Stephen Joseph Balevic | Scholars@Duke

Stephen Joseph Balevic
Assistant Professor of Pediatrics

I am an Adult and Pediatric Rheumatologist and care for patients with a wide variety of autoimmune and rheumatic diseases, including: systemic lupus, rheumatoid arthritis, juvenile arthritis, vasculitis, and sarcoidosis, among others. I have a special interest in using musculoskeletal ultrasound to optimize diagnosis and treatment decisions at the bedside.

I am also a clinical researcher at the Duke Clinical Research Institute (DCRI). My research interests are in clinical trials and precision medicine through population pharmacokinetic/pharmacodynamic modeling. I obtained my PhD in Pharmaceutical Sciences from the UNC Eshelman School of Pharmacy. I serve as the principal investigator on several grants studying hydroxychloroquine and azathioprine pharmacokinetics and exposure-response in lupus, as well as principal investigator or co-investigator for several clinical trials at the DCRI. Additionally, I am an Assistant Scientific Director for the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry- the largest registry of children with rheumatic diseases in North America.

Current Appointments & Affiliations

Assistant Professor of Pediatrics, Pediatrics, Rheumatology, Pediatrics 2021
Assistant Professor of Medicine, Medicine, Rheumatology and Immunology, Medicine 2020
Member of the Duke Clinical Research Institute, Duke Clinical Research Institute, Institutes and Centers 2018

Contact Information

stephen.balevic@duke.edu

Background
Education, Training, & Certifications
- Clinical Research Fellow, Dcri, Duke University School of Medicine 2016 - 2018
- Clinical Pharmacology Fellowship, Duke And Unc School Of Pharmacy, Duke University School of Medicine 2016 - 2018
- Fellowship Adult and Pediatric, Pediatrics, Duke University School of Medicine 2014 - 2018
- Internal Medicine and Pediatric Residency, Medical University of South Carolina, College of Medicine 2010 - 2014
- M.D., Marshall University 2010
Previous Appointments & Affiliations
- Assistant Professor of Pediatrics, Pediatrics, Rheumatology, Pediatrics 2018 - 2020
- Assistant Professor of Medicine, Medicine, Rheumatology and Immunology, Medicine 2018 - 2020
Recognition
In the News
- SEP 22, 2020 DCRI Pulse
  
