Download NEWS NOTES AND

U N I V E R S I T Y
O F
M I C H I G A N
CYSTIC FIBROSIS CENTER
Cystic Fibrosis Center
Department of Pediatrics
C.S. Mott Children’s Hospital
Ann Arbor, MI 48109-5212
734-764-4123
734-936-7635 (FAX)
NEWS NOTES
AND
SPRING 2012, VOL. XXVI
NEWS FROM THE FRONT
NEW UNIVERSITY OF MICHIGAN C.S. MOTT CHILDREN’S HOSPITAL
Same Infection Control Policy
By Samya Nasr, MD
We celebrated the opening of
the new University of Michigan,
C.S. Mott Children’s Hospital
on December 4, 2011. The
new hospital provides a major
improvement in the facilities over
the old hospital that is over 40
years old. The new hospital is
a state-of-the-art hospital. It is
designed with patients and their
families as the center (patient
and family centered care). It
Samya Nasr, MD
provides private rooms for all our
Director, Cystic Fibrosis Center
patients. The pulmonary floor is
on the 12th floor of the building with a beautiful view
from every room. The rooms are designed not only
for patients comfort but also for their families comfort
with input from the patient and family centered care
committee.
The clinic facility has moved to the new hospital
building as well. The pulmonary clinic is located on
the 6th floor of the outpatient clinic building. Among
amenities that the new hospital provides is a cafeteria
for patients’ and families’ convenience.
With these changes, the infection control policy is in
place to prevent transmission of infection between
patients. It is as follows:
INSIDE THIS ISS­UE...
FOR HOSPITALIZED PATIENTS:
1. CF patients must wash/sanitize their hands before
leaving the room and upon returning. Frequent
hand washing/sanitizing should be encouraged.
2. Masks should be worn by CF patients while outside
of their rooms in the Hospital, due to potential
contact with sick patients
or other CF patients.
3. No visitation between CF
patients, unless they are
siblings.
4. Patients should not go to
play area or any common
area. Please see below for
Child Life Guidelines for
more details.
With the infection
control policy in
place, we were
able to reduce/
eliminate patient-topatient transmission
of infection and
improve quality of
life for our patients.
5. A sign designating the
specific type of precautions
(i.e. Contact for BC or
Droplet for viral infection
shall be placed on the patient’s door).
6. CF patients should only be in the hallways for
travel to and from tests, appointments, etc.
7. Visitors / sibling with CF should not use activity
rooms, park areas or the lobby’s play areas.
continued on page 6
News From the Front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 1
Adult Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 5
What’s News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 3
Clinician’s Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 7
Parent to Parent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 4
CFC Staff and Donors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 8
NEWS AND NOTES | VOL. XXV | SPRING 2012
NEWS FROM THE FRONT
Personalized Medicine for Cystic Fibrosis
By Richard H. Simon, MD
The Adult CF Care Program: Dr. Ojo, Dr. Sisson, Dr. Grum, Dr. Coffey and Dr. Simon
More and more frequently, the phrase
“personalized medicine” is being used to
characterize a modern approach to medical
care. The idea of personalized medicine is
that treatments should be carefully selected
to fit the special needs of a patient. In one
sense this in not a new approach. Care
providers have always paid attention to
how a disease affects each patient and have
designed treatments appropriate for that
person. But what is different now is that
increasingly, treatments are being selected
based on a person’s genetic makeup.
This practice is being used a lot in the area
of cancer therapy. It is known that the
genes within cancer cells have undergone
mutations that cause the cells to grow and
spread uncontrollably. Furthermore, even for
cancers of a single type, there are differences
between patients in what mutations their
tumors carry. These differences turn out
to be important because now we know
that some cancer treatments work only on
tumors that have certain mutations. So,
practicing personalized medicine for cancer
patients means analyzing the DNA of their
tumors for specific mutations and choosing
the therapies that will work best on their
tumors.
For cystic fibrosis, knowing a patient’s CF
mutations has already helped doctors choose
2
treatments. We now know that some people
with CF have mutations that allow them to
digest their food without taking enzymes,
so we don’t prescribe pancreatic enzymes
for them. But now, cystic fibrosis care has
taken a giant step forward in the area of
personalized medicine. On January 31,
2012, the Food and Drug Administration
(FDA) approved a drug for patients who
have a specific mutation in their cystic
fibrosis genes, namely the G551D mutation.
