Arizona Respiratory Center (ARC) | Arizona Health Sciences Center

Addition of Proton Pump Inhibitor to Treatment of Poorly Controlled Asthma in Children Does Not Improve Symptoms

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Addition of Proton Pump Inhibitor to Treatment of Poorly Controlled Asthma in Children Does Not Improve Symptoms

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In the January 25 issue of JAMA (Journal of the American Medical Association)

CHICAGO – Children without symptoms of gastroesophageal reflux whose asthma was being poorly controlled with anti-inflammatory treatment did not have an improvement in symptoms or lung function with the added treatment of the proton pump inhibitor lansoprazole, compared to patients who received placebo, according to a study in the January 25 issue of JAMA. Use of lansoprazole was associated with increased adverse events.

“Asthma and gastroesophageal reflux (GER) disease are both common disorders in children, and symptoms of GER are frequently reported among children with asthma,” according to background information in the article. “Untreated GER has been postulated to be a cause of inadequate asthma control in children despite inhaled corticosteroid treatment, but it is not known whether treatment with proton pump inhibitors improves asthma control.”

Janet T. Holbrook, M.P.H., Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues with the Writing Committee for the American Lung Association Asthma Clinical Research Centers, conducted a randomized, placebo-controlled clinical trial to compare the PPI lansoprazole with placebo in children with poor asthma control who were receiving inhaled corticosteroid treatment. The study included 306 participants, enrolled from April 2007 to September 2010 at 19 U.S. academic clinical centers, who were followed up for 24 weeks. A subgroup had an esophageal pH (a test for GER) study before randomization. Children were randomly assigned to receive either lansoprazole (n=149) or placebo (n=157). The primary measured outcome was change in Asthma Control Questionnaire (ACQ) score (range, 0-6; a 0.5-unit change is considered clinically meaningful). Secondary outcome measures included lung function measures, asthma-related quality of life, and episodes of poor asthma control. The average age of the children was 11 years; there were more boys than girls, and 50 percent of participants were black.

The researchers found that after randomization, the ACQ score decreased by less than the meaningful clinically important difference in both groups; the change was not statistically different between treatment groups. There were no statistically significant treatment effects for any of the secondary outcomes.

Among the 115 children with adequate 24-hour esophageal monitoring studies, 43 percent (n = 49) had positive results for GER. In children with GER, there was no significant effect of lansoprazole treatment on any of the study outcomes, including asthma-related quality of life or lung function.

Of the participants, 10 in the lansoprazole group and 9 in the placebo group had 1 or more serious adverse events. The most common serious adverse event in both groups was asthma exacerbation (15 of 25 reports). Treatment with lansoprazole was associated with a greater prevalence of upper respiratory tract infections, sore throats, and episodes of bronchitis. “Our study raises important questions about adverse effects of lansoprazole treatment of children with asthma,” the authors write.

“In conclusion, the results of our study indicate that PPI treatment of children with poorly controlled asthma without symptomatic GER was not an effective therapy for asthma and there may be significant safety concerns for long-term PPI use in children that warrant further study.”

(JAMA. 2012;307[4]:373-381. Available pre-embargo to the media at www.jamamedia.org)

Editor’s Note: This study was supported by the American Lung Association Asthma Clinical Research Centers Infrastructure Award and National Institutes of Health/National Heart, Lung, and Blood Institute grants. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Please Note: For this study, there will be multimedia content available, including the JAMA Report video, embedded and downloadable video, audio files, text, documents, and related links. This content will be available at 3 p.m. CT Tuesday, January 24 at this link.

Editorial: Children, Asthma, and Proton Pump Inhibitors

In an accompanying editorial, Fernando D. Martinez, M.D., of the University of Arizona, Tucson, writes that the “overuse of PPIs in childhood asthma and in pediatrics in general is another example of a subtle but frequent phenomenon in clinical practice: therapeutic creep.”

