News Room Clinical Innovations

6-year-old Boy Receives "Bloodless" Heart Transplant at Nationwide Children's Hospital

Tue, 05 Jul 2011 06:00:00 -0400

Between injuries from severe storms that ripped across the country this spring, to the typical blood donation shortage seen each and every summer, experts say that the nation’s blood supply is running low. At Nationwide Children’s Hospital, doctors are helping to offset that demand by what’s known as “bloodless” techniques.

In December 2010, Nationwide Children’s performed its first bloodless heart transplant on a 6-year-old boy from New Jersey. On that day, Andrew Craver became one of the youngest patients known to have a successful bloodless heart transplant, and at one of only a few pediatric institutions that has the resources to perform it.

Mark Galantowicz, MD, FACS, chief of Cardiothoracic Surgery at Nationwide Children’s, led the bloodless heart transplant on little Andrew, and said that it took an entire team dedicated to blood conservation before, during and after the surgery that made it successful. It was that team approach that helped Andrew get back to being an energetic kid.

“We not only conserve blood when a patient family makes the request, but we do so during all procedures and surgeries here at The Heart Center,” said Dr. Galantowicz, co-director of The Heart Center at Nationwide Children’s Hospital, and also a faculty member of The Ohio State University College of Medicine. “It takes an entire team – from pre-op nurses to anesthesiologists and perfusionists to post-op nurses – to achieve a successful bloodless outcome. It also takes a team with the experience of a systematic approach of always trying to achieve a bloodless outcome no matter the case.”

The bloodless transplant was a religious preference for Andrew’s father and mother, Ian and Rachel Craver, of North Cape May, New Jersey, with the philosopy behind it to avoid the need for blood transfusions.

“When the body is introduced to something foreign (e.g. a blood transfusion), it stimulates the immune system resulting in an inflammatory response,” said Dr. Galantowicz. “With that inflammatory response, the body swells and there is risk for infection. To reduce that risk and swelling, a bloodless procedure is always the goal for my team no matter the case.”

Some of the techniques imployed by Dr. Galantowicz and his team include limiting how much blood they take for testing pre-operatively; using a machine known as a ‘cell saver’ during the procedure which captures shed blood, processes it and puts it right back into the body; and utilizing modified tubes and heart/lung bypass machines which have smaller components to reduce the neccessity of blood.

Andrew’s case – a heart transplant – presented the ultimate challenge for the team in blood conservation as the body needs to react to an entirely new organ. And seven months later, Timothy Hoffman, MD, medical director of the Heart Transplant and Heart Failure Program at Nationwide Children’s, couldn’t be happier with Andrew’s outcome.

“We (The Heart Center at Nationwide Children’s Hospital) had been involved in Andrew’s care since he was just 3-years-old,” explained Dr. Hoffman, also with The Ohio State University College of Medicine. “He presented to us with a condition known as dilated cardiomyopathy in which the heart is weakened and enlarged. We managed Andrew with medications and close monitoring, however, eventually his heart failure worsened despite maximal outpatient therapy. It was then, the end of 2010, that Andrew was placed on the heart transplant waiting list. And, today, Andrew is back to being an active 6-year-old full of energy.”

Studies have shown that using a patient’s own blood cuts infection rates by more than half. Dr. Galantowicz says transfusions are still mostly safe and are needed in many cases, but he would like to see more surgeons try to treat patients with as few transfusions as possible.

The Heart Center at Nationwide Children’s Hospital is a world-class diagnostic, treatment and research facility for pediatric and adult patients with all forms of congenital heart disease and acquired cardiomyopathy. The Heart Center consolidates all cardiology and cardiothoracic surgery services into a comprehensive model for family-centered care and convenience, and is a comprehensive “one-stop” center for care, education and research. The Heart Center is prepared to treat patients from 0 to 100 years of age with experts in all areas of surgical and medical subspecialties.

Catheterization Recommended for Treating Pediatric Heart Conditions

Wed, 04 May 2011 11:15:00 -0400

Doctors should consider using catheterization as a treatment tool in addition to its established role in diagnosing children with heart defects, according to a new American Heart Association scientific statement.

A catheter is a thin flexible tube inserted into a blood vessel and used in procedures such as angiography, in which physicians use the catheter in inject dye into the arteries near the heart to illuminate the vessel via X-ray technology. It can also open a valve, enlarge a narrow blood vessel, close a hole in the heart or close off a blood vessel.

The statement, published in Circulation: Journal of the American Heart Association, is a major overhaul of the association’s last statement released in 1998.

“What we can offer patients now, versus just 10 or 15 years ago, is remarkable different,” said lead author, Timothy F. Feltes, MD, chief of Pediatric Cardiology and co-director of The Heart Center at Nationwide Children’s Hospital. “There have been tremendous advances in the procedures, devices, experience and the expertise of the physicians who perform the procedures. As physicians caring for patients with congenital heart disease, we have to look at heart catheterizations a little differently than we have in the past.”

The statement provides an extensive inventory of diagnostic and interventional techniques that are now considered as options for pediatric patients, noting that catheterization procedures carry a degree of risk for patients.

Some of the 22 new therapeutic options for congenital heart disease include catheter-based techniques to improve blood flow through the heart; repair inborn heart defects such as holes in the heart, repair or replace faulty valves; remove arterial blockages and many other conditions, such as malformed heart chambers.

In addition, the statement covers several hybrid procedures that use traditional surgical techniques in combination with catheterization for treating conditions such as hypoplastic left heart syndrome (severe under development of the left side of the heart), stent implementation (to widen arteries and keep them open) and others.

“The take-home message of this statement is that there are numerous condition that are best served by interventional catheterization procedures,” said Dr. Feltes, also chief of pediatric cardiology and professor of pediatrics at The Ohio State University College of Medicine.

The statement is key to cardiologists who treat pediatric defects, because there are few other sources of such information. “By virtue of the relatively small number of children and adolescents with congenital heart disease, it is difficult to design clinical trials. Ideally, you need thousands of patients to compare one treatment versus another. Only one child in 100 is born with heart disease, so it is very unlikely that one center will have more than one patient to do a side-by-side comparison,” said Dr. Feltes.

The Society for Cardiovascular Angiography and Interventions and the American Academy of Pediatrics endorsed the statement.

The Ohio State University Medical Center Testing New Approach for Aortic Valve Stenosis

Wed, 06 Apr 2011 14:00:00 -0400

A new approach to aortic valve replacement holds promise for better outcomes and more treatment options for patients who are considered inoperable today.

The cardiothoracic surgery and interventional cardiology teams at The Ohio State University Medical Center are participating in a randomized clinical trial comparing the safety and efficacy of a catheter-based delivery system to traditional open heart surgery for the treatment of patients with aortic valve stenosis. The procedure, performed at Ohio State’s Richard M. Ross Heart Hospital, is only available for patients considered a “very high risk” or “extreme risk/inoperable” for conventional surgery requiring cardiopulmonary bypass.

“Surgical aortic valve replacement currently is the only effective treatment for patients with severe aortic valve stenosis,” says Dr. Juan Crestanello, a cardiothoracic surgeon at Ohio State’s Medical Center and the local principal investigator with Dr. John P. Cheatham, director of interventional cardiology at Nationwide Children’s Hospital and a professor of pediatrics and internal medicine, cardiology, at The Ohio State University College of Medicine. “Some patients are poor candidates for surgery due to age, frailty or some other complicating medical condition. This new approach provides another option for those patients,” adds Crestanello.

The new approach, in which pig tissue is formed into a valve, allows a catheter to be inserted into the leg or arm artery through which the new valve is implanted – without the use of cardiopulmonary bypass.

Enrollment of patients in the transcatheter group is expected to be completed within 18 months, with all trial patients being followed for five years. Screening studies include echocardiograms, CT angiograms of the thoracic and abdominal aorta and a cardiac catheterization to rule out significant coronary artery disease.

Patients locally are evaluated at the Ross Heart Hospital’s Heart Valve Clinic. According to Crestanello and Cheatham, this is beneficial since it provides comprehensive evaluation of patients with valvular heart disease in a single setting to achieve maximum efficiency and create a convenient patient experience. The clinic also offers multidisciplinary evaluation by physicians specialized in advanced imaging technologies, cardiac hemodynamic and coronary interventions, and anesthesia.

Aortic valve stenosis occurs when the aortic valve narrows, preventing blood from flowing properly into the aorta and the rest of the body. The heart’s left ventricle must work harder than normal to pump blood, which can lead to symptoms such as fatigue, fainting with exertion, difficulty catching your breath, abnormal heartbeats and chest pain. Problems with valves can be a cause of heart failure.

Among the causes of stenosis are changes due to aging with calcification of the leaflets, congenital abnormality of the valve, and infections in the heart such as rheumatic fever and endocarditis. Aortic stenosis is common among elderly patients and leads to significant deterioration of functional status and ultimately limits survival.

This multi-center CoreValve U.S. Pivotal Trial is sponsored by Medtronic, Inc., Minneapolis, MN. Ohio State is one of 40 sites in the United States participating in this study.

Nationwide Children’s Hospital Unveils Clinical Interiors of New Main Hospital Set to Open in June 2012

Wed, 15 Dec 2010 06:00:00 -0500

Recently, Nationwide Children’s Hospital unveiled publically for the first time the clinical interiors of its new main hospital – the centerpiece of its six-part master facilities plan. On target to open in June 2012, Nationwide Children’s is undergoing the most expansive pediatric healthcare construction project ever undertaken. When complete, the hospital will add one million square feet of clinical and research space to the existing two million square feet; add an additional 2,400 hospital and research jobs; and generate a projected $1.3 billion in new regional economic activity. Once the new facility is open, and renovations have been made to the existing hospital, it will house 460 patient beds.

“Much is changing with Nationwide Children’s campus, but the hospital is still very much grounded in our founding mission,” said Abigail Wexner, Chair of Nationwide Children’s Hospital Board of Directors. “When the new hospital opens in 2012, we will build upon what has always been our key driver – to provide unrivalled pediatric care, and to not only those who seek our care, but beyond our four walls, helping the children of our community reach their optimal health.”

The six key areas of growth in the 2012 plan include a 12-story, 750,000 square foot new main hospital; a six-acre front lawn and green space that will complement Livingston Park; a LEED-certified silver central energy plant; expanded parking with the Livingston Avenue garage (more than 1,500 parking spaces) and the two-story underground parking garage located beneath the front lawn and connected via tunnel to the new tower (more than 400 spaces); a clinical research building that houses the Surgery Center, the Center for Digestive Disorders, GI procedures and clinical psychology as well as two floors dedicated to research; and an expanded West campus that includes a 225,000 square foot research facility known as Research III.

“Nationwide Children’s Hospital is expanding to meet the need of the patients and families we serve right here in our community and across the entire country,” said Steve Allen, MD, chief executive officer of Nationwide Children’s Hospital. “Currently, we see more than 900,000 patients every year. That number will exceed one million patient visits by 2012. Our master facilities plan will allow us to lead the country in providing the best possible health outcomes for the children and families we serve.”

