New Jersey hospitals provide groundbreaking pediatric care for the state’s most precious resource – our children.
By Jennifer Lesser, Contributing Writer on August 10, 2021
In New Jersey hospitals, the most remarkable technological advancements and cutting edge techniques are aimed at the youngest residents of our state. The state’s breakthrough pediatric care treatments and technologies cover a wide range of health issues that affect infants, toddlers and adolescents, from chronic illness to traumatic injury. .
Of course, when it comes to pediatric care, the state’s neonatal care services are at the top of the advancement list. Cooper University Hospital’s state-of-the-art services for its youngest patients include high-frequency ventilation and therapeutic hypothermia, while its pediatric intensive care unit is equipped with the latest technology to care for the sickest and most sick children. seriously injured by a team of pediatric and adult trauma specialists. For complex medical or surgical needs, the Cooper Regional Children’s Hospital employs experts in 27 pediatric subspecialties.
“We offer the most modern treatments and technology, but I think one of the most cutting-edge aspects of Cooper is that we live and breathe compassionate, patient and family centered care that may not be sharp. cutting edge, but in many ways it’s actually cutting edge, ”says Dr. Michael Goodman, chief and chair of pediatrics at the Cooper University Hospital Regional Children’s Hospital. “This kind of environment between providers, physicians, nurses and patients helps create a bond of compassion and leads to better outcomes and better patient satisfaction scores… and we believe medicine in the old – really caring about your patient – is the new way of medicine, especially in pediatrics.
At Saint Peter’s University Hospital in New Brunswick, two of the latest advances in pediatric care include antisense oligonucleotide (AON) and gene therapies. AON therapies target specific RNA sequences and induce targeted reduction or restoration of proteins; Currently approved AON therapies in the United States include treatments for spinal muscular atrophy, Duchenne muscular dystrophy, and acute hepatic porphyria. Viral-based gene therapy products have been registered for ADA-Severe Combined Immunodeficiency (SCID), beta-thalassemia, Leber’s congenital amaurosis and type I spinal muscular atrophy.
“The goal of gene therapy is to introduce a therapeutic or functional gene copy to a level sufficient to improve or cure the symptoms of the disease with minimal adverse events,” explains Dr. Debra-Lynn Day-Salvatore , director of the department of medical genetics and genomics. medicine at the CHU Saint-Pierre. She notes that there are currently hundreds of cell and gene therapy programs in clinical development. “DNA or gene editing techniques are currently in the early experimental stages, but they will provide new opportunities for personalized gene therapy by modifying specific and unique nucleotide sequences. Earlier diagnosis and treatment of genetic diseases reduces morbidity and mortality and improves quality of life and longevity.
Of course, treating children is not without challenges, especially those with progressive genetic diseases. “The initial challenge is the ability to identify them early enough to avoid irreversible complications,” explains Day-Salvatore. “Newborn screening has had a huge impact on infants with a certain subset of inborn errors of metabolism, and will undoubtedly develop in the future as viable therapies are approved.”
Infants and children also present several unique challenges when designing clinical trials, including the fact that the number of procedures requiring sedation and radiation exposure should always be limited. “Neurodevelopmental assessments are also extremely important in assessing the effectiveness of treatment in infants and children who are unable to answer questions or respond to quality of life surveys,” adds Day-Salvatore.
But participating in clinical trials is not the only challenge. Many healthcare facilities across the state are grappling with the same issues they face when treating adult patients and how to make changes within their pediatric departments to improve both the quality of care and results, as well as patient experience and satisfaction. “Children with medical complexity deserve and require a greater investment in direct care, time and coordination of care,” says Dr. Matthew B. McDonald, III, President and CEO of the Specialist Hospital for children (CSH) of New Brunswick. That’s why he notes that the hospital is working to shift the model of care delivery from traditional “fee-for-service” to payment based on value and results. “Alternative payment models will allow our healthcare systems to provide better care and a better experience for our patients,” he adds.
Children’s Specialty Hospital, a RWJBarnabas healthcare facility, provides rehabilitation and specialty care services to nearly 40,000 children and youth each year at 14 locations in New Jersey, and uses the latest and most advanced technology available to his patients. “In our inpatient rehabilitation areas, we are harnessing innovative ventilation and respiratory support technologies, advanced nutrition strategies and creating new adaptive equipment to help our patients reach their full potential,” said McDonald. The CSH is also frequently involved in research focused on creating adaptive technologies for children and in trials related to new treatments for autism, ADHD and cerebral palsy.
At the CSH, advances in genetics have also had a significant impact on its patient population. For example, the early detection of genetic diseases allows physicians to tailor patient care earlier in life. “There are a growing number of children with special health care needs and a marked increase in the demand for behavioral health services as the incidence of anxiety and depression increases,” adds he does. “As the needs of our pediatric patients evolve, CSH will be there to meet their unmet needs so that each patient can reach their full potential. “
Perhaps one of the most important tools that providers use when it comes to pediatric care is collaboration. A recent case – where spinal fusion surgery was performed at the K. Hovnanian Children’s Hospital of the University of Jersey Shore Medical Center in Neptune on a baby who was only a few days old – demonstrated the importance to connect with experts to systematically design new approaches to meet the needs of each patient.
“We had a baby born with a complicated fracture and dislocation of the cervical vertebrae, and when it comes to this type of injury, no one has as much experience of how to deal with it as it is a injury so rare, ”says Dr. Lawrence Daniels, a neurosurgeon at Hackensack University Medical Center. It was the youngest case to be documented with this injury. In these types of pediatric cases, he explains, the first step is to put together a team, made up of plastic surgeons, adult spine surgeons, and neurosurgeons, to help determine how best to meet the needs. unique to each patient.
“We do a lot of spine surgeries in the United States, but they’re usually done on adults with degenerative diseases,” he adds. “We often find ourselves in situations where we have to be creative and use techniques that have been tested and found to be effective in adult patients – using tools and devices and instruments and grafts that are also primarily intended for adults – and make them work in a way that does something very unique and sometimes in a one-off situation for pediatric patients.
In pediatrics, having the latest technology at your fingertips is not always the solution, as is often the case when treating adults. This is why pediatric care specialists from the state’s top hospitals and health networks are constantly at the forefront of new approaches and techniques to address the complex needs of children, whether they are micro-premature babies. born before 26 weeks gestation, from a traumatic injury. from an accident or sports after school, or from a chronic illness or disease such as cerebral palsy.
“We have all these technologies in medicine, like computers and monitoring tools to protect the spinal cord during the operation, for example, but when your patient is only a week old, often these things are not always very. helpful, ”Daniels concludes. “We have to constantly innovate in the way we work with a child’s anatomy and stimulate our youngest patients to grow up in a way that will not hinder them in the future, while still allowing them to grow into adults by healthy and prosperous. “
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