“Clinicians extend the use of a treatment with real or suggestive therapeutic effects observed in a certain age group or in patients with a certain disease phenotype to other patients in whom the efficacy has never been demonstrated,” Dr. Martinez writes. “Therapeutic creep increases the risk of potential adverse effects without any added advantage for patients. It is also plausible to surmise that this phenomenon has substantially contributed to the marked increase in asthma drug costs, which are now the largest component of the direct costs for the disease.”

(JAMA. 2012;307[4]:406-407. Available pre-embargo to the media at www.jamamedia.org)

Editor’s Note: Dr. Martinez has served as a consultant to MedImmune and has presented at an Abbott-sponsored seminar

Media Advisory: To contact Janet T. Holbrook, M.P.H., Ph.D., call Tim Parsons at 410-955-7619 or email tmparson@jhsph.edu. To contact editorial author Fernando D. Martinez, M.D., call Katie Riley at 520-626-4828 or email riley@email.arizona.edu.

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Jean Spinelli

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NIH Study Finds Omalizumab Relieves Seasonal Asthma Attacks in Youth

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NIH Study Finds Omalizumab Relieves Seasonal Asthma Attacks in Youth

Teaser Body:

Symptoms Reduced in Children and Young People with Moderate to Severe Disease

The NIH sent out a press release today regarding a study to be published tomorrow in The New England Journal of Medicine (see press release below): “Randomized Trial of Omalizumab (Anti-IgE) for Asthma in Inner-City Children.”

We wanted to inform you that researchers from the University of Arizona Department of Pediatrics/Steele Children’s Research Center, the BIO5 Institute and the Arizona Respiratory Center were involved in the study. Specifically, Wayne Morgan, MD, professor, Section of Pulmonology/Allergy and Immunology, was the study’s co-first author.

Additional UA faculty from the Department of Pediatrics who contributed to the study were:

Mark Brown, MD, professor; Section of Pulmonology/Allergy and Immunology
Michael Daines, MD, assistant professor; Section of Pulmonology/Allergy and Immunology
Cori Daines, MD, associate professor; Section of Pulmonology/Allergy and Immunology
Roni Grad, MD, associate professor; Section of Pulmonology/Allergy and Immunology
Fernando Martinez, MD, professor, Section of Pulmonology/Allergy and Immunology; Director, BIO5 Institute; Director, Arizona Respiratory Center

EDITORS NOTE: If you are interested in covering this story, Dr. Morgan will be available for interviews. To schedule an interview, please contact Darci Slaten at (520) 626-7217, (520) 954-2395 or darci@peds.arizona.edu.

If you are interested in reviewing the original article, please contact the editorial office at The New England Journal of Medicine.

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A drug that targets the antibody immunoglobulin E (IgE), a key player in asthma, nearly eliminated seasonal increases in asthma attacks and decreased asthma symptoms among young people living in inner city environments, a clinical trial sponsored by the National Institutes of Health has found.

The findings will appear in the March 17 issue of the New England Journal of Medicine.

This investigational use of the drug omalizumab, sold under the brand name Xolair, was conducted in eight U.S. cities by the Inner City Asthma Consortium (ICAC), a nationwide clinical trials network supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. Additional support for this research was provided by the NIH National Center for Research Resources and Novartis Pharmaceuticals Corporation.

“We know that treatment based on NIH asthma guidelines is generally effective in managing the disease, but many patients still experience asthma attacks requiring visits to emergency rooms and hospitalizations,” says NIAID Director Anthony S. Fauci, M.D. “The results of this study are extremely promising because they show that the addition of omalizumab to the NIH guidelines-based therapy for asthma offers improved asthma control and the potential to decrease the burden of this chronic disease in children and adolescents.”

In the United States, asthma affects approximately 18 million adults and 7 million children under the age of 18. Symptoms include wheezing, coughing, chest tightness and shortness of breath, any of which can be provoked by viral infections, allergens and air pollution. The number of asthma attacks rises in the spring and fall seasons when more allergens are in the air and the occurrence of respiratory viruses increases.

