All posts by CHOC Children's

CHOC Children’s ranked as one of the nation’s best children’s hospitals

US NewsCHOC Children’s has been ranked as one of the nation’s best children’s hospitals in U.S. News & World Report’s Best Children’s Hospitals rankings, available today at www.usnews.com/childrenshospitals.  CHOC ranked in the following specialties: Cancer; Diabetes & Endocrinology; Gastroenterology; Neurology & Neurosurgery; Orthopedics; and Urology.

“CHOC deserves high praise for its accomplishments,” said Health Rankings Editor Avery Comarow. “CHOC has a reservoir of dedication and expertise that helps the sickest kids.  Our goal at U.S. News is to identify and call attention to pediatric centers like this one.”

For more about this recognition, click here.

The U.S. News honor adds to a growing list of recent accomplishments for CHOC, including:

  • Recognition by the state as a leader in performance excellence with the Gold Level CAPE Award
  • Distinction as the only pediatric hospital on the West Coast to earn the Gold Beacon Award for Critical Care Excellence
  • National recognition of CHOC Children’s Comprehensive Epilepsy Program as a Level 4 epilepsy center
  • Acknowledgement by the Children’s Hospital Association for improvements in medication safety – the only children’s hospital on the West Coast to be recognized
  • Distinction of earning a $5.5 million research grant from the California Institute for Regenerative Medicine

Genomic Cancer Research Comes to CHOC Children’s

A $10 million donation to CHOC Children’s from Hyundai Motor America, the largest corporate gift in the hospital’s history, will be used to fund ground-breaking pediatric cancer research, including the latest advances in genomic medicine. Kim Cripe, CHOC Children’s president and CEO, Oscar Leeser, Chairman of the Hyundai Hope on Wheels Foundation, Dr. Leonard Sender, medical director of the Hyundai Cancer Institute at CHOC Children’s, and John Krafcik, president and CEO of Hyundai Motor America, gathered for the check presentation in May 2011.

The Hyundai Cancer Institute at CHOC Children’s has enrolled the first patients in a pilot study designed to determine the individual genome profile of a range of pediatric and young adult cancers in the hope of advancing new and more effective treatments for recurrent or refractory disease in this patient population. The commercial availability of cost-effective, whole genome and RNA sequencing technology is making possible the development of individual molecular profiles that one day will allow physicians to “personalize” treatment regimens to target a patient’s specific cancer. Both germ-line and tumor samples from individual patients will be studied.

The results of this pilot study may not have a direct clinical impact, yet genomic medicine promises to take the concept of personalized oncology treatment to unprecedented levels. Molecular profile analysis may ultimately identify oncogenic pathways for which a chemotherapeutic agent already exists or for new ones to be developed.

Phase I Trial for DFMO and Neuroblastoma
Genomic research is just one type of the exciting pediatric cancer studies taking place at CHOC Children’s. We are also the only California hospital participating in a four-center, Phase I clinical trial investigating the potential role of alpha–difluoromethylornithine (DFMO) as a chemoprevention agent for refractory or recurrent neuroblastoma. DFMO, a watersoluable drug associated with low toxicity, has already been shown to reduce the risk of colon cancer. The Phase I study is further assessing toxicity to determine the maximal tolerated dose.

It is essentially a new look at a decades-old drug, which was approved in the 1970s for treating African trypanosomiasis or “sleeping sickness.” But in 2008, research conducted by Frank Meyskens, M.D., director of the Chao Family Comprehensive Cancer Center at the University of California, Irvine, showed DFMO reduced the risk of recurrent colorectal adenomas by up to 95 percent—and with less toxicity than conventional chemotherapy. In fact, an analysis of side effects and toxicity found no difference between the DFMO and placebo groups.

The current Phase 1 study is testing DFMO as a single agent and in combination with etoposide, a semisynthetic podophyllotoxin-derived antineoplastic agent. According to Leonard Sender, M.D., medical director of the Hyundai Cancer Institute at CHOC Children’s, DFMO specifically targets ornithine decarboxylase (ODC), a protein found in high levels in neuroblastoma tumor cell lines associated with poor outcomes. Previous studies involving both cell lines and mouse models have shown that DFMO can inhibit ODC levels. The other centers participating in this Phase I study are the University of Hawaii, University of Arizona and the Van Andel Institute.

“We are very proud to be part of this study, working with one of the premiere researchers, and bringing the best of basic science to the bedside of our patients,” Dr. Sender said. “Neuroblastoma is very aggressive. That DFMO may potentially have a role in treating neuroblastoma is very exciting. It would be fantastic to have a drug with a low toxicity profile.”

For more information about cancer research at CHOC Children’s, please visit www.choc.org.

Becoming One of the Nation’s Best Children’s Hospitals

Construction of the new seven-story, CHOC Children’s patient care tower is proceeding within budget and on schedule, with 87 percent completion. When it opens in Spring 2013, all CHOC patient care services will be provided within a completely pediatriccentric environment:

  • Orange County’s only pediatric emergency department, with 31 treatment rooms
  • Operating rooms
  • Two cardiac catheterization labs
  • Radiology, laboratory and pathology services
  • Shelled space to accommodate future needs

Featuring leading-edge advancements in patient safety and health information technology, the new tower will make CHOC one of the safest hospitals in the nation. The design includes sustainable, green building construction and interior details to enhance the overall patient care experience.

