Innovation – Page 48 – Texas Children's News

August 10, 2015

Bench and Bedside is a digest of the previous month’s stories about the clinical and academic activities of our physicians and scientists. We welcome your subsmissions and feedback.

July 7

Texas Children’s Hospital launches pediatric Thyroid Tumor Program

Texas Children’s Hospital recently formed a new pediatric Thyroid Tumor Program dedicated to the diagnosis and treatment of children and young adults with thyroid tumors, cancer and diseases. Read more

July 7

Radiology expansion promotes environment of collaboration

New and improved office space for the Department of Pediatric Radiology brings together all radiologists in one large reading room and houses the department’s offices in one centralized location. The expansion also provides space for daily morning huddles. These changes help ensure the hospital’s imaging services are available for patients in a timely manner. Read more

July 14

Dr. Susan Blaney elected chair of CPRIT Advisory Committee on childhood cancers

Dr. Susan Blaney, deputy director of Texas Children’s Cancer and Hematology Centers, was recently elected to serve as chair of the Cancer Prevention & Research Institute of Texas (CPRIT) Advisory Committee on Childhood Cancers (ACCC). Blaney, who has been a member of the committee for three years, will serve a two-year term. Read more

July 14

Health Center staff prepares for transition to community hospital setting

With the opening of the outpatient and subspecialty building at Texas Children’s Hospital The Woodlands just 15 months away, steps are being taken to ensure the transition for staff, patients and their families is seamless. One such step was taken June 25 and 26 when staff and leaders at the Woodlands Health Center and staff and leaders at the West Campus Outpatient and Subspecialty Building met and discussed what it’s like to go from working at a small community health center to a community hospital. Read more

July 14

Texas Children’s opens first-of-its-kind pediatric Heart Failure Intensive Care Unit

Texas Children’s Heart Center and the section of Critical Care Medicine cut the ribbon July 6 on a new, first-of-its-kind pediatric Heart Failure Intensive Care Unit. This highly-specialized 12-bed unit focuses on the treatment of children with heart failure, as well as those requiring intensive care before and after heart transplant. Read more

July 14

Young investigator given research boost from national grant

Dr. Rikhia Chakraborty is a young scientist with a distinct goal – to find the causes that potentially lead to Langerhans cell histiocytosis (LCH), a rare cancer mainly affecting pediatric patients, and determine the best way to prevent and treat the disease. Chakraborty’s research was recently recognized by Alex’s Lemonade Stand Foundation with a Young Investigator Grant worth $100,000. Read more

July 14

Hour-long documentary on Mata conjoined twins to air on Discovery Life Channel

An hour-long documentary on the formerly conjoined Mata twins aired on the Discovery Life Channel on July 16 . The program spotlighted Texas Children’s Hospital’s efforts leading up to and after the historic surgery that separated Knatalye Hope and Adeline Faith Mata. Read more

July 14

Department of Surgery makes great strides 2010-2015

During his annual state of the department meeting, Surgeon-in-Chief Dr. Charles D. Fraser Jr. highlighted the impressive efforts within the Department of Surgery. Read more

July 20

A new community hospital partnership allows patients to deliver at CHI St. Luke’s Health – The Vintage Hospital

Pregnant members of Texas Children’s Health Plan – The Center for Children and Women Greenspoint location recently received some big news. They can now deliver their babies at CHI St. Luke’s Health – The Vintage Hospital located in Northwest Houston. Read more

July 21

Texas Children’s conference empowers HH patients, families

On July 11, Texas Children’s Hospital and Hope for Hypothalamic Hamartomas hosted an educational conference to empower patients and their families affected by a rare and often devastating brain condition. Hypothalamic Hamartoma (HH) is a noncancerous tumor of the hypothalamus that causes uncontrollable seizures, early puberty, hormonal imbalances and cognitive and behavioral problems. Read more

July 21

World renowned epileptologist, colleagues visit Texas Children’s Hospital

World renowned epileptologist Dr. Helen Cross and two of her colleagues visited Texas Children’s July 9 and July 10 to get more information on the Medtronic Visualase system, which uses real-time MRI-guided thermal imaging and laser technology to destroy lesions in the brain that cause epilepsy and uncontrollable seizures. Read more

July 21

Leaders prepare for opening of special isolation unit

Clinicians recently participated in a detailed simulation to prepare for the soon-to-be-open special isolation unit. The state-of-the-art facility will open its doors in October and a Special Response Team will stand ready to receive children suspected of having a highly contagious disease. Read more

July 21

End-of-treatment bell brings hope for cancer patients

Patients at the Texas Children Cancer and Hematology Centers now can ring a bell in both the inpatient and outpatient units at the end of their treatment. Listen to a song Purple Songs Can Fly artist and cancer survivor Christian Spear wrote and dedicated to patients entering a new phase of their lives with the ringing of the end-of-treatment bell. Read more

