Childrens Mercy - Kansas City

Data science -- often discussed with terms like artificial intelligence, machine learning, big data, data goverernance -- has the potential to transform every aspect of health care, from the patient experience to how, when and where care is provided, and improving outcomes. In this Transformational Pediatrics episode, Mark Hoffman, PhD, Chief Research Information Officer at Children's Mercy Kansas City, discusses the challenges and opportunities for data science within pediatric health care and gives examples where it is already making a difference for children today.

The health care sector has begun to embrace coaching to promote resilience and innovation during a time of massive disruption while also cultivating healthier workplace cultures. In this podcast, Alyssa Stephany, MD, Director of the Physician Leadership Center at Children's Mercy Kansas City shares how professional and peer coaching can help reduce burnout, increase job satisfaction, and improve the overall provider experience of health care, while also having a positive effect on patient care.

Nearly 1 in 5 children in the United States live in rural areas. Rural children experience health and health care disparities compared to their urban peers and represent a unique and vulnerable pediatric patient population. Important disparities exist in all-cause mortality, suicide, firearm-related unintentional injury, and obesity. In this episode, Dr. Jessica Bettenhausen discusses research into these disparities, their causes and potential actions to address them.

Nearly 1 in 5 children in the United States live in rural areas. Rural children experience health and health care disparities compared to their urban peers and represent a unique and vulnerable pediatric patient population. Important disparities exist in all-cause mortality, suicide, firearm-related unintentional injury, and obesity. In this episode, Dr. Jessica Bettenhausen discusses research into these disparities, their causes and potential actions to address them.

Children's Mercy Kansas City has been at the forefront of implementing genomic sequencing in clinical pediatrics and neonatology. In this podcast, John Lantos, MD, Director of Pediatric Bioethics at Children's Mercy Kansas City, discusses the promise of genomic medicine and three suppressing lessons we have learned about the role of genomic medicine for diagnosing, the response of parents, and how testing is impacting care.

What is informatics and why is it important in health care? Listen as Jill Westcott, MD, MS, FACOG, Physician Informaticist for the Fetal Health Center at Children's Mercy, shares her expertise on the topic and how informatics is improving patient outcomes in fetal health.

The Children’s Mercy Research Institute® is undertaking a research initiative to build a first-of-its-kind pediatric data repository to facilitate the search for answers and novel treatments for pediatric genetic conditions. Our goal is to collect genomic data and health information for 30,000 children and their families over the next seven years, creating a database of nearly 100,000 genomes.

How do we create a healthier future for children?  The Children's Mercy Research Institute with a core focus on genomics, personalized therapeutics, population health, health care innovation and bioethics is positioned to fundamentally transform pediatric research and create a world of well-being for all children. Listen as Thomas Curran, PhD, FRS, Chief Scientific Officer, discusses the institute and the future of pediatric research.

To reduce the risk of complications related to hemodialysis, the Children’s Mercy Kansas City Division of Nephrology has implemented several strategies. Listen as Dr. Bradley Warady shares how the institution of standardized infection prevention practices has resulted in more than 1,200 consecutive days without an outpatient central line-associated blood stream infection (CLABSI) in a hemodialysis (HD) patient. In addition, Dr. Warady discusses how vascular preservation protocols also are improving the long-term venous access options for these and future patients.

Children’s Mercy Kansas City is recognized as one of the top 10 nephrology programs in the nation by U.S. News & World Report, and the kidney transplant program has incorporated a number of innovative practices into their management plan that are designed to enhance patient outcomes. Join us as Dr. Bradley Warady discusses how the program’s personalized approach to meeting each patient’s unique needs — including repeated surveillance biopsies, epitope matching and pharmacokinetic assessment of immunosuppressive medication — has contributed to a 100% three-year patient and graft survival rate for the past six years.

Devika Maulik MD shares her translational research as it relates to folic acid and different responses to dosing among women of various races and ethnicities. She is using the information gathered to create recommended guidelines for folic acid dosing. She discusses current literature on this topic, as well as her studies in this area.

Dr. Christina Low Kapalu discusses cases and literature surrounding pediatric recurrent intentional foreign body ingestion.

Dr. Sarah Tsai discusses his recent findings from his study surround serum morning cortisol levels.

Dr. Emanuel "Mike" Vlastos discusses the algorithm for diagnosing and trading twin to twin transfusion syndrome.