The study enrolled 419 children and youths, ages 6 to 20 years old, diagnosed with moderate to severe allergic asthma lasting more than one year. The children came from Boston, Chicago, Cleveland, Dallas, Denver, New York City, Tucson, Ariz. and Washington, D.C. Nearly all were minorities, including African-Americans (60 percent) and Hispanics (37 percent).

The primary goal of the study was to determine if adding omalizumab to NIH guidelines-based asthma therapy reduced the number of days that participants experienced any asthma-related symptoms. Another aim was to find out if the addition of omalizumab could also reduce the number of severe asthma attacks.

In addition to standard therapy, half of the participants were assigned at random to receive omalizumab, and the other half a placebo. Drug or placebo was delivered via an injection under the skin every two to four weeks over the 60-week period of study.

As the trial proceeded, participants returned to the clinic every three months for evaluation of their symptoms. As needed, their non-trial medications were adjusted according to the NIH asthma treatment guidelines.

At the end of the study, the investigators found that, overall, children and adolescents who received omalizumab had a 25 percent reduction in days with symptoms and a 30 percent reduction in asthma attacks compared with those who received placebo. Those who received omalizumab also had a 75 percent reduction in hospitalizations. Importantly, the spring and fall increases in asthma attacks that were seen in the participants receiving placebo were almost eliminated in those participants receiving omalizumab.

“The spike in asthma attacks in the fall, which is associated with colds and other viral airway infections, disappeared in the kids in the omalizumab group,” says William Busse, M.D., the principal investigator of ICAC and professor of medicine at the University of Wisconsin-Madison. “Because the drug specifically targets IgE, which is the antibody responsible for allergies, our observations show the possible interplay between allergies, respiratory viruses and IgE in provoking asthma attacks.”

Children and adolescents who responded the best to omalizumab had positive skin tests for cockroach allergy and high levels of cockroach allergen in their homes. In previous work by NIAID-supported researchers, the combination of cockroach allergy and exposure to cockroaches was found to be an important cause of asthma-related illness and hospitalization.

Omalizumab is a humanized monoclonal antibody, a pure form of a single protein, custom-made for use in humans, which binds to and blocks the activity of IgE, an important molecule in allergy. When allergens bind to IgE on the surface of certain immune cells, these cells release substances that cause allergic reactions. In the airways, these substances trigger the muscles to contract, trapping air inside the lungs and causing difficulty breathing.

“We continue searching for therapeutic strategies to reduce the enormous burden of asthma. Following on the findings reported here, ICAC studies now under way will help us to determine if adding omalizumab only during the period before fall seasonal asthma symptoms occur, rather than throughout the year, results in the same successful disease management,” says Daniel Rotrosen, M.D., director of NIAID’s Division of Allergy, Immunology and Transplantation, which oversees the ICAC program.

Omalizumab is approved in the United States for patients ages 12 and older with moderate to severe persistent allergic asthma. The drug is jointly developed by Genentech Inc., a member of the Roche group, under an agreement with Novartis Pharma AG. Patients who are interested in adding omalizumab to their current asthma treatment should speak with their health care professional. For more information about omalizumab, visit www.xolair.com.

The NIH Guidelines for the Diagnosis and Management of Asthma can be viewed or downloaded at www.nhlbi.nih.gov/guidelines/asthma/.

The National Center for Research Resources (NCRR), a part of NIH, provides laboratory scientists and clinical researchers with the resources and training they need to understand, detect, treat and prevent a wide range of diseases. NCRR supports all aspects of translational and clinical research, connecting researchers, patients and communities across the nation. For more information, visit www.ncrr.nih.gov.

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at www.niaid.nih.gov.

