Content:

• Welcome Letter
• Program Goals & Objectives
• Subspecialists
• Library & Research Facilities
• Recent Publications & Presentations
  

Welcome Letter

The Neonatal-Perinatal Medicine Fellowship Program of the University of Vermont College of Medicine is an integrated part of the Pediatric Residency Training Program at Fletcher Allen Health Care in Burlington, Vermont. The Program provides comprehensive training in Neonatal-Perinatal Medicine: graduates are well prepared for either academic or clinical practice. The Program is certified by the Accreditation Council for Graduate Medical Education (ACGME); successful completion leads to qualification for subspecialty certification in Neonatal Perinatal Medicine.

The Neonatal-Perinatal Medicine Program has positions for two Neonatal-Perinatal Medicine Fellows. Prospective candidates are encouraged to apply during their second year of pediatric residency. The Fellowship Director, with the aid of the Neonatal-Perinatal Medicine Faculty, selects from the completed applications those candidates who will be offered an interview. Criteria for acceptance into the NPM Fellowship program are:

- Successful completion of an ACGME-accredited pediatric residency program (consideration will also be given to outstanding candidates who have completed pediatric residency programs outside of the United States)

- A commitment to pursue a career in academic or clinical neonatology

- Excellence in the clinical care of children

- Strong potential for success in clinical research

Thank you for considering the Neonatal-Perinatal Medicine Program at Fletcher Allen Health Care/University of Vermont.

Roger F. Soll, MD, FAAP
Professor of Pediatrics
Director, Neonatal-Perinatal Medicine Fellowship

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Program Goals & Objectives

The Neonatal-Perinatal Medicine Fellowship Program has the following educational goals:

- Develop an understanding of the physiology of the normal neonate and the pathophysiology of the sick neonate.

- Develop an understanding of the fundamentals of clinical diagnosis and management of problems seen throughout the continuum of the perinatal period, including the development of the fetus, antenatal care, intrapartum care, the neonatal period, and follow-up period.

- Develop confidence in the management of critically ill newborn infants, including the technical skills of neonatal resuscitation, venous and arterial access, endotracheal intubation, transport of critically ill newborns, ventilatory support (conventional and high frequency oscillatory ventilation), as well as the general principles of critical care, continuous monitoring, maintenance of neutral thermal environment, nutritional support, and advanced life directives.

- Learn to identify newborns at risk of developmental delay and to formulate appropriate disposition plans and followup.

- Develop the skills to perform clinical or laboratory research relevant to the field, including trial design, statistical analysis, relevant laboratory skills, and presentation of research results.

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Subspecialists

The following Pediatric subspecialty consultants are available:

Surgery
Neurosurgery
Orthopedics
Hematology/Oncology
Infectious Diseases
Nephrology
Nutrition
Radiology/Ultrasound
Cardiology
Genetics/Dysmorphology
Neurology
Gastroenterology
Endocrinology

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Library & Research Facilities

The Neonatal-Perinatal Medicine Fellows have an office in the Burgess Building of Fletcher Allen Health Care. At this office, there is a computer for their use with access to the Internet and the ability to perform MEDLINE searches from that terminal.

The Dana Medical Library is located in the Given Building, directly connected to the offices of the Department of Pediatrics at the University of Vermont. The collection includes approximately 25,000 books, 70,000 volumes of bound periodicals, and subscriptions to approximately 1,400 journals. This includes subscriptions to 32 pediatric journals, 22 obstetric journals and 28 genetics journals. The loaning resource collection contains 2,500 titles in a variety of formats, including video cassettes, computer software, slides, filmstrips, etc. Computerized literature search facilities are available.

The database network provides access to approximately 24 databases, including MEDLINE, Cochrane Database of Systematic Reviews, Psychlit, Nursing and Allied Health, and Scientific American Medicine. Neonatal-Perinatal Medicine Fellows can search on their own through these databases at numerous computer terminals, or conduct mediated literature searches by experienced health science librarians.

