Doc Talk

Children and teens can have difficulty with bladder and bowel incontinence (leaking urine or stool), constipation, pain when using the restroom (dysuria) or pelvic pain. There are myriad reasons why kids have pelvic floor issues. This could be due to pelvic floor dysfunction, muscle imbalance or diet, Join us in a lively discussion with Cook Children’s pediatric pelvic floor therapists Caitlin Smith, MOT, OTR/L, and Kathy Manthuruthil, PT, DPT, PCS, CPST on the many causes and when to refer patients to pediatric pelvic floor rehabilitation/

Vice President, Chief Research Officer, William Stigall, MD, MA, shares the frontier-pushing pediatric research happening at Cook Children’s and its power to improve the health and wellbeing of children in Texas, the nation, and internationally.

Whether it's caused by a movement disorder such as Bell's Palsy or Guillain-barre syndrome, trauma, facial palsy, affects a child's look, smile, speech, eating, and self-esteem. Listen in to hear how the speech language pathologists at Cook Children’s facial reanimation program provide therapy that helps to restore facial movement and symmetry, boosting confidence, and turning little smiles into big successes.

Dr. Christos Papadelis shares the strides made by robotic rehabilitation for children with cerebral palsy at Cook Children's. His team uses the Amadeo system, which improves upper extremity functions through video games. The project focuses on children with congenital hemiplegia and is showing significant improvements in finger motion and dexterity after only 15 consecutive days of training. Listen up to discover what’s on the horizon as we understand more about neuroplasticity and the potential for broader applications in both upper and lower extremities.

Can focused ultrasound send tiny bubbles beyond the blood brain barrier and destroy diffuse intrinsic pontine gliomas in children? Hear why Sibo Zhao, M.D., and John Honeycutt, M.D., believe it can, why this research is so important, and what its future applications might be.

Imagine holding a perfect 3D replica of a child's heart, spine, or skull in your hands. Cardiologist Steve Muyskens and plastic surgeon Han Zhuang Beh share the incredible advantages of having an onsite 3D printing lab that creates precise, unique detailed models so surgeons can map out a clear plan before entering the operating room, providing better, more reliable results in even the smallest patients.

For babies born before 28 weeks and full-term infants born with serious complications, the small baby unit team at Cook Children’s NICU adds an extra level of care, and a fighting chance for a bright future.

Cook Children’s pediatric neurologist, Stephanie Acord, M.D., delves into selective dorsal rhizotomy for children with spastic cerebral palsy with a deep dive into the evaluation of each patient, the neurosurgical process, role of the motion lab, and rehab therapies post-surgery. She also discusses the long-term outlook for these kids as more strides are made in the future.

When a child's immune system doesn't work properly, it can cause problems like severe, frequent or unusual infections and autoimmune disorders. Immunologist, Dr. Natalia Chaimowitz, and Pediatrician, Dr. Alice Phillips, discuss the roles of primary care, immunology and fast-breaking medical advancements in genetics research, diagnoses and treatments in pediatric immunology help kids live their best lives.

A podcast on DNA, diagnosing genetic conditions, optical genome mapping for diagnostic accuracy, comprehensive patient histories, and equitable genetic research participation across all ethnicities.

Dr. John Robertson and his team at Cook Children's Exercise Respiratory Center specialize in diagnosing and treating exercise-induced laryngeal obstruction (EILO) and dysfunctional breathing in children and young adults. They use the Continuous Laryngoscopy During Exercise (CLE) test, a pioneering method since 2019, to observe airway, respiratory, and cardiovascular systems during exercise. The center, founded in 2023, offers personalized treatment plans involving speech and physical therapies. Research by Dr. Andy Kreutzer aims to develop a single exercise session to diagnose EILO and other respiratory issues. The team emphasizes the importance of early diagnosis and collaboration with coaches and trainers to help athletes manage symptoms and continue their sports.

A look at the importance of interprofessional care to improve the outcomes of young people with leukemia, with pediatric leukemia specialists Paul Bowman, M.D. and Kenneth Heym M.D.

Join Cook Children’s team of experts on blazing new trails in treating and curing hyperinsulinism (HI) for children across the nation and around the globe. Hear what’s being done to cure more patients and expand treatment most difficult cases.

There is a misconception that palliative means end of life care.  But that's not how we think about palliative surgery at all. Palliative surgery is when we're looking at not necessarily curing something, but alleviating something. Cook Children’s Palliative epilepsy neurosurgery explains how kids with intractable epilepsy are getting a better quality of life.

