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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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. -
Adolescent Medicine Specialty Clinic
Michael Smith and Michaela Voss
Special cases require specialty care. The new Children’s Mercy Adolescent Medicine Specialty Clinic is a clinic designed specifically to treat the extensive and complex needs of teenagers. This team of specialists utilizes a whole care approach, evaluating physical, social, environmental and psychological needs of each teen, recognizing the unique difficulties faced during this stage of life development, including mental health, gynecological and reproductive health, POTS, chronic fatigue, medication adherence and transition to adult care.
Michaela Voss, MD is here today to explain how they are working to expand their reach in the community and develop further clinics based on need, with the aim of supporting the primary care provider through collaboration and consulting. -
Pediatric Adverse Drug Reactions – What’s the Risk?
Michael Smith and Jennifer Goldman
Medications are critical to treat diseases. Unfortunately medications do not come without risks and their use can result in adverse drug reactions.
Listen in as Jennifer Goldman MD, MS discusses the importance that providers understand how to classify adverse drug reactions, how these reactions influence future prescribing of medications, and the importance of informing patients about adverse drug reactions. -
What is a Voiding Dysfunction?
Michael Smith and Mary Langston
Voiding dysfunctions comes in all shapes, sizes and symptoms. With so many presentations, sometimes the common feels uncommon, but you are not alone!
Mary Langston, RN, MSN, CPN, PPCNP-BC discusses voiding dysfunctions and what strategies primary care providers and families can use to help a child before referral to a specialist. -
Multidisciplinary Sickle Cell Pulmonology Clinic
Michael Smith and Alvin Singh
In patients with sickle cell concurrent pulmonary issues such as asthma, allergies, sleep apnea and acute chest syndrome are common. Alvin Singh, MD, is helping save these sickle cell patients an extra trip to the hospital through the multidisciplinary sickle cell pulmonary clinic. Dr. Singh ensures that patients are well oxygenated, ventilated and that pulmonary issues don’t affect their sickle cell disease.
Listen in as Alvin Singh, MD explains that although acute chest syndrome is the second most common complication of sickle cell disease, it can be difficult to determine the source of the problem, especially in young patients with a predilection for asthma. -
Optimum Antibiotic Use for Pediatric Urinary Tract Infections
Michael Smith and Mary Anne Jackson
Opportunities to optimize use of antibiotics in pediatric practice have focused on targeted interventions in acute respiratory infections.
Practice based strategies to improve unnecessary or inappropriate antibiotic prescribing in pediatric urinary tract infection (UTI) are also necessary. Practitioners should develop a process in their practice to appropriately identify those with clinical features of UTI, to optimize specimen collection, to appropriately interpret urinalysis results and to target the initial antibiotic therapy.
Listen in as Mary Anne Jackson, MD explains that pitfalls that may result in injudicious testing and antibiotic use in the child with suspected UTI will be discussed and specific practice based interventions to improve outcomes will be reviewed. -
Genomic Sequencing: The Good, The Opportunities For Improvement, And The Future
Michael Smith and Emily G. Farrow
The field of Next Generation Sequencing is rapidly changing, both in instrumentation and applications, making it difficult even for experts to remain current. Recognizing the advantages and limitations of genomic sequencing is important, especially in clinical testing and research applications.
Listen to Emily Farrow, PhD, provide an overview of current sequencing technology including its strengths and weaknesses. Complimentary technologies commonly used in both the research and clinical setting, and strategies for their utilization will also be discussed.
Looking forward, the Center for Pediatric Genomic Medicine is actively developing new technologies and protocols to expand the use of NGS. Hear about ongoing projects under development that are addressing complex regions and structural variations. -
Myths vs Realities of Eating Disorders
Michael Smith and Kathryn Pieper
Eating disorders present differently in every teen. Teens who look and seem healthy may be secretly suffering from this biologically influenced illness. The Eating Disorder Clinic at Children’s Mercy is fighting Anorexia, Bulimia and related disorders in children and teens using a multidisciplinary perspective by pediatric providers with expertise in treating eating disorders.
Listen in as Clinic Director Katheryn Pieper, PhD, expels some common misconceptions about the disease and discuss how to diagnose and treat it early. Learn how the Children’s Mercy Eating Disorder clinic can help your patients with specialized pediatric providers for the medical, psychological, nutritional, psychiatric and family therapy care for this population. -
Rural Disparities in Pediatric Obesity: The iAmHealthy Intervention
Michael Smith and Ann M. Davis
Childhood obesity is a growing problem across the US, particularly in rural areas. Rural children are disproportionately affected by obesity due at least in part to limited resources. Ann Davis, MPH, PhD, ABPP, and her team of co-investigators are trying to change that through a remotely delivered, family-based obesity intervention. iAmHealthy is composed of a 25-hour behavioral intervention focused on nutrition, physical activity and behavioral change. Families receive eight weekly group sessions followed by monthly group sessions, in addition to individual family-based health behavior coaching.
Listen as Ann Davis, MPH, PhD, ABPP discusses the iAmHealthy program at Children's Mercy. -
Helping Heart Patients, Family, And Staff THRIVE
Michael Smith and Jami Gross-Toalson
In addition to the expert clinical care provided by our Heart Center team, Children’s Mercy also works to provide additional support to our patient and families through our THRIVE program. The THRIVE program focuses on the psycho-social needs of patients, their family members and even the staff members that treat these young patients.
The THRIVE team is made up of social workers, psychologists, child life specialists, chaplains, music therapists, financial counselors, and our palliative care team who are committed to helping everyone involved with their emotional health. This can include helping to create a smooth transition back home by easing fears about returning to school after hospitalization, supporting the emotional well-being of siblings, and providing resources both inside and outside the hospital.
