Surgeons and dentists often use Gelfoam sponges to mop up blood and help stop bleeding. Could they act as drug-eluting devices to grow new heart tissue?
While current heart-attack treatments mainly try to preserve healthy heart tissue, scientists have been finding ways to stimulate growth of new tissue to replace the tissue that’s damaged. They’ve done this either by getting heart muscle cells (cardiomyocytes) to make more copies of themselves, or by stimulating other cells to become cardiomyocytes (one recently reported study, for example, used genetic regulators called microRNAs).
The next challenge lies in getting these regenerative factors into a living patient’s damaged heart tissue — without affecting healthy tissue – and getting the factors to stay in place long enough to work their magic.
A new approach developed at Boston Children’s Hospital, which could be used relatively soon, takes advantage of Gelfoam, a gelatin-based sponge that’s already FDA-approved and has been used by surgeons and dentists for decades. Full story »
Early seizures may disrupt circuit formation in babies' brains, leading to autism. But new research suggests that an existing drug can reverse this.
This is the third post in a series about new approaches for seizures and epilepsy. Read the first and second posts.
We already know that there’s some kind of connection between epilepsy and autism: Children who have seizures as newborns not uncommonly develop autism, and studies indicate that about 40 percent of patients with autism also have epilepsy. New research at Boston Children’s Hospital finds a reason for the link, and suggests a way to break it — using an existing drug that’s already been given safely to children.
In the online journal PLoS ONE, Frances Jensen, MD, in the Department of Neurology and the F.M. Kirby Neurobiology Center at Boston Children’s, and lab members Delia Talos, PhD, Hongyu Sun, MD, PhD, and Xiangping Zhou, MD, PhD, showed in a rat model that early-life seizures not only lead to epilepsy later in life, but also produce autistic-like behaviors.
Drilling deeper, they showed that early seizures hyper-activate a group of signaling molecules collectively known as the mTOR pathway. Full story »
Excess brain electrical activity at night can disrupt development -- but if found, may be treatable.
This is the second post in a series about new approaches for seizures and epilepsy. Read the first post here.
When a 2- or 3-year-old child begins losing milestones like language, walking skills and fine motor abilities, or is slow to achieve them, it’s devastating for families. The good news, at least for some children, is that it might be treatable.
Tobias Loddenkemper, MD, a neurologist in the Epilepsy Center at Boston Children’s Hospital, suspected that some children with developmental delay have seizure-like activity in the brain at night. These spikes of electrical activity, referred to medically as sleep-potentiated epileptiform activity, can be readily and inexpensively detected by electroencephalography, or EEG, and readily treated with nighttime anti-seizure drugs.
But likely, no one’s thought of it. “Very few physicians have been looking to see what’s happening at night,” Loddenkemper says.
He and research fellow Iván Sánchez Fernández, MD, with other colleagues, decided to look themselves. Full story »
This comfy wristband can sound an alarm when a child is having a seizure, and can help doctors better time medication dosing.
This is the first post in a series about new approaches for seizures and epilepsy.
Seizures are often hard to track in children with epilepsy, making it difficult for doctors to optimize their treatment. For parents, the greatest worry is that their child will have a life-threatening seizure in the middle of the night or away from home, unable to get help. And what about when that child goes off to college?
“Every parent asks, ‘What can I do to prevent my child from harm?’” says Tobias Loddenkemper, MD, a neurologist in the Epilepsy Program at Boston Children’s Hospital.
Loddenkemper also wanted to better understand his patients’ seizure patterns so he could better time the dosing of their medications. He’s been testing a wristband sensor system, developed by Rosalind Picard, ScD, and colleagues at the MIT Media Lab (Epilepsia, March 20), and thinks it could be part of the solution. Full story »
(Kenny Louie/Flickr)
National data suggest that up to 70 percent of sentinel events—the most serious errors in hospitals—stem at least in part from miscommunications. Communication problems are especially apt to occur during hospital shift changes, when a patient’s care is transferred to incoming doctors and nurses—known in health care as the “handoff.”
More than a year ago, a team led by Amy Starmer, MD, MPH, of the Division of General Pediatrics at Boston Children’s Hospital, developed and began testing a bundle of interventions to ensure that the hospital’s residents were thoroughly and accurately briefed on each patient’s medical history, status and treatment plan in a standardized way.
Through measures such as communications training, a mnemonic to help residents remember key information to pass on and a computerized handoff tool that integrated with the patient’s electronic medical record, they managed to move the needle: Medical errors fell by 40 percent—from 32 percent of admissions at baseline to 19 percent of admissions three months after the program started.