The National Institutes of Health (NIH)—The Nation's Medical Research Agency—includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

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Reference: WW Busse et al. A randomized trial to evaluate the impact of the addition of omalizumab to guidelines based therapy of inner-city children and adolescents with asthma. New England Journal of Medicine. DOI: 10.1056/NEJMoa1009705 (2011).

Media Contact: Julie Wu

(301) 402-1663

wujuli@niaid.nih.gov

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Darci Slaten, MA

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100 AHSC Physicians Among 'Best Doctors in America’

Teaser Title:

100 AHSC Physicians Among 'Best Doctors in America’

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More than 100 Tucson physicians affiliated with the Arizona Health Sciences Center are included in the latest Best Doctors in America database.

More than 100 Tucson physicians affiliated with the Arizona Health Sciences Center are included in the latest Best Doctors in America database.

This database, compiled for more than 20 years by Best Doctors, Inc., includes about 45,000 U.S. physicians in more than 40 specialties and 400 subspecialties of medicine. They represent the top 3 to 5 percent of specialists in the country.

The list is based on a biennial survey of tens of thousands of leading physicians who were asked whom they would go to for treatment in their own specialty.

The 2011-2012 database includes more than 400 Tucson physicians, of whom about 100 are affiliated with the Arizona Health Sciences Center. Most are on the faculty of the University of Arizona College of Medicine and practice at University Medical Center, University Physicians Hospital and Clinics at Kino Campus and at the Southern Arizona VA Health Care System.

The complete list of Tucson “Top Docs” is available in the January issue of Tucson Lifestyle magazine.