The Dana Medical Library also includes a variety of learning resource laboratories to provide training in a variety of applications such as word processing, graphics, E-mail, and statistical analysis. There are also computer assisted instructional programs and clinical decision support programs, and inter-library loan.

A library of recent Neonatology textbooks is available to the Neonatal-Perinatal Medicine Fellows in the Neonatal-Perinatal Medicine Attending Physicians' office adjacent to the Neonatal Intensive Care Unit, and in the Pediatric Residents Library adjacent to the Pediatric Ward.

The Neonatal-Perinatal Medicine Fellows have access to the CLINFO Computer Facility on the General Clinical Research Center at the Fletcher Allen Health Care. This facility is located on the same floor as the Neonatal Intensive Care Unit. There is a full-time statistician who provides consultation and computer facilities and appropriate statistical software to create databases and to complete sophisticated data analyses.

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Recent Publications & Presentations

Scholarly publications and presentations at national and international meetings by the Neonatal-Perinatal Medicine Faculty and Neonatal-Perinatal Fellows within the last five years.

Publications

Books and Book Chapters

Merritt TA, Soll RF, Hallman M: Overview of exogenous surfactant replacement therapy. Critical Care Medicine, 1993.

Mercier CE, Soll RF: Clinical Trials of Natural Surfactant Extract in RDS. Clin Perinatol 1993; 20:711-735.

Soll RF, Hallman M, Merritt TA: Surfactant in the prevention and treatment of Respiratory Distress Syndrome. In: New Therapies for Neonatal Respiratory Failure: A Physiologic Approach. Boynton BR, Carlo WA and Jobe AH (Eds). Cambridge University Press, 1994.

Soll RF: Review of Clinical Trials of Surfactant Replacement in the Newborn. In Surfactant Therapy for Lung Disease. Robertson B and Taeusch HW (Eds), Marcel Dekker, New York. 1995.

Silver RA, Soll RF: Physiological Adaptation at Birth. In Scientific Essentials of Reproductive Medicine. Hillier, Kitchener and Neilson. W. B. Saunders, London, 1996.

Horbar JD, Gould JB: Databases for the Evaluation of Neonatal Care. In Neonatal-Perinatal Medicine, 6th Edition, Fanaroff AA, Martin RJ (Eds). Mosby, 1997.

Soll RF (Ed): Color Atlas of Pediatric Diseases with Differential Diagnosis. Fourth English Edition, Chapman and Hall, New York. 1998

Journal Articles

Lucey JF: Parent Dissatisfaction with NICU Care. Pediatrics 1993; 92:724.

Mercier CE, Soll RF. Clinical trials of natural surfactant extract in RDS. Clinics in Perinatology. 1993:20;711-736.

Ryan CA, Finer NN, Perreault T, Johnston-Hodgson A. Extracorporeal membrane oxygenation in infants with congenital diaphragmatic hernia and cardiac malformations. Journal of Pediatric Surgery, 1993.

Horbar JD, Onstad L, and the National Institute of Child Health and Human Development Neonatal Research Network. Prediction of mortality risk for infants weighing 501 to 1500 grams at birth. Crit Care Med 1993; 21:12-18.

Investigators of the Vermont-Oxford Trials Network Database Project: The Vermont-Oxford Trials Network: Very low Birthweight Outcomes for 1990. Pediatrics 1993; 91:540-545 (Principal Investigator: J. Horbar)

Horbar JD, Wright E, Onstad L and the National Institute of Child Health and Human Development Neonatal Research Network. Decreasing Mortality Associated with the Introduction of Surfactant Therapy: an observational study of infants 600 to 100 grams at birth. Pediatrics 1993; 92:191-196.

Horbar JD, Wright L, Soll RF and the National Institute of Child Health Neonatal Research Network: A multicenter randomized trial comparing two surfactants for the treatment of neonatal respiratory distress syndrome. J Pediatr 1993; 123:757-66.

