Transformational Pediatrics features interviews with physicians and researchers at Children’s Mercy Kansas City who are transforming pediatric care through genomic medicine, personalized therapeutics, health services and outcomes research, and innovations in health care delivery.
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Bariatric Surgery
Michael Smith and Jason D. Fraser
Childhood Obesity continues to be on the rise and causes serious health consequences. In this podcast, Dr. Jason Fraser discusses the Bariatric Surgery program at Children's Mercy. We learn who is a candidate for bariatric surgery, the requirements for surgery, why Children's Mercy decided to offer bariatric surgery, the type of bariatric surgery offered at Children's Mercy and results.
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Polycystic Ovary Syndrome: Current Concepts for A Complex Condition
Michael Smith and Tania S. Burgert
Dr. Tania Burgert discusses Polycystic Ovary Syndrome (PCOS) and the current ideas surrounding a complex condition.
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How the Cardiac High Acuity Monitoring Program (CHAMP) is Helping Change Lives
Michael Smith and Hayley S. Hancock
CHAMP (Cardiac High Acuity Monitoring Program) is a multi-disciplinary based team that has been designed to meet the needs of the most complex cardiac population with single ventricle heart disease. The program closely monitors patients with single ventricle heart disease between the critical first and second stages (before stage II Glenn surgery). The team at the Ward Family Heart Center at Children's Mercy has also developed a tool that makes it easier for families to report their single ventricle child's vital signs from home and provides the hospital team with frequent updates needed to keep these patients well between visits. Dr. Hancock discusses everything you need to know about CHAMP.
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CKiD Expansion
Michael Smith and Bradley A. Warady
The CKiD study was recently approved for an additional five years and $4.7 million of funding, making 20 consecutive years of funding. Historically, when participants developed end-stage disease, they left the study. The next phase of study will focus on the entire spectrum of the disease, starting with early CKiD in infants and following those who progress to kidney failure, requiring dialysis and transplant. Currently, CKiD is enrolling an additional 190 children in the new cohort. The study will attempt to detect abnormalities earlier in the process for more timely interventions.
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Targeted Therapy to Reduce Relapse of Pediatric Leukemia
Michael Smith and John M. Perry
Patients that have residual leukemia stem cells after chemotherapy and other treatments have substantially higher risk for relapse. Survival rates for relapsed leukemia are very poor. Even when patients survive long-term, the very toxic anti-cancer treatments are escalated in treating relapsed leukemia. This particularly risks long-term health and substantially increases the risk of early death due to side-effects of the treatment itself.
John Perry, PhD, faculty member of the Children's Research Institute at Children's Mercy Kansas City is studying how leukemia stem cells resist current anti-cancer treatments.
Join us for this podcast as Dr. Perry discusses the promise of low-dose doxorubicin as a targeted therapy against leukemia stem cells rather than a broadly toxic chemotherapy drug. -
Identifying Novel Drug Treatment Options for Pediatric Osteosarcoma
Michael Smith and Tomoo Iwakuma
Osteosarcoma is highly metastatic and drug-resistant cancer. The survival rate for metastatic osteosarcoma remains less than 20 percent for the last 40 years. Tomoo Iwakuma, MD, PhD, is leading research focused on the elucidation of mechanisms underlying osteosarcoma progression and the discovery of novel drugs against this osteosarcoma. His laboratory has identified a lead compound that specifically killed canine and human osteosarcoma cells lacking the activity of the tumor suppressor p53, with minimal impact on non-tumor cells. Join us as we visit with Dr. Iwakuma about this promising research.
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Management and Treatment for Peutz-Jeghers Syndrome
Michael Smith, Thomas M. Attard, and Caitlin E. Lawson
Peutz-jeghers syndrome (PJS) is an inherited syndrome, characterized by the development of gastrointestinal polyps and characteristic mucocutaneous freckling. Individuals that present with PJS tend to have polyps often in their small intestine as well as their stomach and large intestine. Recently the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) group published the first set of guidelines in treating PJS in pediatric patients.