Dr. Scott Perry, Medical Director of Neurosciences and Dr. Christos Papadelis, Director of Neurosciences Research along with Dianna Grado, Clinical Coordinator for Neurosciences Research, explore how breaking research boundaries creates limitless possibilities, paving the way for world-class research – and results once thought impossible for kids and young adults with neurological disorders.   Meet the speakers Meet Dr. PerryMeet Dr. PapadelisDianna Grado, RN Related information Jane and John Justin Neurosciences Research Center Clinical Research Adult Genetic Epilepsy Clinic Comprehensive Epilepsy Program Movement Disorders Movement Disorders Clinic Cerebral Palsy Clinic Cook Children’s Neurology Cook Children’s Neurosciences Research Center Dodson Neuro Research Endowment The Arcuate Primary steps for primary care: Sleep disorders in epilepsy and cerebral palsy Infantile Spasms- Primary Steps for Primary Care Staring Spells – Primary Steps for Primary Care Febrile Seizures – Primary Steps for Primary Care The Arcuate – Neuroscience Research Early Identification and Improving Life-Long Outcomes in Cerebral Palsy Patients New-Onset Seizure Clinic Seeks to Decrease Wait Time for Initial Evaluation BE FAST to Recognize the Signs of Pediatric Stroke Pioneering Surgery Disconnects Left Side of Brain to Stop Child’s Daily Seizures Teen Becomes First in North Texas to Undergo Landmark Brain Surgery for Epilepsy   Transcript 00:00:11   Host:  Hello and welcome to this edition of Doc Talk. We're honored and excited today to be speaking with key researchers at Cook Children's Jane and John Justin Neurosciences Center. We're joined by Dr. Scott Perry, Medical Director of Neurosciences, Dr. Christos Papadelis, Director of Neurosciences Research and Diana Grotto, C...

With the growing number of pediatric congenital heart patients growing up thanks to ever improving medical care, Dr. Scott Pilgrim takes us inside one of the few programs in the nation that bridges the gap to adult care without missing a beat. Meet the speaker Meet Dr. Pilgrim Related information Cook Children's Adult Congenital Heart Disease Program Adult Congenital Heart Disease Conditions Cook Children's Heart Center Specialty Programs Cook Children’s Heart Center Coming home: nurse returns to Cook Children’s for open heart surgery Diving heart first Heart-to-heart. Mother and daughter share the same cardiologist   Transcript 00:00:02 Host  Hello and welcome to Cook Children's Doc Talk. Today we're talking with Dr. Scott Pilgrim, who is the medical director of the Adult Congenital Heart Disease program here at Cook Children's. Dr. Pilgrim is board-certified in pediatrics, internal medicine, pediatric cardiology and adult congenital cardiology. Prior to coming to Cook Children's, Dr. Pilgrim founded the adult congenital heart disease program at the Steven and Alexandra Cohen Children's Medical Center in Long Island. Today, under his leadership, the Adult Congenital Heart Disease program at Cook Children's Medical Center has shown tremendous growth with over 500 adult visits every year. Welcome Dr. Pilgrim. 00:00:42 Dr. Pilgrim  Thank you. 00:00:43 Host  So growing up with a sister who had heart surgery as a child had a major influence in your life, and ultimately led you to your role here at Cook Children's as medical director of the ACHD program, compared to many other cardiac specialties, adult congenital as a specialty is relatively new, can you give us a little history. 00:01:03 Dr. Pilgrim  So, as you mentioned, my sister was born with a congenital heart disease. And so growing up with this in my family, it became of interest to me at a very young age. But as a field, congenital heart disease is something that has been around obviously, for several decades, this field of adult congenital heart disease has grown primarily because of the success stories that we've had in pediatric cardiology, namely, the surgical outcomes and the longevity of patients related to improved surgical care, improved surgical technique, you know, recognizing disease, early on fetal diagnosis, and so on and so forth. And so the incidence of congenital heart disease really hasn't changed. But the lifespan of individuals growing up with congenital heart disease has tremendously improved. And so when we think about the growth of adult congenital heart disease in the country, it really has grown out of necessity, because these kids are now growing up and becoming adults. In fact, the number of adults with congenital heart disease now far outweighs the number of children with congenital heart disease in the United States, almost to a 60-40 split. That care gap that...

