Reye's Syndrome: A Real and Present Danger

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Born in Krakow, Poland and a survivor of the Holocaust, Dr. Baral received his medical degree from the University of Sydney, Australia. He then received his New York State license when he immigrated to the United States.

He began his career in the field of Pediatric Medicine, gaining recognition as the co-discoverer of Reye's Syndrome, a potentially fatal disease that affects the liver and brain in children and adults. Dr. Baral was a Resident Pathologist in Sydney Australia, working with Dr. Ralph Douglas Reye on research entitled, "Encephalopathy With Fatty Degeneration of the Viscera," now commonly referred to as Reye's Syndrome.

In 1980, he turned his attention to the study of dermatology, and today his private practice concentrates on cosmetic dermatology and its related treatments and procedures.

Dr. Baral is affiliated with Mount Sinai Medical Center in New York City. He is a diplomat of the American Board of Dermatology and Pediatrics and is a member of several medical societies including the American Society of Laser Medicine and Surgery. In 1997, he was named Mount Sinai School of Medicine's Teacher of the Year.

Dr. Baral's research has been widely published in many well-respected publications including the Journal of American Academy of Dermatology, International Journal of Dermatology, The Journal of Dermatologic Surgery and Oncology, The New York Times and The Mount Sinai Journal of Medicine, among others.

-- Encephalopathy and Fatty Degeneration of the Viscera A Disease Entity in Childhood - RDK Reye, MD, Graeme Morgan, M.RA.C.P, J. Baral, M.B.

-- Aspirin and Reye Syndrome
Jim Baral MD
1 210 Central Park South, New York, NY 10019
Pediatrics Vol. 82 No. 1 July 1988, pp. 135

Dr. James Heubi is Professor / Associate Chair for Clinical Investigation of Pediatrics, Associate Dean for Clinical and Translational Research,
Co-Director Center for Clinical and Translational Science and Training University of Cincinnati College of Medicine Children's Hospital Medical Center.

Dr. Heubi is also the Medical Director for the National Reye's Syndrome Foundation.

He has been a practicing pediatric gastroenterologist since 1979, when he joined the staff at Cincinnati Children's Hospital Medical Center. Dr. Heubi's areas of practice interests include liver disease in the newborn including inborn errors of bile acid metabolism and complications related to end-stage liver disease and liver transplantation. His research includes mechanisms of human cholesterol absorption and synthesis.

Lawrence B. Schonberger, M.D., M.P.H.; Researcher (taped June of 2009)

Dr. Schonberger is currently a Distinguished Consultant and Assistant Director for Public Health, Division of Viral and Rickettsial Diseases, at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

He first joined the CDC in 1971 as an Epidemic Intelligence Service (EIS) Officer in the epidemiology unit responsible for poliomyelitis surveillance and other virus-related neurological illnesses, including Reye syndrome. Since 1976, he has supervised the epidemiology group stationed at CDC that has conducted epidemiological surveillance and investigations of Reye's Syndrome. In this position, he played an important role in markedly reducing the public health impact of Reye's Syndrome through documenting and publicizing its strong association with salicylate exposures.

Dr. Schonberger remains highly interested in Reye's Syndrome and enjoys working closely with the National Reye's Syndrome Foundation.

Education: A.B. in June 1965, Oberlin College, Oberlin, Ohio; M.D. in June 1969, Case Western Reserve University; M.P.H. in May 1974, Johns Hopkins School of Hygiene and Public Health.

Honors: Public Health Service (PHS) Meritorious Service Medal, Outstanding Service Medal, Commendation Medal, five Outstanding Unit Citations, five Unit Commendations, and a Department of Health and Human Services' Secretary's Group Award for Distinguished Service. President of the American Epidemiological Society,

Publications: He has co-authored over 190 papers in scientific journals, including over 20 on Reye's Syndrome . Among the latter are:
1) Hurwitz ES, Barrett MJ, Bregman D, et al. Public Health Service study on Reye's syndrome and medication: report of the pilot phase. N Engl J Med 1985;313:849-857.
2) Hurwitz ES, Barrett MJ, Bregman D, et al. Public Health Service study of Reye's syndrome and medications: report of the main study. JAMA 1987; 257:1905-1911.
3) Pinsky PF, Hurwitz ES, Schonberger LB, Gunn WJ. Reye's syndrome and aspirin: evidence for a dose-response effect. JAMA 1988;260:657-661.
4) Belay ED, Bresee JS, Holman RC, Khan AS, Shahriari A, Schonberger LB. Reye's syndrome in the United States from 1981 through 1997. N Engl J Med 1999;340: 1377-1382.

