Chronic inflammation plays critical role in sustained delivery of recent muscular dystrophy therapy

WASHINGTON─Macrophages, a kind of white-colored bloodstream cell involved with inflammation, readily find a recently approved medication for Duchenne muscular dystrophy (DMD) and promote its sustained delivery to regenerating muscle tissue lengthy following the drug has disappeared from circulation, an experimental model study brought by Children’s National Health System researchers finds. The research, printed online March. 16, 2017 in Nature Communications, details cellular mechanisms of morpholino antisense drug delivery to muscles, improving knowledge of how these medicines target muscle tissues and suggesting a method to enhance treating DMD, a devastating ailment that presently doesn’t have cure.

Duchenne is easily the most common and severe type of muscular dystrophy and affects about one in five,000 boys worldwide. The condition is because mutations within the X-linked DMD gene. DMD is characterised by significant muscle degeneration, regeneration, increased inflammation and fibrosis, resulting in progressive muscle weakness and loss, explains study co-leader James S. Novak, Ph.D., a principal investigator in Children’s Center for Genetic Medicine Research. Mutations within the DMD gene result in a insufficient functional dystrophin, a protein important to maintaining structural support in healthy muscle. Most boys with DMD will not be able just to walk by their teens existence expectancy for those who have this ailment rarely extends beyond the early 30s.

Until lately, the only real pharmaceutical therapies for DMD targeted the signs and symptoms, instead of its root genetic cause. However, in September 2016 the Fda approved the very first exon-skipping medicine for DMD to revive dystrophin protein expression in muscle. Eteplirsen, an antisense phosphorodiamidate morpholino oligomer, has proven significant promise in preclinical studies, but medical trial results have proven variable and sporadic dystrophin production within the muscles of people that receive it. 

Since the medication vanishes in the bloodstream circulation within hrs after administration, Children’s research efforts have centered on the mechanism of delivery to muscle as well as on methods to increase its cellular uptake—and, by extension, its usefulness. However, researchers understand little about how exactly medicines really will get sent to muscle tissue or the way the disease pathology impacts this method, understanding that may offer new methods for boosting both its delivery and effectiveness, states Terence Partridge, Ph.D., study co-leader and principal investigator in Children’s Center for Genetic Medicine Research.

To research this, Novak, Partridge and colleagues used an experimental type of DMD that has a form of the faulty DMD gene that, like its human counterparts, destroys dystrophin expression. To trace the path from the phosphorodiamidate morpholino oligomer (PMO) into muscle tissue, they labeled it having a fluorescent tag. The medication traveled towards the muscle only localized to patches of regenerating muscle where it accrued inside the infiltrating macrophages, immune cells active in the inflammatory response that comes with this method. While PMO is quickly removed in the bloodstream, the medication continued to be during these immune cells for approximately 1 week and then joined muscle stem cells, allowing direct transport into regenerating muscle tissue. By co-administering the PMO having a traceable DNA nucleotide analog, the study team could define happens throughout the regeneration procedure that promotes increased uptake by muscle stem cells and efficient dystrophin expression in muscle tissue.

“These macrophages seem to extend the time of accessibility to medicines towards the satellite cells and muscle tissue at these websites,Inches Partridge explains. “Since the macrophages are serving as lengthy-term storage reservoirs for prolonged delivery to muscle tissue, they might possibly represent new therapeutic targets for increasing the uptake and delivery of the medicine to muscle.” 

Future research with this group will concentrate on testing whether macrophages might be utilized for efficient delivery vectors to move eteplirsen towards the muscle, which may avert the rapid clearance presently connected with intravenous delivery. 

“Understanding just how different classes of exon-skipping medicine is sent to muscle could open entirely new options for improving future therapeutics and improving the clinical benefit for patients,” Novak adds.

Contact: Diedtra Henderson  Children’s National Health System  c: 443-610-9826/o: 202-476-4500

About Children’s National Health System

Children’s National Health System, located in Washington, D.C., continues to be serving the nation’s children since 1870. Children’s National is #1 for babies and rated in each and every niche evaluated by U.S. News & World Report including placement within the top ten for: Cancer (#7), Neurology and Neurosurgery (#9) Orthopedics (#9) and Nephrology (#10). Children’s National continues to be designated two occasions like a Magnet®hospital, a designation provided to hospitals that report the greatest standards of nursing and patient care delivery. This pediatric academic health system offers expert care via a convenient, community-based primary care network and niche outpatient centers. The place to find the Children’s Research Institute and also the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is among the nation’s top NIH-funded pediatric institutions. Children’s National is acknowledged for its expertise and innovation in pediatric care so that as a powerful voice for kids through advocacy in the local, regional and national levels. To learn more, visit ChildrensNational.org, or follow us on Twitter and facebook.

