February 2, 2016

2316zikamosquito640In light of the multiple confirmed cases of recent travelers who returned to the Houston area after contracting Zika in Central America, Texas Children’s leaders encourage employees and staff to arm themselves with facts about Zika virus.

The virus, which has spread rapidly through Central and South America in the last year, is transmitted between humans primarily through mosquito bites. People may not realize they’ve been infected with Zika virus because the majority of people will develop an asymptomatic or mild flu-like infection.

The Zika virus has heightened concern among pregnant women since the virus may increase the risk of microcephaly, a rare neurological birth defect in which babies are born with abnormally small heads.

While there is no vaccine to protect against Zika infection, Dr. Kristy Murray encourages employees, particularly pregnant women, to refrain from travelling to areas where the outbreak is growing. The only way to prevent infection is to avoid getting mosquito bites.

“The only risk factor right now is foreign travel to areas where the virus is epidemic,” said Murray, director of the Laboratory for Viral and Zoonotic Diseases at Texas Children’s. “Currently, we do not have mosquitos locally that can transmit the virus, though we are concerned that an infected traveler could expose our mosquitos, setting up an opportunity for local transmission to begin. For about a week, an infected person has enough virus circulating in his or her blood to infect mosquitos.”

Texas Children’s OB/GYN-in-Chief Dr. Michael Belfort recently convened a task force of physicians and researchers at Texas Children’s and Baylor College of Medicine to develop management and research strategies based on important screening criteria outlined by the Centers for Disease Control (CDC) for pregnant women who may have been exposed to the Zika virus.

Belfort stresses that “women who have traveled to an affected area just before or during their pregnancy should contact their OB-GYN.” As stated in the developed task force guidelines, if pregnant women return from an endemic area and within two weeks develop symptoms, they will be referred to a knowledgeable provider or maternal fetal medicine specialist to test for evidence of Zika virus exposure. Additionally, pregnant women who return from an endemic area, regardless of symptoms, will be referred for ultrasound screening for fetal microcephaly. If fetal microcephaly is detected, an amniocentesis for Zika virus exposure will be offered.

“Our expert group also has recommended testing for chromosomal disorders at the time of amniocentesis for fetal microcephaly,” said Dr. Kjersti Aagaard, vice chair for Research in the Department of Obstetrics and Gynecology at Texas Children’s and Baylor, and a member of the task force. “Since the same mosquito carries Dengue, Chikungunya and Zika, we are advocating for testing of all three viruses once laboratory options become available.”

Below are FAQs about the Zika virus from the CDC and the developed guidelines:

What are the symptoms of Zika?
The most common symptoms of Zika virus disease are fever, rash, joint pain or conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito.

How is Zika transmitted?
Zika is primarily transmitted through the bite of infected Aedes mosquitos. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. We do not know how often Zika is transmitted from mother to baby during pregnancy or around the time of birth, when women are at highest risk, or how the transmission occurs.

Who is at risk of being infected?
Anyone who is living in or traveling to an area where Zika virus is found is at risk for infection, including pregnant women.

What countries have Zika?
Specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to change over time. Click here for the most updated information.

For more information about the Zika virus and ways you can protect yourself, click here.

When Texas Children’s Hospital opened in 1954, we had 128 employees, 106 beds in a three-story building, and we saw 2,300 patients our first year. See how far we’ve come in just 62 years!

 

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2316klineopedinside175The end of this month marks the deadline to sign up for a Marketplace health insurance plan. Unfortunately, for many families, simply having health insurance coverage doesn’t guarantee access to the best possible health care.

The sad truth is that there are many patients who were left scrambling to find a new medical home when a number of insurance companies decided not to provide in-network coverage for many hospitals in the Texas Medical Center, including Texas Children’s Hospital. Children and families, many suffering from serious or complex medical conditions, are being denied access to the largest, and one of the best, pediatric hospitals in the entire nation. Distraught mothers and fathers have called the hospital with emotional pleas for help, concerned that their children can no longer receive care from the doctors and nurses they have known for years or even their entire lives.

The reality is that not all hospitals are created equal. At Texas Children’s, we build facilities and recruit world-renowned pediatric subspecialists to deliver world-class health care and treatment to the children and families who need us most. As the saying goes, “it’s what we do.” We advance pediatric research and drive innovation in pediatric health care, all in hopes of discovering new therapies and cures for children with serious or life-threatening medical problems, and we scrupulously monitor and report the outcomes of the care and treatment we deliver. In conjunction with our partner, Baylor College of Medicine, we invest in the future health of the children of Houston, Texas and the nation by training more of the next generation of pediatricians and pediatric subspecialists than anyone else nationally. Finally, we do all of this in a family-centered and child-friendly way, improving not only the health of the child, but also the well-being of families across our community.

