N E IW IF Er L L QWYV Sx

Dear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to:Carefully review the following list of new Fellows for Academy membership; and relay yourreactions directly to your District Chairperson, whose name and address is at the end of this

list. In submitting these names of board-certified pediatricians to you, it is understood thatacademic and pediatric credentials are not in question. Comments are requested concerningpossible legal and/or ethical situations which you might have personal knowledge.Send any comments on the following list of new Fellows to your District Chairperson.

:Stephen Cook, M.D.:71 Edendery Cir.*Fairport, NY 14450-1013

:Rajiv Jain, M. D.:65 Troy- Del-Way*Williamsville, NY 14221

:Melinda Mantello, M.D.*34 Biscayne Blvd.North Troy, NY 12182-1604

:Jonathan Mink, M.D.*15 Mile Post Ln.Pittsford, NY 14534-2213

*New York 2

:Mitchell Abrons, M.D.:419-00 A Atlantic Ave.East Rockaway, NY 11518-1453

:Vipin Agarwalla, M.D.:7 Hegeman Ave., Apt. 9-D*Brooklyn, NY 11212-4756

:Socorro DeJesus, M.D.324 Waldorf Ave..Elmont, NY 11003-2111

:Ashutosh Gupta, M.D.832 51 st St.*Brooklyn, NY 11220-2908

:Jason Hitner, M. D.*754 Deer Park Ave.North Babylon, NY 11703

Scott Klein, M.D..Dept. of Pediatrics:4802 Tenth Ave.*Brooklyn, NY 11219

.Tejal Mehta, M.D.:60-96 A 69th Ave., Apt. 3F*Ridgewood, NY 11385

:Gale Nadelson-Paul, M.D.:17 Acorn Ponds Dr.*Roslyn, NY 11576-2801

:Cletus Onyiorah, M.D.:220-22 147th Ave., #1*Springfield Gardens, NY 11413

:Zarah Pua, M.D.26 Primrose Ave.*Floral Park, NY 11001

:Eric Schottenfeld, M.D.8304 125th St.*Kew Gardens, NY 11415-2706

Amira Waseem, M.D.*106 Elm Ln.:New Hyde Park, NY:11040-2406

*Sharon Watson, M. D.:90 State St., #6*Brooklyn, NY 11201

*Yechiel Zagelbaum, M.D.lA:1453E.26thStBroo.klyn, NY 11210-5232

:NewYork3

*Lauren Adler, M.D.666 Lexington Ave..Mt Kislo, NY 10549

Ronald Arevalo, M. D.:1579 Rhinelander Ave.:Apt. 1mBronx, NY 10461 -2231

:Lubin Augustin, M.D.:263 North Main St.*Spring Valley, NY 10977

Linda Chokroverty, M.D.: 118 E. 93rd St., #5ANew York, NY 10128- 1663

:Eva Duncan, M.D.:3 Largo Ln.*Livingston, NJ 07039

:Mimi Ton, M.D.:44 E. 65th St., #4A*New York, NY 10021 -7022

*Delaware

:Aguida Atkinson, M.D.*519 Brentwood.Wilmington, DE 19803-4309

*Marina Garcia, M .D33 Karens Way:Bear, DE 19701-5300

*Richard Kruse, D.O.:1600 Rockland Rd.*Wilmington, DE 19803-3607

*Dis*ict of Columbia

:Charnette Huggins Shade, M.D.1942 3rd St. NWWashington, DC 20001 -1771

:MarylandGail Marie Brown, M.D.497 Thames St.Hagerstown, MD 21740-6771

Clara Escuder-Thomas, M.D.12111 Faulkner Dr.Owings Mills, MD 21117-1261

Andrea Gropman, M.D.1645 Nordic Hill Cir.Silver Spring, MD 20906-5929

Terry Kind, M.D.8320 Draper Ln.Silver Spring, MD 20910-3234

Thomas O'Brien, M.D.Div. of Neonatology2401 W. Belvedere Ave.Baltimore, MD 21215

New Jersey

Christopher Amato, M.D.6 Wyckoff Ct.Asbury, NJ 08802

Adam Aronsky, M.D.14 Indian TrailUpper Saddle River, NJ 07458

Aswine Bal, M.D.416 Sweet Briar Ct.Yardley, PA 19067-4760

Larnie Booker, M.D.3 Ari Dr., Ant. KSomerset, NJ 08873-4518

William Freund, D.O.253 99th St.Stone Harbor, NJ 08247-1806

Michael Golub, M.D.172 Columbus Ave.Lakewood, NJ 08701-2951

Pompeo Lucciola, M.D.129 Walton Ave.New Providence, NJ 07974-1748

Vasavi Parikh, M. D.33 Overlook Rd., Ste .304Summit, NJ 07901

Chris Patestos, M.D.121 Rehill Ave.Somerville, NJ 08876-2520

Margarette Pierre, M.D.215 Miller Ave.Elmwood Park, NJ 07407-2762

Elizabeth Recupero, D.O.257 N. Union St.Lambertville, NJ 08530-1505

Pennsylvania

Daniel Church, M.D.246 Elm Dr.Waynesburg, PA 15370

Stephen Cico, M.D.431 Protectory PI.Pittsburgh, PA 15219

Lakshmi Hariharan, M.D.608 Baron Dekalb Rd.Wayne, PA 19087- 1302

Kelly Kane, D.O.120 Clover Dr.Hollidaysburg, PA 16648-2517

Jason Komasz, M.D.209 Hemlock Ln.Springfield, PA 19064-1112

Christopher Morabito, M.D.Neonatology OfficeCedar Crest & 1-78, P.O. Box 689Allentown, PA 18105-1556

Kerry Sease, M.D.516 S. Highland Ave., # 31Pittsburgh, PA 15206-4266

Linda Thomas, M.D.5 Washington Ave.Jermyn, PA 18433

PIR1 A_4

Kentucky

Judd Cox, M.D.4612 Hartland Pky.Lexington, KY 40515

Robin Warner, M.D.567 Savannah Dr.Walton, KY 41094-7431

North Carolina

DurgarAlahari, M.D.3100 Gold Dust Ln.Willow Springs, NC27592-9215

Linda Barlow, M.D.520 S. Van Buren Rd.Eden, NC 27288-5019

Donald Frush, M.D.Div. of Ped. RadiologyMcGove -rn-Davison1^rChildrens Health Ctr Rm 1905Durham, NC 27710