[The designation “G551D” means that a
change has occurred in the 551st amino acid
of the CF protein. The 551st amino acid
should be a glycine (G) but the mutation
causes it to be replaced by an aspartate
(D).] This single amino acid change causes
the CF protein not to function correctly and
leads to many of the problems that occur in
people with CF.
Now, with heavy financial support from
the Cystic Fibrosis Foundation, Vertex
Pharmaceuticals has developed a drug that
can be truly considered a personalized
medicine. It was designed specifically for
CF patients who have the G551D mutation.
The drug, which was originally called
VX-770 during its early testing, has now
been given the generic name “ivacaftor” and
the brand name “Kalydeco” (pronounced
kuh-LYE-deh-koh). The drug corrects most
of the problems caused by the G551D
mutation. People with CF who participated
in the clinical trials of ivacaftor have seen
their sweat tests return toward normal. They
also had large improvements in pulmonary
function test results and increased body
weight. We are recommending that all
people with CF should have their CF
mutations analyzed to see if they have the
G551D mutation. This mutation was first
identified in 1990, so anyone tested after
then would know if they have a G551D
mutation.
Vertex is now planning on studying whether
there are other CF mutations that may
be helped by ivacaftor. Unfortunately,
when used alone, ivacaftor does not help
patients with deltaF508, the most common
CF mutation. However, it may help when
combined with other research drugs that are
undergoing clinical study.
Another example of personalized medicine
for CF is ataluren (PTC124), a drug
designed for people with CF who have a
“stop” mutation in their CF genes. Stop
mutations cause only part of the CF protein
to be made. [Any mutation whose name
ends with an X is a stop mutation, for
example G542X.] Ataluren allows the
full length CF protein to be made, so it
can work properly. Ataluren is currently
undergoing phase III clinical trials.
In conclusion, the expansion of personalized
medicine into CF treatment is an important
milestone. If ivacaftor is any indication
of the future, there is good reason for
optimism. Personalizing medicine will allow
doctors to select for each patient those
treatments that will have the greatest chance
to help them.
WHAT’S NEWS
NEW STAFF IN SOCIAL WORK
In July 2010, we welcomed
Elsa Larson Weber to our
Social Work team. She has
been a part of the University
of Michigan development
community for the past three
years and has experience
volunteering over the past year
with St. Joseph Mercy Hospital.
She worked closely with the
clinical bereavement staff from
the Home Care and Hospice
Elsa Larson Weber
team. She also has worked
closely with SOS Community Services in Ypsilanti, Michigan as a
Children’s Services Case Manager. She is excited to work with the
families, staff and Family Advisory Board at the UM CF Center.
We are very excited to have Elsa join the Social Work team.
ADHERENCE STUDY UPDATE
Our CF Center has been involved in the I Change Adherence
& Raise Expectations (iCARE) Study (developed through John
Hopkins and the University of Miami), with patient participation
since June 2010. This is one of the largest randomized-control trials
that has been done with CF, focusing on patients ages 11 – 21.
At our center, we have 36 patients involved, with a total of 635
patients across the country. So far, this study has helped show gaps
in knowledge across the country that can help all of us improve in
CF education and treatment. The study mainly consists of annual
assessments (completing baseline assessments, and then tracking
progress and increasing knowledge over the next 2 years plus), as
well as problem solving sessions during regular clinic visits. It is
from this study that the PFT lab staff recognized the value of every
patient having an annual assessment/review.
During the problem solving sessions that Social Work facilitates,
families have helped prove that more heads are better than
one, and thinking outside of the box has helped come up with
many different fun and creative solutions – that seem to actually
work! Problem solving sessions focus on breaking down goals
into smaller more manageable steps and brainstorming creative
solutions to help have success in adherence. The idea of the
study is to have the patient in the driver’s seat with the parent/
caregiver(s) and siblings/other family members supporting and
assisting the patient. We have received feedback that some families
have used these same techniques for other areas of their lives (i.e.
helping with homework, chores, other expectations). And, better
yet, families have helped teach us ideas that we’ve shared with
many families outside of the study, and of all ages.
THE ANNUAL RESPIRATORY
ASSESSMENT
In the past year, you may have been contacted by Kim in the
pulmonary lab to schedule an “annual respiratory assessment” and
wondered what this is and why you are being asked to do it. We’d
like to give you a bit of background about the assessments and why
they are such a valuable tool.
Part of the iCARE study required that participating families take
part in an assessment. From the information we gathered, we
determined that this kind of assessment would be most beneficial to
all of our families. At the same time we were networking with other
CF centers and learned that assessments have become a standard of
care in most CF centers in the United States.
