i 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 for Academy membership, and 2) relay your reactions directly to your District Chairperson, whose name and address is at the end of this list. Connecticut Richard Dale England, M.D. Pfizer Inc. Central Research Division Eastem Pdint Rd. Groton, CT 06340-5146 Catherine D. Leidigh, M.D. 29 Hospital Hill Rd. PO Box 157 Sharon, CT 06069 Ana Paula R. Machado, M.D. 107 Newtown Rd., Ste. 1-D Danbury, CT 06810-4120 Unitormed Services East Niaz All, M.D. 3805 Route 33 Jumping Brook West 4 Neptune, NJ 07753-3260 Major Stephen F. Bell, M.D. 3743 Tailboard Way Martinez, GA 30907 Jacqueline Kim Giannini, M.D. 218 Waterfront PI. Centerville, OH 45458-3866 Capt. Kevin R. Johnson, M.D. 264 Kidd St. Ft. Walton Beach, FL 32548 All Shan Khan, M.D. 1868 Georgiana Dr., NE Atlanta, GA 30329-3332 Myma R. Nieves, M.D. Low Rise 10 Apt. 1-F Villas Senonal Rio Piedras, PR 00926 Rozalynde Randolph, M.D. 97th General Hospital, Box 8 Unit 25717 APO, AE 09242 Hector Orlando Santos, M.D. PO Box 1832, Bldg. 18 Cidra, PR 00739-1832 LCDR Jennifer L. Tucker, M.D. 2575 Ridgecrest Ave. Orange Park, FL 32065-8933 Massachusetts Robert Drew Basow, M.D. 17 Ledge Hill Rd. Southborough, MA 01772 Stuart Leonard Goldstein, M.D. 90 Kilsyth Rd., Apt. 38 Brighton, MA 02146, Aline M. Hutner, M.D. 17 Blaney St. Swampscott, MA 01907-2561 Katherine Anne King, M.D. 148 Elgin St. Newton, MA 02159-2302 Claire Mc Carthy, M.D. 2 Fairfield Ave. Melrose, MA 021 765506 Susan K. Milet, DO 21 Neptune Rd. Marblehead, MA 01945-131 1 James William Pellegrini, M.D. 119 Belmont St. Worcester, MA 01605 Nora Lina Daniel, M.D. 159 Confederate Pt. Rd. Palatka, FL 32177-8553 Michael Phililp Dick, M.D. 2817 NW 49th Pi. Gainesville, FL 32605 Anjum P. Hussain, M.D. 255 N.E. 19th Dr. Okeechobee, FL 34972-1933 Doris Margarita Leedy, M.D. 1421 Malabar Rd., Ste. 235 Palm Bay, FL 32907 Noel K. MacLaren, M.D. UF College/Medicine Pathology & Lab Medicine PO Box 100275 Gainesville, FL 32610-0275 Pallavl lQran Patel, M.D. 71 10 Nebraska Ave. Tampa, FL 33604-4915 Melisa Laws Pope, M.D. 323 Shadow Oaks Dr. Casselberry, FL 32707-4019 Nina Carmen Ramirez, M.D. 2765 Hackney Rd. Ft. Lauderdale, FL 33331 Charlene Susan Shookoff, M.D. 3150 NW 42nid AVe., Apt. 405-E Coconut Creek, FL 33066 Mary E. Soha, M.D. 942 Rio St. John's Dr. Jacksonville, FL 32211-5524 Georgia Rita Garda Baens-Bailon, M.D. 3138 Asbury Sq. Dunwoody, GA 30346-2416 Karen M. Foushee, M.D. 1512 Anthony Rd., Ste. C Augusta, GA 30904-4822 Ann Rogers Wilbanks, M.D. 419 Brookside Dr. Augusta, GA 30904 Kentucky Kanta Arya, M.D. 200 Medical Center Dr. Ste. 3-L Hazard, KY 41701-9422 Lori Rae Holtzman, M.D. Park Square, Hwy. 45 North Mayfield, KY 42066 North Carolina Hillary N. Carroll, M.D. 530W. Webb Ave. Burlington, NC 27215 Karen Lynn Cloninger, M.D. 902-C Cox Rd. Gastonia, NC 28054-3456 Nicholas J. D'Avanzo, M.D. 2524 Holbrook Ct. Raleigh, NC 27604-8414 Gary Lee Freed, M.D., M.P.H. CB#7590 Sheps Ctr Health Svc Research Univ of North Carolina Chapel Hill, NC 27599-7590 Sarah Rona Grossman, M.D. Gastonia Pediatric Assoc. 1839 E. Garrison Blvd. Gastonia, NC 28054-4897 Mary L. Undsay-Barber, M.D. 115 Smith St. Wingate, NC 28174-9619 Margaret H. Mustoe, M.D. 528 N. Griffing Blvd. Asheville, NC 28804 Steven Jai Novek, M.D. 2221 Durweston Ct. Raleigh, NC 27615-2549 Joseph R. Tobin, M.D. 672 Bermuda Run Bermuda Run, NC 27006 Cafresporndirng Fe/low Loeto Mazhani, M.D. PO Box 1167 Francistown Botswana Corresponlding Fellow Paul Gordon Taylor, M.D. King Khalid Hospital PO Box 9515 Jeddah 21423 Saudi Arabia In submitting these names of board-certified pediatrcidans to you, It Is understood that academic and pediatric credentials are not in question. Comments are requested concerning possible legal and/or ethical situations of which you might have personal knowledge. Send any comments on the following list of new applicants to your District Chalrperson by September 15. Susan A. Barasch, M.D. 12-F Sentinel Ct. Chatham, NJ 07928 Lucia Paronetto Caruana, M.D. 81 Rockland Rd. Sparkldl, NY 10976 Lindy Lee Cibischino, M.D. 730 Mill St., #F18 Belleville, NJ 07109-5311 Arry Dieudonne, M.D. 136-32 221 st St. Laurelton, NY 11413-2335 Elsie Catacutan Estrada, M.D. 9 ColonilJ Way Chatham, NJ 07928 Emma A. Mangosing, M.D. 295 Fulton Ave. Jersey City, NJ 07305-1401 Kevin J. Mc Sherry, M.D. 154-51 12th Rd. Whitestone, NY 11357 Susan M. Murphy, M.D. 195 Crystal Ave. Staten Island, NY 10302 Pennsylvania Donna Lynn Antonucci, M.D. 722 Brldle Rd. Glenside, PA 19038-2006 Amerigo N. Ceccarelli, M.D. 841 Califomia AVe., #407 Pittsburgh, PA 15202-2719 Philip I. Cook, M.D. 2317 Delancey PI. Philadelphia, PA 19103-6406 George Reyes Dy, M.D. RD 3, Box 51 F Weilsboro, PA 16901-9406 Mary Elizabeth Fontana, M.D. 8778 Duveen Dr. Wyndmoor, PA 19118-1462 Nancy Lynn Jensen, M.D. 27 Skyline Dr. Chalfont, PA 18914-2024 Cathy Springer Kaissi, M.D. 124 Canton Ct. Lower Gwynedd, PA 19002 John J. Ludwicld, M.D. Coventry Family Pratice 730 S. Hanover St. Pottstown, PA 19464-7520 Howard Bruce Pride, M.D. Dept. of Dermatology 14-06 Geisinger Medical Ctr. Danville, PA 17822-0001 Rosy Shah, M.D. 4221 Winterburn Ave., C-301 -'ittsburgh, PA 15207-1 178 West Virginia Darshini Kumarasena, M.D. 107 Westline Dr., Apt. #8 Beckley, WV 25801-2851 Joseph H. Matusic, M.D. 830 Pennsylvania Ave., #200 Charleston, W4V 25302-3389 Omolara Oyewole, M.D. 634 Manor Dr. Beckldey, WV 25801-2551 Mary Pipan, M.D. 1 15 Clyde St. Becidey, WV 25801-3951 Syed M. Maseehur Rehman, M.D. 406 Spruce Ln. Beckldey, WV 25801-2514 Maine John F. Milliken, Jr, M.D. Beech Tree Pediatrics, PA PO Box 207 Ellsworth, ME 04605 Newfoundland Brian S. Simmons, M.D. Hampton Terrace Apts. 153 Forest Rd., Apt. #22 St. John's, NF Al1A 1 E7 Canada Nova Scotia Stacey Ann Schwartz, M.D. IWK Hospital for Children 5850 Univ. Ave. Halifax, NS B3J 3G9 Canada Rhode Island Joseph J. Hallett, M.D. Memorlal Hospital of RI I111 Brewster St. Department of Pediatrics Pawtucket, RI 02860 Laura R. Viehmann, M.D. 2 Abbott Run Valley Rd. Cumberland, RI 02864-3201 Elvin Mendez, M.D. 125 5th Ave., #1 0-C Pelham, NY 10803-1523 Babatunji Omotoso, M.D. 736-A Union St. Brooldyn, NY 11215-1209 Emilia Ramirez Panday, M.D. 87-03 57th Rd., 3rd Floor Elmhurst, NY 1 1373-4898 Usa