Richard Gessner, M.D.2800 Blue Ridge Rd., Ste. 401Raleigh, NC 27607-6477

James Harris, M.D.2800 Blue Ridge Rd., Ste. 401Raleigh, NC 27607

Susan Mims, M.D.1 11 Dayspring Dr.Asheville, NC 28803

Sarah Ogrosky, M.D.4905 Professional Ct.Raleigh, NC 27609

Joseph Pino, M.D.3097 Godfrey WayWilmington, NC 28409-3113

Elizabeth Rashley, M.D.129 Castlecreek Rd.Statesville, NC 28625-8951

Tennessee

Elisa Benaim, M.D.8025 Stage Hills Blvd.Bartlett, TN 38134

Jill Forbess, M.D.529 Sandpiper Cir.Nashville, TN 37221-4387

Carolyn Garcia, M.D.1995 Hwy. 51 South, Ste. 106Covington, TN 38019-3137

J. Steve Hobby, M.D.197 Kenner Ave.Nashville, TN 37205-2207

Olunwa Ikpeazu, M.D.1022 Heritage Woods Dr.Hendersonville, TN 37075-8513

Virginia

Angela Ang-Alhadeff, M.D.1597 Strawberry Mountain Dr.Roanoke, VA 24018

B. Bradshaw, M.D.12004 Starboard Dr., Apt. 202Reston, VA 20194-4345

Michael Hopper, M.D.4601-B Pinecrest Office Park Dr.Alexandria, VA 22312

Sharmila Nair, M.D.9717 Loch Linden Ct.Fairfax, VA 22032-2449

Tara Prieu r, M.D.933 First Colonial Rd.Virginia Beach, VA 23452

Rajesh Punn, M.D.7015 C. Manchester Blvd.Alexandria, VA 22310

Christine Wilson, M.D.20250 Catlett PI.Ashburn, VA 20147-3303

Indiana

Jennifer Hill-Birk, M.D.1614 25th St.Bedford, IN 47401

MaA-ritha- Hollingsworth,AM.D8676 Sommerwood Dr.Noblesville, IN 46060-4728

Thomas Spentzas, M.D.10480 Waterford PI.Newbu rgh, I N 47630

Michigan

Kishwar Enam, M.D.5957 Teakwood Dr.Troy, MI 48085

Thomas Huggett, M.D.1104 Edna St., SEGrand Rapids, MI 49507-3707

:Suzette LaVigne, M.D.:406 Chippewa Dr.*Fremont, Ml 49412

:Lili Levy, M.D.:2877 Crooks Rd..Troy, MI 48084

:Muneeza Mirza, M.B., B.S.*801 Turri PI., Apt. 209Flint, MI 48503-2481

:Christian Okpalo, M.D.*225 Bloomfield Blvd.Bloomfield Hills, Ml:48302-0511

*Amit Sarnaik, M.D.:66 Hampshire Dr..Troy, Ml 48085

*Ohio

:Nalini Aggarwal, M.D..8 Sycamore Creek Dr.:Springboro, OH 45066

Khalid Akbar, M.D.*2517 Deerfield Dr.:Avon, OH 44011 -1785

Omolara Dairo, M. D.8241 Timber Mist Ct.*Dublin, OH 43017-8673

.Charles Hutchison, M.D.:8 Sycamore Creek Dr.*Springboro, OH 45066-2300

Cesar Mesia, M.D.:26525 Amhearst Cir., Apt. 304.Beachwood, OH 44122-8506

*Kalpana Pethe, M .D.:381 Mae St.Logan, OH 43138-8636

:David Rich, M.D.:2549 Poppy Ln.*Columbus, OH 43235-5523

:Jenny Sung, M.D.:3647 Gridley Rd.*Shaker Heights, OH*44122-5034

:Illinois

*Arlene Roman, M.D.:881 1 S. Stony Island*Chicago, lIL 60617

*Belinda Chen, M.D.:4933 N. Oakley Ave., Apt. 1.Chicago, IL 60625

:Linnette Houston, M.D.:1306 Ridgefield Dr.*Godfrey, IL 62035-5716

.~~~~~~AreniePccnc,MD:2101 W. Rice St., #408*Chicago,IL 60622

:Janet Wildman, D.O.:970 N. 5th Ave.*St Charles, IL 60174

Iowa

.Thomas George, M.D.:Dept. of Pediatrics:200 Hawkins Dr., 2576 AJLP*Iowa City, IA 52242 -1009

:Amy Wallin, M.D.:974 73rd St., Ste. 30Des Moines, IA 50312-1024

Atlantic Provinces

Mark Messenger, M.D.1015 Regent St., Ste. 403Fredericton, N B E31361-5Canada

Connecticut

Annette Cameron, M.D.1 BunbarCaM.D.en, CT 06514

Sophia Grant, M.D.95 Mountain View DrHarwinton, CT 06791 -1121

Karen Rubin, M.D.282 Washington St., 2LHartford, CT 06106

Massachusetts

Maria Evales, M.D.53 Green Ln.Holyoke, MA 01040-1338

Peter Lind, M.D.908 W. Falmouth Hwy.Falmouth, MA 02540-2118

John Maddox, M.D.9231 Avalon Dr.Wilmington, MA 01887

Eleanor Menzin, M.D.30 Nardell Rd.Newton, MA 02459

Haroon Patel, M.D.24 Berkshire AveSharon, MA 02067-1828

Wanda Phipatanakul, M.D.Immunology300 Longwood Ave FL GAN 6Boston, MA 02115

Gary Silverman, M.D., PhDChildrens HospitalEnder 970 300 Longwood Ave.Boston, MA 02115