We developed a questionnaire regarding airway clearance,
equipment care, cleaning techniques, medication knowledge, and
other things that are a part of your day-to-day life. We ask that you
bring in your vest compressor, your vest, your nebulizer compressor,
spacers, Acapella, nebulizer cups, and anything else that you use for
your child’s respiratory care. At the evaluation we will look at all of
your equipment, evaluate your airway clearance techniques, adjust
vest settings and check the size. We will talk about proper cleaning
of equipment, be sure that you are using the best nebulizer for the
medications your child is taking, help you get new supplies if you
need them, and make sure that you have everything you need to
provide the best care for your child.
CYSTIC FIBROSIS FAMILY
ADVISORY BOARD
We are excited to announce the U-M Cystic Fibrosis Center Family
Advisory Board was restarted at the end of January. The Family
Advisory Board is instrumental in the improvement in CF Center
Programs using the patient’s and their family’s experiences to drive
quality improvements at the CF Center. The U-M CF center is
committed to patient and family centered care and wants to ensure
our Family Advisory Board serves as an advisory resource for the
center, providing constructive input and assistance to continually
improve our CF center.
3
NEWS AND NOTES | VOL. XXV | SPRING 2012
PARENT TO PARENT
Lessons learned: A Parent’s
Perspective at the North American
Cystic Fibrosis Conference
By Carole McGillen
As a parent advisor attending the North American Cystic Fibrosis
(NACF)conference for the first time, my reactions ranged from
feeling overwhelmed, amazed, grateful and inspired.
Overwhelmed – The wealth of resources and education available
from the speakers, exhibitors and online was amazing. The
challenge we have in follow-up to the conference is to work with
Connor (10 ½) with CF, Brennan (6 ½) and Rory (13) with mom Carole
our advisory group and care teams to determine how we can
and dad Tim
integrate best practices and
lessons learned. There is a fine
I saw how many different
While for some parents this might be ‘old
line that we do not want to
disciplines across the world are
cross with providing too much
working to improve the lives of
news’; for others, reinforcing and improving
information when parents and
those with cystic fibrosis.
the role and relationship as ‘partners’ with
children are not ready.
all members of the health care team can have
Grateful – I was not only
a significant impact on the health of our
One area where this is
thankful for the opportunity
children. Patients and families need to take an
somewhat sensitive surrounds
to attend this conference but
the issue of advanced care
extended this gratitude when I
active role to continue to improve care. Our
planning. As a parent, if anyone
fully recognized how broad the
active involvement can have a positive impact,
addressed the issue of end of
support is in finding a cure for
whatever role we are able to take…. whether it
life care planning, it can be
this disease. It truly takes more
is
as
patient
advisor,
working
on
a
committee,
perceived extremely negative
than ‘a village’ for a cure and I
(giving up hope). As difficult
am convinced that the combined
participating in clinical trials, or closely
as it was to sit through this
efforts of the Cystic Fibrosis
tracking responses to treatments. We all can
session as a parent, I recognized
Foundation (CFF) with our care
make
a
difference
by
recognizing
we
are
not
that all programs across the
team at UMHS, we are receiving
alone in our efforts to provide the highest
country struggle with this issue.
the best care for our children.
Current recommendations from
quality life for those with cystic fibrosis.
the experts at the conference
Inspired – The best care
feel these discussions should be
involves informed decision
part of routine care with annual visits, hospitalizations and new
making with our care team..… treatment regimens are very
interventions. We as parents need to be open and help with these
complicated and we need to work together to provide the best
conversations.
outcomes.
Amazed – While I have been able to attend conferences in my own
profession, I was still taken aback by the wealth of information
and industry support for cystic fibrosis. Visiting the poster sessions,
4
ADULT PERSPECTIVES
TIPS FOR COLLEGE BOUND CFERS
By Anna DiPirro
Hi! My name is Anna DiPirro and I am a 20 year old college
student. Being diagnosed with CF as an infant I have learned to
live with the disease. Life is always slightly more difficult than the
average person. However, overall adherence with treatments and
exercise has been key to staying healthier, longer. Now as a college
student I know firsthand that this isn’t always easy!
My college transition as far as healthcare
was at first fairly simple. As time went on
though, homework became my priority.
Exercise, my vest, sleep and spending time
with friends fell by the wayside. School
work was my priority and although I
wouldn’t call myself a perfectionist, I do
have high standards when it comes to
something that is being graded.