Dr. James Daniel discusses improved outcomes for liver transplantation with Biliary Atresia.

Dr. Nathan Fleishman discusses the clinical characteristics of fractures in pediatric patients exposed to PPIs.

ADHD is among the most common neurodevelopmental disorders of childhood; with treatments including behavior therapy and medication. In this podcast, Carla Allan, PhD will help you learn more about the Attention Deficit-Hyperactivity Disorder Specialty Clinic at Children’s Mercy, which provides expert care for children ages 6-12 who have problems with attention and impulse control issues, and find out how to refer your patients.

The COVID-19 pandemic has created an unprecedented work environment for pediatricians and pediatric subspecialists. How we practice medicine has been dramatically changed. When discussing physical precautions such as PPE and social distancing, provider mental well-being also should be a part of the conversation. In this podcast, Jennifer Bickel, MD, pediatric neurologist and Medical Director of the Children’s Mercy Center for Professional Well-Being, discusses how pediatricians have responded to the pandemic on a personal and professional level, the impact on physical and mental health, adjusting to the decrease in patient and peer contact, warning signs of burnout and mental health issues, steps Children’s Mercy is taking to address physician well-being, and more.

Dr. Kelsee Halpin discusses Endocrinology and Diabetes.

While approximately 10% of US adults and children claim a penicillin allergy, only 1/20 with a reported allergy are truly allergic. Additionally, 80% of patients with IgE mediated penicillin allergy lose sensitivity after 10 years.It is important to clarify and de-label patients to ensure they receive standard of care, avoid other adverse drug reactions and have a lowered risk of clinical failure. This practice also results in cost savings.Amol Purandare, MD explains the de-labeling process in place at Children's Mercy and how to gain insight into what to prescribe to a patient with a penicillin allergy.

Dr. Shayla Sullivant shares warning signs of anxiety and depression in teens, how to talk to your teen about their feelings, and when you should seek professional help.

Dr. Grace Mitchell discusses the latest pediatric radiology trends and technology.

The most common reasons that children are seen by pediatric gastroenterologists relate to their bellyaches, bowels, and barfs. A simple approach to these disorders can guide general practitioners to help families find relief from these distressing symptoms.Dr. John Rosen explains when you might want to take your child to see a pediatric gastroenterologist, what to expect at an appointment, and treatments to common GI issues.

Sports related injuries are on the rise with increasing child and adolescent participation. Many training programs do not cover how to evaluate and treat these patients in the subacute setting.Listen as Donna Pacicca, MD, Orthopedic Surgeon and Sports Medicine specialist with the Sports Medicine Center at Children’s Mercy Kansas City, discusses evidence-based best practices for pediatric patients with sports related musculoskeletal injuries. Dr. Pacicca will discuss how to take a good history for sports-related injuries, key parts of the physical examination, how to best use imaging, and basics of treatment for upper and lower extremity injuries.

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.

Female reproductive health is critical in growing girls and young women. Julie Strickland, MD, Section Chief of Pediatric and Adolescent Gynecology, joins us for this episode of Pediatrics in Practice to talk about the need for pediatric and adolescent gynecologists, the conditions they treat and when to refer.

Dysmenorrhea is the most common gyencologic complaint in adolescent females, affecting more than half of this population. Julie Strickland, MD, Section Chief of Pediatric and Adolescent Gynecology at Children's Mercy, discusses causes, diagnoses and treatment of this painful condition.

Dr. Tania Burgert discusses Polycystic Ovary Syndrome (PCOS) and the current ideas surrounding a complex condition.

Enuresis or bedwetting is a common childhood problem, affecting 5 to 7 million children in the United States each year. By age 7, about 5-10 percent of all children are still wet at night. While 15 percent of kids will outgrow bedwetting without intervention every year, waiting and watching to see what happens could delay children getting dry at night. Listen as Judith VanSickle, MD, Pediatric Nephrologist, discusses causes, diagnosis and treatment of enuresis.

So you think rheumatology is all about joint pain? Think again. Rheumatologists treat a wide array of autoimmune conditions affecting nearly every part of the body- even the eyes. Uveitis is an inflammatory eye condition that can be caused by infection, underlying autoimmune diseases such as juvenile arthritis or sarcoidosis, or as an idiopathic disease. Untreated it can lead to cataracts, glaucoma and even blindness. Listen as Ashely Cooper, MD, pediatric rheumatologist, discusses childhood uveitis and how Children's Mercy Kansas City is improving care for kids with chronic uveitis.