The new main hospital features a healing environment full of comforts and positive distractions for patients, families and staff including multimedia centers in the patient room, educational exhibits and niches with fun animal facts in hallways, views of the outside with large windows and custom furniture for family and patient comfort.

Overall design concepts and elements in the new main hospital center on nature – bringing the outside inside – promoting natural healing. Whimsical forest-friendly animals are incorporated, and a softened look utilizing a warm, glowing color palette is reflected throughout.

Research has shown that exposure to sunlight improves sleep, reduces depression, enhances patient mood, speeds recovery, improves staff productivity and can even reduce lighting expenses. Therefore, every room has a large window allowing natural daylight into the room that will help patients recover by reducing anxiety and associated complications.

Patient rooms and corridors are equipped with sound-absorbing materials to reduce ambient noise. Studies have shown that this supports better sleep and less stress for patients, families and caregivers, while creating a safer environment for the delivery of care. Every patient room in the hospital will be private, reducing the chance of infection and potential errors, enhancing sleep and supporting family inclusion. Also, patients and their families will have control of lighting and thermal comfort systems in their rooms.

The standardization in rooms and unit layout will reduce variability in configurations, increase safety through standardization of clinical support amenities as well as patient movement in the room, ease orientation to units, reduce frustration and stress and enhance facility flexibility for future utilization.

Patient rooms will …

Be private with a full bathroom – tub and shower combo – large enough to accommodate the patient’s caregiver.
Nearly double in size to 300 square feet, and have sleeping accommodations for two visitors with a sleeper sofa and trundle bed and a glider recliner that was specifically designed for the hospital.
Feature a LED color-changing head wall that can be controlled by the patient from their bed – “mood lighting” for kids.
Have a 42-inch flat screen TV.
Have increased storage with shelves for personal display items, and a dedicated locked drawer for patient/family valuables.
Have walls with magnetic paint allowing for artwork, get-well cards, etc. to be displayed.
Come equipped with technology that will support patient identification safety initiatives for medication delivery (bar-coding) and various procedures.
Have ceiling-mounted lifts for movement of patients that provide increased safety for both patients and staff. They will be located in all rehabilitation rooms and in other select patient rooms throughout the facility.
Include isolation supplies, frequently accessed supplies and patient medication in secured cabinets located right outside the patient room.
Have a staff workstation right outside the room so observation and documentation by the nurse can occur without disturbing the patient/family unless necessary.

Critical/intensive care rooms have …

The latest technology to optimize clinical practice and patient safety. For example, a hand held “light stick” allows staff to remotely direct surgical lights for critical procedures and vital patient care.
Overhead service booms that house medical gases, power and data in order to maximize the flexibility and positioning of the bed.
Secured medication pass-through that allows pharmacists to deliver patients’ medications to a locked cabinet from the hallway while the caregiver can then access these medications from inside the patient room. This will support efficiency and patient safety.
Small bathrooms (no shower); our current critical care rooms do not have bathrooms.
Internal windows allowing for staff to view both patients in adjacent rooms at one time in order to maximize clinical care and safety. These windows house mini-blinds to support patient and family privacy when the window is not in use by staff.
Increased storage for families with armoires and cabinets.

Emergency Department and Trauma Suites

Nationwide Children’s Emergency Department, Ohio’s first Level 1 Pediatric Trauma Center, will nearly double in size from 24,000 square feet to 40,000 square feet with an increase of patient exam rooms from the current 39 to 62 general exam and specialty care rooms.
The current emergency department treats more than 70,000 visits a year in spaces originally designed to see far less. The new facility will support rapid throughput, enhanced patient experiences and allow for continued growth.
Current and future trauma rooms allow for family inclusion and appropriate support staff for the family.

Nurse stations are …

Strategically located around the patient care unit. These more centralized work stations will support the collaboration of multiple disciplines that are vital to patient care and unit function. Centralized staff design promotes the family’s ease of accessing their patient caregivers.
Built with acoustic ceiling tiles that decrease the noise associated with natural gathering locations which could potentially minimize the risk of error.
Designed to be neat and orderly with monitors mounted on the wall to maximize work space and desk area.
In addition, centralized medication rooms are located right next to nurse stations. Every unit will have a standardized configuration making inventory and stocking practices efficient and safe. This also benefits unit orientation and efficiency for those caregivers who support multiple patient units.

Hospital Corridors

Reception spaces and elevator lobbies will welcome patients and visitors with expansive views of nature design elements.
Way finding is assisted by graphic applications throughout the facility. Visitors will be instructed to follow color paths to their destination. These destination points along the path will also be color-coded.
Terrazzo flooring will be placed throughout the main floor of the building.
The first floor has acoustic ceilings to decrease ambient noise.

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The Mock Rooms
In a facility near its downtown campus, the hospital has been testing everything from color palettes and furniture design, to patient room layout and Emergency Department (ED) trauma suite functionality in new hospital mock rooms. The mock space has been a cost-saving measure. Hundreds of staff including nurses and doctors and more importantly, patient families, toured the rooms and gave their feedback. Based on their valuable input, numerous changes were made and incorporated in the mock rooms, saving the hospital time and money it would have taken to make those adjustments in the new hospital.

For example, a mock trauma was staged in the ED trauma suite to test the functionality of the entire emergency team making sure equipment placement and room layout was optimized. Also, patients and families involved in the hospital’s teen and parent advisory councils were very vocal about details, such as the amount of storage and the bathtub design in the private patient rooms.

Examples of key learnings from the mock rooms include:
From parents/patients

More storage space for personal items in patient rooms
Changes to the bathtubs in patient rooms
Changes to the sleeper/sofa and glider/recliner in patient rooms

From staff

Reconfiguration of placement of gases on head walls
Built-in shelving in empty spaces of the patient room bathroom for storage of patient care items like the urinal
Redesign of nurse station
Wall-mounted storage bins in medication rooms

The current mock rooms are slated to be taken down in May 2011 to make room for build-out and parking of the Research III building, which is currently under construction. In early 2011, eight rooms will be constructed in the new main hospital. This will support furniture and clinical fit-up, confirmation of configurations, technology and applications, and allow for early staff orientation and preparation. These eight mock rooms in the new main hospital will include a typical acute care inpatient room, critical care room, ED exam room, medication room, family lounge/consultation room, multi-disciplinary work station (also known as a nurse station), standard utility room and telecommunications server room.

Pilot Study Supports Adolescent Diabetes Patients through Personalized Text Messages

Thu, 29 Jul 2010 08:00:00 -0400

Jennifer Dyer, MD, MPH, an endocrinologist at Nationwide Children’s Hospital, has developed and completed a pilot study that uses weekly, customized text messages to remind adolescent diabetes patients about their personal treatment activities. At the conclusion of the study, Dr. Dyer found an increase in overall treatment adherence and improved blood glucose levels.

Dr. Dyer began developing this pilot study after realizing the potential of a simple reminder, in the form of a text message, which can be sent to her teenage patients. During the study, she sent personalized questions and reminders specific to diabetes adherence activities in addition to friendly, supportive messages to her patients. By asking questions about glucose testing, meal boluses and frequency of high and low glucoses, Dr. Dyer has seen an increase in teens taking their medications.

“If adolescent diabetes patients do not adhere to their treatment and medication plan, it can result in difficulty concentrating in school or functioning throughout the day,” said Dr. Dyer, also an assistant professor of Pediatrics at The Ohio State University College of Medicine. “Excellent control and treatment can have a long term positive effect on a patient with diabetes.”

The average teen sends about 50 texts each day while 75 percent of teen cell phone users have a cell phone plan with unlimited texting capabilities. Studies have shown that adolescent patients have a greater difficulty adhering to treatment and medication activities than adults. Thus, there is a significant correlation between increased independence and decreased treatment adherence in adolescents. The rate of medication non-adherence among adolescent recipients is approximately four times higher than that among adult recipients.

“This form of communication allows for real-time health management which is extremely valuable for patients that suffer from a chronic illness like diabetes,” said Dr. Dyer, also a principal investigator in The Research Institute at Nationwide Children’s Hospital.

Due to the success of this study, Dr. Dyer has applied for an internal grant in order to test an iPhone application that she has developed. This application will allow endocrinologists to send personalized, yet automated texts to multiple patients at a specific time.

Gastric Sleeve Surgery Now Offered at Nationwide Children’s Hospital

Thu, 13 May 2010 14:00:00 -0400

A new weight reduction surgical option is now available through the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital. The newest surgical weight loss procedure offered by the Center is the “gastric sleeve,” named as such because a large part of the stomach is removed and the remainder is closed to make a tube-like “sleeve.” The narrow and smaller stomach results in good weight loss by limiting daily food intake, but without the risk of losing vitamins and minerals or the likelihood of diarrhea that can be a problem with gastric bypass surgery. In addition, the gastric sleeve procedure takes less than half as long as gastric bypass and complications after surgery appear to be less common, too.

The gastric sleeve procedure has been gaining popularity among the morbidly obese adult population seeking surgical intervention and there are only a small number of pediatric centers in the U.S. performing this operation for morbidly obese adolescents.

Following surgery, the rate of weight loss from the gastric sleeve procedure seems to fall between the very rapid loss from gastric bypass and the much more gradual loss following the adjustable LAP-BAND® surgery. One feature of the gastric sleeve is that if in the future the weight loss is not acceptable, an option exists to convert the sleeve to a full gastric bypass by creating a small stomach pouch and attaching it further down the small intestine. This results in the decreased absorption of food that is one of the two main ways that the bypass works to cause weight loss. The other, of course, is the smaller stomach to limit intake of calories.

Weight reduction surgery is not advisable for all overweight people, but it does offer an option to those people who have not been able to maintain weight loss through dieting. Typically, those who qualify for weight reduction surgery must be at least 100 pounds over ideal body weight, have a documented attempt to lose weight by following a medically supervised diet for at least 6 months and undergo a comprehensive medical evaluation with the physicians at Nationwide Children's Hospital. Surgical patients must understand that following surgery it will be imperative to maintain an exercise program, limit food amounts and change the types of foods that are eaten. The amount of weight loss and the ability to keep it off depends on how well patients follow the diet and exercise program after surgery.

The Center for Healthy Weight and Nutrition also offers the open gastric bypass surgery in which the surgeon makes a single incision in the abdomen to access the stomach, the laparoscopic gastric bypass surgery in which much smaller incisions are made, and the less invasive LAP-BAND® surgery in which a special band is placed around the top of the stomach during surgery to restrict the amount of food intake.

The Center for Healthy Weight and Nutrition offers families a comprehensive approach to weight management with programs for both the prevention and treatment of overweight children. Additional information is available at http://www.NationwideChildrens.org/HealthyWeight or by calling 614-722-4824.