Aida Yavshayan, M.D.375 Mount Auburn St.Watertown, MA 02472

Rhode Island

Dinusha Dietrich, M.D.76 Ferncrest Ave.Cranston, RI 02905-3511

Uniformed ServicesEast Chapter

Tonya Kratovil, M.D.CMR 402 Box 295APO, AE 09180

Vermont

Anne Johnston, M.D.Burgess 426/FAHC111 Colchester Ave.Burlington, VT 05401

New Yorkc 1

Beth Brown, M.D.124 Croydon Rd.Rochester, NY 14610-1433

218 AAP News www.aapnews.org October 2002

NE'VV FELLOVVSCatherine Frank, M.D.61 1 Pilot Pt.Allen, TX 75013-8552

Jennnifer Harris, M.D.3515 Chatwood Dr.Pearland, TX 77584-2395

Laura McGuinn, M.D.AMEP Pediatrics601 E. 1 5th St.Austin, TX 78701

Shea Palamountain, M.D.4302 KingletHouston, TX 77035

Robert Quillin, M.D.2203 Lakewind Ln.League City, TX 77573-5796

Edgar Romero, M.D.3714 Sheldon Dr.Pearland, TX 77584

Myron Rosen, M.D.530 Clar BartonGarland, TX 75042

Lori Seibert, M.D.5711 Perston Oaks Rd.Apt. #645Dallas, TX 75254-9000

Vanita Shori, M.D.5312 Carnaby St., Apt. 144Irving, TX 75038-6909

Mary Suell, M.D.2121 El Paseo, #2002Houston, TX 77054-3226

Kelly Thorstad, M.D.12201 Renfert Way., Ste. 1 1 0Austin, TX 70758

Lakshmy Vaidyanathan, M.D.7208 Fabion Dr.Austin, TX 78759-7763

Arizona

Johanna Domer, M.D.101 51 E. Tierra Buena Ln.Scottsdale, AZ 85259

Diana Dunnigan, M.D.6137 E. Kings Ave.Scottsdale, AZ 85254-1392

Steven Goldberg, M.D.5335 E. EricksonTucson, AZ 85712-2826

Michael Hurst, D.O.516 W. Palo Verde St.Casa Grande, AZ 85222

Colorado

Laurie Steward, M.D.P.O. Box 1051Conifer, CO 80433-1051

Hawaii

Raquel Chan-Ikeda, M.D.5605 Poola St.Honolulu, HI 96821-1564

Nevada

John Reeves, M.D.8100 Sky Ridge Rd.Las Vegas, NV 89128

New Mexico

Khuram Arif, M.D.1609 Colonial Pkwy.Clovis, NM 88101

Manitoba

Norman Silver, M.D.866 GrosvenorWinnipeg, MB R3M ON3Canada

Minnesota

Pamela Chawla, M.D.347 N. Smith Ave.St Paul, MN 55102

Jimmy Ching, M.D.303 Catlin St.Buffalo, MN 55313

Yoav Messinger, M.D.345 N. Smith Ave.Saint Paul, MN 55106

Missouri

Ayoob Ali, M.D.1465 S. Grand Blvd.St Louis, MO 63104

Steven Fischer, M.D.8031 Appleton Dr.University City, MO 63130-1233

Judith Gurley, M.D.5251 Westminster PI.St Louis, MO 63108

Ramzi Kilani, M.D.Div. of Newborn MedicineOne Children's PI.St Louis, MO 631 1 0

North Dakota

Joan Connell, M.D.828 Kirkwood MallBismarck, ND 58504

Wisconsin

Roberta Hahn, M.D.429 Arbor Ridge Dr.Delavan, WI 53115-2992

Bermans Iskandar, M.D.17 St. Lawrence Cr.Madison, WI 53717

Jeffrey Krawcek, M.D.Sun Prairie Clinic10 Tower Dr.Sun Prairie, WI 53590

Kimberly Lee, M.D.920 Woods Dr.Hartland, WI 53029-2901

Blaise Nemeth, M.D.579 Park Ln.Madison, WI 53711-1653

Kimberlie Ward, M.D.4441 N. 103rd St., Apt. 2Milwaukee, WI 53225-4649

Louisiana

Mudar Kattash, M.D.1512 N. Vintage Ln.Lake Charles, LA 70605

Aaron Thompson, M.D.7933 Ferrara Dr.Harahan, LA 70123

Texas

Brent Cardwell, M.D.8116 Red Bird Ct.Austin, TX 78726-4136

Jennifer Cardwell, M.D.8116 Red Bird Ct.Austin, TX 78726-4136

Uniformed ServicesWest ChapterDavid Capelli, M.D.4094 Denning Spring Dr.Apt. BFort Irwin, CA 92310-2018

Michael Carr, M.D.73973 Playa Vista Dr.Twenty Nine Palms, CA92277

Utah

Darin Bosworth, M.D.4353 Zarahemla Dr.Salt Lake City, UT 84124

Kara Burnett, M.D.253 S. 850 E.Centerville, UT 84014

Kristen Hougland, M.D.1325 E. 1300 S.Salt Lake City, UT 84105-1942

WashingtonCheryl Bratt, M.D.10330 Meridian Ave. N, #210Seattle, WA 98133-9451

Cristian Chiritescu, M.D.601 0 Douglas Dr.Yakima, WA 98908-2738

Linda Grim, M.D.10330 Meridian Ave. N.Ste. 21 0Seattle, WA 98133

Gayathri Rao, M.D., M.B.B.S.13800 SE 79th Dr.Newcastle, WA 98059-3200

Vinita Seru, M.D.19717 Bothell-Everett Hwy., #108Bothell, WA 98012

Colin Sox, M.D.1719 N. 47th St.Seattle, WA 98103-6811

California 1

Attia Abbasi, M.D.5064 W. Westbury Cir.Granite Bay, CA 95746-7193

Daniel Delgado, M.D.520 Marin Oaks Dr.Novato, CA 94949

Jennifer Dovichi, M.D.867 Solana Dr.Lafayette, CA 94549

Julia Getzelman, M.D.1436 Valencia St.Cnn r_r!nnr-,,c._r% rA GA11A

Rhonda Keosheyan, M.D.1378 Birch Ave.Clovis, CA 93611

Lorna Paz, M.D.923 Autumn Oak Cir.Concord, CA 94521-5434

Wivina Urbano, M.D.1660 Jasmine Ct.Tracy, CA 95376-0776

Trinh Vu, M.D.4844 Bridgewater Cir.Stockton, CA 95219.