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.

Dr. Shayla Sullivant discusses warning signs of suicide in teens, and how address it with patients.

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.

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.

Every year, influenza causes many people to become ill. All children 6 months and age and older should receive a yearly flu vaccine. Vaccination remains the best way to prevent influenza. Symptoms of influenza include abrupt onset of fever, myalgias, headache, nonproductive cough, sore throat and runny nose. Fever and cough are the two most common symptoms. When presented with these symptoms, providers are faced with the question to test and confirm the diagnosis of influenza or to initiate influenza treatment. Jennifer Goldman, MD, Infectious Diseases specialist at Children's Mercy, discusses the role of influenza testing in clinical care and the risks and benefits of oseltamivir use.

Osteosarcoma is a highly metastatic and drug resistant cancer. Survival rate for metastatic osteosarcoma remains less than 20 percent for the last 40 years. Tomoo Iwakuma, MD, PhD, is leading research focused on elucidation of mechanisms underlying osteosarcoma progression and 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.

The AAP recommends conducting general developmental screening at 9, 18, and 30 months, or whenever a concern is expressed. In addition, autism-specific screening is recommended at ages 18 and 24 months of age. When families arrive for their child's well-visits, how can each pediatrician be sure the right screening is taking place to identify any developmental delays quickly and effectively? Hear from Cy Nadler, Phd, and Sarah Nyp, MD, as they discuss the screening process and how to navigate the world of developmental delays and disabilities.

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.

Enuresis, hematuria and proteinuria are common pediatric kidney disorders, but the when do these problems warrant a referral to a pediatric nephrologist? What red flag symptoms require more urgent consultation and evaluation? New specialty-specific guidelines from the "Choosing Wisely" campaign were just released for pediatric nephrology in an effort to educate about unnecessary medical tests, treatments and procedures. In this podcast, Darcy Weidemann, MD, pediatric nephrologist at Children's Mercy Kansas City, discusses evaluation and management options primary care providers should consider prior to subspecialty referral.

“Positive ANA” is one of the most common reasons for referral to the pediatric rheumatology clinic. The antinuclear antibody (ANA) is often mistakenly considered a good screening test for rheumatic disease. Dr. Ashley Cooper, Interim Division Director of Pediatric Rheumatology, discusses what it means when a child has a positive anti-nuclear antibody test, when ANA should be checked, and how to talk about the test results with the family.

Orthopedic conditions can cause pain and dysfunction, causing aches and pains in bones and joints. Mobility and activity may be limited by these conditions. Polly Wimer, CPNP, APRN discusses common orthopedic conditions and their treatment.

Although there has been less emphasis on responsible prescribing of opioids in children, with newly developed legal and regulatory efforts focused almost exclusively on adults, it remains important for pediatric providers to be aware of the heightened risk for substance misuse in adolescents, and the appropriate use of opioids in a pediatric population. In this podcast, Daniel Millspaugh, MD, anesthesiologist and Director of the Comprehensive Pain Management and Opioid Stewardship programs at Children's Mercy Kansas City, discusses the current opioid-related public health emergency, as well as the evolving regulatory and agency response, and appropriate actions by medical providers.

As pediatric cancer survival rates continue to improve, we are faced with a new set of health challenges in caring for these survivors. Joy Fulbright, MD, Director of the Survive and Thrive program at Children’s Mercy Kansas City, discusses health concerns after cancer treatment, what primary care providers need to know, and the need for yearly screenings addressing medical and psychosocial issue.

As regional hemophilia treatment center, Children's Mercy follows more than 900 patients with bleeding disorders. Listen as Shannon Carpenter, MD, pediatric hematologist/oncologist and director of the Hemophilia Treatment Center at Children's Mercy Kansas City, discusses hemophilia A and B in children, current treatments and promising new research studies and options on the horizon, such as the PUPS Matter cohort study.

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.

Kidney stones in children have been on the rise for more than a decade, mostly due to hypercalciuria and hypocitraturia. Join us as Uri Alon, MD, Director of the Bone and Mineral Disorders Clinic at Children’s Mercy Kansas City, discusses what is behind the increasing incidence of kidney stones, and medical and non-pharmacological interventions to prevent new stones and inhibit the growth of existing ones.

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.

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.

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.

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.

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).