State Approves Piedmont Fayette Hospital CON Applications for NICU Expansion

“Keep Babies in Fayette” Support Made a Difference
The Georgia Department of Community Health announced Monday its approval of Piedmont Fayette Hospital’s Certificate of Need (CON) applications to expand its Level II neonatal intermediate care unit and to establish a Level III neonatal intensive care unit to care for fragile newborns who are born here.

“We are excited about moving forward with these important services and want to extend our heartfelt thanks to the community for its support of our Keep Babies in Fayette initiative,” said W. Darrell Cutts, president and chief executive officer of Piedmont Fayette Hospital. “The numerous individuals who signed our petition and championed this cause have been vital in ensuring that we will now be able to establish the services necessary to provide the highest level of care for our smallest patients and their families.”

The state’s decision to approve the CON applications comes at an important time for the hospital. Since September 2006, when the hospital started offering obstetric services, over 6,700 babies have been born at Piedmont Fayette Hospital, and the need for such services has grown tremendously. The approved expansion of the Level II intermediate care unit will mean that the need for neonatal care close to home can be accommodated within the planned capacity.

The absence of a Level III neonatal intensive care unit has meant that babies who required more specialized care were transferred to other facilities, forcing families to travel for sometimes over an hour to visit and assist in the care of their sick or premature newborn. Some mothers have travelled outside the community to give birth, anticipating the need for Level III care for their baby. Now, Piedmont Fayette Hospital will be able to offer these highly specialized services, keeping babies closer to home and with their families.

Piedmont Fayette Hospital intends to start construction by December 2010 and offer these expanded critical services close to home beginning in the summer of 2011.
---
Community News You Can Use
Click to read MORE news:
www.GeorgiaFrontPage.com
Twitter: @gafrontpage & @TheGATable @HookedonHistory
www.ArtsAcrossGeorgia.com
Twitter: @artsacrossga, @softnblue, @RimbomboAAG
www.FayetteFrontPage.com
Twitter: @FayetteFP
---

Infant's Gaze May Be an Early, but Subtle, Marker for Autism Risk

/PRNewswire/ -- Kennedy Krieger Institute announced today new study results showing an early marker for later communication and social delays in infants at a higher-risk for autism may be infrequent gazing at other people when unprompted. Published in the September issue of the Journal of Child Psychology and Psychiatry, the study also found that six-month-old high-risk infants demonstrated the same level of cause and effect learning skills when compared to low-risk infants of the same age.

The study observed 25 infant siblings of children with autism (high-risk group) and 25 infants with no family history of autism (low-risk group) at six months of age in order to assess cause and effect learning as well as social engagement. Infant siblings of children with autism are considered at high-risk for the disorder, as they are 25 times more likely to develop autism. Researchers at Kennedy Krieger, in collaboration with colleagues at the University of Delaware, created a novel, multi-stimuli social learning task, where infants were seated in a custom chair with an attached joystick within easy reach, a musical toy located to the right and their caregiver on the left. Researchers evaluated how quickly the infant learned that the joystick activated the toy and the infant's level of social engagement with their caregiver.

Researchers found that, like the low-risk group, the high-risk siblings exhibited typical levels of social gazing when their caregivers actively engaged them, such as pointing at the toy and expressing excitement. However, high-risk sibs spent less time looking to their caregivers and more time fixated on the non-social stimuli (toy or joystick) when the caregiver was not engaging them, which could indicate a disruption in development related to joint attention. Joint attention is often a core deficit for children with autism.

"My colleagues and I wanted to create a task that would involve learning something novel and would give babies an opportunity to pay attention to either an object or their caregiver," said Dr. Rebecca Landa, corresponding study author and director of Kennedy Krieger's Center for Autism and Related Disorders. "This study shows that there is a particular vulnerability in high-risk siblings at six months of age. They are not as socially interactive and engaged on their own as their peers, but still respond typically when engaged by their caregivers, making for a subtle difference that could be easily overlooked by both parents and some professionals."

The study also showed no evidence of impaired associative learning in the high-risk siblings. Both groups demonstrated cause and effect learning abilities; once the infants learned that pulling the joystick activated the toy, they increased how often they pulled on the joystick to activate the toy's music. This finding supports past research demonstrating that associative learning is a relative strength in older individuals with autism and may help to explain why children with autism respond well to teaching approaches that utilize a predictable reward system when children exhibit desired behaviors.

