DOCTOR’S DIGEST A MONTHLY NEWSLETTER FOR ST. LOUIS CHILDREN’S HOSPITAL ATTENDING AND REFERRING MEDICAL STAFFS

AUG/SEPT 2016 ________________________________________________________________

IN THIS ISSUE

3

Pearson Appointed Medical Director, Pediatric Neurology Cerebral Palsy Center

4

SLCH Receives Awards for Patient Satisfaction

5

SLCH Mourns Passing of Jessie L. Ternberg, MD

7

SLCH Physicians Named to “Best Doctors in St. Louis” List

| MAGNETIC GROW RODS FOR SCOLIOSIS TREATMENT REDUCE SURGERIES

[CLINICAL FOCUS]

A standard treatment of care for severe, progressive scoliosis involves surgery to implant adjustable metal rods that brace the spine in order to minimize curvature during growth. Although effective, the rods need to be surgically lengthened or distracted at regular intervals—about every six months—as patients grow and reach skeletal maturity. When the rods are removed, a child could have undergone 10 or more surgeries to adjust the rod length. For the past two years, Scott Luhmann, MD, Washington University pediatric orthopedic surgeon at St. Louis Children’s Hospital, has offered to eligible patients the MAGEC® Spinal Bracing and Distraction System, which provides a less invasive option for distracting grow rods. “These grow rods are implanted the same way as conventional rods—anchoring them above and below the curvature—but the MAGEC rods contain a small internal magnet,” explains Dr. Luhmann. “When the rods need to be lengthened, it’s a simple matter of placing an external remote control over the patient’s spine to activate the magnet and adjust the rods. This is done in the orthopedic surgery clinic without anesthetic and with no pain for the patient.” The Food and Drug Administration approved the MAGEC rods for use in children 10 years old or younger with progressive curvatures of 50 degrees or more. Over the past year, Dr. Luhmann has become the national leader in the use of MAGEC rods, with 26 of his patients now benefiting from them. “I’ve found my outcomes with the MAGEC rods to be comparable to those I achieved using standard grow rods,” says Dr. Luhmann. “My ability to lengthen the rods more frequently certainly contributes to successful outcomes.”

can break and need surgical replacement; in some cases, a longer MAGEC rod may need to be implanted as patients grow. In either case, patients still benefit from not having to undergo multiple surgeries for the sole purpose of lengthening the rods. “Once patients reach skeletal maturity, the grow rods—either conventional or MAGEC— are removed. Most then undergo a definitive spinal fusion, which can further improve alignment and appearance,” says Dr. Luhmann. “We’ve made significant progress in our ability to normalize spinal alignment for our patients with severe scoliosis. The MAGEC rods make it a much less uncomfortable process.” To learn more about the MAGEC system or to refer a patient, call Children’s Direct at 800.678.HELP (4357), or contact Dr. Luhmann at luhmanns@ wudosis.wustl.edu.

As with conventional rods, the MAGEC rods

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SHARE YOUR IDEAS

Should you have ideas or suggestions you would like brought before the Children’s Medical Executive Committee (CMEC), contact one of your CMEC private physician representatives: John Galgani, MD [email protected] Karla Keaney, MD [email protected] Jennifer Arter, MD [email protected] John Cole, MD [email protected] Kevin Murphy, MD [email protected]

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LET US HEAR FROM YOU

If you have comments or suggestions regarding Doctor’s Digest, or if you would like to share information about your activities as a physician, contact: Jennifer Pickett Marketing and Communications St. Louis Children’s Hospital 4901 Forest Park Avenue Suite 1022 St. Louis, MO 63108 Mailstop 90.75.560 314.286.0376 fax: 314.747.8644 [email protected]

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DOCTOR’S DIGEST Published for the attending and referring medical staffs of St. Louis Children’s Hospital. Joan Magruder President Kimberly Quayle, MD Medical Staff President John Galgani, MD Medical Staff President-Elect