Allergy and Immunology

and Internal Medicine

Randy J. Horwitz

Anesthesiology

Steven J. Barker

R. Dennis Bastron

Brenda A. Gentz

Stuart Roy Hameroff

Peter R. Lichtenthal

Robert G. (Butch) Loeb

T. Philip Malan, Jr.

Wallace M. Nogami

Craig M. Palmer

David S. Sheinbein

Cardiovascular Disease

Joseph S. Alpert

Eric A. Brody

Gordon A. Ewy

Paul E. Fenster

Mark J. Friedman

Julia H. Indik

Karl B. Kern

Peter Ott

Vincent L. Sorrell

Clinical Pharmacology

John W. Bloom

David G. Johnson

Colon and Rectal Surgery

Alfred M. Cohen

Critical Care Medicine

Steven R. Knoper

Charles W. Otto

Linda S. Snyder

Dermatology

Clara Curiel

Emergency Medicine

Daniel L. Beskind

Lisa Chan

Albert B. Fiorello

Samuel Keim

Harvey W. Meislin

John C. Sakles

Arthur B. Sanders

Frank G. Walter

Endocrinology

and Metabolism

David G. Johnson

Family Medicine

Erika Albani

Colleen Cagno

Peter Catinella

Barbara Eckstein

Paul R. Gordon

James P. Kerwin

Randa M. Kutob

Patricia Lebensohn

Victoria Hope Maizes

Lawrence M. Moher

Myra L. Muramoto

Victoria E. Murrain

Tejal M. Parikh

Gastroenterology

John Thomas Cunningham

Steve Goldschmid

Hepatology

Thomas D. Boyer

Infectious Disease

John N. Galgiani

Internal Medicine

Randy J. Horwitz

Dawn P. Lemcke

Kevin Moynahan

Anthony M. Stazzone

Jennifer L. Suriano

Medical Oncology

and Hematology

Frederick R. Ahmann

David S. Alberts

Thomas D. Brown

Lee D. Cranmer

Robert B. Livingston

Ana Maria Lopez

Thomas P. Miller

Alison T. Stopeck

Neurological Surgery

Allan J. Hamilton

Neurology

Geoffrey L. Ahern

Harvey W. Buchsbaum

Bruce M. Coull

Hemant S. Kudrimoti

David M. Labiner

Obstetrics and

Gynecology

Setsuko Chambers

Lynn Marie Coppola

Francisco Garcia

Kenneth D. Hatch

James E. Maciulla

Kathryn L. Reed

Orthopaedic Surgery

William A. Grana

John T. Ruth

Joseph E. Sheppard

Otolaryngology

Alexander G. Chiu

Pathology

Thomas M. Grogan

Richard E. Sobonya

Ronald S. Weinstein

Pediatric Allergy

and Immunology

Michael O. Daines

Pediatric Cardiac Surgery

Michael F. Teodori

Pediatric Cardiology

Brent J. Barber

Stanley J. Goldberg

Scott E. Klewer

Daniela Lax

Ricardo Samson

Santiago Valdes

Pediatric Critical Care

Marc D. Berg

Robyn Meyer

Andreas A. Theodorou

Pediatric Developmental

and Behavioral Problems

Sydney Rice

Pediatric Emergency

Medicine

Dale P. Woolridge

Pediatric Endocrinology

Mark D. Wheeler

Pediatric Gastroenterology

Fayez K. Ghishan

H. Hesham A-Kader Hassan

Khalid M. Khan

Pediatric Infectious

Disease

Sean P. Elliott

Ziad M. Shehab

Pediatric Ophthalmology

Joseph M. Miller

Pediatric Pulmonology

Mark A. Brown

Cori L. Daines

Roni Grad

Fernando D. Martinez

Wayne J. Morgan

Pediatric Specialist/

Adolescent and Young

Adult Medicine

Richard A. Wahl

Pediatric Specialist/

Neonatal-Perinatal

Medicine

Alan D. Bedrick

Pediatrics General

Conrad Clemens

Karen M. Davenport

Martha L. Eicher

Jennifer B. Moher

Philip J. Starceski

Maria S. Theodorou

Pediatrics/

Hospital Medicine

Cleo K. Hardin

Psychiatry

Linda Durst

Mark Gilbert

Richard D. Lane

John Misiaszek

Francisco A. Moreno

Bernard Martin Morenz

Rebecca L. Potter

Karen Weihs

Pulmonary Medicine

John W. Bloom

Steven R. Knoper

Linda S. Snyder

Radiation Oncology

Shona T. Dougherty

Baldassarre D. Stea

Radiology

Raymond F. Carmody

Theron W. Ovitt

Joachim F. Seeger

Carl J. Zylak

Rheumatology

Eric P. Gall

Jeffrey R. Lisse

Margaret M. Miller

Surgical Oncology

Alfred M. Cohen

Hugo V. Villar

Urology

Mitchell Sokoloff

Vascular Surgery

Joseph L. Mills

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AHSC Office of Public Affairs

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UA College of Nursing Researchers Awarded $2 Million NIH Grant for Sleep Study

Teaser Title:

Study to help children breathe and sleep better

Teaser Body:

Kristen Hedger Archbold, PhD, RN, assistant professor at the University of Arizona College of Nursing, has received five-year, $2 million funding from the National Institutes of Health/National Heart Lung and Blood Institute (NIH/NHLBI).

Kristen Hedger Archbold, PhD, RN, assistant professor at the University of Arizona College of Nursing, has received five-year, $2 million funding from the National Institutes of Health/National Heart Lung and Blood Institute (NIH/NHLBI). She and her team will study the effects of a ventilator therapy on behavior and cognition in school-aged children who stop breathing during sleep, a condition called obstructive sleep apnea (OSA). Up to 12 percent of school-aged children have symptoms suggesting that during sleep they have brief periods when they stop breathing. The common treatment in adults is positive airway pressure (PAP). PAP uses a ventilator (with mask) to trigger breathing and prevent any drop in blood oxygen levels. Yet to be studied is whether this treatment, adapted for children, would be beneficial. Sixty children between the ages of 6 and 12 with OSA will be enrolled, comparing those who do and do not receive PAP therapy. Behavior and cognition will be measured three times over six months.

