March 25, 2019

In this month’s episode of Medically Speaking, you’ll hear from Texas Children’s urologist, Dr. Ming-Hsien Wang. In her talk, Wang discusses best practices in the treatment of pediatric urinary tract infections (UTIs) and also shares the differing views between American Academy of Pediatrics guidelines and findings from a recent double-blind study on the use of prophylactic antibiotics to treat UTIs.

Learn more about the services provided and conditions treated by Texas Children’s Division of Urology.

Medically Speaking features some of the brightest minds from several Texas Children’s specialty and subspecialty areas. The series is meant to be a helpful educational resource for parents and a convenient way for physicians and other caregivers to stay up-to-date on the latest in pediatric medicine. Viewers can watch talks on a variety of interesting topics, including advancements in surgery, breakthroughs in research, new clinical trials, and novel and back-practice treatments for specific conditions.

Be on the lookout for more Medically Speaking episodes here on Connect, or view additional episodes now.

This presentation is not intended to present medical advice or individual treatment recommendations, and does not supplant the practitioner’s independent clinical judgment. Practitioners are advised to consider the management of each patient in view of the clinical information. All content is shared for informational purposes only, and reflects the thoughts and opinions of the original author. No physician-patient relationship is being created by the use of this presentation. The presentation sets out recommendations based upon similar circumstances and is provided as an educational tool. The presenters are not attorneys, and to the extent this presentation provides commentary on current laws and regulations affecting health care activities, it is not intended as legal advice.

When Texas Children’s Cancer Center opened its doors in 1954, only one in every 10 children with cancer survived. Today, more than 80 percent of children who are diagnosed with cancer will successfully fight the battle and be cured. However, the war with cancer will not be over until there is a cure for each and every child who is impacted by this disease.

The good news is, tremendous progress has been made. With powerful new weapons in our arsenal and incredible breakthroughs in technology and genetics, every day we uncover more information about what causes cancer and how to beat it, because losing even one child to cancer is still one too many.

To learn more about the history of Texas Children’s Cancer Center, our treatments, programs, staff and research, read “And So We Fight,” a publication dedicated to the mission of the Cancer Center and those it serves. The publication is now online. Click here to view.

October 8, 2018

Dr. Jenny Despotovic, director of the Immune Hematology program at the Texas Children’s Hematology Center, served as editor of the recently published textbook Immune Hematology: Diagnosis and Management of Autoimmune Cytopenias. The textbook provides a concise yet comprehensive overview of the most common autoimmune cytopenias affecting adults and children.

This is the first textbook dedicated exclusively to immune cytopenias. Despotovic worked with several of her colleagues to develop, write and edit the content in the textbook, which had over 2,000 downloads in the first two months since publication.

The book is divided into four sections, each of which focuses on a major autoimmune cytopenia. The first section features background, pathophysiology, presentation, evaluation, and treatment strategies for immune thrombocytopenia (ITP), the most common cause of antibody-mediated platelet destruction. The second section reviews common forms and treatment strategies for autoimmune hemolytic anemia (AIHA), including a chapter dedicated specifically to Evans Syndrome. The third section comprehensively reviews the pathophysiology, diagnosis and current management approaches to thrombotic thrombocytopenic purpura (TTP), a potentially life-threatening autoimmune syndrome. The book concludes with a final section on autoimmune neutropenia. Each section includes a review of common underlying systemic autoimmune conditions and immune deficiency syndromes that can accompany or cause autoimmune cytopenias.

“It was a privilege to be part of the creation of this very important textbook,” Despotovic said. “It is an important addition to the body of literature available to guide providers in the diagnosis and management of these challenging disorders, and will hopefully positively impact the care of patients with these complex conditions.”