  DCRI Launches First Direct-to-Family Study
Research
Selected Grants
- Improving Neonatal health Through Rapid malaria testing in Early Pregnancy with high-sensitivity Diagnostics (INTREPiD) awarded by National Institutes of Health 2022 - 2027
- Optimal Dosing for Biologic Agents in Obese Patients with Rheumatoid and Juvenile Arthritis awarded by National Institutes of Health 2020 - 2025
- PTN 2.0 TO #11: CUDDLE 2.0 awarded by National Institutes of Health 2021 - 2024
- PRECISE Study (Precision Biologics in Rheumatology) awarded by Childhood Arthritis & Rheumatology Research Alliance, Inc. 2021 - 2023
- Optimizing Hydroxychloroquine to Reduce Disease Activity in Pediatric Lupus awarded by Thrasher Research Fund 2021 - 2022
- Vamorolone in Juvenile Autoimmune Myositis awarded by Cure JM Foundation 2020 - 2022
- PTN 2.0- TO#4/Option 3 Data Closeout and Dissemination awarded by National Institute for Child Health & Human Develo 2021 - 2022
- PTN2- TO# BPCA Pharmacology Studies awarded by National Institute for Child Health & Human Develo 2018 - 2022
- CARRA Registry Assistant Scientific Director awarded by Childhood Arthritis & Rheumatology Research Alliance, Inc. 2021 - 2022
- Global Pediatric Clinical Trials Network awarded by Food and Drug Administration 2017 - 2022
- OxyContin Pediatric PMR Study awarded by Purdue Pharma 2022
- RTOP 18-0006 Option 1 / Protocol Implementation awarded by National Institute of Allergy and Infectious Diseases 2019 - 2022
- RTOP 18-0006 Option 1 / Protocol Implementation awarded by National Institute of Allergy and Infectious Diseases 2019 - 2021
- HCQ Pharmacokinetics in Pediatric Lupus awarded by Childhood Arthritis & Rheumatology Research Alliance, Inc. 2019 - 2020
- PTN2- TO# Data Closeout and Dissemination awarded by National Institute for Child Health & Human Develo 2018 - 2019
- ACR/Amgen Rheumatology Fellowship Training Award awarded by Rheumatology Research Foundation 2015 - 2016
External Relationships
- NIH
- Patient Centered Outcomes Research Institute
- The Childhood Arthritis and Rheumatology Research Alliance (CARRA)
- UCB Pharma
- US Food and Drug Administration
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Job, Kathleen M., André Dallmann, Samuel Parry, George Saade, David M. Haas, Brenna Hughes, Pamela Berens, et al. “Development of a Generic Physiologically-Based Pharmacokinetic Model for Lactation and Prediction of Maternal and Infant Exposure to Ondansetron via Breast Milk.” Clin Pharmacol Ther 111, no. 5 (May 2022): 1111–20. https://doi.org/10.1002/cpt.2530.
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  - Balevic, Stephen J., Shruti M. Raja, Rachel Randell, Gregory A. Deye, Thomas Conrad, Aya Nakamura, David H. Peyton, et al. “Adverse Reactions in a Phase 1 Trial of the Anti-Malarial DM1157: An Example of Pharmacokinetic Modeling and Simulation Guiding Clinical Trial Decisions.” Infect Dis Ther 11, no. 2 (April 2022): 841–52. https://doi.org/10.1007/s40121-022-00605-z.
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  - Soulsby, William Daniel, Nayimisha Balmuri, Victoria Cooley, Linda M. Gerber, Erica Lawson, Susan Goodman, Karen Onel, Bella Mehta, and Bella CARRA Registry Investigators. “Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis.” Pediatr Rheumatol Online J 20, no. 1 (March 7, 2022): 18. https://doi.org/10.1186/s12969-022-00676-9.
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  - Clowse, Megan E. B., Amanda M. Eudy, Stephen Balevic, Gillian Sanders-Schmidler, Andrzej Kosinski, Rebecca Fischer-Betz, Dafna D. Gladman, et al. “Hydroxychloroquine in the pregnancies of women with lupus: a meta-analysis of individual participant data.” Lupus Sci Med 9, no. 1 (March 2022). https://doi.org/10.1136/lupus-2021-000651.
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  - Balevic, Stephen J., and Anna Carmela P. Sagcal-Gironella. “Precision Medicine: Towards Individualized Dosing in Pediatric Rheumatology.” Rheum Dis Clin North Am 48, no. 1 (February 2022): 305–30. https://doi.org/10.1016/j.rdc.2021.09.010.
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  - Verstegen, Ruud H. J., Peter Shrader, Stephen J. Balevic, Timothy Beukelman, Colleen Correll, Anne Dennos, Thomas Phillips, Brian M. Feldman, and Brian M. CARRA Registry investigators. “Dosing Variation at Initiation of Adalimumab and Etanercept is not Associated with Clinical Outcomes in Juvenile Idiopathic Arthritis: A Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry study.” Arthritis Care Res (Hoboken), January 18, 2022. https://doi.org/10.1002/acr.24859.