H. Shulman, M.D. 1 16 Pinehurst Ave., #A-41 New York-, NY 10033-1755 Lorna Elizabeth Thompson, M.D. 120 Wellington Ct., 3-H Staten Island, NY 10314 Now York 3 -Kathryn Ann Crowley, M.D. 185 E. 85th St. New York, NY 1 0028 Marianne E. De Gennaro, D.O. 36 Red Coach Ln. Holmdel, NJ 07733-1 137 Siddhartha Deb, M.D. 63 Carriage Rd. Roslyn, NY 11576-3122 Joel A. Forman, M.D. 2306 24th Ave. Astoria, NY 1 1102-2834 Yasmin A. Hassan, M.D. 175 Maple Ave., Apt. #1 C Westbury, NY 1 1590-3168 Shaheen Khan, M.D. 3330 Bainbrldge Ave. Ground Floor Bronx, NY 10467-2802 Michael Gary Lasser, M.D. 1985 Crompond Rd. Peekskill, NY 10566 Nancy J. Lippman, M.D. 16 E. 98th St., 3-E New York, NY 10029-6519 Jayne D. Pivas, M.D. 130 W. 12th St. New York, NY 1 001 1 Puerto Rico Maria Del R. Noriega, M.D. C-1 0-B Billa Grillasca Ponce, PR 00731 South Carolina Michael T. Finch, Jr, M.D. 9 Richland Medical Park Suite 11 0 Columbia, SC 29203-6808 Michelle Duchesneau Lally, M.D. 63 Fairway Dunes Ln. Isle Of Palms, SC 29451-2842 Tonnesste Barbara Nabrit-Stephens, M.D. 612 Hill Rd. Brentwood, TN 37027-4401 William B. Sullivan, M.D. 1687 Hunters ENluff Dr. - #1 03 Memphis, TN 38120-4443 Virginia Mary Beth Dinulos, M.D. 808 Gates Ave., #13-3 Norfolk, VA 23517-1635 Elizabeth G. Stallard, M.D. 4409 Clevhamm Common Dr. Virginia Beach, VA 23456 L. Carolyn WaslftjxAlslon, M D. 6601 Lee Park Rd. Mechanicsville, VA 23111-4648 Julie Hope Weaver, M.D. 9750 Gayton Rd. Richmond, VA 23233 Paul P. Wisman, Jr, M.D. 104 Kerry Ln. Charlottesville, VA 22901-2925 Now York 1 Marlene Morrison Bal, M.D. 38 Walnut Hill Dr. Penfield, NY 14526-9542 David Mark Belcher, M.D. 427 Hamilton St. Albany, NY 12203 Gregory P. Conners, M.D. 274 Tobey R(d. Pittsford, NY 14534 Paul E. Gaffuri, M.D. 1 01 Great Oaks Albany, NY 12203 Michael D. Green, M.D. Westside Pediatrics Group 497 Beahan Rd. Rochester, NY 14624-3497 Susan L. Mllard, M.D. Children's Hospital of Buffalo 219 Bryant St. Buffalo, NY 14222-2099 Rebecca K. Potter, M.D. 4812 Lyons Rd. Ext. Marcellus, NY 13108-9762 Eric W. Small, M.D. 920 Browers Point Branch Woodmere, NY 11598-1768 Now York 2 Corazon Laygo Aiialy, M.D. 92-29 Queens Blvd., #1 1-H Rego Park, NY 11374-1056 Nancy Bunker-Goldstein, M.D. 377 Chestnut Ave. East Meadow, NY 11554-2834 Jaw-Tang Chen, M.D. 41-59 Bowne St. Flushing, NY 11355 Samuel Mendel Freedrran, M.D. 103-26 68th Ave., #6-D Forest Hills, NY 11375 Ishrat Ara Hussain, M.D. 80-28 138th St., 1 st Floor Kew Gardens, NY 11435-1034 Jayasri Indaram, M.D. 1108 New Hyde Park Rd. New Hyde Park, NY 11 040 Rukshana Omar Karim, M.D. 96 Searingtown Rd. Searington, NY 1 1507 Marcia Miriam MNein, M.D. 27 Coronet Ln. Plainview, NY 11803 Francine Magaietti, M.D. 154 Strattford Rd. New Hyde Park, NY 11040 Indiana Olufemi O. Olcanlami, M.D. 833 Wheaty Dr. South Bend, IN 46614 Elisabeth Anne Kelley, M.D. 508 S. Mulberry St. Batesville, IN 47006-8910 John E. Montgomery, M.D. 2016-B S. Main St. Goshen, IN 46526 Paul S. Salva, M.D., Ph.D. 332 E. 51 st St. Indianapolis, IN 46205 Lorraine Wean, M.D. 2255 N. Hickory -31vd. Greenfield, IN 46140-8716 Michigan Parviz DJarri, M.D. 6001 W. Outer Dr., #340 Detroit, MI 48235 Vina Ratilal Patel, M.D. 7020 Roedel -Rd. Frankenmuth, MI 48734-9717 Thomas H. Peterson, M.D. 3637 Clyde Park, SW Wyoming, Ml 49509 Regina E. Rizk, M.D. 1227 E. Lake Dr. Novi, Ml 48377-1440 John U. Tan, M.D. 3737 Beaubien i31vd., #701 Detroit, MI 48201 Kamaia J. Vanaharam, M.D. 41 0 S. Main Romeo, Ml 48065-0141 Ohio Diane L. Atldns, M.D. 375 Buhl Morton Rd. Gallipllds, OH 45631 Lee E. Budin, M.D. 6495 E. Broad St. Columbus, OH 43213-1541 District ot Columbia Ngozi R. Agwuna, M.D. 1 0284 Nightmist Ct. Columbia, MD 21044-3303 Merinda Juanita Herron, M.D. 1935 Jackson St., NE Washington, DC 20018-2433 Terry L. Jarrett, M.D. 16 Ingraham St., NW Washington, DC 20011 -2430 Delaware Anne Fitzpatrick Reilly, M.D. 1941 Limestone Rd., Ste. 211 Wilmington, DE 19808 Maryland Stella Debrah-Siriboe, M.D. 44 Klndsman View Cr. Silver Spring, MD 20901-1652 Helen A.K. Dichek, M.D. 2291 Stratton Dr. Rockville, MD 20854 Sheila M. Idzerda, M.D. 15101 Timberlake Dr. Silver Spring, MD 20905-4333 Ernesto H. Ramirez, M.D. 1668 Langley Dr., Apt. #409 Hagerstown, MD 21740-2009 Now Jersey Tess Maggay Alejo, M.D. 1217 Waters Edge Dr. Toms River, NJ 08753-2658 Sayed R. Aly, M.D. 770 Kennedy Blvd. Bayonne, NJ 07002-2859 Florida Navinbai J. All, M.D. 5055 NW 1 04th Ave. Coral Springs, FL 33076 Odett Stanley Brown, M.D. 11331 NW 24th St. Flantation, FL 33323-2030 26 AAP News/August 1994
Transcript
i
Dear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to: 1) carefully reviewthe following list of new applicants for Academy membership, and 2) relay your reactions directly to yourDistrict Chairperson, whose name and address is at the end of this list.
In submitting these names of board-certified pediatrcidans to you, It Is understood that academic and pediatriccredentials are not in question. Comments are requested concerning possible legal and/or ethical situationsof which you might have personal knowledge.Send any comments on the following list of new applicants to your District Chalrperson by September 15.
Susan A. Barasch, M.D.12-F Sentinel Ct.Chatham, NJ 07928
Lucia Paronetto Caruana, M.D.81 Rockland Rd.Sparkldl, NY 10976
Lindy Lee Cibischino, M.D.730 Mill St., #F18Belleville, NJ 07109-5311
Arry Dieudonne, M.D.136-32 221st St.Laurelton, NY 11413-2335
California ICatherine Anne Chin, M.D.6815 Tahoe Pi.El Cerrito, CA 94530-3719
Henry H. Collins, M.D.335 El Toyonal St.Orinda, CA 94563-2013
Mark Stefan Escajeda, M.D.456 Broderick St.San Francisco, CA 94117
Elena Fuentes-Afflick, M.D.73 Dellbrook Ave.San Francisco, CA 94131
Janet U-Tempest, M.D.4828 E. Florence Ave.Fresno, CA 93725-1208
Robert A. Lufburrow, M.D.3603 Maidu Pl.Davis, CA 95616-5080
K. Jane Mc Clure, M.D.1617 Broadway St., #5ValleJo, CA 94589-2738
Brian Robin Mc Creery, M.D.Permanente Medical Group5600 Stoneridge Mall Rd.Pleasanton, CA 94588-2820
IowaVlrg lio D. Corpuz, M.D.Medical Assoc.915 13th Ave., NorthClinton, IA 52732-5031
IllinoisAmy L. Chnstison, M.D.7801 N. Knoxville, Ste. 200Peoria, IL 61614-1145
AAP NVews on callAAP News offers a new way for
readers to express their opinions. TheAAP News reader hotline operates 24hours a day, seven days a week.
