1>l -@ t T L0@/3 IN€¦ · opportunity for advanced degree with tuition benefits. Reviewofapplications will begin April Escanaba, Michigan Formoreinformation, pleasecontact:...

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Connecticut

Seth L. Lapuk, M.D.PO. Box 261079Hartford, CT 06126-1079

Massachusetts

David Antonio Avila, D.O.413 BroadwayMethuen, MA 01844-2022

Stephen Andrew Bean, M.D.Memonal Health Care1 9 Belmont St.Worcester, MA 01605

Greer A. Clarke, M.D.328 N. Main St.South Hadley, AAA 01075

Shirley Gonzalez, M.D.1405 Steams Hill Road.Waltham, AAA 02154

Holly H. Goodale, M.D.1035 South St., #3Roslindale, AAA 02131-2308

Lawrence M. Lerman, D.O.413 BroadwayMethuen, AAA 01844-2022

Carolyn Jean Sedor, M.D.15 Percy Road.Lexington, AAA 02173

Jayshree Sinha, M.D.758 King St.Raynham, MA 02767

Dear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to:1) carefully review the following list of new applicants forAcademy membership; and relay your reactionsdirectly 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 that academic and pedi-atric credentials are not in question. Comments are requested concerning possible legal and/or ethicalsituations of which you might have personal knowledge.Send any comments on the following list of new applicants to your District Chairperson by June 15.

New Jersey

Mischa Franklin Grossman, D.O.9001-C Greentree CommonsMariton, NJ 08003-1366

Subita S. Mangru, M.D.159 Millburn Ave.Millburn, NJ 07041

Pennsylvania

Margaret M. Knox-Lee, D.O.1725 Oregon PikeLancaster, PA 17601

Martha L. Smith, M.D.3118 Victoria CourtBensalem, PA 19020-1945

Michael L. Webster, M.D.6028 Boxwood Dr.Fairview, PA 16415

Bonnie Marie Zehr, M.D.160 N. Pointe Blvd., Suite 110Lancaster, PA 17601

West Virginia

Hussam A. Al-Skaff, M.D.4009 Kanawha Turnpike, #8HSouth Charleston, WV 25309

Penny S. Vandall Di Vita, D.O.P.O. Box316Pratt,WV 25162

Markos Yibas, M.D.1 100 Crescent Dr., #7Reidsville, NC 27320

Tennessee

Todd Farryl Glass, M.D.3073 Darrow St.Memphis,TN 38118-3518

Virginia

Emmanuel Estranero Eugenio, M.D.Lee-Davis Pediatrics7023 Lee Park RoadMechanicsville, VA 231 11

Minnesota

Deepak Krishan Lachhwani, M.D.2921 N. Valley Dr., NE, #2Rochester, MN 55906

Missouri

Mary Kathryn Bowen, M.D.10004 Kennerly Road, #195-BSt. Louis, MO 63128

Oregon

Eunju R. Metzler, M.D.3680 N.W. Samaritan Dr.Corrallis, OR 97330

Uniformed Services West

Patrick Kyran Hunter, M.D.1100 Lambrusco Dr.Harker Heights, TX 76548

DISTRICT V

Stanford A. Singer, M.D.16800 W. Twelve Mile Road.Suite 205Southfield,MI 48076-2138

DISTRICT VI

Ordean Torstenson, M.D.1313 Fish Hatchery Road.Madison,WI 53715

DISTRICT Vll

Carden Johnston, M.D.Children's Hospital of Alabama1600 7th Ave., SouthSuite 001Birmingham, AL 35233-1711

DISTRICT Vlill

Donald E. Cook, M.D.The Monfort Children's Clinic947 First StreetGreeley, CO 80631