Children’s National Health System experts to provide at 49th Congress from the Worldwide Society of Paediatric Oncology (SIOP)

WASHINGTON– Leading pediatric oncology experts at Children’s National Health System will join a large number of their peers in Washington, D.C., for that 49thCongress from the Worldwide Society of Paediatric Oncology (SIOP) March. 12-15. Chaired by Jeffrey Dome, M.D., Ph.D., V . P . from the Center for Cancer and Bloodstream Disorders at Children’s National, and Stephen P. Hunger, M.D., Chief from the Division of Oncology and Director from the Center for Childhood Cancer Research at Children’s Hospital of Philadelphia, the meeting will feature presentations, debates and discussions by world-famous leaders within the pediatric oncology field.

“I am honored for everyone because the chair of SIOP this season, a substantial gathering of a few of the finest minds in the area of childhood cancer,” states Dr. Dome. “In particular, I’m very happy with my colleagues from Children’s National, who’ll highlight the key work they’re doing to accelerate treatments for pediatric cancer. The wedding marks an amazing year within the advancement of cancer research and treatment, and that i expect to a different dynamic meeting focused on working perfectly into a world free from pediatric cancer.”

One of the featured loudspeakers is Catherine Bollard, M.D., M.B.Ch.B., director from the Center for Cancer and Immunology Research inside the Children’s Research Institute. Dr. Bollard will show a chat included in the SIOP-St. Baldrick’s Symposium on Cell Therapy for Infections, concentrating on the most recent approaches in anti-viral T-cell therapy to enhance patient outcomes. Like a distinguished hematologist and immunotherapist, Dr. Bollard can also be the present president of the International Society for Cellular Therapy.

D. Ashley Hill, M.D., professor of pathology and pediatrics in the George Washington College Med school & Health Sciences, will provide a keynote address focusing on DICER1 mutations in pediatric cancer. Dr. Hill first reported the bond between pleuropulmonary blastoma (PPB), an uncommon childhood lung tumor, and mutations in a gene DICER1, setting happens for any better knowledge of microRNA processing gene mutations in the introduction of pediatric cancer. Her study of PPB has reveal the way the human genetic program can orchestrate rapid development of an embryo in one cell to some baby in nine several weeks, that is quicker than nearly every cancer. Dr. Hill and her team are actually researching to introduce these naturally sourced growth molecules for stopping PPB effectively and securely.

AeRang Kim, M.D., Ph.D., principal investigator for that Children’s National Development Therapeutics Program, is chairing the Advances in Sarcoma session included in SIOP Education Day. Her recent research on new methods to local charge of sarcomas, for example surgery, radiation along with other ablative measures, will be provided included in the SIOP Education Day. Dr. Kim’s work concentrates on the development of novel agents and devices for pediatric cancer including pre-clinical testing of novel agents, pharmacokinetic analysis, developing innovative means of toxicity monitoring and medical trial design.

Every year, SIOP hosts clinicians, scientists, nurses, allied health care professionals, parents and survivors to facilitate the exchange of ideas and knowledge in pediatric oncology, with the aim of striving perfectly into a world free from childhood cancer. Greater than 20 nurses and doctors from Children’s National across several fields will speak and offer at SIOP.

Contact: Rebecca Porterfield Siddon [email protected] 202-476-4500.


About Children’s National Health System

Children’s National Health System, located in Washington, D.C., continues to be serving the country’s children since 1870. Children’s National is #1 for babies and rated in each and every niche evaluated by U.S. News & World Report including placement within the top ten for: Cancer (#7), Neurology and Neurosurgery (#9) Orthopedics (#9) and Nephrology (#10). Children’s National continues to be designated two occasions like a Magnet® hospital, a designation provided to hospitals that report the greatest standards of nursing and patient care delivery. This pediatric academic health system offers expert care via a convenient, community-based primary care network and niche outpatient centers. The place to find the kids Research Institute and also the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is among the nation’s top NIH-funded pediatric institutions. Children’s National is acknowledged for its expertise and innovation in pediatric care so that as a powerful voice for kids through advocacy in the local, regional and national levels. To learn more, visit ChildrensNational.org, or follow us on Twitter and facebook.

