December 2, 2014

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Texas Children’s Neonatologist Dr. Jennifer Arnold, her husband, Bill Klein, and their two children, Will and Zoey, are back for another season of their hit reality show, “The Little Couple” on TLC, December 2.

The family’s adventures begin again with a trip to Washington, D.C. as the family represents Texas Children’s to advocate on Capitol Hill for the ACE Kids Act which stands for “Advancing Care for Exceptional Kids Act.” The proposed legislation will ensure that children with medical complexities who rely on Medicaid are able to receive the care they need from a center equipped to provide comprehensive care, even if they are required to cross state lines to receive the appropriate care.

12314littlecoupleinsideThe Kleins joined other families from across the nation for Children’s Hospital Association’s (CHA) Family Advocacy Day, which supports a grassroots initiative called Speak Now for Kids. The family visited the offices of members of congress where they spoke about their personal experiences and asked them to support the legislation by signing on as co-sponsors for the bill. ACE Kids Act, H.R.4930, currently has 97 cosponsors.

Watch the first episode and join the efforts to Speak Now for Kids:

  1. #Speaknowforkids. Use this hashtag and saturate social media with your stories about why children’s hospitals matter.
  2. Get social with your policymakers. Find the social media pages for your representatives and senators and post messages on their pages about why you want them to Speak Now for Kids. Encourage them to sign on as co-sponsors for this important piece of legislation.
  3. Call, write, and reach out. Lawmakers are elected by you to stand up for you. Make your voice heard. Contact their offices and let them know why you care about Medicaid reform for medically complex children. Click here to find out who represents you.
November 18, 2014

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Each year more than two million people in the United States get infections that are resistant to antibiotics and at least 23,000 people die as a result.

Dr. Debra Palazzi, a pediatric infectious diseases specialist and medical director of Texas Children’s Hospital’s Antimicrobial Stewardship Program, said the hospital has a good history of keeping antibiotic resistance at bay, but that the organization isn’t immune to the worldwide problem and has seen an increase in such cases during the past few years.

“We now see children with complicated diseases for whom we have limited or no effective antimicrobial therapy,” Palazzi said. “This is a growing problem in our pediatric population and results in increased morbidity and mortality.”

To help raise awareness of antibiotic resistance and the importance of appropriate antibiotic prescribing and use, Texas Children’s Hospital is joining more than 20 children’s hospitals across the country this week to promote the Center for Disease Control and Prevention’s Get Smart About Antibiotics Week. The goals of the annual event are to raise awareness of antibiotic resistance and to educate health care providers and the public about the appropriate and safe use of antimicrobial therapy.

Palazzi and Ruston Taylor, the clinical pharmacy specialist for the Antimicrobial Stewardship Program, have been working hard to achieve both of those goals and formed earlier this year a multidisciplinary Antimicrobial Stewardship Program aimed at optimizing the selection, dose, duration and route of therapy given to patients at Texas Children’s Hospital. Since then, a member of the program’s team has reviewed microbiology reports daily to assist healthcare providers in prescribing the appropriate antimicrobial therapy.

In some cases, the stewardship team – which is composed of people from multiple departments including Pharmacy, Infection Control, Infectious Diseases, Microbiology, and Quality and Safety – makes a recommendation to improve a patient’s antimicrobial treatment plan. The recommendation might be to de-escalate therapy, use an alternative therapy or stop therapy altogether.

“When most people think of antimicrobial stewardship, they say ‘antibiotic police’,” Taylor said. “We’ve actually called providers to START a drug that’s active against a reported bacterial pathogen rather than calling for discontinuation of agents.”

Another tool the team uses to help optimize a patient’s treatment plan is a rapid diagnostic test that can identify the presence of certain antibiotic-resistant strains of bacteria in a few hours instead of days. Before the availability of the test, physicians had to wait on culture-dependent methods for identification, which could take two to three days. Now, results can be determined in about an hour, allowing physicians to prescribe more appropriate treatment sooner rather than later.

Another intervention developed by the Antimicrobial Stewardship Program team started in the Pediatric Intensive Care Unit (PICU) and has quickly spread to other parts of the hospital. This summer, members of the stewardship team began rounding with all PICU teams to introduce a care bundle for antimicrobial prescribing to their daily provider progress notes. The bundle addresses the infectious disease the team is trying to treat, the antimicrobial agents the patient is on, microbiology data obtained, and the plan for antimicrobial therapy.

“The appropriate use of antimicrobials is something that affects all of us,” Taylor said. “The choices we make today may have consequences for generations to come.”

For more information on Get Smart About Antibiotics Week and how you can help, visit http://www.cdc.gov/getsmart/week/.

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If you have been thinking about quitting smoking or using nicotine, you are not alone.

Texas Children’s is here to support your efforts to quit, especially in light of the Great American Smokeout, an annual event that occurs the third Thursday of November and challenges smokers across the nation to make a plan to stop smoking.

Tobacco consumption remains the largest preventable cause of disease and premature death in the Unites States, and it is estimated that about 43.8 million Americans still smoke cigarettes, which is almost one in every five adults.

