2018 - February Edition
Edward Curry, MD, FAAP   President, AAP-CA2
It's February and Valentine's so love is in the air. The Chapter would like to share its love with all the pediatricians who called, texted, and emailed their Federal legislator on CHIP Day of Action to help pass Childhood Health Insurance Program (CHIP). The Chapter would like to give an extra shout out and love to all the residency programs who came out in full force on Day of Action to support CHIP. All this support means millions of children will continue to receive healthcare coverage for the next 6 years. 
The Chapter would like to share its love with the pediatric practices that just completed a year-long Quality Improvement (QI) project to improve immunization rates of children between the ages of 12 and 35 months. These practices were able to decrease their missed opportunity rate, increase their combo 3 immunization rate, and implement a recall and reminder system. The practices were able to achieve these results by utilizing quality improvement techniques such as Plan, Do, Study, Act Cycles. The Pediatricians received valuable insight on how to handle vaccine hesitant patients by Dr. Ken Hempstead. Practices remained committed to QI processes and their patients were rewarded with improved protection against these infectious diseases. These practices were so impressed with the success of QI techniques that they will continue to use them and spread them to other parts of their practice.

The Chapter will be starting a HPV quality improvement project to improve completion of HPV series. The Chapter would love to have you join this QI project which will help decrease the cancer causing effects of HPV. Pediatricians who join this HPV QI project can earn 25 MOC part 4 points.
Our Chapter 2 Annual Pediatric Symposium will be held on April 28, 2018. We have an outstanding line up of speakers and topics. The Chapter loves our chapter members so much that we will be offering a special early bird rate. Registration will be in the next 2 weeks so sign up early.
Keep Love in your heart.
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Member Spotlight
Congratulations to Tanya Altman, MD, MPH, FAAP for the release of her latest book. View the full press release HERE 
AAP Publishes New Book to Help Parents Step Away from Dr. Google
New parents are full of questions. While you are always their best resource, a new book is available to help anxious parents put down their smart phones and get answers they can trust.  Baby and Toddler Basics: Expert Answers to Parents' Top 150 Questions by Tanya Altmann, MD, FAAP, is now available. Presented in a convenient Q&A format, this book helps parents find the reliable, pediatrician-approved answers they're looking for without going down any Internet wormholes.
Generous discounts are available when you buy in bulk for the families in your care - up to 50% off! For more information, visit shopAAP.
Member Spotlight
Congratulations to Leila M. Yoonessi, MD, MPH, FAAP of Long Beach for the upcoming launch of her book!


The 29th Annual AAP-CA2 Pediatric Symposium

Saturday, April 28, 2018
Sheraton Universal Hotel
Registration Opens Soon
Dr. Michael Brady received his undergraduate degree from the University of Notre Dame and his medical degree from Jefferson Medical College in Philadelphia. He completed his post-graduate training in Pediatrics at Nationwide Children's Hospital and Baylor College of Medicine. His subspecialty training in pediatric infectious diseases was performed at Baylor College of Medicine.

Dr. Brady was named to the American Academy of Pediatrics Committee on Infectious Diseases (Red Book Committee) in 2005 and served as its Chair from July 2010 until June 2014. He is an Associated Editor for the 2015 and 2018 Red Book. He has participated in other AAP activities on the state (Ohio AAP Committee on Child Care and HPV Education activities) and national AAP (Section on Infectious Diseases, Executive Committee, Committee on Pediatric AIDS, PREP-ID, AAP Practical Pediatrics Course committee and the Task Force on Circumcision).

In The Community
January 24 in Marina Del Rey 
Local pediatricians gathered at Cafe Del Rey in Marina Del Rey for a Town Hall sponsored by Abbvie. Norman Lavin, MD, PhD provided an in-depth lecture on
Central Precocious Puberty.  

