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.
-
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. -
Sickle Cell Disease Treatment Demonstration Program
Michael Smith and Gerald Woods
Gerald Woods, MD, Division Director of Hematology/Oncology/BMT, has more than 30 years experience in sickle cell treatment. Dr. Woods is currently a PI for a study of GBT-440, a new drug to treat sickle cell.
Children’s Mercy is one of only two U.S. hospitals initially invited to participate in this research. Dr. Woods is leading the hospital’s participation in a Health Resources and Services Administration grant for the Sickle Cell Disease Treatment Demonstration Program Regional Collaborative.
Join us as Dr. Woods discusses the latest advancements in sickle cell disease and efforts to increase treatment options. -
The Image of Interventional Radiology
Michael Smith and Brenton Reading
Minimally invasive interventional radiology services, including angiography, vascular malformations, and tumor ablations, boast lower costs, fewer complications and faster recovery times compared to open surgery.
However, 65 percent of patients are entirely familiar with interventional radiology (IR) with 54 percent of medical students “unclear” of IR duties.
Join Brenton D. Reading, MD, with the Division of Radiology at Children’s Mercy Kansas City, as he introduces us to IR, IR services and outcomes from his dedicated interventional radiologist team at one of the largest pediatric radiology divisions in the nation. -
Translating Genome Sequences into Patient Prescriptions
Michael Smith and Neil Miller
Researchers at Children’s Mercy have developed Astrolabe, software for predicting a patient’s response to medications using whole genome sequencing. When used with a newly developed, low cost sequencing method, the software can identify the pharmacogenetics profile of each patient, enabling physicians to tailor medication selection to the patient’s DNA.
Join Neil Miller, Director of Informatics and Software Development in the Children’s Mercy Genome Center, as he introduces us to the Astrolabe software and the benefits it will offer to physicians and our pediatric patients. -
Cardio-Oncology: Addressing Cardiotoxicity in Pediatric Cancer Survivors
Michael Smith, Aliessa P. Barnes, and Joy M. Fulbright
Research shows that the most common cancer treatments can result in damage to the heart or vascular system. Children’s Mercy is now one of only a few pediatric hospitals in the world offering a Cardio-Oncology Program to address cancer treatment-related cardiotoxicity. In one appointment, patients will receive evaluation and expert advice from an oncologist and a cardiologist.
The program provides early detection of patients at risk for cardiotoxicity, early application of cardioprotective agents and ongoing monitoring to minimize damage secondary to cancer treatment.
Aliessa Barnes, MD, Medical Director of Pediatric Cardiac Transplant and Joy Fulbright, Director of Survive and Thrive, discuss how they are helping make sure today’s cancer survivors are not tomorrow’s heart failure patients. -
Rapid Exchange of Continuous Renal Replacement Therapy for Acute Kidney Injury
Michael Smith and Vimal Chadha
Children’s Mercy is one of only a handful of programs across the nation using a unique bridging technique called Rapid Exchange of Continuous Renal Replacement Therapy (RECRRT) for children diagnosed with acute kidney injury. By consistently using RECRRT, Children’s Mercy has become proficient in the bridging technique, resulting in significantly less blood exposure and therapy downtime for these critically ill children.
The technique’s primary goal is to reduce exposure to blood products for these patients.
Vimal Chadha, MD, Pediatric Nephrologist explains how this technique helps lower the risk for iron overload, transfusion reactions, exposure to infectious agents and sensitization to different antigens that could jeopardize a future kidney transplant. -
Treating Newly Diagnosed Diabetes Patients in the Ambulatory Setting
Michael Smith and Ryan McDonough
The Children's Mercy Diabetes Center is making a change to the way it cares for the 250 to 300 type 1 and 2 diabetes patients newly diagnosed each year, transitioning them from inpatient to outpatient treatment.
Patients over 5 years old and their families will receive the education and training needed to maintain healthy blood glucose levels in three outpatient visits over the course of 1 month. Children under 5 or those who present with diabetic ketoacidosis will continue to be admitted to the hospital. This change is being made to enhance the patient experience in receiving and retaining education related to their new diabetes diagnosis.
Hear from Ryan McDonough, DO, as he discuss this new clinic model and the benefits it will offer to patients newly diagnosed with diabetes.
