PAEDIATRICS AND NEONATOLOGY

Contact
Phone: +61 2 47343363
Email:Karen Burnham

Nepean Hospital
P.O Box 63
Penrith NSW 2751

PAEDIATRIC RESEARCH STAFF

NEONATOLOGY STAFF

Professor Ralph Nanan

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Professor, Dr med. habil (University of Wuerzburg)
CHAIR OF PAEDIATRICS
SUB-DEAN OF RESEARCH
DIRECTOR OF CHARLES PERKINS CENTRE NEPEAN
PROJECT NODE LEADER (DEVELOPMENTAL ORIGINS OF HEALTH & DISEASE)
ACTING CLINICAL DIRECTOR OF CHILDREN’S HEALTH NBMLHD
Academic profile

Professor Nanan is Chair and Professor of Paediatrics at the Sydney Medical School Nepean and Sub-dean of Research. He is also the Director of the Charles Perkins Centre Nepean and leads the Developmental Origins of Health and Disease project node. Professor Nanan’s main areas of interest are the developmental origins of health and disease with a specific focus on paediatric clinical immunology, allergy and perinatology. He is also a Chief Investigator on several clinical cohort studies.
Professor Nanan started his scientific career in Paediatrics at the Children’s University Hospital in Wuerzburg, Germany, where he completed his PhD in 1991 in basic immunology. He then completed the Habilitation, which is the highest German academic degree, in 2002 in clinical immunology, before accepting the position of Director of Paediatrics at Nepean Hospital in 2003 and then his current position in 2005.
Professor Nanan was the first to describe measles virus epitopes recognised by human T-lymphocytes. In addition, his research has contributed to our understanding of which elements of the immune system confer long-term protection after immunisation. His group was the first to provide evidence that preeclampsia, the most common and serious pregnancy related disorder, is likely to be the result of an imbalance between T-regulatory cells, which consequently leads to rejection of the fetus by the maternal immune system.
Professor Nanan and his group are currently investigating key regulatory cells in the immune system, exploring the development of preeclampsia, predicting adverse outcomes in pregnancy by measuring abdominal fat, examining the effects of gestational diabetes on the unborn baby, developing an early childhood allergy questionnaire, and more. In November 2015, the National Health and Medical Research Council awarded a grant of $1.13 million dollars to fund a research study into the treatment of peanut allergy. A large component of the study investigating immunological mechanisms will be conducted at CPC Nepean under the guidance of Professor Nanan.
Since beginning at Nepean, Professor Nanan has also established a paediatric immunology laboratory and developed a comprehensive paediatric allergy service. He has been heavily involved in policy development on a state level. Apart from this, he has multiple teaching and supervisory responsibilities at the University of Sydney and regularly speaks at national and international conferences.
Professor Nanan welcomes all enquiries regarding potential research collaborations and opportunities for student research projects.

Contact:

Phone: +61 2 4737 2612
Fax: +61 2 4734 2561
Email:

Nepean Hospital
P.O Box 63
Penrith NSW 2751

Dr Alison (Sally) Poulton

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Senior Lecturer, MA MBBChir MRCP(UK) FRACP
PAEDIATRICIAN
Academic profile

I am a paediatrician specialising in treating children with attention deficit hyperactivity disorder (ADHD). I studied medicine at Girton College Cambridge and Guy’s Hospital London, qualifying in 1982. I trained in paediatrics in Stoke-on-Trent and Birmingham UK before migrating to Australia. I completed my advanced training in Melbourne and Sydney and gained the FRACP in 1993. I work at Nepean Hospital, at Penrith Child and Youth Mental Health Service and in private practice in Penrith and have raised a family of four children.
I was awarded my MD from the University of Cambridge in 2011. This was based on research into the collateral effects of stimulant medication on children’s height, weight, physical maturity and body composition.

Interview with Dr Poulton

Opportunity for Postgraduate students to be involved in a novel and cost–effective obesity treatment program

Obesity Study

Research Interests

Attention Deficit Hyperactivity Disorder (ADHD)

I have been studying the effects of stimulant medication in children with ADHD since 1996. The initial period of weight loss associated with the appetite suppression that occurs on a stimulant leads to transient slowing of growth and in the longer term, to slower progress through puberty [1] [2]. Stimulant medication improves the symptoms of ADHD, enhancing motivation; it also stabilises the negative mood in oppositional defiant disorder.
Around 40% of children with ADHD also meet diagnostic criteria for oppositional defiant disorder (ODD), which is far higher than would be anticipated by a chance association. I have developed a clinical model, the Mental Effort-Reward Imbalances Model to explain this [3]. The model describes the clinical characteristics of ADHD as the outcome of an interaction between executive functioning deficits and a lack of the subjective experience of reward. In my current research with children with ADHD I am collecting data to test the model and also comparing the clinical effects of dexamphetamine and methylphenidate on the symptoms of ADHD, ODD, mood, appetite and weight.

Obesity

There is substantial overlap between ADHD and obesity; symptoms of ADHD, such as inconsistent motivation and impulsiveness, with lack of meaningful consideration of the consequences of an action, are also common in obesity. The efficacy of the stimulants for treating obesity has long been recognised, but they are not generally considered appropriate due to their abuse potential [4]. However, similar arguments have not prevented their ongoing use in ADHD; moreover opiates are far more addictive but still have an important role in clinical medicine. I am working towards developing an inexpensive intervention that emphasises establishing a healthier lifestyle with the help of a 6 month course of treatment using the stimulant medication dexamphetamine to target the behavioural characteristics that can make weight loss almost unachievable for people with obesity [5].

