Inside Pediatrics Fall/Winter 2024

ENDOCRINOLOGY

GASTROENTEROLOGY

A potential breakthrough in hypothalamic obesity treatment Acquired hypothalamic obesity has long presented a complex challenge in healthcare, leaving pediatric patients struggling to lose weight. To address the problem, Children’s of Alabama is involved in an innovative study involving a medication called setmelanotide, a drug that targets melanocortin receptors, which are crucial in regulating the body’s satiety signals. According to Children’s endocrinologist Hussein Abdul-Latif, M.D., the medication can have an impact on correcting the disrupted signals that lead to continuous hunger and reduced metabolism— two key factors contributing to this form of obesity. The ongoing phase 3 trial involves multiple sites, including Children’s of Alabama, enrolling patients up to 30 years old. The research offers hope to those struggling with acquired hypothalamic obesity, Abdul-Latif says. The condition, which previously was perceived as challenging to treat

New Polyposis Clinic aims to enhance gastrointestinal care

Successfully managing gastrointestinal issues in children can be extremely challenging, but a new clinic at Children’s of Alabama is providing a hub of specialized care.

The Children’s of Alabama Polyposis Clinic was conceived to fill a crucial gap in pediatric gastroenterology. Recognizing the need to provide focused expertise and coordinated care for patients with polyposis syndromes “was the major impetus for establishing a dedicated clinic,” said pediatric gastroenterologist Cary Cavender, M.D., who leads the clinic. The clinic, which opened in January 2024, operates on a quarterly basis. It offers advanced diagnostic and treatment procedures, including advanced endoscopy and colonoscopy techniques such as pill cam endoscopy as well as medication management. Because many patients have an increased risk for cancer, the clinic works with members of the oncology team specializing in cancer predisposition. Among their other duties, oncology team members coordinate genetic counseling for high-risk patients at the Oncology Cancer Predisposition Clinic, ensuring families receive comprehensive support. The clinic is one of the first of its kind in the Southeast. Cavender believes it will serve as a vital resource, offering top-tier care for children with polyposis syndromes.

effectively, now has a potential breakthrough. The medication provides promise for a segment of the population in need of more personalized solutions, hinting at a positive outlook for the future of treating this condition.

UROLOGY

ORTHOPEDICS

A new model for testicular torsion detection

Orthopedics team expands to meet patients’ needs In response to increased demand for services, the Children’s of Alabama orthopedics team has expanded, adding two orthopedic surgeons and two advanced practice providers since late 2022. The division now has six surgeons and four advanced practice providers.

10 - 20 %

Testicular torsion is a serious medical emergency that requires immediate surgical intervention. Yet the condition may present with vague symptoms such as abdominal pain and nausea. That’s why Children’s urologist Carmen Tong, D.O., teamed up with the hospital’s Pediatric Simulation Center team to create a new model to help with diagnosis. Prompt diagnosis is crucial. The so-called “golden window” to salvage testicular function after symptom onset is between four and eight hours. So to improve detection, Tong turned to Nick Rockwell, M.D., and advanced nurse educator Autumn Layton, MSN, RN, in the simulation center. Together, they created a testicular torsion model that provides experiential learning for residents. Rockwell, Layton and their team used Play-Doh–covered Styrofoam balls to simulate a torsed testicle, while a stress ball represents a normal testicle. These are enclosed in balloons to mimic scrotal skin and attached to a mannequin. Residents can then practice palpating the model to distinguish between normal and torsed testicles. The response to the training has been overwhelmingly positive, Tong said. “What’s super impressive about this model is that it’s easily replicable,” she added. “So once we publish this, other institutions can take what we did and create the same model. It doesn’t cost thousands of dollars.”

Increased demand each year since 2020

The staff additions are the department’s response to steady population growth in the Birmingham area and lengthening wait times for clinic appointments. According to orthopedic surgeon Kevin Williams, M.D., demand for the team’s services has continued at a clip of 10% to 20% year over year since 2020. “We’re constantly looking to provide better care for children of Alabama,” Williams said. “One way was to put more providers in place who can take care of these patients in clinic and think about how to best care for children with difficult pathologies.” With the new providers, the team can now see patients within an appropriate time frame instead of having to book appointments months out. Adding team members also adds flexibility to everyone’s roles. Advanced practice providers can see patients independently, freeing up surgeons for surgical cases. They can also assist in the operating room.

3

Inside Pediatrics | Children’s of Alabama