Along with the research and academic opportunities now available through the affiliation with the University of California, Irvine, the new tower will give CHOC a competitive edge in attracting — and retaining—more of the top pediatric specialists and researchers from throughout the world.

For more information about CHOC’s expansion, please visit www.choc.org.

In the Spotlight: Burton Willis, M.D. & Harry Pellman, M.D.

About 28 years ago, Fountain Valley pediatricians Burton Willis, M.D., and Harry Pellman, M.D., and others saw the need for local representation at the national level. They petitioned the American Academy of Pediatrics (AAP) to form a new chapter in Orange County, separate from the Los Angeles Chapter.

Their efforts led to the formation of California Chapter 4 in 1986. Still the youngest AAP chapter, this strong, local organization provides evidence-based education, practice support and advocacy on the local, state and national level.

After nurturing the chapter’s development, Dr. Pellman and Dr. Willis remained involved. Among their many notable successes are the consistently high-quality continuing medical education programs offered by the chapter. In October, they once again chaired “Advances in Pediatrics,” an annual program held in conjunction with CHOC Children’s and the University of California, Irvine, that is attended by more than 200 physicians.

Improving The Practice of Pediatrics
Dr. Willis and Dr. Pellman met during medical training at the University of Illinois. Years later, they reconnected at a medical conference, and Dr. Pellman joined Dr. Willis at Edinger Medical Group in 1972.

Forty years ago, the Orange County medical landscape was much different. Office visits cost $8, and there usually was no insurance. Dr. Pellman and Dr. Willis were on-call for afterhours neonatal care and emergency room visits. And at that time, CHOC and UC Irvine Medical Center had the only children’s wards and NICUs in Orange County.

In 1973, Dr. Pellman and Dr. Willis helped develop a pediatric service at Fountain Valley Community Hospital, a newly opened hospital near their practice. Next, they were instrumental in starting the first community NICU in the county. They also joined the teaching faculty at UC Irvine, and became involved with CHOC.

“A lot of our friends asked why we were doing all this,” Dr. Pellman said. “We felt for our own education, as well as for the quality in the community, a university affiliation and a children’s hospital were important.”

Dr. Pellman and Dr. Willis have made lasting contributions to the quality of pediatric care provided in Orange County today. So the next time you receive a mailing from California Chapter 4 of the American Academy of Pediatrics, think about them—and think about getting involved.

Pediatricians Harry Pellman, M.D., and Burton Willis, M.D., are in practice at Edinger Medical Group, which has offices in Fountain Valley and Huntington Beach. For more information, please call 714-965-2500.

Burton Willis, M.D.
Fellow, American Academy of Pediatrics

Past President, American Academy of Pediatrics, California Chapter 4

Clinical Professor, Department of Pediatrics, UC Irvine

National AAP Involvement: Committee on Development

District IX, AAP Involvement: Past District Chair

Harry Pellman, M.D.
Fellow, American Academy of Pediatrics

Past President, American Academy of Pediatrics, California Chapter 4

Clinical Professor, Department of Pediatrics, UC Irvine

National AAP Involvement: Chapter Coordinator Pediatric Research in Office Settings (PROS) and Chapter Breast Feeding Coordinator. Member of both Infectious Disease and Breastfeeding Sections

Distict IX, AAP Involvement: CME Co-Chairman Chapter Involvement: CME Chairman, Board Member

NIH Study Assesses Cooling After Pediatric Cardiac Arrest

Controlled therapeutic hypothermia after cardiac arrest may improve survival and outcomes for adults, but is the same true for infants, children and adolescents? The CHOC Children’s Pediatric Intensive Care Unit is one of 33 in the nation participating in the NIH-funded Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA) study investigating the potential benefits.

“There are significant differences between the pediatric and adult populations,” said pediatric intensivist Adam Schwarz, M.D., who is leading the study at CHOC. “First, the causes of cardiac arrest in children are usually quite different than for adults. About 90 percent of pediatric cardiac arrests are secondary to asphyxiation or hypoxia. Additionally, control groups in the adult studies showed a high incidence of fever.” The THAPCA study seeks to answer whether one strictly controlled temperature or another, after resuscitation from cardiac arrest, lead to significant survival outcomes. Half of the participants are randomized to being placed onto temperature-controlled blankets and cooled to 32°C – 34°C for 48 hours, then slowly re-warmed back to 37°C and maintained at normal body temperature for three more days until five days of study are completed. The control group keeps body temperature at 37°C for all five days. Cooling is not without potential risks. Dr. Schwarz said a study involving children who were cooled following traumatic brain injuries showed worse outcomes than those in the control group. “Controlled hypothermia after pediatric cardiac arrest is absolutely not a proven therapy in our patient population and shouldn’t be done outside a strictly controlled study until such results are known,” Dr. Schwarz said. CHOC went live with the THAPCA study in April 2011, and three patients have been enrolled. Nationwide, more than 250 infants, children and adolescents are currently enrolled with a target of 800. For more information about research at CHOC, please visit www.choc.org.