California 2

Caroline Chen, M.D.25965 S. Normandie Ave.Normandie North Bldg.2nd Fl., PedsHarbor City, CA 90710-3416

Kamakshi Devarajan, M.D.339 Coronado Ave.Long Beach, CA 90814

Mohammad Siddiqui, M.D.1626 Ford St.Redlands, CA 92373-7131

Brigham Willis, M.D.1771 N. Vermont, #409Los Angeles, CA 90027

California 3

Karen Loper, M.D.UCSD Medical Center200 W. Arbor Dr.San Diego, CA 92103-8449

Emma Raizman, M.D.6156 Caminito Del OesteSan Diego, CA 921 1 1

Neelesh Tipnis, M.D.3030 Childrens Way, MC 5030San Diego, CA 92103

Sajani Tipnis, M.D.9723 Kika Ct.San Diego, CA 92129-5051

Lori Wan, M.D.10715 Wexford St., #6San Diego, CA 92131-3951

California 4

Maria Abrantes, M.D.2301 E. Ball Rd., Apt. 133Anaheim, CA 92806-5327

Uyen Bui, M.D.9532 Andover Cir.Fountain Valley, CA92708-1022

Antonette DelValle Blogg, D.O.9 FlossmoorDove Canyon, CA 92679-3717

Chris Koutures, M.D.500 S. Anaheim Hills Rd.Ste. 140Anaheim Hills, CA 92807

Laura Murphy, M.D.84 SorensonIrvine, CA 92602-1642

Maria Plum, M.D.22521 Avenida EmpresaSte. 107Rancho Santa Margaft, CA 92688

Michael Reuben, M.D.AAA C n:- '----4. r%-

Anaheim, CA 92807-2075

Richard Van Woerkom, M.D.18 Schubert Ct.Irvine, CA 92612-4036

Alabama

Jennifer Chambers, M.D.5625 Double Tree Cir.Birmingham, AL 35242

Michael Lunsford, M.D.207 Seven Bark Dr.Cullman, AL 35057

Maria Cristina Sabio, M.D.4800 Whitesburg Dr.Ste. 2Huntsville, AL 35802

Ted Sigrest, M.D.1529 7th St.Tuscaloosa, AL 35401-1907

Florida

Ramin Amani, M.D.2640 S. University Dr., #326Davie, FL 33328

Randolph Cohen, M.D.1 1 50 N 35th Ave., Ste. 345Hollywood, FL 33021

Lisa Gwynn, D.O.3605 Park Ct.Weston, FL 33332-2105

Kennessa Hugger, M.D.1132 Lee Ave.Tallahassee, FL 32303

Gail Kay, M.D.880 6th St. South, Ste. 210Saint Petersburg, FL33701-4827

Glenn Leonard, M.D.Dept. of Pediatrics CardiologyBox 100296Gainesville, FL 32610

Gratias Mundakel, M.D.5530 Lyons Rd., Apt. 304Coconut Creek, FL 33073

Michelle Muriel, M.D.9209 Larette Dr.Orlando, FL 32817-2619

Andrew Reiss, M.D.4500 Sheridan St.Hollywood, FL 33021-3516

Jose Rodriguez, M.D.5040 NW 7th St., Ste. 630Miami, FL 33126

Christina Urena, M.D.1 1 204 NW 56th St.Miami, FL 33178

GeorgiaStephanie Hassel, M.D.2275 Sumter Lake Dr.Marietta, GA 30062-5434

David Kwee, M.D.3501 Kensington Parc Cir.Avondale Estates, GA 30002

Puerto Rico

Nerian Ortiz, M.D.Almendro 1319Hacienda BorinquenCaguas, PR 00725

DISTRICT I

Eileen M. Ouellette, M.D., J.D.Pediatric NeurologyNorth Shore Children'sHospital57 Highland Ave.Salem, MA 01970-2197e-mail: eouellette.aap.orgDISTRICT 11

Robert M. Corwin, M.D.Medical Director MedBest251 Salina Meadows Pkwy.Suite 100Syracuse, NY 13212-4572e-mail: rcorwin.aap.org

DISTRICT III

:Alan E. Kohrt, M.D.Medical Director/Children's Health NetChildren's Hospital ofPhiladelphia34th and Civic Center Blvd.Philadelphia, PA 19104-4399e-mail: akohrt.aap.orgDISTRICT IV

David T. Tayloe, Jr, M.D.2706 Medical Office PlaceGoldsboro, NC 27534-9460e-mail: sewards.aap.orgDISTRICT V

Stanford A. Singer, M.D.36700 Woodward Ave.Suite 300Bloomfield Hills, MI 48304-0908e-mail: ssinger.aap.orgDISTRICT VI

Kathryn Piziali Nichol, M.D.1314 Morrison St.Madison, WI 53703-3812e-mail: knichol.aap.orgDISTRICT Vil

Gary Q. Peck, M.D.Office of Public Health325 Loyola Avenue Suite 513New Orleans, LA 70112-1829e-mail: gpeck.aap.orgDISTRICT Vill

Jon R. Almquist, M.D.Virginia Mason Medical CenterDepartment of Pediatrics33501 First Way SouthFederal Way, WA 98003-6208e-mail: jalmquist.aap.orgDISTRICT IX

Burton F. Willis, M.D.9900 TalbertSuite 201Fountain Valley, CA 92708-5153e-mail: bwillis.aap.orgDISTRICT X

Charles Linder, M.D.Medical College of Georgia1 1 20 1 5th St.Rm HF1117Augusta, GA 30912-0004e-mail: clinder.aap.org

:American:Academy of0Tediatrics0

0

0

0

October 2002 wwwaapnewsorg AAP News 2'19

( M. i 31 i ;D L--- ( D ) /-IAN D". 'j

Glasev Vislmm. ILLCPrdc Patn Pbng

* "Eye Examination and Vision Scening in Infants, Children and Young AdWts." Pediatrics. 1996;98:153-157.

-

- Undetected amnblyopla is the leading cause of vision loss In children.- Early detection allows for treetncent to preen Irreversible blindness.- AAPguidelines recommend vision testing for all children starting at age V.