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  - Balevic, Stephen J., Daniel Weiner, Megan E. B. Clowse, Amanda M. Eudy, Anil R. Maharaj, Christoph P. Hornik, Michael Cohen-Wolkowiez, and Daniel Gonzalez. “Hydroxychloroquine PK and exposure-response in pregnancies with lupus: the importance of adherence for neonatal outcomes.” Lupus Sci Med 9, no. 1 (January 2022). https://doi.org/10.1136/lupus-2021-000602.
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  - Gerhart, Jacqueline G., Stephen Balevic, Jaydeep Sinha, Eliana M. Perrin, Jian Wang, Andrea N. Edginton, and Daniel Gonzalez. “Characterizing Pharmacokinetics in Children With Obesity-Physiological, Drug, Patient, and Methodological Considerations.” Front Pharmacol 13 (2022): 818726. https://doi.org/10.3389/fphar.2022.818726.
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  - Karatza, Eleni, Samit Ganguly, Chi D. Hornik, William J. Muller, Amira Al-Uzri, Laura James, Stephen J. Balevic, and Daniel Gonzalez. “External Evaluation of Risperidone Population Pharmacokinetic Models Using Opportunistic Pediatric Data.” Front Pharmacol 13 (2022): 817276. https://doi.org/10.3389/fphar.2022.817276.
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  - Dave, Ishaan, Brandon Estroff, Talia Gergely, Christina A. Rostad, Lori A. Ponder, Courtney McCracken, Sampath Prahalad, and Sampath CARRA Registry Investigators. “Impact of the Season of Birth on the Development of Juvenile Idiopathic Arthritis in the United States: A Nationwide Registry-based Study.” J Rheumatol 48, no. 12 (December 2021): 1856–62. https://doi.org/10.3899/jrheum.201238.
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  - Lane, Morgan D., Sujata Kishnani, Obianuju Udemadu, Samuel Eshun Danquah, Robert M. Treadway, Aaliyah Langman, Stephen Balevic, et al. “Comparative efficacy and safety of late surfactant preparations: a retrospective study.” J Perinatol 41, no. 11 (November 2021): 2639–44. https://doi.org/10.1038/s41372-021-01142-2.
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  - Ong, Mei Sing, Sarah Ringold, Yukiko Kimura, Laura E. Schanberg, George A. Tomlinson, Marc D. Natter, and Marc D. CARRA Registry Investigators. “Improved Disease Course Associated With Early Initiation of Biologics in Polyarticular Juvenile Idiopathic Arthritis: Trajectory Analysis of a Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans Study.” Arthritis Rheumatol 73, no. 10 (October 2021): 1910–20. https://doi.org/10.1002/art.41892.
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  - Beukelman, Timothy, Aimee Lougee, Roland A. Matsouaka, David Collier, Dax G. Rumsey, Jennifer Schenfeld, Scott Stryker, Marinka Twilt, Yukiko Kimura, and Yukiko CARRA Registry Investigators. “Patterns of etanercept use in juvenile idiopathic arthritis in the Childhood Arthritis and Rheumatology Research Alliance Registry.” Pediatr Rheumatol Online J 19, no. 1 (August 21, 2021): 131. https://doi.org/10.1186/s12969-021-00625-y.
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  - Balmuri, Nayimisha, William Daniel Soulsby, Victoria Cooley, Linda Gerber, Erica Lawson, Susan Goodman, Karen Onel, Bella Mehta, and Bella CARRA Registry Investigators,. “Community poverty level influences time to first pediatric rheumatology appointment in Polyarticular Juvenile Idiopathic Arthritis.” Pediatr Rheumatol Online J 19, no. 1 (August 14, 2021): 122. https://doi.org/10.1186/s12969-021-00610-5.
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  - Mannion, Melissa L., Fenglong Xie, Daniel B. Horton, Sarah Ringold, Colleen K. Correll, Anne Dennos, Timothy Beukelman, and Timothy CARRA Registry Investigators. “Biologic Switching Among Nonsystemic Juvenile Idiopathic Arthritis Patients: A Cohort Study in the Childhood Arthritis and Rheumatology Research Alliance Registry.” J Rheumatol 48, no. 8 (August 2021): 1322–29. https://doi.org/10.3899/jrheum.200437.
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  - Rumsey, Dax G., Aimee Lougee, Roland Matsouaka, David H. Collier, Laura E. Schanberg, Jennifer Schenfeld, Natalie J. Shiff, et al. “Juvenile Spondyloarthritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: High Biologic Use, Low Prevalence of HLA-B27, and Equal Sex Representation in Sacroiliitis.” Arthritis Care Res (Hoboken) 73, no. 7 (July 2021): 940–46. https://doi.org/10.1002/acr.24537.