"Babies in both groups of the study learned the multi-stimuli task to the same degree," said Dr. Landa. "While the high-risk siblings are at a higher risk for developing autism later in life, they still have the capacity to learn cause and effect as well as their low-risk peers at this young age."

Implications from the overall study findings reveal that like older children, infants at high risk for autism may benefit from frequent exposure to simple cause and effect learning opportunities to aid in their development. For example, Landa recommends using simple songs paired with easy, predictable gestures to promote language and social learning, rather than using electronic toys that children can enjoy and operate without engaging with their peers or caregivers.

It is expected that about 20 percent of the high-risk infants in this study will receive a diagnosis of autism. While participants in this study have not yet reached their third birthday, the age at which the research diagnoses are confirmed, the study findings help to highlight the vulnerability of developing social initiation skills in high-risk infants. This study is the first of its kind, and a follow-up will soon be published from the Center for Autism and Related Disorders at Kennedy Krieger Institute.

The research study was supported by grants from the National Institutes of Mental Health.

-----
Community News You Can Use
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter:  @GAFrontPage

Mayo Researchers Find Anesthesia Not Harmful for Babies During Birth Process

Mayo Clinic researchers have found that children exposed to anesthesia during Cesarean section are not at any higher risk for learning disabilities later in life than children not delivered by C-section. These findings are reported in the current issue of the journal Anesthesiology.

"We found that the incidence of learning disabilities was equal between children who were delivered vaginally and those who were delivered via C-section but with general anesthesia," says Juraj Sprung, M.D., Ph.D., a Mayo Clinic anesthesiologist who led the study. "It's reassuring that the anesthetics required for Cesarean delivery do not appear to cause long-term brain problems."

The study was conducted with data from the Rochester Epidemiology Project. Researchers analyzed the medical records of 5,320 children born between 1976 and 1982 to mothers living in Olmsted County. They compared birth records with scholastic achievement and IQ tests administered to the children later in life as part of their schooling.

The study builds on a previous project, reported in March, which found that children exposed to a single dose of anesthesia during the first three years of life had no increased risk for learning disabilities, but those exposed multiple times had an almost doubled risk for later identification of learning disabilities.

Prolonged exposure to anesthetics has been shown to cause brain abnormalities in young animals, which was the impetus behind these two studies. Scientists think that the brains of young animals and humans are more vulnerable to a variety of problems because they are undergoing rapid growth. The brain is forming vital connections between cells during this time.
Not only did the researchers find that the use of anesthesia during delivery was not harmful to the baby, they found that babies delivered by Cesarean using an epidural anesthetic (which numbs only the lower region of the body and does not involve the mother going to sleep) had a substantially reduced risk for learning disabilities later in life. "The risk was reduced by about 40 percent compared to children delivered vaginally and those delivered via Cesarean section but with general anesthesia," says Dr. Sprung.

Study co-author and Mayo Clinic anesthesiologist Randall Flick, M.D., cautions that because this study is preliminary, changes to medical practice should not be considered at this point. "What we've found is an association between two things," says Dr. Flick. "One is the way a child was delivered, either vaginally or under regional or general anesthesia. The other is a difference in the incidence of learning disabilities as the child attended school. It's important to recognize there may be many other factors that impact learning disabilities."

The team is investigating whether use of an epidural on a mother during natural labor has similar effects on the incidence of learning disabilities in children as a C-section with an epidural.
Dr. Flick says the research team also is working with the U.S. Food and Drug Administration (FDA) on a related study that looks more closely at young children with specific medical conditions who have been exposed to anesthesia and compares them to children with similar medical conditions who were not exposed to anesthesia. The study is part of a national SAFEKIDS Initiative that the FDA is undertaking with several academic and clinical institutions to study the effects of anesthetics and sedatives on brain development in infants and young children.

Funding for this study was provided in part by the Mayo Clinic Center for Translational Science Activities (CTSA). The Mayo Clinic CTSA is part of a national consortium working to improve how biomedical research is conducted across the nation. The consortium, funded through Clinical and Translational Science Awards, shares a common vision to accelerate the time it takes for laboratory discoveries to become treatments for patients and to engage communities in clinical and translational science. It is also fulfilling the critical need to train the next generation of clinical researchers. The CTSA initiative is led by the National Center for Research Resources at the National Institutes of Health.