Hear from Thomas Attard MD, a core contributing author to the ESPGHAN guidelines and Caitlin Lawson, MS, CGC, on how Children’s Mercy manages pediatric patients in view of the new recommendations and how novel techniques available at Children’s Mercy impact patient management and outcomes. -
Getting in Front of Type 2 Diabetes
Michael Smith and Yun Yan
Type 2 diabetes was commonly associated with the adult population. This diagnosis was even referenced as adult-onset diabetes but in recent years type 2 diabetes in children is on the rise.
Although researchers aren’t clear as to why some children develop type 2 diabetes there are some causes that can increase the risk. When children present with these risks the Children Mercy Diabetes Center can evaluate these patients and create a care plan to possibly alter the path to such a diagnosis.
Hear from Dr. Yan as she explains the types of children that can be seen in clinic and how to proactively get in front of a life altering diagnosis of type 2 diabetes. -
Is There a Role for Fecal Transplant in IBD?
Michael Smith and Alka Goyal
Can an effective treatment for medically refractive Crohn’s disease be found in the gastrointestinal tract itself?
Dr. Alka Goyal with Children’s Mercy Kansas City is exploring the role of fecal transplant as a rescue therapy for patients whose inflammatory bowel disease has not responded to traditional treatment. Early research showed that a single transplant is relatively safe and can result in a short-term response in young patients with active IBD but doesn’t provide long-term relief. Now Dr. Goyal is launching a new study to help determine whether there is an advantage to a stronger induction phase for transplant, and any benefit to performing maintenance therapy for patients with Crohn’s.
Dr. Goyal highlights her research findings recently published in the IBD Journal, reviews her next study and the potential it holds for patients whose disease requires longer-term effective therapy. -
Tourette Syndrome: Using an Evidence-based Algorithm to Guide Treatment
Michael Smith, Keith A. Coffman, and Julio Quezada
As an expert in the treatment of Tourette Syndrome (TS), recently, Dr. Coffman was asked to author an article on the pharmacological treatment of Tourette Syndrome.
In collaboration with Dr. Quezada, the paper was published in CNS Drugs Journal, focusing on current approaches and new developments regarding treatment of Tourette Syndrome. The team developed a visual algorithm to help guide the treatment of TS using medication based on the level-of-evidence and side-effects. It has been designed for others to use both inside the U.S. and globally. In this podcast, Drs. Coffman and Quezada will discuss the findings of the review publication. -
Precision Therapeutics in the NICU
Michael Smith and Tamorah R. Lewis
Neonatal pharmacotherapy is a field ripe with opportunity. Efficacy and toxicity is unpredictable and varies greatly for many drug classes commonly used. Weight-based dosing continues to be the standard of care as individualized drug markers are lacking. To better understand variability in drug response, the focus must shift from drug dosing to drug exposure.
Tamorah Lewis, MD, neonatologist and clinical pharmacologist, joins us to discuss how pharmacotherapy and individualized medicine can transform care for critically ill newborns. -
Cancer Genomics: Finding Answers Through Data and DNA
Michael Smith and Erin M. Guest
Approximately 10 to 15 percent of childhood cancer cases are due to a genetic predisposition. Children’s Mercy Kansas City is searching within the genetic code to not only identify genes that may lead to cancer, but to find answers in how to better treat or cure pediatric cancer.
Erin Guest, MD, Director of Cancer Genomics at Children’s Mercy, discusses the growing role of cancer genomics and how big data, new tests, and personalized treatments could change the future of pediatric cancer treatment. -
Mitigating Hyperfiltration-Mediated Kidney Injury
Michael Smith and Tarak Srivastava
Thanks to the research being done in CKid, we know that children diagnosed with chronic kidney disease progress over time to dialysis and transplantation. That makes it very important to address therapies which can mitigate the progression of chronic kidney disease.