During the time of my transition I still
made sure to do my breathing treatments, I
could do them while doing my homework.
However, I no longer did my vest or
exercised much at all. Any exercise was
a weekly game or two of co-ed softball
or some tennis a few times a week in the
Fall. Once it started getting colder those
irregular exercises turned into an even
Anna DiPirro
more irregular “weekly” volleyball. And
this quickly turned into an “if I’m not too
busy” volleyball game every other week or once a month. Instead
of my vest I became content with just doing my acapella.
I quickly learned that not only was I being graded by my teachers,
but my body too. My decrease in treatment and exercise adherence
along with previous problems with lower lung functions took its
toll. My next year and a half in college were filled with hospital
visits and IV meds. My body was giving me an “F,” the worst
“F” I could ever get. Not only was my body failing, but I couldn’t
function for school. I wasn’t always able to drive myself to school,
do my homework, or sometimes, even attend class. However, I had
joined an adherence study this previous summer. This study helped
me get my healthcare back to where it needed to be. It became a
priority for me again and with much help I was able to find time
in my already busy schedule for the treatments and exercise that I
had been neglecting.
It has been hard trying to fit in treatments, school, and a job into
a working schedule. I’m slowly making it work and hope to reach
this goal my first month back to school. Oh,
and my friends! During school I don’t have
much time to spend with friends, but I use
the time I do have. At the beginning of the
semester I sit down and make a schedule
that allows me to spend time with friends on
the weekends. My friends are all in college
too and understand how hectic college life
can be. They’ve also known from early on
that I have things I have to do with my
health that makes my schedule even more
crazy. In order to hang out they know it will
probably have to be a movie on a Saturday
night at my house while I do my treatments.
They understand this though and we make
the most of it.
Okay, so now to my tips for college-bound
CFers: (1) Work out a schedule at the
beginning that will make doing treatments
and exercise easier to fit in everyday. This
is a must or everything else will fail. Also,
it may seem obvious, but I have learned the hard way that you
can’t just get up and run out the door in the morning without
sacrificing your treatments. You must learn to adjust your
schedule without omitting treatments. (2) Know your limits. If a
paper usually takes you a day or so to complete, don’t try to fit
it into an hour or two. Don’t procrastinate! You’ll only become
stressed and frustrated, and (3) If you find it hard to exercise in
the winter because of the cold, invest in a gaming station and get
interactive games that will get your heart beating.
I challenge all CF patients (myself included) to fight this disease
with exercise and treatment adherence. There are many resources
to fight this disease and to create a better and healthier life.
5
NEWS AND NOTES | VOL. XXV | SPRING 2012
Great Strides Walk
Fundraising Events
Same Infection Control Policy
continued from page 1
Looking for more ways to make a difference
in the CF community? Join the Cystic Fibrosis
Foundation at one of their annual Great
Strides walks. Great Strides is the Foundation’s
largest, national, fundraising endeavor and
offers individuals a chance to raise vital funds
and much needed awareness for cystic fibrosis.
Whether you join members of the U-M Care
Center staff at the Ann Arbor walk site or choose
one of our other 13 sites, you’re sure to make a
difference.
This year we’ll be walking towards a cure in:
Ann Arbor
Lansing/
Tri-City
Birch Run
DeWitt
(Midland-
Charlotte
Port Huron
Bay City)
Detroit
Rochester
Toledo, OH
Fremont, OH
Sterling
West
Grand Blanc
Heights
Bloomfield
Hartland
For more information or to register your
team please visit http://detroit.cff.org/
greatstrides or call (248) 269-8759.
Other CF resources:
Josh from Minnesota (an adult who has CF) has
created a terrific website that may help educate
your children. He has a “muppet” named Moganko
who sings songs about doing therapy and having
CF. Check it out: www.mogankoforcf.org/p/musicvideos.html
For adults, he also has a blog where he writes about
coping with CF: www.welcometojoshland.com
6
CHILD LIFE GUIDELINES FOR HOSPITALIZED PATIENTS:
1. School
No more than one pediatric CF patient at a time may attend the school
room. A mask and hand washing/sanitization are required for the patient.
Tables in the school room should be disinfected prior to and after use by a
CF patient.
2. Activity rooms, park areas, lobby play areas, and outdoor play area
Pediatric CF patients should not play in park areas or in lobby play areas in
Mott Hospital. Child Life staff are available to provide bedside activities.