Those in the Hematology Center who contributed to the effort include:
Dr. Alicia Chang
Dr. Clay Cohen
Dr. Jenny Despotovic
Dr. Amanda Grimes
Dr. Taylor Olmsted Kim
Dr. Jacquelyn Powers
Dr. Shawki Qasim
Dr. Sarah Sartain

December 12, 2017

On February 10 at Third Coast on Bertner Avenue in Houston, Texas Children’s Chief of Otolaryngology Dr. Ellis Arjmand and Dr. Oded Netzer, professor of business at Columbia Business School in New York City, will lead an interactive workshop focused on the psychology of decision making in medicine.

During the 8-hour course, attendees will learn about the psychology of decision making and how to make smarter decisions in the presence of uncertainty.

Building on the landmark research from two trailblazing psychologists, Drs. Daniel Kahneman and Amos Tversky, attendees will learn how to recognize cognitive bias and systematic errors in decision making. Topics discussed include:

  • Cognitive Bias and Decision Making
  • Systematic Forms of Error: Understanding Our Biases
  • System I and System II: Thinking Fast and Slow
  • Interrogating the Data
  • Understanding Error in Medical Decision Making
  • Syntheses vs. Summary
  • Reducing Bias in Medical Decision Making

To register for the Continuing Medical Education course or for more information about the event, click here.

May 30, 2017

As chief of the newly created section of Public Health Pediatrics at Texas Children’s – the nation’s largest and first public health section within a children’s hospital – Dr. Christopher Greeley has devoted much of his resources and time toward developing a one-of-a-kind, community wide program aimed at child abuse prevention.

“As a board certified child abuse physician, I kept seeing children after they were harmed,” said Greeley, who also is a professor of pediatrics at Baylor College of Medicine. “It would be a great day if no one were hurt. And the only way for that to happen would be for the health care team to spend more time on prevention.”

Greeley uses this analogy to illustrate his point:

Imagine standing by a river and watching kids floating by. You pluck them out of the river to rescue them. But you need to go upstream to find the break in the fence that is allowing the kids to fall into the water. Going upstream to find and correct the cause of problems is the model of public health.

“We have been spending all of our time scooping kids out of the river, and now we’re developing a program, a strategy to start going upstream,” Greeley said. “We will always take care of these kids, but part of what our team does is focus on socioeconomic factors that place kids and families at risk in the first place.”

Launched in October 2015, the Public Health Pediatrics section has two components – child abuse pediatrics and the Center for the Study of Childhood Adversity and Resilience (CARE). Both components work together to engage the community around perceived risk factors and improve the trajectory for children of abuse and neglect.

The child abuse pediatrics program focuses on four main areas:

  • Excellence in clinical care: About 2,500 suspected victims of abuse and neglect are evaluated annually at Texas Children’s and the Children’s Assessment Center (CAC) in Houston. Care is provided at Texas Children’s Main Campus and planned for the new Texas Children’s Hospital The Woodlands campus. Consultative services are available at Texas Children’s Hospital West Campus. The program provides medical support to CACs in Houston and Brazoria County. Because children in the foster care system are at risk of abuse, Texas Children’s is developing a foster care clinic.
  • Training and education: Baylor and Texas Children’s have three doctors in training in an accredited fellowship in child abuse pediatrics, one of the largest such programs in the country. Besides education for medical students and the greater Houston medical community, a training program is being developed for post-doctoral public health practitioners. An outreach program trains members of the community on signs and symptoms of child abuse.
  • Scholarship and new knowledge: Clinical research varies from early recognition of abuse to improving mental health services for children in foster care.
  • Community presence: The program’s interdisciplinary team of physicians, nurses, social workers and public health practitioners help primary care physicians and nonprofits who care for abused and neglected children and are available to civic groups, church groups and YMCAs.

In conjunction with child abuse pediatrics, the main focus of CARE is community-level research to identify, promote and implement strategies to prevent adverse childhood experiences such as poverty, violence, inequality, homelessness, and lack of mental health, education and nutrition.

