Pediatric Pulmonology and Sleep Medicine Research
The Division of Pediatric Pulmonology and Sleep Medicine’s research efforts focus on areas of clinical expertise within the faculty. Varied research interests include how the nervous system influences the structure and function of the airways, acute lung injury, mechanical ventilation, near-fatal asthma, pulmonary outcomes in neuromuscular disease, respiratory consequences of early-onset scoliosis, and molecular mechanisms that regulate lung development.
The Division is primarily clinically oriented, but investigator-initiated research from within our Division is a growing endeavor. Some of the grants and projects in which faculty members are currently participating include:
- Preeti Sharma, M.D.
Dr. Preeti Sharma’s research continues to incorporate clinical drug trials through the Cystic Fibrosis Foundation and the Therapeutics Development Network, studying cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies in infants and young children, infection control and prevention, as well as the role of highly effective modulator therapy in ongoing cystic fibrosis (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 ensure that patients with advanced CF lung disease are carefully monitored within the guidelines of the CF Foundation. She has continued to innovate quality improvement (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 in which they have participated. 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.
- Devika Rao, M.D.
Dr. Devika Rao spearheaded research on the pulmonary harms of e-cigarettes in 2019. She published her findings on her EVALI (e-cigarette or vaping product-associated lung injury) cohort in the form of a case series in 2020 in Pediatrics, and since then, continues to study EVALI. She has submitted a follow-up manuscript to Pediatrics on the clinical manifestations of EVALI before and after the COVID-19 pandemic and has mentored medical students on a neighborhood analysis of vape shop density and EVALI cases in the Dallas-Fort Worth area.
Future planned studies include performing an analysis on health disparities with respect to EVALI in the Hispanic versus non-Hispanic population; a cross-sectional study on vaping habits in adolescent e-cigarette users during the COVID-19 pandemic (CoVAPE study); and 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 on the basis of a school-based vaping screening study in the Dallas Independent School District. She is mentored by Sarah Messiah, Ph.D., M.P.H., the Director of the Center for Pediatric Population Health at UT Southwestern.
- Michelle Caraballo, M.D.
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, and her endeavors have been successful in effecting change across both hospital campuses.
With the help of Anna Wani, M.D., from the Department of Family Medicine, Dr. Caraballo is working on an early termination sleep project. They realize that many children with possible obstructive sleep apnea remain unidentified due to a 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 underdiagnosis or treatment of sleep-disordered breathing.
Their 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.
- Syed Naqvi, M.D.
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. One ongoing study investigates improving adolescent suicidal ideation through a standardized brief group sleep intervention.
In addition to this, he is working on a study of 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 at Children’s Health.
- Aarti Shakkottai, M.D.
Dr. Aarti Shakkottai’s 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 (OSA) 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, and she has expanded her work to include OSA screening using home monitoring as well as targeted screening for OSA in patients with CF.
- Yadira Rivera-Sanchez, M.D.
Dr. Yadira Rivera-Sanchez's research focuses on the demographics of patients with primary ciliary dyskinesia (PCD). She has an IRB-approved study 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.
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 Children’s Medical Center Dallas who meet PCD evaluation criteria with a goal of improving timely referral. Her next steps include providing a short education module to residents, hospitalists, cardiologists, and neonatologists in Children’s Medical Center Dallas and determining whether this intervention improves referral rates and identifies patients with PCD.
- Folashade Afolabi, M.D.
Dr. Folashade Afolabi's research interests center around asthma, access to care, and environmental triggers in asthma severity. She seeks to better understand equity in asthma care and management and coauthored an abstract on the creation of a consortium for unassigned albuterol.
Her advocacy work has pioneered the ability for schools to have stock albuterol to help mitigate asthma symptoms in life-threatening situations. Additionally, she is working on projects along with Andrew Gelfand, M.D., centered around patient care in the chronic ventilator population.
- Andrew Gelfand, M.D., and Tanya Martinez-Fernandez, M.D.
Drs. Andrew Gelfand and Tanya Martinez are involved in asthma pharmaceutical trials to help achieve better outcomes for outpatients and understand more therapeutic options for patients with severe asthma.