Callers may use the hotline to reactto AAP News stories and expressopinions about issues you would liketo see covered in the newspaper. Wewill be sure to answer your questions,take down your comments and passthem along to the appropriate AAPauthorities.
If you're too busy to write a letter tothe editor for the Second Opinionscolumn, you may phone in yourcomments. We'll take them down andconsider them for an upcoming issue.
Contact the hotline at: (800) 433-901 6, ext. 6770.
If you prefer not to use the hotline,you may still call AAP News editorElizabeth Oplatka, from 8 a.m. to 4:30p.m., Monday through Friday.
AAP News/August 1994 27
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Accurate diagnosis of ADHD is often dif-fi!cult because nearly 80% of ADHD chil-
. T s ~dren behave well in the doctor's office.d For this reason, physicians rely heavily| ] on feedback from classroom teachers in
rlm diagnosing, medicating, and monitoringfi children with attention disorders.
!8a ACTeRS is a standardized teacher ratingform for grades K-8 that objectively mea-
9 sures four separate characteristics: At-| tention, Hyperactivity, Social Skills, and* Oppositional Behavior. The reliability,
_ validity, and utility of ACTeRS have been- ~~repeatedly demonstrated in published
studies and clinical trials throughout its 20-year re-search history. Teachers respond to the 24 items thatdescribe classroom behavior. These ratings aresummed and transferred to the Profile Form wherenorm comparisons are read directly.
Positions Wanted, Practices Available andResidencies/Fellowships Available. Contact AAP Newsfor display classified ad sizes and rates.
Blind Box Returns: Available for a $25 servicecharge per ad insertion. To reply to a box number, sendyour response to: Box Number, AAP News, ClassifiedAds, P.O. Box 927, Elk Grove Village, IL 60009-0927.
For more information, contact: Pamela Malik,Classified Ad Coordinator, at (800) 433-9016, ext. 7667.In Illinois, (708) 981-7667. Ad copy and payments maybe sent to: Classified Ads, AAP News, 141 NorthwestPoint Blvd., P.O. Box 927, Elk Grove Village, IL 60009-0927.
Advertising policy: Afthough the Academy believesthese classified ads are from reputable sources, theAcademy does not investigate the offers made andassumes no responsibility concerning them.
Frequently, it is necessary to modify the wording ofclassified ads. These changes are generally made incompliance with the regulations of various federal and/or
state commissions against discrimination orbecausetheymight be interpreted as being unlawful or in conflict withprofessional standards of medical practice.
Advertisements for employment containing specHica-tions as to race, creed, color, age, religion, sex, ethnicorigin, or national origin may be unlawful and profession-ally improper. Accordingly, discriminatory wording is notacceptable in AAP News.
Other phrases for publication in various advertisingclassifications might be interpreted as being unlawful andin conflictwith professional standards of medical practice.Improper language could include:
"Complete list of patients' records for sale." The offerof rebates or "kickbacks;" wording that could be inter-preted as derogatory or defamatory to other physicians;the mis-representation of skills expected or job require-ments.
These advertising modifications are made to rnaintaina classified advertising section that is professionally re-
sponsible, lawful, scientific and free of discrimination.
When you need to contact pediatricians, contact AAPNews. Each month, more than 46,000 pediatricians, third-year pediatric residents and other subscribers turn to AAPNews for child health information they cannot getelsewhere. With a classified ad, you can speak directly tothose readers.
Rates: The one-time cost for placing a classffied adis $1 20 for30 orfewerwords and $1 .50 for each addftionalword. A $20 discount per month is allowed for ads thatare published in three or more consecutive issues. Thethree issues must be purchased at the same time. Adsmay be boxed for a one-time cost of $80.
Classifications: Classified ads are accepted underBusiness Services, General Announcements, MedicalMeetings, Physicians Wanted, Positions Wanted,Practices Available, Publications, Real Estate, andResidencies/Fellowships Available.
Display Classified Ads: Camera-ready and 2-colordisplay classified ads are accepted under General.Announcements. Medical Meetings, Physicians War,ted,
January 1995
THE SAN DIEGO CONFERENCEON RESPONDING TO CHILDMALTREATMENT, January 23-27,1995, Town and Country Hotel, SanDiego, CA. Join us in a beautifulsetting for five exciting and inten-sive days of general sessions,workshops, open forums, slide ses-sions, and research papers.Traditional and innovative tech-niques for practice! Varied levels ofpractice addressed! For further in-formation, call the RegistrationCoordinator at (619) 495-4940.
MANAGED CARE IN THE 90s:PERSPECTIVES ON MEDICALPRACTICE AND RISK PREVEN-TION, September 15-16, 1994,Marriott Mountain Shadows,Scottsdale, AZ; October 6-7, 1994,Grenelefe Golf and Ten,nis Resort,Haines City, FL; December 1-2,1994, Hyatt Regency Embarcadero,San Francisco, CA. Designed forphysicians and other health careproviders who are or will be in-volved in the managed care system.Topics include documentation, li-ability, ethical issues and clinicalpractice guidelines. ACCME, ANAand ACNM credit available. Forcomplete brochure, contact: Con-temporary Forums, 11900Silvergate Drive, Dublin, CA 94568;(510) 828-7100, Ext. 3.
CONTINUING MEDICAL EDUCA-TION COURSE #6 - DEERHURSTRESORT, September 29 -October2, 1 994, Huntsville, Ontario, Can-ada. Sponsored by the CanadianPaediatric Society, the University ofToronto Dept. of Paediatrics andthe Hospital For Sick ChildrenAlumni Association. Further detailsm ay o btai ned by co ntacti ng:Danielle Solimka, 401 Smyth Road,Ottawa, Ontario, Canada Kl1H 81-1;(613) 738-3900.
October
WHAT IS NEW WITH THE NEW-BORN? October 8-9, 1994, TaosSki Valley, New Mexico. Sponsoredby the New Mexico Pediatric Soci-ety. For more information, contact:Richard Rolston, M.D., 4808 McMa-hon Blvd., N.W., Suite 16,Albuquerque, NM 87114; (505) 898-7898.
ALOHA UPDATE: PEDIATRICS1994, October 8-14, 1994, Island ofKauai, Hawaii. Sponsored by Uni-versity Childrens Medical Groupand AAP California District IX,Chapter 2. For further details, con-tact: Wendy Fukamali, 6430 SunsetBoulevard, Suits #600, Los Ange-les, CA 90028-7900; (800)3KID-CME or (800) 354-3263.
CARING FOR CHILDREN IN THE909, October 14 & 15, 1994, Olda-homa City, OK. Sponsored by AAPOkldahoma Chapter. For more infor-mation, contact: Anne Roberts,Institute for Child Advocacy, 4030N. Lincoln, #208, Oklahoma City,OK 73105; (405) 424-8014.
PEDIATRIC INFECTIOUS DIS-EASE SEMINAR (Sixth AnnualLloyd Noland), Walt Disney World,Florida, October 19-22, 1994. Fac-ulty: Drs. Brunell, Marchant,Overturf, Powell, and Stull. Call orwrite: Department of Medical Edu-cation, Lloyd Noland Hospital, P.O.Box 538, Fairfield, AL 35064; (205)783-5276.
November
JOE DiMAGGIO CHILDREN'SHOSPITAL AT MEMORIAL 5THANNUAL PEDIATRIC SYMPO-SIUM will be held at the Pier 66Resort and Marina, Fort Lauder-dale, Florida, November 11 -1 3,1994. For information, contact (305)985-5837.
The American Society of Addic-tion Medicine (ASAM) will besponsoring its 7th National Confer-ence on Nicotine Dependence inCambridge, MA, November 3-6,1994. The conference is intendedfor any health care professionals,physicians, nurses, counselors, res-piratory therapists, clinicalpsychologists, hospital administra-tors and any others involved in themanagement of nicotine depend-ence. For more information, pleasecontact Sandy Schmedtje at (202)244-8948.