July 21

ICD-10: Let’s reach 100 percent educational compliance by September 1

On October 1, Texas Children’s and other hospitals around the nation will convert to the federally-mandated ICD-10 coding system to better report patients’ diagnoses and inpatient procedures. To ensure we are ready systemwide for this transition, employees must complete their required online education and training by September 1. You can access your assigned e-learning module here. Read more

July 28

Texas Children’s Auxiliary awards given to Gargollo and Rosenfeld

The Texas Children’s Hospital Auxiliary awarded urologist Dr. Patricio Gargollo the Denton A. Cooley Fellowship in Surgical Innovation Award and orthopedic surgeon Dr. Scott Rosenfeld the Outcomes Fellowship Award for 2015. Each award totals $75,000. This is the fourth year the Department of Surgery has received funding from the Texas Children’s Auxiliary. Read more

July 28

NRI study: Insufficient energy production by mitochondria can lead to neural degeneration

In a fascinating study recently published in PLOS Biology, Dr. Hugo Bellen, Manish Jaiswal and their colleagues at the Jan and Dan Duncan Neurological Research Institute at Texas Children’s found that insufficient energy production by the mitochondria can cause photoreceptor neurons in the retina to degenerate. Read more

July 28

Fraser celebrates 20 years with Texas Children’s Hospital Heart Center

Thanks to the vision of legendary heart surgeon Dr. Denton H. Cooley and the leadership of Texas Children’s Hospital Surgeon-in-Chief Dr. Charles D. Fraser Jr ., the Texas Children’s Hospital Heart Center is one of the most active pediatric heart programs in the United States, setting a record with 32 heart transplants in 2014 and consistently treating the most complex heart issues every day. Read more

July 28

Texas Children’s expands crucial care to cancer and hematology patients in developing countries

Texas Children’s Cancer and Hematology Center physicians are crossing the globe to provide care for children suffering from cancer and blood disorders. Watch a video to see how the care they provide continues to reach new populations. Read more

July 28

Zarutskie’s arrival, expertise complements patient care at Family Fertility Center

Dr. Paul Zarutskie recently joined the Family Fertility Center at Texas Children’s Pavilion for Women. With more than 30 years in the field of reproductive medicine, Zarutskie combines his expertise and compassionate approach to patient care to help infertile couples achieve their dream of starting a family. Read more

August 14

Transplant Services team to host pediatric transplant symposium

Texas Children’s Hospital Transplant Services team is hosting the 2015 Pediatric Transplant Symposium at Texas Children’s Hospital. Learn how to register for this conference. Read more

August 4, 2015

Twenty years ago on August 1, Texas Children’s launched what is now the largest pediatric network in the nation with more than 200 board-certified pediatricians and 50 practices throughout the greater Houston area. Each year, the group sees 400,000 patients and completes more than a million visits.

“Texas Children’s Pediatrics has been one of the best things for Texas Children’s Hospital,” CEO and President Mark A. Wallace said. “More importantly, it’s been one of the best things for the community.”

The physician network was formed in 1995 with the purchase of a practice in west Houston owned and operated by four brothers – Drs. Ben, Morris, Harry and Paul Rosenthal. Because of its success, more and more pediatricians joined the group, making it what it is today.

Harry Rosenthal, who still practices at Texas Children’s Pediatrics Ashford with his brother, Ben Rosenthal, and his brother’s daughter, Dr. Rachel Rosenthal Bray, said his family is happy to be part of such a successful organization.

“It was one of the best decisions we’ve ever made,” Rosenthal said. “Texas Children’s Pediatrics has been wonderful for our practice.”

Dr. Kamini Muzumdar of Texas Children’s Pediatrics North Cypress agreed and said joining the group 15 years ago “made sense in every possible way” and has allowed her and her more than 20 other colleagues at the practice to accomplish things they never would have been able to do had they been on their own.

“Being part of Texas Children’s has given us the opportunity to be a part of an organization that has a reputation for providing exceptional care,” Muzumdar said.

In addition to providing its physicians with administrative, financial and management expertise, Texas Children’s Pediatrics offers a link to the entire Texas Children’s system, which includes more than 2,000 medical staff who provide care in more than 40 pediatric subspecialties.

“Texas Children’s Pediatrics is part of the Texas Children’s family,” said Kay Tittle, president of Texas Children’s Pediatrics. “The organizations support each other and allow everyone to focus on our top priority, which is taking care of patients and their families.”

The close working relationship also helps us grow to meet the ever-changing needs of those we serve.

“We’ve been doing this for 20 years and have been doing a phenomenal job,” Texas Children’s Pediatrics Vice President Lou Fragoso said. “But, the needs of families are changing, the way they need their care delivered is changing and we need to change with them.”

