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Grand Rounds: Medical and Psychological Care for DSD

Dr. Akhila Ramakrishna

On September 19th, Dr. Ramakrishna from our division co-presented Pediatric Grand Rounds along with pediatric psychologist Dr. Laura Fuller. Their talk, entitled “Treating Patients with Differences of Sexual Development: The Intersection of Medicine and Psychology”, explored the complexities of the medical and psychological healthcare of Differences of Sexual Development (DSD).

DSDs encompass a group of conditions in which the typical processes of sexual development—anatomical, hormonal, functional, and reproductive—do not follow the usual male or female patterns. These variations may be apparent at birth or even prenatally, though some forms may not be diagnosed until adolescence or adulthood.

The primary goal of pediatric DSD care is to support the physical and emotional well-being of affected individuals during youth. During their presentation, Drs. Ramakrishna and Fuller provided an overview of the various types of DSDs and illustrated the unique medical and psychosocial needs of patients through case examples. They emphasized the importance of a multidisciplinary approach to care.

Drs. Ramakrishna and Fuller lead a multidisplinary DSD clinic that includes pediatric endocrinologists, pediatric urologists, clinical geneticists, and pediatric radiologists, with support from reproductive endocrinology and clinical pharmacy services.

We extend our sincere thanks to Drs. Ramakrishna and Fuller for their insightful presentation and for their leadership in delivering expert, compassionate DSD care through their multidisciplinary team.

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New Podcast: Endocrine Disorders in Infants and Young Children

Dr. Kanner

We’re pleased to share that Dr. Kanner from our division was recently featured in a YouTube podcast hosted by pediatrician and author Dr. Carole Keim. In their 40-minute conversation, Dr. Kanner provides expert insights into a range of endocrine conditions that can affect infants and young children.

The discussion begins with congenital hypothyroidism, a serious but treatable condition that can be identified through routine newborn screening. Dr. Kanner then explores disorders related to growth abnormalities, including both insufficient and excessive growth patterns.

The conversation also covers the various forms of pediatric diabetes, highlighting key symptoms that caregivers should watch for. The episode concludes with practical advice on promoting healthy nutrition and physical activity habits in children to support long-term endocrine health.

We invite you to watch this informative and accessible interview here: the podcast on YouTube.

Thank you, Dr. Kanner, for sharing your expertise and helping to raise awareness about these important pediatric health issues.

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Supporting Medical Student Education

Dr. Eirene Alexandrou

We are excited to announce that Dr. Alexandrou has been selected to serve as Co-Director of the Flocks Learning Community at the University of Iowa’s Carver College of Medicine. Each medical student at the Carver College of Medicine is matched into one of four Learning Communities. These Learning Communities enhance the activities and learning environment of students, in part by providing a physical study space. In her role as Co-Director, Dr. Alexandrou will provide leadership for the students in the Flocks community. She will support their support educational, philanthropic, and social endeavors in a way that extends beyond the formal medical school curriculum. Furthermore, she will provide guidance to ease transition to the rigors of medical school and give career mentorship. This is a part-time activity and Dr. Alexandrou will continue her important role as a clinical doctor providing care to children and youth with hormonal and endocrine disorders. We envision that she will provide astute and caring guidance to the Flocks Learning Community.

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Dr. Castano Leads Webinar for Medical Students

Dr. Castaño

On June 10th, Dr. Castano from our division lead a live, national, free Webinar for medical students across the country. The title of his webinar was “Growth and Puberty”. His purpose was to elevate the clinical knowledge of medical students on this important topic. The session was sponsored by the Pediatric Endocrine Society. Dr. Castano covered a range of important topics ranging from normal growth patterns in children and adolescent, to various medical disorders that disrupt puberty and growth. Thank you Dr. Castano for lending your expertise to help teach tomorrow’s physicians about these important topics.

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Dr. Pesce Serves as Content Expert for Ongoing Education of Endocrinologists

Dr. Pesce

Self-guided learning is an important method for physicians, including endocrinologists, to continually enhance their knowledge. This is especially vital after formal training ends, as it helps endocrinologists  keep up with their ever-evolving field. With this in mind, we are proud to acknowledge Dr. Pesce’s contributions that have developed self-study materials for pediatric endocrinologists. In collaboration with a handful of pediatric endocrinologists across the country,  she helped create the 2025-2026 Pediatric Endocrine Self-Assessment Program. In particular, she served as a content expert, especially for knowledge related to pediatric thyroid conditions. The specific publication is

  • Miller RS, Pesce LM, Bowden SA, Chan L, Dauber A, Demirci CS, Gourgari EA, Hawkes CP, McCormack S, Pittock S, Raman S, Sarafoglou K, Trapp C, Wasserman H, Wassner A. Pediatric ESAP 2025-2026: Pediatric Endocrine Self-Assessment Program.  Washington, DC: Endocrine Society.