Nationwide Children’s Hospital Sees Rise in Children with Pseudotumor Cerebri; Opens Clinic to Treat These Unique Patients

Thu, 29 Apr 2010 07:00:00 -0400

While most headaches in children can be treated with over-the-counter pain medications or lifestyle changes, it is important to pay attention to their symptoms in case they herald something more serious.

Doctors at Nationwide Children’s Hospital are at the forefront of treating a disorder that causes headaches called pseudotumor cerebri. This disorder is characterized by chronically increased pressure inside the head in the absence of a brain tumor. The name of the condition derives from the similarity of its symptoms to those of a brain tumor. If left untreated, pseudotumor cerebri typically causes continued headaches and often leads to permanent visual loss in children.

“The diagnosis of pseudotumor cerebri in children has increased dramatically in recent years,” said E. Steve Roach, MD, Chief of Neurology and Vice-Chair of Pediatrics at Nationwide Children’s Hospital and professor of Pediatrics and Neurology at The Ohio State University College of Medicine. “While the exact prevalence of pseudotumor cerebri in children is unknown, researchers suspect that the rise in childhood obesity coupled with increased awareness of the condition has led to more diagnoses.”

Most patients who suffer from this disorder are overweight, but about a third of the children are not obese. Pseudotumor cerebri is typically suspected after a child with headaches is found to have optic nerve edema. The diagnosis is confirmed after a brain scan eliminates a tumor and after the pressure elevation is confirmed. Once the diagnosis is confirmed, the child’s visual function is closely monitored and any underlying risk factors are eliminated. While medications are typically administered to relieve the pressure, surgical procedures to lower the intracranial pressure or to prevent pressure damage of the optic nerve are prescribed as needed.

“Nationwide Children’s is leading the response to this trend with the development of a multidisciplinary clinic for the specialized diagnosis, treatment and on-going care of these unique children,” said David Rogers, MD, an ophthalmologist at Nationwide Children’s Hospital. “We encourage early referral of any child with optic nerve edema or other signs of pseudotumor cerebri.”

The physician team at Nationwide Children’s introduced the first pediatric Pseudotumor Cerebri Clinic in the United States that provides comprehensive care by an array of disciplines including child neurology, ophthalmology, nutrition and referrals as needed to pediatric neurosurgery and endocrinology. Currently, physicians at Nationwide Children’s are treating about 80 children with pseudotumor cerebri. The clinic, which officially launched in March 2010, is treating patients who have shown common symptoms like those of headaches and vision loss. The loss of vision can be rapid or insidious, and the severity of headaches or other symptoms does not reliably correlate with the risk of visual loss.

Nationwide Children’s supports research into the disorder in The Research Institute at Nationwide Children’s Hospital and The Ohio State University College of Medicine as an academic partner. The clinic is managed by board certified child neurologists and board certified pediatric ophthalmologists.

Pacemakers Used to Help Children with Stomach Problems

Mon, 03 Aug 2009 00:00:00 -0400

Physicians at Nationwide Children’s Hospital in Columbus, Ohio are turning to a device typically used in adults with heart problems to help children with severe stomach conditions.

In June, surgeons implanted a pacemaker in a 16-year-old patient with gastroparesis, a debilitating stomach condition that affects the way the body processes food. This is the first time the procedure has been performed in a child at Nationwide Children’s Hospital, which is now one of only a handful of institutions across the country offering this type of treatment in children.

Gastroparesis is a condition where the stomach contracts less often and less powerfully, causing food and liquids to stay in the stomach for a long time. In as many as 60 percent of children with gastroparesis, the cause is not known. The condition often leaves children feeling constantly bloated and nauseated and can result in malnourishment and significant weight loss. In severe cases, symptoms may prevent children from attending school or taking part in other daily activities.

The pacemaker is inserted into the abdomen, with electrical wires leading to the stomach. It sends electrical impulses to stimulate the stomach after eating.

"The pacemaker is surgically implanted under the skin and is connected to two electrodes placed on the stomach wall. It tells the stomach to empty at a certain frequency. The initial settings are fairly low and, as with a pacemaker in the heart, we can change the settings as needed,” explained pediatric surgeon Steven Teich, MD, surgical director of the Bariatric Surgery Program at Nationwide Children’s Hospital and clinical assistant professor of surgery at The Ohio State University College of Medicine. “It empties the stomach, alleviating bloating, vomiting and nausea.”

Gastroenterology, Hepatology and Nutrition at Nationwide Children's Hospital is one of the leading programs in the country in the field of diagnosing and treating gastrointestinal motility problems in children. It is the only children’s hospital in the nation that offers the full spectrum of treatment options for motility disorders, including diagnosis, medications, endoscopic procedures, surgical options, pacemakers and follow up care.

Pacemakers have been used for years in adults with delayed gastric emptying. Nationwide Children’s received IRB approval to implant the device in children as a humanitarian device exemption (HDE), and although this is a new procedure in children and adolescents, doctors at Nationwide Children’s say the early results are promising.

“In patients who have received this type of treatment, nearly all symptoms were resolved within two weeks,” said pediatric gastroenterologist Hayat Mousa, MD, medical director of the Motility Center at Nationwide Children’s Hospital and associate professor of Clinical Pediatrics at The Ohio State University College of Medicine. “Previous treatment options, including medications, have been much less effective.”

Transition Program Aims to Provide Life-Long Cardiac Care for Adolescents with Congenital Heart Disease

Mon, 02 Feb 2009 00:00:00 -0500

Congenital heart disease (CHD) – being born with a heart defect – is the most common birth defect in the United States affecting one out of every 120 babies. Because of major advances in medical and surgical care, more than 90 percent of these patients are living into adulthood. Today, there are more than one million adults living with CHD, and less than 5 percent of them are receiving the specialized cardiac care they need.

“Many times when we do see adults with congenital heart disease come back to care, it’s during a crisis situation,” explains Curt Daniels, MD, cardiologist and director of the Adult Congenital Heart Disease program at Nationwide Children’s Hospital. “These adults come back with heart failure, or with an arrhythmia [abnormal heart rhythm] that could be life threatening.”

Dr. Daniels, also an associate professor of Cardiology at The Ohio State University College of Medicine, and a team of physicians in The Heart Center at Nationwide Children’s Hospital recognized the need for a seamless, gradual transition for their adolescent CHD patients and through the Adolescent and Adult Congenital Heart Disease program, developed the Transition Program – a patient education program that aims to successfully transition adolescents to continue specialized cardiac care.

Physicians believe that these adolescent patients are simply not continuing their care to adult congenital cardiac clinics for several reasons. This often occurs after 18 years of age when many patients leave their parents’ home for work or college. Pediatric cardiologists are trained in CHD and understand the anatomy and special needs of children born with heart defects. Adult cardiologists receive little or no training in CHD. As these patients become adults, they may develop new problems and should continue to be followed by a congenital heart specialist to keep their heart healthy.

John Wheller, MD, cardiologist at Nationwide Children’s, believes that parents play an integral role in helping to educate their child with CHD about the importance of life-long care. “I have worked with many of our current adolescent [congenital heart disease] patients since childhood. With the Transition Program, I know that they will not be lost to such care once they move away from home and enter the next phase of their lives.”

The Transition Program at Nationwide Children’s targets patients 15-17 years of age. It provides education regarding the importance of life-long cardiac care and an understanding of critical lifestyle choices to consider as an adult living with CHD including exercise, career/job counseling, medication coverage, health and life insurance, symptoms of concern, nutrition, local and national support groups and psychosocial issues, etc. The time at which a patient is transitioned to an adult congenital heart specialist is up to the cardiologist and the patient. There is no set age as every patient has different circumstances and may need more time than others before changing physicians.

Nationwide Children’s is also partnering in a first ever, multi-center study of adults with CHD led by the Adult Congenital Heart Association (ACHA). The two-year study, funded by the National Institutes of Health, will seek to determine why these patients become lost to care and how best to reach out to them.

The Heart Center at Nationwide Children's Hospital Opens First Hybrid Congenital Cardiac Operating Suite in U.S.

Mon, 12 Nov 2007 00:00:00 -0500

The innovative spirit of the cardiothoracic surgery and interventional cardiology teams in The Heart Center at Nationwide Children’s Hospital have come together again to bring technology first developed in its Hybrid Catheterization Suites to a state-of-the-art operating suite – the first Hybrid Congenital Cardiac Operating Suite in the U.S.

This operating suite is designed specifically around the cardiac surgeon and cardiac surgical patient, offering new advanced access and imaging in an operating room environment. The suite accommodates the collective catheterization and surgery team, and facilitates rapid information sharing with new technology from TOSHIBA Medical Systems and Maquet Surgical Workplaces.

The Hybrid Congenital Cardiac Operating Suite features:
*More than 900 square feet of working space to accommodate the team involved in a hybrid case (surgeons, interventional cardiologists, electrophysiologists, echocardiographers, cardiac anesthesiologists, advanced level nurse practitioners, physicians’ assistants, cath/O.R. nurses, technicians and perfusionists).

*A surgical theater with a fixed base surgical table, modutec booms and surgical lighting from Maquet Surgical Workplaces, allowing for more precise and consistent imaging, as well as greater flexibility without taking up critical floor space.

*Flat Panel Detectors (FPD) from TOSHIBA America Medical Systems for a better quality picture which facilitates more accurate assessment and diagnosis.

*Technical capabilities that allow staff members the ability to transmit information anywhere in the suite, at remote sites within the hospital, or even to countries around the world, enabling Nationwide Children’s Heart Center faculty to consult with physicians in distant countries and to serve as a teaching hospital.

*Nine interconnected, flat panel, high-resolution display screens for superior visualization and better information exchange among the team members; at least two monitors are visible to all team members at any time, from any location.

*A non-sterile control/observation room to serve as an educational and training resource for students, staff and faculty.

The Hybrid Congenital Cardiac Operating Suite can accommodate any cardiac surgical case, catheterization or collaborative hybrid procedure. Cardiothoracic surgeons and interventional cardiologists working together in this suite will reduce the amount of time required to correct a heart problem and the amount of emotional and physical stress placed on a patient or their family – which translates into less pain, less scarring and a faster recovery time for patients.

The Nationwide Children’s Hospital Heart Center was established in 2002 when all Cardiology and Cardiothoracic Surgery services were consolidated into a comprehensive “one-stop” model of patient/family convenience and excellence in patient care, education and research. The Heart Center opened the nation’s first Hybrid Cardiac Catheterization Suites in 2004 in an innovative new approach to cardiac care, whereby the benefits of cardiothoracic surgery and interventional cardiology were combined in two suites to help critically ill children and adults with congenital heart disease achieve improved therapeutic outcomes. These facilities harness state-of-the-art technology that allows surgeons and interventionalists to collaboratively perform a wide range of innovative hybrid procedures. In 2005, the existing imaging equipment in these suites was replaced by the world’s first 5 Axis Biplane Positioner with Flat Panel Detector (FPD) imaging, permitting surgeons and interventionalists to view images more clearly, as well as to improve access to patients. The Heart Center opened its 100-seat Telemedicine Center in 2004, facilitating transmission of any image from inside the Hybrid Cardiac Catheterization Suites and the Hybrid Congenital Cardiac Operating Suite to provide educational opportunities toward advancement of congenital heart disease treatment strategies.