DISTRICT IX

Lucy S. Crain, M.D.UCSF Box 0374400 Parnassus AvenueSan Francisco, CA 94143-0374

AmericanAcademy ofPediatrics

IE

Florida

Angel Dario Acevedo, M.D.1653 Jess Parrish CourtTitusville, FL 32796

Mayra Felicia Capote, M.D.3175 S.W. 113th CourtMiami, FL 33165

Rohan Anil Dial, M.D.5375 Vernon Road, (NWQCHC)Jacksonville, FL 32209

Luis Orlando Dominguez, D.O.1688 West Ave., #1007Miami Beach, FL 33139

Van S. Lilly, M.D.880 6th St., South, #470St. Petersburg, FL 33701

Elvira J. Rives, M.D.1222 El Rado St.Coral Gables, FL 33134

Georgia

Jeffrey Clark Williams, M.D.1 1 Hampton LaneCartersville, GA 30120

North Carolina

David C. Harvey, M.D.103 W. 27th St.Lumberton, NC 28358

Roger Steven Pence, M.D.7601 Spurge Dr.Fayetteville, NC 28311-9266

Alabama

Tatiana Bidikov, M.D.1001 Leighton Ave., Suite AAnniston, AL 36207

Oklahoma

Sylvia Elena August, M.D.3218 S. 79th E. Ave.Tulsa, OK 74145

Douglas Wayne Stewart, D.O.2815 S. Sheridan Road.Tulsa, OK 74129-1045

Texas

Elizabeth Ann Bartlett, M.D.11645 Angus Road, #5Austin, TX 78759

Elsa Imelda Castro, M.D.P.O. Box 331240Corpus Christi, TX 78463-1240

Mark Edward Holton, D.O.1605 Wimbleton Dr.Bedford, TX 76021

AAohammad Mahmud Hussain, M.D.2822 Swiss Pine CourtHarlingen, TX 78550

Lubna Shahid Kamal, M.D.929 N. Galloway, #121Mesquite, TX 75149

Renata M. Stoszek Moon, M.D.12519 Cherry Creek BendHouston, TX 77041-6669

Tram Gina Thu Nguyen, D.O.4600 Fairbanks, #417El Paso, TX 79924

Maria Joslyn A. Pablo, M.D.3150 International Blvd.Brownsville, TX 78521

California 1

Florinda Galang Mallorca, M.D.1660 Jasmine CourtTracy, CA 95376-0776

Julia M. Martino, M.D.370 Distel CircleLos Altos, CA 94022

California 2

Francisco Agnila Armosilla, M.D.1045 Atlantic Ave., #818Long Beach, CA 90813

Michelle Harumi Leinaala Loh, M.D.11160 Poplar St., #BLoma Linda, CA 92354-2945

Susan Helen Teaford, M.D.2008 Rachel St.San Luis Obispo, CA 93401

Califomia 3

Cesar Lim Dua, M.D.23 Mesa Ave.National City, CA 91950-1910

New York 1

Pablito Sulit Dela Cruz, M.D.1410 N. George St.Rome, NY 13440-2704

New York 2

Jeong Ran Oh Lee, M.D.241-43A Oak Park Dr.Douglaston,NY 11362

Rajesh PRiaant Savargaonkar, M.D.7520 255th St., 2nd FloorGlen Oaks, NY 11004-1137

New York 3

Alan M. Harawitz, M.D.22 McGarrah Road.Monroe, NY 10950

Edward F. Rossi, M.D.157 E. 81st St.NewYork,NY 10028

DISTRICT I

Gilbert L. Fuld, M.D.The Hitchcock Clinic590 Court StreetKeene, NH 03431 -1719

DISTRICT II

Louis Z. Cooper, M.D.St. Lukes Roosevelt Hospital1000 Tenth Ave.NewYork,NY 10019

D)ISTRICT III

Susan Aronson, M.D.605 Moreno Road.Narberth, PA 19072-1618

DISTRICT l\/

E. Stephen Edwards, M.D.2800 Blue Ridge Blvd.Suite 501Raleigh, NC 27607-6496

Illinois

MafiaAntonia De Leoz Banal, M.D.1 South, 272 Ingersoll LaneVilla Park, IL 60181

Maria A. Carlos, M.D.195 N. Harbor Dr., #2809Chicago, IL 60601-7532

Lisa Giordano, M.D.400 N. McClurg Court, #2006Chicago, IL 60611

Arizona

Robert Frank Altamura, D.O.4701 W. Indian SchoolPhoenix,AZ 85031

Colorado

Aurelio Etcheverry, D.O., PC1060 Orchard Ave. #JGrand Junction, CO 81503

Delaware

Christopher Joseph Keenan, D.O.2914 Jaffe Road.Wilmington, DE 19808

May 1998 AAP News 31

Michigan

Sander E. Lipman, D.O.2100 W. Big Beaver, #101Troy, MI 48084

Chanh Duc Nguyen, M.D.4360 Cherry HillOkemos, MI 48864-2971

Kathleen A. Reinhart, D.O.14930 LaPlaisance, #127Monroe, Ml 48161

Mark Alan Sloane, D.O.2490 South 1 1 thKalamazoo, Ml 49009

Ohio

Stephen Raymond Bauer, D.O.5125 Beacon Hill Road., #102Columbus, OH 43228

John Robert Bockoven, M.D.Dayton Children's Cardiology702 Valley St.Dayton, OH 45404-1958

James Edward Foy, D.O.5125 Beacon Hill Road, #102Columbus, OH 43228

Jill Ann Neff, D.O.536 Hammerton Road.Jackson, OH 45640

Hannelore Smith, M.D.6046 Whipple Ave.North Canton, OH 44720

SUBSCRIPTION INFORMATIONSubscriptions to AA4P News cost $40 for nonmembers.

To subscribe, contact: Pete Petersen,subscriptions and advertising coordinator at

1 ~~~~~~(800) 433-9016, ext. 7667.

P-M.Numbb.mlow

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CaliforniaJune

21st Annual Black Hills Seminar on Advances inClinical Pediatrics -Rapid City, S. D., June 17 -

19, 1998. Sponsored by University of SouthDakota School of Medicine, Department ofPediatrics. Contact: Lawrence R. Wellman, M.D.,Program Coordinator, USD School of Medicine,1 100 S. Euclid Avenue, Sioux Falls, SD 571 17-5039; (605) 333-7178; fax (605) 333-1585.

"Pediatrics by the Sea" -MAP Georgia Chapter,The Cloister, Sea Island, Ga., June 18-20, 1998.Contact Louise Pringle-Jones at (404) 881-5094;fax (404) 249-9503, or email: louise@?mag.org.

"Practical Topics in Children's Medicine"22nd Annuai Florida Suncoast PediatricConference, June 26 - 28, 1998, at the TradeWinds Resort, St. Pete Beach, Fla. Sponsored bythe University of South Florida College ofMedicine. Presented by All Children's Hospital.For information, call All Children's HospitalConference Administration, (813) 892-8834.

September

"The Developing Child XIX: Attention DeficitHyperactivity Disorder Update" -September18, 1998, Champaign, Ill., by Carle ClinicAssociation. Contact: Annette Lansford, M.D.(217) 383-3100; fax (217) 383-7018.

Salinas-BC/BE pediatrician to j'oin a growingmultispecialty-primary care group just outsideof Monteray/Carmel (2 hours south of SanFrancisco). Medical Spanish required. Fax: CVto Darrin Bright, D.O. (408) 771-5510.

Monterey Bay Coast -Fourth BC/BE pediatri-cian for thriving practice in beautiful communitywith beaches, mountains, university. Level II nurs-ery; new hospital. Flexible schedule. Fax c.v. to(408) 722-9604.

