Pediatric Endocrinology at Maimonides Infants and Children's Hospital
Svetlana Ten, MD
Director, Pediatric Endocrinology
The Division of Pediatric Endocrinology understands that the whole family is often affected when a child has an endocrine disorder or diabetes. Our dedicated team of highly trained physicians and nurses are here for you. We provide a coordinated approach to diagnosing and treating all forms of endocrine and diabetes problems in children and adolescents, as well as disorders related to growth and puberty. We take the time to explain treatment and plans to both child and parent, and in order to reduce the child’s anxiety, we evaluate and deliver care that is child-friendly, in an environment created just for them.
The division has three full time attendings: Dr. Svetlana Ten, Dr. Irina Kazachkova and Dr. Sonal Bhandari. We see patients at the 48th Street Subspecialty Center and Bay Parkway site. The joint Pediatric Endocrinology Fellowship Program, formerly between Maimonides Medical Center and SUNY Downstate Medical Center, recently became fully independent at Maimonides Medical Center. Our superior program and results has allowed us to do so. We have been given full ACGME accreditation with approval for four fellowship positions.
We treat a variety of conditions including:
- Juvenile Diabetes
- Adrenal disorders
- Thyroid disorders
- Bone and mineral metabolism
- Puberty disorders
We offer a number of services including:
- Thyroid sonogram
- Glucose sensor placement and reading
- Insulin pump education and management
- Endocrine stimulation tests to study in-depth adrenal, growth hormone axis and other endocrine systems
- Nutrition and exercise consultation at the time of visit
We are excited to announce that the Pediatric Endocrinology program is opening an endocrine basic research laboratory at Maimonides. Research conducted in this lab is for the purpose of advancing patient care. As a result of data collection and lab experience, fellows will have the opportunity to learn the process required for IRB proposals and writing grants. This will lead to medical collaborations and publications, and the ability to establish themselves in the academic medical community as ambassadors of Maimonides Medical Center. In addition, there will be an opportunity for residents from the Department of Pediatrics, or departments interested in common areas, to participate in basic science research. This will add to their educational progress and create a platform of collaboration and development of ideas.
Genetic Analysis of Children with Monogenic Diabetes, supported by The Maimonides Research and Development Foundation and Juvenile Diabetes Research Foundation (JDRF).
Our project on monogenic diabetes revealed that genetic diabetes is frequently misdiagnosed and unnecessarily treated with Insulin or other medicines that don’t work, as in the case of genetic diabetes. We found that patients who were erroneously diagnosed as having Type 1 DM can be transitioned from insulin to oral medication, which can change the lives of these patients and their families. Colon cancer frequency in type 2 diabetes also can be explained by the same underlying effect and some liver and kidneys cysts and tumors as well in adults. We are interested in understanding the role of Monogenic Diabetes in cases of gestational diabetes. Collaboration on Monogenic diabetes was established this year with Kazakhstan Medical School.
Polycystic ovarian syndrome and the role of glucocorticoid signaling in health and disease, supported as part of collaboration of two federal grants: GH signaling in short stature, supported by Genentech; Metabolic syndrome in children supported by the Amdec Foundation
Our second project on glucocorticoid resistance can present a new and revolutionary way of approaching disease states, such as metabolic syndrome, PCOS and adrenarche. Understanding etiology of these conditions can give approach to individual approach for treatment of infertility. Understanding of glucocorticoid signaling can also have implications in immune problems and treatment of disease states such as asthma, nephrotic syndrome, inflammatory bowel disease and other states where glucocorticoid are used for treatment.
Dr. Svetlana Ten has been invited for the 5th year in a row to review submitted abstracts for three important Pediatric and Endocrine meetings: PAS, ESPE and Endocrine Society. In 2011, the division published 15 articles in peer-reviewed journals: 7 papers on disorders of sex differentiation, 2 papers on hypogonadism, 1 paper on GH signaling in short stature, 2 papers on endothelial dysfunction and cognition problems in diabetes, 2 papers on complications of metabolic syndrome in childhood and 1 on glucose monitoring in diabetes.
In 2012, the division published 5 papers in peer-reviewed journals: 2 papers on PCOS in adolescents, 1 on hypogonadism, 1 on BP in weight gain and the most important one by fellow, Amrit Bhangoo, on the role of 11βHSD Type 2 Enzyme Activity, revealing novel mechanism of hypertension in Chronic Kidney Disease.
Our work has been and will be presented at several local, national, and international meetings again this year. We will present data on interaction of Growth Hormone receptor signaling with Glucocorticoid receptor signaling in cases of short stature not responsive to GH therapy. Such interaction can give key to new treatment approaches in such cases. We found significantly lower cortisol response in cases of Glucocorticoid resistance PCOS cases compared to Glucocorticoid sensitive PCOS. This can lead to a new approach to treatment. Lastly, the role of glucocorticoid resistance in cases of adrenacrche and PCOS was emphasized in our 2 posters.