Thank you Dr. Pesce!

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Dr. Pinnaro Recognized for her Outstanding Teaching

Dr. Catherina Pinnaro

On May 31st, Dr. Pinnaro received the Excellence in Clinical Coaching award from the Graduate Medical Education office. This award is given to faculty who are distinguished as outstanding clinical teachers of resident and fellow physicians. Comments written about Dr. Pinnaro’s teaching include a reflection of her approach to hospital rounds where she is renowned for “probing each learner with thought-provoking questions to assess their understanding, empowering the learners to take ownership of the patients, and dropping clinical pearls about even the mundane patient.” Congratulations Dr. Pinnaro, and thank you for your outstanding clinical teaching efforts.

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Dr. Pesce Recognized for her Outstanding Clinical Teaching

Dr. Pesce

Dr. Liuska Pesce is being recognized by the Carver College of Medicine for outstanding teaching. Today she is receiving the Collegiate Teaching Award. This award is given to recognize teaching that demonstrates unusually significant and meritorious achievement. The Award includes a plaque and monetary bonus. Those who have trained under her have many laudatory statements, including the following anonymous comment: “Dr. Pesce is the Mary-Poppins of physicians, ‘practically perfect in every way.’ She is an excellent teacher with clear explanations behind her thought processes which are always guided by best practices. She is very professional and thorough in all of her patient interactions and examinations. She provides excellent and timely feedback on presentations, physical exam findings, and clinical notes. She goes out of her way to ensure learners get the feedback they need.” Dr. Pesce is also involved in educational efforts at the national level, for example having just contributed as an author to this educational material “Pediatric ESAP 2023-2024: Pediatric Endocrine Self-Assessment Program. Washington, DC: Endocrine Society; 2023.”

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Expert Advice on Providing Estrogen Replacement Therapy for those with Turner Syndrome

Dr. Eirene Alexandrou

The majority of women with Turner syndrome experience primary ovarian failure, meaning that their ovaries never produce estrogen in normal quantities. For this reason, normal puberty does not occur. Estrogen production is not only important for a feminizing puberty to occur but also is important for overall health and wellness. Dr. Eirene Alexandrou heads the Turner syndrome clinic (clinic homepage link) at the University of Iowa Stead Family Children’s Hospital. She is a published expert in Turner syndrome care. Recently, on April 4, Dr. Alexandrou gave an invited webinar entitled “Estrogen Replacement Therapy in Turner Syndrome” (announcement link) for the Turner Syndrome Foundation. She reviewed the prevalence of primary ovarian failure in Turner syndrome, the benefits of estrogen replacement therapy, and the timing of such replacement including initiation.

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Diabetes Research Training Program Receives Renewed Grant Support

Fraternal Order of Eagles Diabetes Research Center

There is a drastic need to devise better approaches to prevent, treat, and ultimately reverse diabetes. Essential to any progress is the constant training of skilled cohorts of research investigators. To this end, since 2017, the University of Iowa has nurtured a Diabetes Research Training Program. The Program supports mentored postdoctoral training focused on various diabetes research topics. Six postdoctoral trainees are supported at any given time, typically for two years each. To date, 19 postdoctoral trainees have been support by this Program, including pediatric endocrine faculty Dr. Pinnaro while she was a fellow. The Program was conceived by adult endocrinologist Dr. Dale Abel and pediatric endocrinologist Dr. Norris. Based on a proposal detailing their vision, they received a 5-year “T32” grant from the NIH to fund the program 2017-2022. During this time, the Program has been a resounding success, with most trainees having progressed onward in their research careers in academia or related private industry. Based on the strengths of the initial trainees, their research, and career progress, last year Drs. Norris and Abel wrote a renewed 5-year proposal for ongoing training. Today, we are pleased to announce that the proposal was viewed very favorably and that an additional 5 years of grant support will be provided by the NIH (you can view a summary of the grant at this link). Future or existing pediatric endocrine fellows who are interested a career focused on diabetes research can benefit from this program and are encouraged to contact Dr. Norris to discuss the application process.

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Dr. Kanner talks at the Healthy LifeStars “Preventing Childhood Obesity” Conference

Dr. Kanner

Today the Iowa Institute of Public Health Research and Policy help its 3rd annual Healthy Lifestars Conference. This year’s topic was “Improving Health Outcomes Through Preventing Childhood Obesity”. Our division’s Dr. Kanner spoke at the conference on her area of expertise. Her talk was entitled “The Impact of Adolescent Polycystic Ovary Syndrome on Obesity and the Accompanying Lifestyle and Medicine Management Requirements“. This is one of her areas of clinical expertise. She heads the University of Iowa Stead Family Children’s Hospital pediatric polycystic ovary syndrome clinic.