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The Pediatrician’s Role in Health and Hope after Trauma
 The Pediatrician’s Role in Health and Hope after Trauma 150 150 Anna Kerlek, MD
By: Anna Kerlek, MD

A primary care provider’s ability to identify and treat symptoms associated with trauma can increase positive outcomes for patients and families. Almost two-thirds of the children and their caretakers in your office have experienced at least one trauma. Many have experienced more. As a primary care provider, you can provide early intervention and support for…

Mapping the World of Pediatric Severe Sepsis
 Mapping the World of Pediatric Severe Sepsis 1024 576 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
Blood cells

Researchers work to reveal the many subtypes of pediatric sepsis — and what to do about them. Once upon a time, sepsis was just sepsis. Children experiencing septic shock and its aftermath — any resulting organ failure — were viewed as a fairly homogenous group of patients. But now, thanks in a large part to…

How to Identify and Treat Blood Clots in Pediatric Patients With Cancer
 How to Identify and Treat Blood Clots in Pediatric Patients With Cancer 1024 575 Mary Bates, PhD
By: Mary Bates, PhD
Black and white photo of a young patient with cancer wearing a mask and gown and holding an IV poll smiling and giving a thumbs up in the hospital

New guidelines will help doctors recognize and treat children at risk of venous thromboembolism. Prevention of blood clots is well described in adult cancer patients, but data on the problem in pediatric cancer patients is limited. In a new publication initiated at the request of the International Society of Thrombosis and Hemostasis, researchers provide guidance for…

The PDA Conundrum
 The PDA Conundrum 150 150 Jeb Phillips
By: Jeb Phillips

A patent ductus arteriosus is associated with increased morbidity and mortality, but common treatments are associated with poor outcomes as well. What is a neonatologist to do? Until the mid-2000s, most neonatologists were pretty sure they knew how to handle a patent ductus arteriosus (PDA) in an infant born preterm – it needed to be…

Can Gene Therapy Treat Dominantly Inherited Disorders?
 Can Gene Therapy Treat Dominantly Inherited Disorders? 1024 575 Abbie Miller
By: Abbie Miller
Colorful illustration of gene therapy in action

Recent applications of adeno-associated virus (AAV) mediated gene therapy have focused mainly on correcting recessively inherited diseases. But what about dominantly inherited disorders? It looks like AAV could be a delivery mechanism for treating those genetic disorders, too. Most applications of AAV-mediated gene therapy research are in recessively inherited rare diseases. The affected individuals have…

Accessing Genomic Data for Research and Clinical Diagnostics – Meeting the Challenge
 Accessing Genomic Data for Research and Clinical Diagnostics – Meeting the Challenge 1024 575 Rajeswari Swaminathan, MS
By: Rajeswari Swaminathan, MS
Rajeswari Swaminathan smiling and posing for photo in front of windows

What good is genomic data if it can’t be shared efficiently? The genesis of DNA sequencing technology in the 1970s was a turning point in science, giving birth to a modern era in biology. Further, with the unfolding of the relationship between nucleic acid order and uniqueness across species, improvement in strategies to sequence this…

FDA APPROVAL: Gene Therapy Comes of Age
 FDA APPROVAL: Gene Therapy Comes of Age 1024 575 Abbie Miller
By: Abbie Miller
Colorful illustration of gene therapy in action

UPDATED: May 2019 On May 24, 2019, the FDA approved Zolgensma (formerly AVXS-101), a first-of-its-kind gene therapy for spinal muscular atrophy. In the 13 months that have passed since this article first posted, the long-term outcomes of gene therapy for spinal muscular atrophy (SMA) have continued to bolster the community’s hope for the treatments. Now,…

Weaving an Antimicrobial Safety Net
 Weaving an Antimicrobial Safety Net 150 150 Kevin Mayhood
By: Kevin Mayhood