That’s why just this past year, Texas Children’s opened its first two urgent care centers and started a pilot program called Texas Children’s Pediatrics Walk-In-Now (W.I.N.) at Texas Children’s Pediatrics Cy-Fair. Both programs offer additional access to quality pediatric care any time of the day or night. Additional urgent care and W.I.N. locations will be opening soon.

A few months ago, Texas Children’s Pediatrics launched the ParentAdvice Center, a new mobile health management app available for free on iTunes and Google Play that will help families make smart decisions about what level of care is needed for their child and how to provide symptom relief for minor illnesses or injuries at home.

And, for years Texas Children’s Pediatrics Community Cares Program has provided trusted, high-quality pediatric medical services for children who otherwise would seek care from emergency rooms or possibly go without care or treatment due to low family incomes and/or lack of health insurance.

Regardless of the family’s financial situation, the Community Cares Program provides health care to children from birth to age 18 and offers the opportunity to develop a trusting, long-term relationship with a board certified pediatrician. The program also collaborates with community partners to assist families with other needed health care services.

Texas Children’s Pediatrics Chief Medical Officer Dr. Stanley Spinner said as long as the organization continues to come together as a unified group of physicians whose primary focus is the patient then Texas Children’s Pediatrics will continue to be successful.

“It’s exceeded my expectations,” said Spinner, who was one of the first physicians to join Texas Children’s Pediatrics. “And, I’m sure it will continue.”

They’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.

While 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.

The 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.

Dr. 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.

July 28, 2015

Thanks to the vision of legendary heart surgeon Dr. Denton H. Cooley and the leadership of Texas Children’s Hospital Surgeon-in-Chief Dr. Charles D. Fraser Jr., the Texas Children’s Hospital Heart Center is one of the most active pediatric heart programs in the United States, setting a record with 32 heart transplants in 2014 and consistently treating the most complex heart issues every day.

Since its inception 60 years ago, surgeons with the program have performed more than 27,000 cardiac operations, many of which have pushed the boundaries of a field pioneered by Cooley at Texas Children’s Hospital. The center has continued to push such boundaries under the leadership of Fraser, who joined Texas Children’s in 1995 and has helped focused the center on increasingly complex repair work, particularly in newborns and premature infants.

“I think Cooley would say that some of the contributions we’ve made in the past 20 years he didn’t dream could possibly be happening,” Fraser said. “We will continue to reach for a high bar and not coast on what Cooley and others got started here.”

The Heart Center began shortly after Texas Children’s opened its doors in 1954, a time when the idea of specializing in cardiology or heart surgery was a new concept on adults, much less children and infants. But, Cooley, a masterful surgeon ready to implement the advancements he had seen in medical school, was determined to make Texas Children’s the birthplace of pediatric cardiac care.

One of the program’s first major advances came when Cooley and his colleagues were able to open up the heart and operate inside it. The development of the heart-lung machine, which diverted blood from the heart and lungs, allowed this to happen and drove other doctors to Texas Children’s to observe what was unfolding.

Another milestone that garnered the Heart Center a lot of attention came in 1984 when Cooley performed the first pediatric heart transplant on 6-month-old Sara Remmington. The procedure was unlike anything that had been done, even in adults.

“That really was an exciting occurrence that attracted a lot of attention to the Texas Children’s surgical program,” Cooley said.

Fraser, who recently celebrated his 20th anniversary with Texas Children’s Hospital, is no stranger to monumental surgeries. During his career with the organization, he has performed the smallest arterial switch operation ever reported on a baby girl weighing less than two pounds. He also led a surgery on then 5-week-old Audrina Cardenas, who was born with her heart outside her chest. Fraser and a group of multidisciplinary surgeons saved Audrina’s life during a miraculous six hour open-heart surgery where they reconstructed her chest cavity to make space for the one-third of her heart that was outside of her body.

“We have a tremendous breadth of expertise in pediatrics at Texas Children’s,” Fraser said. “The Heart Center couldn’t be successful with a small baby without this whole focused interest on the children.”

Looking forward, Fraser said his team will continue to refine their techniques and focus on smaller and smaller children. Also, he said his team will work toward providing children with heart problems a life similar to that of a person with a normal, healthy heart.

“The pediatric cardiovascular field has had great success in obtaining survival and meaningful life for people with heart problems,” Fraser said. “Giving such patients a completely normal life, however has not yet been attained and is a goal we want to work toward.”

An important part of the Heart Center’s path forward is its continued relationship with the Texas Heart Institute, which Cooley started in 1962. For more than four decades, the two institutions have worked closely as they achieved numerous successes and Fraser said as long as he’s with Texas Children’s that relationship will continue.

“We’re enormously respectful and grateful for that mutually beneficial partnership,” Fraser said. “We can do so much more together moving forward.”

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