3. Toys
It is suggested that CF patients bring toys and games from home.
However, CF patients may use toys, games and art supplies provided by
Child Life staff if the items are disinfected before and after use. Items such
as board games or cards that are not easy to disinfect, may be brought to a
CF patients room by child life. They should be discarded or sent home with
the patient.
4. Books and magazines
CF patients should bring books and magazines from home. Child Life may
provide new/never used books or magazines that will be discarded after use
or taken home by the patient.
5. Special events
Mott Hospital CF patients may participate in special events with Physician’s
approval and with monitoring of infection control practices by a volunteer
or staff member. Patients must wear a mask and perform hand washing/
sanitization prior to and following attendance at an event.
FOR OUTPATIENT CLINICS:
1. Because of the limited space in the waiting area in the new clinic, we
recommend that all patients continue to wear masks as soon as they arrive
to the clinic area [masks will be provided by the front desk] to protect them
from other sick contact.
2. To reduce the time spend in the waiting area, patients will be placed in
exam or consult rooms as soon as possible. Siblings may be placed in the
same room.
3. All CF patients will have their diagnosis listed in the comments section of
the appointment scheduling screen for prompt identification.
4. Children with CF can bring toys from home to avoid playing with
communal toys.
With the infection control policy in place for the last 18 years, we were able
to reduce/eliminate patient to patient transmission of infection and improve
quality of life for our patients. Currently, the CF Foundation formed a
committee to review and revise the CFF infection control policy. Once the new
recommendation is available, we will revise our policy accordingly.
CLINICIAN’S CORNER
UPDATE ON BMI PROJECT
By Amy Filbrun, MD
In addition to working on our
goals, we have been tracking
our progress. At the start of our
project, we set a specific aim
to improve the median BMI by
20% for those who had BMI
less than the 25th percentile.
We actually saw a 32% increase
in median BMI in the group
that started out below the 25th
percentile, in the first year of
The Pediatric CF Care Team: Back row from left to right: Dr. Saba, Dr. Popova, Dr. Arteta, Dr. Filbrun, Dr. Keaton,
our project. As seen in the graph
Dr. Hershenson, Dr. Hassan; Front row left to right: Dr. Lumeng, Cathy Boehle, RN, Dr. Nasr, Dr. Ramirez, Dr.
from our CF Foundation Patient
Lewis, Sue Critz, RN, and Donna Genyk, LMSW
Registry Report below, we have
improved the overall BMI in
This past year we continued to work hard on our project to improve our center over the past two years, but we seem to have leveled
our center’s body mass index (BMI). However, we did so in a more
off. We are now above the national average, with a mean BMI of
formalized fashion, as part of the CF Foundation’s Learning and
53.6 percent for our center as a whole. We will continue to work to
Leadership Collaborative: Self Study Action Guide Program. This
improve the nutritional status of our center to hopefully reduce the
program provided us with a coach and a study guide with the goal
percentage of our population with low BMI, and to strive to be the
of accelerating improvement in CF care. We got our whole team
very best we can be. Much as we needed a whole team to participate
involved, including the doctors, nurses, dietician, social workers,
in this program, we consider all our patients and families part of
psychologist, and a parent representative. For some of us, it was like
the team, and we look forward to continuing to work together to
learning a foreign language at first, as we learned about macro- and
achieve these goals.
microsystems, fish-bones, PDSA cycles, etc. Fortunately we had our
coach that helped us. Also, some team members were more familiar
with the concepts and they helped guide our team. We created a
large story board to track our progress through the program, met
regularly as a team, and had regular conference calls with our coach.
During the past year, we were able to achieve several goals. We
determined that there were access issues with supplements. Some
of them were not covered by insurance. We were able to address
these issues, and now have expanded the patient group who
qualifies for supplements. Next we worked on providing written
care plans at each visit. We felt that if we provided a care plan with
recommendations regarding enzymes and supplements, it would
be easier for families to follow those recommendations. We made
this a priority, and saw a dramatic improvement over the course of
the year. Finally, we are working on making sure everyone receives
information about energy needs (how many calories are needed per
day) as well as weight gain goals for the next visit. The weight gain
goal was added to the plan.