MAGNETIC GROW RODS FOR SCOLIOSIS continued from page 1 PATIENT PROFILE: STANDING TALL As Loewy Noud stood next to her hospital bed for the first time after undergoing surgery to correct scoliosis, her mother was amazed. Loewy was at least two inches taller. “I remember looking at her and saying ‘wow!” recalls Loewy’s mother, Carol Noud. “I could tell she was taller immediately.” Loewy, (pictured at right) an active 15-year-old from Glen Carbon, Ill., was diagnosed with adolescent idiopathic scoliosis when she was 12 years old. “I actually didn’t know my spine was curved until I had a sledding accident in 2013,” she says. “I was tubing downhill, hit a ramp and was launched about four feet up into the air. When I landed, I smacked my tailbone really hard.” Worried about a possible fracture, Loewy’s mother took her to an urgent care center. What the doctor saw on an x-ray, however, wasn’t a fractured tailbone. It was the backward “C” shape to Loewy’s spine, a characteristic of scoliosis. “She never had a scoliosis check in school and she didn’t have any pain previously, so it was surprising to hear that she had a significant spinal curve,” says Loewy’s mother. Loewy was soon referred to Scott Luhmann, MD, a Washington University pediatric orthopedic surgeon at St. Louis Children’s Hospital who sees hundreds of children each year with spinal abnormalities. In adolescents, scoliosis can affect as many as four in every 100 teens, making it one of the most common spinal deformities diagnosed in children. “Dr. Luhmann not only confirmed that I had scoliosis, he also noticed a difference in my shoulder height and said I had a slight hump in my back,” Loewy says. “Because I wasn’t finished growing yet, he said to wait and see what happened to my spine as I got older.” Over the next six months, Loewy’s spine bent further, changing slowly from a “C” shape into an “S” shape, with two significant curves. Dr. Luhmann first discussed using a custom back brace to prevent further progression of the scoliosis, but because one of Loewy’s curves impacted the upper regions of the thoracic spine, bracing wasn’t optimal. By fall of 2014, with one of the curves approaching 50-degrees, Dr. Luhmann recommended surgery and sent Loewy for physical therapy to strengthen her core and back in

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preparation for a spinal fusion. Because Loewy also wanted no interruptions in her school schedule, surgery took place the following summer, in June 2015. During the four-hour procedure, called a posterior spinal fusion with segmental spinal instrumentation, Dr. Luhmann gently straightened Loewy’s spine and inserted two 12” cobalt chrome rods and 15 screws to hold the rods in place. By the next morning, Loewy was up and walking in her hospital room. “Well, I’m not going to sugar coat it and say it was easy, but Dr. Luhmann told me every patient always wishes they got up as early as they could,” says Loewy. “I would sit for 20 minutes and walk twice a day until I could walk around the nurses’ station and go up some stairs. My mom also had to learn how to keep my spine straight, roll me to one side, and get me out of bed.” “It was definitely a challenging recovery,” admits Carol. “I had to help her sit in a chair, get to the bathroom and bathe. It took us about two weeks before we both said we got this.” Loewy couldn’t take physical education classes for a year and was restricted from lifting heavy items for months. She also couldn’t run or jump around. When she was finally cleared to resume activities, she was thrilled. “I play tennis for my high school, swim, ride bikes and even run now,” she says with a smile. “And I’m 5’9” tall. Before my surgery, I was 5’7”. “I can’t say enough good things about Dr. Luhmann and his team,” adds Carol. “I always felt they were thinking both as a parent and as a kid whenever they talked to Loewy and me. We had some tough days because it was such an extensive surgery, but it was all worth it.”





[FACULTY UPDATE]

PALSY CENTER

| PEARSON APPOINTED MEDICAL DIRECTOR, PEDIATRIC NEUROLOGY CEREBRAL

The department of neurology, division of pediatric neurology, together with St. Louis Children’s Hospital, recently announced the appointment of Toni Pearson, MD, as medical director of the Cerebral Palsy (CP) Center.

American Academy of Neurology Foundation clinical research training fellowship in 2009 to study mechanisms of motor learning and recovery in children.

“Dr. Pearson is a highly skilled pediatric neurologist with specialty training in pediatric movement disorders, including cerebral palsy and dystonia,” says Bradley Schlaggar, MD, PhD, division director for pediatric neurology. “She is committed to understanding and improving the care for children with these disorders.” Originally from Australia, Dr. Pearson began her studies at the University of Sydney and continued her medical education and training at Montreal Children’s Hospital. She completed a fellowship in movement disorders at Columbia University. Most recently she served as pediatric neurologist and assistant professor of neurology and pediatrics at Icahn School of Medicine Mount Sinai in New York City.