The Coalition to Stop Gun Vio-lence, the Episcopal Diocese ofWashington and the WashingtonNational Cathedral will convene aunique conference against gun vio-lence this November 11-13 at thehistoric Sheraton Washington Hoteland the majestic Washington Na-tional Cathedral. Knowledgeablespeakers and opportunities to ex-change information will ensure thatparticipants develop a grassrootsnetwork of supportive friends. Eve-ryone will receive a reference bookcontaining tested action plans and adirectory of anti-gun violence lead-ers. Registration is $75. Reducedhotel rates and airfares are avail-able by calling Conference head-quarters at (202) 338-2422. Limitedscholarships are available uponwritten application.
IowaSeeking BC/BE Pediatrician forfull-time faculty position with clinicaland academic responsibilities. SendCV to: Lawrence E. Jacobson, D.O.,Dean for Academic Affairs, Univer-sity of Osteopathic Medicine andHealth Sciences, 3200 Grand Ave-nue, Des Moines, IA 50312. TheUniversity is an Equal OpportunityEmployer.
AAP News advertisingFor advertising information,
contact Pamela Malik at (800)433 9016. ext. 7667.
STADIOMETER measures height tonearest millimeter or sixteenth/in.Provides accuracy needed to trackgrowth disorders. Durably con-structed of anodized aluminum.Extraordinary quality, and ease ofuse. Made in the U.S.A. Satisfactionguaranteed. $595. Contact Ameri-can Frontier Technology at (800)357-8999.
SeptemberANNUAL MEETING: A WEEKENDREVIEW OF GENERAL PEDIAT-RICS, September 9-11, 1994, NorthMyrtle Beach, South Carolina.Sponsored by North Carolina Pedi-atric Society. For further details,contact: Carol Russell, P.O. Box27167, Raleigh, NC 27611; (919)833-3836.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~m
O Examiner's Kit (Manual and Rating/Profile Forms) @ $58.00 plus $5 s+hO Microcomputer Version (IBM-PC oEly. Examiner's Kit also required.)
@ $145.00 plus $5 sch. Disk size: UJ 51/4 0- 31/2El Please bill me El Please send me more information
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1994 AAP Residency ScholarshipsAwarded
Ihe Committee on Residency Scholar-ships is pleased toannounce the 1994 Residency Scholarship Awar-ds. 'MeCommnittee met during the AAP Denver Spring Session inApril and selected 49 pediatric residents from 110 applicantsin the United States and Canada to receive awards totaling$97,000. Ihe scholarships were in the amounts of $1,000,$3,000 and $5,000.
Ihe Committee on Residency Scholarships, the ResidentSection, and the American Academy of Pediatrics wish toexpress their appreciation to this year's sponsors for theircommitment to the Residency Scholarship Awards.
SPONSIORSBeiersdorf, Inc.
Connaught Laboratorles, Inc.Genentech, Inc.
Lederle Laboratorles, A Division ofAmerican CyanamidCompany
Lederle-Praxis Biologicals, A Cyanamid Business UnitMcNefl Consumer Products Company
Parke-Davis Consumer Health Products GroupRh6ne-Poulenc Rorer Pharmaceuticals, Inc.
Deadline for 199X; Residency Scholarship Applications:Fanuary 30, 1995. Applications wlll be sent to residentmembers of the Academy in early November. Nornmemberresidents may request an application by wrilting to theAmerican Academy of Pediatxics, Linda Lipinsky, SectionsManager, 141 Northwest Point Blvd., Elk Grove Village, IL60007.
zT(A*IW%I111 N. Market St.Champaign, IL 61820800Ol47-4868217/398-4868
28 AAP News/August 1994
Full-time, BC/BE Pediatri-cian to join a well-established, 4-person group.This rapidly growing commu-nity, has a diverse populationand is 20 minutes from Char-lotte:, 2 hours from mountains/skiing, and 4 hours from theAtlantic coast. 450-bed gen-eral hospital with a separateWomen's and Children's Cen-ter. This hospital is affiliatedwith Duke Universit-y MedicalCenter. Weekly faculty con-tact provides 50 hours CMEannually. Practice thrivingsince 1952, indudes childrenof former patientcs and a sig-nificant adolescent group.One full week day off, workevery 5th weekend. Excellentsalary and benefits package.Full partnership options after2 years. Send CV and refer-ences to: George Engstrom,M.D., 40 Ardsley Avenue,N.E., Concord, NC 28025.
Ft. Myers: The NemoursChildrcn's Clinic is develop-ing a now program inPediatric Hematology/Oncol-ogy which will be based in ourrapidly growing, 6-memberPediatric Subspecialty Clinicat Health Park in Ft. Myers,Florida. P.O.G. affiliation isanticipated. Please call orsend CV to: Prentiss E. Find-lay, M.D., The NemoursChildren's Clinic, 807 NiraStreet, Jacksonville, FL32207; (904) 390-3687. TheNemors Children's Clinic is anEqual Opportunity Employer.
HSoffman Estates: Exciting oppor-tunity for BC/BE Pediatrician withexperience in emergency medicineor neonatology for a 356-bed hospi-tal located in an upscale suburb ofnorthwest Chicago. Excellent com-pensation package. Please contact:Jennifer Hymcs, Neo- Med, I nc.,1200 S. Pine Island Road, Suite600, Fort Lauderdale, FL 33324-4460; (800) 422-3672, Ext. 7260.EOE/AA/M/F.
Indiana
South Bond: We are looking for aBC/BE Pediatrican to join a busy,collegial group of four pediatriciansin a 43-physician, multispecialtygroup. Excellent call schedule. Twoexcellent tertiary leVel hospitalswithin 5 minutes. Neonatology andother subspecialists available. At-tractive university community withreasonable housing, excellentschools and diverse cultural andrecreational opportunities. Competi-tive guarantee and one year topartnership. Send CV to: TimothyDurham, M.D., Administration,South Bend Clinic & SurgiCenter,211 N. Eddy, South Bend, IN46617.
MarylandBC/BE Pediatrician (Full- or part-time): Unexpected opening inactive, three-pediatrician practice inMontgomery County. Please replyto Box #06024.
Montgomery County (D.C. Sub-u rb): Part- to full-time BC/BEPediatrician to join a six-person,well-established, quality group. In-office residency training andresearch projects. Competitive sal-ary. Reply with CV to: 19251Montgomery Village Avenue, SuiteF-10, Gaithersburg, MD 20879.
Pediatricin -Immediate opportu-nities for BC/BE Pediatricians. tomoonlight nights and weekends forlarge, multispecialty group provid-ing care for Blue Cross and BlueShield affiliated HMO. Please directCV to: Patuxent Medical Group,Inc., 2 Knoll North Drive, Columbia,MD 21045, Attn: Physician Person-nel. EOE/M/F/H/V.
MabssachusettsPediatrician -Boston area: WestSuburban. Multispecialty grouppractice seeking weekend and holi-day moonlighters. Hours: 9:00 AM -
5:00 PM. Please send CV to:Caroline Smith, Dedham MedicalAssociates, Inc., One Lyons Street,Dedham, MA 02026.
Florida
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Upland: Pediatric Practitioner(General) of 30 years seeks BC/BEpartner. Full/busy practice, 300-bedhospital, neonatal nursery. Onehour away from mountains,beaches and Disneyland. Pleasereply to: Box #08024.
Connecticut
Coastal Connecticut: BC/BE Pe-diatrician wanted to join thriving,lucrative practice in beautiful shore-line community. Un iversity-affiliatedhospital (Yale) nearby. Excellentsalary, production bonus, early part-nership. Available immediately. Call(203) 483-0918, 9:00 AM until noon.
Florida
Challenging hospital-basedpediatric positions! Flexiblescheduling and no additional on-callcoverage. EMSA is seeking BC/BEPediatricians for full-time/part-timepositions in South Florida. Competi-tiVe compensation packageincluding full benefits and profes-sional liability insurance. Contact:Chauna Marksbury, EMSA, 1200 S.Pine Island Road, Suite 600, FortLauderdale, FL 33324-4460; (800)422-3672, Ext 7468. EEO/AA/M/F.
Dade City: NEEDED!! BC/BE Pe-diatrician to join our well-established, patient-oriented and in-novative practice in the beautifulWest Central Florida area. Modernand well-equipped facilities. Com-petitive salary/benefit package. Noadministrative headaches! Pleasesend CV to: Primary Medical Care,P.O. Box 1236, Dade City, FL33526.
Seeking BC/BE Pediatrician forhospital-based practices in severalprogressive hospitals in South Flor-ida. Schedule yourself for up to 20days off per month. No on-call re-sponsibilities or overhead. Averageannual FFS remuneration of$120,000 plus. Please send CV to:Steve Koronic, Pediatric Health-care, Inc., 2828 Croasdaile Drive,Durham, NC 27705, or call (800)476-8954.
