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Children's National News - Fall 2010




September is Childhood Obesity Awareness Month!
Children’s National Creates Weight-Loss Surgery Program


Childhood obesity is an important public health epidemic that is pervasive throughout our society. To combat this issue, Children’s National established the Obesity Institute to contribute innovative solutions to the preventable threats to children’s health caused by overweight and obesity.

The Institute advances clinical care that achieves healthy growth by developing, validating, and disseminating best practices in prevention and intervention for overweight across the age continuum from birth to age 21 years, and to foster novel research in genomics, proteomics, and epigenetics that provides evidence for optimizing clinical care for individuals to achieve healthy body weight. It offers effective and compassionate treatment, advocacy and public policy, research, and education. In addition, the Institute’s weight loss surgery program helps adolescents who are morbidly obese through surgical intervention. 

Dr. Evan Nadler, MD, who is co-director of the Obesity Institute along with Michele Mietus-Snyder, MD, a preventative pediatric cardiologist and recent recruit from the University of California, San Francisco, has been busy over the past few months getting the word out about the Institute and sharing the many advances the Institute is making to overcome this crisis. This past May, Dr. Nadler along with more than one hundred pediatricians, researchers, policy experts, and other stakeholders from around the Washington, DC, region, came together at Children’s National to discuss the importance of community-wide involvement to combat childhood obesity, as part of its second annual Obesity Institute Symposium.

Most recently, Dr. Nadler presented “Bariatric Surgery for the Treatment of Morbid Obesity in Adolescents” to regional pediatricians at the Future of Pediatrics annual meeting, where he discussed the current trends in childhood obesity, the rationale for surgical intervention, and information on evaluating the choices for a surgical procedure.
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Children's National Bullying Expert Participates in Federal Summit on Prevention

Joseph L. Wright, MD, MPH, senior vice president of the Child Health Advocacy Institute at Children’s National, has been active in advocacy around the issue of bullying, related to his co-authoring of the American Academy of Pediatrics’ (AAP) statement on the prevention of bullying and Children’s National efforts to prevent and treat children involved in bullying. He was featured on a practitioner panel at the Federal Partners to Prevent Bullying Summit on August 11, 2010, which was carried in its entirety by C-SPAN. In addition, Dr. Wright participated in several media interviews, including an April interview with MSNBC, discussing the consequences of bullying. [Watch the MSNBC interview]

Dr. Wright also will present on bullying at the upcoming American Academy of Pediatrics conference in San Francisco on Saturday, October 2, at 8:30 am.


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Children's National Researchers Unlock a Key Cause of Fragile X Syndrome

Researchers with the Center for Neuroscience Research at Children’s National Medical Center have unlocked the key cause of Fragile X Syndrome (FXS). Through their research, investigators have identified a brain defect responsible for many of the social and emotional problems associated with the condition. Specifically, researchers uncovered that neuronal inhibitory neurotransmission, a major form of communication in the brain, is significantly diminished in the animal model of FXS. FXS is the most common inherited cause of mental retardation and the leading known genetic cause of autism as one-third of people with FXS also have autism spectrum disorders.

In addition to this discovery, in slice cultures, the team also demonstrated the effectiveness of a drug that may correct the defect, which may inform the development of therapies for FXS and other autism spectrum disorders. The next step is to collaborate with clinical researchers to test the drug more broadly for safety and efficacy. According to Children’s National researchers and other studies, the national and international neuroscience research community is exploring how best to take that next step.

The discoveries resulted from the three-year collaboration of two laboratories at Children’s National and a Kennedy Krieger-Johns Hopkins laboratory. One laboratory, led by Joshua Corbin, PhD, co-principal investigator, works to understand the basic mechanisms of development of the amygdala—a specific part of the brain intimately involved in behavioral deficits in autism spectrum disorders. The other laboratory, led by Molly Huntsman, PhD, co-principal investigator, studies how neurotransmitters that are responsible for inhibitory and excitatory behavior work for proper communication in the brain.

A paper detailing the research was published in the July issue of the Journal of Neuroscience.

Our two groups pooled our expertise to explore our hypothesis that there is something deficient in the development of the amygdala that leads to the abnormal behavioral manifestations that are seen in Fragile X, and more broadly in autism," said Dr. Corbin.

Researchers found that in the Fragile X model, neurons do not communicate with each other properly. There is too little of the specific neurotransmitter GABA (γ-aminobutyric acid), which is the neurotransmitter required for inhibition. This made the system hyper-excitable. After identifying this deficit, the team looked for ways to make the GABA receptors more sensitive. They experimented with a drug called THIP, a GABA-specific, GABA receptor subtype agonist, and found that it restored the balance in neuronal communications.

In our slice preparation, the drug actually was able to correct back to normal—not over-correcting or too under-correcting," said Dr. Huntsman. “This discovery could be significant to the development of therapies specifically for Fragile X and perhaps for other autism spectrum disorders.

The more we understand the mechanism of the deficit, the more deeply we can think about how to fix it,” continued Dr. Corbin. “Neurological disorders are complex, so no one can take a single approach. One of the advantages of the model at Children’s National is that we are able to work together across multiple teams and in partnership with our clinical colleagues to tangibly solve neurological disorders in children.

Others authors of the study included Jose Luis Olmos-Serrano of the Center for Neuroscience Research; Scott M. Paluszkiewicz and Brandon S. Martin, of the Center for Neuroscience Research and the Interdisciplinary Program in Neuroscience at the Georgetown University School of Medicine; and Walter E. Kaufmann, MD, of the Center for Genetic Disorders of Cognition and Behavior at the Kennedy Krieger Institute, Johns Hopkins University School of Medicine.

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Alumni Spotlight: Children’s National Mourns the Loss of John Cockerham, MD

Alumni Spotlight: Children’s National Mourns the Loss of John Cockerham, MD
John Cockerham, MD, a pediatric cardiologist and active leader of the medical staff at Children's National Medical Center, passed in late August from cancer. He served in many capacities at Children's National for 22 years.

Dr. Cockerham was known for his warm rapport with the hundreds of children and families for whom he cared over the years. In addition to his expertise in pediatric cardiology, Dr. Cockerham was recognized as a thought leader in the use of technology by physicians to advance performance and quality outcomes. He applied his expertise in medical informatics as director of Clinical Operations with the Center for Heart, Lung, and Kidney Disease, for which he assumed responsibility for management of the ambulatory clinical practice. He most recently applied his expertise to Children's National’s Quality Council, and is widely recognized for his collaboration in the work that again secured Children's National its Joint Commission accreditation.

"John will be greatly missed by everyone across the organization," said Peter R. Holbrook, MD, executive vice president and chief medical officer. "He was a friend, a colleague who worked tirelessly to make Children's a world-class center of care, and a true visionary."

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Children’s National Alumni are invited to
The American Academy of Pediatrics Meeting
ALUMNI RECEPTION

October 2, 2010
6:30-8:00 pm
San Francisco Marriott Marquis- Pacific B Room

RSVP by September 24 at www.ChildrensNational.org/Alumni
.



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