SOfLUTION: Preschool Si.G.H.T Screening System'*- bevloped by leaiding pediatric opktholmnologist, Stephen R. Glaser Ml), FAA^P- EaSY to us, portable, only one examiner needed

- Pr-ovides quick, accurate results

- Elinitnates need for expensive and bulky nichines- Appropriate for use at3,4 and 5 year-old well child visits

- No special testing hallway needed

THIS MONTH'S FEATURED PRODUCT

Chow vibrc Hon and/or sound withft rwwU4ncAkm byAk

Extensive Product SelectionBrand Nam,e AlarmsWatches for Timed V/oidingBedwetting ResourcesGuaranted Low PricesFast DeliveryCall or e{mail us for a supplXof catalogt, for lour pationts.

wvww.bedweffirecomi . c om-de inseo

DEDICATED TO THE HEALTH OF ALL CHILDRENn^

220 AAP News wwwaapnews.org October 2002

0*a^ at*

FCS:

-GREAT1FAVAlS

BIG Opport mity UnderMontana's Big Sky

The Great Falls Clinic is looldng for a BC/BENeonatologist interested in j'oini'ng the

Neonatology departmnent of a loo+ provider, multi-specialty organization. This position will provide theright candidate with the unique opportunity to work

in a progressive level 3 nursery engaged inmultidisciplinaxy care, tacklde challenging neonatal

cases, work with conventional/high frequencyventilation and nitric oxide therapy and collaboratewith a nationally recognized perinatologist, and

broad base of subspecialty providers and surgeons.Great Falls is a family-friendly community withexcellent schools, low crime, clean air, and a

reasonable cost of living. In addition, you will haveaccess to world-class recreational venues, outdooractivities, scenic vistas and regional culture right

outside your practice door.Qualified candidates will have excellent clinical and

interpersonal sldlls, be a team player and enjoyworldng closely with families and other physicians.The Great Falls Clinic offers a competitive benefitpackage and salaxy leading to partnership. If

interested, send CV and professional goals to: JeffHinz, M.D., Medical Director, PO Box 5012, GreatFalls, MT 59403. E-mail: jeff.hinz@gfclinic.com or

check out our web site at www.gfclinic.com

'MAY CL:INIC

CHILD ABUSE PROGRAM DIRECTORMayo Clinic

Mayo Medical SchoolRochester, Minnesota

The Mayo Clinic seeks a physician Director for our Child Abuse Program. The Director wouldcoordinate other physicians, psychologists, and nurse practitioners on the Child Abuse/NeglectAdvisory Team. The well-established program has an experienced LICSW serving as the ChildAbuse Coordinator with whom the Director will work. Clinical and educational opportunitiesexist with Mayo's Pediatric, Family Medicine, Psychiatry, Psychology, and Emergency Medicinefaculty and residents, as well as with Mayo Medical School students and allied health staff. Thecandidate will represent Mayo in child abuse/neglect related matters on a regional, state, andnational level.

Mayo Clinic provides excellent career opportunities through our large outpatient clinical practice;the comprehensive Mayo Eugenio Litta Children's Hospital, and our commnitment to educationand research. Mayo Clinic offers the advantages of a renowned medical center with a successfulintegrated group practice in a very attractive Midwestem locale with a population of 125, 000.

T'he position would be divided between the Child Abuse Program and clinical work in theprimary specialty area in which the candidate is ftained. Caniae may come from one ofthefollowing clinical disciplines: Pediatrics, Psychiatry, Family Medicine, Behavior/Development,or Emergency Medicine.

Qualified individuals should forward their curriculum vitae and letters of interest to the chair ofthe search committee:

Jay L. Hoecker, M.D.Interim-Director, Mayo Child Abuse Program and Search Committee Chair

Mayo Clinic200 First Street, SW

Rochester, MN 55905

(507) 284-5247(Fax: 507-284-9744)

Mayo Foundation is an afflr?native action and equal opportunity educator and employer.

tedwttingeStore"~~~~~~~~T

,Amnerican A6cadenmyof Pediatrics

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~- - --- - - -

isa registered trademark of GlaxoSmithKIine.k, NY. LBlockSl_ Arrieta A, Seibel M, Mclinn S, Eppes SC. Single dose azrdiromycin (30 mglkg) in acuteotftis media. Paper presented atInfectious Diseases Society of

2000,New Orleans, La. Abstract 174.

ITHROMAX"-infor oral suspnsinIEFSUMMARYTIONS AND USAGEatment of patients with mild to moderate infections (pneumonia:the designiated microorganisms in the specfc conditions listed

raRy.,iand -Waplialp tientpouaion vayaogteeifec-lurfor Mpc4fcdosin recommedtos

on a mg/mlbasis, are estimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animalstudies, no evidenmce of harm to the fetus due to azithromycin was found. There are, however, no adequate andwell-controlled studies in pregnant women. Because animal reproduction studies are not always predictive ofhumaresonse azihromcinshould be used during pregnancy only if clearly needed.NursigMo:It i not nownwhether azithromycin is excreted in human milk. Because many drugs areexcrtedn hman ilk cauionshould be exercised when azithromycin is administered to a nursing woman.Pediatric Use: (See INDICATIONSAND USAGEAND DOSAGEAND ADMINISTRAlnON.)

Acute Otitis Media (total dosage regimen: 30mq/kg, see DOSAGE AND ADMINISTRATION): Safetyandeffectiveness in the treatment of children with otitis media under 6 months of age have not been established.

Community-Acquired Pneumonia (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5):Safety and eTfectiveness in the treatment of children with cornrunity-~acquired pneumonia under 6 months ofage have not been established. Safetyand effectiveness for pneumonia dueto ChlamydiapneumoniaeandM#ycoplasmapneumoniaewere documented in pediatric clinical trials. Safetyand effectivenessfor pneumoniadue to Haemophilus influenzaeand Streptococcuspneumonliaewere not documented bacteriologically in thepediatric clinical trial due to difficultyin obtaining specimens. Use of azithromycin for thesetvvo microorganismsIS supported, however, by evidence Trom adequate andwell-controlled studies in adults.Pharngiis/onsilits (osae regimen: 12 mg/kg on Days 1-5): Safety and effectiveness in the treatment of chil-drnwtphrnii/oslii under 2 years of age have not been established.