Toni Pearson, MD

He notes that the pediatric neurology division’s mission continues to focus on providing top-quality care for children with cerebral palsy and other movement disorders and to provide support, education and appropriate services for their parents, family and caregivers. To make a referral to Dr. Pearson or learn more about the CP Center, contact Children’s Direct, 800.678.HELP (4357).

In addition to direct patient care, Dr. Pearson has overseen multiple research studies on pediatric movement disorders and authored numerous articles related to her research. She was awarded an

[FACULTY UPDATE]

“Our CP team is excited to welcome Dr. Pearson and move forward under her leadership. She shares our philosophy of recognizing that each child is unique and deserves the best care available to enjoy a happy and healthy life,” says Dr. Schlaggar.

| ODOM RECEIVES PRESTIGIOUS AWARD TO FURTHER MALARIA RESEARCH

Support from Burroughs Wellcome Fund will boost research into the disease Originally published by Washington University School of Medicine Audrey R. Odom, MD, PhD, has received a five-year, $500,000 award from the Burroughs Wellcome Fund to further her research into malaria. Dr. Odom is an infectious diseases physician at St. Louis Children’s Hospital (SLCH) and an associate professor of pediatrics and of molecular microbiology at Washington University School of Medicine (WUSM). The nonprofit organization selected Dr. Odom as one of 10 recipients of the 2016 Investigators in the Pathogenesis of Infectious Diseases Award. The Burroughs Wellcome Fund, which supports biomedical science through research and education, noted the funding honors “the scientific excellence and innovation of the proposal, the strength of the scholarly environment at the institution, and the accomplishments of Audrey as an independent researcher.” Gary A. Silverman, MD, PhD, the Harriet B. Spoehrer Professor and head of the Department of Pediatrics and pediatrician-in-chief at SLCH, called Dr. Odom one of the university’s finest young investigators. “She has a stellar global reputation for her malaria research,” he said. “This award is a testament to her outstanding scientific accomplishments and future studies on this very important world health problem.” In 2015, malaria globally affected 214 million people worldwide and caused 438,000 deaths, according to the World Health Organization. It is most prevalent in younger children in Africa. Dr. Odom’s research lab focuses on the chemical ecology of malaria

parasites, with the goal of developing diagnostic tools and new treatments. Dr. Odom and her colleagues are developing a device that would detect malaria with a simple, inexpensive breath test, similar to a breathalyzer used to measure blood alcohol content. “This award will allow us to move forward in our work to understand why malaria parasites make Audrey R. Odom, MD, PhD volatile compounds,” said Dr. Odom, who discussed the research late last year during a TED Talk in Kansas City, Mo. “It gives us the freedom to explore our ‘high risk-high reward’ research, meaning the studies aren’t meant to make incremental advances, but rather to have the potential for opening up new fields.” She added, “These studies are otherwise difficult to fund since they necessarily have a higher failure rate. But they have a great potential to be transformative.” To learn more about Dr. Odom, visit StLouisChildrens.org/DD.

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[CONTINUING EDUCATION]

| EARLY BIRD ROUNDS CONTINUE AS CONVENIENT SOURCE OF CME CREDITS

Conferences offer pediatric-focused knowledge, multiple CME credits St. Louis Children’s Hospital’s Early Bird Rounds began again in September, and it’s a good time to remember the presentations earn participants one hour of continuing medical education (CME). In recent years, this has become easier with CMEasy, through which the recorded Early Bird Rounds presentations may be viewed online at times convenient for physicians. The presentations cover a range of important pediatric topics; last year’s talks addressed such subjects as adolescent substance abuse, sports-related concussions, and management of pediatric pain and depression in adolescents. The CMEasy presentations include pre-test, post-test and evaluation sections.

In addition, community physicians may take advantage of several annual and semi-annual conferences throughout the year that provide them with in-depth updates while earning multiple CME credits.

“The Early Bird Rounds presentations are a valuable resource for physicians who want to keep abreast of the latest advances in diagnosing and treating pediatric-related illnesses and disorders,” says Ellyn Rosenblum, manager of physician services/telehealth.

For details about other programs and CME opportunities, go to StLouisChildrens.org/Med_Ed.