Karen M. Starko, M.D., is a 1975 graduate of Temple University School of Medicine.

She completed her internship and residency in internal medicine at Boston City Hospital and served as an infectious disease fellow at the Brown University Hospitals and a fellow in Clinical Medicine at Harvard University.

She entered the Epidemic Intelligence Service (EIS) of the Centers for Disease Control in 1978 and was stationed at the Arizona Department of Health Services, Phoenix, Arizona where she conducted the first quantitative study linking salicylate, most commonly aspirin, with Reye's syndrome and a study with Floribel Mullick, M.D. of the Armed Forces Institute of Pathology, showing the similarities between the pathology of Reye's syndrome and salicylate intoxication.

Dr. Starko has written a book about Reye's Syndrome, and was the NRSF's 35th Annual Meeting Keynote Speaker.

BSc, University of King's College, Halifax, Nova Scotia
MD, Dalhousie University School of Medicine, Halifax, Nova Scotia
Fellow, Royal College of Physicians and Surgeons of Canada

APPOINTMENTS
Assistant Professor of Pediatrics, Dalhousie University, Halifax, Nova Scotia
Associate Professor of Pediatrics, Dalhousie University, Halifax, Nova Scotia
Professor of Pediatrics, Dalhousie University, Halifax, Nova Scotia
Adjunct Professor of Pediatrics, Memorial University, Newfoundland

COMMITTEES
National Reye's Syndrome Foundation Scientific Advisory Board
Subcommittee on Nephrology Royal College of Physicians and Surgeons
Chief Examiner, Subcommittee on Nephrology, Royal College of Physicians and Surgeons (1985 1989)
Kidney Foundation of Canada
- Provincial Advisory Board
- National Scientific Council
- Grant Review Committee
Journal of the National Reye's Syndrome Foundation (Editorial Board)
Federal Commission on Cough and Cold Remedies (1987 1990)
President, Canadian Society of Pediatric Nephrology
Children's International Medical Association
Resident Training Committee Dalhousie University
Canadian Medical Society Subcommittee on Pharmacotherapy and Toxicology

Tylenol and Ibuprophen do not contain Salicylates and can be used as a fever reducer. When taking any medication we recommend you check with your doctor first.

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A Morphometric Study Of Reye's Syndrome. Correlation Of Reduced Mitochondrial Numbers And Increased Mitochondrial Size With Clinical Manifestations.
C. C. Daugherty, P. S. Gartside, J. E. Heubi, K. Saalfeld, and J. Snyder
Division of Pathology, Children's Hospital Medical Center, Cincinnati, OH 45229.
Am J Pathol. 1987 November; 129(2): 313-326

Reye Syndrome In Children Receiving Salicylate Therapy For Connective Tissue Disease.
Rennebohm RM, Heubi JE, Daugherty CC, Daniels SR.
J Pediatr. 1985 Dec;107(6):877-80.

Reye's Syndrome Associated With Adenovirus Infections
Cynthia C. Daugherty; James E. Heubi
Am J Dis Child, Nov 1985; 139: 1076.

Grade I Reye's Syndrome--Outcome And Predictors Of Progression To Deeper Coma Grades.
Heubi JE, Daugherty CC, Partin JS, Partin JC, Schubert WK.
N Engl J Med. 1984 Dec 13;311(24):1539-42.

Grade I Reye's Syndrome. A Frequent Cause Of Vomiting And Liver Dysfunction After Varicella And Upper-Respiratory-Tract Infection.
Lichtenstein PK, Heubi JE, Daugherty CC, Farrell MK, Sokol RJ, Rothbaum RJ, Suchy FJ, Balistreri WF.
N Engl J Med. 1983 Jul 21;309(3):133-9.