Tampa: Full-time/part-time opportu-nity exists for a pediatrician to workin an emergency room setting. Ex-cellent working conditions indudingno call, low patient acuity, and lowpatient volume. Outstanding com-pensation package, including paidbenefits. Contact Eileen MacLeanat (800) 422-3672, Ext. 7644, ormail/fax C.V. to: EMSA Limited Part-nership, 1200 S. Pine Island Road,Suite 600, Fort Lauderdale, FL33324-4460; FAX (305) 424-3270.EEO/AAIM/F.
Illinois
Hinsdale Hospital seeWdng full-timeBC/BE Pediatrician or intensivistwith recent experieince in managingacutely ill children. Unit is a 4-bedPediatric Special Care Unit. Posi-tion involves shared 24-hour/daycoverage. 65 pediatricians on staff;3000+ births annually. Excellentsalary/benefits. Hinsdale Hospital(462 beds) is located in Hinsdale,Illinois, an affluent western suburbof Chicago. Call or write: LouellaFreeman, Director, Women's andChildren's Services, 120 N. OakStreet, Hinsdale, IL 60521; (708)856-6667 or FAX (708) 856-4296.
BC/BE Pediatrician: Excellent pri-vate practice opportunity availableimmediately with well-established,three-physician practice in family-oriented community. Competitivesalary and benefits with partnershippotential after one year. Send C.V.to: Alan Weiner, M.D., MiddlebeltPediatrics, 21000 Middlebelt Road,Farmington Hills, Ml 48336.
Mod/Pods or internist needed tocomplete group of compassionatephysicians worldng in small, inner-city, not-for-profit health center. Ourmission is providing quality care tochronically underserved popula-tions. Your family will enjoyexcellent schools and high-qlualitylife in this resort community on theshores of Lake Michigan - about 90miles from Chicago. If you share ourbias for excellence in a unique, pri-mary care, Med/Peds model, sendyour CV to: Meredith Schmidt, R.N.,Physician Services Liaison,Lakeland Regional Health System,1234 Napier, St. Joseph, Ml 49085,FAX (616) 927-5338 or call (800)726-8939.
MarylandKaiser Permanente: Our Mid-Atlantic States Region is currentlyseeking a BC/BE Pediatric Endocri-nologist to join our practice inMaryland. Comprehensive compen-sation and benefit package.Contact: William J. McAveney,M.D., 2101 E. Jefferson Street, Box6649, Rockville, MD 20849. FAX:(301 ) 816-7472. EOE.
lOarning exercises empha-self-improvement. Practicals from nationally recognizedoeers, are featured.
v pediatricians inon a national,te confidentiality.Iigment credits
just $70 forirs. Use ourtactice:
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Young dinosaur seeks an-other. BC/BE Pediatricianwanted to join a booming solopractice in the beautiful Berk-shires. Competitive salaryand benefits. Partnershipavailable in 1-2 years. Goodcoverage. Rural-suburbanlifestyle with myriad outdoorand cultural activities. Largecommunity hospital with uni-versity affiliabon. Send CV inconfidence to: Box #08014.
ext 4727 for
O Yes, I'm interested in ACQIP. Send me more informationand an enrollment form today.
Send to:Division of Quality Care: ACQIPAmerican Academy of PediatricsPO Box 927Elk Grove Village, IL 60009-0927
IIOUIwith tezory Care uitit ProgramtAC:QIP)healthcar t the pressurettX,more ec ive care. To
)articipa elP, a programtice gui ad managementlator rs, from the
Alabama
HuntsvilleMadison: Outstandingopportunity for BC/BE Pediatricianto join two recently-trained BC Pe-diatricians in a thriving practice.Diverse practice from infants to ado-lescents. Offering excellent salaryand benefits with opportunity forpartnership. Every third weekendcall with evenly split weekday call.Full day off each week. Beautifularea with excellent schools andmany recreational opportunities.Send CV to: Cornerstone Pediat-rics, P.C., 540 Hughes Road, Suite10, Madison, AL 35758; or call(205) 461-7440.
Alaska
Pediatric Opportunity In Alaska:Two BC/BE Pediatricians to join twoother pediatricians and twelve Fam-ily Practitioners at a 50-bed hospitalin rural westem Alaska. Responsi-bilities include inpatient pediatriccare, acute/walk-in care, as well asa very busy pediatric dinic. Com-petitive salary and benefits. Loanrepayment available. For more in-formation and an application,please contact: William F. Bergen,D.O., Medical Administrator, Yukon-Kuskokwim Delta RegionalHospital, P.O. Box 287, Bethel, AK99559; (907) 543-6218.
CaliforniaSouthern California: CIGNAMedical Group has practice oppor-tunities for pediatricians available atseveral health care centers in LosAngeles, Riverside, and San Ber-nardino counties. We are a qualityand service-oriented medical groupwhose principal commitment is toour members' well being. Our focuscenters on the strong relationshipbetween patient and primary carephysician. Enjoy the advantages ofpractcing vAth an established mul-tispecialty group in a sophisticated,metropolitan environment. We offeran outstanding compensation pack-age. Call (800) 468-9013 or sendCV to: Professional RecruitmentDepartment, CIGNA Medical Group,505 N. Brand Blvd., Suite 400-14,Glendale, CA 91203. EOE
Advertising pays""I always get an
excellent responsewhen I use AAP Newsto find candidates formy open positions."N
Staephanie Czerwonka,EMS;A H"l'pi Services
MichiganAnn Arbor: Full- and part-timephysicians to staff busy PediatricEmergency/Urgent Care Center.Board-eligible/Board-certified in pe-diatrics of PED/IM/ PED/ER, orPED/ER, or PED/ER fellowshiptraining. Over 21,000 visits peryear, excellent specialty back-up,resident and student teaching, paidmalpractice, generous moving ex-penses, excellent remuneration. Formore information, contact LauraZech at (800) 466-3764.
AAP News/August 1994 29
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HIV Gieie vailableThe chairperson of thle AAP Provisional Committeeon Pediatric AIDS and other members of theAcademy served on the federal Agency for HealthCare Policy and Research (AHCPR) panel andparticipated in the development of Managementand EvalucLin of Early HIV Infection, a clinicalpracticc guideline sponsored by AHCPR andendorsed by the Academy.
Multiple free copies of the guideline and theaccompanying Quick Reference Guide forphysicians and Understanding HIV and HIV andYour Child for patients and families are available.To order materials or for more information, w-riteto:
AHCPTR EIEV GuidelineCDC National AIDS ClearinghouseP. O. Box 6003Rockcville. MD 20849-6003
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PennsylvaniaThe Golsinger system of healthcare presently has opportunitiesavailable for Board-Certified orBoard-Eligible Pediatricians in itsWilkes-Barre, Lewistown, Philips-burg, and Tyrone offices. Geisingeris a health care network with twohospitals and 46 patient care of-fices. Open positions consist ofoffice and inpatient general pediat-rics with tertiary care provided atG;eisinger Medical Center in Dan-ville, PA. Competitive salaries andexcellent benefit package available.Interested individuals should sendtheir C\/s to: Geisinger, PhysicianRecruitment Department PD-AB,100 N. Academy Avenue, Danville,PA 17822-3024 or call (800) 845-7112. EOE/M/F/H/V.
Philadelphia Western Suburbs,Delaware County: Outstanding im-mediate opening for BC/BEPediatrician. Full-time or part-time,to join group of four busy pediatri-cians and nurse practitioner.Excellent recreational and culturalopportunities. Guaranteed salaryand benefit package complete with401K retirement plan and opportu-nity for partnership in a verysuccessful practice. Send CV to:Children's Medical Associates, 23Chester Pike, Suite 200, RidleyPark, PA 19078; (610) 521-1297.
OregonFull-time SC/BE Pedlstriclan tojoin eight pediatridans in a 60-phy-sician, multispecialty group withmain office and satellite. Located ina growing southwest Washingtoncommunity of 250,000, neighboringPortland, Oregon. Salary andbenefits leading to partnership.Please send C.V. to: Bev Karlzen,c/o The Vancouver Clinic, 700 NE87th Avenue, Vancouver, WA98664.
Two pediatricians needed in a Now Jerseyrapidly-growing suburban commu-nity near Ann Arbor. Share call with Princeton: BC/BE Pediatrician to15 other pediatricians in a large and Join established group practice. Ex-growi'ng physician-owned and oper- cellent benefits and guaranteedated primary care group. Expert salary. Send CV or contact: Geraldmanagement systems allow you to M. Raymond, M.D., 1 1 N. Harrisonconcentrate on patient care. Oppor- Street, Princeton, NJ 08540; (609)tunities for academic affiliation, 924-5510.teaching, and hospital-based workare available and encouraged. Teaneck: Third BC/BE Pediatrician,Send curriculum vitae to: Nadine full-time preferred, for young, grow-Lewis, Administrator, 3100 E. Eis- ing practice, 10 minubis from NYC.enhower Parkway, Suite 100, Ann Salary leading to partnership. RePlYArbor, Ml 48108. with CV to: Edward Zajkowski,
M.D., 197 Cedar Lane, Teaneck, NJ07666.