District of Columbia

Primary Care Pediatrics - Clinical DivisionDirector: The George Washington UniversityMedical Center is seeking a Clinical Director forits Pediatrics Division in the GW Primary CareAssociates, a multidisciplinary primary care

group. Director will oversee clinical operations of15 pediatricians in Washington, D.C., office andfive suburban Maryland and Virginia offices.Majority of time in clinical activities; includessome teaching/clinical precepting. AAust be BC inpediatrics. Desire candidates with primary care,managed care, administrative experience.Faculty appointment; excellent benefits package;opportunity for advanced degree with tuitionbenefits. Review of applications will begin April

Escanaba, MichiganFor more information, please contact:

Wendy Bass at (800) 462-3621; Fax (309) 685-2574; Email:[email protected]

IDEAS FOR LIVING, INC. BOULDER, COLORADO 80304

32 '' May 1998

"WVe do the OS 'VVell. F MEDICAL GROUP

The Sisters of the Third Order of St. Francis (OSF) have beenproviding medical care for residents of Illinois, Iowa andMichigan for more than 1 20 years. Their corporation, nowknown as OSF HealthCare, includes seven hospitals, twoextended care facilities, an insurance company with its ownmanaged care products, more than one dozen affiliated com-panies providing medical products and services, and OSFAAedical Group, a multi-specialty physician group with morethan 220 providers in its multi-state service area. We now havegeneral pediatrics opportunities in:

Peoria, Illinois

"I'd thioughit nothitng coul uwak oursix year old son. B3ut uwhen a urologistrecommtencded the .PottyPagr, wvecec cZe togve it a try. Thlree uweekzslater our son's Ibedwuettingproblemnswvere over!

Jan Van Hoffo

BEDWETTING! WHY JUST "CONTROL" IT WHEN YOU CAN CURE ITT

WITH THE WIRELESS ALARM THAN ALERTS THE BEDWETTER... NOT

THE WHOLE HOUSE!

THE POTTY PAGER TEACHES BEDWETTERS TO RESPOND NORMALLY TO

BLADDER FULLNESS. IT USES A TACTILE ALARM,, MUCH LIKE A SILENT

BUSINESS PAGER. IT IS 1 00°/ SAFE, RUNS ON TWO "AA" BATTERIES,AND COSTS JUST $49.95 + S&H. IT COMES WITH A 30 DAY NO-QUES-

TIONS GUARANTEE. WE9RE THAT SURE IT9LL WORK!

FOR COMPLETE INFO: 800-497-6573 OR 303-440-851 7

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may

MAYO CLINICCOMMUNITYPEDIATRICANDADOLESCENT MEDICINE

The Mayo Clinic is seeking to fill three staff positions in the Section ofCommunity Pediatric and Adolescent Medicine with ind'iv'iduals interested inacademic community-based primary care. Candidates must be board certi-fied/eligible in Pediatrics and have an interest in primary care as well asteaching medical students, residents, and nurse practitioners. This recruitmenteffort includes our interest in adolescent medicine and/or primary careresearch. Academic rank would depend on certification and experience.Candidate should be interested in becoming part ofa large, unique multi-spe-cialtyr group practice in an academic setting. For information, please enclose acurriculum vitae and write to:

Jay Hoecker, M.D.Chair, Search Committee

Department of Pediatric and Adolescent MedicineMayo Clinic and Foundation

200 First Street, SWRochester, MN 55905

MayoFoundation isanaffrmativeactionand equalopportunityeducatorand employer

Tired ofPprokWe let yo rcie miedccine.

After all, practicing medicine is about people - not paperwork.We have practice opportunities available for all specialties in ournationally ranlked medical centers and throughout our network ofcommunity-based health groups in northeastem and centralPennsylvania. A torch is not the answer to paperwork, we are.

We'll make all our resources available to you.

For more information, call Penn State GeisingerHealth System, Professional Staffing O>ffice toll-free at1-800- 845-7112 or FAXus at 800-622-2515. E9 PennState Geisinger

_Health Systeman equal opportunity employer

1, and continue until position is filled. Anticipatedstart date is July. Interested candidates shouldsend letter and CV to Debbie Eiland, Departmentof Health Care Sciences, The GeorgeWashington University, Room 213-415, 2150Pennsylvania Ave., NW, Washington, DC 20037.The George Washington University is an affir-mative action/equal opportunity employer.

/A :<:.iy@^-z|AI)S BYE-MAILAAPNews canl now accept

your classified advertising by e-mail!Send ads to [email protected]

call for consultation, with ER and after hours cov-ered by primary care. Comprehensive trainingexperience with diverse types of patients pre-ferred, including interest in behavior disorders.Outreach clinic development in process as signif-icant need exists. For more information, contactCarri Prudhomme, Allina Health system. Fax c.v.to (612) 992-2927 or call (800) 248-4921 .

New York

Join successful practice in upstate New YorkBC/BE pediatrician needed to join group prac-tice in Watertown, N.Y. Competitive salaryand benefits; call 1 in 8; partnership desired.Contact Dr. Al

...

Gianfagna (315)

(315) 782-5773.

Kentucky

Hazard Pediatrics -needs a pediatricianin Hazard, Ky., in a fairly rural setting. Allcandidates welcome to apply. Send reply toHazard Pediatrics, P.O. Box 2748, Pikeville,KY 41 502-2708.

MAinnesota

New Ulm Medical Center -We are currentlyseeking a third consultant pediatrician to join 25-person multi-specialty clinic in south-centralMinnesota. Roles include high risk delivery-roomcoverage, management of complex pediatricpatients, consultation service for family practiceinternally and from surrounding communities,managing growing premature infants, and devel-oping your own well-child practice. Every third

New Jemey

Pediatrician and Family PractitionerSouthern Jersey Family Medical Centers, Inc.,a multi-site, community health center inAtlantic and Salem counties has two providerpositions available: Staff Pediatrician andFamily Practitioner. We offer an excellentsalary and comprehensive benefit package.Successful candidates may qualify for loanrepayment. Board Certification preferred.Mail CV with salary requirements to SouthemJersey Family Medical Centers, Inc., 860 So.White Horse Pike, Bldg. A., Hammonton, NJ08037, or fax to (609)567-1169.

