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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Concussion Treatment At Children's Mercy
Michael Smith and Greg Canty
Concussion is a growing and publicized concern in Sports Medicine.
We know that children are much more vulnerable to concussion because their neurological system is still developing and their neck muscles are unable to absorb the blow.
These important and unique services offered at a Children’s hospital used to treat concussions :
• trained to care for adolescents
• ability to identify risks for long-term return to play
• baseline testing, ImPACT Test, VSR Sport test
• vestibular therapy
• physical therapy
Unique approach to concussion treatment: a Comprehensive clinic. Our comprehensive clinic has experts in neurology, rehabilitation and sports med working together to treat concussions.
Greg Canty, MD is here to discuss how Children's Mercy works to treat concussions. -
Predictors of Rapid Progression of Kidney Disease in Children and Adolescents
Michael Smith and Bradley A. Warady
Few studies have prospectively evaluated the progression of chronic kidney disease (CKD) in children and adolescents, as well as factors associated with progression.
A multicenter observational study conducted as part of the NIH-funded Chronic Kidney Disease in Children study found characterization and modeling of risk factors for CKD progression can be used to predict the extent to which factors such as proteinuria, hypoabluminemia, blood pressure, dyslipidemia and anemia -- either alone or in combination -- would shorten the time to renal replacement therapy or 50% decline in GFR in children with chronic kidney disease.
Bradley Warady, MD is here to discuss chronic kidney disease in children and adolescents. -
Survive and Thrive: Addressing the Late Effects of Pediatric Cancer
Michael Smith and Joy M. Fulbright
As pediatric cancer survival rates continue to improve, we are now faced with a new challenge --transitioning care to adult providers and managing the long-term effects of cancer and cancer treatment, which often includes endocrine and cardiac related problems.
There are currently very few adult-based follow-up or survivor clinics.
Children’s Mercy, in partnership with the Midwest Cancer Alliance and the University of Kansas Cancer Center, has developed a Transition Clinic to evaluate the needs of this patient population, track patients and adherence to follow-up guidelines, and improve long-term outcomes.
Joy Fulbright, MD is here to discuss the need for this type of program, and discuss the types of issues pediatric cancer survivors face as they transition to adult care and to talk about the work Children’s Mercy is doing in the areas of cardiotoxicity research; endocrine disorders in cancer survivors, study participation and interventional studies. -
Fetal Health: Advancing Outcomes for High Risk Infants
Michael Smith and Timothy Bennett
With the opening of the Elizabeth J. Ferrell Fetal Health Center, Children’s Mercy Kansas City became one of only a few children’s hospitals in the country to offer comprehensive care, including on-site delivery, for babies with fetal anomalies.
This allows mothers, families and newborns to remain in the same hospital regardless of the complexity of the newborn’s medical condition with access to the region’s only Level IV neonatal intensive care unit.
Tim Bennett, MD, a Professor and Vice Chairman of the Department of Obstetrics and Gynecology of the University of Missouri – Kansas City School of Medicine, is here to discuss comprehensive care, including on-site delivery, for babies with fetal anomalies. -
Turner Syndrome: Taking Care to Great HeighTS
Michael Smith and Joseph Cernich
Designed with the patient in mind, the Great HeighTS Turner Syndrome Clinic at Children’s Mercy Kansas City is a one-day clinic where patients can see multiple specialists in one, convenient location.
Not only does this minimize the number of medical visits for families, but it also gives the girls with this rare disease, and their parents, an opportunity to meet and interact with others who are going through the same situations they are.
Joe Cernich, MD, a Pediatric Endocrinologist at Children’s Mercy Kansas City, is here to discuss Turner Syndrome. -
Neonatal Abstinence Syndrome: Exploring New Treatment Methods for a Growing Problem
Michael Smith and Tamorah R. Lewis
Both in our region and nationally, the occurrence of Neonatal Abstinence Syndrome (NAS) has grown steadily over the past few years.
Combining the expertise of neonatologists, pediatric clinical pharmacologists and a multidisciplinary team of caregivers into a single NAS program has put Children’s Mercy Kansas City in a unique position to explore new methods for treating this growing problem.
Children's Mercy has developed a family-integrated process for infants at risk for Neonatal Abstinence Syndrome.
The goal moving forward is to work with area community hospitals to prenatally identify infants at risk for NAS and provide education to the family before birth.