Studesniutingtheuseofrepeated coumes oftherapy have notbeen conducted.GeriFiUwPhmmacoknetic arametrs in older volunteers (65-85 years old) were similar to those in younger

volunteers (18-40 years old)frth5-a therapeutic regimen. Dosage adjustment does not appear to be necessaryfor older patients with nommal renal andhepatic function receiving treatmnent with this dosage regqimen.

ADVERSE REACTIONSIn clinical tfials, most of the reported side effects were mild to moderate in severity andvvere reversible upon dis-continuation of the drug. Potentially sefious side effects of angioedema and cholestatic jaundice were reportedrarely. Apoximately0.7% of the patients (adults and children) from the 5-day muftiple-dose clinical trials discon-tinued ZffHROMAX"(azithromycin) therapy because of treatment-related side effects. In clinical tfials in childrengiven 30 mg/kg, either as a single dose or over 3 days, discontinuation from the trials due to treatment-related sideeffects was approximately 1%. (See DOSAGEAND ADMINISTRATION.) Most of the side effects leading todiscontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, or abdominal pain.Clinical:Children: Single andMultiple-dose regimens,The types of side effects in children were comparable to those seenin adults, with different incidence rates for the dosage regimens recommended in children.Acute Otitis Media: For the recommended total dosage regimen of 30mg/kg, the most frequent side effects(21%)attributed to treatment were diarrhea, abdominal pain, vomiting,nausea and rash. (See DO1SAGEAND ADMIN-ISTRATION.)The incidence, based on dosing regimen, is described in the table below:Dosage Diarrhea, % Abdominal Vomiting,% Nausea, % Rash,YO

Regimen Pain,%1 -day 4.3% 1.4% 4.9% 1.0% 1.0%3-day 2.6% 1.7% 2.3% 0.4% 0.6%5-day I1.8% 11.2% 1.1% 0.5% 0.4%

CommunityAcquired Pneumonia: For the recommended dosage regimen of10 mg/kg on Dayl1followed by 5mg/kgon Days 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stoois (5.8%), abdominalpain, vomiting, and nausea (1.9% each), and rash (1.6%).Pharyngitis/tonsillitis: Forthe recommended dosage regimencof 12 mQagkon Days 1-5,the mostfrequentside effects attributed to treatmnent were diarrhea (5.4%), vomiting (5.6%), abdaominal pain (3.4%),nausea (2%),rash (0.7%), and headache(1.1%).

With anyof the treatment regimens, no other treatment-related side effects occurred in children treated withZIHOMAXIvwith a frequency greater than 1%. Side effects that occurred with a frequency of 1% or less includedthe following:CardiovascularChest pain.Gastmointestinal: Dyspepsia, constipation, anorexia, entefitis, flatulence, gastritis, jaundice, loose stools and oralmoniliasis.HmllacadLynwhatic: Anemia and leukopenia.NervousSyb:HeadBache (otitis media dosage),hyperkinesia, dizziness, agitation, nervousness and insomnia.Geneali:Fee,face edema, fatigue, fungal infection, malaise and pain.Al0rgic: Rash and allergic reaction.RepeatryCugh increased, pharyngitis, pleural effusion and rhinitis.

SkinadApnagex.Eczema, fungal dermatitis, pruritus, sweating, urticaria and vesiculobullous rash.SeilSne:Conjunctivitis.PotM rketina Experience: Adverse events reported with azithromycin dufing the post-marketing period in

adult and/or pediatric patients for which a causal relationship may not be established include:Allerg9ic: Arthralgia, edema, urticaria and angioedema.Cardiovascular Arrhythmias including ventriculartachycardia and hypotension.Gastrointestinal: Anorexia, constipation,dspepsia, flatulence, vomiting/diarrhea rarely resufting in dehydration,pseudomembranous colitis, pancreatitis, oral candidiasis and rare reports of tongue discoloration.General: Asthenia, paresthesia, fatigue, malaise and anaphylaxis (rarely fatal).Genitourinary:Interstitial nephritis and acute renal failure and vaginitis.H_ieec: Thrombocytopenia.Lie/iin boma ie ucininldn eaii and cholestatic jaundice, as well as rare cases of hepaticnecrosis andeai alr,sm fvhc aersle in death.NervousS m Covlin,dziesertigo, headache, somnolence, hyperactivity, nervousness, agitationarlsyncoitRe. Aggressive reaction and anxietvSkiaApnae Prufitujs, rarely sefious si-in reactions irncluding erythema multiforme, Stevens-Johnson syn-drom an oi pdermal necrolysis.Spca fsHaing disturbances including hearing loss, deafness and/ortinnitus and rare reports of tasteperversion.Laboratory Abnormalities:Children:One, Three and Five Day RegimnLaboratory data collectedtfrom comparative clinical trials employing two 3-day regimens (30Omgkgor 60mg/kgindivided doses over 3 days), or two 5-day regimens (30 mgAg or60 mg/kg in divided doses over b aays) were simi-lar for regimens of azithromycin and all comparators com-bined, with most clinically significant laboratory abnor-malities occurring at incidences of 1-5%. Laboratory data for patients receiving 30 mah as a single dose werecollected in one single center trial. In that tfial, an absoluite neutrophil count betweenu1500 celIS/MM3 wasobserved in 10/64 patients receiving 30 mg/kg as a single dose, 9/62 patients receiving 30 mg/kgqiven over3days, and 8/63 comparator patients. No patient had an absolute neutrophil count <500 cel Is/mmy See DOSAGEID ADMINISTRAlON)

In muftiple-dose clinical trials involving approximately 4700 pediatfic patients, no patients discontinued therapybecause of treatment-related laborator abnormalities.

