Boston -- Although adult robot-assisted surgery has been available for several years in the US, last year only 55 pediatric procedures were performed, most of them at Children's Hospital Boston. On Sunday, Oct. 20, at the American Academy of Pediatrics (AAP) 2002 National Conference in Boston, Craig Peters, MD, associate in Urology at Children's Hospital Boston, will present results of a cohort of patients who underwent procedures at Children's Boston. Peters is nationally recognized for his expertise in minimally invasive and laparoscopic surgery.
Robot-assisted surgery in both children and adults is gaining popularity because of its minimally invasive techniques and accompanying shorter recovery times. While additional studies need to be done, robot-assisted surgery also shows promise in reducing lengths of stay, less painful recovery, lower infection rates, enhanced surgical precision and improved patient outcomes.
RESEARCHERS FIND ALTERNATIVE SOURCES OF FETAL CELLS FOR TISSUE ENGINEERING
Boston -- Animal studies by Children's Hospital Boston researchers show that cells obtained from amniotic fluid, umbilical cord blood and the placenta during pregnancy can be engineered into increasingly specific types of fetal tissues that may be useful in repairing life-threatening congenital defects. The study will be presented at the AAP 2002 National Conference in Boston by Dario Fauza, MD, from the Surgical Research Laboratories at Children's Hospital Boston.
Fauza and his team have shown that primitive cells shed by the fetus or the placenta in early gestation can be isolated from the amniotic fluid and cultured in laboratory media that favor the growth of specific cell types. They also noted that amniotic fluid cells may be uniquely suited for transplantation in other fetuses because they underexpress biologic markers often responsible for immunologic rejection. The researchers also report successfully using umbilical cord blood samples for the first time to engineer fetal cartilage tissue in sheep.
Until recently, invasive fetal biopsy surgery was the only way to provide the cells necessary to engineer different types of fetal tissues. The harvesting of fetal tissue from sources other than fetal biopsy reduces potential complications of fetal tissue engineering, according to Fauza.
CHILDREN POSE UNIQUE PROBLEMS IN PREPARATION FOR BIOTERRORISM ATTACK
Boston --The unique issues and problems associated with the treatment of children in the event of a bioterrorism attack have been largely ignored during the nation's defense planning and preparation. On Tuesday, Oct. 22, Michael Shannon, MD, MPH, associate chief of Emergency Services at Children's Hospital Boston, will present a media briefing on this subject at the AAP 2002 National Conference in Boston.
The release of biological toxins would disproportionately affect children. Because of their higher number of respirations per minute, the release of aerosolized agents, such as anthrax, would result in relatively greater exposure for children than adults. Moreover, children would be much more difficult to treat in the event of an attack. Decontamination by showering is more problematic because children can become hypothermic very quickly. Many of the vaccines and antibiotics used in treatment and prevention after a biological weapons attack are not in a form that children can take and have not been properly dosed for children. Personal protection equipment that would need to be worn by health care providers in the event of an attack would greatly impede the handling of small children.
Because children spend most of their day in school, and schools are potential targets of terrorist attacks, local school districts must begin contingency planning for terrorist events. The biodefense team at Children's Hospital is taking the lead nationally in creating protocols for treating large numbers of pediatric victims of a biological attack. And Children's is working with the Boston Health Commission to assist schools in planning for the unthinkable.
"SICK SCHOOLS" AFFECT HEALTH OF US CHILDREN
Boston -- Research estimates that 60 percent of the schools in the United States have environmental problems severe enough to cause potential health effects in children. Michael Shannon, MD, MPH, director of the Pediatric Environmental Health Center and associate chief of Emergency Services at Children's Hospital Boston, is advocating a new model of pediatric care that emphasizes the impact of the environment, especially in schools, on the health of children.
According to Shannon, most problems stem from indoor environmental conditions, and he identifies the most common as: molds, improper use of cleaning solvents, shop chemicals, art supplies, unclean carpets and curtains, pet dander carried to school by children, and HVAC units that are insufficient to properly regulate ventilation, temperature and humidity. Outdoor environmental conditions, including pressure treated wood, proximity to toxic waste sites, soil contamination, and overexposure to ultraviolet radiation, also have been associated with health problems in children.
The Pediatric Environmental Health Center at Children's Hospital Boston is the largest such center in the nation collecting data on this issue. Shannon reports that pediatricians are treating increasing numbers of children experiencing headaches, respiratory ailments, eye irritation, lethargy and a lack of concentration associated with the schools they attend.
ADVANCES IN TISSUE ENGINEERING MAY EASE DONOR TISSUE AND ORGAN SHORTAGE
Boston --Researchers at Children's Hospital Boston have shown for the first time that a stem cell population can be isolated from human foreskins and coaxed into forming functioning fat (adipogenic) tissue in the laboratory. The research offers hope that the use of laboratory-engineered fatty tissue may be useful for diverse reconstruction surgeries, including genital reconstruction, post-mastectomy breast reconstruction, joint repair and more. The research team, headed by Anthony Atala, MD, director of Tissue Engineering at Children's Hospital Boston, will present an abstract on this work at the AAP 2002 National Conference in Boston on Saturday, Oct. 19.
Atala and other regenerative medicine experts are exploring a wide array of avenues to create laboratory-grown tissues and organs. In the study, mesenchymal stem cells from human foreskins were grown on biodegradable scaffolds in a culture containing specific growth factors and nutrients known to be needed by fat cells, or adipocytes. After eight days in culture fat formation was detected. When the scaffolds were implanted into mice, fat tissue grew at the implantation site within one week. Studies confirmed that the engineered fat tissue behaved metabolically like normal fat cells.
Children's Hospital Boston is the nation's premier pediatric medical center, the primary pediatric teaching affiliate of Harvard Medical School, and home to the world's leading pediatric research enterprise. For more information about the hospital visit: www.childrenshospital.org.
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