Stewards thread together monitoring programs and new protocols while trimming unwarranted tests and diagnostic speed. This story also appeared in the Spring/Summer 2018 print issue. Download a PDF of the print issue. Studies estimate that 30 to 50 percent of antimicrobials prescribed in hospitals and up to 50 percent prescribed in outpatient settings are either unnecessary…

A Heart in Three Dimensions
 A Heart in Three Dimensions 1024 575 Abbie Miller
By: Abbie Miller

The 3D Printing Lab at Nationwide Children’s Hospital provides comprehensive patient-specific treatment planning and device development services from a pediatric perspective. The tiny heart pictured above is just one of the many 3D printed models created by the 3D Printing Team at Nationwide Children’s. It represents one of the many helped by the technology and…

Can We Prevent Future Language Delays in the NICU?
 Can We Prevent Future Language Delays in the NICU? 150 150 Abbie Miller
By: Abbie Miller

Researchers investigate the use of event related potentials to measure the effects of mother’s voice exposure on speech sound differentiation. Preterm infants are at high risk for neurosensory impairments and developmental delays, including hearing loss, which may have lasting consequences. Compared to babies born at term, preterm infants are twice as likely to have a…

Solving the Puzzle of Transfusion-Related Immune Reactions
 Solving the Puzzle of Transfusion-Related Immune Reactions 576 367 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
Illustration of a blood bag

Now that physicians have the “how” of blood transfusions mastered, they are starting to explore the “what” — and they’re learning that the effects of sharing human blood may be even more far-reaching and complex than previously imagined. With the initial safety challenges addressed and the technical barriers of donor blood storage and cleaning improved,…

The Challenge of Studying Supplementation: Omega Fatty Acids to Prevent Preterm Birth and Associated Complications
 The Challenge of Studying Supplementation: Omega Fatty Acids to Prevent Preterm Birth and Associated Complications 1024 575 Abbie Miller
By: Abbie Miller

Dietary supplements: it seems that medical professionals either love them or hate them. And while much research shows that the average healthy adult with a good diet probably doesn’t need them, studies of specific supplements in specific patient populations may show efficacy. For example, studies show that omega-3 fatty acid supplements can reduce inflammation and…

Conquering the Biological Politics of Cancer: Corruption, Coercion and Collusion
 Conquering the Biological Politics of Cancer: Corruption, Coercion and Collusion 150 150 Timothy Cripe, MD, PhD
By: Timothy Cripe, MD, PhD

Understanding the “Three C’s” may provide the insights need to move the needle on the cancers with the bleakest prognoses. Broadly speaking, cancers fall into three categories: leukemias, brain tumors and other solid tumors. Since the dawn of chemotherapy in the 1940s, we’ve converted the most common type of leukemia, acute lymphoblastic leukemia, from incurable…

To Test or Not to Test: The Inherited Thrombophilia Question
 To Test or Not to Test: The Inherited Thrombophilia Question 150 150 Abbie Miller
By: Abbie Miller

When a result provides questionable or limited clinical utility, physicians and genetic counselors must educate patients and providers on the pros and cons of genetic testing. Between the increased ease of clinical genetic testing and the direct-to-consumer genetic testing kits now available, physicians and genetic counselors face education challenges that simply did not exist a…

Considerations for Integrating Behavioral Health and Primary Care
 Considerations for Integrating Behavioral Health and Primary Care 150 150 Cody Hostutler, PhD
By: Cody Hostutler, PhD

As increasing numbers of pediatric patients require behavioral health care, primary care providers look to integrate behavioral health providers in their practice. You know the story. It’s the middle of a busy Friday afternoon, you just finished up an adolescent well-visit, your hand is on the door and you hear, “Doc, one more question?” The…

Phase 1 Study Shows Promise of Gene Replacement Therapy for Spinal Muscular Atrophy Type 1
 Phase 1 Study Shows Promise of Gene Replacement Therapy for Spinal Muscular Atrophy Type 1 150 150 Abbie Miller
By: Abbie Miller