THE 2015-2016 EARLY BIRD ROUNDS PRESENTERS

“Early Bird Rounds are an integral part of the educational and training experience at St. Louis Children’s Hospital,” says Ellyn Rosenblum, manager of physician services/ telehealth. “We are grateful to our attending physicians for their exceptional efforts in developing informative, interesting presentations throughout the year.” Presenters for 2015-2016: Philip Abraham, MD, Hospitalist Medicine Shafkat Anwar, MD, Cardiology Kevin Baszis, MD, Rheumatology Avi Beigelman, MD, Allergy, Immunology and Pulmonary Medicine Kathleen Berchelmann, MD, Hospitalist Medicine Candice Burns, MD, Critical Care Medicine John Constantino, MD, Psychiatry

[SLCH NEWS]

“This is a great opportunity for physicians to advance their knowledge with presentations conducted by nationally recognized leaders in their subspecialties.”

“For example, we conduct spring and fall clinical pediatric updates and annual psychiatry and coding conferences,” says Linda Menard, program coordinator in physician services. “Physicians may learn and network with their peers while earning seven to eight CME credits.”

Douglas Coplen, MD, Urology Susan Culican, MD, PhD, Ophthalmology Pirooz Eghtesady, MD, Cardiothoracic Surgery Michele Estabrook, MD, Infectious Diseases Eric Eutsler, MD, Radiology Paul Glaser, MD, PhD, Psychiatry Andrea Granados, MD, Endocrinology and Diabetes Carmen Halabi, MD, Nephrology Mark Halstead, MD, Pediatric Orthopedics and Sports Medicine Christina Hickey, MD, Gastroenterology, Hepatology and Nutrition Keiko Hirose, MD, Pediatric Otolaryngology/ Head & Neck Surgery; Craig Buchman, MD, Otolaryngology; Jamie Cadieux, Audiology; Drea Gregg, SLP Dee Hodge III, MD, Emergency Medicine Rochelle Holtzman, PhD, Clinical Pediatrics

David Hunstad, MD, Infectious Diseases Martin Keller, MD, Trauma Services James Kemp, MD, Allergy, Immunology and Pulmonary Medicine; and Maithilee Menezes, MD, Otolaryngology Sarah Mermelstein, MD, Adolescent Medicine Diane Merritt, MD, Gynecology Peter Michelson, MD, Allergy, Immunology and Pulmonary Medicine Jessica Muse, MD, Hospitalist Medicine Jeff Nepple, MD, Pediatric Orthopedics and Sports Medicine Shalani Shenoy, MD, Hematology and Oncology Janis Stoll, MD, Gastroenterology, Hepatology and Nutrition Zachary Vesoulis, MD, Newborn Medicine Adam Vogel, MD, Surgery Michael Wong, MD, PhD, Neurology

| SLCH RECEIVES AWARDS FOR PATIENT SATISFACTION

St. Louis Children’s Hospital (SLCH) received 15 awards for achievement of excellence in patient satisfaction from Professional Research Consultants (PRC). The company measures patient satisfaction for health systems, including BJC. The winners were: Awards of Distinction: Overall Quality of Care to St. Louis Children’s Hospital Specialty Care Center and SLCH Emergency Unit These awards recognize health care facilities that score at or above the 100th percentile for the Overall Quality of Care percent

“Excellent” score in PRC’s national client database for the prior calendar year. Top Performer to St. Louis Children’s Hospital Specialty Care Center Outpatient Surgery Services This award is for outpatient services lines, inpatient units and outpatient clinics that score at or above the 100th percentile for the Overall Quality of Care percent “Excellent” score in PRC’s national client database for the prior calendar year.

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[FACULTY UPDATE ]

| SLCH MOURNS PASSING OF JESSIE L. TERNBERG, MD

The first female surgical resident at Barnes-Jewish Hospital, Dr. Ternberg served for decades at the School of Medicine and St. Louis Children’s Hospital. By Elizabethe Holland-Durando / Washington University School of Medicine In 1954, when Jessie L. Ternberg, MD, PhD, became the first female surgical resident at what was then Barnes Hospital in St. Louis, the young physician-scientist was not given a warm welcome by her new, male colleagues. Undaunted, Dr. Ternberg’s pioneering step became the first of several, as she eventually was embraced not only as an extremely talented surgeon but an excellent leader, role model and mentor. She served on the Washington University School of Medicine (WUSM) faculty for 37 years, first as a general surgeon and later as the director of pediatric surgery at St. Louis Children’s Hospital (SLCH).