The new Hybrid Congenital Cardiac Operating Suite and the Hybrid Cardiac Catheterization Suites deviate from traditional cardiac care delivery by allowing surgical and interventional catheterization procedures to be performed by a single interdisciplinary team in one setting. This approach supports enhanced patient outcomes through shorter and safer procedures that require less recovery time and rehabilitation. The expansive suites accommodate the collective catheterization and surgical teams, and facilitate rapid information.

Congenital heart defects are present in about one percent of live births. While most often scientists are unsure of how a patient contracted a specific defect, advancements in pediatric cardiac care -- such as the hybrid procedures performed at Nationwide Children’s Hospital Heart Center -- are changing treatment options to help children live healthy, normal lives.

The first procedure performed in the Hybrid Congenital Cardiac Operating Suite occurred in November 2007 and the first procedure in the Hybrid Cardiac Catheterization Suites took place in May 2004. Both procedures were conducted to treat Hypoplastic Left Heart Syndrome.

Ranked in the top 12 on U.S.News & World Report’s 2007 list of “America’s Best Children’s Hospitals,” Nationwide Children’s Hospital is one of the nation’s largest pediatric healthcare networks providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children, adolescents and adult patients with congenital disease. A medical staff of nearly 900 and a hospital staff of 6,000 provide state-of-the-art pediatric care for more than 700,000 patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s Hospital physicians train the next generation of pediatricians and pediatric specialists. The Research Institute at Nationwide Children's Hospital is one of the top 10 National Institutes of Health-funded free-standing pediatric research facilities. In honor of a $50 million transformational philanthropic gift from Nationwide Foundation, Columbus Children’s Hospital became Nationwide Children’s Hospital September 24, 2007. This renaming reflects the hospital’s national stature while staying true to the original mission since its founding in 1892 of providing care regardless of any family’s ability to pay. More information is available by calling (614) 722-KIDS (5437) or through www.NationwideChildrens.org.

NOTE TO MEDIA REPRESENTATIVES: EFFECTIVE 9/24/2007, COLUMBUS CHILDREN'S HOSPITAL BECAME NATIONWIDE CHILDREN'S HOSPITAL. TO ENSURE YOU CONTINUE TO RECEIVE MEDIA MESSAGES, PLEASE UPDATE YOUR ADDRESS BOOK WITH OUR NEW E-MAIL ADDRESS - info@media.nationwidechildrens.org

Virtual Reality Games Used to Distract Young Burn Victims from Pain and Anxiety

Fri, 28 Sep 2007 00:00:00 -0400

Nurses and physicians at Nationwide Children’s Hospital are using the latest technology to help young burn victims endure the extreme pain of dressing changes and wound care. Instead of traditional distraction devices, such as books and music, Nationwide Children’s Hospital Burn Center is now using virtual reality games to distract patients while nurses attend to the patients’ burn wounds.

“It’s long been known that the actual treatment for a burn is far worse than the actual injury. Initially, the wound has to be cleaned and the dressing applied, and that can be a very painful and lengthy procedure,” said Catherine Butz, PhD, a psychologist at Nationwide Children’s Hospital and an Assistant Professor at The Ohio State University College of Medicine.

Following this initial treatment, patients must endure subsequent wound care procedures, some of which can be both extensive and painful, depending on the extent of the burn. During these procedures, anxiety often plays a major role in the patient’s pain level.

“Research shows a very strong connection between anxiety and pain,” said Dr. Butz. “Distraction does a great job in decreasing any kind of anxiety that might be associated with the anticipated procedures, so by distracting patients and keeping anxiety at a minimum, procedures tend to go much more smoothly and be much less painful for the child.”

The device, made possible by a donation from the Aladdin Shriner’s Hospital Association for Children, allows patients to escape into a computer-generated world complete with its own environment, creatures and sounds. Patients wear a virtual reality helmet, and once in this new world, they interact in the virtual environment with the help of child life specialists, trained to assist kids through stressful medical treatments.

Since Nationwide Children’s Hospital began using the device in May 2007, it has already resulted in positive feedback from burn patients. Burn nurses report several patients have noticeably improved in terms of their ability to tolerate dressing changes.

In order to better understand the effect on pain, doctors at Nationwide Children’s have launched a study to compare the results of virtual reality pain distraction with traditional distraction techniques, such as watching television, listening to music, counting and deep breathing. Patients will be randomly assigned to receive virtual reality or another pain distraction technique. Following the procedure, they will be asked to gauge their level of pain on a scale of zero to 10. The study will also assess the perspectives of parents and nurses in terms of the child’s pain and level of distress.

The burn program’s goal is to be able to better engage the child in a distraction activity which will hopefully have a beneficial affect on the procedure. An added benefit for patients may be a decrease in the amount of pain and anxiety medications needed. However doctors point out that pain is a very individual experience, and the benefits of virtual reality distraction as well as the level of medication must be determined on a case by case basis.

NOTE TO MEDIA REPRESENTATIVES: EFFECTIVE 9/24/2007, COLUMBUS CHILDREN'S HOSPITAL BECAME NATIONWIDE CHILDREN'S HOSPITAL. TO ENSURE YOU CONTINUE TO RECEIVE MEDIA MESSAGES, PLEASE UPDATE YOUR ADDRESS BOOK WITH OUR NEW E-MAIL ADDRESS - info@media.nationwidechildrens.org

Ohio Boy Receives Gift of Hearing

Wed, 28 Mar 2007 00:00:00 -0400

Although born deaf, 15-month old Jonah Knueve is now able to hear his parents voices. Weeks before his first birthday, Knueve became one of only a handful of children in the country under the age of one to receive simultaneous, bilateral cochlear implants.

Doctors at Columbus Children’s Hospital implanted a computer chip and electrode in each ear's cochlea to stimulate undamaged hearing-nerve fibers. When the implant's external microphones detect speech and other sounds, the speech processor codes sound information to the internal computer chip and transfers the coded information to Jonah's brain, which not only allows him to hear, but will help him learn how to talk.

“The more time that passes before the child receives the implants, the more difficult normal speech development is for that child,” said Richard Kang, MD, chief of Otolaryngology at Columbus Children’s Hospital and a faculty member at The Ohio State University College of Medicine.

In fact, many physicians say the sooner kids have the surgery, the better. Each year, more than 13,000 babies are born deaf or born with severely limited hearing. Doctors in the United States began fitting patients with cochlear implants in the 1980’s, but only if they were 18-years or older. Today, the age continues to decrease, and despite some concerns the implants could affect a child’s balance, doctors at Children’s say that was not the case with Knueve. The results they see are positive.

“He actually took his first step right after the surgery,” said Kang. “So clearly, at least clinically, that indicates that the implants did not impact his development in balance in terms of learning to walk.”

Knueve will require adjustments to the implants throughout his life, but by the time he is old enough to share his thoughts, he likely will not remember the 11 months he spent in silence.

Contact:
Pam Barber / Mary Ellen Fiorino
Columbus Children's Hospital Marketing and Public Relations
(614) 722-4595

Columbus Children’s Hospital Involved in an Investigational Clinical Trial Using a Gastric Band in Adolescents

Thu, 01 Feb 2007 00:00:00 -0500

Columbus Children’s Hospital is one of several pediatric institutions in the country involved in an investigational clinical trial using a gastric band in severely obese adolescents 14-years-old to 17-years-old. During the trial, researchers will study the effects of the band over a long-term follow-up period. The goal of the trial is to evaluate the safety and effectiveness in a morbidly obese adolescent population (ages 14 to 17 years) and to assess associated changes from baseline in obesity-related comorbidities (i.e., diabetes, sleep apnea, hypertension, etc.) as well as psychosocial functioning.

“By the time overweight children reach their teens, if nothing has changed in terms of their weight and their weight-growth curve, they have an overwhelming chance of carrying that weight into their adult years,” said Marc Michalsky, MD, surgical director of the Center for Healthy Weight and Nutrition at Columbus Children’s Hospital and a faculty member at The Ohio State University College of Medicine.

During this new type of weight reduction surgery, a small band is placed around the upper part of the stomach. This creates a small pouch, so that the area where food enters the stomach is small and restricts the amount of food a person can eat. Patients who have this surgery feel full after eating small amounts.

Not all overweight people qualify for bariatric surgery. Adolescents who have a Body Mass Index (BMI) of at least 40, or a BMI of at least 35 with one or more obesity-related comorbidities, who have a documented attempt to lose weight by following a medically supervised diet, and who have undergone a thorough medical screening process at Columbus Children’s Hospital may qualify for the weight reduction surgery under this investigational clinical trial.

“Bariatric surgery is a big step for patients,” Michalsky said. “But we believe that it is a step in the right direction. It gives severely obese patients a chance to take control of their body’s weight and improve their overall medical condition. It is surgery to help cure disease.”

For the ultimate success of bariatric surgery, lifestyle adaptation is necessary and patients must closely follow a special diet to lose weight. Balanced nutrition and exercise is the key for patients to control their weight and lower their risk for health problems. This includes a healthy eating pattern and regular exercise for the rest of their lives.

Contact:
Pam Barber / Mary Ellen Fiorino
Columbus Children's Marketing and Public Relations
(614) 722-4595

Bone Marrow Transplantation Offers Hope for Extreme Cases of Sickle Cell Disease

Fri, 01 Dec 2006 00:00:00 -0500

Two-thirds of the patients who receive bone marrow transplants (BMT) at Columbus Children’s Hospital are treated for cancer conditions. The remaining BMT patients undergo the procedure for a variety of genetic disorders, including sickle cell disease. Children’s Hospital has completed three successful BMT for sickle cell disease over the past year. In the United States, there have been approximately 100 cases in which BMT was used for sickle cell disease, and about 150 cases in the world.

Sickle cell disease affects a person’s ability to make normal red blood cells. Their cells form rigid structures that look like sickles and clog up small blood vessels depriving tissues of oxygen. This produces extreme pain and can cause damage to the body’s organs.

BMT works as a cure for sickle cell disease because red blood cells come from mother cells that originate in bone marrow. BMT wipes out the bone marrow a child is born with, and replaces it with a healthy sibling’s who has the same tissue type. After the procedure, normal red blood cells are produced from the new bone marrow and the disease is cured.

Amanda Termuhlen, MD, associate chief of Hematology/Oncology at Columbus Children’s Hospital, and a faculty member at The Ohio State University College of Medicine, explained that BMT is only used for the most severe sufferers of sickle cell because of the risk factors associated with transplantation.

“The procedure itself has about a five percent mortality rate,” Termuhlen said. “Not every child with sickle cell is the same. Some children will have very few problems; some will have chronic and life-threatening problems. Our current approach is to pick children who are severely affected with multiple pain episodes, and are at risk of stroke, or are at risk for dying from sickle cell disease at a very young age.”

