Wednesday, August 24, 2011

Washington, DC, and Abu Dhabi share community health challenges

During a late June trip to Abu Dhabi, Denice Cora-Bramble, MD, MBA, senior vice president of Diana L. and Stephen A. Goldberg Center for Community Pediatric Health at Children’s National, which serves is the primary care arm of Children’s National, offered a series of presentations addressing common challenges her team experienced while working with the diverse populations of Washington, DC. Her focus was on three topics that our pediatricians fight every day as the largest providers of pediatric primary care in the region. Tackling these areas was of great interest to the doctors and health care policymakers she met with while in Abu Dhabi as well.

Photo right: Children’s National doctors from left, Craig Peters, MD, Peter Kim, MD, PhD, and Denice Cora-Bramble, MD, MBA, visit Sheikh Khalifa Medical City in Abu Dhabi.
  • Cultural competence: This presentation at Sheikh Khalifa Medical City resonated with the local doctors. Just as Children’s works to identify obstacles to care delivery for every child in the DC area regardless of location, ethnicity, or primary language, the diverse expatriate population of the U.A.E. presents similar challenges for care providers, who were eager to learn more about efforts underway at Children’s in this area.
  • Children’s National Obesity Institute: Dr. Cora-Bramble set the stage by presenting stark figures about the depth of the obesity epidemic in Washington, DC, children. She showed how the Obesity Institute is working with the community and families to find workable solutions that curb this concerning trend.
  • School nutrition policies: As part of her efforts related childhood obesity, Dr. Cora-Bramble offered an analysis of international, national, and local policies aimed at school-delivered meals. She assessed the current state of efforts by national, state, and local governments to help deliver necessary nutrition, including fresh fruits and vegetables, during school hours.
This was Dr. Cora-Bramble’s third trip to Abu Dhabi for Children’s National. “I am very enthusiastic about ongoing and future collaborative opportunities with an outstanding team of Abu Dhabi partners,” she said. She departed with a better understanding of how Children’s National and the health care providers and policymakers of Abu Dhabi can work together to develop innovative solutions to these shared, pressing health challenges.

Note: Dr. Cora-Bramble will return to Abu Dhabi for the 2011 World Health Care Congress Middle East, where she will be featured at a luncheon called, "Innovations in Pediatric Health Care" sponsored by Children's National and the Sheikh Zayed Institute.

Wednesday, August 17, 2011

From the Bioengineering Initiative: The Potential of MR-Guided Focused Ultrasound

Guest post by Kevin Cleary, PhD, Technical Director and Principal Investigator at the Sheikh Zayed Institute for Pediatric Surgical Innovation

The Bioengineering Initiative of the Sheikh Zayed Institute for Pediatric Surgical Innovation welcomed a special visitor and guest speaker on August 4th. Professor Andreas Melzer, MD, DDS, the Director of the Institute for Medical Science and Technology at the University of Dundee, toured the Bioengineering lab and gave a lecture titled “Pediatric Multimodality Image Guided Diagnosis, Therapy and Non invasive Surgery: the Integrated Interventional Imaging Operating System IIIOS”.

(Photo, right: Dr. Melzer delivers a lecture on focused ultrasound to the Bioengineering team.)

Dr. Melzer’s talk described his experiences developing novel technology for minimally invasive interventions over the last 20 years. He focused on non-invasive therapy applications such as MR-guided focused ultrasound (MRgFUS). MRgFUS works by focusing an ultrasound beam on a small target area where it can heat and destroy cancerous tissue from outside the body, without the need for a surgical incision. The procedure is monitored by MR imaging, and the treatment area can be shaped to conform to the region of interest, so that the cancerous region can be destroyed without damaging nearby healthy tissue or critical anatomy.

“MrgFUS now has over 100 installations worldwide and interest in this technology continues to grow”, said Dr. Melzer. “While to date the vast majority of these applications have been for the adult population, now is an opportune time to investigate the applicability of these techniques to pediatrics. Recent exciting research has revealed the option to use MRgFUS for release of drugs from nano-encapsulated drugs and to increase cell permeability for enhanced drug uptake, which is another venue for this technology”. Further information can be found at www.nanoporation.eu.

“Focused ultrasound is an ideal treatment modality for pediatrics because of the non-invasive nature of the treatment”, said Peter Kim, MD, PhD, vice president of the Sheikh Zayed Institute, who also attended the lecture. “This treatment concept fits in perfectly with our vision of making pediatric surgery less invasive and more precise”.

In the discussion that followed, led by Dr. Melzer and Dr. Kim, the group talked about exploring the use of non-ionizing radiation in image-guided interventions for neonatal and fetal procedures and establishing collaborations between the two institutes.