Additional co-authors include Robert Wilder, M.D., Ph.D.; Slavica Katusic, M.D.; Tasha Pike; Mariella Dingli, M.D.; Darrell Schroeder; William Barbaresi, M.D.; Andrew Hanson; and David Warner, M.D. Another co-author is Stephen Gleich, M.D., of the Primary Children's Medical Center, Salt Lake City.
--
Community News You Can Use
Follow us on Twitter: @gafrontpage
http://www.fayettefrontpage.com/
http://www.georgiafrontpage.com/
http://www.politicalpotluck.com/
http://www.artsacrossgeorgia.com/
---

JAMA Revisits Classic Hopkins Blue Baby Study That Revolutionized Cardiovascular Medicine

A Johns Hopkins study published 63 years ago will make an encore appearance in the July 16 issue of the Journal of the American Medical Association (JAMA) as part of a year-long retrospective celebrating JAMA's 125th anniversary by revisiting papers that changed the course of modern-day medicine. Full text of the original paper is available online.

The now-classic "blue baby" report by pediatric cardiologist Helen Taussig (1898-1986) and surgeon Alfred Blalock (1899-1964) first appeared in JAMA on May 19, 1945. In their paper, Taussig and Blalock described for the first time the physiology of tetralogy of Fallot, one of the most common congenital malformations of the heart that was poorly understood at the time, considered inoperable and ultimately fatal. The malformation causes inadequate blood flow from the heart to the lungs and profound lack of oxygen in the blood, giving an infant's skin its hallmark bluish hue, hence "blue baby."

In addition, the paper described the first three operations in medical history designed to alleviate the defect using a special "shunt" technique that increased blood flow from the heart to the lungs. Children undergoing the surgery experienced an immediate and dramatic improvement while still in the operating room. When their oxygen-starved bodies were finally flushed with oxygen-rich blood, their bluish complexions turned a healthy pink color, an observation that prompted Blalock to exclaim famously after surgery number three, "The boy's a lovely color now."

At the time, Taussig and Blalock almost certainly knew their work would dramatically change treatment of heart disease, and records at Johns Hopkins show that hundreds and hundreds of parents sought help for their children in the months that followed. The study also revolutionized pediatric cardiology, a then nascent field, and ushered in a new era of cardiac surgery. In hindsight, it also altered the course of academic medicine, according to Johns Hopkins Children's Center cardiac specialists writing in a July 16 JAMA commentary accompanying the reprint summary of the original paper.

Historians, filmmakers and journalists have widely told the story of the research and eventual surgical solution, which began with an idea from Taussig, who took it to Blalock, who first sketched a surgical approach to the repair. But it was Vivien Thomas (1910-1985), a black surgical technician, at the time working as a lab and office assistant with Blalock, who was instrumental in developing the necessary procedure and instrumentation in dogs.

This mélange of disciplines as disparate as pediatric cardiology, surgery and anesthesiology working toward treatment of a single disorder became and to date remains the model for progress and innovation in medicine.

"Not only did the team's unprecedented collaboration in effect give birth to pediatric cardiology and led to the first successful treatment of this fatal heart defect, but it later became the prototype of the bench-to-bedside approach, a staple in academic medicine today," says Anne Murphy, M.D., an author on the commentary and a pediatric cardiologist at Johns Hopkins Children's Center.

In the decades that followed, the teamwork by Taussig, Blalock and Thomas also foreshadowed Johns Hopkins' efforts to eliminate racial and gender inequalities in academic medicine. In the 1940s, at Johns Hopkins, the venerable citadel of medicine, Taussig, a woman, and Thomas, an African-American, teamed up with Blalock, a white male surgeon -- a diverse and brilliant crew whose combined talent and expertise pioneered a surgery that has saved millions of lives worldwide.

Taussig went on to achieve the status of a full professor at Johns Hopkins -- one of the first women to do so -- but Thomas' role was not fully acknowledged until much later, the JAMA commentators point out, and the original paper did not credit Thomas' contributions.

"The collaboration awakened everyone to the fact that talented people like Thomas, who would have clearly been a superb surgeon, were marginalized, and medicine suffered for it," says commentary co-author Duke Cameron, M.D., head of pediatric cardiac surgery at Johns Hopkins. "It was a realization that drove much of Hopkins' subsequent efforts toward equality and diversity."

In 1976, Hopkins gave Thomas an honorary doctoral degree and appointed him instructor in surgery. Today, one of the four advisory colleges for medical students at Hopkins is named for Thomas. Every entering class learns about Thomas' story and his contributions to modern medicine.

Four out of 1,000 U.S. babies are born with heart defects, such as tetralogy of Fallot. Worldwide, nearly 1 million babies are born with heart defects, researchers estimate.