Only non-afflicted, full siblings are suitable for transplantation. Less than 19 percent, or one-in-five children with sickle cell, will find a suitable donor.

At Columbus Children’s Hospital, there is new hope for a young girl Kimmi Desir. Kimmi became the first sickle cell BMT recipient at Children’s when she received a transplant from her sister Melissa Desir. Transplants are considered successful if the recipient is healthy a year after the procedure. While Kimmi has passed that mile marker with flying colors, she continues to be monitored by specialists at Children’s Hospital.

“To be able to help those children who are at a higher risk of having complications, and being able to offer a cure for their disease is critical,” Termuhlen said. “It provides a service from toddlers to older teenagers with sickle cell disease.”

Doctors Collaborate To Spare Kids the Scars of Surgery After Removing Facial Tumors

Wed, 26 Jul 2006 00:00:00 -0400

COLUMBUS, Ohio—Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign tumor around the cheek area, occurring exclusively in adolescent boys. The symptoms, which are easy to overlook initially, include repeated nose bleeds, nasal congestion, nasal discharge and hearing loss. If left untreated, boys with the condition can bleed to death.

JNA accounts for 0.05 percent of all head and neck tumors, at a frequency anywhere from 1:5,000-1:60,000 boys. Onset is most common between the ages of 7 and 19. Girls with JNA are genetically tested because of the hormones involved.

The most common method of removing such a tumor has been extensive, bloody surgery that leaves the patient with facial scars from the cutting. Surgeons would remove half of the cheek, and the front part of the neck in order to find the blood supply and remove the tumor. As a result, patients usually lost up to a quart of blood.

Doctors of interventional radiology and ears, nose & throat surgery at Columbus Children’s Hospital are teaming up to save teenagers from living with the physical and emotional scars of that surgery for the rest of their lives. The collaborative procedure is far less invasive, and patients lose less than a half of a cup of blood.

Doctor William Shiels and Doctor Richard Kang performed the collaborative procedure using interventional radiology to stop the blood supply to the tumor, then fiberoptic endoscopy to remove the tumor on 13-year-old Matthew Sexton. They saved his life, and allowed him to remain a handsome kid at the same time.

On day one of the procedure Dr. Shiels, chief of radiology at Children’s, inserted a catheter through Matthew’s leg and used high-tech imaging to map every blood vessel supplying the tumor. He then injected tiny beads into those vessels to cut off the flow of blood to the tumor. On day two of the procedure, Dr. Kang, chief of the Department of Otolaryngology at Children’s, removed the tumor through Matthew’s nasal cavity.

Shiels said the benefits of the collaborative procedure include reducing the need for blood transfusions; getting rid of the tumor safely, and less deformity for the child.

“Thirteen year old boys are self conscious,” Shiels said. “They are developing their self image, and if there is deformity visible to everyone he meets at first glance, it can be a life changing event and affect him through his whole adult life.”

In addition to the reduction of scaring and blood loss, there is also a reduction in recovery time. After the extensive surgery, typically the patient endures a week of pain and swelling in recovery. Matthew felt no pain after the collaborative surgery, and was able to go home the next day.

The procedure has been in use for the last 5 to 10 years, but is not widely practiced. Kang said more doctors around the country do not perform this procedure because of a reluctance to proceed without open access to the tumor.

“Sinal surgery is a simpler and quicker way to go,” Kang said. “But, because if you were to get into any trouble, your ability to get to the source of bleeding and stop it [is limited], the stress level is higher. ‘Big incisions for big surgeries’ was the old school of thought, but now we can do big surgeries with small incisions.”

Shiels said doctors at Columbus Children’s train interventional radiologists around the world in this procedure.

International Symposium Explores New Hybrid Approach to Congenital Heart Disease

Tue, 27 Jun 2006 00:00:00 -0400

Interventional cardiologists and cardiothoracic surgeons from throughout the United States, North and South America, Europe, Australia and Asia will gather at Columbus Children’s Hospital from June 28-30, 2006, for the inaugural International Symposium on the Hybrid Approach to Congenital Heart Disease (ISHAC). This conference is the first of its kind dedicated to exploring advancements in “Hybrid” management strategies which combines surgical and transcatheter therapies in order to minimize the cumulative impact of treatment for complex congenital heart disease (CHD). In the United States alone, more than 40,000 babies are born with some form of CHD with many requiring high risk surgical procedures.

During Hybrid procedures, cardiothoracic surgeons and interventional cardiologists work collaboratively to correct defects in the heart, often with the use of stents and devices delivered through limited surgical access. Columbus Children's Hospital is considered a benchmark institution in this area where two uniquely designed Hybrid Cardiac Catheterization Suites were constructed opened in June, 2004 - the first in the world dedicated to this new therapy.

The two-day Symposium will feature lectures and panel discussions from international pioneers in the field, as well as live case demonstrations broadcast from Miami Children’s Hospital, University of Chicago Comer Children’s Hospital, and the Hybrid Suites at Columbus Children’s Heart Center. A special hands-on workshop will be offered to a limited number of participants on the third day.

Symposium directors are John P. Cheatham, MD, Director of Cardiac Catheterization and Interventional Therapy at Columbus Children’s Heart Center, and Mark Galantowicz, MD, Co-Director of The Heart Center and Chief of Cardiothoracic Surgery at Children’s. Both are faculty members of The Ohio State University College of Medicine. Drs. Cheatham and Galantowicz have organized this world-class event to encourage international discussion for potential Hybrid cardiac procedures to that will result in improved outcomes while decreasing risks. The target audience consists of not only surgeons and interventional cardiologists, but also other members of heart centers who help care for children and adults with CHD.

The Heart Center at Columbus Children’s Hospital is a regional, national and international referral center for the diagnosis and treatment of all forms of CHD and acquired cardiomyopathy in both pediatric and adult patients. After opening the unique Hybrid Suites in 2004, a prototype 5 axis positioner and biplane flat panel detectors from Toshiba Medical Systems were installed in July 2005. Unparalleled patient access, cardiac imaging and telemedicine capabilities are now possible. Visitors from around the world visit the Hybrid Suites in order to construct similar facilities at their own institutions.

ISHAC Symposium has received financial support from Toshiba Medical Systems, AGA Medical Corporation, Stryker, Cook, Medtronic, Gore, NuMED, Inc., Cordis Corporation, Heartlab and B.Braun Medical, Inc. More information on ISHAC is available on the web at www.hybridsymposium.com.

Young Woman Undergoes First Heart/Double Lung Transplant at Columbus Children's Hospital

Tue, 14 Feb 2006 00:00:00 -0500

The first heart/double lung transplant at Columbus Children’s Hospital occurred Saturday, December 24, 2005, when 22-year-old Sandy Shreck received a heart and lungs provided by an out-of-state donor.

Born with complex congenital heart disease, Shreck was referred in 2002 to Curt Daniels, MD, of the Columbus Children’s Heart Center and a faculty member of The Ohio State University College of Medicine and Public Health. Daniels is director of the Adolescent and Adult Congenital Heart Disease Program at Children’s and The Ohio State University Medical Center. This highly-specialized program was created to meet the medical and surgical needs of adolescents and adults with congenital heart disease, providing comprehensive care for this unique and complex patient population.

Born in 1983, Shreck underwent her first heart surgery shortly after birth, followed by additional surgical procedures in 1989 and 2005. She was admitted to Columbus Children’s last November 29, where it became evident that her congenital heart disease had progressed and led to worsening congestive heart failure. All medical treatment options had been exhausted and transplantation was the only option left to her. She was placed on the United Network of Organ Sharing (UNOS) transplant list December 12 and was notified the evening of December 23 that donated organs had become available to her.

Mark Galantowicz, MD, co-director of the Columbus Children’s Heart Center and surgical director of the Lung, Heart and Heart-Lung Transplant Programs at Columbus Children’s, led the transplant surgical team. Todd Astor, MD, a transplant pulmonologist and medical director of the Children’s Lung and Heart-Lung Transplant Programs, is directing Shreck’s post-surgical care. Both physicians are faculty members of The Ohio State University College of Medicine and Public Health.

Shreck and her boyfriend, Keary Miller, reside in Lancaster, Ohio, with Shreck’s nearly-three-year-old son, Payton Harris. Discharged February 8 from the hospital, she is staying with her son at the Ronald McDonald House on the campus of Children’s Hospital, after which she will be cared for by relatives in her hometown of Chillicothe, Ohio, during her recovery. Shreck credits her son with being her “inspiration to undergo the surgery and work hard to recover” so that she can be there for him as he grows up. She wants to share her story so that others will recognize the importance of the incredible gift of organ donation.

The comprehensive Transplant Program at Columbus Children’s is comprised of lung, heart, heart-lung, kidney and blood and marrow transplant services.

Columbus Children's Hospital Researchers Prove Vagus Nerve Stimulation (VNS) is Effective in Treating Children With Epilepsy

Tue, 30 Aug 2005 00:00:00 -0400

Epilepsy, a brain disorder that occurs when the electrical signals in the brain are disrupted, affects about two million Americans. Most people with Epilepsy respond well to medication, but in approximately 25-30 percent of patients, medication doesn't work. As an alternative to medication, the FDA approved implantation of a vagus nerve stimulator (VNS) in patients older than 12 to help control or reduce the seizures that occur because of epilepsy, but until recently, there was no data to illustrate how children younger than 12 years of age would respond to VNS implantation. Now, researchers at Columbus Children's Hospital have demonstrated that using a VNS in children is effective in reducing seizures and epilepsy-related hospital visits. Results of a two-year study will be presented at the International League Against Epilepsy Congress August 28–September 1 in Paris.

“In the study of more than 75 patients between the ages of one and 17 years treated at the Comprehensive Epilepsy Clinic at Columbus Children's Hospital, we found that 59 percent of the patients implanted with the VNS did not have localization-related epilepsy (seizures occurring in one part of the brain) and side effects requiring discontinuation were low (5 percent),” said Juliann Paolicchi, M.A., M.D., director of the Comprehensive Epilepsy Center at Columbus Children's Hospital and associate professor at the Ohio State University College of Medicine and Public Health. “Further, we observed that hospital visits for epilepsy-related conditions decreased by 41 percent—this will have an impact on the long-term cost-effectiveness of VNS therapy and decrease overall patient morbidity. For families of children with intractable epilepsy, less time spent in the hospital has a significant, positive impact socially and financially by reducing the loss of parental work time, the patient's school absences, and family stressors relating to caring for a hospitalized child. ”

The VNS is implanted in the left side of a patient's neck and works by sending signals to the brain to decrease the electrical activity that leads to seizures. It was approved for intractable partial epilepsy (epilepsy that does not improve with medication) of adults (children greater than 12 years) in 1997. Columbus Children's Hospital was one of the first institutions to begin using VNS in children.