Soll RF, Jacobs J, Pashko S and Thomas R: Cost-effectiveness of Beractant in the Prevention of Respiratory Distress Syndrome. Pharmaco Economics. 1993; 4:278-286.

Merritt TA, Soll RF, Hallman M: Overview of exogenous surfactant replacement therapy. Critical Care Medicine, 1993. (Not in Ovid)

Mercier CE, Soll RF: Clinical Trials of Natural Surfactant Extract in RDS. Clin Perinatol 1993; 20:711-735.

Bovill EG, Soll RF, Bhushan F, et al: Vitamin K Metabolism and the Production of Abnormal des carboxy prothrombin and Protein C in the term and premature neonate. Blood: 1993;81:77-83.

Ryan CA, Finer NN, Perreault T, Johnston-Hodgson A. Extracorporeal membrane oxygenation in infants with congenital diaphragmatic hernia and cardiac malformations. J Pediatr Surg. 1994;29:878-881.

Horbar JD: Antenatal Corticosteroid Administration and Neonatal Outcomes for Infants weighing 501-15090 grams: Vermont-Oxford Trials Network 1991-92. Report of the Consensus Development Conference on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. NIH Publication No. 95-3784. November 1994.

Tarnow-Mordi WO, Soll RF: Artificial versus natural surfactant - Can we base clinical practice on a firm scientific footing? Eur J Pediatr 1994; 153(9 Supp 2):S17-21.

Perreault T, Mullahoo K, Morneault L, Johnston A, Adolph V. Use of a 12 French double-lumen catheter in a newborn supported with extracorporeal membrane oxygenation. ASIAO 1994;40:100.

Fanaroff AA, Korones SB, Wright LL, et al: A Controlled Trial of Intravenous Gamma Globulin Infusions to Reduce Nosocomial Infections in Low Birth Weight Infants. N Engl J Med 330:1107, 1994.

Adolph V, Flageole H, Perreault T, Johnston A, Nguyen L, Youssef S, Guttman F, Laberge J-M: Repair of congenital diaphragmatic hernia after weaning from extracorporeal membrane oxygenation. J Pediatr Surg 1995;30:349.

Horbar JD, Leahy KA for the investigators of the Vermont-Oxford Trials Network: An Assessment of Data Quality in the Vermont-Oxford Trials Network Database. Controlled Clinical Trials 1995; 16:51-61.

Hack M, Wright LL, Shankaran S, Tyson JE, Horbar JD, et al: Very-low-birth-weight outcomes of the National Institute of Child Health and Human Development Neonatal Network, November 1989 to October 1990. Am J Obstet Gynecol 1995; 172:457-64.

Horbar JD, Lucey JF: Evaluation of Neonatal Intensive Care Technologies. The Future of Children 1995;5(1):139-161.

Lucey JF: (Introduction/Forward) In: A. Sabatino Will Appalachia Overcome Poverty? McClanahan Publishers, 1995.

Horbar JD for the Investigators of the Vermont-Oxford Neonatal Network: Antenatal Corticosteroid Treatment and Neonatal Outcomes for Infants 501 to 1500 grams in the Vermont-Oxford Neonatal Network. Am J Obstet Gynecol 1995; 173:275-281.

Wright LL, Horbar JD, et al: Evidence from Multicenter Networks on the Current Use and Effectiveness of Antenatal Corticosteroids in Very Low birthweight Infants Am J Obstet Gynecol 1995; 173:263-269.

Horbar JD: The Vermont-Oxford Neonatal Network: Integrating Research and Clinical Practice to Improve the Quality of Medical Care. Sem Perinatol 1995; 19(2):124-131.

Hagstrom JN, Bovill EG, Soll RF, et al. The pharmacokinetics and lipoprotein fraction distribution of intramuscular vs oral Vitamin K1 supplementation in women of childbearing age: Effects on hemostasis. Thrombosis and Haemostasis. 1995; 74:1486-1490.