Nemours Children's Clinic has the following full-time positions available in Pensacola, Florida:

Pediatric GastroenterologistApplicant should be Board certified in Pediatricsand Board eligible/certified in PediatricGastroenterology.

Pediatric Infectious DiseaseApplicant should be Board certified in Pediatricsand Board eligible/certified in Pediatric InfectiousDisease.Be part of a 15 person Pediatric Surgical andMedical Subspecialty Group practicing in arefeffal Pediatric Center with a 92-bed Children'sHospital PICU-NICU and a Residency TeachingProgram. Interested candidates should send theirCV to: c/o Nemours Children's Clinic, PrentissFindlay, MD, 5225 Carmel Heights Road,Pensacola, FL 32504. Phone: (850) 505B4773.Fax: (850) 505a4710. EOE.

I.s..

CLASSIFIEDADVERTISING POLICY

Whenyou need to contactpediatricians, contactAAPNews. Each month more than 53,000 pediatricians,pediatricspecialists, third-yearpediatric residents and othersubscribers turn toAAPNewsfor child healthinformation they cannotget elsewhere. With a classified ad, you can speak directly to those readers.

Although the Academy believes these classified ads are fromreputable sources, the Academy does not investigate theoffers made and assumes no responsibility concerning them.

Occassionally, it is necessary to modify the wording of classi-fied ads. These changes are generally made in compliancewith the regulations ofvarious federal and/or state commis-sions against discrimination or because they might beinterpreted as being unlawful or in conflict with accepted pro-fessional standards ofmedical practice.These advertising modifications are made to maintain a clas-sified section that is professionally responsible, lawful,scientific and free ofdiscrimination.

RO~~~~~~~~~~~~~~~fE. Boxf2El Gwsfrme n4A& .-iiLt60009 09-:

Publication ofan advertisement in AAAP News neither consti-tutes nor implies a guarantee or endorsement byAAP Newsor the AmericanAcademy of Pediatrics ofthe product or ser-vice advertised or of the claims made for the product orservice by the advertiser.

Classification: Classified ads are accepted under BusinessServices, General Announcements, Medical Meetings,Physicians Wanted, Positions Wanted, Practices Available,Publications, Real Estate and Residencies/FellowshipsAvailable.

DisplayClassifiedAds: Camera-ready, 4-color, 3-color and2-color display classified ads are accepted under GeneralAnnouncements, Medical Meetings, Physicians Wanted,Positions Wanted, Practices Available and Residencies/Fellowships Available. ContactAAPNews for display classifedad sizes and rates.

Formore information, contact: Pete Petersen, ClassifiedAdCoordinator, at (800) 433-9016, ext.7667. In Mlinois, (847) 981-7667. Ad copy and payments may be sent to: Classified Ads,AAPNews, RO. Box927, ElkGrove Vfllage, IL60009-0927.

May 1998 AAP News 33

.......''... el_.....

An Operating Division of The Nemours Foundation

I II I I I

Oregon

Poibezprcces

enjPazSPEPerpo!meOriwiltirresaftciai

irtlandNancouver and Salem-Experience the!st of the Northwest! Practice in a stimulatingDfessional environment in one of the most suc-ssful managed care systems in the country andijoy a quality lifestyle inherent to the beautifulbcfic Northwest. Our physician-managed multi-ecialty group, providing care for 430,000 Kaiser!rmanente members, has full-time and part-time)sitions available for BC/BE pediatricians at ouredical offices in Portland/Vancouver and Salem,re. In addition to general pediatrics, the practice11include urgent care call. We also have a part-ne position in the Portland area that would sharesponsibility for covering our urgent care clinicster-hours and weekends. We offer our physi-ins a competitive salary and a benefits package

which includes a generous retirementprogram, professional liability coverage,sabbatical leave and more. For informa-tion regarding these excitingopportunities, please forward CV to A.P. Clark, Director of ProfessionalResources, Northwest Permanente,P.C., 500 NE Multnomah, Suite 100,Portland, OR 97232-2099; (800) 813-3763. EOE.

I LSi J;Ffitrlm;p-mv IIu1:1

Tomorrow's solutions resultfrom strategies and insights sbared today.

Pennsylvania

Penn State Geisinger Health Systemis currently seeking BC/BE pediatriciansto join its multispecialty group practicein State College, Penn. Join two otherpediatric physicians in this busy medicalpractice. Call is shared with nearby sis-ter clinic and is 1:5. Administrativeopportunity available if desired. StateCollege, located in the heart ofPennsylvania, is home to Penn StateUniversity. The area offers a tremen-dous amount of educational, culturaland recreational activities to enjoy.State College provides an excellentbusiness climate and offers a superiorquality of life. We offer a competitivesalary and excellent benefit package.For additional information, please con-tact: Penn State Geisinger ProfessionalStaffing (PP-AB), 100 North AcademyAve., Danville, PA 17822-1528. Phone(800) 845-7112; fax (800) 622-2515.E. O. E. M/F/H/V.

Virginia

Richmond area - Part /full-timeBC/BE pediatrician for dynamic,growing practice. Competitive salarywith eventual partnership. Hospitalswith full service pediatrics, NICU,PICU. Attractive planned communi-ties. Excellent schools and recreationalfacilities. Nearby Medical College ofVirginia. Extremely light call. Send CVor call Judith F. McGhee, M.D., 4902Millridge Parkway, AAidlothian, VA231 12; (804) 744-1231; or fax (804)744-9521 .

Growing solo pediatric practice -inS.W. Virginia seeking BC pediatrician.1:2 call. Bilingual English/Spanishdesired. Fax CV to Children's Clinic(540) 489-6504.