Secondhand and thirdhand smoke also present health risks to those who smoke and to those around them. Research shows that secondhand smoke can seep into hair, clothing, dust, and other surfaces, and that it creates thirdhand smoke or particles that are left on surfaces after the visible smoke is gone. These particles can become airborne and can be picked up by people – especially babies and small children – who touch the surfaces and get the particles on their hands and bodies.

The best way to prevent all such risks is to stop smoking, a step the Acting U.S. Surgeon General Boris Lushniak said is the “single most important step that smokers can take to enhance the length and quality of their lives.”

Here at Texas Children’s, we value your total well-being and are committed to providing education and resources that optimize your health and wellness. That’s why employees covered under the Texas Children’s medical plan can receive free tobacco cessation medications and over-the-counter treatments. As of September 1, these tools are covered at 100 percent for Texas Children medical plan participants with a prescription.

Before you go out and get these medications and treatments, however, it’s best to set a date for when you want to quit smoking and devise a plan on how to do it. Here are some tips on how you can kick the habit:

  1. Set a Quit Date
    First things first – pick your quit date. By having a day you’re working toward, you’ll be able to prepare mentally and physically to quit smoking. Avoid choosing a day where you know you will be busy, stressed, or tempted to smoke.
  2. Tell Family and Friends You Plan to Quit
    Quitting smoking is easier when the people in your life support you. Let them know you are planning to quit and ask for their support in staying accountable.
  3. Anticipate and Plan for Challenges While Quitting
    Quitting smoking is hardest during the first few weeks. You will deal with uncomfortable feelings, temptations to smoke, withdrawal symptoms, and cigarette cravings. Just remember that they are temporary, no matter how powerful they feel at the time.
  4. Remove Cigarettes and Other Tobacco from Your Home‚ Car‚ and Work
    Don’t be tempted to smoke during your quit. Stay strong. You can do it! Removing cigarettes and things that remind you of smoking will get you ready to stop.
  5. Talk to Your Medical Provider about Quit Options
    It is difficult to quit smoking on your own, but quitting “cold turkey” is not your only choice. Smoking cessation medications can dramatically increase your likelihood of successfully quitting. Texas Children’s medical plans covers prescription medication and over-the-counter treatments at 100 percent with a prescription.

Your well-being contributes to making Texas Children’s the best possible place to work and receive care. Good luck and thank you for continuing to optimize your health and wellness.

For more information or additional guidance, please call the Employee Medical Clinic at Ext. 4-2150 or visit the Wellness Website on Connect.

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Texas Children’s was well represented this month at the Periwinkle Foundation Kickball Classic, an event that raises money for an organization that provides healing programs and camps to children, young adults and families who are challenged by cancer and other life-threatening illnesses.

Employees from across the hospital organized 23 of the 36 teams that participated in the November 8 event at the Houston Sportsplex. Kicks R 4 Kids, the team that represented Texas Children’s Hospital’s Pediatric Radiology Department, took home the second-place title.

First place went to Lamar Squad, a team representing Lamar High School, and third place went to Kick Ballers, a team representing Bellaire High School.

More than 700 people turned out to watch the tournament, which raised $32,000 for the Periwinkle Foundation’s inaugural Kickball Classic.

The Kickball Classic involves teams of at least 10 people rallying together to raise funds while kicking to improve the lives of those affected by cancer. Each team is guaranteed three games in the round robin tournament and individuals are welcome to attend as well.

For more information about the Periwinkle Foundation, visit the organization’s website at http://periwinklefoundation.org/.

November 11, 2014

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Texas Children’s Hospital is working hard to prepare its staff and its facilities for a patient with Ebola or a similar infectious disease.

Isolation units have been designated. PPE has been purchased. Staff is being trained on how to use it. And, leaders are meeting regularly to assess the organization’s preparedness as it relates to the most current information available.

Another initiative in the works will give the hospital the capability to test for the Ebola virus onsite instead of depending solely on lab results from state and federal government laboratories.

Dr. James Versalovic, who heads up the hospital’s pathology department, said he is in the process of purchasing equipment that will allow his staff to test for Ebola and similar infectious diseases at the main campus. Being able to test for such conditions at Texas Children’s Hospital will enable medical staff to quickly determine and provide appropriate care.

Currently, lab samples from suspected Ebola patients are sent to the Texas Public Health Department in Austin and the Centers for Disease Control and Prevention in Georgia. Results are typically released within 72 hours. In the meantime, the patient is isolated and his or her symptoms are treated.

Versalovic said even with onsite diagnostic capabilities, lab samples from suspected Ebola patients still would be sent to the state and the CDC for confirmatory testing. Treatment, however, could be started sooner with the initial result in hand in hours compared with days. And, by ruling out Ebola more quickly in suspected patients, the correct diagnosis can be made more rapidly.

All onsite testing will be done at the main campus by a specialized team in a negative-pressure bio-containment laboratory. A similar unit is being planned for the west campus.