Behr C, Schrieffer J, Mercier C. Strategies to gain physician involvement in CQI. Journal for Healthcare Quality, 1996; 18:21-23.

Vermont-Oxford Neonatal Network: A Multicenter Randomized trial Comparing Synthetic Surfactant to Modified Bovine Surfactant extract in the treatment of respiratory distress syndrome. Pediatrics 1996; 97:1-6 (Principal Investigator: R. Soll).

Soll RF: Appropriate surfactant usage in 1996. Eur J Pediatr 1996; 155(Suppl. 2):S8-S13.

Soll RF: Commentary: Neonatal extracorporeal membrane oxygenation - a bridging technique. Lancet 1996;348-75-82.

Horbar JD, Badger GJ, Lewit EM, Rogowski J, Shiono P: Hospital and Patient Characteristics Associated with Variation in 28-Day Mortality Rates for Very Low Birth Weight Infants. Pediatrics 1997; 99:149-156.

Soll RF: Surfactant Therapy in the USA: Trials and Current Routines. Biol Neonate 1997;71(Suppl 1):1-7.

The Neonatal Inhaled Nitric Oxide Study Group. Inhaled Nitric Oxide in Full-Term and Nearly Full-Term Infants with hypoxic Respiratory Failure. N Engl J Med 1997;336:597. (Anne Johnston, co-investigator).

The Neonatal Inhaled Nitric Oxide Study Group. Inhaled nitric oxide and hypoxic respiratory failure in infants with congenital diaphragmatic hernia. Pediatrics 99:838, 1997. (Anne Johnston, co-investigator).

Sinclair JC, Bracken MB, Horbar JD and Soll RF: Introduction to Neonatal Systematic Reviews. Pediatrics 1997; 100(5):892-895.

Suresh G, Lucey JF. Lack of Deafness in Crigler-Najjar Syndrome Type 1: a patient survey. Pediatrics 1997;100(5): E9. Lucey J. Neuroprotection and perinatal brain care: the field of the future currently going nowhere?! Pediatrics 1997;100:1030-1031 (Editorial).

Lucey J. Why All Pediatricians Should Read This Book. Pediatrics 1997:100; A77. (Book Review)

Lucey, JF: New International Airport Medical School. Pediatrics 1997;101:A37.

Halliday HL, Soll RF: Timing of Surfactant Treatment (letter). Arch Dis Child Fetal Neonatal Ed 1998;78(2):F157.

Lucey, JF: Conversion Foundations. Pediatrics 1998;102:136.

Anderson K and Lucey JF: Pediatric electronic pages: looking back and looking ahead. Pediatrics 1998;102:124-128.

Fanaroff AA et al: Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants. The National Institute of Child Health and Human Development Neonatal Research Network. Pediatr Infect Dis J 1998; 17(7): 593-8

Soll RF: Surfactant Treatment of the Very Preterm Infant. Biol Neonate 1998; 74(suppl 1): 35-

Soll RF, Andruscavage L: Evidence-Based Quality Improvement in Neonatal Perinatal Medicine. Pediatrics 1999; 103(1 Suppl E): 215-224.

Horbar JD: The Vermont Oxford Network: evidence-based quality improvement for neonatology. Pediatrics 1999; 103(1 Suppl E): 350-9

Soll, RF. Consensus and controversy over resuscitation of the newborn infant. Lancet 1999 Jul 3; 354(9172): 4-5

Horbar JD, Rogowski J, Plsek P, Bloom BT, Edwards WH, Hocker J, Kantar AD, Lewallen P, Lewis W, Lewit E, McCarrol CJ, Mujsce D, Payne NR, Shiono P, Soll RF, for the Vermont Oxford Network: Collaborative Quality Improvement for Neonatal Intensive Care. In preparation.