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  - Randell, Rachel L., Lindsay Singler, Anthony Cunningham, Laura E. Schanberg, Michael Cohen-Wolkowiez, Christoph P. Hornik, Stephen J. Balevic, and Stephen J. with the CARRA Registry investigators. “Delivering clinical trials at home: protocol, design and implementation of a direct-to-family paediatric lupus trial.” Lupus Sci Med 8, no. 1 (May 2021). https://doi.org/10.1136/lupus-2021-000494.
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  - Rajendran, Aardra, Amanda M. Eudy, Stephen J. Balevic, and Megan E. B. Clowse. “The importance of pregnancy planning in lupus pregnancies.” Lupus 30, no. 5 (April 2021): 741–51. https://doi.org/10.1177/0961203321989803.
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  - Balevic, Stephen J., Lindsay Singler, Rachel Randell, Richard J. Chung, Monica E. Lemmon, and Christoph P. Hornik. “Bringing research directly to families in the era of COVID-19.” Pediatr Res 89, no. 3 (February 2021): 404–6. https://doi.org/10.1038/s41390-020-01260-1.
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  - Udupa, Akrithi, David Leverenz, Stephen J. Balevic, Rebecca E. Sadun, Teresa K. Tarrant, and Jennifer L. Rogers. “Hydroxychloroquine and COVID-19: a Rheumatologist's Take on the Lessons Learned.” Curr Allergy Asthma Rep 21, no. 1 (January 21, 2021): 5. https://doi.org/10.1007/s11882-020-00983-9.
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  - Balevic, S. J., M. L. Becker, D. Gonzalez, and R. S. Funk. “Low etanercept concentrations in children with obesity and juvenile idiopathic arthritis.” Journal of Pediatric Pharmacology and Therapeutics 26, no. 8 (January 1, 2021): 809–14. https://doi.org/10.5863/1551-6776-26.8.809.
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  - Balevic, Stephen J., Christoph P. Hornik, Thomas P. Green, Megan E. B. Clowse, Daniel Gonzalez, Anil R. Maharaj, Laura E. Schanberg, et al. “Dr. Balevic, et al reply.” J Rheumatol 47, no. 10 (October 1, 2020): 1587. https://doi.org/10.3899/jrheum.200681.
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  - Maharaj, Anil R., Huali Wu, Christoph P. Hornik, Stephen J. Balevic, Chi D. Hornik, P Brian Smith, Daniel Gonzalez, et al. “Simulated Assessment of Pharmacokinetically Guided Dosing for Investigational Treatments of Pediatric Patients With Coronavirus Disease 2019.” Jama Pediatr 174, no. 10 (October 1, 2020): e202422. https://doi.org/10.1001/jamapediatrics.2020.2422.
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  - Balevic, Stephen J., Christoph P. Hornik, Thomas P. Green, Megan E. B. Clowse, Daniel Gonzalez, Anil R. Maharaj, Laura E. Schanberg, et al. “Hydroxychloroquine in Patients with Rheumatic Disease Complicated by COVID-19: Clarifying Target Exposures and the Need for Clinical Trials.” J Rheumatol, May 11, 2020. https://doi.org/10.3899/jrheum.200493.
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  - Dallefeld, S. H., P. B. Smith, E. G. Crenshaw, K. R. Daniel, M. L. Gilleskie, D. S. Smith, S. Balevic, et al. “Comparative safety profile of chloral hydrate versus other sedatives for procedural sedation in hospitalized infants.” J Neonatal Perinatal Med 13, no. 2 (2020): 159–65. https://doi.org/10.3233/NPM-190214.
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  - Thompson, Elizabeth J., Huali Wu, Chiara Melloni, Stephen Balevic, Janice E. Sullivan, Matthew Laughon, Kira M. Clark, et al. “Population Pharmacokinetics of Doxycycline in Children.” Antimicrob Agents Chemother, September 23, 2019. https://doi.org/10.1128/AAC.01508-19.
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  - Balevic, Stephen J., P Brian Smith, Daniela Testoni, Huali Wu, Kim L. R. Brouwer, Kanecia O. Zimmerman, Nazario D. Rivera-Chaparro, Daniel K. Benjamin, and Michael Cohen-Wolkowiez. “Cefazolin pharmacokinetics in premature infants.” J Perinatol 39, no. 9 (September 2019): 1213–18. https://doi.org/10.1038/s41372-019-0368-z.
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  - Thompson, Elizabeth J., Huali Wu, Anil Maharaj, Andrea N. Edginton, Stephen J. Balevic, Marjan Cobbaert, Anthony P. Cunningham, Christoph P. Hornik, and Michael Cohen-Wolkowiez. “Physiologically Based Pharmacokinetic Modeling for Trimethoprim and Sulfamethoxazole in Children.” Clin Pharmacokinet 58, no. 7 (July 2019): 887–98. https://doi.org/10.1007/s40262-018-00733-1.