“She had a wonderful life, and it was a life she made for herself— Jessie L. Ternberg, MD, PhD nobody gave it to her,” said Chancellor Emeritus William H. Danforth, MD. “She had enormous determination and focus and courage, and she was unflappable and put up with things that other people didn’t have to. She never gave up, she never slowed down. She just kept going and was an absolutely wonderful surgeon and a wonderful physician who was greatly admired by everybody. I was very lucky to know her.”

A professor emerita of surgery and pediatric surgery, Dr. Ternberg died July 9, 2016, of natural causes while on vacation in Zermatt, Switzerland. Zermatt was one of her favorite places, according to her longtime friend and travel companion, Mabel Purkerson, MD, also a School of Medicine professor emerita. Dr. Ternberg, of Creve Coeur, was 92. Dr. Ternberg paved the way for many women in medicine. During her internship at Boston City Hospital, Dr. Ternberg—a 1953 graduate of WUSM—decided she wanted to be a surgeon. When she couldn’t find a surgical residency program that would consider an application from a woman, she wrote to Carl Moyer, MD, the head of surgery at Washington University. “I told him I thought it was a bum rap they wouldn’t take women,” Dr. Ternberg recalled in a 2002 interview published in Washington Magazine. “He agreed— and he accepted me.”

During Dr. Ternberg’s tenure at the School of Medicine and SLCH, she routinely performed more than 500 operations a year. In addition, she led a surgical team in successfully separating two sets of conjoined twins, connected at the pelvis, a very rare condition. Colleagues described her surgeries as “works of art.”

There were still many obstacles to overcome, though, from where she would live—residents lived at the hospital, and no one had ever had to make room for a woman before—to how and where she would prepare for surgery. “She had to be twice as good and twice as smart as everybody else to survive, and she was,” said Timothy J. Eberlein, MD, head of the Department of Surgery, director of Siteman Cancer Center and a longtime friend of Dr. Ternberg. “She had a fierce determination, and that’s probably how she overcame all those obstacles over the years. She was like that to the end.” In 1958, she became the first female chief resident at Barnes, and

in 1959, she became an instructor in surgery at the School of Medicine. Promoted to professor of surgery in 1971, she was instrumental in establishing the Division of Pediatric Surgery and was named its director in 1972. The next year, she became the first woman to be elected head of the School of Medicine’s faculty council.

“Jessie was the go-to person,” said Dr. Eberlein, who is also the Bixby Professor of Surgery. “If you had a child with a tough problem—and it didn’t necessarily have to be a surgical problem—Jessie was the person you consulted. Everybody regarded her with a kind of awe. She was a remarkable individual.” She is survived by a multitude of friends and by her nieces and nephews. A memorial service was held September 25 in St. Louis. Memorial contributions may be made to the Jessie L. Ternberg, PhD, MD, Scholarship Fund, Attn. Helen Z. Liu; 7425 Forsyth Blvd., Suite 2100; St. Louis, Mo. 63105. Contributions also may be made to Opera Theatre of Saint Louis, Attn. Nicole Ambos, 210 Hazel Ave., St. Louis, Mo. 63119; or to the Missouri Botanical Garden. To learn more about Dr. Ternberg’s distinguished background, visit StLouisChildrensHospital/DD.

PATIENT SATISFACTION continued from page 4 5-Star Award Winners St. Louis Children’s Hospital Specialty Care Center • Outpatient Therapy Services • Outpatient Oncology Services • Outpatient laboratory Services • Outpatient Radiology Services • Outpatient Therapy Services

St. Louis Children’s Hospital • Outpatient Surgery Services • Outpatient Pediatric Services • Outpatient Behavioral Health Services • Outpatient Radiology Services • Outpatient Surgery Services • Outpatient Services

Awards are for health care facilities, providers, outpatient service lines and inpatient units that score in the top 10 percent (at or above the 90th percentile) in PRC’s national client database for the prior calendar year. These awards are based in the percentage of patients who answer “excellent” for the Overall Quality of Care question.

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[CASE STUDY ]

| SLOBBER

The following case study was used by Andrew J. White, MD, the James P. Keating, MD Professor of Pediatrics and division director of pediatric rheumatology, Washington University School of Medicine, and director of the St. Louis Children’s Pediatric Residency Program, as part of the “Patient of the Week” (POW) series. Many of the POW case studies cover uncommon illnesses, or common illnesses with unusual presentations. If you would like to be added to the POW email distribution, send an email to [email protected]. CC: Rash HPI: 3-month-old boy with two weeks of a worsening rash. It started around his mouth, and mom thought it was irritation from the “slobber” from his pacifier. It started to spread and a new “raspiness” to his cry prompted a visit to an urgent care center, where he was diagnosed with impetigo and started on an oral antibiotic and topical mupirocin. He had been afebrile, maintaining good PO, no URI symptoms, no respiratory distress, no vomiting/diarrhea. The rash did not improve, so he was brought to the ED.