Horbar JD: Increasing Use of Antenatal Corticosteroid Therapy Between 1990 and 1993 in the Vermont-Oxford Neonatal Network. J Perinatol 1997; 17(4): 309-13.

Soll RF: Commentary: Antenatal corticosteroid therapy. Evidence Based Medicine. March/April 1998;92.

Lucey JF: Comments on a sudden infant death article in another journal. Pediatrics 1999; 103(4 Pt 1): 812

Yoshioka M, Vacek PM, Poseno T, Silver RA, and Finette BA: Gender-specific frequency of background mutations at the HPRT locus in cord blood T-lymphocytes from preterm infants. Proc Natl Acad Sci 1999; 96: 586-591.

Anderson K, Lucey JF: A new capability: post-publication peer review for Pediatrics. Pediatrics 1999;104:106.

Lucey JF, Suresh G: Crigler-Najjar Syndrome 1952-1999; Learning from parents and patients about a very rare disease. Pediatrics 2000;105: in press.

Mercier CE, Soll RF, Sinclair JC, Bracken MB: Meta-analysis of the effect of erythropoietin in treating the anemia of prematurity. Submitted for publication.

Horbar JD, Badger GJ: Trends in Outcomes for Infants 501 to 1500 grams: 1991-1995. In preparation.

Muskovitz LA, Soll RF, Bovill EG, Church WR, Sandowski JA: Des gamma carboxy Protein C and Vitamin K levels at birth and at 3-5 days of life. In preparation.

Suresh G, Soll RF: Feeding the extremely low birthweight infant: A survey of the Vermont Oxford Network. In preparation.

Horbar JD, Rogowski J, Plsek P, Bloom BT, Edwards WH, Hocker J, Kantar AD, Lewallen P, Lewis W, Lewit E, McCarrol CJ, Mujsce D, Payne NR, Shiono P, Soll RF, for the Vermont Oxford Network: Collaborative Quality Improvement for Neonatal Intensive Care. In preparation.

Presentations

Horbar JD, Wright LL, Soll RF, Wright EC, Fanaroff AA, Korones SB, Shankaran S, Oh W, and the NICHD Neonatal Research Network. A multicenter randomized trial comparing two surfactants. Presented at the Society for Pediatric Research Annual Meeting (Subspecialty Session), Washington, DC, May 6, 1993.

Muskovitz LA, Soll RF, Bhushan FM, Sadowski JA, Bovill EG. Des Gamma Carboxy Protein C and Vitamin K levels at birth and at 3-5 days of life. Presented to the Society for Pediatric Research, Washington, DC, May 1993 (Poster Session).

Soll RF, Sinclair JC, Bracken MB. Meta-analysis of surfactant trials: The effect of prophylactic surfactant vs surfactant treatment of established RDS. Presented to the Society for Pediatric Research, Washington, DC, May 1993 (Poster Session).

The Vermont Oxford Trials Network: A Multicenter Randomized Trial Comparing Natural Surfactant Extract to Synthetic Surfactant in the Treatment of RDS. Society for Pediatric Research, Seattle, Washington, May 1994 (Poster Session) Pediatr Res 1994;35:295A. (Presented by R. Soll)

Horbar JD: Antenatal Corticosteroid Administration and Neonatal Outcomes for Infants 501 to 1500 grams: Vermont-Oxford Trials Network 1991-1992. NIH Consensus Development Conference on Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. Program and Abstracts (presented by L. Wright, MD, February 28, 1994). Horbar JD, Bernstein I and the Vermont Oxford Neonatal Network. Neonatal Outcomes Associated with Intrauterine Growth Restrictions. New England Perinatal Research Society, Chatham, MA, October 1995. (Presented by I. Bernstein).

Vijayakumar E, Soll RF, Bracken MB, Sinclair JC: Early Postnatal Corticosteroids for the Prevention of Chronic Lung Disease (CLD): Meta-analysis of Clinical Trials. Presented at the Society for Pediatric Research, San Diego, California, May 8, 1995.