Across the country recognized laboratory medicine expert Meghan Delaney, D.O., M.P.H., joins Children’s National Health System as chief of pathology and lab medicine

Meghan Delaney

WASHINGTON – Children’s National Health System today announced that Meghan Delaney, D.O., M.P.H., has became a member of Children’s National as chief of pathology and lab medicine. Like a across the country recognized expert in the area of transfusion medicine, Dr. Delaney may lead efforts to unify Children’s divisions of Anatomic Pathology and Laboratory Medicine into just one division while evolving cutting-edge practices within the laboratory to guarantee the greatest standard of quality and safety for patients. 

“I’m thrilled that my experience and fervour with this field have brought me to participate the incredible team at Children’s National,” states Dr. Delaney. “My ultimate goal would be to continue the hospital’s legacy of innovative research, whilst concentrating on executing safe, efficient and effective pathology and lab medicine services.”

Dr. Delaney earned a Bs degree in biology in the College of Vermont, physician of osteopathy degree in the Colonial College of Osteopathic Medicine and Master of Public Health in the College of Washington. She completed her residency in clinical pathology at Janet Israel Deaconess ClinicOrStanford School Of Medicine along with a fellowship in transfusion medicine and bloodstream banking in the Puget Seem Bloodstream Center in San antonio. Following her fellowship, she held several leadership roles within the San antonio area, including becoming medical director in the Pediatric Apheresis Program at San antonio Children’s Hospital & San antonio Cancer Care Alliance, the bloodstream bank at San antonio Children’s Hospital and also the Immunohematology & Red Bloodstream Cell Genomics Reference Laboratory at Bloodworks Northwest. 

Dr. Delaney works as a person in the editorial board of Transfusion, chair from the AABB Transfusion Medicine Pediatric Subcommittee and chair from the AABB Molecular Testing Accreditation Committee. She’s authored 51 peer-reviewed articles, 20 chapters and editorials and it has presented nearly three dozen lectures across the country and worldwide for that AABB, American Society for Apheresis, the Association of Molecular Pathology, the Worldwide Society of Bloodstream Transfusion and also the Canadian Society of Transfusion Medicine, amongst others. 

“Dr. Delaney brings extensive experience of laboratory medicine innovation and program-building, and we’re confident she creates a lasting effect on our patients,” states Jeffrey Dome, M.D., Ph.D., V . P . for that Center for Cancer and Bloodstream Disorders at Children’s National. “Her leadership will bolster our dedication to supplying high quality take care of our patients through growth of lab research and coverings.” 

Contact: Rebecca Porterfield Siddon [email protected] 301-244-6737

About Children’s National Health System

Children’s National Health System, located in Washington, D.C., continues to be serving the nation’s children since 1870. Children’s National is #1 for babies and rated in each and every niche evaluated by U.S. News & World Report including placement within the top ten for Cancer (#7), Neurology and Neurosurgery (#9) Orthopedics (#9) and Nephrology (#10). Children’s National continues to be designated two occasions like a Magnet®hospital, a designation provided to hospitals that report the greatest standards of nursing and patient care delivery. This pediatric academic health system offers expert care via a convenient, community-based primary care network and niche outpatient centers. The place to find the Children’s Research Institute and also the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is among the nation’s top NIH-funded pediatric institutions. Children’s National is acknowledged for its expertise and innovation in pediatric care so that as a powerful voice for kids through advocacy in the local, regional and national levels. To learn more, visit ChildrensNational.org, or follow us on Facebook and Twitter.

Childrens National awarded Doris Duke Charitable Foundation Grant for sickle cell disease

WASHINGTON – Children’s National Health System will get greater than $550,000 in funding to guide a 3-year, multi-center trial which will practice a low intensity, chemotherapy-free transplantation method of cure patients with sickle cell disease utilizing a matched related donor. The grant was awarded with the Doris Duke Charitable Foundation’s inaugural Sickle Cell Disease/Evolving Cures Awards, which supplies funding to succeed curative methods for sickle cell disease.