The phase 1 clinical study shows that gene therapy extends survival of patients and supports achievement of milestones previously unseen in the natural course of the disease. A one-time intravenous infusion of the high dose of gene therapy extended the survival of patients with spinal muscular atrophy type 1 (SMA1), according to a study published in…

On the Road to Eliminating RSV
 On the Road to Eliminating RSV 150 150 Abbie Miller
By: Abbie Miller

With the recent publication of two papers, researchers shed light on factors that influence disease severity and immune response to respiratory syncytial virus infection in infants and young children. “RSV is a very common infection in infants and young children – almost everyone will be infected by age 2. In the United States, 2-3 percent…

8 Ways You Can Support Families in Need of Behavioral Health Services
 8 Ways You Can Support Families in Need of Behavioral Health Services 150 150 Nancy Cunningham, PsyD
By: Nancy Cunningham, PsyD

Long wait times and difficulties accessing behavioral health services cause stress for many patients and families. As awareness grows about the prevalence of behavioral health challenges for children and adolescents, more patients and families are seeking specialized care. However, due to a shortage of behavioral health specialists, wait times can seem daunting. As the pediatrician,…

6 Strategies for Incorporating Behavioral Economics in Your Practice
 6 Strategies for Incorporating Behavioral Economics in Your Practice 150 150 Kevin Mayhood
By: Kevin Mayhood

Behavioral economics combines insights from psychology, economics and marketing to improve or direct decision-making. It can be used to “nudge” patients, their families and practitioners in the direction of better health if used by health care providers. While the use of behavioral economics strategies has limited study in pediatrics, the existing research indicates a number of…

Bouncing Back: Overcoming Physician Burnout With Resilience
 Bouncing Back: Overcoming Physician Burnout With Resilience 1024 575 Suzanne Reed, MD and John Mahan, MD
By: Suzanne Reed, MD and John Mahan, MD

Physician burnout is becoming increasingly recognized as an extensive and debilitating reality. Present in specialties across the spectrum of medicine, most disciplines report burnout rates of 50 to 60 percent or more, and these rates have been increasing over the last several years. Pediatrics alone demonstrated a more than 16 percent increase in burnout, up…

Can Behavioral Economics Help People Adopt Better Health Habits?
 Can Behavioral Economics Help People Adopt Better Health Habits? 150 150 Kevin Mayhood
By: Kevin Mayhood

Simple incentives may nudge patients, caregivers and clinicians to make more healthful choices. Behavioral economics has helped electricity customers cut down on usage, new employees to start setting aside money for retirement from day one and, more recently, to change health care provider and patient behaviors. The practice combines insights from psychology, economics and marketing…

Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease
 Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease 1024 575 Abbie Miller
By: Abbie Miller

From bioengineers to interventional cardiologists, molecular biologists to cardiothoracic surgeons, experts with diverse backgrounds are focusing on the problem of heart valve disease in children. Heart valve disease affects more than 5 million Americans. And while acquired disease in the adult population certainly accounts for much of this, children with heart valve disease face multiple…

Creative Reality: Using a New Platform Technology to Improve Patient Experience
 Creative Reality: Using a New Platform Technology to Improve Patient Experience 1024 575 Abbie Miller
By: Abbie Miller

Amy Dunn, MD, had a problem. Some of her patients in the hematology clinic at Nationwide Children’s Hospital receive hundreds of needle sticks each year. “Needle phobia is very real for these patients and their families,” says Dr. Dunn, director of Pediatric Hematology at Nationwide Children’s. “In some cases, ports need to be implanted so that these…

Mapping the Journey to Optimal Health for NICU Graduates
 Mapping the Journey to Optimal Health for NICU Graduates 1024 683 Jeb Phillips
By: Jeb Phillips

Babies born preterm need ongoing, specialized care to help them thrive after discharge from the hospital. Innovative programs are being designed to ensure that they get that care. In the early 1980s, only 10 percent of infants born before 28 weeks of gestational age survived to be discharged from the hospital. By 2015, 65 percent…