These are significant investments, but we are the hospital of last resort for many children. We turn no family away and take care of the most critically ill patients and treat more complex cases than any other hospital in the state, many times absorbing the cost so every family who needs that higher level of care receives it.

We see the unfortunate results when children don’t have access to the best facilities and health professionals. Getting the right care at the right place and in a timely fashion can save insurance companies millions of dollars in the end. In other words, ensuring access to the best facilities and health professionals, like those at Texas Children’s, not only is the right thing to do, but also makes good business sense. Denying even one child access to potentially life-saving care is one too many.

Good health demands that every child should receive care regularly from a pediatrician or family physician. The many children across our community suffering from serious or complex medical conditions require more. Recent decisions by several health insurance companies make clear that while they might agree in principle with these statements, they are blind to the ramifications of their decisions for many of our community’s most vulnerable children and families. Our children need and deserve access to state-of-the-art facilities and medical equipment designed specifically for children. They need and deserve access to pediatric specialists who are among the best in the world. Little lives depend on it.

Dr. Mark W. Kline serves as physician-in-chief of Texas Children’s Hospital and chairman of the Department of Pediatrics at Baylor College of Medicine.

8515Drzoghbi175Dr. Huda Zoghbi, director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s, will receive this year’s prestigious Jessie Stevenson Kovalenko Medal for her pioneering advancements in neuroscience research.

The National Academy of Science (NAS) presents this award every two years for outstanding research in the medical sciences. The Kovalenko Fund was gifted by Michael S. Kovalenko in 1949 in memory of his wife, Jessie Stevenson Kovalenko. For the last 63 years, the NAS has chosen distinguished scientists who have made landmark discoveries in medical research to receive this medal.

“Zoghbi unraveled the molecular basis of Spinocerebellar ataxia and Rett syndrome, providing novel insight into the pathogenesis of a broad range of neurologic disorders,” NAS Home Secretary Susan R. Wessler said. “Over the years, she has received numerous awards and prizes that honor her leadership in neuroscience research and exemplary mentorship to young neuroscientists. We couldn’t be more excited about this latest award. Her research initiatives have provided much needed rays of hope for many patients and their families.”

Zoghbi, who is a professor of molecular and human genetics, pediatrics, neurology and neuroscience at Baylor College of Medicine, has made several seminal discoveries in diverse areas of neuroscience. Her work has significantly furthered our understanding of neurodevelopmental and neurodegenerative disorders and revealed novel strategies to reverse these conditions. In addition, her forays in basic developmental neurobiology have led to important insights in a broad range of conditions from hearing loss to colon cancer.

Among her many scientific accomplishments, Zoghbi is widely recognized for her pioneering work on Rett syndrome, a form of autism common among girls. In 1999, she and her colleagues discovered that Rett syndrome is caused by loss-of-function mutations in the X-linked gene MeCP2 (methyl-CpG-binding protein 2) which established it as the first autism spectrum disorder that is largely caused by sporadic gene mutations. She would go on to demonstrate that the brain is exquisitely sensitive to levels of what she terms the “goldilocks” protein, MeCP2, and that doubling MeCP2 levels causes another devastating neurological syndrome among boys.

Recently, her lab showed that using small antisense oligonucleotides to normalize MeCP2 levels in the brain reversed the debilitating symptoms of MeCP2 duplication syndrome in a mouse models of that disease.

Zoghbi will receive the Jessie Stevenson Kovalenko Medal on Sunday, May 1, at the National Academy of Science’s 153rd Annual Meeting.

2316DrJacotinside175Bioengineers at Texas Children’s Hospital and Rice University have won a National Institutes of Health grant to develop a new generation of patches to repair the damaged hearts of infants.

The $1.9 million, 5-year grant will allow Jeffrey Jacot and his team to take the next steps in a long-running drive to improve the survival rates of such infants, many of whom are diagnosed in utero and require surgery soon after birth.

Jacot, who has appointments at Rice and Texas Children’s, and his colleagues will test patches that encourage a child’s own heart cells to invade and, over time, regenerate tissue to repair birth defects.

The multilayer patches include a rudimentary preformed vasculature – a blood-vessel system – that encourages cells to migrate. Over time, as the cells form organ tissue, the patches degrade and leave the body. The new tissue will ideally grow with the heart and have no fibrous scar that could interfere with its normal operation.

“Our goal is to have something that blends in with the tissue, so you can’t tell it’s a patch,” Jacot said. “It grows with the rest of the heart, and you don’t have these issues that you have with a piece of plastic.”

Jacot said cell survival in forming tissue has limited the effectiveness of such scaffolds until now. “We think if it has a good vasculature, it can recruit the cells that it needs,” he said. Preliminary studies show the immature vasculature hooks into the heart’s existing system “fairly quickly without needing to be surgically attached,” he said.