This study is the first known to use a placebo or sham PAP ventilator, created by Dr. Archbold and her research team, in school-aged children and compare it to actual PAP. Currently, there are no accepted standards of care for using PAP therapy in pediatric OSA patients. This project has the potential to change significantly the clinical trajectory and course of treatment of OSA in children.

Dr. Archbold is an expert in the area of sleep disorders and sleep research with a particular focus on how to optimize pediatric neurobehavioral health through the mechanism of healthy sleep. Her team includes James Goodwin, PhD, Arizona Respiratory Center at the UA College of Medicine, and Stuart Quan, MD, professor emeritus at the UA College of Medicine.

Faculty at the University of Arizona College of Nursing envision, engage and innovate in education, research and practice – to help people of all ages optimize health in the context of major life transitions, illnesses, injuries, symptoms and disabilities. Established in 1957, the College ranks among the top nursing programs in the United States. For more information about the College, visit the website, www.nursing.arizona.edu

Media Contact:

Phyllis Kabins

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Original Story

More than 100 University Physicians Among Nation’s 'Best Doctors'

Teaser Title:

More than 100 University Physicians Among Nation’s 'Best Doctors'

Teaser Body:

<p>For more information or to arrange an appointment with these and others affiliated with the University of Arizona, please call the University Health Connection at (520) 694-8888.</p>

December 15, 2009

More than 100 Tucson physicians affiliated with the Arizona Health Sciences Center (AHSC) at the University of Arizona are included among the 2009-2010 Best Doctors in America database.

The database includes about 45,000 U.S. physicians in more than 40 specialties and 400 subspecialties of medicine. They represent the top 3 to 5 percent of specialists in the country, according to Best Doctors Inc of Boston (www.bestdoctors.com).

The list is based on a biennial survey by Best Doctors Inc of tens of thousands of leading physicians who were asked whom they would go to for treatment in their own specialty. Founded in 1989 by doctors affiliated with Harvard University, the Best Doctors database helps patients identify specialists for complex medical cases or second opinions.

The 2009-2010 list includes more than 100 AHSC doctors in 25 specialties. Most are on the faculty of the University of Arizona College of Medicine and are members of University Physicians Healthcare. They practice primarily at University Medical Center and its physician offices, at the University Physicians Hospital and Outpatient Clinics, and at the Southern Arizona Veterans Health Care System.

Allergy and Immunology
and Internal Medicine
Randy J. Horwitz

Anesthesiology
Steven J. Barker
R. Dennis Bastron
Geraldine C. Diaz
Brenda A. Gentz
Stuart Roy Hameroff
Peter R. Lichtenthal
Robert G. (Butch) Loeb
T. Philip Malan
Wallace M. Nogami
Craig M. Palmer
David S. Sheinbein

Cardiovascular Disease
Joseph S. Alpert
Eric A. Brody
Gordon A. Ewy
Paul E. Fenster
Mark J. Friedman
Steven Goldman
Julia H. Indik
Elizabeth B. Juneman
Karl B. Kern
Beth R. Malasky
Peter Ott
Vincent L. Sorrell
Hoang M. Thai
Sergio G. Thal

Clinical Pharmacology
and Endocrinology
and Metabolism
David G. Johnson

Clinical Pharmacology
and Pulmonary Medicine
John W. Bloom
Steven R. Knoper

Critical Care Medicine
Charles W. Otto

Dermatology
Clara Curiel

Emergency Medicine
Daniel L. Beskind
Lisa Chan
Albert B. Fiorello
Harvey W. Meislin
John C. Sakles
Arthur B. Sanders

Family Medicine
Colleen Cagno
Paul R. Gordon
Cynthia C. Johnston
James P. Kerwin
Randa M. Kutob
Patricia Lebensohn
Victoria Hope Maizes
Lawrence M. Moher
Myra L. Muramoto
Victoria E. Murrain
Tejal M. Parikh
Edward G. Paul