Investigations: 1. Alkaline phosphatase level (this zinc-dependent enzyme is low in zinc deficiency and returns quickly from the lab) 2. Zinc level 3. Biotin level

He has been breastfeeding well since birth, although he is small (25 percent).

4. Sweat chloride

ROS: No hair loss, no diarrhea or vomiting.

Results:

FH: No similar rashes in siblings.

1. Alk Phos was low (AlkPhos 60 Units/ml . . . normal range is 110 - 320 Units/ml)

Exam: General – alert, active, healthy-appearing African-American male infant. T-37.2, RR 38, HR 110, normocephalic head shape. Anterior fontanelle was soft and flat. Hair distribution normal. Areas of skin breakdown and scaling in the scalp over the occipital region. The pupils were equal and round. Extraocular muscles intact. Nose and mouth were normal. He had no dentition. Palate was intact and normally shaped. Ears were normally formed. However, the skin of the face showed a rash around the mouth with a denuded area surrounded by crusty, dark-black scaling. He also had rash on his ears and around his eyes, as well as on his chin and upper neck. Chest shape was normal. Lungs were clear. He had a regular heart rate and rhythm with no murmur. His abdomen was rounded and soft with no organomegaly. GU was circumcised male with testes descended bilaterally. He had a rash in the diaper area. The limbs were normally formed. He had rash involving the elbows of both arms and a couple of patches of involvement on the skin of his fingers. The lower extremities were spared from rash. Neurological examination was unremarkable. Diagnostic considerations: 1. Zinc deficiency a. congenital, aka Acrodermatitis enteropathica, aka Danbolt-Closs syndrome, aka Brandt’s syndrome b. acquired (malabsorption [CF, celiac], inadequate intake) 2. Biotin deficiency (also has a classic perioral rash) 3. SSSS (lack of a more disseminated rash makes staph toxin mediated disease less likely)

5. Sequencing of the SLC39A4 gene

2. Zinc was low (Zinc = 0.18 mcg/ml . . . normal range is 0.6 – 1.2 mcg/ml) 3. SLC39A4 is pending Treatment: 1. Zinc sulfate (or gluconate, which is often better tolerated), 3 mg/kg per day Comment: Acrodermatitis enteropathica is the clinical syndrome of zinc deficiency (rash, diarrhea, alopecia and poor weight gain) caused by defects in the SLC39A4 gene (autosomal recessive), although the term is often applied to dietary zinc deficiency as well. The skin findings are typically present around the mouth, in the perianal area and in an acral distribution (hence the term) and can be confused with diaper rash or eczema. Dietary causes are typically due to malabsorption syndromes such as cystic fibrosis, and have even been reported in several cases of celiac disease. Treatment is supplementation with zinc, which makes sense for the acquired forms, but also works (for unclear reasons) for the congenital form. Recall that the SLC39A4 gene encodes a transmembrane protein that functions as a zinc transporter and allows the absorption of zinc from the GI tract. Clearly, however, oral zinc supplementation is able to overcome the defective transporter and correct the deficiency. Zinc is better absorbed from breast milk than from formula, affecting the age of presentation (bottle fed infants present earlier in life than breastfed infants). Zinc is present in meat and shellfish, but not in most plant products, leading some to estimate that nearly 2 billion people suffer from zinc deficiency worldwide.