For instance, to help relieve parental stress and improve children’s outcomes, the launch of the upWORDS program at Texas Children’s teaches parents how to improve the quantity and quality of language spoken with their children, which has been known to increase brain development and positively impact their child’s future.

The Public Health Pediatrics section is also working with nonprofit communities, city and county agencies to develop partnerships and strategies to help families cope with other issues including postpartum depression, violence, and food insecurity or hunger in Houston.

“Improving the circumstances that cause adverse childhood experiences is a long-term complex undertaking that must be adapted to fit each community,” Greeley said. “But the section of Public Health Pediatrics is ready to do whatever it takes to improve the lives of children.”

Texas Children’s Physician-in-Chief Dr. Mark W. Kline who recruited Greeley to head this new section applauds the success and foresees the future growth and far reaching impact of this program.

“As a transformative figure in the Department of Pediatrics, Greeley will inspire a generation of public health-oriented pediatricians-in-training who, in turn, will populate programs across the country,” Kline said. “His program is a prime example of the things that we are doing that other pediatrics departments in the U.S. can replicate.”

December 6, 2016

113016drprakashmasand175Dr. Prakash Masand, director of Cardiac Imaging Service in the Texas Children’s Hospital Department of Radiology has been awarded a Fulbright & Jaworski LLP Faculty Excellence Award from Baylor College of Medicine. He is the first pediatric radiologist at Texas Children’s to receive this award.

To be considered for an award in Teaching and Evaluation, a member of the Baylor faculty must show evidence of quality of teaching, number of teaching hours and diversity in content of material, and variety of teaching formats among medical students, residents and fellows.

“One of the most valuable assets of any academic medical center is a great teacher,” said Texas Children’s Radiologist-in-Chief George S. Bisset. “Dr. Masand understands the power of teaching and his commitment has inspired many of our trainees in radiology.”

As a Radiology attending physician since 2010, Masand has contributed to the training and education of numerous residents and fellows who rotate on the Radiology service from Baylor College of Medicine, University of Texas in Houston and the San Antonio military program.

As an educator, Masand inspires residents and fellows by incorporating effective teaching methods to help them discover their true potential. He enjoys teaching while interpreting case studies with trainees and enjoys interactions with his trainees during clinical conferences, didactic and lecture based teaching. Masand is also passionate about optimizing and setting up imaging protocols and sequences, which eventually helps with standardization of imaging based algorithms, and provides him with the unique opportunity to participate in the education of our Radiology staff, including nurses, technologists and sonographers.

“My collaboration with residents, fellows and faculty from other clinical specialties has continually enhanced my learning and I am happy to say that we have developed several successful clinical programs using a multidisciplinary approach,” Masand said. “Being the imaging spearhead for these programs, I am able to impart knowledge about the latest and the best imaging techniques to my clinical colleagues, which improves patient care and benefits the community.”

Congratulations to Dr. Masand for this prestigious excellence in teaching award!

December 22, 2015

122315nurseresident640The July 2015 class of nurse residents were recognized at their graduation ceremony on December 10. Chief Nursing Officer Mary Jo Andre delivered an inspirational welcome to the graduates and guests – encouraging the graduates to get involved and to stay connected with their fellow nurse residents.

The 47 graduates were applauded by proud friends, family members, co-workers and leaders as they received their certificates. Each nurse resident was required to select a project to work on during their residency. The posters illustrating their respective projects were on display at the graduation ceremony. All attendees were encouraged to view the poster projects and graduates were available to respond to questions.

At the conclusion of the ceremony, graduates and their guests enjoyed refreshments.

Nursing Professional Development Specialist Megnon Stewart, who shepherded the graduates through their residency program, described the July 2015 class as “extraordinary. The nurse residents went above and beyond to give back to their units as shown through their evidence based and/or quality improvement projects.”

Stewart also recognized Clinical Training and Development Coordinator Jaime Choate who helped co-lead the group; as well as the educators, clinical nurse specialists and the nurse residents preceptors who ensured that each resident had a successful orientation.