Our daughter, Saoirse, was diagnosed with cancer when she was 11 months old. Her care, safety and comfort were our first priorities. When she had a PICC line and later a central line placed to infuse drugs and fluids, we saw a need for a better way to keep these lines safe and secure without using skin-damaging tape and irritating mesh netting. Saoirse was tugging at her lines and trying to pull off the tape, so I handmade a fabric sleeve for her PICC line and a chest wrap for her central line, and she went back to playing and being a kid.
Vaccines to protect against infectious disease are the single most effective medical product, but developing new ones is a challenging and lengthy process, limiting their use in developing countries where they are most needed. Once a new vaccine is developed, it undergoes animal testing, which is time-consuming and does not necessarily reflect human immunity.
“It can take decades from the start of vaccine development to FDA approval at huge cost,” says Ofer Levy, MD, PhD, a physician and researcher in the Division of Infectious Diseases at Boston Children’s Hospital. “We are working on making the process faster and more affordable.”
A variety of new strategies are emerging to facilitate vaccine development and delivery:
1. Modular approaches to vaccine production
The Multiple Antigen Presenting System (MAPS) is one innovative modular method to more efficiently produce vaccines that provide robust immunity.
Last week was a good week for neuroscience. Boston Children’s Hospital received nearly $2.2 million from the Massachusetts Life Sciences Center (MLSC) to create a Human Neuron Core. The facility will allow researchers at Boston Children’s and beyond to study neurodevelopmental, psychiatric and neurological disorders directly in living, functioning neurons made from patients with these disorders.
Patient-derived neurons are ideal for modeling disease and for preclinical screening of potential drug candidates, including existing, FDA-approved drugs. Created from induced pluripotent stem cells (iPSCs) made from a small skin sample, the lab-created human neurons capture disease physiology at the cellular level in a way that neurons from rats or mice cannot.
Tools like CRISPR could give us the power to alter humanity’s genetic future. A group of senior American scientists and ethicists have called for a moratorium any attempts to create genetically engineered children using these technologies until there can be a robust debate.
Judy Wang, MS, is a program manager in the Telehealth Program at Boston Children’s Hospital.
In 2012, when I attended the South by Southwest (SXSW) Interactive conference for the first time, health tech was still an emerging field. It was the first year the world’s leading conference for emerging technology and digital creativity made any effort to include health tech programming, and the first time its Accelerator pitch event included a category for health tech startups.
Only three years later, SXSW Interactive (March 13–17, 2015) has grown to include almost 50 events related to health and medical technologies. Martine Rothblatt, CEO of the biotech company United Therapeutics, gave a keynote titled “AI, Immortality and the Future of Selves” that was both inspiring and provocative. She spoke to a world in which our 24/7 selves are increasingly being captured digitally. Audience questions captured by Twitter pondered the ethical implications of what Rothblatt called “mind clones”: future mechanical beings digitally programmed with our mannerisms, habits and memories.
There’s been a lot of speculation about whether low vaccination rates are feeding the 2015 U.S. measles outbreak, which as I write this stands at 145 cases across seven states. Well, we can stop speculating, because the numbers are in, and measles is taking advantage of pockets of inadequately vaccinated people.
Our genes can mutate at any point in our lives. In rare cases, a mutation randomly occurs in a single cell of an embryo and gets carried forward only in the descendants of that particular cell, leaving its mark in some tissues, but not in others. This pattern of mutation, called somatic mosaicsm, can have complicated consequences down the road.
While studying quality of care in the 1990s, Mark Schuster, MD, PhD found that few studies on pediatric quality had been conducted. The typical explanation that he was given was that the federal government wasn’t funding research into quality measures because children on Medicaid don’t drive federal health-care costs nearly as much as adults on Medicaid and Medicare do.
But Schuster, chief of General Pediatrics at Boston Children’s Hospital and William Berenberg Professor of Pediatrics at Harvard Medical School, believes there have been other challenges in measuring care quality in children. In an acceptance speech upon receiving the 2014 Douglas K. Richardson Award for Perinatal and Pediatric Healthcare Research, published today in the journal Pediatrics (PDF), Schuster points to factors including the relative rarity of many pediatric conditions and that many of the benefits of excellent pediatric care are not observed until adulthood.
From a series on researchers and innovators at Boston Children’s Hospital. At left, David Casavant demos TeleCAPE at a Boston Children’s Hospital Innovators Showcase.
It is said that necessity is the mother of invention, so when David Casavant, MD, observed his teenagers routinely using FaceTime and Skype to connect with friends, he had a lightbulb moment. Could videoconferencing help him support his patients—children and young adults who require mechanical ventilation in their homes?
“It just seemed obvious,” says Casavant, a physician in the Boston Children’s Hospital’s CAPE (Critical Care, Anesthesia and Perioperative Extension & Home Ventilation) program, part of the Division of Critical Care Medicine. “In my work we are always weighing the risk versus the benefit to the patient. It’s easy for ambulatory patients to swing by their primary care office, get a prescription or go for an x-ray, but that’s not the case for patients who have to have their oxygen, their suction or their ventilator. If you don’t have to put them on the road you are better off not to.”
Protection Without a Vaccine(The New York Times)
Scientists at the Scripps Research Institute have successfully used a type of gene therapy to make monkeys resistant to HIV. Could this be applied to other diseases for diseases for which there is no vaccine?
More about that doctor shortage, er, poor distribution of physicians(The Washington Post)
On Tuesday, the American Association of Medical Colleges released a report predicting a national physician shortage of 90,000 doctors by 2025. But it may be that we have more of a distribution problem than a volume problem; we need more incentives for doctors to practice in medically underserved areas.