which relies heavily on the cooperation of all the faculty and staff who provide care to these infants.
How can you help? Continue to use strict and correct hand washing or alcohol scrub before and after patient care, no long shirtsleeves without a gown, new gloves for each infant, and familiarization with the guidelines. Let's all continue to take responsibility and help make a difference.
News from the Administrator
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John Sanders, MHA
Administrator
MUSC Children's Hospital |
As we approach the first anniversary of the Children's Emergency Department, many celebrations are in order and excitement for continued expansion is evident. Physicians and families in the Charleston area are finding the Children's ED to be completely dedicated to the needs of their children. During the summer we expanded the hours of the unit to provide 24/7 coverage, with pediatricians making the service constantly available for children in need. Drs. Joseph Dobson and Joseph Losek work with nursing to continually provide quick, effective care.
The volume of patients utilizing this wonderful service has consistently increased and new services are being evaluated. Plans are now being developed to provide a "Fast Track" program to take care of those children that need quick service for minor illnesses, bumps and bruises. Patients will enter the Children's ED and be triaged to the appropriate service. Those who qualify for the Fast Track will move quickly through the system to have their problem assessed, so that they can be on their way. This program will be housed in the same area, but has the ability to move down the hall when the ED becomes crowded. We anticipate being able to open this important service in February. This is just one more step in making sure that our community's children have access to the care that is right for them. Children are different, so are we!
Children's Research Institute News Brief
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Bernard L. Maria, MD, MBA
Executive Director
Children's Research Institute |
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Inderjit Singh, PhD
Scientific Director
Children's Research Institute |
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The Laboratory of Drug Disposition and Pharmacogenetics on the fourth floor of the Children's Research Institute includes a multi-disciplinary and multi-departmental group of investigators from the Department of Psychiatry and Behavioral Sciences and the Department of Pharmaceutical Sciences. The laboratory has three principal investigators, C. Lindsay DeVane, Pharm.D. (Principal Investigator), John S. Markowitz, Pharm.D., and Jennifer L. Donovan, Ph.D.
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C. Lindsay DeVane
Professor
Psychiatry & Behavioral Sciences |
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Jane Charles, MD
Professor
Genetics & Developmental Pediatrics |
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A major research theme being pursued in the laboratory is the role of drug protein transporters in controlling the pharmacologic effects of antipsychotic drugs, the common psychostimulants used to treat attention deficit disorder, and other psychoactive drugs. Additional ongoing projects include pharmacogenetic studies of antidepressants and antiepileptic drugs during pregnancy and studies aimed at understanding the drug interactions and health effects of herbal preparations. Funding for the laboratory is provided by the National Institute of Mental Health, the National Institute of Drug Abuse, the National Center for Complimentary and Alternative Medicine, and the pharmaceutical industry.
Research in the laboratory is exemplified by a current project to study the role of P-glycoprotein (PGP) in regulating the exposure of antipsychotic drugs to the brain, using animal models. PGP is a protein transporter, increasingly recognized as influencing the distribution and elimination from the body of a variety of drugs used to treat disease in both children and adults. Laboratory investigators have used a knock-out mouse model of PGP deficiency to demonstrate this protein's importance in controlling brain access to risperidone, a widely used anti-schizophrenic drug. In addition, they are using molecular biology techniques to discover that a relatively high percentage of the population has a genetic mutation in the PGP gene. This gene codes for a functional deficiency in transporter activity. Such a finding is potentially important for the use of risperidone in children and adolescents.
| "We are very pleased to announce that Dr. Lyndon Key, Chairman of Pediatrics, has been elected to membership in the American Pediatric Society, the oldest academic society in America. This is a distinctive honor and we encourage you to congratulate Lyndon as a new member." |
An increasing body of data from clinical trials is documenting the utility of risperidone for managing the symptoms of autistic spectrum disorder and other neurobehavioral disorders. Unfortunately, there are few guidelines for selecting the optimal dose of risperidone at the outset of treatment. In collaboration with Jane Charles, MD in the division of genetics and developmental pediatrics of the Department of Pediatrics, the laboratory investigators are initiating a new line of research that hopefully will bring the field of pharmacogenetics closer to providing individualized drug treatment of children with common childhood disorders, who are seen and treated at MUSC Children's Hospital. The division of genetics and developmental pediatrics in the Department of Pediatrics provides a top quality program for diagnosing children and young adults with autism spectrum disorders. Multidisciplinary diagnostic clinics provide comprehensive evaluations for persons exhibiting neurobehavioral disorders. Clinics are staffed by one of the five developmental pediatric providers and a clinical psychologist. Tools used in the workup require extensive training and validation procedures. In the past five years, developmental pediatrics has followed nearly 500 children with autism. Once diagnosed, patients are followed closely for developmental progress and psychopharmacological management of common behavior issues.
In summary, the 'bench top to bedside' collaboration emerging between research groups in the Children's Research Institute and health professionals from the Children's Hospital in the field of pharmacogenetics is an outstanding example of the type of synergy that can push the field of research forward. In furthering this research, the lives of children and teens with neurobehavioral disorders, such as autism spectrum disorders, can be improved.
New Mental Health Resource Discussion Group
MUSC is one of 10 institutions with funding to support the development of a resource for physicians managing challenging mental health problems. A monthly discussion group of health professionals meets in room 377 - Rutledge Tower. The group is using Bright Futures: Mental Health as a reference, along with other valuable sources of information including well-researched websites. Drs. Eve Spratt and Michelle Macias co-moderate (Drs. Angie LaRosa and Roxanne Scott also serve as back-up moderators). The creation of this valuable problem-solving resource for pediatricians and pediatric specialists is especially timely because the American Academy of Pediatrics (AAP) has identified mental health issues in primary care pediatrics as a top priority in the coming year.The collaborative office rounds method implemented by this group is an ideal way to disseminate information in an informal setting and that can be customized to the needs/questions of attendants. Upcoming topics for discussion include screening and treatment for substance use disorders, screening for child abuse and neglect, culturally competent care and other areas of interest identified by participants.
The mental health "pearl" for the month is: Psychosocial dysfunction is associated with poor medical and mental health outcomes. One of the most efficient ways to screen for these issues is by use of the free Pediatric Symptom Checklist, which can be completed by a parent in 4 minutes and scored in less than 1 minute.
Please visit psc.partners.org for more details.
Any interested pediatric health care provider is welcome to attend monthly meetings held at 8 a.m. on the third Tuesday of each month. A bonus is that breakfast is provided! For more information, please call Dr. Spratt or Cristol Duke at (843) 876-0504 or e-mail
spratte@musc.edu.
A special thanks to the following individuals for their efforts in putting together Kids Connection each month.
Managing Editor: Bernard L. Maria, MD, MBA
Assistant Editor: Mary Jacobs
Publisher: Jessica Munday (Trio Solutions Inc.)
Web design: Jennifer Cherock (Trio Solutions Inc.) and Brian Dadin (MUSC IT Lab)
Contributing Writers: Lyndon Key, MD; Phil Saul, MD; Bernard Maria, MD; Jane Charles, MD; C Lindsay DeVane, PharmD; Inderjit Singh, PhD and John Sanders
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