Listen in as Jami Gross Toalson, PhD explains how THRIVE also helps patients and families look towards the future, whether that's going off to college, transitioning to adult care or finding independent living. -
Brace Yourself – Minimally Invasive Surgery for Pectus
Michael Smith and George W. Holcomb
Thanks to years of experience, the Children’s Mercy Center for Pectus is getting children feeling better faster. The center is the oldest in the nation and sees more patients yearly than almost every other hospital. The center offers the “Nuss technique” of minimally invasive surgery with a 99 percent success rate for children with pectus excavatum. For pectus carinatum, the center corrects nearly every patient case without surgery through the dynamic compression device (DCD) bracing system.
Listen in as George ‘Whit’ Holcomb III, MD explains the “Nuss technique” and that Children’s Mercy is the region’s only authorized bracing system provider. -
The GERD, The Bad, The Ugly: When Dosing Guidelines Ignore A BIG Problem
Michael Smith and Valentina Shakhnovich
The medications used to treat gastroesophageal reflux (GERD) in children ignore one BIG factor – obesity. Obesity is a known risk factor for GERD in children, but the proton pump inhibitor (PPI) pantoprazole commonly used to treat GERD has no dosing guidelines for overweight and obese children.
Dr. Shakhnovich is here to explain that through her research, she has found that giving overweight children larger doses, a recently suggested practice with adults, could actually cause more harm than good and predispose children to unwanted side-effects from unintentional systemic overexposure to PPIs. -
Maternal Fetal Transport: Ensuring the Best Care for Expecting Mothers
Michael Smith, Sherry McCool, and Melanie Foltz
The award-winning Children’s Mercy Transport team has partnered with the Elizabeth J. Ferrell Fetal Health Center to provide safe and specialized transport for pregnant women needing immediate access to a higher level of care. This new service provides an invaluable resource for our region to ensure immediate transportation is offered, to the best place of care, for both mom and unborn baby.
Hear from Sherry McCool, RRT-NPS, MHA, CMTE and Melanie Foltz, MSN, RN, on the benefits it will offer our region. -
Oncology Biorepository: Banking on Finding Answers for Childhood Cancers
Michael Smith and Erin M. Guest
Why does one child respond well to cancer treatment and another not? The Children’s Mercy Oncology Biorepository hopes to answer that question and more. This research facility includes biobanking technology and the staff to manage patient samples and assist with research. The 200 new pediatric cancer patients at Children’s Mercy each year can contribute to research efforts regardless of diagnosis or age simply by donating their blood, leftover tumor samples, DNA and clinical data.
In this segment, Erin Guest, MD explains that the biorepository is open to research scientists to study cancer and related diseases and hopes to collaborate with other oncology programs on novel research projects. -
Families Did Their Research, Now What? Health Information Seeking in the Digital Age
Michael Smith and Rupal Gupta
New innovations in digital media allow for more access to more health information than ever before. Parents and teens are now taking their health information into their own hands, but what does this mean for providers?
Rupal C. Gupta, MD, explains how this new digital health innovations affect the provider-patient dynamic and what providers can do to make sure their patients are receiving accurate and helpful information. -
BRICK: Unblocking The Facts
Michael Smith and Kacie Kaufman
Whether regular or irregular, the causes of constipation in children can be broad and difficult to diagnose. The BRICK (Bowel Retraining in Constipated Kids) clinic is a special clinic within the Division of Gastroenterology at Children’s Mercy Hospital dedicated to the care of children with constipation and encopresis.
BRICK clinic director Kacie Kaufman will discuss the care children receive at the BRICK clinic and how doctors can implement best practices into their own clinics. -
Crossing Over: How a New Procedure Heals Keratoconus
Michael Smith and Erin Stahl
A newly FDA approved procedure has the power to save children from a painful cornea transplant. Keratoconus presents in about 1:2000, with a high prevalence in the Down Syndrome population. The disease causes the cornea to become thin and bulge. Corneal crosslinking improves the connections among the membranes of the cornea by a factor of four, preventing the need for a cornea transplant.
Erin Stahl, MD is here to explain that Children’s Mercy Kansas City provided one of the first FDA-approved pediatric treatments in February 2017, providing new hope for Keratoconus. -
Jaw Surgery from Infancy to Adolescence
Michael Smith and Michael Lypka
Could jaw surgery help you sleep better?
This interdisciplinary clinic at Children's Mercy brings in orthodontics, sleep medicine and plastic surgery and focuses on a surgical orthodontic treatment of obstructive sleep apnea and other jaw deformities.
Hear Dr. Michael Lypka detail jaw surgeries from airway obstruction in the neonate to definitive jaw surgery in the adolescent. -
Pediatric Cancer Medicines: Reducing Treatment-Related Mortality
Michael Smith and Jaszianne A. Tolbert
For kids with cancer, the treatment that cures them can also kill them.
Through the Genomic and Ontogeny Linked Dose Individualization and Clinical Optimization for Kids (GOLDILOKs) program, doctors can find a treatment not too big, not too small, but just right.
Listen as Dr. Jaz Tolbert explains that by finding the perfect dose, doctors can improve treatment outcomes and decrease treatment-related mortality. -
Improving Outcomes for Ewing Sarcoma Patients
Michael Smith and Glenson Samuel
In Ewing Sarcoma patients, exosomes in the blood may be an early detector of relapse. Partnering with the University of Kansas, Glenson Samuel, MD created a chip that could detect and analyze these exosomes and their proteins with minimum blood. Now, he is using that knowledge to find, and reverse, chemo-therapy-related resistance in tumor cells, making patients more responsive to therapy.
Join Glenson Samuel, MD as he discusses his studies and his work with the genome center.