Dr. Lavin shares the following insights: 
Skipping a shower in not the only reason for body odor in a child.  Beyond hygiene, there are several diseases or medical conditions that can alter the apocrine glands causing an unpleasant aroma.
Diabetes can produce body odor and a fruity breath smell. When you have hyperthyroidism, the body produces an excessive amount of sweat leading to odor. If the kidneys and liver fail to function properly, toxins can build up in the blood and digestive tract leading to odor. Also some rare genetic diseases like trimethylaminuria releases a "fishy" smell.
Several years ago, my colleagues and I observed that  several boys and girls with body odor had an endocrine  disorder, but no other sign or symptoms.  That is, no signs of puberty or adrenal hyperplasia  (no pubic  or axillary hair, no testicular enlargement or no breast development.)  We felt that there must be a reason so we investigated the pituitary and adrenal glands and discovered they had "Premature Adrenarche".  Typically, the child with this disorder would present with pubic or axillary hair emanating from an elevation of adrenal androgens such as DHEA (or DHEA-Suflate).  But in a minority of cases, the aroma preceded the pubic or axillary hair.  Occasionally, the bone age was mildly advanced
There are no specific treatments for Premature Adrenarche except to make sure this is not true Precocious Puberty, Therefore follow-up is important, If pubic hair and axillary hair become an overwhelming concern to the parent, some blocking agents are available if needed.
Norman Lavin,M.D.,PhD.
Clinical Professor of Endocrinology
UCLA School of Medicine
Private Consultation  Practice in Pediatric Endocrinology
18370 Burbank Blvd. Tarzana, CA 91356
Editor of "Manual of Endocrinology and Metabolism"
(5th Edition in April 2018)
February 1, in Victorville
AAP-CA2 Area Representative for San Bernardino County - High Desert, Damodara Rajasekhar, MD, FAAP hosted a Town Hall at Thai Dawn Bistro in Victorville on February 1st. Guest speaker and AAP-CA2 Area Representative in San Bernardino Mitchell Goldstein, MD, FAAP spoke on the Diagnosis and management of neonatal Syphilis. Dr. Goldstein is a neonatologist at Loma Linda University Medical Center.
On left, Mitchell Goldstein, MD, FAAP begins his lecture on Syphilis. 
Damodara Rajasekhar, MD, FAAP 
February 7, CQN All Immunizations QI - Final Webinar

We would like to congratulate the following practices for participating in the Chapter Quality Network All Immunizations Quality Improvement Project. National AAP funded this project, and provided our chapter with tools, resources and technical support from beginning to end.

Antelope Valley Community Clinic 
Paul Round, DO, FAAP
Britney D'Ambra, PNP
Clinicas Del Camino Real 
Pallavi Kamra, MD, FAAP
Anagha Suresh, MD, FAAP 
Vikram Naga Prasad Sarva Rama Murthi, MD, FAAP  
Evangeline G. Roxas-Butlig, MD, Inc 
Evangeline Roxas-Butlig, MD, FAAP
Mark Goya, MD
Kids and Teens 
Barbara Rodriguez, MD, FAAP 
Janesri De Silva, MD, FAAP
Los Angeles Christian Health Center 
Dina Brent, MD, FAAP
Mary Walker Health Center - Fort Irwin
Christina Casas,
Northeast Valley Health Corporation 
Elisha Featherstone, MD, FAAP
Buenaflor Uy , MD, FAAP  
Providence Pediatrics 
Victor Tamashiro, MD, FAAP
Southern California Permanente Medical Group
Glenn Miya, MD, FAAP
UCLA West Pediatrics 
Heide Woo, MD, MPH, FAAP
Blake Alban, MD
Candice Ho, MD
June Liu, MD, FAAP 
Young Nam-Choi, MD
Practices focused on improving missed opportunities rates, raising individual coverage rates in the HEDIS Combination 3 Childhood Immunization Status (CIS) Composite (DTaP, IPV, MMR, HiB, HepB, VZV, PCV), and implementing a reminder/recall system targeted to patients not up-to-date on childhood vaccines. 

February 7, in Woodland Hills
Ken Saul, MD, FAAP

AAP-CA2 Member-At-Large Ken Saul, MD, FAAP hosted a Town Hall at Maggiano's of Woodland Hills this past Thursday, sponsored by Abbott Nutrition.