The Children’s National project, brought by Allistair Abraham, M.D., bloodstream and marrow transplantation specialist, and Robert Nickel, M.D., hematologist, is among seven projects receiving roughly $six million total with the awards. The work won support because of its possibility to considerably enhance the only current proven remedy for sickle cell disease-hematopoietic cell transplantation. While transplantation utilizing a matched brother or sister donor today includes a high cure rate (more than 90 %) for sickle cell disease, traditional transplant approaches have numerous risks and negative effects both in rapid and lengthy term.

The research will examine if your chemotherapy-free approach can result in a effective transplant without leading to graft-versus-host disease (GVHD). GVHD is among the most difficult complications of the transplant, where the transplant immune cells attack the patient’s body. They anticipate this new transplant approach is going to be very well tolerated that patients’ quality of existence is going to be maintained and improved through the process, with the majority of the care administered inside a clinic setting.

“This approach has shown to be effective for adults with sickle cell disease, therefore we are grateful for that chance to do this important trial for kids because of the Doris Duke Charitable Foundation,” states Dr. Abraham, who together with Dr. Nickel also can serve as assistant professor of pediatrics in the George Washington College Med school and Health Sciences. “Children with sickle cell disease require innovative treatments, so we expect to locating more solutions that improve the caliber of existence of these patients.”

“Advancing strategy to sickle cell patients enough where they are able to live free from the condition is our main concern,Inches states Dr. Nickel. “This funding is crucial to the study and it’ll accelerate the timeline to offer the objective of a properly-tolerated and safe remedy for kids with sickle cell disease.”

Matthew Hsieh, M.D., who helped pioneer the work in the National Institute of Health in grown-ups, and Greg Guilcher, M.D., that has used this transplant approach in youngsters, are key collaborators around the project.

The research is forecasted to start in December 2018 and go on for 3 years. The Excellent Sickle Cell Disease Program at Children’s National is probably the largest in the united states, treating greater than 1,400 children and youthful adults with lots of different sickle cell disease. Children’s National also provides the biggest, very indepth bloodstream disorders team within the Washington, D.C., area.

Contact: Rebecca Porterfield Siddon [email protected] 301-244-6737


About Children’s National Health System

Children’s National Health System, located in Washington, D.C., continues to be serving the nation’s children since 1870. Children’s National is #1 for babies and rated in each and every niche evaluated by U.S. News & World Report including placement within the top ten for: Cancer (#7), Neurology and Neurosurgery (#9), Orthopedics (#9) and Nephrology (#10). Children’s National continues to be designated two occasions like a Magnet® hospital, a designation provided to hospitals that report the greatest standards of nursing and patient care delivery. This pediatric academic health system offers expert care via a convenient, community-based primary care network and niche outpatient centers. The place to find the Children’s Research Institute and also the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is among the nation’s top NIH-funded pediatric institutions. Children’s National is acknowledged for its expertise and innovation in pediatric care so that as a powerful voice for kids through advocacy in the local, regional and national levels. To learn more, visit ChildrensNational.org, or follow us on Facebook and Twitter.

Concerning the Doris Duke Charitable Foundation
The mission from the Doris Duke Charitable Foundation would be to improve the caliber of people’s lives through grants supporting the performing arts, ecological conservation, child well-being and scientific research, and thru upkeep from the cultural and ecological legacy of Doris Duke’s qualities. The foundation’s Scientific Research Program supports clinical research that advances the translation of biomedical breakthroughs into new preventions, diagnoses and coverings for human illnesses. To understand more about this program, visit world wide web.ddcf.org.

Newborns with CHD show indications of brain impairment before cardiac surgery

WASHINGTON — Survival rates have soared for infants born with hereditary cardiovascular disease (CHD), the most typical birth defect, because of innovative cardiac surgery that typically occurs within hrs of birth. However, the neurodevelopmental picture of these infants has continued to be stubbornly unchanged using more than 50 % experiencing neurodevelopmental disabilities.

Utilizing a novel imaging technique, Children’s National Health System researchers demonstrate the very first time the brains of those high-risk infants already show indications of functional impairment before they undergo corrective open heart surgery. Searching in the newborns’ entire brain topography, they found intact global organization—efficient and efficient small world networks—yet reduced functional connectivity between key brain regions.

“A robust neural network is crucial for neurons to go to their intended destinations but for the body to handle nerve cells’ instructions. Within this study, we found the density of connections among wealthy club nodes was reduced, there was reduced connectivity between critical brain hubs,” states Catherine Limperopoulos, Ph.D., director from the Developing Brain Research Laboratory at Children’s National and senior author from the study printed online Sept. 28, 2017 in NeuroImage: Clinical. “CHD disrupts how oxygenated bloodstream flows through the body, including towards the brain. Despite disturbed hemodynamics, infants with CHD still can efficiently transfer neural information among neighboring regions of the mind and across distant regions.” 