7
NON-PROFIT
U.S. POSTAGE
PAID
ANN ARBOR, MI
PERMIT NO. 144
Cystic Fibrosis Center
Department of Pediatrics
L2201 Women’s
1500 E. Medical Center Dr. SPC 5212
Ann Arbor, MI 48109-5212
734-764-4123
734-936-7635 (FAX)
T H E M I C H I G A N D I F F E R E N C E
CFC STAFF
Personnel
Samya Z. Nasr, MD, Director, CF Center
Richard H. Simon, MD, Director, Adult CF Center
Amy Filbrun, MD, Associate Director, CF Center
Mary Ball, MS, RN, Adult Program Coordinator
Donna Genyk, LMSW, Pediatric Program
Coordinator
Julie Merz, LMSW, Clinical Social Worker
Elsa Weber, LLMSW, Clinical Social Worker
Manuel Arteta, MD, Pediatric Pulmonology
Fauziya Hassan, MD, Pediatric Pulmonary
Marc Hershenson, MD, Pediatric Pulmonology
Toby Lewis, MD, MPH, Pediatric Pulmonology
Carey Lumeng, MD, PhD, Pediatric Pulmonology
Antonia Popova, MD, Pediatric Pulmonology
Meghan Keaton, MD, Pediatric Pulmonary Fellow
Ixsy Ramirez, MD, Pediatric Pulmonary Fellow
Thomas Saba, MD, Pediatric Pulmonary Fellow
Michael Coffey, MD, Adult Pulmonology
Cyril Grum, MD, Adult Pulmonology
Tammy Ojo, MD, Adult Pulmonology
Thomas Sisson, MD, Adult Pulmonology
Hope O’Leary, MS, RD, Nutrition Specialist
Cathy Boehl, RN, Pediatric Pulmonary Nurse
Kristen Cauchon, RN, Pediatric Pulmonary Nurse
Nancy McIntosh, PhD, RN, Pediatric Pulmonary
Nurse
Tanya Emch, Pediatric Pulmonary
Barbara Slattery, RN, BC, Coordinator, Pediatric
Liz Baron, RN, BSN, CPN
Theresa Kennedy, RN, BSN, BC
Alison Wilson, BSN, RN, CCM, Practice
Management
Barb Butler, MS, PT
Betsy Howell, MS, PT, Pediatric PT
Chris Tapley, MS, PT, Pediatric PT
Paulette Ratkiewicz, RRT, Respiratory Therapist
Mary Britt, RRT, RPFT, Respiratory Therapist
Suzanne Eyer, RRT, Respiratory Therapist
Kathy Faber-Pitts, RRT, RPFT, BA, Respiratory
Therapist
Mark Waltrip, RRT, RPFT, Respiratory Therapist
Kim Shaffer, PFT Lab
Stephanie Reid, PFT Lab
Ronnie Downer, RN, Coordinator, Adult Inpatient
Barbara Carpenter, BSN, RN, Adult Pulmonary
Nurse
Karri Looker, RN, Adult Pulmonary Nurse
Kristin Keith, MS, PT, Adult PT
Geeta Peethambaran, MS, PT, Adult PT
Rachel Wilken, BSN, RN, Practice Management
Karen Carskadon, Pediatric Pulmonary
Angie Adams-Stephens, Pediatric Pulmonology
Kathy Parrish, Pediatric Clinic
Kelly Smutek, Pediatric Pulmonary
Kim Casto, BFA, Pediatric Pulmonology
Nicole Cheesman, Pediatric Pulmonology
Research Division Personnel
Amy Filbrun, Assistant Professor
Dawn Kruse, CCRC, Research Coordinator
John LiPuma, Professor
Kelley Bentley, PhD, Research Assistant Professor
Marc Hershenson, MD, Pediatric Pulmonology
Marisa Linn, Research Lab Specialist Associate
Samya Nasr, Professor
Uma Sajjan, PhD, Research Assistant Professo
DONORS
The following families and organizations have made donations to the CFC in the past year:
Axcan Scandipharm, Inc. • Digestive Care, Inc. • Electromed • Genentech • Solvay Pharmaceuticals
Executive Officers of the University of Michigan Health System
Ora Hirsch Pescovitz, Executive Vice President for Medical Affairs; James O. Woolliscroft, Dean, U-M Medical School;
Douglas Strong, Chief Executive Officer, U-M Hospitals and Health Centers; Kathleen Potempa, Dean, School of Nursing
The Regents of the University of Michigan
Julia Donovan Darlow, Laurence B. Deitch, Denise Ilitch, Olivia P. Maynard, Andrea Fischer Newman,
Andrew C. Richner, S. Martin Taylor, Katherine E. White, Mary Sue Coleman, ex officio
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