Dr. Holly Pacenta, Pacenta takes us into the future of curing and treating pediatric cancer through the use of the patient's own immune system to target the cancer. At the forefront of the technology is CAR T-cell therapy targeting relapsed and refractory B-ALL cells to eradicate cancer with minimal side effects. Meet the speaker  Meet Dr. Pacenta Related information Cook Children's Cellular Immunotherapy program Cook Children’s Leukemia and Lymphoma care Cook Children's Oncology program  Cook Children's Hematology and Oncology   Transcript 00:00:02  Host:  Hello and welcome to Cook Children's Doc Talk. Our guest for this episode is pediatric hematologist oncologist Dr. Holly Pacenta. Dr. Pacenta began her career at Children's Hospital Colorado, where she developed her primary interest in new treatments for children with relapsed leukemia, including immunotherapy, cellular therapy and targeted therapy. She has been heavily involved in research, has published several works and received awards and recognition for her work. Today, Dr. Pacenta oversees the Cellular Immunotherapy program at Cook Children's where she and the oncology team are very excited about providing CAR T-cell therapy to patients with relapsed B-cell acute lymphoblastic leukemia, or ALL. Cellular immunotherapy introduces a new era in the treatment of children and young adults here at Cook Children's. Welcome Dr. Pacenta. We are very excited to have you here to talk about this incredible program and CAR T-cell therapy. 00:01:01  Dr. Pacenta: Thank you so much for having me. 00:01:03 Host: Can you start by giving us a little background on the cellular immunotherapy program and an overview of immunotherapy and CAR T-cell therapy? 00:01:11  Dr. Pacenta  Sure. So I think first to give an overview of immunotherapy and CAR T-cell therapy, we think at the forefront of the future of curing and treating pediatric cancer is to use, help use the patient's own immune system to target the cancer. So that's what immunotherapy is. Immuno meaning the immune system in therapy meeting treatments, so using the immune system to help treat your own cancer. And then CAR T-cell is a form, kind of a hybrid, of cellular immunotherapy. So we use one of the cells as part of the immune system, the T cells that typically help fight infection, and those get sent to a lab where they're reprogrammed to target the leukemia. So that's CAR T-cell therapy is. Then, our cellular immunotherapy program is a dedicated group of oncologists and stem cell transplant doctors here at Cook Children's along with some supportive services like pharmacy, dieticians, psychologists, etc., that will help provide these types of therapies to our patients. 00:02:13  Host:  So KYMRIAH® is the CAR T-cell therapy currently approved for pediatric treatment of children and young adults with refractory or relapsed B-cell ALL, why this particular condition? 00:02:26 Dr. Pacenta:  Immunotherapy and cellular therapy are a big interest in pediatric cancer in general. And there has been a lot of research to try to use this type of treatment for many different cancers....

Listen Now Preventing adult heart attacks in early childhood? Don Wilson, M.D., explains why it's absolutely within REACH. Children with high cholesterol, especially those who have a genetic cause, such as familial hypercholesterolemia, also know as fH, are at a higher risk for developing premature heart disease, such as heart attack or stroke as they become adults. At the forefront of developing guidelines for lowering this risk, Dr. Wilson details how the Risk Evaluation to Achieve Cardiovascular Heath, or REACH, clinic at Cook Children's is putting those guidelines to work and changing the outcomes for these in the future, and saving the lives of parents today. Meet the speaker Dr. Don Wilson Related InformationRisk Evaluation to Achieve Cardiovascular Health (REACH) Clinic Diabetes Program Endocrinology Program They're Active, Eat Healthy, and Have High Cholesterol-Why? Harper's Story Kids at Risk of Smoke Exposure in Smoke-Free Areas? A Simple Blood Test Could Save Your Child's Life The Unique Risks of Being a Woman with Diabetes Number of Children and Adolescents Who are Obese 10 Times Higher than 40 Years Ago   Transcript: 00:00:03   Host:  Hello, and welcome to Cook Children's Doc Talk. Today we're talking with Dr. Don Wilson about genetic dyslipidemia, and cardiovascular disease. But first, here's just a little about Dr. Wilson. He is board certified in pediatrics, pediatric endocrinology and clinical lipidology. He is the founder and currently the medical director of Cook Children's REACH program, one of the first cardiovascular risk assessment clinics for children and adolescents in the nation. Dr. Wilson is a fellow of the National Lipid Association and an associate editor for The Journal of Clinical Lipidology and a member of the board of directors of the Southwest Lipid Association...