The study team brought by Josepheen De Asis-Cruz, M.D., Ph.D., compared whole brain functional connectivity in 82 healthy, full-term newborns and 30 newborns with CHD just before corrective heart surgery. Conventional imaging had detected no brain injuries either in group. They used resting condition functional connectivity magnetic resonance imaging (rs-fcMRI), a imaging technique that characterizes fluctuating bloodstream oxygen level dependent signals from various parts of the mind, to map the result of CHD on newborns’ developing brains.

The newborns with CHD had lower birth weights minimizing APGAR scores (a gauge of methods well brand-new babies fare outdoors the womb) at one and 5 minutes after birth. Prior to the scan, the infants were given, wrapped snugly in warm blankets, safely positioned using vacuum pillows, as well as their ears were protected with sleeping earplugs and ear muffs.

As the infants with CHD had intact global network topology, a detailed study of specific brain regions revealed functional disturbances inside a subnetwork of nodes in newborns with cardiac disease. The subcortical regions were involved with the majority of individuals affected connections. They also found less strong functional connectivity between left and right thalamus (the location that processes and transmits physical information) and between your right thalamus and also the left extra motor area (the portion of the cerebral cortex that can help to manage movement). The regions with reduced functional connectivity portrayed by rs-fcMRI complement with regional brain anomalies described in imaging studies operated by conventional MRI and diffusion tensor imaging.

“Global network organization is preserved, despite CHD, and small world brain systems in newborns show a outstanding capability to withstand brain injuries at the start of existence,” Limperopoulos adds. “These intact, efficient small world systems bode well for targeting early therapy and rehabilitative interventions to reduce the newborns’ chance of developing lengthy-term nerve deficits that may lead to issues with executive function, motor function, learning and social behavior.”

Contact: Diedtra Henderson Children’s National Health System c: 443-610-9826/o: 202-476-4500 [email protected]


About Children’s National Health System

Children’s National Health System, located in Washington, D.C., continues to be serving the nation’s children since 1870. Children’s National is #1 for babies and rated in each and every niche evaluated by U.S. News & World Report including placement within the top ten for: Cancer (#7), Neurology and Neurosurgery (#9) Orthopedics (#9) and Nephrology (#10). Children’s National continues to be designated two occasions like a Magnet® hospital, a designation provided to hospitals that report the greatest standards of nursing and patient care delivery. This pediatric academic health system offers expert care via a convenient, community-based primary care network and niche outpatient centers. The place to find the Children’s Research Institute and also the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is among the nation’s top NIH-funded pediatric institutions. Children’s National is acknowledged for its expertise and innovation in pediatric care so that as a powerful voice for kids through advocacy in the local, regional and national levels. To learn more, visit ChildrensNational.org, or follow us on Twitter and facebook.

Leaders of Hereditary Zika Virus Program at Childrens National share training learned with peers

SAN DIEGO—Throughout their lifetimes, the tainted Aedes nasty flying bugs that spread Zika virus only fly a couple of hundred ft where they hatch. And Zika hotspots—Texas and Florida domestically and a large number of nations round the world—all lie a good distance in the nation’s capital. Still, the Hereditary Zika Virus Program at Children’s National Health System evaluated 36 ladies and their fetuses from The month of january 2016 through May 2017. Another 14 ladies and their infants were known the Zika program for postnatal consultations in that time.

“As the times grow shorter and temperatures drop, we still receive referrals to the Zika program, which is proof of the critical require it fulfills within the greater metropolitan D.C. region,” states Roberta L. DeBiasi, M.D., M.S., chief from the Division of  and co-leader from the program. “Our multidisciplinary team presently has consulted on 90 dyads (moms as well as their Zika-affected fetuses/infants). The training we discovered how and when they were infected and just how their offspring were impacted by Zika might be instructive to institutions thinking about launching their very own programs.”

Dr. DeBiasi will outline training learned throughout a pediatric virology workshop at IDWeek2017, 1 of 3 such Zika presentations brought by Children’s National research-clinicians in this year’s meeting of pediatric infectious disease specialists.