1995 Certffying Excamirations of theAmerican Board of Pediatrics
I I11 Silver Cedar CourtChapel Hil,NC 27514
Telephone: (919) 929041
GENERAL PEDIATRICS EXAMINATIONWill be hold in variouscities throughout the Unitad States -October 10-11, 1995.
FIRST TIMIE APPLICANTS:Now Regular Registratlon (Fee 1135): December 1, 1994, through February 28, 1995
(postmarked).Partial Payment Plan deadline (3 payments of $395): January 13, 1995 (postmarked).Late Now Rgilstration (FeesS1360): March 1, 1995, through April 29, 1995 (postmark4ed);
a late fee is required.No nowappbscatonsaccepted af>rAprl29, 1995 (postrnarksed).RE-REGISTRATION:
Regular Registratlon (FeeS$1035): February 15, 1995,through April 29, 1995(postmarked).
Late Re-registmation (Fee S1260): May 1, 1995,through May 31, 1995 (postmarked); alate fee is required.
_M PEDIATRIC GASTROENTEROLOGY SUBSPECIALTY E)CAMINATION_Will be held in 3citiesthroughout the Unitad States -August 8, 1995.
illed by firemsevtda,1chlrnaekldbyhearms.every day, 14 children are killed by .ierseeydy 14 childr,arms.~~~~~~~~~~~ evra,1 hlrnaekle y firearms.
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*concerned citizens from across the countrywill meet to share ideas, compare strategies,and learn how to build safer communities.
*experienced, local grassroots leaderswill provide model programs and shareeffective strategies.
*national, state and local leaders will briefparticipants on proposed legislation and
For further information, call or write to: educational efforts concerning gun violence.For a Safe Community:A Citizens' Conference to Stop GunViolence3421 1/2 M Street, NW, name ---
Washington, DC 20007 addressTelephone (202) 338-2422cyste ziFax: (202) 338-2458 ct tt i
Registration fee: $75.00 (includes ban-tephn
quet dinner andkeynote lunch) ~~Ican volunteer time toward this cause
reduced air fares and hotel rates ($39.00 dou-Ia nlsn oaino
ble occupancy) are available on a first-come, pesmaecckpybltofirst-served basis pes aecek aal oThe Educational Fund to End Handgun Violence
30wf AAP News/August 1994
tussis DTP vaccine, the role of serum antibodies ir! protection against pertussis is unknown at this time.Tripedia is not recommended for use in children below 15 months of age. This vaccine is not recommended foruse as a primary series in children of any age.Tripedia Is not recommended for individuals over 7 vears of age. Tetanus and Diphtheria Toxoids Adsorbed ForAdult Use (Td) is to be used in individuals 7 years ofrage or olaer. Diphtheria and Tetanus Toxoids and AcellularPertussis Vaccine Adsorbed should not be used to immunize children lessthan 15 months of age.ADVERSE REACTIONSLocal adverse reactions which include pain, erythema, heat, edema, and induration, and systemic reactions suchas fever, drowsiness, freffulness, and anorexia may occur following vaccination. Table 3 lists the frequency ofadverse reactions in 372 children who received Tripedia at 15 to 20 months and 239 children who receivedTripedia at 4 to 6 years of age. These children had previously received three or four doses of whole-cell pertussisDTP vaccine at approximateSy2, 4, 6and18 months ofaae."1Rarely, an anaphylactic reaction (i.e., hives, swelling of the mouth, dificufty breathing, hypotension, or shock) hasbeen reported after receiving preparations containing diphtheria, tetanus, and/or pertussis antigens.2Arthus-type hyper'sensitivity neactions, characterized by severe local reactions (generally starting 2 to 8 hours afteran injection), may follow receipt of tetanus toxoid. A few cases of peripheral neuropathy have been reported fol-lowing tetanus toxoid administration, atthough a causal relationship has not been established!2The following illnesses have been reported as temporally associated with vaccine containing tetanus toxoid: neu-rological complications""1 including cochlear lesion," brachial plexus neuropathies,'4'51 paralysis of the radialnerve," paralysis of the recurrsnt nerve,'5 accommodation paresis, and EEG disturbances wih encephalopathy.'7In the differential diagnosis of polyradiculoneuropathies following administration of a vaccine containing tetanustoxoid, tetanus toxoid should be considered as a possible etiology.4"lTABLE 3.' ADVERSE EVENTS OCCURRING 24, 48 AND 72 HOURS FOLLOWI116 DIPHTHERIA AND TETAIIUS TOXOIDSAND ACELULAR PERTUSSIS VACCINE ADSORIBED (TRIPEDIA) IMMliUNIZATIONS GIVEII AT 15 TO 20 MONTHS AND 4 TO 6YEARS OF AGE.
*Includes all occurrences of erythema.ZIndludes all occurrences of swelling.DOSAGE AND ADMINISTRATIONParenteral drug products should be inspected visually for extraneous particulate matter and/or discoloration priorto administration whenever solution and container permft. If these conditions exist, the vaccine should not beadministered.SHAKE VIAL WELL before withdrawing each dose. Inject 0.5 mL of Tripedia intramuscularly only. The preferredinjection sites are the anterolateral aspect of the thigh and the deltoid muscle of the upper arm. The vaccine shouldnot be injected into the gluteal area or areas where there may be a major nerve trunk. During the course of immu-nizations, injections should not be made more than once at the same site.The use of reduced volume (fractional doses) is not recommended. The effect of such practices on the frequencyof serious adverse events and on protection against disease has not been determined.Do NOTadminister this product subcutaneously. Special care should be taken to ensure that the injection does notenter a blood vessel.TRIPEDIA IS INDICATED FOR THE FOURTH DOSE OF THE DIPHTHERIA, TETANUS AND PERTUSSIS IMMUNIZA-TION SERIES. TRIPEDIA MAY BE GIVEN 6 TO 12 MONTHS AFTER THE THIRD DOSE OF WHOLE-CELL PERTUS-SIS DTP TO MAINTAIN ADEOUATE IMMUNITY DURING THE PRESCHOOL YEARS. THIS DOSE IS AN INTEGRALPART OF THE PRIMARY VACCINATING COURSE.TRIPEDIA IS INDICATED FOR THE FIFTH DOSE OF THE DIPHTHERIA, TETANUS AND PERTUSSIS IMMUNIZATIONSERIES. PRIOR IMMUNIZATIONS MAY CONSIST OF THREE DOSES OF WHOLE-CELL PERTUSSIS DTP AND ONEDOSE OF ACELLULAR PERTUSSIS DTP OR FOUR DOSES OF WHOLE-CELL PERTUSSIS DTP. TRIPEDIA MAY BEGIVEN TO CHILDREN 4 TO 6 YEARS OF AGE, BEFORE ENTERING KINDERGARTEN OR ELEMENTARY SCHOOL(NOT CONSIDERED NECESSARY IF FOURTH PRIMARY VACCINATING DOSE ADMINISTERED AFTER FOURTHBIRTHDAY).The vial of vaccine should be shaken to ensure a proper suspension of the vaccine prior to use.The simultneous administration of DTaP, OPV, and MMR has not been evaluated. However, on the basis of stud-ies using whole-cell DTP, the ACIP does not anticipate any difflerences in seroconversion rates and rates of sideeffects from those observed when the vaccines are administered separately. The ACIP recommends the simuttane-ous administration of all vaccines approDpriate to the age and the previous vaccinatinn status of the child, includinsthe special circumstance of simultaneous administration of DTP or DTaP, OPV, HbCV, and MMR at age >15months."HOW suPPLIED15-dose vial, 7.5 mL - Product No. 49281-282-15STORAGEStore between 20 - BOC (350 46°F). DO NOT FREEZE. Temperature extremes may adversely affect resuspendabil-ity of this vaccine.REFERENCES1. Wilson GS. The Hazards of Immunization. Provocation poliomyelitis. 270-274,19672. Recommendations of the Immunization Practices Advisory Committee (ACIP). Di htheria, Tetanus, and
Pertussis: Recommendations for vaccine use and other preventive measures. MMWVR To: No RR-10, 19913. Noble GR, et al. Acellular and whole-cell pertussis vaccines in Japan. JAMA 257: 1351-1356, 19874. ACIP. Pertussis immunization: Family history of convulsions and use of antipyretics - Supplementary ACIP
statement. MMWR 36: 281-282,19875. Pertussis. Report of the Committee on Infectious Diseases. American Academy of Pediatrics, Evanston, Illinois.
