August 4, 2015

Making a trip to the hospital can be stressful for both our patients and their families. Most often, they come to us because something is wrong and they want to figure out how to get well. Whatever we can do to make that experience a good one, the better off everyone will be. That’s why the staff at Texas Children’s Hospital West Campus strives to make its facility a fun, caring environment.

One program at West Campus that brings smiles to a lot of faces is called That’s How We Roll. Created in honor of the hospital’s first leaders, Michelle Riley-Brown and Dr. Charles Hankins, the program offers rides on colorful toy cars and wagons to incoming patients. Volunteers working the entrances to the hospital manage the program and help the children get into the cars and wagons safely.

“We love it, the patients love it and so do their parents,” Guest Services Representative Karen Collins said. “It’s a win-win for everybody.”

Julia Tucci, who brings her 2-year-old son Andrew to West Campus three times a week for occupational and speech therapy, said the service is comforting.

“It makes for a nice transition to our therapy sessions,” she said. “It eases the process.”

Sheri Pivonka agreed and said her 5-year-old daughter, Faith, looks forward to riding the wagon to her weekly therapy session.

“She loves riding the wagon,” Pivonka said. “She’s always looking for it when we come in.”

The idea for the That’s How We Roll program was sparked late last year when Riley-Brown, former West Campus president, and Hankins, former West Campus medical officer, announced they were leaving to lead Texas Children’s Hospital The Woodlands.

“We wanted to honor the time and effort Michelle and Dr. Hankins spent opening the campus and running it for the first four years,” said Bobbie Jehle, project manager for West Campus and The Woodlands. “So, we started thinking of things we could do around the phrase ‘That’s how we roll’ since that was a common quote from Michelle to the West Campus leadership team.”

After several brainstorming sessions, Jehle said leadership decided to focus the project on patient experience and the idea for the That’s How We Roll program was born. West Campus leaders donated money to purchase the cars and wagons as a gift to Riley-Brown and Hankins. Since then, the program has taken off and happily escorts patients to their appointments every day.

“We use it twice a week and enjoy it each and every time,” said Lajuan Rose, the mother of 1-year-old Demari. “It makes our experience here a little bit easier.”

8515chagas640They’re often referred to as “kissing bugs,” but a bite from a Triatomine can pose a serious health threat. These small insects carry the parasite that causes Chagas disease. Chagas is a parasitic infection caused by a single cell parasite, known as a trypanosome that has the ability to infect the heart often causing severe and debilitating heart disease. Recently, the Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, received a grant of $1.8 million from the Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation. The grant will fund accelerated development of the first therapeutic vaccine for Chagas disease in humans, in a development program under the direction of Drs. Peter Hotez, Texas Children’s Hospital endowed chair in Tropical Pediatrics, and Maria Elena Bottazzi, deputy director of Sabin product development partnership.

“Chagas disease is considered one of the most important neglected tropical diseases affecting Central and South America, but the kissing bugs are also here in Texas, but so far there has been minimal activity toward active surveillance of the disease,” Hotez said. “This grant will help us create a vaccine that is used as an innovative immunotherapy, administered to those infected with trypanosomes to prevent the development of heart disease.”

Bottazzi said this funding is critical to making a real impact toward understanding and treating this neglected tropical disease.

“This is instrumental funding that will not only accelerate the product development but also close the gaps in evaluating parallel vaccine targets which will allow a higher probability of success,” Bottazzi said. “It will allow to transition rapidly into clinical safety evaluations which will bring the vaccine program closer to making a difference in the field and the afflicted populations.”

It’s difficult to determine when an individual has been infected with the parasite because most patients could go decades without symptoms. About a third to a fourth of those infected will eventually progress to severe heart disease, at times even resulting in sudden death. Dr. Kristy Murray, director of the Laboratory of Viral and Zoonotic Diseases, said it’s hard to pinpoint individuals who are infected because there are no real initial symptoms. Most of the patients being monitored at this point are those who have donated blood to a blood bank and tested positive.

“With the current studies being done, we’ll better understand the real at-risk population and formulate screening around that,” Murray said. Chagas disease is one of the most common diseases of people living in poverty in Latin America. One of the real surprises for us is finding evidence of transmission of the disease here in Texas,” said Hotez.

Dr. Murray said in Texas, the affected population also includes people with unique occupational or recreational exposures, for example hunters and campers. She said this isn’t to sound the alarm, but to be aware to take precautions such as staying inside in shelters or a tent to avoid the creatures that feed at night.

Ultimately, the Chagas disease vaccine could benefit up to 10 million people living with Chagas disease in the Western Hemisphere. Hotez hopes with the help of the Kleberg grant, the vaccine will be ready for clinical testing within the next few years.

8515breastfeeding640While August is National Breastfeeding Awareness Month, educating new mothers about the importance of breastfeeding happens every day at Texas Children’s Pavilion for Women.

“A natural, life-saving gift mothers can give their newborns is their own breast milk,” said Women’s Support Services Director Nancy Hurst. “Unlike formula, human milk contains powerful antibodies that protect infants against disease and infection, while strengthening the indelible bond between a mother and her baby from the earliest moments of life.”

The Pavilion for Women has implemented numerous breastfeeding practices to ensure our nurses, obstetricians and pediatricians are well trained to teach mothers how to breastfeed and maintain lactation. Even when separated from their infants, which can occur when premature babies are confined to the neonatal intensive care unit (NICU) for long-term care, mothers are shown how to initiate and maintain lactation. A nursing and medical staff that is educated in evidence-based breastfeeding practices is one of the many requirements to achieve the designation of Baby Friendly Hospital.