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[SLCH NEWS]

SLCH PHYSICIANS NAMED TO “BEST DOCTORS IN ST. LOUIS” LIST

In August, St. Louis Magazine published its annual “Best Doctors” list for the metropolitan area. As in years past, St. Louis Children’s Hospital physicians are well represented. Best Doctors, Inc., a company founded more than 25 years ago by doctors affiliated with Harvard Medical School, generates the list. The methodology used by the Best Doctors’ team of researchers mimics the informal peer-to-peer process doctors themselves use to identify the right specialists for their patients. The organization Adolescent Medicine Sarah Garwood, MD Kate Plax, MD Allergy, Immunology & Pulmonology Leonard B. Bacharier, MD Albert Faro, MD Thomas Ferkol, MD James S. Kemp, MD Peter Michelson, MD Stuart Sweet, MD, PhD Anesthesiology Tom E. Cox, MD James Fehr, MD David J. Murray, MD Cardiology David T. Balzer, MD Charles C. Canter, MD R. Mark Grady, MD Mark C. Johnson, MD Caroline Lee, MD Gautam Singh, MD George F. Van Hare, III, MD Cardiothoracic Surgery Peter Manning, MD Pirooz Eghtesady, MD, PhD Critical Care Allan Doctor, MD Avihu Gazit, MD Matthew Goldsmith, MD Mary Hartman, MD Jose Pineda, MD Philip C. Spinella, MD

Gastroenterology Lori R. Holtz, MD Shannon M. Joerger, MD Robert Rothbaum, MD David Rudnick, MD Charles Samson, MD Janis M. Stoll, MD Phillip Tarr, MD Yumirle Turmelle, MD Elizabeth Utterson, MD Alexander Weyman, MD Genetics D. Kathy Grange, MD Gynecology Diane F. Merritt, MD Laura Parks, MD Valerie Ratts, MD Hematology/Oncology Frederick S. Huang, MD Monica L. Hulbert, MD David Wilson, MD, PhD Hospitalist Medicine Kim Hamlin, MD Michael Turmelle, MD Infectious Disease David Hunstad, MD Rachel C. Orscheln, MD Gregory A. Storch, MD

contacts physicians in the St. Louis region who have been included on a previous Best Doctors list and asks to whom they would refer a loved one in their particular specialty. After verifying licensing and certification requirements and any disqualifying disciplinary actions, physicians are added to the annual list. Only 5 percent of physicians practicing in the United States earn this honor, decided by impartial peer reviews.

Newborn Medicine F. Sessions Cole, MD Jeffrey G. Dawson, MD Brian P. Hackett, MD, PhD Sherrie M. Hauft, MD Anna S. Lijowska, MD Amit M. Mathur, MD Joan L. Rosenbaum, MD Barbara Warner, MD Nuclear Medicine Farrokh Dehdashti, MD Henry D. Royal, MD Akash Sharma, MD Barry Siegel, MD Ophthalmology Susan M. Culican, MD Gregg T. Lueder, MD Lawrence Tychsen, MD Orthopedic Surgery Keith H. Bridwell, MD Ryan Calfee, MD Richard H. Gelberman, MD Charles A. Goldfarb, MD J. Eric Gordon, MD Mark Halstead, MD Devyani Hunt, MD Scott J. Luhmann, MD Matthew J. Matava, MD Douglas McDonald, MD Perry L. Schoenecker, MD

Nephrology Anne Beck, MD Otolaryngology Vikas Dharnidharka, MD,MPH Richard A. Chole, MD Paul Hmiel, MD, PhD Keiko Hirose, MD Keith A. Hruska, MD David W. Molter, MD Dermatology Neurological Surgery Allison Ogden, MD Susan J. Bayliss, MD Ralph G. Dacey, Jr., MD Pathology Emergency Medicine David D. Limbrick, MD Louis P. Dehner, MD Doug Char, MD Matthew D. Smyth, MD Plastic Surgery Dee Hodge III, MD Neurology Susan E. Mackinnon, MD Robert M. Kennedy, MD Mary E. Bertrand, MD Thomas H. Tung, MD Endocrinology & Metabolism Anne M. Connolly, MD Psychiatry Ana Marie Arbelaez, MD Christina Gurnett, MD Robert Brady, MD Abby Hollander, MD Soe S. Mar, MD John N. Constantino, MD Paul W. Hruz, MD, PhD Michael J. Noetzel, MD Anne L. Glowinski, MD Bess Marshall, MD Alan Pestronk, MD Joan L. Luby, MD Neil White, MD K. Liu Lin Thio, MD, PhD Ginger Nicol, MD Michael Wong, MD, PhD T. Eric Spiegel, MD Kelvin A. Yamada, MD John M. Zempel, MD, PhD