“The Zika virus is constantly on the circulate in a large number of nations, from Angola towards the U.S. Virgin Islands. Clinicians thinking about a proper method of managing pregnancies complicated by Zika may consider enlisting a range of specialists for attending infants’ complex care needs, including experts in fetal imaging, pediatric infectious disease, physiotherapists, audiologists, ophthalmologists and radiologists good at studying serial magnetic resonance images in addition to ultrasounds,” Dr. DeBiasi states. “At Children’s there exists a devoted Zika hotline to triage patient and family concerns. We offer detailed instructions for referring institutions explaining protocols pre and post giving birth, so we provide ongoing education for medical professionals.Inches

From the 36 women that are pregnant possibly uncovered to Zika while pregnant observed in the program’s newbie, 32 resided within the U . s . States and traveled to countries where Zika virus was circulating. Two women had partners who traveled to Zika hot zones. And 2 gone to live in the Washington region from places where Zika is endemic. Such as the postnatal cases, 89 percent of patients have been bitten by Zika-tainted nasty flying bugs, while 48 percent of ladies might have been uncovered to Zika via sex by having an infected partner.

20 % from the women were uncovered before conception 46 percent were uncovered to Zika within the first trimester of being pregnant 26 % were uncovered within the second trimester and eight percent were uncovered within the final trimester. In just six of fifty cases (12 %) did the Zika-infected individual experience signs and symptoms.

Zika infection could be confirmed by discovering viral fragments as long as the exam occurs soon after infection. Twenty-four from the 50 women (nearly 50 %) showed up for any Zika consultation outdoors that 12-week testing window. Eleven women (22 percent) had confirmed Zika infection and the other 28 percent tested positive for that broader group of flavivirus infections which includes Zika. Another recognition method accumulates antibodies the body produces to neutralize Zika virus. For seven women (14 %), Zika infection was eliminated by testing method.

“Tragically, four fetuses had severe Zika-related birth defects,” Dr. DeBiasi states. “Due towards the gravity of individuals abnormalities, two pregnancies weren’t transported to term. The 3rd pregnancy was transported to term, however the infant died soon after birth. The 4th pregnancy was transported to term, however that infant survived under twelve months.Inches

IDWeek 2017 presentations:
Saturday, March. 7, 2017

  • “Zika A to Z” session moderated by Roberta L. DeBiasi, M.D., M.S.
    8:30 a.m. to 10 a.m.(PT)
    • “Differential neuronal susceptibility and apoptosis in hereditary Zika virus infection.”
      9:15 a.m. (PT)
      Cheng-Ying Ho, M.D., Ph.D. Louise Ames, M.D., Ph.D. Ashley Tipton, B.S. Gilbert Vezina, M.D. Judy Liu, M.D., Ph.D. Frederick Scafidi, D.O. Masaaki Torii, Ph.D. Fausto Rodriguez, M.D.  Adré J. du Plessis, M.B.Ch.B., M.P.H. and Roberta L. DeBiasi, M.D., M.S.
  • “Evaluation of women that are pregnant, fetuses and infants with Zika virus exposure and infection: Training learned in the Hereditary Zika Virus Program at Children’s National.”
    12:30 pm. to two p.m. (PT)
    Roberta L. DeBiasi, M.D., M.S. Sarah B. Mulkey, M.D., Ph.D. Caitlin Cristante, B.S. Lindsay Pesacreta, R.N. Gilbert Vezina, M.D. Dorothy I. Bulas, M.D. and Adré J. du Plessis, M.B.Ch.B., M.P.H.

Contact: Diedtra Henderson  Children’s National Health System  c: 443-610-9826/o: 202-476-4500  [email protected]


About Children’s National Health System
Children’s National Health System, located in Washington, D.C., continues to be serving the nation’s children since 1870. Children’s National is #1 for babies and rated in each and every niche evaluated by U.S. News & World Report including placement within the top ten for: Cancer (#7), Neurology and Neurosurgery (#9) Orthopedics (#9) and Nephrology (#10). Children’s National continues to be designated two occasions like a Magnet®hospital, a designation provided to hospitals that report the greatest standards of nursing and patient care delivery. This pediatric academic health system offers expert care via a convenient, community-based primary care network and niche outpatient centers. The place to find the Children’s Research Institute and also the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is among the nation’s top NIH-funded pediatric institutions. Children’s National is acknowledged for its expertise and innovation in pediatric care so that as a powerful voice for kids through advocacy in the local, regional and national levels. To learn more, visit ChildrensNational.org , or follow us on Twitter and facebook.
About IDWeek2017
IDWeek may be the combined annual meeting from the Infectious Illnesses Society of the usa, the Society for Healthcare Epidemiology of the usa, the Aids Medicine Association, and also the Pediatric Infectious Illnesses Society. Using the theme, “Advancing science, improving care,” IDWeek2017 features the most recent science and bench-to-bedside approaches in prevention, diagnosis, treatment and epidemiology of infectious illnesses, including Aids, over the lifespan. For information, visit IDWeek2017