Joining the show today is Tarak Srivastava, MD, he has been awarded R01 funding from the National Institutes of Health to work on targeting EP2, one of the four PGE2 receptors to mitigate hyperfiltration–mediated kidney injury as a way to delay the progression of chronic kidney disease in children born with congenital anomalies of kidney and urinary tract (CAKUT). -
The Decision to Withhold Life-Sustaining Medical Treatment for Children
Michael Smith and Brian S. Carter
In pediatrics care most often supports life-sustaining treatment to promote the best interests of the child. But in some circumstances (after weighing the balance of benefits and burdens of a range of treatment choices) continuing life-sustaining treatment is decided to no longer be in the child’s best interests. Collaboration and clear communication are essential in these difficult discussions.
Join Bioethicist and Neonatologist Brian Carter, MD at Children’s Mercy Kansas City, as he provides insights on his recommendations and contributions to the American Academy of Pediatrics’ newly updated policy statement on how to promote the best possible end-of-life care for children. -
Chronic Abdominal Pain Triggers: Is Personalized Assessment Feasible?
Michael Smith and Jennifer Verrill Schurman
It’s well-accepted that there are a variety of complex pathways that contribute to abdominal pain in children; but what are these pathways, and how can they be measured? By combining the data from mobile body sensors and self-reporting from participants, researchers at Children’s Mercy Kansas City were able apply “big data” to identify pain triggers for each individual patient. The results were very encouraging.
Join Dr. Jennifer Schurman with the Division of Gastroenterology at Children’s Mercy Kansas City as she introduces us to the importance of monitoring and collecting data on triggers for abdominal pain and the value that data holds for individualizing pain treatment in the clinic setting, real-time. -
The Importance of Reducing Pediatric Lawnmower-Related Injuries
Michael Smith and Dale E. Jarka
Did you know over 17,000 children are treated for lawnmower injuries each year in the US, resulting in 4,000 trips to the ER. About 75 children die annually from these injuries.
Our Guest Dale Jarka, MD is leading a first of its kind research study at Children’s Mercy to better define the causes, patterns and effects of Lawn Mower injuries, identify predictors of severe injuries in order to elevate public education and prevent injuries. -
Is There a Non-Invasive Way to Detect Colorectal Activity?
Michael Smith and John Rosen
Manometry has long been the standard to measure colorectal activity, but it’s a lengthy and invasive test.
Doctors at Children’s Mercy Kansas City wanted to know if there was a better, non-invasive way to monitor colonic activity. The search for an answer led to a promising innovation. Along with a scientific partner, John Rosen, MD, developed a device that monitors colorectal activity using electrical bio-impedance with electrodes on the skin.
Join Dr. John Rosen with the Division of Gastroenterology at Children’s Mercy Kansas City, as he introduces us to colonic monitoring, his pre-clinical findings presented at a major gastroenterology conference in 2017, and the potential the new device holds to make colorectal activity detection more accessible to patients. -
Lessons Learned from the CKID Study
Michael Smith and Bradley A. Warady
What are the risk factors for CKID progression? Should children with CKID be screened for cardiovascular risks? Can we predict relative time to a composite event?
These are a few of the questions being answered by the CKID study. To date, the translational research study has resulted in more than 90 publications.
Listen as Dr. Warady highlights some of the key findings that are shaping care and providing answers that matter now to pediatric patients with CKID. -
Fetal Surgery Interventions: Hope, Hype and the Future
Michael Smith and Emanuel Vlastos
Since opening as one of the first fetal centers based in a children’s hospital, the Elizabeth J. Ferrell Fetal Health Center at Children’s Mercy has delivered nearly 1,000 high-risk babies, with more than one third having complex heart disease. The addition of Emmanuel “Mike” Vlastos, MD further expands the center’s fetoscopy experience, which includes open myelomeningocele repair and other advanced in-utero procedures. While fetal surgery has been around for decades, the hope has not always lived up the hype.
In this podcast, Dr. Vlastos discusses the current status of open and minimally invasive fetal procedures, where we’ve seen success, and where the field is heading. -
Transparency in Heart Surgery Outcomes
Michael Smith and James O'Brien
Children’s Mercy was one of the first pediatric cardiac surgery programs in the nation to voluntarily share surgical outcomes with the public via the Society of Thoracic Surgeons’ (STS) website.