Radiation Oncology Jeff M. Michalski, MD Radiology Thomas E. Herman, MD Geetika Khanna, MD Robert McKinstry, III, MD Marilyn J. Siegel, MD Surgery Kathryn Q. Bernabe, MD Patrick A. Dillon, MD Maria B. Doyle, MD Martin Keller, MD Jacqueline Saito, MD Adam M. Vogel, MD Brad W. Warner, MD Urology Paul F. Austin, MD Douglas E. Coplen, MD Community Pediatricians/ Subspecialists Susan Elizabeth Adams, MD Ardis Allison, DO Patricia J. Amato, MD Jennifer L. Arter, MD Jean E. Birmingham, MD Trina J. Blythe, MD Lorena Buffa, MD Darryl S. Cohen, MD David J. Callahan, MD Susan C. Conger, MD John Davis, MD Ray S. Davis, MD Jane Elizabeth DeFalco, MD Gerry L. Deschamps, MD Alla Dorfman, MD Charles Dougherty, MD Matthew P. Dougherty, MD Jennifer Dunn, MD Adam C. Eaton, MD Jay Epstein, MD Gregory K. Finn, MD Edward Fliesher, MD Joel Goebel, MD Joseph Goldenberg, MD Laquita A. Graham, MD David Hartenbach, MD Laura K. Hartman, MD Jacqueline Harvey, MD

Nicholas A. Holekamp, MD Angela Jones, MD Joel Koenig, MD Denise H. Kung, MD Richard L. Lazaroff, MD Kenneth C. Levy, MD John Madden, MD Julia Mayer, MD Kimberli E. McCallum, MD Maggie McCormick, MD Thomas C. McKinney, Jr.,MD Margaret M. Mueller, MD Alison C. Nash, MD Karen K. Norton, MD Jerome O’Neil, MD Allison H. Oswald, MD Jennifer A. Panasci, MD Daniel Plax, MD Santiago Bo Plurad, MD Juanita Polito-Colvin, MD Peter Putnam, MD George Rezabek, MD James R. Rohrbaugh, MD Isabel L. Rosenbloom, MD Christina Ruby-Ziegler, MD Martin D. Rudloff, MD Joseph Schachter, MD Margaret Ann Schmandt, MD Connie D. Simmons, MD Paul S. Simons, MD Alan J. Skoultchi, MD Joshua Smith, MD Robert D. Spewak, MD Randall S. Sterkel, MD Rosa Suarez-Solar, MD Elizabeth Sugarbaker, MD Kristen A. Terrill, MD Stanley E. Thawley, MD Donna T. Thackrey, MD Hayley M. Wurzel, MD Julia C. Young, MD Cecilia H. Yu, MD Andrew Zuckerman, MD

CHILDREN’S DIRECT LINE 800.678.4357 • STLOUISCHILDRENS.ORG [ 7 ]

One Children’s Place St. Louis, MO 63110

Non-profit Organization U.S. Postage PAID St. Louis, MO Permit No. 617

Marketing and Communications 314.286.0324 Fax: 314.747.8644

IN THIS ISSUE • AUG/SEPT 2016

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1 Magnetic Grow Rods for Scoliosis Treatment

Reduce Surgeries



Malaria Research



Source of CME Credits

3 Odom Receives Prestigious Award to Further 4 Early Bird Rounds Continue as Convenient 6 Case Study: Slobber

CONTINUING EDUCATION Early Bird Rounds resumed in September! Specialty Care Speaker Series (Last Tuesday of every month, St. Louis Children’s Hospital Specialty Care Center, I-64 and Mason Road. Enjoy a light complimentary meal at 5:30 p.m., one-hour presentation begins at • Oct. 25 – Georgeann Groh, MD, Cardiology • Nov. 29 – Paul Austin, MD, Urology

Upcoming Conferences: • Ninth Annual Pediatric Nurse Practitioner Conference, Friday, Nov. 11, 8 a.m.-4:30 p.m., Eric P. Newman Education Center, 320 S. Euclid, St. Louis, MO 63110 • 10th Annual Pediatric Trauma Update, Tuesday, Nov. 15, John A. Logan College, Carterville, Ill. For additional information about these conferences, go to StLouisChildrens.org/Med_Ed.

To request your CME transcripts online, visit cme.wustl.edu/ and click on the yellow transcript request button on the right side of the page. Complete and submit the request form, and your transcript will be sent to you in 1-2 business days.

[ 8 ] CHILDREN’S DIRECT LINE 800.678.4357 • STLOUISCHILDRENS.ORG SLC25221

09/16