Brain damage brought on by Zika exposure in utero could be detected by fetal MRI and ultrasound

SAN DIEGO—Clinicians managing Zika-affected pregnancies should use magnetic resonance imaging (MRI) additionally to plain ultrasound (US) since the more in depth MRI images can reveal more extensive regions of harm to the developing fetal brain, based on research presented during IDWeek 2017.

“MRI and US provide complementary data required to assess ongoing changes towards the brains of fetuses uncovered to Zika in utero,” states Sarah B. Mulkey, M.D., Ph.D., a fetal/neonatal specialist at Children’s National Health System and lead author from the research paper. “In addition, our study discovered that counting on ultrasound alone might have given one mother the false assurance that her fetus’ brain was developing normally as the sharper MRI clearly pointed to brain abnormalities.”

By Sept. 13, the Cdc and Prevention (CDC) reported that 1,901 U.S. women were uncovered to Zika sooner or later throughout their pregnancies however their infants made an appearance normal at birth. Another 98 U.S. women, however, delivered infants with Zika-related birth defects.  And eight more women had pregnancy losses with Zika-related birth defects, based on CDC registries.

The longitudinal neuroimaging study brought by Children’s National enrolled 48 women that are pregnant uncovered towards the Zika virus within the 1st or 2nd trimester whose infection was confirmed by reverse transcription polymerase squence of events, which detects Zika viral fragments soon after exposure, and/or Immunoglobulin M testing, which reveals antibodies your body produces to neutralize herpes. Forty-six from the study volunteers reside in Barranquilla, Colombia, where Zika infection is endemic. Two women reside in the Washington region and were uncovered to Zika when traveling elsewhere.

All the women went through a minumum of one diagnostic imaging session during pregnancy, receiving a preliminary MRI or US at 25.1 days gestational age. Thirty-six women went through another MRI/US imaging pair at roughly 31 days pregnancy. Children’s National radiologists read every image.

Three of 48 pregnancies, or 6 %, were marked by abnormal fetal MRIs:

  • One fetus had heterotopias (clumps of gray matter found at the incorrect place) and abnormal cortical indent (a deformation in the surface from the cerebrum, a brain region involved with awareness). The United States taken in the same gestational age with this fetus demonstrated its brain was developing normally.
  • Another fetus had parietal encephalocele (an infrequent skull defect) and Chiari malformation Type II (a existence-threatening structural defect at the bottom of the skull and also the cerebellum, negligence the mind that controls balance).The United States with this fetus also detected these brain abnormalities.
  • The 3rd fetus were built with a thin corpus callosum (bundle of nerves that connects the brain’s right and left hemispheres), an abnormally developed brain stem, temporal cysts, subependymal heterotopias and general cerebral/cerebellar atrophy. This fetal US demonstrated significant ventriculomegaly (fluid filled structures within the brain which are too big) along with a fetal mind circumference that decreased dramatically in the 32nd to 36th gestational week, a hallmark of microcephaly.

Once they were born, infants went through a follow-up MRI without sedation and US. For nine infants, these ultrasounds revealed cysts within the choroid plexus (cells that leave cerebrospinal fluid) or germinal matrix (the origin for neurons and glial cells that migrate during brain development). And something infant’s US after birth demonstrated lenticulostriate vasculopathy (brain lesions).

“Because numerous factors can trigger brain abnormalities, further studies are necessary to see whether the cystic changes to those infants’ brains are due to Zika exposure within the womb or if another insult caused these troubling results,” Dr. Mulkey states.