DOSAGEAND ADZMINISTRATION (See INDICATIONS AND USAGE)Zithromaxefor oral susDension can be taken with or vithout food.AcuteOtitis Media:te recommended dose of ZITHROMAX° for oral suspension for the treatmnent of childrenwith acute otitis media is 30 mg/kggiven as a single dose or 10 mg/kg once dailyfor 3 days or 10 mg/kg as a singledose on the first day followed by 5 mg/kg/dayon Days 2 ithrough 5. The safetyof re-dosing azithromycin in childrenwho vomit after receiving 30 mg/kg as a singie dose nas not been established. In clinical studies involving 8

patients vith acute obtis media given a single 30 mglkgdose of azithromycin, eight patients whovoiedwthin30 minutes of dosin,g wvere re-dosed at the same tDtal dose.C_muiqy-Acquifed Pneumonia: The recommended dose of ZITHROMAX"for oral suspension for the treat-ment of children with community-acquired pneumonia is 10 mg/kg as a single dose on the first day followed bV5m/g on Days 2 thouwh 5.Piaryngitsi/Tonsillitis: The recommended dose of ZITHROMAX for children with pharyngitis/tonsillitis is12 mg/kg once dailyfor 5 days.Formore detailedproduct infountion please refer to the fullprescribing inforrnation orcall 14600 879-3477.

Rev.9 January 2002

AcuFteodtis media caused by HaemophilusMinfuenzae, MoraKellacatarrhalis, or Streptococcuspneumoniae.(For specificdosage recommendation, see DOSAGEAND ADMINISTRATION.)

Community-acquired pneumonia due to Chlamydiapneumoniae, Haemophilus influenzae, Mycoplasmapneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy. (For specific dosage recom-mendation, see DOSAGE AND ADMINISTRATION.)

NOTE: Azithronvycin should not be used in pediatric atients wilth pneumonia who are judged to beinappropriate for oral therapy because ofmodrate to severe illness or risk factorssuch asanyof die following:patients with cystic fibrosis, patients with nosocognially acquiredinfections, padientsvith known orspected bacteremia, patients requiring hospitalization,oratintswit siifcantundertng'eahltproblemsthat maycomnpromise theirability torespond to their ilness{includingirnm nodefciency orfunctionalaspenia).PharyngifltUnsillitis caused by Streptococcuspyogenesas an altemative to first-line therapyin

individuaiswvho cannot use first-line therapy. (Forspecific dosage recomnmendation, see DOSAGEAND ADMIN-ISTRATION.)

NOTE: Penicillinb the intramuscular route is the usual drugof choice in the treatrnent of Streptococcuspryo-genes infcio andte prophylaxis of rheumatic fever. ZITHROMAX"is often effective in the eradication of sus-ceptible strains of Streptococcusp)vgenesfrom the nasopharynx Because some strains are resistant to ZITHRO-MAX, susceptibility tests should be perforrned when patients are treated with ZITHROMAX°. Data establishingeffiacyofzitromyin n sbseuent prevention of rheumatic fever are not available.

Approriatecultue andsusce tVblttests should be performed before treatmnent to determine the causativeorgnisan it sucepibiitytoaihoyn.Tepywt HROMAX° may be initiated before results of thesetests~~~~~~aekononeterslsbcmaviabl,atmcoil therapy should be adjusted accordingly.

CONTReAINDIA ONSZITHROMAX° is contraindicated in patients vfith known hypersensitivity to azithromycin, erythromycin or any

macrolide antibiotic.WARNINGS

Serious allergic reactions, including angioederna anaphylaxis, and dermatologic reactions includincgStevensJohnson Syndrome and toxic epiderTnalnecrolysis have been reported rarelyin patients on azithoyi thrpy.Although rare, fatalitieshv been reported. (See CONTRAINDICATIONS.) Despite initiallyscefusy pto-matic treatment of theallergic symptoms, when symptomatic therap vwas discontinued, thealrisypo srecurred soon thereafter in some paffents witout furter aznhromycin exposure.Teeptnsrquredmrlongeid periods of observation and symptomatic treatment. The relationship of these episoetoheln tise

half-life of azithromycin andsusqetpoogdepsre to antigen is unknown at presentHfan allergic reaction occus tedushldbdicnnued anaappropriate therapy should be instituted.

Physicians should be awarethtrapaac ftealric symptoms may occur when symptomatic therapy isdiscontinued.

In thetvaa nentofpemna ztrmcn has onlybeen shown to be safe and effective in thete of connunnyaqie duennid toQSlmiyiapneumnis, Haarnophiiusirilwenzo,aycoplwpoui0,o Slpoocsnoa- ini inipatients appropriate for oral therapy.

Azdthrornycinshoudndb sdi ainswMlpneunmoia who areiudedfo beinaprprate fororaltherpy,because ofmoderatetsereillness or riskh tomssuchas any of=tehNongpatients vith cystic fibrosis, patients withnooconmiially acquired infections, pal'mtinswtkon or

cbdbcterania,pdiens reui in hositalizain,ed el ordbilittdWpatients, or padientswithigniicantundelymgheahh problestia maycopoieter ability to respond to their ill-newincldinaimrnnod encyor fnction al %sIniwPseuomsnranos coitishasbeen feportdwihnearly all antibacterial agents and may range inserlrr ild tolIffethmoatening. Themfefoe, it is importantfo consider this diagnosis in pdientswopeetihdianhea subsequenttothe administraidon of antibacterial agentLTrarent with antibacterial agents alters the normmal flora of the colon and niay permit overgrowth of clostridia.

Studies indicate that a toxin produced by Clostridium difficile is a pnimary cause of "antibiotic-associated colitis."After the diagnosis ofuDseudomembranous colitis has been estaolished, therapeutic measures should be initi-

ated. Mild cases of pseudomernbranous colitis usually respond to discontinuation of the drug alone.In moderate to severe cases, consideration should be given to management with fluids and electrolytes,proteinsupplementation, and treatment with an antibacterial drub;clinically effective against Clostridium difficilecolitis.

PRECAUTONSGeneral: Because azithromycin is pDrincipally eliminated via the liver, caution should be exercised whenazithromycin is administere to patients with impaired hepatic function.

There are no data regarding azithromycin usage in patients with renal impairment; thus, caution should be exer-cised when prescribing azithromycin in these patients.

The following adverse events have been reported with macrolide products: ventricular arrhythmias, includingventricular tachycardia and torsades depointes, in individuals with prolonged OT intervals.

