This Thanksgiving week, as Epilepsy Awareness month closes out, we’re gratified to see an innovation tested here at Boston Children’s—a wearable device for patients with epilepsy—move toward commercial development. Called Embrace, it’s like a “smoke alarm” for unwitnessed seizures that could potentially prevent tragic cases of sudden, unexpected death from epilepsy (SUDEP):

The Bluetooth-enabled, sensor-loaded watch, designed by Rosalind Picard, ScD, and colleagues at the MIT Media Lab, can detect the onset of a convulsive seizure based on the wearer’s movements and autonomic nervous system activity. Full story »

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Gomez's team at work on a platform for vaccine tracking and ordering

Gómez's team at work on an app for vaccine tracking and ordering

Eva Gómez, RN-BC, MSN, CPN, is a staff development specialist in Clinical Education and Informatics 
at Boston Children’s Hospital. She and Tami Chase, RN, nurse manager at Martha Eliot Health Center, received the Springboard Prize from Boston Children’s Innovation Acceleration Program at last month’s Hacking Pediatrics.

For months, my colleague Tami Chase and I had been experiencing a big pain point in our patient-care process: the complicated and time-consuming task of ordering vaccines—a task that requires providers and nurses to memorize or figure out complex algorithms based on variables like patient age, ethnicity and medical/family history. There are many vaccines and formulations, and if vaccine supplies are used incorrectly, we are less able to order free vaccines from federal and state sources. We’re then forced to purchase vaccines privately—tapping hospital funds that could be used for many other worthy projects. Full story »

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This post is first in a series of profiles of researchers and innovators at Boston Children’s Hospital.

Martha Murray, Braden Fleming and their children in San Francisco.

Martha Murray, Braden Fleming and their children in San Francisco.

“I’d like to meet the innovator who made the tricorder that Bones used on Star Trek,” says orthopedic surgeon Martha Murray, MD. “A push of the button and things healed, no muss, no fuss. I’d like to know how he or she made that work because I could really use one.”

Murray has been on a 30-year quest to devise a better way to treat anterior cruciate ligament (ACL) tears. She recently crossed a major milestone: The Food and Drug Administration approved a first-in-human safety trial of a bio-enhanced ACL repair that encourages the ligament to heal itself. Murray expects the first patients to enroll in the 20-patient trial by early 2015. We had a few questions for her.

Full story »

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UV light-activated aptamers Dan Kohane drug delivery

Short snippets of DNA called aptamers (red) readily get into cancer cells (green and blue) on their own (left panel). They can't penetrate cells when stuck to an oligonucleotide (center), but regain the ability when the oligonucleotide's bonds are broken by UV light (right). (Images courtesy Lele Li, PhD.)

You have a drug. You know what you want it to do and where in the body you need it to go. But when you inject it into a patient, how can you make sure your drug does what you want, where you want, when you want it to?

Daniel Kohane, MD, PhD, who runs the Laboratory of Biomaterials and Drug Delivery at Boston Children’s Hospital, has one potential solution. In the Proceedings of the National Academy of Sciences, Kohane; postdoctoral fellows LeLe Li, PhD, and Rong Tong, PhD; and Robert Langer, PhD, of Massachusetts Institute of Technology, describe a drug- targeting system that’s based on a combination of ultraviolet (UV) light and short, single strands of DNA called aptamers. Full story »

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WilliamsDavidDSC_0056PreviewlargeDavid A. Williams, MD, is chief of hematology/oncology at Boston Children’s Hospital and associate chairman of pediatric oncology at Dana-Farber Cancer Institute. This column was first published on Huffington Post.

The fact that childhood cancer is, thankfully, rare belies the fact that it is the leading cause of disease-related death in U.S. children age 1 to 19. The number of people with a direct stake in expanding research into pediatric cancer is quite large, well beyond the small number of children with cancer and their families. Not only are the life-long contributions of children cured of cancer enormous, but understanding cancers of young children could also hold the key to understanding a broad range of adult cancers. The time is ripe to allocate more resources, public and private, to research on pediatric cancer.

In an age of increased understanding of the genetic basis of diseases, one thing is striking about many childhood cancers. They are relatively “quiet” cancers, with very few mutations of the DNA. Young children haven’t lived long enough to acquire the large number of mutations that create the background “noise” associated with years of living. This makes it much easier to pinpoint the relevant genetic abnormalities in a young child’s cancer.

