Childrens Mercy - Kansas City

For more than a decade, the Preventive Cardiology Clinic at Children’s Mercy has been providing comprehensive evaluation, risk factor counseling and management for children with familial dyslipidemia, lifestyle-induced dyslipidemia and chronic diseases that associated with development of atherosclerosis. Each year, the clinic sees approximately 300 patients. The Preventive Cardiology Clinic began tracking patient outcomes in 2008 and has built a database that includes demographic, anthropometric, blood pressure, clinical and laboratory information on more than 610 children with dyslipidemia and other atherosclerosis-promoting factors. Geetha Raghuveer, MD is here to explain how the database has been used as a resource for patient screening and research studies.

Children’s Mercy is preparing to become one of the few institutions in the country to perform a procedure known as “Double Balloon Enteroscopy” (DBE) for children with small bowel disorders.Listen in as Thomas Attard, MD, FAAP, FACG, Medical Director of Endoscopy Services-Division of Gastroenterology, has shared that DBE provides a more complete evaluation of the small intestine because the instrument used allows access to areas beyond the reach of conventional endoscopes. The DBE scope provides sharp, clear, high-definition images; it can be used to biopsy tumors, remove small lesions and mark an area with dye for future surgical localization, helping a surgeon know exactly where to go. Gastrointestinal bleeding, abdominal pain, chronic diarrhea, polyps and tumors are among the conditions that can be evaluated and treated with DBE technology.

Drug-resistant temporal epilepsy can now be treated with minimally invasive Stereotactic Laser Amygdalohippocampectomy (SLAH). This same technology also is being used to treat certain brain tumors, further expanding treatment options for children. The state-of-the art technology allows patients to remain neurologically intact and be discharged home within one day of the surgery. The technology dramatically can reduce risks, morbidities and length of hospital stay. Learn more from Dr. Christian Kaufman on this edition of Transformational Pediatrics.

While 80 percent of pharyngitis is viral in etiology, Group A streptococcus (GAS) remains an important cause of pharyngotonsillitis in the pediatric population. Inappropriate testing for GAS pharyngitis inevitably leads to overuse of antibiotics, which can result in a pitfall of treatment with an inappropriate antimicrobial agent. Join Dr. Myers, MD, MPH to learn more about an algorithm your office can use to optimize testing and treatment of GAS pharyngitis, avoiding the five most common pitfalls in diagnosis and treatment of GAS Infection.

Typically, less than 10 percent of the patients transported by traditional “adult” transport teams are under the age of 14.Research has shown that outcomes are better when children are transported by dedicated neonatal and pediatric transport teams. Highly specialized neonatal and pediatric programs, such as the Critical Care Transport Program at Children’s Mercy Kansas City, can be the difference between life and death. What do these programs offer that others don’t? Angie Cunningham, RN, CCRN, C-NPT is here to explain how the Transport Program at Children’s Mercy is one of the largest in the nation and was the first neonatal/pediatric specialty program in the nation accredited by the Commission on Accreditation of Medical Transport Services (CAMTS) in all three forms of transport: ground, rotor wing and fixed wing.

Based on guidelines from the American Academy of Pediatrics (AAP), approximately 0.8 percent of adolescents 12 to 17 years old with dyslipidemia may qualify for pharmacological treatment. That translates into approximately 200,000 adolescents who could be eligible for statin therapy.With the increasing prevalence of overweight children, the incidence of clinically diagnosed coronary artery disease in young to middle-aged adults is expected to increase by 5 to 16 percent over the next two decades. Jon Wagner, DO, is here to discuss how he is leading a research study looking at the liver specific protein transporter, OATP1B1, which is the major transporter of statins from the blood to the liver to better understand how children’s bodies distribute statins in the body.

Food allergies have increased dramatically over the past 15 years with more and more children affected. In addition to traditional food allergies such as peanuts, dairy products and shellfish, there has been a increase in children with reactions to foods not previously considered part of the top eight allergens. Specialists are now seeing allergies to sesame, fruits, and other foods as we are importing more foods and consuming more foods from other cultures. The increase has been seen in both percentage of people with reactions and in the severity of reactions, and is particularly a problem in developed countries and among the children of immigrants.How big is the problem?  What is the reason for the increase?  How do you prevent or treat these allergies? Chitra Dinakar, MD is here to discuss the future with food allergy treatment and prevention?

Neurological movement disorders can cause symptoms that negatively impact a child’s quality of life. Dystonia is of special concern in children, because research shows early intervention is imperative. Deep brain stimulation is available as a treatment option for dystonia and other movement disorders to children as young as seven years old. It works by altering abnormal signals in the brain that interfere with meaningful movement. Brian Aalbers, DO talks more about deep brain stimulation as a treatment option and the success that’s been seen in the nine patients who have received treatment at Children’s Mercy Kansas City.

Children’s Mercy Kansas City is one of only 20 children’s hospitals in the nation selected to participate in the early user group for the MAGEC® (MAGnetic Expansion Control) System. In early 2015, a seven-year-old became the first patient in Kansas and Missouri to receive a new, ground-breaking treatment for scoliosis, aptly named MAGEC. To brace the spine and minimize the progression of spinal curvature, the MAGEC system’s magnetic rods are implanted along each side of the spine during a one-time, surgical procedure. Nigel Price, MD shares more about how MAGEC is transforming pediatric medicine during this segment of Transformational Pediatrics.

In the NICU, the decision to initiate inotropic therapy, provide volume support, or initiate antihyperintensive therapy is often guided by blood pressure measurements. However, research led by Doug Blowey at Children’s Mercy and reported in the Journal of the American Society of Hypertension, found that standard oscillometric measurement overestimates the blood pressure in very ill neonates. Dr. Blowey is here to explain elevated blood pressure in children and is now part of an international committee that is writing guidelines to address the measurement, evaluation and treatment of hypertension in hospitalized children.