As part of the next phase of her study, Paolicchi plans to further analyze the data to look for patterns in children with one type of epilepsy versus another, whether the outcomes differ by age, whether the VNS impacts the duration of epilepsy depending on timing of implantation, and quality of life outcomes.

Columbus Children’s ranks among the top 10 in National Institutes of Health research awards and grants to freestanding children’s hospitals in the country and houses the Department of Pediatrics of The Ohio State University College of Medicine and Public Health. With nearly 600,000 patient visits each year, Children’s Hospital is a 112-year-old pediatric healthcare network treating newborns through age 21. In 2004, the Columbus Children’s Research Institute conducted more than 300 research projects and is the home of Centers of Emphasis encompassing gene therapy; molecular and human genetics; vaccines and immunity; childhood cancer; cell and vascular biology; developmental pharmacology and toxicology; injury research and policy; microbial pathogenesis; cardiovascular medicine; and biobehavioral health. Pediatric Clinical Trials International (PCTI), a site management organization affiliated with the hospital, also coordinated more than 50 clinical trials. In addition to having one of the largest ambulatory programs in the country, Children’s offers specialty programs and services. More than 75,000 consumers receive health and wellness education each year and affiliation agreements with nearly 100 institutions allow more than 1,700 students and 500 residents to receive training at Children’s annually. More information on Children’s Hospital of Columbus is available by calling (614) 722-KIDS (5437).

First-Generation Hybrid Cardiac Catheterization Suites Install 5 Axis Biplane Positioner and Flat Panel Detectors at Columbus Children's Heart Center

Wed, 27 Jul 2005 00:00:00 -0400

In an innovative new approach to cardiac care, physicians at The Columbus Children’s Heart Center have coupled the benefits of cardiothoracic surgery and interventional cardiology in two suites to help critically ill newborns, children and adults with congenital heart disease achieve improved therapeutic outcomes. Known as the Hybrid Cardiac Catheterization Suites, these facilities harness state-of-the-art technology that allows surgeons and interventionists to collaboratively perform a wide range of innovative new hybrid procedures.

Since June of 2004, Columbus Children’s Hospital has been operating the country’s first of its kind, Hybrid Cardiac Catheterization Suites. Now one year later, the existing imaging equipment is being replaced by the world’s first 5 Axis Biplane Positioner with Flat Panel Detector (FPD) imaging. The new equipment allows surgeons and interventionalists to view images more clearly, as well as to improve access to patients.

John P. Cheatham, MD, Director of Cardiac Catheterization and Interventional Therapy and a faculty member at The Ohio State University College of Medicine and Public Health, worked with colleagues at Columbus Children’s Hospital and the President and CEO of Toshiba Medical Systems Corporation and his design team to develop this new equipment. As part of the development phase, Dr. Cheatham traveled to Nasu, Japan to meet with Toshiba engineers. Thomas N. Hansen, MD, CEO, and Mark Galantowicz, MD, Chief of Cardiothoracic Surgery and Co-director of the Heart Center, accompanied him on the trips to provide their input and direction. Toshiba engineers where shown actual cardiac catheterization and surgery film footage to allow them to see how the equipment is used in the Hybrid Suites, and to see what modifications to the equipment were needed.

Dr. Cheatham, Dr. Galantowicz and Dr. Hansen spearheaded the project using input from all areas of the hospital who utilize the suites. As a result, this collaboration with Toshiba in Japan and its subsidiary Toshiba America Medical Systems (TAMS) has allowed development of the most innovative imaging equipment available in the world – the 5 Axis Biplane Positioner with FPD. Currently, the first prototype has been installed in Hybrid Suite 1 by the engineers from Japan and America, with help from the team at Columbus Children's Hospital. After initial testing and evaluation is complete, the first production model will then be installed in Hybrid Suite 2.

The Hybrid Cardiac Catheterization Suites deviate from traditional cardiac care delivery by allowing surgical and interventional catheterization procedures to be performed by a single interdisciplinary team in one setting. This approach supports enhanced patient outcomes through shorter and safer procedures that require less recovery time and rehabilitation. The expansive suites accommodate the collective catheterization and surgical teams, and facilitate rapid information sharing with new technology from Toshiba America Medical Systems and Stryker Communications. The Hybrid Cardiac Catheterization Suites are designed to meet the special needs of newborns, adolescents and adults with congenital heart disease.

Congenital heart defects are present in about one percent of live births. While most often scientists are unsure of how the child contracted a specific defect, advancements in pediatric cardiac care -- such as the hybrid procedures performed at Columbus Children’s Heart Center -- are changing treatment options to help children live healthy, normal lives. There are a variety of congenital heart diseases, and treatment can begin, or continue into, adulthood.

The two Hybrid Cardiac Catheterization Suites feature:

- The first installation of the most advanced 5 Axis Biplane x-ray imaging technology with Flat Panel Detectors (FPD) from Toshiba America Medical Systems for a better quality picture which facilitates more accurate assessment and diagnosis and improved access to patients, regardless of size or complexity of disease.

- Six interconnected, flat panel, high-resolution display screens (Stryker Vision) for superior visualization and better information exchange among the team members. At least two monitors are visible to all team members at any time, from any location.

- 930 square feet of working space to accommodate the team involved in a hybrid case (surgeons, interventional cardiologists, electrophysiologists, echocardiographers, cardiac anesthesiologists, advanced level nurse practitioners, physicians’ assistants, cath/O.R. nurses, technicians and perfusionists).

- A large, central control room where additional staff members have the ability to transmit information anywhere in the suite, at remote sites within the hospital, or even to countries around the world, enabling Columbus Children’s Heart Center faculty to consult with physicians in distant countries and to serve as a teaching hospital as further advancements are made.

The first procedure performed in the Hybrid Cardiac Catheterization Suites took place on May 25, 2004, and included treatment for a newborn with hypoplastic left heart syndrome. Since then many patients have undergone treatment in the suites. The Heart Center opened its 100-seat Telemedicine Center in July 2004. The capabilities of the Telemedicine Center will enable viewing of any image from inside the two suites or cardiac O.R.s to provide educational opportunities toward advancement of congenital heart disease treatment strategies.

The Hybrid Cardiac Catheterization Suites can accommodate any catheter treatment, selective surgical cases, or any collaborative hybrid procedures. Interventional cardiologists and cardiothoracic surgeons working together in these suites will reduce the amount of time required to correct complex heart disease and reduce the emotional and physical stress placed on a patient and their family – which translates into less pain, less scarring and a faster recovery time.

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Pickerington Resident Undergoes First Lung Transplant at Columbus Children's Hospital

Tue, 19 Jul 2005 00:00:00 -0400

The first lung transplant at Columbus Children’s Hospital occurred Monday, July 11, 2005 when twenty-three-year-old Emily DeArdo of Pickerington, Ohio, received two lungs.

Diagnosed with Cystic Fibrosis (CF) at 11 years of age, DeArdo has been cared for since then at the CF Foundation-accredited Children’s Hospital Cystic Fibrosis Center by Chief of Pulmonary Medicine Karen McCoy, MD. DeArdo graduated from Capital University in Columbus and works fulltime at the Statehouse.

DeArdo was placed on the list for a double lung transplant May 31, 2005, with the United Network of Organ Sharing (UNOS). Finding a suitable match for DeArdo was especially challenging due to her rare AB-positive blood type and the need for small adult lungs. A match was located late the night of July 10 and DeArdo arrived at Columbus Children’s the morning of July 11 to prepare for transplant surgery. Columbus Children’s Cardiothoracic Surgeon Terry Davis, MD, began the transplant operation in preparation for the arrival of Children’s Cardiothoracic Surgery Chief Mark Galantowicz, MD, who had gone to procure the donor lungs from another state.

Children’s transplant pulmonologist, Todd Astor, MD, removed DeArdo from the ventilator Tuesday, July 12, and heard her first post-surgery comment: “This feels wonderful!” She remained in the intensive care unit until Monday, July 18, when she was moved to the Heart Center inpatient unit where she will remain in reverse isolation for her protection until her hospital discharge.

The Lung Transplant Program at Columbus Children’s is headed by Astor as medical director and Galantowicz as surgical director. Astor has previous lung transplantation experience with the University of Colorado Health Sciences Center, Division of Pulmonary Sciences and Critical Care Medicine Lung Transplant Program. Galantowicz previously served as director of Cardiopulmonary Transplantation at the Children’s Heart Center at Columbia-Presbyterian Medical Center in New York.

Galantowicz and Astor are also members of the full-time faculty of The Ohio State University College of Medicine and Public Health.

CF is an inherited disorder of epithelial gland secretion which affects the respiratory and digestive systems as well as sweat and salivary glands. In the lungs, the disease results in infection, which ultimately destroys the organs. Bilateral lung transplantation is the course of action when patients are no longer responsive to medical therapy. Ohio is the fifth largest state in terms of CF population and the Columbus Children’s Hospital CF Center staff currently care for 375 patients.

The Columbus Children’s Lung Transplant Program was certified earlier this year by UNOS and the Ohio Department of Health and Human Services and accepted into the Ohio Solid Organ Transplant Consortium. The Transplant Program at Children’s is comprised of Lung Transplant, Heart Transplant, Heart-Lung Transplant, and Blood and Marrow Transplant.

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Todd Astor, MD, is medical director of the Lung and Heart-Lung Transplant Programs at Columbus Children’s Hospital. He is also Assistant Professor of Clinical Pediatrics at The Ohio State University College of Medicine and Public Health. He was recruited in July 2004 from the Lung Transplant Program and Division of Pulmonary and Critical Medicine at the University of Colorado Health Sciences Center. He is board certified in internal medicine, pulmonary medicine, and critical care medicine, and is a United Network of Organ Sharing (UNOS) certified lung transplant pulmonologist. Astor’s research interests concentrate on the diagnosis and treatment of allograft rejection in lung transplant recipients. He currently is studying the mechanisms by which respiratory viruses may trigger rejection in patients who have undergone lung transplantation.

Mark Galantowicz, MD, is the co-director of Columbus Children's Heart Center, chief of the Department of Cardiothoracic Surgery and surgical director of the Heart Transplant, Lung Transplant and Heart-Lung Transplant program at Children’s. He is also an associate professor of Surgery at The Ohio State University College of Medicine and Public Health.. After receiving his undergraduate degree from the University of Pennsylvania, Galantowicz was awarded a Fulbright Scholarship to conduct molecular biology experiments at the University of Geneva, Switzerland. He received his medical degree from Cornell University Medical College and completed his surgical training including a fellowship in Cardiothoracic Surgery and Pediatric Cardiothoracic Surgery at Columbia-Presbyterian Medical Center. He has a special interest in the surgical repair of newborns with heart disease as well as cardiopulmonary transplantation. His research interests focus on the development of innovative, less-invasive strategies for the management of congenital heart disease.