--Kevin Cleary, PhD

Friday, August 12, 2011

Children’s surgeons collaborate with NIH to identify gene variant in Proteus syndrome

Orthopaedic surgeons from Children’s National Medical Center are part of a team of researchers that has identified the genetic mutation causing Proteus syndrome, a rare disorder in which tissue and bone grow massively out of proportion. The discovery appears in the July 27, 2011, online edition of the New England Journal of Medicine. The study, led by researchers at the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health (NIH), may have larger implications in both the identification and treatment of Proteus syndrome, as well as for certain types of cancer. The NIH-based research team found that a point mutation — a single-letter misspelling in the DNA of the genetic code — in the AKT1 gene activates the sporadic tissue growth associated with Proteus syndrome.

“Proteus syndrome is an extremely rare disorder, making tissue sample collection especially challenging,” said Laura L. Tosi, MD, of the Division of Orthopaedic Surgery and Sports Medicine at Children’s National. “Given the importance of this research, we stepped up to the plate and, over the last decade, Children’s National surgeons have collected more than one third of the study’s tissue samples while Proteus syndrome patients underwent necessary procedures here at Children’s National and at NIH.”

Dr. Tosi, as well as the Chief of Orthopaedics and Sports Medicine, Laurel Blakemore, MD, and Kurt D. Newman, MD, Senior Vice President of the Joseph E. Robert, Jr., Center for Surgical Care, contributed tissue samples from Proteus patients treated at Children’s National to help fuel the NIH-based genetic research.

“Children’s National has a vision that surgery might be less painful and more precise for pediatric patients, especially those who require multiple surgeries and lifelong support, as in the case of Proteus syndrome,” said Dr. Newman, who was recently named the incoming president and CEO of Children’s National. “This study and similar studies underway in systems biology programs around the world, including our own Sheikh Zayed Institute for Pediatric Surgical Innovation, all share one common goal: identifying these disorders and their causes as early as possible and finding better treatments.”

Read the media release from Children's.
Read the NIH media announcement.

Friday, August 5, 2011

Children’s National Welcomes Vice President for Sheikh Zayed Institute

Children’s National Medical Center has announced the appointment of Peter C.W. Kim, MD, CM, PhD, as vice president of the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Medical Center, associate surgeon-in-chief, and co-lead of the Institute’s Systems Biology Initiative. An internationally known pediatric surgeon and scientist, Dr. Kim will implement the institute’s vision of innovative, multidisciplinary research and development in pediatric surgery.

In addition to leading the day to day activities of the Sheikh Zayed Institute, as co-lead of the Systems Biology Initiative, he will develop smarter surgical tools that will enhance pediatric surgeons’ capacity and capability. His focus is on three main areas: image guidance and next generation robotics, simulation technologies to teach tomorrow’s pediatric surgeons through hands-on approaches rather than the apprenticeship-based medical training model, and exploration of technologies such as high intensity focused ultrasound (HiFU) as potential non-invasive alternatives to conventional surgery.

“The Sheikh Zayed Institute creates unprecedented opportunity to make fundamental differences in pediatric surgery, in real time, and truly affect the well being of children worldwide,” said Dr. Kim. “The Institute’s model creates an ecosystem where care, education, and research work simultaneously together.”  Read the media release.

Tuesday, August 2, 2011

A Visit with His Highness, the Crown Prince of Abu Dhabi


On our recent trip to Abu Dhabi, representatives of the Children’s National delegation were honored to be invited to an audience with His Highness General Sheikh Mohammed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi, during his leadership Majlis. This was a welcome opportunity to express once more Children’s gratitude for the generosity and leadership of His Highness Sheikh Mohammed, which led to the creation of the Sheikh Zayed Institute for Pediatric Surgical Innovation.

The delegation included James W. Lintott, Chairman of the Children’s National Medical Center Board as well as Pam King Sams, Executive Vice President and Chief Operating Officer for Children's Hospital Foundation, who took the opportunity to personally introduce His Highness to the newly-appointed, incoming vice president of the Sheikh Zayed Institute, Peter Kim, MD, CM, PhD. Chairman Lintott reflected on the visit saying, “After meeting the Crown Prince in Washington, we were so privileged to be able to visit him in Abu Dhabi. His commitment to children around the world is clear every time we have the opportunity to see him, and his generosity in helping us create the Sheikh Zayed Institute reflects his vision and leadership.”

The Crown Prince was presented with a small memento highlighting special moments from his recent visit to Children’s National, and the new Sheikh Zayed Institute. The Children’s team shared greetings from the patients, families, and staff whom he met during April’s visit. Additionally, they provided updates on the Institute’s progress and the work under way to build health care partnerships with the United Arab Emirates in areas including newborn screenings and obesity to improve children’s health in the UAE and around the world.