From Science to Practice:

San Antonio, TexasSeptember 1 6 - 1 9, 1 998

.tJ't>-|.G: :.I I 'The Family Forum featuring Family Voices,

Polly Aranga. Discussions on parent advocacy with adialogue of interest. Child care provided.o State of the Art Symposia, scientific papers andposters and clinical demonstration posters.o The International Affairs Luncheon featuring aworld renowned speaker.

This letter was received from parent Charlotte Ann B.Colton after the Portland meeting. A portion is below.

"DearDr. Rosenbaum:

This letter isjust a small way ofsaying "tbank you " to theentire Academyfor its dedication and commitment. Ihad the unique opportunity to attend the conference inPortland, boping tofind some answers to some verydifficult questions regarding our son, Kyle... I not onlyfound answers to my questions, along with a lot morequestions, but to my amazement, Ifound an enormousamount ofcaring and dedicatedpeople all trying in theirown way - but together as a team - to give us asparentsandprofessionals, new direction and bope. ")

Guest speaker Jeffrey C. Murray, MD, Professor ofPediatrics and Biological Sciences, Director of theHuman Genome Cooperative Linkage Center, Depart-ments of Pediatrics and Biological Sciences, TheUniversity of Iowa, Iowa City, Iowa. Dr. Murray is wellknown for his research on human molecular geneticsand will address the scientific and ethical implications ofhuman molecular genetics.O Guest speaker Polly Aranga, Director of FamilyVoices. Ms. Aranga is well known as a writer and childadvocate. Family Voices is a national grassrootsnetwork of families and friends speaking on behalf ofchildren with special health care needs.

O Guest speaker Jim Abrahams, parent, film producerand director, The Charlie Foundation to Help CurePediatric Epilepsy, Santa Monica, California. A fathertells his story about advocating for his child and how themedia affects the medical/professional in special healthissues.

11PROIFESSIONAIL

o TEAMWOlRKo.HOPE

34 .-t= o ;sMay 1998

CIALARGE IYou can now charge yourA"PNews classifiedad vertising costs on

yourVisa orMasterCard credit cards.

So charge ahead with yourplans to advertise in

AAPNews.Call (800) 433-9016,

766. fo asfeac.etsgratesandc dc adl,ines.

Spec'ialty Revilews. in Pediatric CardilologyJune 23-27, 1998

Specialty Revilewsm 'in Pediatrilc Hlematology/Oncology-September 13-1S,1998

NTIONA Call 800-404 3637CENTER to register or for more information on thesefor Advanced outstanding courses providing comprehensive,Medical Education- fully-accredited Board preparation and

2000 Crawford Place * Suite 100 patclapiain o iiarcieMount Laurel, NJ 08054 patclaplaln o lla rcle

PARTICIPAE IN...THE AMERICAN ACADEMY FOR CEREBRALPALSY AND DEVELOPMENTAL MEDICINE

ANN AL EETIN

Enriching the fives of others through your profession.

To obtain a preliminary program or for further informationcall (847)698-1635 or fax (847)823-0536, note code: AAPKeepilng the Promise

SAVE THE DATElSeptember 13-15, 1998 * Salt Lake City, Utah|

The Second Nationai Conference on Shaken Baby Syndrome will bring together multi-disciplinary experts on Shaken Baby Syndrome as well asfamily members of victims to share the most up-to-date information about this form of child abuse. A comprehensive program will include pre-sentation on medical, investigative, legal, protective, therapeutic, and prevention aspects of Shaken Baby Syndrome. Profiles of victims andperpetrators, family impact issues, and problems of re-traumatization of families also will be addressed.The Second National Conference on Shaken Baby Syndrome is jointly sponsored by Primary Children's Medical Center, the Child Abuse

Prevention Center of Utah and SBS Prevention Plus. Supporting organizations include: the American Academy of Pediatrics; the NationalAssociation of Children's Hospitals and Related Institutions (NACHRI); Brain Injury Association: Violence and Brain Injury Institute; National Centeron Child Abuse and Neglect; and the National Center for Prosecution of Child Abuse.

This conference will benefit physicians, nurses, coroners, law enforcement officers, attorneys, judges, child protection workers, child advocates,child death investigators, child care licensing agencies, therapists, public policy administration, child abuse researchers, child abuse prevention spe-cialists, teachers, and family members of Shaken Baby Syndrome victims.

For more information, or to obtain a "Call for Presenters" brochure, contact the Child Abuse Prevention Center of Utah atl ~~~~~~~~~(801)393-3366, orbye-mail [email protected]

ZITHROMAX'{azithromycin for oral suspension)

BRIEF SUMMARY

INDICATIONS AND USAGEZITHROMAX' (azithromycin) is indicated for the treatment of patients with mild to moderate infections (pneumonia: seeWARNINGS) caused by susceptible strains of the designated microorganisms in the specific conditions listed below. Asrecommended dosages. durations of therapy, and applicable patient populations vary amonQ these infections, please seeDOSAGE AND ADMINISTRATION for specific dosing recommendations.

Acute otitis media caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae. (Forspecific dosage recommendation, see DOSAGE AND ADMINISTRATION.)

Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasma ptieumoniae,oi Streptococcus pneumoniae in patients appropriate for oral therapy, (For specific dosage recommendation, see DOSAGEAND ADMINISTRATION.)

NOTE: Azithromycin should not he used in pediatric patients with pneumonia who are judged to beinappropriate for oral therapy because of moderate to severe illness or risk factors such as any of thefollowing: patients with cystic fibrosis, patients with nosocomially acquired infections, patients withknown or suspected bacteremia, patients requiring hospitalization, or patients with significantunderlying health problems that may compromise their ability to respond to their illness (includingimmunodeficiency or functional asplenia).

Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individuals whocannot use first-line therapy. (For specific dosage recommendations, see DOSAGE AND ADMINISTRATION.)