On July 22 and 23, surveyors from Baby Friendly USA visited Texas Children’s Hospital to evaluate our adherence to the Ten Steps for Successful Breastfeeding. These steps – which the Pavilion for Women has successfully implemented – include teaching mothers to respond to their infant’s early feeding cues rather than schedule feedings, avoiding the use of pacifiers and bottles until breastfeeding is well established which normally occurs during the first two weeks, feeding infants only breast milk and providing mothers with resources for lactation support prior to leaving the hospital.

Other breastfeeding efforts initiated at the Pavilion for Women include:

  • Helping mothers breastfeed within one hour of birth
  • Encouraging “rooming in” so mothers and infants can stay together 24 hours a day
  • Implementing immediate skin-to-skin contact between mother and baby following delivery, even after cesarean birth
  • Standardizing prenatal education to educate women about the benefits of breastfeeding
  • Providing 20 hours of didactic and skills-based education and instruction to all nursing staff caring for mothers and babies at the Pavilion for Women, including three hours of breastfeeding education to our obstetricians and pediatrics providers
  • Promoting the Breastfeeding Champions Program to inspire nurses to become role models for other nurses by reminding them why it is important to encourage women to breastfeed

“New mothers often times do not succeed in breastfeeding because there are no systems in place to support them,” said Prenatal Education Program Manager Anne Wright. “Since 88 percent of the mothers who deliver at the Pavilion for Women want to breastfeed, it is important that we implement and sustain practices that ensure their success.”

The Baby Friendly Hospital designation is important to Texas Children’s because it complements our commitment to delivering high-quality care to improve long-term outcomes for our neonatal patients.

Since Texas Children’s Newborn Center implemented the exclusive human milk feeding protocol six years ago, the rate of necrotizing enterocolitis – a devastating intestinal disease that affects premature infants – has dropped by 77 percent in our NICU. This remarkable feat is attributed to the generous mothers, many of whom are Texas Children’s and Baylor College of Medicine employees, who donate their excess breast milk to Texas Children’s Mother’s Milk Bank.

“Every ounce of donor breast milk improves outcomes for our NICU babies,” said Texas Children’s Neonatal Nutrition Director Dr. Amy Hair. “Mothers who donate their excess supply to our milk bank ensures our tiniest, most vulnerable patients receive a constant supply of nourishment and protection to build their developing immune system.”

While achieving the Baby Friendly Hospital designation is a lengthy four-phase process, Hurst says it could take up to 10 weeks to find out if Texas Children’s joins the roster of hospitals that proudly display this coveted distinction.

“Right now, it’s a waiting game for us,” Hurst said. “But, I am confident that we will achieve this designation because we’ve worked so hard to meet the rigorous criteria for implementing successful breastfeeding practices at the Pavilion for Women.”

For more information about Baby Friendly USA, click here. To learn more about Texas Children’s Mother’s Milk Bank, click here.

8515DrRoth175The Department of Urology will be well represented at the 26th Congress of the European Society for Paediatric Urology this October in Prague. Twelve of the department’s abstracts were chosen for posters, most with presentations.

“This is a wonderful opportunity for our staff to talk about the innovative things we are doing here at Texas Children’s Hospital,” said Chief of Urology Dr. David Roth. “We look forward to sharing our knowledge with the world of pediatric urology.”

Roth added that he could not be prouder of our faculty for contributing to the advancement of pediatric urology in this international forum.

“This is a further reflection of our recent No. 3 ranking by U.S. News & World Report,” he said.

In continuing with the tradition, the 26th Congress of the European Society for Paediatric Urology will be a joint meeting with the Society for Paediatric Urology, American Association of Pediatric Urologists, American Academy of Pediatrics/Section on Urology, Society for Fetal Urology and International Children’s Continence Society.

8515Drzoghbi175Dr. Huda Zoghbi, a Howard Hughes Medical Institute investigator and the director of the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s, has been awarded a Javits Neuroscience Investigator Award from the National Institute of Neurological Disorders and Stroke for her “distinguished record of substantial contributions in the field of neurological science.”

Zoghbi received this award for her groundbreaking research on spinocerebellar ataxia, a neurodegenerative disorder that affects gait, speech and other activities controlled by voluntary muscles as a result of a CAG repeat in Ataxin-1 protein. Zoghbi identified the gene responsible for this disorder almost 20 years ago. Spinocerebellar ataxia continues to be a primary focus of her research program at the NRI.

This seven-year research grant will allow Zoghbi’s team to further explore the molecular mechanisms underlying spinocerebellar ataxia-1 by which the mutant protein Ataxin-1 cannot be folded properly in the cell, interfering with action of neurons. The protein contains many repeats of the CAG or glutamine amino acid, making it unwieldy for activity in the cell.

Zoghbi’s research project aims to lower the level of toxic protein in the cell, screen human cells in culture and the fruit fly for additional drug targets that can help lower the levels of the protein, and explore modifications and interactions of the Ataxin-1 protein to understand features that would be relevant outside the cerebellum of the brain.

The Javits Neuroscience Investigator Award is named in honor of the late Senator Jacob Javits of New York, a strong advocate for neurological research who died of amyotrophic lateral sclerosis.