Integrating Research Into the “Journeys”
 Integrating Research Into the “Journeys” 1024 683 Jeb Phillips
By: Jeb Phillips

Along with their work to build an innovative follow-up program, Nationwide Children’s faculty and staff members are international leaders in NICU follow-up research. A number of foundation and National Institutes of Health-funded follow-up studies are housed entirely or in part at the hospital, and The Research Institute at Nationwide Children’s is one of 17 member…

Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care
 Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care 1024 575 Rachael Hardison
By: Rachael Hardison
Teen girl with backpack

An estimated 20 percent of children struggle with mental health illness. As awareness grows, the call for primary care physicians to play a leading role in care grows louder. One in five children will struggle with a mental health illness by the age of 12, but a recent survey by the American Academy of Pediatrics…

Inside the Good Manufacturing Production Facility
 Inside the Good Manufacturing Production Facility 1024 575 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

By removing a barrier to access – production of pharmaceutical products for clinical trial – the team at the GMP facility is bringing more treatments to rare diseases. A newly designed, 7,500 square foot clean room suite with multi-use viral vector and cell therapy capabilities is expediting the bench-to-bedside process of bringing life-saving treatments to…

Neurosurgery May Provide Lasting Relief From Spasticity
 Neurosurgery May Provide Lasting Relief From Spasticity 1024 575 Abbie Miller
By: Abbie Miller

Selective dorsal rhizotomy can provide life-changing results, but patients work hard in physical and occupational therapy to get there. When Sushma Manjunatha watches her daughter sleep, she sees something new. Instead of being tightly curled up, with legs pulled in, her daughter’s legs are stretched out, finally relaxed. This change is the result of a…

In Sight: Three Procedures, One Surgery
 In Sight: Three Procedures, One Surgery 388 320 Jeb Phillips
By: Jeb Phillips

Colorectal Surgery, Urology and Gynecology coordinate to save tissue and time. A child with a complex colorectal and pelvic condition may require several surgeries over months or years before they are able to successfully manage their urine and stool. With advance planning and coordination it can be possible to treat many issues at once and…

A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts
 A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts 1024 575 Abbie Miller
By: Abbie Miller
image of heart with fontan conduit highlighted

A pair of surgeon-researchers is perfecting tissue engineered vascular grafts through bench, clinical and computational modeling studies.

Intervention for Medically Complex Children Improves Health, Saves Money
 Intervention for Medically Complex Children Improves Health, Saves Money 800 533 Kevin Mayhood
By: Kevin Mayhood

The population-based program features coordinated care, education and feeding tube management. A population-based intervention for children with medical complexity in central and southeast Ohio led to fewer admissions, shorter hospital stays and a reduction of inpatient charges of nearly $11.8 million over 30 months, all while making children healthier. Nationwide Children’s Hospital and its affiliated…

The Equity Equation
 The Equity Equation 1024 575 Deena Chisolm, PhD
By: Deena Chisolm, PhD

Deena J. Chisolm, PhD, director of the Center for Population Health and Equity Research at Nationwide Children’s Hospital, applies a health equity approach to improving infant mortality outcomes. Health care quality and outcomes differ by race, ethnicity, wealth and place of residence. In fact, we know that health outcomes such as life expectancy, health-related quality…

Discovery to Drug Development: Expanding the Role of Academic Centers
 Discovery to Drug Development: Expanding the Role of Academic Centers 1024 575 Abbie Miller
By: Abbie Miller

As more researchers at academic centers become involved in drug development, institutions are responding with support and guidance. Researchers at academic institutions regularly make discoveries about disease processes and potential therapeutic agents. Translational medicine is focused on moving these discoveries out of the laboratory and into the clinic where they can potentially help patients. But…

How to Solve Feeding Disorders Without a G-Tube
 How to Solve Feeding Disorders Without a G-Tube 1024 575 Jeb Phillips
By: Jeb Phillips