NOTE: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcus pyogenesinfection and the prophylaxis of rheumatic fever. ZITHROMAXI is often effective in the eradication of susceptible strains ofStreptococcus pyogenes from the nasopharynx. Because some strains are resistant to ZITHROMAXI, susceptibility testsshould be performed when patients are treated with ZITHROMAXI. Data establishing efficacy of azithromycin in subsequentprevention of rheumatic fever are not available.

Appropriate culture and susceptibility tests should be performed before treatment to determine the causative organismand its susceptibility to azithromycin. Therapy with ZITHBOMAXI may be initiated before results of these tests are known:once the results become available, antimicrobial therapy should be adjusted accordingly.

CONTRAINDICATIONSZITHROMAX' is contraindicated in patients with known hypersensitivity to azithromycin, erythromycin, or any macrolideantibiotic.

WARNINGSSerious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including Stevens JohnsonSyndrome and toxic epidermal necrolysis have been reported rarely in patients on azithromycin therapy. Although rare,fatalities have been reported. (See CONTRAINDICATIONS.) Despite initially successful symptomatic treatment of theallergic symptoms, when symptomatic therapy was discontinued, the allergic symptoms recurred soon thereafter in somepatients without further azithromycin exposure. These patients required prolonged periods of observation andsymptomatic treatment. The relationship of these episodes to the long tissue half-life of azithromycin and subsequentprolonged exposure to antigen is unknown at present.

If an allergic reaction occurs, the drug should be discontinued and appropriate therapy should be instituted. Physiciansshould be aware that reappearance of the allergic symptoms may occur when symptomatic therapy is discontinued.

In the treatment of pneumonia, azithromycin has only been shown to be safe and effective in the treatment ofcommunity-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasmapneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy. Azithromycin should not beused in patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate tosevere illness or risk factors such as any of the following: patients with cystic fibrosis, patients withnosocomially acquired infections, patients with known or suspected bacteremia, patients requiringhospitalization, elderly or debilitated patients, or patients with significant underlying health problems that maycompromise their ability to respond to their illness (including immunodeficiency or functional asplenia).

Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severityfrom mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present withdiarrhea subsequent to the administration of antibacterial agents.

Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studiesindicate that a toxin produced by Clostri'dlum di'fficile is a primary cause of "antibiotic-associated colitis."

After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated. Mildcases of pseudomembranous colitis usually respond to discontinuation of the drug alone. In moderate to severe cases,consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with anantibacterial drug clinically effective against Clostri'dium difficile colitis.

PRECAUTIONSGeneral: Because azithromycin is principally eliminated via the liver, caution should be exercised when azithromycin isadministered to patients with impaired hepatic function.

There are no data regarding azithromycin usage in patients with renal impairment-, thus, caution should be exercised whenprescribing azithromycin in these patients.

The following adverse events have not been reported in clinical trials with azithromycin, an azalide; however, they havebeen reported with macrolide products: ventricular arrhythmias, including ventricular tachycardia and torsades de pointes, inindividuals with prolonged OT intervals.

There has been a spontaneous report from the post-marketing experience of a patient with previous history of arrhythmiaswho experienced torsades de pointes and subsequeiit myocardial infarction following a course of azithromycin therapy.Information for Patients: Patients should be cautioned to take ZITHROMAX" suspension at least one hour prior to a mealor at least two hours after a meal This medication should not be taken with food.

Patients should also be cautioned not to take aluminum- and magnesium-containing aiitacids and azithromycinsimultaneously,

The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs of an allergicreaction occur.Drug Interactions: Aluminum- and magnesium-containing antacids reduce the peak serum levels (rate) but not the AUC(extent) of azithromycin absorption

Administration of cimetidine (800 mg) two hours prior to azithromycin had no effect on azithromycin absorption.Azithrornycin did not affect the plasma levels or pharmacokinetics of theophylline administered as a single intravenous

dose. The effect of azithromycin on the plasma levels or pharmacokinetics of theophylline administered in multiple dosesresulting in therapeutic steady-state levels of theophylline is not known. However, concurrent use of macrolides andtheophyllinie has been associated with increases in the serum concentrations of theophylline Therefore, until further dataare available, prudent medical practice dictates careful monitoring of plasma theophylline levels in patients receivingazithromycin and theophyll'!ne concomitaiitly

Azithromycin did not affect the prothrombin time response to a single dose of warfarin. However, prudent medicalpractice dictates careful monitoring of prothrombin time in all patients treated with azithromycin and warfarin concomitantly.Concurrent use of macrolides and warfarin in clinical practice has been associated with increased anticoagulant effects.

The following drug interactions have not been reported in clinical trials with azithromycin-, however, no specific drug*interaction studies have been performed to evaluate potential drug-drug interaction. Nonetheless, they have been observedwith macrolide products. Uiitil further data are developed regarding drug interactions when azithromycin afid these drugs areused concomitantly, careful monitoring of patients is advised.

Digoxin-elevated digoxin levels.Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia.Triazolam-decrease the clearance of triazolam and thus may increase the pharmacologic effect of triazolam.Drugs metabolized by the cytochrome P'50 system-elevations of serum carbamazepine, terfenadine, cyclosporine,hexobarbital, and phenytoin levels

Laboratory Test Interactions: There are no reported laboratory test interactions.Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term studies in animals have not been performed toevaluate carcinogenic potential. Azithromycin has shown no mutagenic potential in standard laboratory tests: mouselymphoma assay, human lymphocyte clastogenic assay, and mouse bone marrow clastogenic assay. No evidence of impairedfertility due to azithromycin was found.

