Stories about: Innovation

Simulation in clinical design: Testing a building before it’s built


How do you go about building a new medical facility that improves upon current workflow and safety but also anticipates technologies and care models yet to be developed?

It’s a daunting task, and one that demands collaboration among all stakeholders: clinical staff, patients/their families and building architects. A workgroup from Boston Children’s met with consultants from FKP architects to come up with a vision for a brand new clinical building set to open in 2022. As part of the pre-planning process, FKP proposed a bold idea: constructing life-size cardboard replicas of clinical areas for doctors, nurses and patient families to “test” with simulated scenarios.

“There are no disadvantages to this approach,” says Uma Ramanathan, AIA, lead architect on the project for Shepley Bulfinch, the architecture firm designing the new building. “If only everyone could use this level of detail!” Shepley Bulfinch joined the simulation project to observe and record data and insights.

“For architects, visualizing space comes easily,” Ramanathan adds. “Not so much for others.” …Read More

New study offers hope for kids with peanut allergy

Peanut allergy research

A study last week in The New England Journal of Medicine suggests that exposing infants to peanuts can provide lasting protection against peanut allergy. But what about peanut-allergic children right now? They and their parents live a life of precautions — from pre-screening birthday party menus to segregation at the school lunch table — to avoid life-threatening consumption of even trace amounts of peanut.

Now, a multi-center study reports on a protocol combining the allergy medication omalizumab (Xolair) with controlled, gradually increasing peanut consumption. After 20 weeks, most initially allergic children could safely consume the equivalent of 8 to 10 peanuts at a time. Three months after stopping the medication, most had worked up to 16 to 20 peanuts.

The small boost in peanut tolerance may not seem like much, but it could mean less worry for parents who are constantly on guard for even trace amounts of the substance. Our sister blog, Vector, has more of the story.

Learn more about peanut allergy research on Vector

Time for a personalized approach to managing kidney stones?

kidney stones Friedhelm Hildebrandt nephrology

One in 10 people in their lifetime will have a kidney stone — a small, hard deposit of mineral and acid salts that can obstruct the drainage of urine, cause intense pain and, if not treated properly, lead to long-term kidney issues. Kidney stones are relatively uncommon in children, but the number of cases over the past two decades has risen.

The treatment for kidney stones has remained the same for decades — increased fluid intake, limited sodium intake, diuretics and potassium citrate therapy. Lifestyle factors are typically blamed for kidney stones, yet twin studies suggest a genetic component.

Our sister blog Vector spoke to Friedhelm Hildebrandt, MD, chief of the Division of Nephrology at Boston Children’s Hospital, about new research that supports pursuing a genetic diagnosis for kidney stones, especially in kids.

“The minute we find a mutation that causes disease, we have the cause of disease in hand,” Hildebrandt tells Vector. “And finding the cause has consequences for therapy.”

Learn more about research on personalized medicine for kidney stones on Vector.

Is the time right for pediatric precision cancer medicine?

precision cancer medicine personalized medicine pediatric oncology childhood tumors Vector
What is precision cancer medicine all about? See the full infographic at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

Precision cancer medicine — an approach in which doctors treat a tumor based on its genetic profile, rather than where it is — has benefited a growing number of adults with cancer. It’s not yet a standard approach in pediatric oncology, but the times may be a-changing.

Our sister blog Vector reports on the results of the Individualized CAncer Therapy (iCat) trial, a four-center study led by Katherine Janeway, MD, PhD, clinical director of the Solid Tumor Center at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, that investigated the feasibility of clinical sequencing and precision medicine in patients with relapsed or refractory pediatric solid tumors. In 43 out of the study’s 100 participants, the iCat investigators made genetic findings suggesting a new treatment approach, a new diagnosis and/or a genetic predisposition to cancer.

The study joins a growing body of evidence in favor of incorporating sequencing into pediatric oncology care, at least among children with relapsed tumors.

“There’s a lot more going on than any one study would suggest,” Janeway says. “Every study, every paper is all part of one big story about bringing precision medicine to children with cancers.”

Read more about the iCat study on Vector. And visit the Thriving blog to read about a young patient who is now a brain tumor survivor thanks to precision cancer medicine.