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  - Watt, Kevin M., Christoph P. Hornik, Stephen J. Balevic, Gratias Mundakel, C Michael Cotten, Barrie Harper, Daniel K. Benjamin, et al. “Pharmacokinetics of ticarcillin-clavulanate in premature infants.” Br J Clin Pharmacol 85, no. 5 (May 2019): 1021–27. https://doi.org/10.1111/bcp.13882.
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  - Balevic, Stephen J., Thomas P. Green, Megan E. B. Clowse, Amanda M. Eudy, Laura E. Schanberg, and Michael Cohen-Wolkowiez. “Pharmacokinetics of Hydroxychloroquine in Pregnancies with Rheumatic Diseases.” Clin Pharmacokinet 58, no. 4 (April 2019): 525–33. https://doi.org/10.1007/s40262-018-0712-z.
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  - Balevic, Stephen J., Michael Cohen-Wolkowiez, Amanda M. Eudy, Thomas P. Green, Laura E. Schanberg, and Megan E. B. Clowse. “Hydroxychloroquine Levels throughout Pregnancies Complicated by Rheumatic Disease: Implications for Maternal and Neonatal Outcomes.” J Rheumatol 46, no. 1 (January 2019): 57–63. https://doi.org/10.3899/jrheum.180158.
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  - Balevic, Stephen J., and Michael Cohen-Wolkowiez. “Innovative Study Designs Optimizing Clinical Pharmacology Research in Infants and Children.” J Clin Pharmacol 58 Suppl 10 (October 2018): S58–72. https://doi.org/10.1002/jcph.1053.
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  - Wang, Laura A., P Brian Smith, Matthew Laughon, Ronald N. Goldberg, Lawrence C. Ku, Kanecia O. Zimmerman, Stephen Balevic, et al. “Prolonged furosemide exposure and risk of abnormal newborn hearing screen in premature infants.” Early Hum Dev 125 (October 2018): 26–30. https://doi.org/10.1016/j.earlhumdev.2018.08.009.
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  - Mater, Heather van, Stephen J. Balevic, Gary L. Freed, and Sarah J. Clark. “Prescribing for Children With Rheumatic Disease: Perceived Treatment Approaches Between Pediatric and Adult Rheumatologists.” Arthritis Care Res (Hoboken) 70, no. 2 (February 2018): 268–74. https://doi.org/10.1002/acr.23273.
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  - Sadun, Rebecca E., Melissa A. Wells, Stephen J. Balevic, Victoria Lackey, Erica J. Aldridge, Nicholas Holdgagte, Samya Mohammad, Lisa G. Criscione-Schreiber, Megan E. B. Clowse, and Mamata Yanamadala. “Increasing contraception use among women receiving teratogenic medications in a rheumatology clinic.” Bmj Open Qual 7, no. 3 (2018): e000269. https://doi.org/10.1136/bmjoq-2017-000269.
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  - Balevic, Stephen J., Mara L. Becker, Michael Cohen-Wolkowiez, and Laura E. Schanberg. “Clinical Trial Design in Juvenile Idiopathic Arthritis.” Paediatr Drugs 19, no. 5 (October 2017): 379–89. https://doi.org/10.1007/s40272-017-0244-2.
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  - Balevic, Stephen J., and Ankoor Shah. “Islands of Inflammation: Neurosarcoidosis.” Am J Med 130, no. 2 (February 2017): 157–60. https://doi.org/10.1016/j.amjmed.2016.09.009.
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  - Balevic, Stephen J., and C Egla Rabinovich. “Profile of adalimumab and its potential in the treatment of uveitis.” Drug Des Devel Ther 10 (2016): 2997–3003. https://doi.org/10.2147/DDDT.S94188.
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  - Balevic, Stephen, Michael Taylor, and Michelle Amaya. “Penile and scrotal swelling mimicking child abuse.” Clin Pediatr (Phila) 52, no. 10 (October 2013): 988–90. https://doi.org/10.1177/0009922813497826.
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- Conference Papers
  - Jones, Jordan T., Chelsey Smith, Mara L. Becker, Daniel Lovell, and Daniel CARRA Registry Investigators. “Down Syndrome-Associated Arthritis Cohort in the New Childhood Arthritis and Rheumatology Research Alliance Registry: Clinical Characteristics, Treatment, and Outcomes.” In Arthritis Care Res (Hoboken), 73:1739–45, 2021. https://doi.org/10.1002/acr.24418.
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  - Commander, S. J., D. Gonzalez, K. R. Kumar, T. Spears, M. Cohen-Wolkowiez, K. O. Zimmerman, S. J. Balevic, and C. P. Hornik. “The relationship between simulated milrinone exposure and hypotension in children.” In Cardiology in the Young, 2021. https://doi.org/10.1017/S1047951121003103.
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Education, Training, & Certifications

Previous Appointments & Affiliations

In the News

Selected Grants

External Relationships

Selected Publications

Academic Articles

Conference Papers