The goal is to have both labs ready and equipped to test for Ebola and other such diseases next year. The upgrades and additions will provide Texas Children’s with the best tools to diagnose and treat patients with infectious diseases, Versalovic said. The tools also will position the organization’s staff for effective patient care, optimal protection and safety.

 

Return to Ebola Response site.

 

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If you are holding off on getting a flu shot because you got one last year and think it’s still protecting you, think again.

The flu vaccine is seasonal and is designed to protect against the main flu viruses that research suggests will cause the most illness during the upcoming flu season. Physician-in-Chief Dr. Mark W. Kline elaborates on why it’s important to get vaccinated against the flu each and every year.

“The flu is a virus that changes every year and the vaccine has to change with the virus,” Kline said. “We achieved a great protection rate last year, better than 90 percent here at Texas Children’s Hospital, but that doesn’t protect us this year. So, we are asking everyone to get a flu vaccine to protect themselves to protect their families and to protect their patients.”

According to the Centers for Disease Control and Prevention, a lot of research goes into the composition of the seasonal flu vaccine. More than 100 national influenza centers in more than 100 countries conduct year-round surveillance for influenza. This involves receiving and testing thousands of influenza virus samples from patients with suspected flu illness. The laboratories send representative viruses to five World Health Organization (WHO) Collaborating Centers for Reference and Research on Influenza.

In February of each year, WHO consults with experts from WHO Collaborating Centers, Essential Regulatory Laboratories, and other partners to review data generated by the worldwide network of influenza laboratories. Afterward, WHO makes recommendations for the composition of the seasonal influenza vaccine for the Northern Hemisphere.

The U.S. Vaccines and Related Biological Products Advisory Committee, which is a part of the U.S. Food and Drug Administration, considers the WHO recommendations and makes a final decision regarding the composition of seasonal flu vaccine for the United States.

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules for both Main and West Campuses. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic.

And, remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3, we are amplifying unity and working together to get at least 90 percent of our staff vaccinated by Monday, December 1.

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When you think about our outstanding neurology team at Texas Children’s Epilepsy Center – one of the largest Level 4 epilepsy centers in the nation – one particular attribute comes to mind: their passion for innovation.

“Our focus has always been to discover new and innovative ways to treat and cure children with various forms of epilepsy,” said Dr. Angus Wilfong, a Texas Children’s neurologist who is leading the hospital’s first worldwide clinical trial of a cannabis-derived experimental drug to treat pediatric Dravet Syndrome.

The syndrome, which occurs in about one in every 30,000 births, is a rare and catastrophic form of intractable epilepsy that causes patients to experience dozens or even hundreds of seizures a day. If left untreated, children struggle with developmental delays, serious health complications and death.

That’s the grim reality 6-year-old Izaiah Ruiz faces daily. His grandmother, Lori Fountain, says Ruiz’s epilepsy is so severe that despite taking numerous seizure medications, nothing seems to produce long-term relief. Ruiz’s first seizure occurred when he was 2 months old, and since then, he’s almost lost his life twice. “I want him to be a normal little boy without having to worry about a seizure every time he goes to the playground or when he gets a runny nose,” said Fountain.

Ruiz is one of 30 patients worldwide enrolled in Texas Children’s study to examine the safety and efficacy of Epidiolex®, a highly purified cannabis extract that contains pure Cannobidiol (CBD). Although it is derived from the cannibas plant, Epidiolex contains no tetrahydrocannabional (THC), the psychoactive chemical in marijuana. GW Pharmaceuticals, who will fund the trial, is the only company in the world that produces pure plant-derived CBD, which is believed to help control seizures in children. The CBD medication is administered orally as a suspension or via feeding tube.

Wilfong, who is the study’s lead investigator and the first physician to administer Epidiolex in Texas, says the trial will be conducted in two stages. The first phase will determine the ideal dosage for children with Dravet Syndrome and the second phase will evaluate the drug’s safety and efficacy in this patient population.

“We are hopeful that in the next year, the results of this trial will show this drug has a positive impact on enrolled patients and that it will have implications for patients with other forms of intractable epilepsy,” said Dr. Gary Clark, chief of Neurology and Developmental Neuroscience at Texas Children’s.

Texas Children’s first began using Epidiolex in April of this year under a compassionate use protocol approved by the Food and Drug Administration for patients with catastrophic forms of epilepsy who were not responsive to seizure medications.

Wilfong said, “Initial trials of Epidiolex demonstrate promising signs of efficacy in children with treatment-resistant epilepsy. We are excited to partner with GW Pharmaceuticals in the first worldwide trial for this group of patients with such a catastrophoic form of epilepsy.”

Fountain hopes her grandson receives the experimental CBD medication rather than a placebo, but she knows that if he doesn’t, he’ll get the drug soon thereafter.

“If this drug could reduce Izaiah’s seizures and give him any semblance of a normal life, I can’t tell you how ecstatic I’ll be,” said Fountain.

Currently, Texas Children’s Epidiolex trial is accepting only pediatric patients with confirmed Dravet Syndrome. To learn more, click here or call Christina Tally, BS, CCRP, at Ext. 2-1276.

Click the link for more information about Texas Children’s Epilepsy Center.