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N A T I O N A L

W E E K

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References: 1. I)ata on file. Pfizer Iric, New! York, N'Y. 2. NIcLinn 5, W\illiams D. 11igh incidlence of')trept?coco:Lts ptictnome1nzl and Hacxtni(lplildws in-PL(ctiz(ic tbeta-lactamase) resistance in recent otitis mediacliiiical trial isolates. Presented at the 35th Inlterscience Conference on Antiniicrobial Agents aiidChemotherapy. Septeiiiber 17-20, 1995,1 San Francisco, (Calif. Abstract. 3. Har-dy D], Hensey M191, Be%er]M1, V'ojtko C, MIcDo(nald EJ, Fernandes PB. Comparative in vilro activities of nlew 14-, 15-, and 16-nmembewred maicrolides. Antuneicro( h Agc wls Cllb1aiotAl r. 19883;32: 1710-171'. 4. Retsema J, Girard A,Schclkl%, W\, et al. Spectrum and imocde of action of azithromycin (CP-62,993), a new! 1 5-memlbered-ringrriacroli~de with imlproved potency against gram-negative organismTs. Antinlict-ob1 Agcnts Clhemothe1-.11)87;3 1:IQ39-1947. 5. %IlcLinnl S. Double blind zand open label studies of azithromycin in theiiianagement of acute otitis media in clhildren: a reviex!. Pediatr In-f-ct Dis J. I1995;14:S62-S60.6. Khurana C, Nicl-inn S, Block S, Pichichero %I. Trial of azithromycin (AZ) vs Augimentin (AUG,) fortreaLment of acLite otitis media (AO1). Presented at the 34th Iiiterscience Conference on AntinmicrobialAgents and Chemotherapy,. October 4-7, 1994; Orlando, F la. Abstract.

Augmentin (amoxicillin/clavulanate potassiumn) is a registe red trademark of .SmlithKline BeechamPharmaceuticals

Pregnancy: Teratogenic Effects. Pregnancy Category 13: Reproduction studies have been performed in rats and mice atdoses up to moderately maternally toxic dose levels (i.e., 200 mg/kg/day). These doses, based on a mg/m2basis, areestimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animal studies, no evidence of harm tothe fetus due to azithromycin was found, There are, however, no adequate and well-controlled studies in pregnant women.Because animal reproduction studies are not always predictive of human response, azithromycin should be used duringpregnancy only if clearly needed.Nursing Mothers: It is not known whether azithromycin is excreted in human milk. Because many drugs are excreted inhuman milk, caution should be exercised when azithromycin is administered to a nursing woman.Pediatric Use: (INDICATIONS AND USAGE.)

Acute Otitis Media (dosage regimen-. 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5)~Safety and effectiveness inthe 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 followed by 5 mg/kg on Days 2-5): Safety andeffectiveness in the treatment of children with community-acquired pneumonia under 6 months of age have not beenestablished. Safety and effectiveness for pneumonia due to Chlamydia pneumoniae and Mycoplasma pneumoniae weredocumented in pediatric clinical trials. Safety and effectiveness for pneumonia due to Haemophilus influenzae andStreptococcus pneumoniae were not documented bacteriologically in the pediatric clinical trial due to difficulty in obtainingspecimens. Use of azithromycin for these two microorganisms is supported, however, by evidence from adequjate and well-controlled studies in adults.

Pharyngitis/Tonsillitis (dosage regimen: 12 mg/kg on Days 1-5): Safety and effectiveness in the treatment of children withpharyngitis/tonsillitis under 2 years of age have not been established.

Studies evaluating the use of repeated courses of therapy have not been conducted.Geriatric Use: Pharmacokinetic parameters in older volunteers (65-85 years old) were similar to those in younger volunteers(18-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessary for older patientswith normal renal and hepatic function receiving treatment with this dosage regimen.

ADVERSE REACTIONSIn clinical trials, most of the reported side effects were mild to moderate in severity and were reversible upondiscontinuation of the drug. Approximately 0.7% of the patients (adults and children) from the multiple-dose clinical trialsdiscontinued ZITHROMAXI (azithromycin) therapy because of treatment-related side effects. Most of the side effectsleading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, or abdominal pain.Potentially serious side effects of angioedema and cholestatic j'aundice were reported rarely.Clinical: Adults: Multiple-dose regimen: Overall, the most common side effects in adult patients receiving a multiple-doseregimen of ZITHROMAXI were related to the gastrointestinal system with diarrhea/loose stools (5%), nausea (3%), andabdominal pain (3%) being the most frequently reported.

No other side effects occurred in patients on the multiple-dose regimen of ZITHROMAX" with a frequency greater than1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular: Palpitations, chest pain.Gastrointestinal: Dyspepsia, flatulence, vomiting, melena, and cholestatic j'aundice.Genitourinary: Monilia, vaginitis, and nephritis.Nervous System: Dizziness, headache, vertigo, and somnolence.General: Fat'igue.Allergic: Rash, photosensitivity, and angioedema.Single 1-gram dose regimen: Overall, the most common side effects in patients receiving a single-dose regimen ofgram of ZITHROMAXI were related to the gastrointestinal system and were more frequently reported than in patients

receiving the multiple-dose regimen.Side effects that occurred in patients on the single one-gram dosing regimen of ZITHROMAXI with a frequency of 1% or

greater included diarrhea/loose stools (7%), nausea (5%), abdominal pain (5%), vomiting (2%), dyspepsia (I%), and vaginitis(1 %).Si'ngle 2-gram dose regimen. Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAX"' were related to the gastrointestinal system. Side effects that occurred in patients in this study with afrequency of 1% or greater included nausea (18%), diarrhea/loose stools (14%), vomiting (7%), abdominal pain (7%),vaginitis (2%), dyspepsia (1 %), and dizziness (1 %). The majority of these complaints were mild in nature.Children: Multiple-dose regimens. The types of side effects in children were comparable to those seen in adults, withdifferent incidence rates for the two dosage regimens recommended in children.

Acute Otitis Meclia: For the recommended dosage regimen of 10 mg/kg on Day followed by 5 mg/kg on Days 2-5, themost frequent side effects attributed to treatment were diarrhea/loose stools (2%), abdominal pain (2%), vomiting (1 °h), andnausea 1 % ).