Reye's syndrome: Current concepts
James E. Heubi, M.D., John C. Partin, Jacqueline S. Partin, William K. Schubert
Hepatology
Volume 7, Issue 1 , Pages 155 - 164

Hepatic And Cerebral Pathology Findings In Children With Fatal Salicylate Intoxication: Further Evidence For A Causal Relation Between Salicylate And Reye's Syndrome.
Starko KM, Mullick FG.
Lancet. 1983 Feb 12;1(8320):326-9.

Aspirin Consumption And Severity Of Reye's Syndrome
Karen M. Starko Md
Maricopa County Department of Health Services, Phoenix, AZ 85008
Pediatrics Vol. 71 No. 2 February 1983, Pp. 294-295

Reye's Syndrome And Salicylate Use
Karen M. Starko MD1, C. George Ray MD1, Lee B. Dominguez BS1, Warren L. Stromberg MA1, and Dora F. Woodall BS1
1 Field Services Division, Bureau of Epidemiology, Center for Disease Control, Atlanta; Departments of Pathology and Pediatrics, University of Arizona, College of Medicine, Tucson; and Bureau of Epidemiology and Laboratory Services, Division of Disease Control Services, Arizona Department of Health Services, Phoenix
K Vol. 66 No. 6 December 1980, pp. 859-864

Effects Of Antipyretics On Mortality Due To Influenza B Virus In A Mouse Model Of Reye's Syndrome.
Crocker JF, Digout SC, Lee SH, Rozee KR, Renton K, Field CA, Acott P, Murphy MG.
Clin Invest Med. 1998 Aug-Oct;21(4-5):192-202.

Abnormalities In Hepatic Fatty-Acid Metabolism In A Surfactant/Influenza B Virus Mouse Model For Acute Encephalopathy.
Murphy MG, Crocker JF, Her H.
Biochim Biophys Acta. 1996 Apr 12;1315(3):208-16.

Beta-Oxidation Of [1-14c]Palmitic Acid By Mouse Astrocytes In Primary Culture: Effects Of Agents Implicated In The Encephalopathy Of Reye's Syndrome.
Murphy MG, Jollimore C, Crocker JF, Her H.
J Neurosci Res. 1992 Nov;33(3):445-54.

Surfactant-Potentiated Increases In Intracranial Pressure In A Mouse Model Of Reye's Syndrome.
Crocker JF, Lee SH, Love JA, Malatjalian DA, Renton KW, Rozee KR, Murphy MG.
Exp Neurol. 1991 Jan;111(1):95-7.

Hepatic Lipid Abnormalities In A Chemical/Viral Mouse Model For Reye's Syndrome.
Murphy MG, Archambault-Schertzer L, VanKessel J, Digout SC, Malatjalian DA, Crocker JF.
Lipids. 1987 Apr;22(4):217-23.

Serum Lipid Abnormalities In A Chemical/Viral Mouse Model For Reye's Syndrome.
Murphy MG, Archambault-Schertzer L, Ackman RG, Crocker JF.
Lipids. 1986 Jun;21(6):378-82.

Biochemical And Morphological Characteristics Of A Mouse Model Of Reye's Syndrome Induced By The Interaction Of Influenza B Virus And A Chemical Emulsifier.
Crocker JF, Renton KW, Lee SH, Rozee KR, Digout SC, Malatjalian DA.
Lab Invest. 1986 Jan;54(1):32-40.

Reye's Syndrome.
Crocker JF.
Semin Liver Dis. 1982 Nov;2(4):340-52.

Is A Compromised Interferon Response An Etiologic Factor In Reye's Syndrome?
Rozee KR, Lee SH, Crocker JF, Digout S, Arcinue E.
Can Med Assoc J. 1982 Apr 1;126(7):798-802.

Commentary: Acetylsalicylic Acid Or Aspirin?
Crocker JF.
Can Med Assoc J. 1982 Mar 15;126(6):611-2.

Reye's Syndrome: A Clinical Review.
Crocker JF, Bagnell PC.
Can Med Assoc J. 1981 Feb 15;124(4):375-82, 425.