That level of transparency is critical to quality improvement for patients, families and staff, as well as for pediatric heart surgery programs nationwide.
Today of the approximately 120 pediatric heart surgery programs belonging to the database, about half voluntarily share data publicly.
Children’s Mercy has been an early adopter of transparency.
In this podcast James E. O'Brien Jr, MD, explains that evaluating this objective information, Children’s Mercy has improved the care we provide patients and their families, helping us rank among the top programs in the country. -
Innovative Interventions for Children with Type 1 Diabetes
Michael Smith, Mark A. Clements, and Susan Patton
How can technology improve adherence and control for children and their families dealing with type 1 diabetes?
Mark Clements, MD, PhD, Endocrinologist and Associate Professor of Pediatrics, University of Missouri-Kansas City School of Medicine, and Susana Patton, PhD, Psychologist and Professor of Pediatrics, University of Kansas Medical School, are working in partnership on three unique collaborative projects funded by the National Institutes of Health which are utilizing technology to investigate innovative approaches to adherence and control of type 1 diabetes in young children.
Join us to learn more about this collaborative research and preliminary results. -
Help for Opiate Exposed Babies: Family-Centered NAS Care Initiative
Michael Smith and Jodi K. Jackson
The recent trend in infants born exposed to neurotropic substances during pregnancy is increasing at an alarming rate across the United States, posing a public health threat in the form of neonatal abstinence syndrome (NAS). Jodi Jackson, MD, Children’s Mercy Neonatologist and Medical Director of the Shawnee Mission Medical Center (SMMC) level III NICU, has implemented family-centered care initiatives that have improved outcomes for these infants.
This family-centered protocol for NAS has been implemented at the other community hospitals where Children’s Mercy neonatologists serve as medical directors, and now Dr. Jackson is chair of the Kansas perinatal quality collaborative (KPQC) and working on a state wide initiative for NAS.
Hear from Dr. Jackson as she discusses the program and impact it is having on the neonatal population. -
Collaborating to Cure Pediatric Cancer
Michael Smith and Alan S. Gamis
As a consortium partner of the NCI-designated University of Kansas Cancer Center and Stowers Institute for Medical Research, Children’s Mercy Kansas City is part of an elite group of pediatric cancer research centers. The strength in pharmacogenomics and genomics at Children’s Mercy, opens up new avenues for diagnosis and treatment of various forms of childhood cancer. Combining these strengths with the full range of expertise at The University of Kansas Cancer Center offers hope for current and future patients fighting cancer.
Join us as Alan Gamis, MD, discusses the importance of NCI designation and what it means to pediatric research and patient care. -
Pediatric Dialysis: What’s Next?
Michael Smith and Bradley A. Warady
Bradley Warady, MD, Division Chief of Pediatric Nephrology at Children’s Mercy Kansas City is an international leader in pediatric dialysis. In addition to being one of the principal investigators for CKiD, the largest study of pediatric chronic kidney disease ever conducted in North America, Dr. Warady is the lead editor of two authoritative textbooks: Pediatric Dialysis Case Studies and Pediatric Dialysis. He is also on the international committee developing new pediatric dialysis guidelines.
In this podcast, Dr. Warady discusses the state of pediatric dialysis today, where improvements can and are being made, and next steps for improving care.Click here to stream the podcast episode.
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Cancer Immunotherapy and the Promise of CART19
Michael Smith and Douglas Myers
Acute lymphoblastic lymphoma is the most common childhood cancer, with about 3,100 patients younger than 20 diagnosed every year, according to the National Cancer Institute. Children’s Mercy contributed to the trial of the first U.S. approved cancer gene therapy, Kymriah, for children and young adults with acute lymphoblastic leukemia that is resistant to treatment or has relapsed.
Doug Myers, MD, Children’s Mercy oncologist, was an early investigator of immunotherapy using chimeric antigen receptor t-cells to treat pediatric cancer and led the hospital’s participation in the Kymriah trials.
Join us as Dr. Myers discusses immunotherapy, the science behind chimeric antigen receptor technology, and it significance for patients now and in the future.