Guest speaker Doron Kahana, MD shares the following insights:
Human milk oligosaccharides - a new strategy for preventing infant infections
Doron Kahana, MD, PNS
Pediatric GI & Medical Nutrition
The discovery of human milk oligosaccharides (HMO) in the late 19 th century was driven by pediatricians and microbiologists who were trying to understand the observed health benefits of human milk (HM). Namely, HM-fed infants have a lower rate of infection than those fed formula. Fast forward more than a century and researchers are still trying to close the gap between HM and formula.
Doron D. Kahana, MD, PNS

Mature HM contains 5-15 g/L of HMO, which constitutes the third largest solid component in HM after lactose and lipids. Concentrations of HMO vary among individuals and over the course of lactation, with known genetic and seasonal variations. HMO are believed to enhance gut maturation in the infant, act as prebiotics, antiadhesives, and antimicrobials, and also directly modulate infant immune responses. Research has shown an association between infant consumption of HMO and reduced rates of infections due to Campylobacter jejuni and caliciviruses, presumably by inhibiting pathogen binding (Morrow 2004); other research has shown reduced rates of respiratory infection due to multiple viruses (Stepans 2006). Recent ex-vivo research on RSV found that infants who were fed 2'-fucosyllactose (2'FL)-fortified formula exhibited innate cytokine profiles that were more similar to breastfeeding than to a control group fed formula without 2'FL (Goehring 2016), suggesting a direct immune benefit to supplementing infants with HMO.
In summary, HMO, an essential component of HM that is missing from most commercial formulas, may hold a key to preventing infant infections and work both directly and indirectly to stimulate the immune system during a vital window of infant development.
Doron D. Kahana, MD, PNS
Center for Digestive Health & Nutritional Excellence
23600 Telo Av. Ste. 260, Torrance, CA 90505
Tel: (424)234-1840  Fax:(866)591-7297
info@KahanaMD.com   drk@KahanaMD.com 
www.KahanaMD.com   www.Facebook.com/CDHNE  
Pediatrician Needed:
Expert Witness case review, reporting and testimony ; Starting out part-time position; Downtown Los Angeles.
Inquiries: Contact Michael Weinraub, MD.
Office: (213)335-6512
Email: WeinraubMD@gmail.com

New QI Project - HPV Vaccine Series Completion

We are now recruiting practices to participate in a quality improvement project aimed at improving HPV vaccine series completion in 11 and 12 year olds. This project is open to all practices.  
Pallavi Kamra, MD, FAAP
Dr Pallavi Kamra is a primary care pediatrician at Clinicas del Camino Real in Ventura County practicing at their Moorpark and Simi Valley locations. She moved to California after completing her pediatric residency and chief residency at the University of Minnesota. Immunizations are an area of interest for her and she recently participated in the CQN All Immunizations QI project through the AAP-CA 2 chapter. She will be a part of the HPV Phase 2 project and says the following about it:

 " I am excited to be a part of the AAP-CA2 HPV Vaccine Series Completion Project. HPV vaccine is one that I find most challenging in clinic with parents not wanting to administer it for a variety of reasons - their child is too young for it, it's meant for girls and not for boys, their child is not sexually active and doesn't need it, or because it's not required by school. I learned a lot from the experience of other practices during the all immunization QI project and am looking forward to hear what other providers in the community are doing and try and incorporate that at my clinic. I am thankful to the AAP CA 2 chapter for the opportunity to participate in the QI training in Phoenix and for conducting projects that allow for collaboration with other providers and learning from each other"

Now Recruiting Practices!

