Research in Pediatric Pulmonology and Sleep Medicine
The Division’s research efforts focus on areas of clinical expertise within the faculty. The division is primarily clinically oriented, but investigator-initiated research from within our division is a long-term goal. However, mentioned are some of the grants and projects in which members of the division are currently participating.
- Dr. Preeti Sharma’s research continues to incorporate clinical drug trials through the Cystic Fibrosis Foundation and the Therapeutics Development Network, studying CFTR modulator therapies in infants and young children, infection control and prevention, as well as the role of highly effective modulator therapy in ongoing CF care. With this, she has continued her work in adherence research, and has been closely working with the Success with Therapies Research Consortium of the CF Foundation. She has been investigating more patient and family-centered care models and how that affects outcomes and adherence, such as adherence coaching in adolescents and young adults with CF, and the role of caregiver stress in childhood outcomes. In addition to her drug trials and qualitative research endeavors, she has continued her work in quality improvement. She has continued to improve access to care by continuing to understand the impact of social determinants of health in chronic illness, and how this contributes to outcomes in chronic illness. Additionally, she has led an effort to improve sweat chloride testing and assure that patients with advanced CF lung disease are carefully monitored within the guidelines of the CF Foundation. She has continued to innovate QI endeavors based on improving clinical care and outcomes. CF research endeavors have continued to increase in number, and Dr. Sharma and team members have received national recognition from the CF Foundation and other research collaborative groups that they have continued to participate in. Not only has the CF center participated in numerous research and QI studies, but they have also been the lead site for multicenter QI endeavors which have influenced care across the CFF Care Network System. In addition to research work in CF, Dr. Sharma has led the pulmonary division in quality improvement projects aimed at improving care for children with other pulmonary illnesses. By designing a parent questionnaire and implementing written influenza vaccine information, she seeks to better understand and overcome vaccine hesitancy in high-risk patients.
- Dr. Devika Rao, spearheaded research in the pulmonary harms of e-cigarettes in 2019. She published her findings on her EVALI cohort in the form of a case-series in 2020 in Pediatrics, as since then continues to study EVALI, or e-cigarette, or vaping-production, associated lung injury. She has submitted a follow-up manuscript to Pediatrics on the clinical manifestations of EVALI before and after the COVID-19 pandemic, and is mentoring a medical student, Harin Lee, on a neighborhood analysis of vape shop density and EVALI cases in the DFW area. Future planned studies include performing an analysis on health disparities with respect to EVALI in the Hispanic versus non-Hispanic population, performing a cross-sectional study on vaping habits in adolescent e-cigarette users during the COVID-19 pandemic (CoVAPE study, IRB approval obtained), and is also working on a cross-sectional cohort study on pulmonary function and vaping habits in three groups of adolescents: former e-cigarette users, current e-cigarette users, and never users (IRB approval pending, funding provided by Children’s Foundation in the amount of $80,000). Dr. Rao is additionally working on submitting a K01 grant for the June 2022 cycle on the basis of a school-based vaping screening study in the Dallas Independent School District. She is mentored by Sarah Messiah, Ph.D., MPH, the Director of the Center for Pediatric Population Health at UT Southwestern.
- Sleep positioning and other aspects of sudden infant death syndrome risk prevention are the focus of Dr. Michelle Caraballo’s research. She continues to work on a project to promote safe sleep in the hospital setting.
- Dr. Kamal Naqvi’s investigative efforts involve pediatric sleep disorders, including narcolepsy. The sleep program, under Dr. Naqvi’s direction, also participates in numerous multicenter research trials. Dr. Naqvi is also participating in a few IRB approved studies. One is involved in improving Adolescent Suicidal ideation through a standardized brief group sleep intervention. In addition to this, he is working on a study for healthy sleep for children with Down Syndrome. He is also participating in a pilot study to evaluate safety and efficacy of the hypoglossal nerve stimulator in adolescents with Down Syndrome and obstructive sleep apnea. Lastly, he is doing an in-depth analysis of sleep studies that have been done Children’s Health.
- Dr. Aarti Shakkottai research interests center around the impact of highly effective modulator therapy on sleep and upper airway pathology among patients with cystic fibrosis. Prior to her move to UT Southwestern, she looked at risk factors for obstructive sleep apnea in patients with cystic fibrosis and found upper airway pathology including tonsillar hypertrophy and chronic sinusitis to be an important risk factor for OSA in children with cystic fibrosis. Her current project builds on this work.
- Dr. Yadira Rivera-Sanchez's research focuses on the demographics of patients with primary ciliary dyskinesia (PCD). She has an IRB to utilize nasal nitric oxide to screen patients for PCD, and her PCD center has recently been selected by the PCD Foundation to participate in the PCD clinical registry multicenter study through Vanderbilt University IRB. Additionally, It is suspected that patients with PCD are underdiagnosed due to a lack of recognition of clinical criteria by primary care providers and specialists caring for these patients. Dr. Rivera-Sanchez looks at the referral rate of patients cared for at Dallas Children's Health who meet PCD evaluation criteria. Her next steps include providing a short education module to residents, hospitalists, cardiologists, and neonatologists in Dallas Children's Heath and determining whether this intervention improves referral rates and identifies patients with PCD.
- Dr. Folashade Afolabi research interests center around Cystic Fibrosis and asthma. She serves as a co-investigator for multiple CF studies and also is involved in one asthma study. Her passion is on asthma equity and coauthored an abstract on the creation of a consortium for unassigned albuterol. Additionally, she is working on projects along with Dr. Andrew Gelfand centered around patient care in the chronic ventilator population.
- Dr. Elisa Basora has research interests in pediatric sleep medicine. She presently is working on 2 projects. She is studying the correlation between age and initial findings of sleep breathing disorders in children with achondroplasia. Additionally, she is investigating the incidence of sleep disordered breathing and patients with Chiari malformation.
- The optimization of care of children with asthma is the focus of the scholarly pursuits of Dr. Yadira Rivera-Sanchez and Dr. Tanya Martinez.
- Drs. Andrew Gelfand and Tanya Martinez are getting involved in asthma pharmaceutical trial to help achieve better outcomes for outpatients.
- Dr. Michelle Caraballo, with the help of Dr. Anna Wani from the Department of Family Medicine, are working on an early termination sleep project. They realize that many children with possible obstructive sleep apnea remain unidentified due to low referral rate. Of the patients who successfully get referred, scheduled, and show up to their polysomnography (PSG), a proportion fail to complete the study, which wastes resources, contributes to long wait times, and may lead to under-diagnosis or treatment of sleep disordered breathing. Our focus is to explore what factors can lead to early PSG termination in hopes of proactively identifying the at-risk groups and implementing strategies in the future to help bridge the gap between scheduled and completed studies.
- Drs. Kubra Melike Bozkanat has partnered with Dr. Sarah Messiah from UT Health Houston School of Public Health. Together, they presented an abstract highlighting the effects of long COVID on physical activity and cardiorespiratory fitness on children and teens as a late breaker at the CHEST Annual Meeting in Nashville. The future planned studies include investigating the clinical course, radiological and pulmonary function abnormalities of children who were admitted to the hospital with COVID-19 pneumonia. Dr. Kubra Bozkanat and Dr. Aarti Shakkottai are co-investigators in this study.