Add to this the growing realization that biology, including how various tumors use common “pathways,” is a major factor in how the cancer responds to treatment. Thus, a mechanism that’s relatively easier to observe in the cancers of young children could help scientists understand cancers in adults, in whom the same mechanism is hidden amid the clutter of mutations acquired over a longer life. Full story »

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A biospleen is born

by Tom Ulrich on November 17, 2014

biospleen sepsis Wyss Institute Donald Ingber

The Wyss Institute's biospleen. (Photos courtesy of the Wyss Institute)

On a Friday morning a few years ago, a childhood friend of mine walked into his doctor’s office, saying his hip hurt. The pain was pretty severe, and had been getting worse for several days.

By Saturday morning, he was in intensive care, fighting for his life against an overwhelming case of sepsis. He survived, but at a cost: he’s now a quadruple amputee.

It’s people like him—and the other million-plus Americans who develop sepsis every year—that Donald Ingber, MD, PhD, and his team had in mind while developing the biospleen, a device that filters sepsis-causing pathogens from the blood. Announced to the world in September, the biospleen grew out of the organs-on-chips technology that Ingber’s team at the Wyss Institute for Biomedically Inspired Engineering launched commercially this past summer.

Full story »

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Jack Andraka Pediatric Innovation Summit

Jack Andraka holding his pancreatic cancer detection strip

Boston Children’s Global Pediatric Innovation Summit + Awards (October 30-31) drew innovators, thought leaders and researchers from around the globe.

And one guest speaker who’s still in high school.

Teen science prodigy Jack Andraka, 17, addressed more than 300 summit attendees and shared his journey from Baltimore, Maryland high school freshman to developer of an early diagnostic test for pancreatic, ovarian and lung cancers. And he achieved this extraordinary task before getting his driver’s license.

After the loss of a close family friend to pancreatic cancer in 2010, Andraka, then 13, sought answers. Full story »

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Patient handoff I-PASSIt’s increasingly clear that good health care is as much about communication as about using the best medical or surgical techniques. That’s especially true during the “handoff”—the transfer of a patient’s care from provider to provider during hospital shift changes. It’s a time when information is more likely to fall through the cracks or get distorted.

Now there’s solid proof that focusing on communications counts. Last week, The New England Journal of Medicine (NEJM) published a paper showing that implementing a set of handoff procedures and training tools led to a 30 percent drop in injuries from medical errors across the nine participating sites. Full story »

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pulse pressure

Subtract 68 from 100 to get a pulse pressure of 42 (Wikiphoto/Creative Commons)

Second in a two-part series on cardiovascular prevention in children. Read part 1.

Carrying too much weight is tough on the body. The dramatic rise of obesity in recent years means more and more people are confronting increased cardiovascular risk due to changes in their blood vessels, cholesterol levels, blood pressure, and blood sugar. And the problem isn’t limited to adults: Today, there are more than three times as many obese children in the U.S. than there were in the early 1970s.

However, not every person with excess weight has cardiac risk factors, and not everyone with cardiac risk factors carries excess weight. So what is the relationship between childhood obesity and cardiac risk factors later in life? What links excess weight to its consequences?

Justin Zachariah, MD, MPH, a cardiologist at Boston Children’s Hospital, was inspired to investigate these “risk factors of risk factors” when he observed a pattern in his pediatric preventive cardiology clinic. He noticed that many of his patients who were carrying excess weight did not have very high blood pressure, or hypertension. Full story »

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Blood pressure taken in child-shutterstock_181679828First of a two-part series on cardiovascular prevention in children. Read part two.

As childhood obesity has increased over the past 30 years, so has pediatric hypertension, which now affects one in 20 children. However, 48 percent of children with high blood pressure (BP) are of normal weight; other risk factors include low birth weight, which has also increased in the past 30 years (more recently dipping slightly to about 8 percent of births).

While children with hypertension rarely develop diseases that adults do, such as myocardial infarction, heart failure and stroke, they are at risk for adult hypertension and early symptoms of heart disease. “Attacking pediatric hypertension is the next frontier in cardiovascular disease prevention,” says Justin Zachariah, MD, MPH, of the Department of Cardiology at Boston Children’s Hospital.

The Affordable Care Act’s mandate to identify elevated BP in children is expected to increase referrals for screening. But diagnosing pediatric hypertension through BP screening in the clinic can be problematic. In a recent study, Zachariah found that ambulatory BP monitoring (ABPM) with a take-home device is both effective and cost-effective—especially when done from the get-go. Full story »

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