HPV Series Completion (Phase 2) Begins in March
Get CME and MOC Part 4 

Project Requirements, Per Participating Provider 

  1. Pull 10 consecutive charts of patients ages 11 and 12 years to determine a baseline HPV vaccine series completion rate, and again monthly to track progress.
  2. Attend the In-Person Learning Session in Pasadena in March, date TBD.
  3. Collect monthly data and upload onto QIDA (AAP's Quality Improvement Data Aggregator), to track progress and produce run charts.
  4. Participate in monthly webinars (usually at 12:15 PM on a Wednesday)

Click Here To Sign-Up 


UPCOMING EVENTS -  Save The Dates!
February 21 in Riverside -  Town Hall / Dinner 
Please join us in Riverside for an evening of professional development and networking.   
Topic: Central Precocious Puberty - Early Recognition & Management 
Amrit Bhangoo, MD
Speaker: Amrit Bhangoo, MD - Pediatric Endocrinologist , CHOC 
Date: February 21, 2018 at  6:30 PM. 
LOCATION:       Mario's Place Restaurant, 3646 Mission Inn Ave, Riverside, CA 92501  
Best Practices in Developmental Screening - An Inside Look (Town Hall) 
An inside look, from the systematic approach of Regional Center clinicians and therapists, to strategies  used by local pediatricians. Funded by First 5 Los Angeles. Join us on the evening listed below.

We are also working on the Lanterman/South Central/East LA event, TBA shortly. 
March 28 in Torrance -  Town Hall / Dinner 6-8 PM
This event will take place at the Harbor Regional Center in Torrance. Clinical Geneticist Sri Moedjono, MD, FACMG and General Pediatrician Ahoo Sahba, MD, both clinicians at the Harbor Regional Center, will discuss best practices in developmental screening, clinical cases and the referral process. This event will begin at 6:00 PM (Dinner and Lecture). CME Accreditation: 1.5 AMA PRA Category 1 Credits™.

Wednesday, March 28 in TORRANCE at 6 PM 
LOCATION: Harbor Regional Center 
21231 Hawthorne Blvd, Torrance, CA 90503 (Room A4) 
Guest Speakers: Sri Moedjono, MD, FACMG, and Ahoo Sahba, MD.

March/April/May - Grand Rounds Lecture on Suicide
It is Time to Open our Eyes! As pediatricians and health professionals working with children and adolescents, little attention is given in training or ongoing education to the third leading cause of death in 10-14 year olds and second leading cause of death in 15-34 year olds - SUICIDE. This presentation is to raise your awareness and give an overview of the scope of the problem and associated risk factors. An extensive list of resources will be provided for further training, referrals, and to use as resources professionally or personally.
Topic: "It is Time to Open Our Eyes - Suicide Risk with a Focus on the Pediatric and Adolescent Population"
Speaker: Susan Igdaloff, MD, FAAP
3/12 Huntington Hospital; Medical Staff Conference (12PM) 
3/20 LA County USC Pediatric Grand Rounds (9 AM)
3/22 Harbor-UCLA Pediatric Grand Rounds (8:30 AM)
3/27 Valley Presbyterian; Medical Staff Conference (12 PM) 
4/3  Pomona Valley Hospital; Medical Staff Conference (12:30) 
4/10 CHLA - Clinical Services; Non-physician Staff  (12 PM) 
4/23 Citrus Valley Medical Center; Pediatric Department Conference (12P)  
5/2 Riverside Community Hospital (12:30 PM)

While registration is not required, you may still sign up to receive a reminder. 
RSVP : Please Click To Register

The 29th Annual AAP-CA2 Pediatric Symposium

Saturday, April 28, 2018
Sheraton Universal Hotel
Save The Date!
Statewide  Advocacy
Please visit the AAP-CA website for more information on the most current Advocacy Priorities and High Priority Bills list for the 2017-2018 Session.

AAP-CA2 Video: We Are The AAP-CA Chapter 2 -  2017

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Please Donate
AAP-CA2 is a 501(c)(3) non-profit organization. Please consider a tax-deductible charitable donation to one of our many programs
  • The Medicine-Biological Sciences Scholarship Program, which awards scholarships to exceptional high school students each year.
  • The Committee on Service, Education, and Mentoring, which awards scholarships to pediatric residents for outstanding research projects. 
  • The S. Michael Marcy Memorial Lecture, which helps sponsor a portion of our annual Advances in Pediatrics Conference in his honor.

Thank you for your support
PO Box 94127 Pasadena, CA 91109
(818) 422-9877
Please visit our website at  http://aapca2.org/