Neurosurgeon, Daniel Hansen, M.D. shines a light on this barrier breaking approach to epilepsy surgery. Using an endoscopic method to disconnect the left and right brain, this minimally invasive procedure has the same chance of seizure freedom post-surgery as traditional callosotomy, while reducing operating time and recovery time. Meet the speaker Meet Dr. Hansen Related information Pioneering Surgery Disconnects Left Side of Brain To Stop Child’s Daily Seizures Boy Receives Pioneering Surgery to Stop Child's Daily Seizures The Pioneer: Child Becomes First Patient in Trailblazing Endoscopic Surgery that Disconnects Part of His Brain to Stop Daily Seizures Cook Children's Patient Becomes First in North Texas Implanted with Smart Device to Control Seizures  Teen with Cancer Walks a Marathon During Hospital Stays Cook Children's Neurosurgery Cook Children's Neonatal Neurology and Neurosurgery Comprehensive Epilepsy Program Jane and John Justin Neurosciences Center   Transcript 00:00:03 Host:  Hello and welcome to Cook Children's Doc Talk. Our guest for this episode is pediatric neurosurgeon Dr. Daniel Hansen. Dr. Hansen sees and treats children for the whole range of pediatric neurosurgical issues, and has special interest in minimally invasive surgery, endoscopic surgery, tumors and epilepsy. He works closely with the neuro-oncology and epileptology teams to provide cutting edge patient-centered treatment, using the most up to date information and treatment options. Dr. Hansen is the first neurosurgeon at Cook Children's and one of only two in the state of Texas to perform an endoscopic corpus callosotomy and endoscopic surgery on the corpus callosum that separates the right and left sides of the brain for children with certain types of intractable epilepsy or severe seizures. He's also one of the first pediatric surgeons in the nation to perform the endoscopic approach. Welcome, Dr. Hansen. 00:00:58 Dr. Hansen:  Thank you.                                                                                                     00:00:58 Host:  I want to start off with a little background about you. Initially, your career choice was between becoming an astrophysicist or a surgeon, clearly surgery won out. But why neurosurgery and in particular, pediatric neurosurgery? 00:01:12 Dr. Hansen:  Well, you probably noticed, those are two pretty diverse career choices. But the link between them was a love of the unknown, of the unexplored. And I really can't see any better comparison than deep space, and the human brain, something that we live with every day, but is still vastly...

Listen NowDr. Steve Muyskens, Medical Director, Cardiac MRI, 3-D aPPROaCH Lab, Cook Children's, takes us into the world of 3D heart printing. It’s a fascinating journey into how this advancing technology can take the guess work out of pediatric heart surgery, helping more young patients can thrive into adulthood. Dr. Steve Muyskens Related InformationCook Children's 3D aPPROaCH LabCardiac Magnetic Resonance ImagingCook Children's Cardiothoracic Surgery programCook Children's Endowed Chair ProgramCook Children's Heart Center Transcript 00:00:02  Host:  Hello and welcome to Cook Children's Doc Talk. Today we welcome Dr. Steve Muyskens, medical director of the Cardiac MRI program here at Cook Children's in Fort Worth, Texas. Dr. Muyskens, is an endowed chair supporting the expansion of our CMRI program and its diagnostic uses. He has since established the three-dimensional lab for the planning and printing of congenital heart disease, which uses advanced technology to support presurgical planning and family education for patients with complex heart conditions. He is our expert on this subject. So thank you for being with us today, Dr. Muyskens/ 00:00:36  Dr. Muyskens: Thank you very much for the invitation. 00:00:38 Host: So what exactly is a 3D model? And what is the process for creating that model? 00:00:44  Dr. Muyskens  So I think the important part is to kind of start with the patient. There are conditions with varying degrees of complexity that our current diagnostic modalities fall short in some manner. So those patients have long been difficult to manage. We started realizing that we can use technology like 3D printing and virtual 3D animation to help us better understand their condition. So when we identify that patient, whether it be an older patient who has already had some surgeries, or a newborn who has a very complex heart, who we're hoping to do an initial palliation, or surgical repair on, the first thing we decide is, what is the best modality to obtain the information that we would need to then use that technology. The two most commonly used technologies would be MRI, or cardiac CT. You can use rotational angiography in the cath lab, but that's much less commonly used. Once we have that selection made, the data is obtained by us obtaining a typical CT scan or a typical cardiac MRI. But then that data, which is in a raw form called DICOM. DICOM data is then moved to specialized software. And from there, I take that data, and we segment it is the term we use, basically manipulate that data and create a virtual model, essentially, from that information. That model can then be viewed either in the virtual space, so on a typical computer that you would flip around, but then again, you're still only in two dimensions you're looking at in a screen. So then typically, we move on to a 3D printing of that data. So the typical segmentation portion, or manipulation of the data, can vary from anywhere to two to 24 hours of time, depending on the complexity of the model. And then the printing on the actual 3D print...