Soll RF, Sinclair JC and Bracken MB: Natural surfactant extract vs synthetic surfactant: Meta-analysis of randomized controlled trials. Presented at the Society for Pediatric Research, San Diego, California, May 8, 1995.

Horbar JD, Bernstein IM and the Vermont Oxford Neonatal Network. Neonatal Outcomes Associated with Intrauterine Growth Restrictions. J Soc Gynecologic Invest 1996;3:249A (presented by Bernstein IM, Society for Gynecologic Investigation, Philadelphia, PA, 1996).

Mercier CE, Honeyfield PR, Ohlsson A, Horbar JD for the Vermont Oxford Neonatal Network: Survival of infants with birth weight (BW) less than 501 grams. Society for Pediatric Research, Washington, DC May 1996. (Poster Session) Pediatr Res 1996; 39:273A.

Bernstein IM, Horbar JD, Badger GJ, Golan A, Ohlsson A and the Vermont Oxford Neonatal Network. Intrauterine Growth Restrictions in very low birthweight newborns: Neonatal Outcome. Presented by Bernstein IM, Society of Perinatal Obstetricians. Am J Obstet Gynecol 1996;176:S31.

Silver RA, Soll RF, Poseno T, Finette Ba: Determination of somatic mutant frequencies at the HPRT locus in T-lymphocytes from preterm infants. Presented at the Society for Pediatric Research, Washington, DC, May 10, 1996 (Poster Session).

Bernstein IM, Silver R, Nair S, Stirewalt W: Amniotic Fluid Glycine/valine ratio and neonatal morbidity in fetal growth restriction. Presented to the Society of Perinatal Obstetricians, Anaheim, CA, 1997.

Horbar JD, Badger GJ for the Vermont Oxford Network. Decreasing mortality and other trends for infants 501 to 1500 gms (1991-1995). Society for Pediatric Research Washington, DC May 1997 (Poster Session).

Soll RF, Sinclair JC, Bracken MB (spon. JF Lucey, MD). The effect of prophylactic surfactant vs surfactant treatment of established respiratory distress syndrome: Updated overview. Society for Pediatric Research, Washington, DC, May 4, 1997 (Poster Session)

Horbar JD, Rogowski J, Plsek P, Bloom BT, Edwards WH, Hocker J, Kantak AD, Lewallen P, Lewis W, Lewit E, McCarroll CJ, Mujsce D, Payne NR, Shiono P, Soll RF, Vermont Oxford Network. Collaborative Quality Improvement in Intensive Care. Society for Pediatric Research, New Orleans, May 1998. Pediatric Res 1998;43:177A (Poster Session).

Finer Neil N, Horbar JD for the Vermont Oxford Network: Delivery Room CPR in Premature Infants: The Vermont Oxford network Experience. Society for Pediatric Research, New Orleans, May 1998. Pediatric Res 1998;43:173A (Poster Session).

Suresh GK, Horbar JD for the Vermont Oxford Network: Major birth defects in infants with birth weight 501 to 1500 grams. Society for Pediatric Research, New Orleans, May 1998. Pediatric Res 1998;43:65A (Poster Session).

Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A for the Vermont Oxford Network. Morbidity and Mortality are Increased in Growth Restricted Very Low Birth Weight Newborns. Society for Pediatric Research, New Orleans, May 1998. Pediatric Res 1998;43:207A (Poster Session).

Soll RF, Plante DA: Prophylactic indomethacin to prevent intraventricular hemorrhage: A decision analysis. Society for Pediatric Research, New Orleans, May 1998 (Poster Session).

Soll RF for the Vermont Oxford Network: Early Postnatal dexamethasone for the prevention of Chronic Lung Disease. Society for Pediatric Research, San Francisco, CA, May 4, 1999 (Platform Session).

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