Community-Acquired Pneumonia: For the recommended dosage regimen of 10 mg/kg on Day followed by 5 mg/kg onDays 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools (5.8%), abdominal pain, vomiting,and nausea (1.9% each), and rash (1.6%).

Pharyngitis/tonsillitis: For the recommended dosage regimen of 12 mg/kg on Days 1-5, the most frequent side effectsattributed to treatment were diarrhea/loose stools (6%), vomiting (5%), abdominal pain (3%), nausea (2%), andheadache (1 %).

With either treatment regimen, no other side effects occurred in children treated with ZITHROMAX' with a frequency ofgreater than I1%. Side effects that occurred with a frequency of I1% or less included the follovving:Cardiovascular: Chest pain.Gastrointestinal: Dyspepsia, constipation, anorexia, flatulence, and gastritis.Nervous System: Headache (otitis media dosage), hyperkinesia, dizziness, agitation, nervousness, insomnia.General: Fever, fatigue, malaise.Allergic: Rash.Skin and Appendages: Pruritus, urticaria.Special Senses: Conjunctivitis.Post-Marketing Experience: Adverse events reported with azithromycin during the post-marketing period in adult and,'orpediatric patients for which a causal relationship may not be established include:Allergic: Arthralgia, edema, urticaria.Cardiovascular: Arrhythmias including ventricular tachycardia.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting in dehydration.General: Asthenia, paresthesia.Genitourinary: Interstitial nephritis and acute renal failure.Liver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice.Nervous System: CoiivulsionsSkin/Appendages: Rarely serious skin reactions including erythema multiforme, Stevens Johnson Syndrome, and toxicepidermal necrolysis.Special Senses: Hearing disturbances including hearing loss, deafness, and/or tinnitus, rare reports of taste disturbances.Laboratory Abnormalities: Adults: Significant abnormalities (irrespective of drug relationship) occurring during the clinicaltrials were reported as follovvs: with an incidence of 1-2%, elevated serurn creatine phosphokinase, potassium, ALT ISGPT),GGT, and AST (SGOT),~ with an incidence of less than 1%, leukopenia, neutropenia, decreased platelet count, elevated serumalkaline phosphatase, bilirubin, BUN, creatinine, blood glucose, LDH, and phosphate.

When follow-up was provided, changes in laboratory tests appeared to be reversibleIn multiple-dose clinical trials involving more than 3000 patients, 3 patierits discontinued therapy because of treatment-

related liver enzyme abnormalities and 1 because of a renal function abnormalityChildren: Significant abnormalities (irrespective of drug relationship) occurring during clinical trials were all reported at afrequency of less than 1%, but were similar in type to the adult pattern,

DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE.)Acute Otitis Media and Community-Acquired Pneumonia: The recommended dose of ZITHROMAX" for oral suspensionfor the treatment of childrerl with acute otitis media and community-acquired pneumonia is 10 mg/kg as a single dose on thefirst day (not to exceed 500 mg/day) followed by 5 mg/kg on days 2 through 5 (not to exceed 250 mg/day).Pharyngitis/Tonsillitis: The recommended dose for children with pharyrigitis/tonsillitis is 12 mg/kg once a day for 5 days(not to exceed 500 mg/day).ZITHROMAX" for oral suspension should be given at least I hour before or 2 hours after a meal.ZITHROMAXI for oral suspension should not be taken with food.

d More detai'led professional information avalilable Ot1 request.Revised January 1997

ZC1 78A97t) 1997, Pfizer Inc

May 1998 35

Washington

Virginia Mason Federal Way -Virginia MasonAAedical Center is seeking a full-time pediatricianto join an established seven-physician pediatricgroup at its largest primary and specialty care

satellite in Federal Way, Washington. Applicantsmust be BE/BC. Clinical responsibilities will includeoutpatient and newborn care in Federal Way andinpatient attending at Seattle's Children's Hospitaland Medical Center. Enjoy the immediate needfor your services, in addition to the rich culturaland recreational environment of the Puget Soundarea. Please respond with CV and cover letter to:Gordon Naylor, M.D., Section Head, VirginiaMason South Pediatrics, 33501 First Way South,Federal Way, WA 98003. Phone (253) 874-1618;fax (253) 874-1634.

General

Adverse events in children following exposuresto insect repellents containing DEET. PEGUSResearch, Inc., is studying adverse events follow-ing exposures to DEET. We are seekinginformation from pediatricians regarding patientswho may have experienced neurological, sys-temic or unusual symptoms. Parents of patientswill be asked to participate in a telephone inter-view. For additional information, please call Dr.Brent Page, or Karen Bateman, R.N., at PEGUSResearch, (800) 949-0089.

(azithrom c n fororul suspension) 5

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A well established solo pediatric practice in theSan Francisco area-Respond to: AAP News,Box 01228, 141 Northwest Point Blvd., Elk GroveVillage, IL 60007.

42 U.S. Pharmaceuticals

MAY 17 - 235 1998

The antibi-otic solutionwith predictable results inunpredictable patientsPredictable Coverage of

Key Pathogens:H influenzae, S pneumoniae, and

AM catarrhalisl-4

Predictable Results:Proven as effective as

AugrnientinII, s 6'

Predictable Convenience:The only 5-day, once-daily

treatrnient

Predictably VVell Tolerated:

Only 0.3% discont'inuati-on dueto side effects

The most frequent side effects are

diarrhea/loose stools (2%), abdominal pain (2%),vomiting (1%), and nausea (1%). ZithromaxO

(azithromycin) is contraindicated in patients withknown hypersensitivity to azithromycin,erythromycin, or any macrolide antibiotic.

THE PREDICTABILITY YO'U N EED I N PEDIATRICS m

THE IONLY 5-DAYl,,,ONCE DIkLY THERAkPY

FR ASCUTE IOTITISM EDIAt