Babies in a neonatal intensive care unit must have a safe way of receiving nutrition in order to go home. Full oral feeding is ideal, of course. But for those patients with persistent difficulty feeding by mouth, there were two primary options before 2002 to guarantee nutrients by the time of discharge. Both had their…

Human Trafficking: How many victims have you treated?
 Human Trafficking: How many victims have you treated? 1024 575 Abbie Miller
By: Abbie Miller

Data shows that health care providers may be coming into contact with victims and those at risk with more frequency than expected. How many victims have you treated? The answer is probably higher than you think. According to a report published in the Annals of Health Law, 88 percent of sex trafficking survivors reported contact with…

Changes to Medicaid: The Health of 30 Million Children at Risk
 Changes to Medicaid: The Health of 30 Million Children at Risk 150 150 Steve Allen, MD
By: Steve Allen, MD

If we care about children in our city, in our state and in our country, we must care about what happens to Medicaid. Medicaid is critical to the health of our children. That is why those of us in pediatrics are so concerned about the recently proposed American Health Care Act. The proposal, in effect,…

Stronger Together: A Multi-institutional Database Is Connecting Down Syndrome Clinics for Better Outcomes
 Stronger Together: A Multi-institutional Database Is Connecting Down Syndrome Clinics for Better Outcomes 1024 575 Stephanie Santoro, MD
By: Stephanie Santoro, MD

Due to medical advances, people with Down syndrome are living longer than ever before. This increased life expectancy has nearly doubled in the past 25 years. The National Down Syndrome Society estimates that 400,000 people with Down syndrome are living in the United States. Despite this increased life expectancy, little current information on the secondary…

Pediatricians and Subspecialists May Need to Up Their ADHD Game
 Pediatricians and Subspecialists May Need to Up Their ADHD Game 150 150 Kevin Mayhood
By: Kevin Mayhood

From sixth to eighth grade, Stacy Gibson sought out kids he knew had attention-deficit/hyperactivity disorder and bought their Ritalin or Adderall, sometimes by the handful. “I would party all night,then I’d take the pills to get through class. It gave me a rush of energy that I needed,” says Gibson, now 32 and in his…

How Can We Increase the HPV Vaccination Rate?
 How Can We Increase the HPV Vaccination Rate? 150 150 Michael T. Brady, MD
By: Michael T. Brady, MD

Cancer is a terrifying diagnosis for a patient to receive or a doctor to give. So it would make sense that a vaccine proven to prevent cancer would be welcomed by everyone. The human papillomavirus (HPV) vaccine could prevent 28,500 HPV-related cancer cases – cervical, vaginal, vulvar, anal, rectal, penile and oropharyngeal – each year. The Centers…

In Sight: Two Stage Surgery for Epilepsy
 In Sight: Two Stage Surgery for Epilepsy 150 150 Abbie Miller
By: Abbie Miller

Surgery proves to be a viable option for patients with medically refractory epilepsy. Childhood onset epilepsy affects 1 percent of children worldwide. About 25 to 30 percent of these patients will have medically refractory epilepsy, continuing to have seizures despite using two or more antiseizure medications. Options for this group of patients include intercranial epilepsy surgery, Vagus…

A Better Approach to Prescribing Medication
 A Better Approach to Prescribing Medication 150 150 Jeb Phillips
By: Jeb Phillips

A small change in the way a doctor prescribes a medication can make a big difference. Officials from the accountable care organization Partners For Kids use this example all the time: Abilify, a behavioral health drug, is usually priced per pill, not by strength of dose. Two 5 mg pills cost nearly twice the amount of…

Best Practices for Research Recruitment and Retention
 Best Practices for Research Recruitment and Retention 1024 575 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

You can’t obtain study data without participants. From initial design and promotion to communication tactics and patient satisfaction, here are some strategies to ensure success. Advancing pediatric research depends on successful recruitment and retention of study participants. Unfortunately, 9 out of 10 trials end up having to double their original timelines in order to meet…

