Stories about: Market trends

Surgical 3-D printing: 300 prints, 16 specialties and counting

3-D printing is rapidly becoming a part of surgical planning. Since July 2013, Boston Children’s Hospital’s 3-D printing service, part of the Simulator Program, has received about 200 requests from 16 departments around the hospital. It’s generated a total of about 300 prints, most of them replicating parts of the body to be operated on.

Most prints take between 4 and 28 hours to produce. The largest to date—an entire malformed rib cage—took 105 hours and 35 minutes to create and weighed 8.9 pounds. The smallest—a tiny tangle of blood vessels in the brain—took 4 hours and 21 minutes and weighed 1.34 ounces. Here is sampling of what’s been coming off the production line.

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Maternal-infant health research will bring placenta into view

placental health
A pre-1858 schematic of the placental circulation from Gray’s Anatomy (Wikimedia Commons).

The afterbirth has generally been an afterthought, but that’s about to change.

This week, 19 research centers were awarded grants from NIH’s Human Placenta Project, which is seeking to learn more about the intricate organ that sustained us in the womb, the interface between us and our mothers.

A robust placenta is key to a healthy pregnancy and baby, but strangely, not much is actually known about it. “It’s a fascinating but very poorly understood structure,” says P. Ellen Grant, MD, who directs the Fetal-Neonatal Neuroimaging and Developmental Science Center at Boston Children’s Hospital and is leading one of the projects.

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Four emerging advances in childhood cancer

girl-in-jfcThe 20th century saw great strides in curing childhood cancer, thanks primarily to the discovery that broadly toxic chemotherapy agents could kill malignant cells. Once virtually incurable, pediatric cancer now has an overall long-term survival rate topping 80 percent.

In the 21st century, attention is turning to additional, less toxic developments in cancer therapy. Lisa Diller, MD, Chief Medical Officer of Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, cites four coming changes:

  • Precision medicine treatments targeting specific genetic and epigenetic pathways
  • Immunotherapy drugs gaining FDA approval
  • Innovations to reduce treatment toxicity
  • A stronger focus on improving survival of childhood cancer globally.

Read more on the Dana-Farber/Boston Children’s website.

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Respiratory illness in children with gastroesophageal reflux: Are acid blockers part of the problem?

Lungs stomach-cropped-Shutterstock-flatcat
(Flatcat via Shutterstock)

Gastroesophageal reflux disease (GERD), in which stomach acids back up into the esophagus, is increasingly diagnosed in children. One study based on insurance-claims data found that GERD diagnoses in infants more than tripled between 2000 and 2005 (from 3.4 to 12.3 percent). In addition to heartburn and chest pain, GERD has been implicated in cough, wheezing and pneumonia.

To reduce such acid-related symptoms, doctors increasingly prescribe acid suppression medications such as proton pump inhibitors (PPIs). They’re among the most-prescribed drug classes in the U.S. But clinicians in the Aerodigestive Program at Boston Children’s Hospital noticed that a large number of their GERD patients had lung cultures positive for bacteria, and that a strong predictor was the amount of non-acid reflux the child had.

“We then had to ask the question, ‘are acid suppression medications, which are being prescribed to treat respiratory symptoms, actually worsening the problem?’” says program director Rachel Rosen, MD, MPH. “What are these medications doing to change the bacteria composition in children?”

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Daniel Kohane, MD, PhD, at TEDMED: “Smart vehicles for safer medications”

“The drugs that I take don’t just go to the places in my body they’re supposed to go to do the things they do. They actually go everywhere. And what they do in those other places can be whatever.”

With those words, Daniel Kohane, MD, PhD—director of the Laboratory for Biomaterials and Drug Delivery at Boston Children’s Hospital—launched into a TEDMED talk about technologies that get drugs to where they need to go with much greater precision, like:

“Progress in this field is limited only by the imagination of the investigators and, to some degree, by reality,” says Kohane, who also sees patients in Boston Children’s Department of Critical Care Medicine. “You can achieve really big things by thinking really small.”

Click the image above to watch his whole talk.

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Power to the people: Citizen science meets precision medicine for rare disease

At this recent GoldLab Symposium presentation in Colorado, parent Matt Might shows how it’s done.

People credit rapid next-generation gene sequencing for the increased pace of medical discovery. But patients and their families—especially those with rare or undiagnosed conditions—are emerging as the true engines of precision medicine. Racing against the clock to save their children, parents are building databanks, connecting scientific dots and fueling therapeutic advances that could otherwise take a decade or more to happen.

“There’s a culture shift,” said Isaac Kohane, MD, PhD, chair of Harvard Medical School’s Department of Biomedical Informatics (DBMI), which hosted a conference titled Precision Medicine 2015: Patient Driven in late June. “A culture shift where patients feel empowered morally and intellectually to lead in precision medicine research and delivery.”

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Fighting crime in the health enterprise: Five tips for building academic-industry partnerships

shutterstock_224589463Bruce Zetter, PhD, wears quite a few hats: Pioneer. Partner. Teacher. Mentor. Charles Nowiszewski Professor of Cancer Biology in Boston Children’s Hospital’s Department of Surgery.

Now, he’s adding crime fighter to the list. “The biggest crime in the health enterprise is when the next cure for Parkinson’s disease, cancer or multiple sclerosis is left on the bench because the researcher completed the discovery phase and decided that was enough,” he says. “So the breakthrough never becomes a drug or test.”

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Bioinformatics, big data and putting the ‘count’ in accountable care

Tally_marks_counting_visitors-Wikimedia CommonsWhen you go into Netflix to choose a movie or Amazon to buy a book, they’re ready with proactive suggestions for your next purchase, based on your past history. Isaac Kohane, MD, PhD, would like to see something similar happening in medicine, where today, patients often find themselves repeating their medical history “again and again to every provider,” as Kohane recently told Harvard Medicine.

“Medicine as a whole is a knowledge-processing business that increasingly is taking large amounts of data and then, in theory, bringing that information to the point of care so that doctor and patient have a maximally informed visit,” says Kohane, chair of informatics at Boston Children’s Hospital and co-director of the Center for Biomedical Informatics at Harvard Medical School.

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What we’ve been reading: Week of April 6, 2015

What we've been readingExome sequencing comes to the clinic (JAMA)
An approachable and thorough summary of the growing trend, describing the ways in which sequencing can help provide a diagnosis, the diagnostic yield (as high as 40 percent or more, depending on the population), how often the results have changed treatment decisions and the question of who pays.

Who Owns CRISPR? (The Scientist)
Excellent coverage of the escalating patent scramble for genome editing.

Doctors Make House Calls On Tablets Carried By Houston Firefighters (NPR)
Interesting use of telemedicine in Houston, where many people call 911 in non-emergency situations. EMTs carry tablets, and can have callers chat with a physician on a video app, avoiding the need to take them to the ED.

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DNA sequencing in newborns: Where do we go from here?

newborn DNA sequencingCan sequencing of newborns’ genomes provide useful medical information beyond what current newborn screening already provides? What results are appropriate to report back to parents? What are the potential risks and harms? How should DNA sequencing information be integrated into patient care?

Four teams from across the country will converge this week (April 8–10) in Kansas City, Mo., to address these questions and share learnings from NIH-funded pilot projects. The four teams, comprising the NIH’s Newborn Sequencing In Genomic medicine and public HealTh (NSIGHT) project, will give updates on their work at the 6th Annual Pediatric Genomics Conference, hosted by Children’s Mercy Kansas City.

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