Population based research and Data linkage

I am interested in the long-term effects of ADHD and stimulant medication at a population level and have been carrying out a data linkage study of the reproductive outcomes of women with previous stimulant treatment for ADHD. I am planning a study of the cardiovascular effects of long-term treatment.

Full text links

[1] ncbi.nlm.nih.gov/pmc/articles

[2] Stimulant medication effects on growth and bone

[3] Therapy for adhd directed towards addressing the dual imbalances in mental effort and reward

[4] journal.frontiersin.org/article

[5] www.ncbi.nlm.nih.gov/pmc/articles

Contact:

Phone: +61 2 4734 3363
Fax: +61 2 4734 2561
Email:

Dr Anthony Liu

tony liu

Senior Lecturer, MBBS (USyd), DCH, FRACP, MPH
PAEDIATRICIAN

Dr Liu was appointed Lecturer in Paediatrics in 2006 having been a Staff Specialist Paediatrician at Nepean Hospital. Dr Liu has a keen interest in teaching and is currently enrolled in the Master of Medical Education at the University of Sydney. His research interest revolves around the effects of illicit drug use in pregnancy on the newborn infant.

Contact:


Phone: +61 2 47343363
Fax: +61 2 4734 2561
Email:

Dr Brigitte Nanan

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Scientific Officer

Dr Brigitte Nanan graduated in Nutritional Sciences at the University of Vienna, Austria. After completing her diploma in Immunology at the Institute of Virology and Immunobiology, University of Wuerzburg, Germany, in 1998, she continued to work in Immunology and completed her PhD in 2002 mainly working on the role of cellular Immunology in models of autoimmunity.
Since 2004 Brigitte has worked at the University of Sydney Medical School Nepean. Her main interest is to study the role of human regulatory T cells in health and disease, as well as the Immunology of pregnancy.

Contact:


Phone: +61 2 47342612
Fax: +61 2 47342561
Email:

Dr Peter Hsu

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Dr Peter Hsu

Contact:


Phone: +61 2 47342121
Email:

PAEDIATRIC RESEARCH PROJECTS

  • Fetal origins of diseases.
  • How maternal factors influence fetal growth patterns.
  • The impact of the internet/Apps on medical care.
  • Infectious diseases, clinical immunology and neonatology.
  • The role of T regulatory cells in newborns as well as in children suffering from atopic eczema.
  • The effects of illicit drug use in pregnancy on the newborn infant.
  • The role of cellular Immunology in models of autoimmunity.
  • The role of human regulatory T cells in health and disease.
  • The Immunology of pregnancy.
  • The use of probiotics in premature babies.
  • Phenotypic and functional analysis of regulatory T cells in adults and newborns.
  • Neonatal Abstinence Syndrome.
  • Investigation of height, weight and pubertal status of adolescents with attention deficit hyperactivity disorder (ADHD)
  • The effect of stimulant medication on appetite and hormone levels and correlation with clinical effect on alertness.
  • The effects of smoking on glucose metabolism of the newborn.
  • The effects of maternal obesity in perinatal medicine.

NEONATOLOGY

Dr Girish Deshpande

girish

Dr Girish Deshpande, FRACP, MSc
Senior Neonatologist, Nepean Hospital Sydney
Senior Lecturer, University of Sydney, Australia

Dr Girish Deshpande is a senior neonatologist at Nepean Hospital in Sydney and senior lecturer at University of Sydney, Australia. Dr Deshpande’s research interest include neonatal nutrition particularly probiotics, parenteral nutrition, intravenous lipids and evidence based medicine, systematic reviews. In recent years his main focus was to convince neonatal community across the globe to introduce routine probiotics in preterm neonates for prevention of Necrotising enterocolitis.
His current research is focused on probiotics and meta-genomics, randomised controlled trials of newer lipids and evaluation of body composition after selective nutritional interventions in preterm neonates.

“Probiotic gives new hope to premature babies” Dr Girish Deshpande from Sydney’s Nepean Hospital and Nepean Clinical School
ABC News Report - 2 case studies

Contact:


Phone: +61 2 47342121
Email:

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the PEAPOD

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The ADIPOS Project

Despite the advances made in neonatal care, neonates born prematurely are at significant risk of postnatal growth restriction and are at increased risk at developing obesity, hypertension, coronary artery disease and stroke. Various maternal conditions such as diabetes and pre-eclampsia are also known to trigger premature birth and alter fetal growth. Prenatal substance exposure has also been associated with greater risk of premature delivery and altered fetal growth.The ‘Developmental Origins of Adult Disease’ hypothesis, often called the 'Barker hypothesis' after one of its leading proponents, states that adverse influences early in development, can result in permanent changes in physiology and metabolism, which result in increased disease risk in adulthood. This hypothesis is evidenced by studies in humans that link decreased birthweight, head circumference to diseases such as coronary heart disease, hypertension, type-2 diabetes mellitus and dyslipidemia as well as in various animal models that link altered fetal nutrition and increased glucocorticoid exposure to reduced birthweight, increased blood pressure and glucose intolerance.

The ADIPOS project aims to study 1800 infants born of varying degrees of prematurity, birth-weight and whether being born to mothers with diabetes, pre-eclampsia or substance exposure during pregnancy has an effect on body fat composition at time of discharge (>36 weeks corrected gestational age). Babies born <28 weeks corrected gestational age and those requiring specialist follow-up will be followed up at 4 and 8 months of age to determine changes in body fat composition. This will be done with the use of an equipment “PEAPOD”, which accurately measures fat and non-fat mass without the use of radiation unlike existing technology like Dual X-Ray Absorptiometry. This is a collaborative project between University of Sydney and Women’s and Children’s health at Nepean Hospital.