Twenty-second Edition, 19916. ACIP. General recommendation on immunization. MMWR 38: 205-227,19897. CDC. Vaccine Adverse Event Reporting System - United States. MMWR 39: 730-733,19908. CDC. National Childhood Vaccine Inj'ury Act: requirements for permanent vaccination records and for reporting
of selected events after vaccination. MMWR 37: 197_200, 19889. Food and Drug Administration. New reporting requirements for vaccine adverse events. FDA Drug Bull 18 (2),
16-18, 198810. Active Immunization Procedures. Report of the Committee on Infectious Diseases. American Academy of
Pediatrics, Evanston, Illinois. Twenty-second Ediffon, 199111. Unpublished data available from Connaugh Laboratories, Inc.12. Rutledge SL, et al. Neurological complicartios of immunizaffons. J Pediatr 109: 917-924, 198613. Walker AM, et al. Neurologic events following Diphtheria-Tetanus-Pertussis immunizaffon. Pediatr 81: 345-
349, 198814. Wilson GS. The Hazards of Immunization. Allergic manifestations: Post-vaccinal neuriffs. 153-156,196715. Tsairis P, et al. Natural history of brachial plexus neuroLathy. Arch Neurol 27: 109-117, 197216. Blumstein GI, et al. Peripheral neuropathy following Tetanus toxoid administration. JAMA 198: 1030-1031,
196617. Cody CL, et al. Nature and rates of adverse reactions associated wffl DTP and DT immunizations in infants and
302, 197719. CDC. Advers events following immuneatjon. Surveillance Report No. 3, 1985-1986, Issued February 198920. ACIP. Pertussis Vaccination: Acellular Pertussis Vaccine for reinforcing and booster use - supplementary ACIP
statement. MMWR 41: No. RR-1, 1992Produe-t informationas of August 1992
Manufactured_by: Prnted in U.SACONNAUU6HT LABORATORIES,-INC. 1158
Florida, VirginiaHospital-based pediatrics as afulfilling and gratifying career track.Very attractive call schedule offer-ing participation in all areas ofpediatric practice. High quality sub-specialty support. Opportunities inareas of high geographic desirabil-ity. Children's Hospital Servicesoffers an outstanding employeecompensation package, includingfull benefits and professional liabil-ity insurance. Contact: RecruitmentOffice, Children's Hospital Services,Inc., 21644 State Road 7, Boca Ra-ton, FL 33428; (800) 300-5232 orFAX (407) 488-8279.
DIPHTHERIA AND TETANUS TOXOIDS AND Brief SummaryACELLULMR PERTUSSIS VACCINE ADSORBED
TripedialPlease consult package insert for full prescribing information.INDICA;TIONS AND USAGEDiphthenia and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed, Tripedia, is indicated as a fourth and/orfith dose for immunization of children 15 months to 7 years of agse (prior to seventh birthday) who have previ-ously been immunized against diphtheria, tetanus and pertussis with three or four doses of whole-cell pJertussisDTP vaccine. However, in instances where the pertussis vaccine component is contraindicated, Diphtheria andTetanus Toxoids Adsorbed (For Pediatric Use) (DT) should be used for each of the remaining doses.Persons recovering from confirrned pertussis do not need additional doses of DTP but should receive additionaldoses of DT to complete the series.THIS VACCINE IS NOT RECOMMENDED FOR USE IN CHILDREN BELOW THE AGE OF 15 MONTHS. THIS VACCINEIS NOT RECOMMENDED FOR USE AS A PRIMARY SERIES IN CHILDREN OFANY AGE.CONTRAINDICATIONSHypersensitivity to any component of the vaccine, including thimerosal, a mercury derivative, is a contraindication.Immunization should be deferred during the course of any febrile illness or acute infection. A minor afebrie illnesssuch as a mild upper respiratory infection is not usually reason to defer immunization.Elective immunization procedures should be deferred during an outbreak of poliomyelitis.'Data on the use of Tripedia in children for whom whole-cell pertussis DTP vaccine is contraindicated are not avail-able. Until such data are available, ft would be prudent to considerthe Immunization Practices Advisory Committee(ACIP) and American Academy of Pediatrics (AAP) contraindications to whole-cell pertussis DTP vaccine to becontraindications to Tripedia.Immunization with Tripedia is contraindicated if the child has experienced any event tollowinswprevious immuniza-tion with pertussis vaccine (whole-cell DTP or acellular pertussis-containing DTP vaccine) whch is considered bythe ACIP or AAP to be a contraindication to further doses of pertussis vaccine. The ACIPstates that if any of thefollowing events listed in Table 2 occur in temporal relation to receipt of DTP, the decision to give subsequentdoses ot vaccine containing the pertussis component should be carefully considered.It is a contraindication to use this or any other vaccine after a serious adverse reaction temporally associated witha previous dose, including an anaphylactic reaction!2Encephalopathy not due to an identifiable cause, occurring wHthin 7 days of a prior whole-cell pertussis DTP oracellular pertussis DTP immunization and consisting of major alterations of consciousness, unresponsiveness,Deneralized or focal seizures that persist for more than a few hours and failure to recover wHthin 24 hours shouldbe considered a contraindication to further use; this includes severe alterations in consciousness wHth generalizedor focal rneurologic signs. Even though causation cannot be established, no subsequent doses should be given.'TABLE 2.1 Cofnhindicatlons and Precutions to Flirther DTP (or atuliluh portbak) VacelRatlon
Encephalopathvy occurring within 7 days following DTP (or acellular pertussis) vaccination.Pr cagutons
Temperature >-40.50C (105°F) within 48 hours not due to another identifiable cause.Collapse or shock-like state (hy otonic-hyporesponsive episode) within 48 hours.Persistent, inconsolable crying latng 03 hours, occurring within 48 hours.Convulsions with or without fever occurring witthin 3 days.
WARNINGSThis vaccine Is not recommended for Use In children below the age of 15 months. Efficacy data for Tripedia ininfants is not available. Afthough anffbody responses to diphtheria, tetanus, and pertussis toxin, and FHA in infantsimmunized with Tripedia were at least equivalent to those for CLI's whole-cell pertussis DTP vaccine, the role ofserum antibodies in protection against pertussis is unknown.Tripedia is not recommended for immunization on or after the seventh birthday.If any of the following events occur in temporal relation to receipt of DTP, the decision to give subsequent doses ofvaccine cofftaining the pertussis component should be carefully considered. There may be circumstances, such asa high incidence of pertussis, when the potential benefits outweigh possible risks, particularly since these eventsare not associated wfth permanent sequelae.1Tripedia should not be given to children wfth anly coa lation disordeir, including thrombocytopenia. that wouldcontraindicate intramuscular injection unless the potena bee lal uwih h iko dinistration.In the opinion of the manufacturer, use of this vaccine is alocontraindicated if the child, siblings, or parents havea history of a seizure disorder. Recent studies suggest that infants and children with a history of convulsions infirst-degree family members (i.e., siblings and parents) have a 3.2-fold increased risk tor neurologic events com-Dared with those without such histories."4however, the ACIP has concluded that a family history of convulsions in parents and siblings is not a contraindica-tion to pertussis vaccination and that children with such family histories should receive pertussis vaccine accord-ing to tne recommended schedule.'"Acetaminophen should be given at the time of DTP vaccination and every four hours for 24 hours to reduce the
Posbility of post-vaccination fever.'Infsasnits and children with recognized possible or potential underlying neurologic conditions seem to be atenhanced risk for the appearance of manifestations of the underlying neurologic disorder wHthin two or three daysfollowing vaccination. Whether to administer DTP (or Tripedia to children with proven or suspected underlyingneurologic disorders must be decided on an individual basis. Important considerations include the current localincidence of pertussis, the near absence of diphtheria in the United States and the low risk of infection wHh C.tetani.1Only full doses (O.5 mL) of DTP (or Tripedia) vaccine should be given; if a specific contraindication to DTP exists,the vaccine should not be given.'PRECAUTIONSGENERALCare is to be taken by the health-care provider for the safe and effective use of this vaccine.EPINEPHRINE INJECTION (1:1000) IIUST BE IMMIIEDIATELY AVAILABLE SHOULD AN ACUTE ANAPHYLACTICREACTION OCCUR DUE TO ANY COIIPONENT OF THE VACCINE.Previous immunization history should be ascertained to confirm that at least three doses of whole-cell pertussisDTP vaccine have been given.Prior to an injection of any vaccine, all known precautions should be taken to prevent adverse reactions. Thisincludes a review of the paffent's history with respect to Possible sensitivity and any previous adverse reactions tothe vaccine or similar vaccines, previous immunization history, current health status (see CONTRAINDICATIONSsection), and a current knowledge of the literature concerning the use of the vaccine under consideration.Immunosuppressed patients may not respond. Tripedia is not contraindicated based on the presence of HIV infec-tion.'Special care should be taken to ensure that the injection does not enter a blood vessel.A separate, sterile syringe and needle or a sterile disposable unftshould be used for each Patient to prevent trans-mission of hepatitis or other infectious agents from person to person. Needles should not be recapped and shouldbe disposed of properly.INFORMATION FOR PATIENTParents should be fully informed of the benefits and risks of immunization with Tripedia. The heafth-are providershoudprvidethe accntnormation Pamphlets (when available from the Centers for Disease Control andPreenton}whih ae rquiedto be given with each immunization.
