CHOC Children’s Grand Rounds Video: Hypotonia in an Infant – A Case Review

In this CHOC Children’s grand rounds video presentation, Dr. Jenna Timboe, third-year pediatric resident at CHOC/UCI, highlights a case of a 4-month-old presenting with hypotonia, also known as “rag doll” syndrome.  Dr. Timboe explains how to evaluate an infant with hypotonia and how to differentiate between various etiologies.

In addition, she reviews the history of botulism and associated risk factors.  She also provides an overview of the diagnostic evaluation of botulism and explains who to contact if botulism is suspected.  Lastly, she reviews treatment and expected prognosis.

Understanding how to appropriately diagnose and treat botulism can impact the duration of the illness and the need for ICU support.

CHOC is proud to offer continuing medical education and grand rounds on topics of interest to medical and allied professionals.

View previous grand rounds videos.

CHOC Physician Engagement Survey Starts April 25

MP9004486371-300x200The 2016 Physician Engagement Survey will begin April 25, 2016 and conclude May 23, 2016 for both campuses – CHOC Children’s Hospital and CHOC Children’s at Mission Hospital. Don’t miss this opportunity to provide us with your valuable input, which will allow CHOC to further strengthen and improve our programs and services, to better serve you and our children.

For those who participated last year, thank you for your feedback which helped place CHOC within the 96th national percentile!

In just a few weeks you will receive information on the survey from both CHOC and Press Ganey.  Should you have any questions, please feel free to contact Leslie Castelo, director, business development at CHOC, at 714-509-4329 or


In recognition of Doctors’ Day, we would like to take the opportunity to recognize our physicians for their dedication to the children we serve. Each day they offer hope and healing through their compassionate and world-class care.

A luncheon, themed “CHOC Docs Lift Us Up,” will be held on:

April 8, 2016

11:30 a.m. to 2 p.m.

CHOC Children’s Hospital

1201 W. La Veta Ave., Orange, Ca 92868

Bill Holmes Tower, second floor outdoor patio

Recognition ceremony begins promptly at noon.

Please note: If you need a professional head shot, there will be a photographer available on site to take photos.

Please RSVP by March 25 at, or call Cristen Frost, in business development at CHOC, at 714-509-4807.

A luncheon at Mission Hospital will be held on:

March 30, 2016

11:30 a.m. to 2 p.m.

Mission Hospital

27700 Medical Center Rd., Mission Viejo, Ca  92691

Tent outside tower 2

No RSVP is required.

CHOC Joins National Pediatrics Consortium to Fight Childhood Cancer


Announced this week, the Cancer Institute is among 10 founding members of the Cancer MoonShot 2020 Pediatrics Consortium, the pediatric arm of a collaborative initiative launched earlier this year involving academic institutions, insurers and pharmaceutical companies working to create a new paradigm in cancer treatment. Cancer MoonShot 2020 aims to initiate randomized Phase II trials in 20,000 patients with 20 tumor types of all stages within three years. Those findings would inform Phase III trials and the development of a vaccine-based immunotherapy by the year 2020.

Moonshot 2020’s Quantitative Integrative Lifelong Trial (QUILT) program will allow Pediatrics Consortium participants to apply the most comprehensive cancer molecular diagnostic testing available, as well as leverage proven and promising combination immunotherapies and clinical trials. Additionally, infrastructure established by MoonShot 2020 will allow for real-time data sharing to accelerate clinical learning and insight among participants.

“The Pediatric Cancer MoonShot 2020 is so visionary and, at the same time, has the capacity to disrupt the cancer health care industrial complex,” says Dr. Leonard Sender, medical director of the Cancer Institute. “The Cancer MoonShot will attempt to cure all the numerous types of pediatric cancers with the least toxicity by harnessing the patients’ own immune systems and using the tumors’ unique genomic mutations to create individualized cancer vaccines.”

The work to be accelerated by Cancer MoonShot dovetails with existing efforts around genomic sequencing, precision medicine, bioinformatics and research at CHOC’s Cancer Institute. CHOC has been named a Caris Center of Excellence for its commitment to precision medicine, and participates in the California Kids Cancer Comparison, which brings big data bioinformatics to patients. CHOC has also recently enrolled its first patient in a multi-center clinical study for the treatment of relapsed or refractory acute lymphoblastic leukemia (ALL) with investigational immunotherapy.

“Our Center has studied the value of whole genome sequencing for several years and has recognized the enormous value in such a test to assist in clinical decision making,” Dr. Sender says. “Now with the availability of the next evolution of molecular diagnostics from the genome to the proteome, we are excited by the acceleration of knowledge that this system will provide and are honored to be a founding member of such an important initiative.”

20140916_2712The formation of the Cancer Moonshot 2020 Pediatrics Consortium was shaped by three underlying drivers:

  1. Treatment of cancer – a heterogeneous disease shaped by multiple variables – requires a more personalized and precise approach. The Pediatrics Consortium will lead and use next-generation precision clinical genomic-proteomics enabling doctors and patients to get the most comprehensive molecular diagnosis in the market.
  2. The collaboration across industry and the medical and scientific community, as well as whole genomic and proteomic sequencing and clinical trials established under Cancer MoonShot, will help reduce barriers in the battle against pediatric cancer.
  3. The benefits afforded by a real-time data sharing infrastructure established by Cancer MoonShot 2020, combined with multiple participation from pharmaceutical companies, have not previously been available to individual pediatric cancer centers.

In addition to CHOC, the other founding members of the Consortium are Ann & Robert H. Lurie Children’s Hospital of Chicago; Children’s Healthcare of Atlanta, Aflac Cancer & Blood Disorders Center; Children’s Hospital of Philadelphia; Children’s Hospital of Pittsburgh of UPMC; Duke Department of Pediatrics – Duke University School of Medicine;  Floating Hospital for Children at Tufts Medical Center; Huntsman Cancer Institute at the University of Utah and Intermountain Primary Children’s Hospital; Phoenix Children’s Hospital; and Sanford Health.



CHOC Children’s Grand Rounds Video: Optic Neuritis in Pediatric Patients

In this CHOC Children’s grand rounds video, Dr. Chantal Boisvert, neuro-ophthalmologist, addresses optic neuritis in pediatric patients.  Specifically, she discusses how the presentation and outcome can be different for children compared to adults. Pediatric optic neuritis is often bilateral and tends to occur within one to two weeks after a known or presumed viral infection/vaccination. Children with optic neuritis are also at lower risk of developing MS compared to the adult population.

Dr. Boisvert also shares some of the challenges associated with diagnosing and treating optic nerve problems.  Sudden inflammation of the nerve, which carries visual information from the eye to the brain, can cause acute vision loss. Most cases will improve after a few weeks, but injury to the nerve fibers can sometimes result in permanent loss of vision. Physicians need to know when to refer to neuro-ophthalmologists. Neuro-ophthalmologists are familiar with all aspects of both optic nerve and brain disorders, and will be able to provide up-to-date recommendations on complex treatment issues and follow-up.

View previous grand rounds videos.