Children’s Mercy Kansas City’s Infant Tracheostomy and Home Ventilator Program provides infants and children who require long-term ventilation, individualized care in the home setting. Children’s Mercy’s program is one of the largest in the U.S., with more than 25 new patients treated each year.  While at home, patients and their families are given the opportunity to have a sense of normalcy and thrive in an environment outside the hospital critical care units while still receiving complex medical care with access to on-call physician 24/7 and multidisciplinary care team and the support of local private duty nurse in the home. The program has seen excellent results both in survival rate and short-term neurodevelopmental outcome since its creation in 2005. Most infants are successfully weaned off the ventilator by the time they are 2 ½ to 3 years of age and the tracheostomy tube removed after several months.Winston Manimtim, MD is here to discuss Children’s Mercy Kansas City’s Infant Tracheostomy and Home Vent

Home to a Level IV designated Comprehensive Epilepsy Center, Children's Mercy offers one of the largest ketogenic diet programs in the U.S. The diet is an effective non-medication treatment for intractable epilepsy. While it is unclear exactly how the diet works, it has been shown to control seizures and minimize the need for antiepileptic drugs, which can have unpleasant side effects. Children’s Mercy patients have fared better than national averages, with ketogenic diet patients seeing a 72 percent improvement after one year, and 90 % after two years.Dr. Ahmed Abdelmoity, the Chief of the Section of Epilepsy and Neurophysiology at Children’s Mercy Kansas City, is here to discuss ketogenic diet programs.

Children’s Mercy Kansas City understands that children are not simply small adults. From physical to cognitive process, pediatric medicine requires a holistic understanding of the child – including how they react to radiation. With the guidance of staff physicist, Nima Kasraie, PhD, Children’s Mercy Kansas City radiology treatments provide the least amount of radiation possible to its patient – thought to be the least amount of radiation a child would receive from any hospital in the country. Join Dr. Kasraie as we learn more about Image Gently and why it matters for our children.

The Children’s Mercy Beacon Program provides a patient-centered primary care medical home for children with the most complex special needs, as well as for their siblings. The Beacon team communicates with health care providers in clinics, hospitals, schools and at home to coordinate care and assist with transition throughout the health care system. The program streamlines the health care process for families with at least one child with medical complexity, from birth to 21 years, and their siblings. Amber Hoffman,MD is here to discuss how care is coordinated across multiple specialties to simplify appointment scheduling and to reduce patent visits and inpatient admissions.

Bronchiolitis is a common lung infection in children and the leading cause of hospitalization in children under 2. The Children’s Mercy Respiratory Outpatient Clinic provides 24/7 outpatient treatment for young infants who have been referred by their primary care provider following assessment and diagnosis of bronchiolitis.Pediatric registered respiratory therapists provide respiratory assessments and airway clearance as well as educational resources with the goal of reducing hospital admissions and readmissions. Therapists follow the hospital’s Bronchiolitis Care Process Model to assess and provide treatment.Patrice Johnson, MBA, the Director of Respiratory Care at Children’s Mercy Kansas City, is here to explain The Children’s Mercy Respiratory Outpatient Clinic.

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.Amy Lay, MD, the Director of Inpatient Cardiology at Children’s Mercy Kansas City, is here to help you better understand CHAMP.

Clinicians involved in palliative care are inclined to be sensitive to the humanistic aspects clinical practice – foremost among them being good communication. For both children and their families choosing the time, manner, environment and context into which communication about care that is oriented towards optimizing the quality of their days throughout a disease trajectory is extremely important. Dr. Carter is here to discuss the verbal and non-verbal communication that clinicians should be aware, as well as strategies around active listening, reflection and an effort to engage in relational communication with an allowance for timely silence, acknowledgment of suffering and emotional validation. Finally, the importance of key words – those that may be easily taken out of context, or heard differently than intended – will be addressed.

As many as 5 million women in the U.S. may be affected by polycystic ovary syndrome, a hormonal imbalance in which the ovaries make more androgen than normal.  PCOS can occur in girls as young as 11 years old and may lead to acne, excessive hair growth, weight gain, high blood pressure, pelvic pain, and problems with menstrual cycles and fertility. The cause of PCOS is not known, but some have linked the condition to overproduction of insulin. Tania Burgert, MD is here to discuss the Polycystic Ovary Syndrome Clinic at Children’s Mercy and how they're  focused exclusively on identifying and treating PCOS in adolescent girls.

Though survival rates are increasing, critically ill premature and term babies are often at risk for long-term developmental issues due to neurological damage from hypoxia, hemorrhages, brain malformations, genetic disorders, seizures and other injuries and disorders. New treatment approaches, as well as technology, are helping providers prevent, diagnose and treat neurodevelopmental disorders in newborns and improve long term outcomes. Steven Olsen, MD is here to discuss how the Neuro NICU program at Children’s Mercy brings neurology and neonatologists together in the Level IV NICU to offer the highest level of care to these newborns and improve neurological development.

Feeding problems are quite common, affecting approximately 25 % of children. With all these children, the number one treatment goal is to identify the underlying causes of the problem to better enable adequate growth. Children’s Mercy Kansas City utilizes a multidisciplinary feeding clinic to bring all the specialists needed together to address the often complex needs of these patients. Team members include physicians, psychologists, occupational therapists, speech pathologists and nutritionists.  The clinic focuses on assessing the need for tube feedings, weaning children off tube feedings, assessing for underlying causes, and providing education for parents all with an end goal focused on promoting oral intake while maintaining growth.Listen today as Sarah Edwards, DO discusses Children’s Mercy's Multidisciplinary Feeding Clinic.