There hasbeen a spontaneous report from the post-marketing experience of a patient with previous history ofarrhythmias who experienced torsades depointesand subsequent myocardial infarction following a course ofazithromycin)therapy.Innain,fo -F atientr.Zithromax° oral suspension can be taken with or without food.

Patients should also be cautioned not to take aluminum- and magnesium-containing antacids and azithromycinsimuftaneously.

The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs ofan allergic reacton occur.

DJ _ Aluminumn- and magnesiurr-containirig antacidsrrduce the peak serum conr,ntrtons (rate)but riotthmAUC(extent mmfazithromycin absorption.Administration of cimetidine (B00 mg)two hours prior to azithromycin had no effect on azithromycin absorption.AzithrDmycin did not affect the plasma concentrations or phaminacokinetics of theophylline administered as a

single intravenous dose. The effect of azithromycin on the plasma concentrations or pharmiacokinetics of theo-phylline administered in multiple doses resulting in therapeutic steady-state concentrations of theophylline is notKno)wn. However, concurrent use of macrolides andtheopnylline has Deen associated with increases in the serumconcentrations of theoghylline. Therefore, until furtherdata are available, prudent medical practice dictates carefulmonitoring of plasma Iheophylline concenitrations in patients receiving azithromycin and theophylline concomi-tantly.

Azithromycin did not affect the prothrombin time response to pigedsfwrai.Hwv r,pudent med-ical practice dictates careful monitoring of prothrombin time inal alnstetdwt ztrmcnand warfarinconcomitantly. Concurrent use of macrolides and warfafin in clica prciehsbe soitdwth increasedanticoagulant effects.

The iollowing drug9 interactions have not been reported in clinical trials with azithromycin. hozwever, no specificdrug interaction studies have been performed to evaluate potential drug-drug interaction. Nonetheless, they navebeen observed withmaucrolide products. Until further data are developed regarding drug interactions wvhenazithromycin and these drugs are used concomitantly, careful monitoring of patients is advised:

Digoxin-elevated digoxin concentrations.Ergotamine or dihydroergotamine-,acute ergot toxicity characterized by severe peripheral vasospasm and dyses-thsia.Tfiazolam-decrease the clearance of triazolam and thus may increase the pharmacologic effect of triazolam.Drugs metabolized by the cytochrome P450 system-elevations of serum carbamazepine, tefenadine, cyclosponne,hexobairbital,anlUdUoi onetatin.

lUUbo sytS In to There are no reported laboratorytest interactions.Carciinognssueesaa is, kmpainnent ofhFality. Long-termn studies in animals have not been pr-formedtevlaecarcinogenic potential. Azithromycin has shown no mutagenic potential in standard laboatorytests: mouse lymphoma assay, human lymphocyte, clastogenic assay, and mouse bone marrow clastogenicassa.Noevienceof mparedfertility aue to azithromycin was found.Prwnncy Tertognic ffets.Pregnancy Category B: Reproduction studies have been performed in rats and

mice~~~~~~~~~atdssu omdrtl aealy toxic dose concentrations (i.e., 200 mg/kg/day). These doses, based

MID-ATLANTIC

North Carolina - Busy, well-established pediatric practice in Wake Forest, NorthCarolina, seeks part-time (full-time call) or full-time board certified pediatrician.Competitive salary and benefits. Forward CV to: Practice Manager, Wake ForestPediatric Associates, 835-A Wake Forest Business Park, Wake Forest, NC 27587, faxto (919) 556-5277 or e-mail to kduncan.wakeforestpediatricAbtitelecom.net.

SOUTHEAST

Kentucky: Pediatrician needed immediatelyin HPSA location. J -1,H1-111, Permanent Augmentin(amoxicillir/clavulanatepotassium) i

Resident or US Citizen all welcome. Computer Areenesrica DataonnualePfierigInpc.,Neew Yo°rk,literacy preferred. Send CV to AAP 8, P.O. arBox 149, Bel Air, MD 21014. (afrni

BRII

Florida, Okeechobee . Community health cen - ZTRM) (ztrmcnisndaedfIrNtDICtATater seeks experienced BC/BE Ped iatrician . below. As recommnndddoues dratoso hRilinaiinl (Cnninich/Fna1iich)nroofPrrAti I imitpri tions. pleasesee OSAGEAND ADMINISTAIDulillUdP;aJa 1C l IE>lJ l sl Clu. Llf1IILCU

hospital. Competitive salary and great benefitsincluding FTCA liability coverage. Fax resumeto Medical Director, (561 ) 844-101 3EOE/DFWP.

Fellowships in General Pediatrics, AdolescentMedicine and Pediatric Environmental Health- Cincinnati Children's Hospital Medical Centerin Cincinnati, Ohio offers a 3-year, research-oriented fellowship in General Pediatrics &Adolescent Medicine. Fellows will receive train-ing to conduct prevention-oriented research onprevalent conditions in childhood and adoles-cence, such as obesity, bone health, asthmaand injuries, sexually transmitted diseases, andschool health, especially among underservedpopulations. A fellowship in PediatricEnvironmental Health, focusing on lead poi-soning, asthma and residential hazards is alsoavailable. Physicians will earn a MSc in ClinicalEpidemiology and provide medical care in ourambulatory clinic and Generalist InpatientService. Candidates who have completed aPh.D. in a relevant field are also encouraged toapply. Inquiries to Bruce Lanphear, M.D.,M.P.H., Director, Fellowship Training Program,CCHMC, 3333 Burnet Ave., Mail Location7035, Cincinnati, Ohio 45229-3039;Telephone: (513) 636-7028, e-mail bruce.lan-phearOchmcc.org. Cincinnati Children'sHospital is an equal opportunity employer.

Am~tericanA4cadenmy ofPediatrics

10 U.S. PharmaceuticalsZX 1 2067 (B 2002 Pfizer Inc. All rights reserved.

October2002 www.aapnews.org AAPNews 3221

l1--

----

-----Mi ! t S . S S i& * 1=

- | | | | | | | | || | | | | | | i g |; S , - R E ^ S r S g| | | | S i | - - | | k- ||

E :f X R gX0 g s 00vS L s5__ i __ a dLl B ;