Roles
Medical Co Director Pediatric Hemophilia Treatment Center
Associate Director Pediatric Hematology/Oncology Fellowship Program
Associate Professor of Clinical Pediatrics
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Biography
I received my undergraduate degree, summa cum laude, in Biology from Barnard College of Columbia University. I received my MD degree from the Albert Einstein College of Medicine in NYC. My training in Pediatrics occurred at the Montefiore Hospital Medical Center (now the Children’s Hospital at Montefiore) in the Bronx, NY for PL1 and PL2 years, any my PL3 year was completed at the Jackson Memorial Hospital in Miami. My Fellowship in Pediatric Hematology/Oncology was completed at Jackson Memorial Hospital as well.
I am board certified in both Pediatrics and Pediatric Hematology/Oncology.
I am currently an Associate Professor of Clinical Pediatrics, and now devote my clinical and research time through the Hemophilia Treatment Center for the care and advancement of the bleeding disorders community.
I am a member of the American Society of Hematology (ASH), the Hemostasis and Thrombosis Research Society (HTRS), the Thrombosis and Hemostasis Society of North America (THSNA), the International Society of Hemostasis and Thrombosis (ISTH), the National Hemophilia Foundation (NHF), the World Federation of Hemophilia (WFH), the Foundation for Women and Girls’ Bleeding Disorders Group and the American Thrombosis and Hemostasis Network (ATHN).
I am an active member of the Florida State Hemophilia Treatment Center Network.
I have served on several advisory boards reviewing new therapies.
I established the Comprehensive Pediatric Hemophilia Treatment Center at the University of Miami in 1987. Today the Center is the only federally-funded combined Adult and Pediatric Hemophilia Treatment Center in South Florida. With close to 400 active patients, it is one of the largest such programs in the Southeastern United States, achieving regional, national and international recognition for innovative education and outreach , and participation in a robust portfolio of industry-sponsored and investigator- initiated research.
Under my direction, the Hemophilia Program has expanded to include 2 pediatric hematologists, 1 adult hematologist, a pediatric and an adult APRN, a dedicated research management team, a dedicated physical therapist, a dedicated MSW, an outreach specialist, secretary and 340B program manager.
Recognizing the need for coagulation-specific education in the medical community I developed a clinically-focused comprehensive overview of the Hemophilias. Supported by patient advocacy groups, these lectures --- updated annually – have been presented to over 4000 health care providers across the country. The program continues to this day and has served as a prototype for similar projects on related topics.
I created a bilingual, patient/family-oriented booklet series addressing the challenges of living with a bleeding disorder. These have been sent to various Hemophilia programs and distributed at patient meetings serving as a prototype for similar endeavours nationally.
A long-standing interest has been the often-unrecognized impact of undiagnosed bleeding disorders in girls and women. In 2021 a dedicated Girls’ clinic – the Cycle Clinic – has been added under the umbrella of the Hemophilia Treatment Center. Projects evaluating the impact of a bleeding disorder on women’s joint health are unique and ongoing.
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Education & Training
Education
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Honors & Awards
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Teaching Interests
Patient care and trainee education have been the linchpins of my personal approach. Having recognized the need for education in the field of coagulation, as described in my biosketch, I created a basic, clinically-oriented lecture covering the basics of coagulation and the hemophilias. This has been presented over the years to UM trainees in pediatrics, adult medicine, OB-GYN, ENT and Dental, as well as to over 4000 health care providers across the country.
It is a priority that all our trainees --- both at resident and Fellow level --- on the wards and in the clinics, are exposed to a panoply of practical and science-based lectures covering all aspects of hemostasis and thrombosis. It is critical that these young physicians understand how to take and understand a bleeding history, and how or why certain evaluations should be pursued.
I served as the Pediatric Hematology/Oncology Fellowship Program Director, and more recently as the Associate Program Director, since 2015. In that role, I guide our trainees and help them create innovative clinical research projects in Hemostasis which have been recognized as projects which advance knowledge in the field.
Our Pediatric Residency program has long included trainees who are interested in coagulation. I have mentored these residents, helping identify opportunities for professional as well as academic growth. Several of our graduates are now themselves recognized in the field of coagulation at other well-reputed institutions. I personally mentored Dr. Corrales-Medina, who is currently the co-Director of our Hemophilia Program.
My teaching focus , within hemostasis, has increasingly centered on both the impact of the genetics of different bleeding disorders and the need to understand the ramifications of even mild bleeding tendencies in girls and women. I have collaborated to develop algorithms of approach for identifying affected girls and women as they present to our Emergency Rooms/Clinics/Wards and have developed several presentations for local and national use detailing these efforts. I actively participate in the on campus educational symposia for adult and pediatric trainees. -
Research Interests
At the beginning of my academic career, my research interests were focused in pediatric oncology.
I was a member of, sequentially, the Children’s Cancer Study Group (CCSG), the Pediatric Oncology Group (POG) and, most recently the Children’s Oncology Group (COG). Through these organizations I participated in numerous treatment protocols which ultimately advanced the management of pediatric cancer patients, leading to the vastly improved life expectancies and minimized toxicities that this population experiences today.
In the 1990s, with my development of the Pediatric Hemophilia Treatment Center in 1987, I became involved in coagulation research, and it is in this broad space that my current research efforts remain. Federal funding, granted since 1987, created the opportunity to participate in studies developed by the Centers for Disease Control in response to the HIV/Hepatitis C epidemics. Since those early days, I have participated in regional and national protocols advancing the understanding of the natural history and approach to bleeding disorders through the American Thrombosis and Hemostasis Network and the Centers for Disease Control.
I have brought industry-supported protocols to the University, focusing on new treatments, novel therapies, and gene therapy, and have served either as a Principal Investigator, Sub-investigator or investigator.
I have been instrumental in identifying gaps, utilizing the new point-of-care ultrasound technology (MSKUS) to help facilitate local initiatives to understand the impact of hemophilia treatments or hemophilia the disease on cardiovascular risk factors, the impact of hemophilia carriage or other bleeding disorders on the joint health of affected women, the potential identification of early joint disease in toddlers affected by all severities of hemophilia. These projects, managed and developed by our Fellows, Physical Therapist, and/or Junior Faculty , are ongoing and have, in several instances, been expanded to multi-institutional studies as the value of the information accrued is recognized.
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Publications
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