Thehysmanshoud ifor theparntsor guardians about the potential for adverse reacfions that have beentemoralyssoiatd wth hol-cel prtssis DTP vaccine and Tripedia administration and obtain informed con-
sent. Prents or guardians shoul be instructed to report any serious adverse reactions to their heafth-careprovider.FIT IS EXTREMELY IMPORTANT WHEN A CHILD IS RETURNED FOR THE NEXT DOSE IN THE SERIES, THAT THEPARENT SHOULD BE QUESTIONED CONCERNING OCCURRENCE OF ANY SYMPTOMS AND/OR SIGNS OF ANADVERSE REACTION AFTER THE PREVIOUS DOSE (SEE CONTRAINDICATIONS; ADVERSE REACTIONS).The U.S. Department of Health and Human Services has established a new Vaccine Adverse Event ReportingSystem (VAERS) to accept all r0ports of suspected adverse events after the administration of any vaccine, includ-inD but not limited to the reporting of events rmquimed by the National Childhood Vaccine Injury Act of 1986.' Theto4-ree numberforVAERS forms and information is 800 822-7967.
The National Vaccine Injury Compensation Program, established by the National Childhood Vaccine Injury Act of1986, requires physicians and other heafth-cre providers who administer vaccines to maintain permanent vacci-nation records and to report occurrences of certain adverse events to the U.S. Department of Health and HumanServices. Reportable events include those listed in the Act for each vaccine and events specified in the packageinsert as contraindications to further doses of the vaccine.$-'DRUG INTERACTIONSAs wihot,hoe,r ,I,M inj,e-ctions USewith caution in patients on anticoagulant therapy.Influenza Virus Vaccine should not be given within three days of the administration of Tripedia.'°1Immunosuppressive therapies, including irradiation, antimetabolftes,alkylating agents, cytotoxic drugs, and corti-costeroids (used in greaterthan physiologic doses.), mayreduce the immune responseto vaccines.IfTripedia has been administered to persons receiving immunosuppressive therapy, a recent injection of immuneglobulin or having an immunodeficiency disorder, an adeauate immunologic response may not be obtained.ITetanus Immune Globulin, or Diphtheria Antitoxin, if used, should be given in a separate site, wimha separate nee-dle and syringe.CARCINOGENESIS, MUTAGENESIS, IMPAIRMENT OF FERTILITYTripedia has not been evaluated for its carcinogenic, mutagenic potentials or impairment of fertility.PEDIATRIC USEEfficacy data for Tripedia in infants is not available. Although antibody responses to diphtheria, tetanus, and per-tussis toxin and FHA in infants immunized with Tripedia were at least equivalent to those for CLI's whole-cell per-
American Clinic In Abu-Dhabi,U.A.E., offers a challenging oppor-tunity for employment in a 9-personclinic in this modern and excitingmulti-cultural city. Many benefits in-cluding no personal income taxes,paid travel for vacations, rent-freeaccomodations, club memberships,etc. Mail your resume to: Faisal Al-Alawi, General Administrator, c/oAmerican Clinic, P.O. Box 3374,Abu-Dhabi, U.A.E. or phone(00971-02) 771310.
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I
Te'nnesses Wisconsin
Pediatrics -La Salle Clinic, a150-plus physician-owned, multis-pecialty group, is recruiting BC/BEPediatricians. With 16 clinic loca-tions throughout northeasternWisconsin, we're one of the state'slargest group practices. We offer anindustry leading salary and benefitspackage, with an opportunity to ad-vance to shareholder status aftertwo years. Live and practice in afriendly, comfortable family environ-ment, enjoy a strong referral base,and benefit from a growing regionaleconomy and nationally acclaimededucational systems. For more in-formation, contact: LaSalle Clinic,Physician Services, P.O. Box 8005,Menasha, WI 54952-8005; (800)722-9989
Vlrgina, Maryland,Washington, D.C.
Kaiser Permanente: General pe-diatric opportunities are currentlyavailable in Virginia, Maryland, andWashington, D.C. Candidates mustbe BC/BE. Comprehensive com-pensation and benefit packageoffered. Contact: William J.McAveney, M.D., 2101 E. JeffersonStreet, Box 6649, Rockville, MD20849. FAX (301 ) 816-7472. EOE.
Tennessee - Beautiful Area!Seeking additional pediatri-cian for expanding facility inmiddle Tennessee. Excellentcommunity, new schools, cen-tral to major cities.Guaranteed income, reloca-tion, benefits. Contact GloriaBryant, of River Park Hospital,at (800) 453-0225.
Texas
Tyler: Mother Frances Hospitalneeds additional BC/BE Pediatri-cian to join its FamilyCare Center.Competitive salary, incentive, andbenefits package. Northeast Texasis one of the garden spots in thenation with rolling hills, lakes,streams, and temperate climate. Ty-ler (known as the "Rose Capital") issituated 90 miles east of Dallas witha population of about 90-100k andis a regional center for health care,education, retail, and employment.Contact: Randy Perdue, MotherFrances Hospital, 800 E. Dawson,Tyler, TX 75701; (800) 443-3849,Fax (903) 531-4234.
Course calendarThe AAP Department of
Education has announced its1995 continu ing medicaleducation course schedule.Some of the courses include:* "Current Concepts 'in
Pediatrics," Jan. 12-15, Vail,Colo.;
. "Pediatrics 1995," March10-12, Maui, Hawaii;
* "State-of-the-Art Pediatrics,"April 28-30, New York;
. "Pediatric Advances," May26-28, Hilton Head Island, S.C.;
To register for these courses,contact: AAP CME Registration,141 Northwest Point Blvd., ElkGrove Village, IL 60007; (800)
Sw ~Xer, Pennsylvania 18370, U.SAandThe Research Foundafion tor MicrobialDiseases of Osaka Unhversty ('BIKEN"')Suita, Osaka, Japan T16
AAP News/August 1994 31
Carge itDue to popular
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C O N N A U G H T
...~~....Iau
PertussisVaccine91AdsorbdFOR CHILDREN 15 MONTHS TO THE SEVENTHI BIRTHDAY*
Unque baanefpuri t'ed pertusi atigens*Highly purified pertussis toxoid' and filamentous hemagglutinin (FHA)in a 1:1 ratio'
* Two to three times fewer local reactions (including tenderness, erythemaand swelling)
* Three to five times fewer systemic reactions when given as the fourth doseto chfldren at 15-20 months and as the fifth dose at 4-6 years of age 1-3M§
Hfigh levels of immunogenitcity* When given as the fourth dose to children at 15-20 months and as the fifthdose at 4-6 years of age, Tripedia provided:High antibody levels to pertussis toxidn and filamentous hemagglutininHigh antibody levels to diphtheria and tetanus toxoids213
Before administering Tripedia, please see the Contraindications, Warnings, Precautionsand Adverse Reactions sections of the complete prescribing information.*Tripedia is indicated for the fourth dose immunization in children at 15 monthsand for fifth dose immunization in children at 4-6 years of age (up to the seventh birthday).
t Pertussis Toxoid = Inactivated Lymphocytosis Promoting Factor (LPF).*All children in the 15-20 month group received whole-cell DTP vaccine for their first three doses.§All children in the 4-6 year group received whole-cell DTP vaccine for their first four doses.References: 1. Data on file, Connaught Laboratories, Inc. 2. Marcinak JF, Ward M, Frank AL, et al. Comparisonof the safety and immunogenicity of acellular (BIKEN) and whole-cell pertussis vaccines in 15- to 20-month-oldchildren. AJDC. March 1993;147:290-294. 3. Bernstein HH, Rothstein EP, Pichichero ME, et al. Clinical reactionsand immunogenicity of the BIKEN acellular diphtheria and tetanus toxoids and pertussis vaccine in 4- through6-year-old US children. AJDC. May 1992;146:556-559.t 1994 Connaught Laboratories, Inc. MKT1206
ABalance of Protection and Purity~~
Manufactured by
L A D O R A T O R E S, N C.
Swiftwater, PA 18370, U.S.A.Printed in U.S.A. 1/94
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