Shining Stars Spring 2012 : Page 6
Cholesterol Screening For Children Now Urged Once believed to be an afﬂ iction of adulthood, cardiovascular disease can have deep roots in lifestyle choices that impact kids before they get to middle school. That is why the American Academy of Pediatrics endorses new guidelines issued by the National Institutes of Health (NIH) that call for all children to be screened for high cholesterol at least once between the ages of 9 and 11 years, and again between ages 17 and 21. Previous guidelines called for childhood screenings only if there was a family history of heart disease or high cholesterol. Karen Seligman, M.D., a pediatric cardiologist at Maria Fareri Children’s Hospital at Westchester Medical Center, says screening based only on family history has allowed many children to slip through the cracks, especially given our nation’s growing battle with childhood obesity and diabetes. Doctors can educate and work with children who have high cholesterol to make the appropriate lifestyle changes — primarily dietary changes and increased physical activity—to reduce their risk for cardiovascular Model of a molecule of cholesterol, a steroid which is essential for animal life but is also implicated in cardiovascular disease. Karen Seligman, M.D. Pediatric Cardiologist (Preventive Cardiology Specialist) Maria Fareri Children’s Hospital at Westchester Medical Center “It has been estimated that by using just family history (as the criteria for childhood screening) we may miss anywhere from 30 percent to 60 percent of the children who are at risk,” Dr. Seligman says. Visit westchestermedicalcenter.com/resources and listen to Dr. Seligman‘s audio interview “Cholesterol Screening for Kids” where she talks about her work at Maria Fareri Children‘s Hospital to help families and children manage cholesterol. and other chronic diseases in adulthood. “We encourage children to get involved and take responsibility for their well-being early because that responsibility does not diminish as they grow older,” Dr. Seligman says. For those who question the costs associated with this additional level of pediatric screening, Dr. Seligman is quick to point out that an ounce of prevention is worth a pound of cure. “This is a drop in the bucket compared to what will be needed to treat chronic diseases in adults,” she says. These new NIH recommen-dations, therefore, are really about improving the odds and helping children avoid a variety of chronic diseases later in life. “Although some children inherit high cholesterol, we are also seeing a marked increase in association with the current obesity epidemic,” Dr. Seligman says. “The guidelines also address nutrition, physical activity, tobacco use, weight, blood pressure and blood sugar in childhood. Studies have revealed changes in the arteries of children that correlate with these multiple risk factors. These are the type of changes that can cause grave problems early in adulthood.” For more information about the pediatric cardiology program at Maria Fareri Children’s Hospital, please call 877-WMC-DOCS or visit www.westchestermedicalcenter.com/pediatriccardiology. Maria Fareri Children’s Hospital at Westchester Medical Center 6
Big Advances in Minimally-Invasive Surgery
Physicians at Maria Fareri Children’s Hospital at Westchester Medical Center continue to lead the way in pediatric surgery, having recently performed a complicated operation on a baby girl weighing less than 3 pounds.<br /> <br /> <br /> Surgical literature suggests she may be one of the smallest babies to undergo this kind of operation in the United States.<br /> <br /> Zoey Eckert was born 9 weeks premature December 4, 2011 at Vassar Brothers Medical Center in Poughkeepsie. Doctors there immediately recognized there was a problem with her esophagus and within hours, Zoey, who weighed just 2 pounds 13 ounces at birth, was transferred to Maria Fareri Children’s Hospital at Westchester Medical Center. Upon arrival, Samir Pandya, M.D., a pediatric surgeon at the Children’s Hospital, evaluated Zoey and knew he could help her.<br /> <br /> Zoey was born with a congenital anomaly called esophageal atresia with distal tracheoesophageal fi stula, which means the upper and lower halves of her esophagus were not connected to each other and the lower half was in fact attached to her trachea. Because of this “detour,” every time Zoey took a breath, the air she inhaled was diverted into her stomach instead of her lungs. As a result, her stomach became distended with air and her lungs could not expand fully for complete breaths. Further complicating matters was the fact that because her lower esophagus was attached to her trachea, her stomach acids could also refl ux back into her lungs.<br /> <br /> Dr. Pandya says Zoey’s condition, seen in only one out of every 4,000 live births, has historically been addressed through a traditional open surgery in which a large incision was made in the chest. In fact, the vast majority of hospitals still correct the condition that way. But under the skilled hands and eyes of Dr. Pandya, his associate Dr. Whitney McBride, and the surgical team at Maria Fareri Children’s Hospital, Zoey’s surgery was done in a minimally invasive way, using a thoracoscope and required only three tiny incisions each approximately one-eighth of an inch long.<br /> <br /> During the four-hour operation, Dr. Pandya detached Zoey’s lower esophagus from her trachea and connected the upper and lower parts to each other so that the esophagus was one straight passageway. What made the already complex procedure even more challenging was the fact that because of her size, Zoey’s esophagus was no more than 5 millimeters in diameter.<br /> <br /> “While the approach is not novel, Zoey may have been one of the smallest babies in the country to have the operation. It is certainly the fi rst time that it was applied here,” Dr. Pandya says. “At Maria Fareri Children’s Hospital, we strive to safely push the envelope and pursue excellence in pediatric surgical care,” he adds. “The foundation in excellence established by my partners Dr. Gustavo Stringel, Dr. Whitney McBride, Dr. Anthony Sanfi lippo, and the phenomenal teamwork by our entire staff certainly made this landmark surgery more achievable.”<br /> <br /> In the weeks following her surgery, Dr. Pandya tested Zoey’s newly repaired esophagus, confi rmed there were no leaks and was sure she could breathe on her own and was ready to begin feeding by mouth. After only six weeks in the hospital—which included another operation by Dr. Pandya to close an accessory vessel between two of the major arteries connected to her heart—Zoey was able to go home.<br /> <br /> For Zoey’s mother, Jennifer and her husband, William, the doctors and nurses at Maria Fareri Children’s Hospital made a difficult time much easier. “Dr. Pandya was wonderful,” Jennifer recalls. “He made us feel very comfortable and went through everything that he was going to do in the surgery.” The Eckerts also have high praise for the nurses and support staff in the Isaac and Naomi Kaplan Family Regional Neonatal Intensive Care Unit who took good care of Zoey while her parents were home tending to their son, Liam, who just turned a year old. “The nurses were very reassuring, which was really nice because I couldn’t be there every day,” Jennifer says.