Gastroenterology
John Thomas Cunningham
Ronnie Fass
Steve Goldschmid
M. Peter Lance
Richard E. Sampliner

Geriatric Medicine
Mindy Fain
Hepatology
Thomas D. Boyer

Infectious Disease
Neil M. Ampel
John N. Galgiani

Internal Medicine
Kathleen E. Gibson
Dawn P. Lemcke
Kevin Moynahan
Sonia M. Perez-Padilla
Anthony M. Stazzone
Jennifer L. Suriano

Internal Medicine,
Clinical Pharmacology
Timothy C. Fagan

Medical Oncology
and Hematology
Frederick R. Ahmann
David S. Alberts
Thomas D. Brown
Robert B. Livingston
Ana Maria Lopez
Thomas P. Miller
Alison T. Stopeck

Neurological Surgery
Allan J. Hamilton

Neurology
Geoffrey L. Ahern
Bruce M. Coull
Hemant S. Kudrimoti
David M. Labiner
Steven Z. Rapcsak

Neurology and
Pain Medicine
Harvey W. Buchsbaum

Obstetrics and
Gynecology
Setsuko K. Chambers
Lynn M. Coppola
Francisco A. Garcia
Kenneth D. Hatch
James E. Maciulla
Kathryn L. Reed

Ophthalmology and
Pediatric Ophthalmology
Joseph M. Miller

Orthopaedic Surgery
Robert B. Dzioba
William A. Grana
John T. Ruth

Pathology
Thomas M. Grogan
Anil Prasad Rama Rao
Ronald S. Weinstein

Pediatric Allergy
and Immunology
Michael O. Daines

Pediatric Cardiac Surgery
and Thoracic Surgery
Jack G. Copeland
Michael F. Teodori

Pediatric Cardiology
Brent J. Barber
Stanley J. Goldberg
Scott E. Klewer
Daniela Lax
Ricardo Samson

Pediatric Critical Care
Marc D. Berg
Robyn Meyer
Andreas A. Theodorou

Pediatric Developmental
and Behavioral Problems
Sydney Rice

Pediatric Emergency
Medicine
Dale P. Woolridge

Pediatric Endocrinology
Mark D. Wheeler

Pediatric
Gastroenterology
Fayez K. Ghishan
H. Hesham A-Kader Hassan
Khalid M. Khan

Pediatric Hematology
and Oncology
Michael Lucien Graham
Andrew M. Yeager

Pediatric Infectious
Disease
Sean P. Elliott
Ziad M. Shehab

Pediatric Pulmonology
Mark A. Brown
Cori L. Daines
Roni Grad
Fernando D. Martinez
Wayne J. Morgan

Pediatric Specialist/
Adolescent and Young
Adult Medicine
Richard A. Wahl

Pediatric Specialist/
Neonatal-Perinatal
Medicine
Alan D. Bedrick

Pediatrics General
Conrad Clemens
Karen M. Davenport
Martha L. Eicher
Cleo K. Hardin
William A. Madden
Jennifer B. Moher
Philip J. Starceski
Maria S. Theodorou

Psychiatry
Linda Durst
Richard D. Lane
John Misiaszek
Francisco A. Moreno
Bernard Martin Morenz
Timothy I. Mueller
Rebecca L. Potter

Pulmonary Medicine
Sammy C. Campbell

Radiation Oncology
Shona T. Dougherty
Baldassarre D. Stea

Radiology
Raymond F. Carmody
Theron W. Ovitt
Joachim F. Seeger
Carl J. Zylak

Rheumatology
Jeffrey R. Lisse
Margaret M. Miller

Surgical Oncology
Hugo V. Villar

Urology
John J. Mulcahy
Mitchell Sokoloff

Vascular Surgery
Joseph L. Mills

For more information or to arrange an appointment with these and others affiliated with the University of Arizona, please call the University Health Connection at (520) 694-8888.

Media Contact:

Katie Riley

Original Story Link:

Original Story