The study initially will be geared toward infants who suffer from Tetralogy of Fallot, a birth defect in which blood bypasses the lungs. The problem occurs in 4.7 of every 10,000 infants born in the United States. Cell-free patches are currently used to repair the damage, but they neither degrade nor grow with the infant and often need to be replaced, Jacot said.

“The surgeons we work with feel like there needs to be something better,” Jacot said. “What they see is that 10 to 20 percent of patches need to be replaced over time for various reasons, like if it has a severe strain or calcifies.”

The proposed new patches consist of a polyurethane core strong enough to handle sutures and the constant stress provided by a beating heart, surrounded by a porous gel that will welcome cells from neighboring heart tissue.

The lab had already derived endothelial cells and mesenchymal stem cells from amniotic fluid stem cells and determined that combining them in a hydrogel scaffold induces the formation of a rudimentary vascular structure. The use of readily available amniotic stem cells from a newborn’s own mother cuts the risk of tissue rejection, Jacot said.

2316SIUgrant640

Texas Children’s is set to receive a $1 million grant from the Texas Department of State Health Services (DSHS) to put toward its newly constructed Special Isolation Unit at Texas Children’s Hospital West Campus. The funds, to be delivered during the next five years, will specifically go toward Ebola preparedness activities that bolster employee safety and quality of care.

Texas Children’s began ramping up its Ebola preparedness and decided to build a special isolation unit almost a year ago, shortly after an unprecedented outbreak of the disease resulted in the realization that we must be prepared to handle emerging infections as an institution. As a result, the state and the Centers for Disease Control and Prevention designated Texas Children’s Hospital as one of several pediatric Ebola treatment centers countrywide.

Texas Children’s Special Isolation Unit is the only one of its kind in Texas and the southwest region, and is among the few in the United States designated just for children. Located on the fifth floor of West Campus, the eight-bed unit is fully equipped to care for any infant or child with a serious communicable disease and has all of the measures available to assure safety of the health care team, other patients and their families.

As a condition of the DSHS grant, members of the National Ebola Training and Education Center (NETEC) – created to ensure health care providers and facilities are prepared to safely identify, isolate, transport and treat patients with Ebola and other emerging threats. – recently visited the Special Isolation Unit. During NETEC’s two-day trip, members of the newly formed federal entity toured the Special Isolation Unit and spoke with leaders in detail about the formation of the unit, its capabilities and its potential usages.

“We were glad to have subject matter expertise tour our facility and provide knowledge and insight that will help us improve patient and staff satisfaction,” said Special Isolation Unit Medical Director Dr. Gordon Schutze. “They were very complimentary of the unit and told us we were fortunate to have leadership that is very supportive of doing what is best for their employees and patients.”

Once received, a portion of the DSHS grant will be used to compensate Texas Children’s for the Ebola preparedness activities undertaken since July 2014. Unit and West Campus leaders are working together to identify the best use of the remaining funds and how they can be invested to better health care professional safety and quality of care.

January 26, 2016

When two patient families came through the Texas Children’s doors looking lost and confused, Feba Payne from Facilities wanted to help. Neither family spoke English, but Payne wasn’t about to point them in the direction of their clinics and leave them to figure out the rest on their own. She stopped what she was doing in the lobby and personally accompanied each family through the hospital to their appointments.

Every day at Texas Children’s, people like Payne take time to make a difference. Whether for our patients or colleagues, these small acts often determine the experience we create. Payne’s kindness not only made the stressful time less difficult for the families, but also caught the attention of one of her team members who shared the story on a Caught You Caring card. With the launch of Caught You Caring, Texas Children’s aims to recognize the work we all do to make a difference.

Caught You Caring is an organization-wide initiative to recognize those every day acts of compassion. The program began in ambulatory surgery and has been incredibly successful among staff and physicians, recognizing hundreds who have gone above and beyond.

“It’s so easy to tell stories or complain about what went wrong,” said Erica Diaz, a child life specialist. “We thought maybe a way to change our culture is to change our conversation.”

Patients, families and employees are encouraged to catch someone who is making a difference. Boxes and cards will be placed throughout all Texas Children’s sites for patients and families to recognize staff. Employees can fill out a Caught You Caring form on Connect. Cards and online submissions will be distributed to leaders for staff recognition.

“I’ve had a chance to write a lot of thank you cards to the recipients of Caught You Caring and I can’t tell you how surprised these individuals are, how happy they are, and that has a ripple effect on those around them,” said Chief of Plastic Surgery Dr. Larry Hollier.

Join the Caught You Caring launch events at Main Campus from 10 a.m. to 1 p.m. Wednesday, January 27 on The Auxiliary Bridge, and from 10 a.m. to 1 p.m. Thursday, January 28 at West Campus on the first floor near the cafeteria.

Will you get caught caring?