J. Terrance Davis, MD, is a member of the Division of Cardiothoracic Surgery at Children’s Hospital and a professor of Clinical Surgery at The Ohio State University College of Medicine and Public Health in the Division of Cardiothoracic Surgery. His current clinical interests include general thoracic surgery and chest wall deformities. Beside the common deformities such as pectus excavatum and carinatum, he is internationally recognized for his work related to the Jeune’s Asphyxiating Thoracic Dystrophy. He is also active administratively and has held the post of chief surgical officer and administrative surgical director at Columbus Children’s Hospital since 1997. He sits on the Promotion and Tenure Committee of The Ohio State University College of Medicine and Public Health. He has a long-standing interest in mission work in Central and South America as well Africa.

Karen S. McCoy, MD, is the chief of the Section of Pulmonology at Columbus Children's Hospital and the chief of the Division of Pediatric Pulmonology and associate professor of Pediatrics at The Ohio State University College of Medicine and Public Health. Her clinical interests focus on managing patients of all ages with cystic fibrosis (CF) and pediatric asthma. Her research interests revolve around clinical outcomes and trials in cystic fibrosis and asthma. She is the principal investigator for the CF Therapeutic Development Center and the Asthma Clinical Research Center. She is the director for the CF Center and the fellowship training program in Pediatric Pulmonology at Children's Hospital. She is conducting a large community-based project to enhance asthma care among pediatric and family practice offices.

New Program Encourages Kids to Make Healthier Lunch Choices

Wed, 16 Mar 2005 00:00:00 -0400

With government figures estimating 30 percent of all U.S. children are overweight or at risk for being too heavy, there is a necessity for innovative new strategies to prevent these young people from becoming overweight or obese adults. New research meets this growing challenge through a first-of-its-kind computerized nutritional tool known as the Snackwise^SMNutrition Rating System.

Developed by researchers at the Columbus Children?s Hospital?s Borden Center for Nutrition and Wellness, Snackwise^SM is available to schools around the country for addressing the specific nutritional needs of children ages 5 and up. In particular, the innovative computer software program allows school officials to determine and color assign a specific nutritional value to the range of foods commonly available to students from vending machines, a la carte lunch lines or school stores.

Snackwise^SMarms young people with an easy-to-use system that leads to hassle-free nutritional decisions information that we hope will carry over to adulthood, said Kristi Houser, M.S., R.D., research dietitian, Borden Center for Nutrition and Wellness. The response has been so positive that we're planning on developing a version for toddlers, as well as direct the technology to grocery store snack foods.

To use the computer program, school officials simply input 10 key components posted on the nutritional label of the food packaging. The program automatically computes the points and assigns the appropriate rating to the snack foods (ratings for the top 100 most common snack foods found in a vending machine have already been computed in the program). Schools can then color code the snacks in the machine by sections, or devote entire machines to healthy options. The rating system means schools can be assured they are providing their students with highly nutritious snack food options, while retaining the financial benefits of vending machines.

The 10 components that represent major nutritional concerns for American children are: total energy, total and saturated fats, fiber, sugars, protein, calcium, iron and vitamins A and C. Through a system of assigned points for each of these components?adding or subtracting based on whether the component makes a positive or negative contribution?each food is assigned a total point value which translates into an easy-to-follow color-coding chart. Foods with the least amount of points were deemed least nutritious and assigned the color red to signify foods that should rarely be chosen. For snack foods that received the highest amount of points, or rated most nutritious, the color green was used to indicate that they are the best choices. Snack foods receiving points in the middle of the range (for being moderately nutritious) were assigned yellow to remind children to choose those snacks occasionally.

School officials looking for more information on Snackwise^SM or interested in purchasing a kit containing the software program, point-of-sale, stickers, press release and parent letter can visit http://www.snackwise.org.

International Adoption Clinic at Columbus Children's Hospital Helps Prospective Parents Find Their Dreams Overseas

Tue, 25 Jan 2005 00:00:00 -0500

Columbus Children’s Hospital now offers an International Adoption Clinic to guide parents throughout the process of international adoption—the first of its kind in central Ohio. The clinic’s focus is helping prospective parents understand the potential health condition of the children they are preparing to adopt and to thoroughly evaluate the health condition of adopted children shortly after their arrival in the United States.

International adoption potentially can save the lives of thousands of children throughout the world who grow up in orphanages struggling with poor nutrition, diseases, behavioral problems and developmental delays. The reward of providing new and better possibilities for a child in need is certainly worth the long and demanding process international adoption often can be.

Because traveling to another country can be difficult and confusing, physicians at Columbus Children’s International Adoption Clinic talk with parents about traveling abroad and initially assessing their child’s health. Staff trained in pre-adoptive services review any medical records, videotapes or photographs that are sent from the child’s home country and, together with the parents, develop a health care plan for the child. During the time parents are outside the U.S., they have 24-hour access to clinic staff for immediate guidance.

After arriving home in the U.S., physicians at Columbus Children's International Adoption Clinic evaluate an adopted child’s development, nutrition, immunization history and perform a complete physical examination. Other tests also are performed to look for possible infections or other health problems. Based on these exam results, a more definite health care plan for the child is developed and shared with his or her primary care physician.

In addition to the services offered by the Columbus Children’s International Adoption Clinic, parents preparing to navigate the adoption process can also take advantage of Children’s Adoption Academy, an educational program that presents introductory information about adoption in a comprehensive and sensitive manner to help prospective parents make informed choices. To learn more about or to register for Adoption Academy, contact Columbus Children’s Institute for Pediatric Education, (614) 722-4949.

For more information abut Children’s International Adoption Clinic, call (614) 722-4459 or email InternationalAdoption@chi.osu.edu.

Radiological Invention Will Improve Health Care for Children

Thu, 11 Mar 2004 00:00:00 -0500

Small patients normally do not fit into standard medical practice—young children are naturally active, making tasks as simple as performing an X-ray problematic for pediatric radiology professionals around the country. Columbus Children’s Hospital has invented a unique device to replace the Pigg-o-stat®, a less effective apparatus currently used throughout the United States to restrain a child in an upright position for radiological examination. The new Columbus Pediatric Radiography Board was designed to improve film quality and patient comfort.

The Columbus Board is a lightweight, stable, transparent positioning board that can accommodate many types of examinations, as well as children of a wide range of ages and sizes. Patients are positioned once with the Columbus Board and remain in one place during the exam while equipment is moved around them for multiple film exposures. The Columbus Board provides meticulous detail in examinations. The quality of films produced by the conventional Pigg-o-stat® is inconsistent, frequently with artificial images that mimic pneumonia.

The Columbus Board not only enables a more efficient exam that produces higher quality films, but is also more comfortable and visually appealing to patients and their families. A parent gently holds a child in a designated position with the Columbus Board, actively communicating with him or her to help relieve anxiety during an examination. This system increases parental presence by allowing a parent to be an active part of the healthcare team and process. The Pigg-o-stat® does not hurt a child but its appearance is often threatening to parents and the device can be cumbersome to radiology personnel.

“The consistent positive parent response that we see with the use of the Columbus Board underscores the fact that customer service goes beyond simply ‘service’ in pediatric health care and clearly is an issue of exceptional patient and family care,” said William E. Shiels, D.O., chief, Children’s Department of Radiology. “The innovative team of technologists at Columbus Children’s identified a pediatric health care problem, created a solution and accepted a national leadership role in improving care for children.”

Young Iraqi-Kurdish Patients Treated at Columbus Children's Hospital Heart Center

Wed, 07 Jan 2004 00:00:00 -0500

Two Kurdish girls from Iraq will begin 2004 with a new lease on life following open-heart surgery at Columbus Children’s Hospital Heart Center. Warveen Khalil, 9, and Chra Rashid, 6, arrived in Columbus with their fathers Dec. 20. Diagnostic tests were conducted Dec. 22, and Warveen underwent corrective surgery Dec. 23. Chra underwent surgery Dec. 24.

It was discovered that the girls needed heart surgery when Mercy Ships, in collaboration with Humedica, sent medical teams to the northern Iraqi city of Erbil as part of Operation Iraqi Mercy.

At Children’s Hospital, Warveen was diagnosed with a complex form of congenital heart disease called transposition of the great arteries, as well as ventricular inversion, ventricular septal defect and left ventricular outflow tract obstruction. There was an embryologic reversal of the two pumps and the two main pipes coming out of her heart with a large hole between the pumps and a significant narrowing that limited flow of blood to the lungs. This combination of abnormalities left Warveen blue with limited red, oxygenated blood reaching her body. Her quality of life had become significantly limited—her father reports that for the past couple of years Warveen was unable to walk more than a few steps without exhaustion and used a wheelchair. Without repair she would not have lived to be a teenager.

Warveen underwent a ten-hour corrective surgery led by cardiothoracic surgeon Mark Galantowicz, M.D., co-director, Children’s Hospital Heart Center. She spent the first day after her surgery staring into a mirror at her pink lips, the first time in her memory that they were not blue.

Chra was diagnosed with Tetralogy of Fallot, a congenital heart defect characterized by a hole between the bottom two chambers of the heart, a narrowing at the pulmonary valve, an enlargement of the bottom right side of the heart and alignment of the aorta over the hole between the two bottom chambers. Patients with this defect experience mixing of oxygenated and non-oxygenated blood, and blood traveling to the lungs is restricted by the narrowing at the pulmonary valve.

Samuel Weinstein, M.D., a cardiothoracic surgeon in the Heart Center, led the team that repaired Chra’s heart. The repair involved closing the hole inside the heart with a patch of Gortex material and enlarging the outflow area in the heart to the lung. An abnormally placed coronary artery added to Chra’s congenital problem but was successfully managed.

Terry Davis, M.D., a cardiothoracic surgeon at Columbus Children’s Hospital Heart Center and chairman of the hospital’s International Patient Steering Committee, coordinated arrangements among all the involved organizations and individuals for the patients to be treated at Columbus Children’s and directed the girls’ care during travel from Iraq.

Galantowicz, Weinstein and Davis are all faculty members in the Department of Surgery at The Ohio State University College of Medicine and Public Health.

The efforts of several organizations and individuals have been integral in getting Warveen and Chra to treatment in the United States and hosting them during their stay in Columbus. They include: Mercy Ships, Humedica, Kurdish Human Rights Watch, Council on American-Islamic Relations/Ohio Chapter, Asian and Pakistan Cultural Association, Downtown Rotary Club, Rotary Club of Upper Arlington, Capital Square Rotary Club, First Community Church, National Council of Jewish Women/Columbus Section and the offices of Sen. George Voinovich (R-OH), Sen. Mike DeWine (R-OH) and Rep. Deborah Pryce (R-OH).

Warveen and Chra were discharged from Children’s on Dec. 29, and are currently staying with their host families. Both are doing well—Warveen already is walking vigorously—and they will return home to Iraq with their fathers near the end of January.