Dr. Tamorah R. Lewis, a Neonatologist at Children’s Mercy Kansas City, is here to help families better understand NAS. -
Enteral Connectors: Improving Quality and Safety
Michael Smith and Ruba A. Abdelhadi
All syringes and tubings used for enteral feeding and medication admission are changing this year.
This change will impact ALL families and clinicians caring for children with feeding tubes.
This change will prevent accidental connections to IV catheters.
The following changes will occur: the end piece of the feeding tubes where the feeding bag tubing connects, the feeding bag pointed end and the syringes used to put medicines in the tubes.
Ruba Abdelhadi, MD is here to discuss all the changes and what it means to your family. -
Gender Pathway Services: Charting a Course for Transgender Youth
Michael Smith and Jill Jacobson
Gender dysphoria, if left untreated, has a 40 to 50 percent attempted suicide rate.
Medical, social and psychological problems all need to be addressed and often dealt with simultaneously.
Children’s Mercy has developed the new Gender Pathway Services (GPS) Clinic to help manage these issues.
Based in the Division of Endocrinology, the team provides interdisciplinary family-centered services for transgender, gender-variant, and gender-questioning patients. This is the only center of its kind in the Midwest and one of only a handful in the country.
Specialists that are part of the clinic include: endocrinology, psychology, adolescent medicine and social work.
New patients receive a psychological evaluating to help ensure the mental health needs of the family and patient are continuously supported.
Jill Jacobson, MD is here to discuss Gender dysphoria. -
Genomics of Newborns: The Value of Rapid Genetic Testing in the NICU
Michael Smith and Josh E. Petrikin
Children’s Mercy Kansas City is one of four sites participating in Newborn Sequencing In Genomic Medicine and Public HealTh (NSIGHT), which is sponsored by the NIH along with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Human Genome Research Institute (NHGRI).
NSIGHT is designed to explore the implications, challenges and opportunities associated with the possible use of genomic sequence information in the newborn period.
The emphasis of the Children’s Mercy NSIGHT project is gaining rapid access to genetic diagnostic information so that clinical care can be managed effectively for acutely ill neonates.
Early evidence of the feasibility of this approach was recently published by Children’s Mercy investigators in The Lancet Respiratory Medicine.
Conclusions from this study suggest that STAT-Seq, a rapid whole-genome sequencing test developed at Children’s Mercy, has the potential to alter clinical management or genetic counseling and provides a novel framework for implementing precision medicine in a level 4 NICU or PICU.
Josh Petrikin, MD is here to discuss Genomics of Newborns. -
GOLDILOKS: Getting Medication Dosage “Just Right” for Children
Michael Smith and J Steven Leeder
Why does one child respond to a medication, but another doesn’t?
What are the factors that influence how a child responds to a medication and how do those differ from adults?
Despite all the talk about “big pharma” and research, very little has been done about testing the safety and efficacy of medications for children.
Even with new FDA regulations in place, pediatric labeling is decreasing, not increasing.
The Clinical Pharmacology, Toxicology and Personalized Therapeutics program at Children’s Mercy is the largest and most comprehensive pediatric pharmacology program in North America and has been at the forefront of advocating and advancing research.
The GOLDILOKS initiative acknowledges that individual children are not small average adults; dosing of medications must include factors that make each child unique in order to deliver the dose of medication that is “just right” for each individual child.
Children’s Mercy faculty (trained in a pediatric subspecialty and clinical pharmacology) are looking at how this applies in several subspecialty areas including cardiology, infectious disease, asthma/allergy, rheumatology, gastroenterology, neonatology and hematology/oncology.
Steve Leeder, PharmD, PhD is here to discuss the best ways to keep your child and their medications safe. -
Image Gently: Reducing Radiation Exposure in Children
Michael Smith and Douglas C. Rivard
Children’s bodies are more sensitive to radiation so it is imperative that they are exposed to the least amount of radiation as possible to avoid a lifetime of cumulative damage.
Research conducted at Children’s Mercy showed the hospital uses up to 80% less radiation than community imaging centers for some procedures.
The hospital’s protocols are based on the child’s size and weight, and take into consideration the body part to be imaged.
In addition, a PhD medical physicist helps calibrate imaging equipment to provide high quality images using the least amount of radiation.
In addition to following national Image Gently guidelines, Children’s Mercy offers additional services such as Child Life specialists, sedation and anesthesia to help keep children calm so high quality images are achieved without the need to rescan.
Doug Rivard, DO is here to discuss how Children’s Mercy is leading the way toward reducing the radiation your child is exposed to and answer any questions about keeping your child safe.