Childhood Kidney Stones: Their Surprising Connection to Future Disease
 Childhood Kidney Stones: Their Surprising Connection to Future Disease 150 150 Jeb Phillips
By: Jeb Phillips

Once thought to be an adult condition, urinary stone disease is increasingly found in children – and may be related to the development of cardiovascular disease, chronic kidney disease and low bone density. By one well-regarded estimate, the risk of developing urinary stone disease in childhood doubled between 1997 and 2012. That’s worrying enough on…

Harnessing the Immune System: Has the Cure for Cancer Been Within Us All Along?
 Harnessing the Immune System: Has the Cure for Cancer Been Within Us All Along? 1024 575 Abbie Miller
By: Abbie Miller

By learning to manipulate the immune system to target cancer cells, clinician-scientists are ushering in a new era in cancer treatments. The advances in cancer immunotherapy have been headline-making, and some clinical studies have produced stories of near-miraculous recoveries. From the immunotherapy drug credited with curing former president Jimmy Carter’s cancer (pembrolizumab) to the promising…

Changing the Game: Virtual Reality Distracts From Pain, Transforming the Patient Experience
 Changing the Game: Virtual Reality Distracts From Pain, Transforming the Patient Experience 844 487 Gina Bericchia
By: Gina Bericchia

A first-of-its-kind virtual reality experience from the hemophilia team and design experts at Nationwide Children’s Hospital and The Ohio State University distracts patients with an immersive environment of penguins, pirates and hermit crabs during infusions and other procedures. A pilot study is testing the feasibility of integrating the virtual reality technology into the clinic setting.…

How Does Genomic Medicine Become a Reality for Children’s Health?
 How Does Genomic Medicine Become a Reality for Children’s Health? 1024 575 Jan Arthur
By: Jan Arthur
conceptual art of DNA

Perhaps one of the most important initiatives to advance our understanding of pediatric disease is genomic analysis. Genomics encompasses all aspects of understanding the human genetic code, especially how genetic information contained in every human cell can be interpreted to prevent disease and customize treatments for nearly every type of illness. Genomic analysis allows us…

Long Acting Reversible Contraceptives: A First-Line Approach to Prevent Teen Pregnancy
 Long Acting Reversible Contraceptives: A First-Line Approach to Prevent Teen Pregnancy 150 150 Elise Berlan, MD, MPH
By: Elise Berlan, MD, MPH

Unplanned teen pregnancies remain a problem in American society. In the United States, 82 percent of teen pregnancies are unplanned, and the United States has the highest teenage pregnancy rate among high income nations. Despite being highly effective and safe, misconceptions around long acting reversible contraceptives (LARC), such as etonogestrel implants and intrauterine devices (IUDs),…

Uncovering Racial Disparities in Down Syndrome
 Uncovering Racial Disparities in Down Syndrome 1024 575 Stephanie Santoro, MD
By: Stephanie Santoro, MD

Life expectancy for people with Down syndrome varies depending on race, but why? An estimated 6000 infants with Down syndrome (DS) are born in the United States annually, making it the most common liveborn trisomy and chromosomal condition.[1] And a significant increase in overall life expectancy has been noted over the last several decades.[2] However,…

Creating the Patient-Centered Medical Neighborhood
 Creating the Patient-Centered Medical Neighborhood 1024 575 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

How do we create a more integrated healthcare delivery system to improve outcomes in our community? The Agency for Healthcare Research and Quality (AHRQ) conceptualizes the medical neighborhood as a patient-centered medical home (PCMH) and the network of other clinicians providing health care services to patients within it, along with community and social service organizations, as well…

Using Social Media to Advance Care
 Using Social Media to Advance Care 150 150 Nationwide Children's
By: Nationwide Children's

As the use of social media has grown, so has the medical community’s understanding of how it can be harnessed for health care. From collaborating with peers and educating the public to building your career, physicians have a growing responsibility and growing presence in the social media arena. David R. Stukus, MD Section of Allergy…