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Cystic Fibrosis Foundation Selects Columbus Children's Hospital For Its Therapueutics Development Network

Mon, 25 Nov 2002 00:00:00 -0500

Cystic Fibrosis Foundation Therapeutics, Inc. (CFFT), the nonprofit drug development affiliate of the Cystic Fibrosis Foundation, announced today that it has selected Columbus Children's Hospital's Cystic Fibrosis (CF) Care Center to be part of the Therapeutics Development Network (TDN). The TDN is a network of health care institutions accredited by CFFT to conduct clinical trials of possible new treatments for CF. Columbus Children's Hospital's CF Care Center was one of the top applicants for inclusion in the TDN based on expertise, ability and facilities.

The CF Foundation's TDN, composed of eight original centers, was created in 1998 to capitalize on the increasing wealth of information uncovered by scientists about the basic defect in CF and to give CF patients access to clinical trials in cutting edge medicine traditionally available only to larger disease populations. By establishing specialized clinical centers, researchers can seize opportunities to intervene in the disease process through promising new CF treatments. The CF Foundation has taken a unique approach to drug development and through this network, now has infrastructure in place to expedite the time it takes to bring a new CF drug to market and at a significantly lower cost. Traditional drug development takes 10-15 years and approximately $800 million, but with the Therapeutics Development Network model, the CF Foundation has set its goal at seven to nine years and less than $100 million.

The principal investigators at Columbus Children's Hospital CF Foundation TDN Center are Karen S. McCoy, M.D., director of the Division of Pediatric Pulmonology and director of the CF Care Center, and John S. Heintz, M.D., director of the adult CF program at Columbus Children's Hospital.

"Columbus Children's Hospital has a long-standing commitment to providing both excellent care to people with CF and to conducting outstanding CF research. The leadership displayed by the CF team in patient care, drug development and core clinical research over the past several years is the primary reason behind their inclusion in the TDN," said Robert J. Beall, Ph.D., president and CEO of the Cystic Fibrosis Foundation and CFFT. "We are confident that by becoming part of the TDN, Dr. McCoy, Dr. Heintz and their team will be able to increase their involvement in the fight against CF and will play an integral role in moving CF drug discovery from the test tube to the bedside in a safe and expeditious manner."

Columbus Children's Hospital will receive up to $108,000 per year over the next five years with the opportunity for renewal after the initial five-year period. This money will help the center establish the facilities, personnel and infrastructure necessary to conduct CF clinical trials. To select the new centers, the CF Foundation appointed a committee consisting of representatives from the academic medical community, the pharmaceutical industry and from the CF Foundation itself. The basis for selection included numbers of CF patients in the affiliated care center, expertise of personnel in clinical research, specialty facilities and university/hospital commitment to CF clinical research.

The CF Care Center at Columbus Children's Hospital regularly cares for more than 350 children and adults with CF. Information regarding these patients is entered into a secure database, which allows at-a-glance assessment of inclusion and exclusion criteria when recruiting for clinical trials. As a TDN center, Columbus Children's Hospital will participate in the development of novel assessment tools, as well as identifying patient participants for clinical trials, completing and documenting study procedures and complying with protocol and regulatory guidelines.

The Columbus team has outstanding laboratory capabilities that will specifically aid in evaluating the responses to CF interventions. For example, they have research quality bronchoscopy expertise, pulmonary physiology assessment proficiency (including for infants) and experience with highly sensitive, specialized radiographic techniques. These techniques include stop-ventilation high-resolution computed tomography of the chest, which allows visualization of very minor airway inflammatory changes.

In fact, Columbus Children's Hospital is ranked eighth in the nation among freestanding children's hospitals for receipt of research dollars from the National Institutes of Health. Columbus Children's Pediatric Clinical Trials International, in conjunction with the Division of Pediatric Pulmonology, already has participated in several important multi-center, TDN-sponsored projects.

"Our commitment to CF research extends beyond our staff and includes our patients who actively seek participation in research protocols," said McCoy. "In our new role as a member of the CF Foundation's TDN, we have the opportunity to use our resources to become an even greater force in CF research - to help improve care and realize a cure. We are extremely pleased and excited about the opportunity to be a part of this important initiative."

CF is a genetic disease that affects approximately 30,000 people in the United States. A defective gene causes the body to produce an abnormally thick, sticky mucus. This abnormal mucus leads to chronic and life-threatening lung-infections and impairs digestion. When the CF Foundation was created in 1955, few children lived to attend elementary school. Today, because of research and care supported by the CF Foundation with money raised from donations by individuals, corporations and foundations, the median age of survival for a person with CF is now 33.4 years.

Columbus Children's Hospital Childhood Obesity Expert Recommends Simple Intervention To Prevent School- Age Children From Becoming Overweight Adults

Sun, 20 Oct 2002 00:00:00 -0400

With one in four children at risk for becoming overweight and one in 10 children already overweight, simple interventions that will have more kids standing in line at their school cafeterias and more pediatricians weighing in on the subject could be the answer, according to a childhood obesity expert from Columbus Children's Hospital. Robert Murray, M.D., F.A.A.P., director of the Center for Nutrition and Wellness at Columbus Children's Hospital, proposes that to combat childhood obesity, greater emphasis should be placed on school-based nutrition policies as well as weight management and nutrition counseling during the recommended 12 well-child visits with the child's pediatrician. Dr. Murray discussed these strategies and others Sunday, October 20 at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Boston.

Dr. Murray suggests using the 12 well-child visits between birth and age 5 to treat obesity with the same level of seriousness and aggressiveness used when promoting child immunizations. Typically during the visits, physicians will monitor a child's progress on the body mass index (BMI) curve by reviewing dietary habits and basic nutrition with parents. Dr. Murray said keeping children on the BMI curve will prevent the vast majority of adulthood obesity.

Secondly, Dr. Murray recommends developing school-based nutrition policies to maintain a reasonable weight for every child into their adolescent years. According to Dr. Murray, the cost of providing a universal breakfast and lunch through the National School Lunch Program (NSLP) is minimal compared to the cost of treating the obesity epidemic. Research indicates the positive impact of breakfast and lunch on the academic performance of students. Through the NSLP, children consume twice the servings of fruits and vegetables and greater amounts of grains and dairy.

"Obesity is a pediatric disorder," Dr. Murray said. "The obese child at age 6 has a 50 percent chance of obesity as an adult, while an obese child at age 10 has a 70-80 percent chance of becoming an overweight adult. We need to optimize interventions that are effective and influence children early in life to prevent obesity in adults."

Dr. Murray said interventions with children at school and at home will decrease obesity, improve fitness, prevent health problems and achieve Healthy People 2010 goals. Healthy People 2010 is a United States Department of Health and Human Services program that challenges individuals, communities, and professionals to take specific steps to ensure that good health is enjoyed by all.

Columbus Children's Hospital ranks among the top 10 in National Institutes of Health research awards and grants to freestanding children's hospitals in the country. With nearly 500,000 patient visits each year, Children's Hospital is a 110-year-old pediatric healthcare network treating newborns through age 21. In 2001, the Children's Research Institute conducted more than 105 research projects. Pediatric Clinical Trials International (PCTI), a site management organization affiliated with the hospital, also coordinated more than 50 clinical trials. In addition to having one of the largest ambulatory programs in the country, Children's offers specialty programs and services. Each year, more than 75,000 consumers receive health and wellness education and 2,000 students from 100 institutions and 500 residents receive training at Children's. More information on Children's Hospital of Columbus is available by calling (614) 722-KIDS (5437) or through the hospital's Web site at http://www.columbuschildrens.com.

CONJOINED TWINS SUCCESSFULLY SEPARATED

Wed, 04 Sep 2002 00:00:00 -0400

Twin girls born joined at the chest and abdomen are in critical condition and comfortably resting after surgery to separate them Friday, Aug. 30, at Columbus Children's Hospital. Four-month-olds Makayla and Jazmine Heaberlin, daughters of Trinda Kaminski and Shane Heaberlin of Mansfield, Ohio, were born at 33 weeks gestation at The Ohio State University Medical Center on April 24, 2002, at 11:25 p.m. via cesarean section. The twins were transported to the Neonatal Intensive Care Unit at Columbus Children's Hospital shortly after their birth. They arrived at Children's at 2:03 a.m., April 25. Upon their arrival to Columbus Children's Hospital, the twins were admitted, given a complete neonatal screening and underwent diagnostic tests to determine if surgery was possible. Tests included close scrutiny of the central nervous, cardiac, pulmonary, gastroenteric, hepatic, vascular and skeletal systems. The twins were classified as thoracopagus-meaning they were joined at the chest. Thoracopagus is the most common type of conjoinment, accounting for 35 percent of all conjoined twins cases. The twins had no sternum and shared a liver and diaphragm. They also shared a pericardium (sac enclosing the heart) but had separate, adjacent hearts. Makayla's heart is normal in size and anatomy. A new heart sac was created and her chest was closed. Jazmine's heart has a large hole in the wall separating the pumping chambers and therefore is enlarged. Her enlarged heart required the creation of an artificial front chest wall from titanium mesh to protect it. It is likely that surgery will be necessary to repair her heart defect. "The separation of conjoined twins has long been a surgical challenge. Successful separation is often precluded by the nature of the conjoining," said Gail Besner, MD, the pediatric surgeon who first became involved with the Heaberlin case. The surgery began at 7:30 a.m. and concluded at approximately 8 p.m. A surgical team composed of specialists from pediatric surgery, thoracic surgery, plastic surgery, cardiology, anesthesiology and nursing performed the operation. The twins together weighed 19 pounds prior to the separation. "We are pleased with the outcome of the surgery," said Besner. "The truly wonderful part is we are optimistic that Makayla and Jazmine will eventually be able to go home and live happy and healthy lives." Since 1978, surgeons at Columbus Children's Hospital have successfully separated four sets of conjoined twins, including the current patients. The hospital staff has cared for two additional sets of conjoined twins that died within days of their births-one set was separated and no surgical intervention was possible for the other set. "This type of surgery is an example of the experience and expertise of the entire staff at Columbus Children's Hospital," said Donna Caniano, MD, surgeon-in-chief at Children's. "It was with the combined efforts of numerous departments and specialties - such as laboratory, neonatology, radiology, among many others - that we were able to help these children. From the doctors and the operating room staff to the intensive care nurses - we can't thank them enough for making it possible to help these patients." It is not yet known how long the girls will remain at Children's Hospital before going home. Children's Hospital, Inc., in Columbus, Ohio, is a healthcare network that provides wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children, adolescents and selected adult patients. A medical staff of more than 750 and a hospital staff of nearly 4000 provide state-of-the-art pediatric care for 500,000 patient visits annually. Children's is home to Ohio's first Level 1 Pediatric Trauma Center and its Children's Research Institute is one of the top ten National Institutes of Health-funded pediatric research facilities. Each year, more than 75,000 consumers receive health and wellness education and 2,000 students from 100 institutions and 500 medical residents receive training at Children's. The preferred pediatric provider in Central Ohio since 1892, Children's Hospital is dedicated exclusively to full-service health care for children - serving every child for every reason. Click here to see photos