But that wasn’t all. Full story »
Brain MRIs from mice after stroke. Mice lacking Hv1 (right panels) had a much smaller volume of infarcted tissue than normal mice. Hv1 can also be blocked chemically.
Whether it’s in adults or in children with clotting disorders or other conditions such as sickle-cell disease, a stroke can be likened to an atomic bomb. Just as ongoing radiation can do more damage than the bomb itself, the secondary damage of a stroke can devastate the brain.
In an ischemic stroke, accounting for nearly 90 percent of all stroke cases, it happens like this: When vessels supplying blood and oxygen to the brain are blocked by a narrowing or a clot, immune cells in the brain sense the low-oxygen conditions, suspect an invading organism and try to kill it by producing molecules known as reactive oxygen species or ROS’s. These, unfortunately, have an inflammatory effect that actually damages the brain further, injuring and killing neurons.
“Stroke produces inflammation, and that’s one of the main things people have been after in trying to reduce stroke damage,” says David Clapham, MD, PhD, chief of the Basic Cardiovascular Research Laboratories at Boston Children’s Hospital.
Right now there’s nothing that can do this. Most existing stroke drugs are aimed at preventing the stroke or dissolving blood clots once the stroke is happening – but they can’t deal with the aftermath. Full story »
Valentine's Day is Innovation Day (image: Richard Giles/Flickr)
In a series of 17 short TED-style talks next Tuesday, February 14, clinicians and scientists from Children’s will present new products, processes and technologies to make health care safer, better and less expensive. The event, from 1-5 p.m. Eastern, is sponsored by the Innovation Acceleration Program. It’s now running a wait list, but you can also watch the live stream or track the proceedings on Twitter (#iDay) or via @science4care. Here’s a small sampling of next week’s presenters; for details, read the press release or view the full agenda.
Diagnosing lazy eye when it’s most treatable: in preschoolers
If lazy eye, or amblyopia, is caught early – ideally, before age 5 – it’s easily treated by patching the “good” eye, forcing the child to use and strengthen the weaker eye. But if it goes unnoticed, the weak, unused eye can slowly go blind, Full story »
Lorraine Sweeney in 1963, on the 25th anniversary of her historic heart operation. (Children's Hospital Boston Archives)
When the first fetal cardiac surgery was performed at Children’s Hospital Boston in 2001 – entering Jack Miller’s heart through his mother’s abdomen and opening blood flow – the world was stunned. But more than 60 years earlier, another operation was equally game-changing.
It was 1938, a time before heart-lung bypass, when ether and chloroform were only starting to be supplanted by more controllable anesthetics, when tinkering with the heart or even opening the chest were seen as dangerous and taboo.
Tinkering was what Robert E. Gross, chief surgical resident at The Children’s Hospital, liked to do. He was interested in a congenital heart condition known as patent ductus arteriosus, a passageway between the pulmonary artery and the aorta that’s supposed to close after birth — but doesn’t. Full story »
Spherical nanoparticle (Fangting/Wikimedia Commons)
Recent research on Type 1 diabetes has begun focusing on prevention: Studies indicate that children start developing diabetes-related autoantibodies sometimes years before they develop clinical diabetes requiring insulin shots. The autoantibodies are an indicator of insulitis – a precursor condition in which the insulin-producing islets in the pancreas become inflamed and infiltrated with white blood cells.
In animal models, immune-suppressing drugs have been shown to blunt this attack by curbing the number of white blood cells circulating in the body. That reduces the need for insulin treatment – but at a high cost: Given systemically, the high doses needed to suppress the immune attack cause kidney toxicity, reduce the ability to fight infections, and decrease the body’s ability to respond to insulin.
That’s a tough sell for a child who doesn’t yet have symptoms of diabetes – but that’s where nanotechnology can help, say researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University and Children’s Hospital Boston. What if immunosuppressants could be delivered in far smaller doses, just to where they’re needed in the pancreas? Full story »
(Lars Plougmann/Flickr)
Your child has been in the hospital and it’s discharge day. It’s a chaotic scene: You’re trying to take care of him and maybe his little sister who keeps running down the hall, while completing hospital paperwork and packing your bags.
You’re finally out the door, in your car, kids strapped in and … what? You’ve just lost contact with the medical professionals who took care of your son. What was it they said to do at home again?
Perhaps you try phoning but can’t get through to your doctor. Or you try to email through the hospital’s secure system, but can’t put your hands on the password. The doctors hope you remember to pick up your son’s meds.
Vinny Chiang, a physician at Children’s Hospital Boston, came up with a simple idea. Could day-after communication with patients be “pushed” — proactive and automated? Could it be texted? Full story »