IDWeek 2017 presentations:
Friday, March. 6, 2017

  • “Fetal and postnatal brain imaging for that recognition of ZIKV encephalopathy within the fetus/newborn.”
    8:45 a.m. (CT)
    Sarah B. Mulkey, M.D., Ph.D. Gilbert Vezina, M.D. Yamil Fourzali, M.D. Dorothy I. Bulas, M.D. Margarita Arroyave-Wessel, M.P.H. Caitlin Cristante, B.S. Christopher Swisher, B.S. Youssef Kousa, D.O., Ph.D. Carlos Cure, M.D. Roberta L. DeBiasi, M.D., M.S. and Adré J. du Plessis, M.B.Ch.B., M.P.H.

Contact: Diedtra Henderson  Children’s National Health System  c: 443-610-9826/o: 202-476-4500  [email protected]


About Children’s National Health System
Children’s National Health System, located in Washington, D.C., continues to be serving the nation’s children since 1870. Children’s National is #1 for babies and rated in each and every niche evaluated by U.S. News & World Report including placement within the top ten for: Cancer (#7), Neurology and Neurosurgery (#9) Orthopedics (#9) and Nephrology (#10). Children’s National continues to be designated two occasions like a Magnet®hospital, a designation provided to hospitals that report the greatest standards of nursing and patient care delivery. This pediatric academic health system offers expert care via a convenient, community-based primary care network and niche outpatient centers. The place to find the Children’s Research Institute and also the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is among the nation’s top NIH-funded pediatric institutions. Children’s National is acknowledged for its expertise and innovation in pediatric care so that as a powerful voice for kids through advocacy in the local, regional and national levels. To learn more, visit ChildrensNational.org, or follow us on Twitter and facebook.

Perinatal Palliative Care around the agenda from the Portuguese Neonatal Society in Portugal

Since 2010 the Portuguese Neonatal Society continues to be addressing perinatal and neonatal palliative care as a fundamental part of integrative care in the finish of existence. Several workshops along with other educational sessions occured all over the country with national and worldwide experts. Lately, the board, brought through the president, Dr Joana Saldanha, produced a cutting-edge and multidisciplinary Ethics and Palliative Care commission, coordinated by Professor Lincoln subsequently Justo da Silva.

Produced by this latest group, last September, the next edition of the two-day workshop on perinatal palliative care required place. This time around there is a significant concentrate on communication, like a defacto standard to beat myths and improve collaborative work and advance care planning within the NICU. Workshop details in Portuguese are available via this link .

The workshop occured within the northern area of the country, Vila Real, with the objective of getting together professionals in the major NICU tertiary centres and regional hospitals, in addition to primary health care providers (community general palliative care teams).

Around 40 professionals took part in highly interactive sessions. During each lecture, some questions were posed that encouraged debate. Aside from the traditional medical and biological perspectives along with other size of care, the controversy explored everyone’s individual emotional journey on being faced with human suffering. The crowd was multidisciplinary and incorporated NICU professionals (nurses, physicians, psychologists, social workers), philosophers and healthcare students.

Role play
Probably the most effective activities would be a role play done by actors and video recorded to grew to become an academic tool. The scenario addressed a great along with a bad illustration of professional interventions when getting together with parents during difficult conversations. This activity permitted a secure spot to meditate regarding how to break not so good news when faced with personal, interdisciplinary and institutional constraints. It explored different approaches, needs, expectations and feelings and explored how you can enhance the outcome for families.

The crowd feedback was very obvious. All agreed that these types of workshops are necessary to improve professional skills around communication, particularly in palliative care situations, while pregnant, work and also the neonatal period.

Hundreds Hurt as Catalan Election Turns Ugly

Image: Spanish Guardia Civil guard smash the door of a polling station Catalonia's president was due to vote, early Sunday.

Spanish Guardia Civil guard smash the doorway of the polling station Catalonia’s president was because of election, early Sunday. LLUIS GENE / AFP – Getty Images

Spain’s interior ministry published an image on Twitter early Sunday of the items it stated were the very first ballot boxes grabbed by police. Additionally, it also published video of officials transporting the boxes through crowds. “Law enforcement, despite harassment, remove ballot boxes in the illegal referendum in the Jaume Balmes institute in Barcelona,” it stated inside a caption.

Crowds collected outdoors Ramon Llull school, in Barcelona’s central Sagrada Familia district, to cast their election early Sunday but riot police showed up and scaled fencing to prevent the procedure. Nearby at Els Llorers school, voting went ahead unhindered.

It had been unclear why police were apparently blocking voting at some schools although not others.

Soon after 2 p.m. local time (8 a.m. ET) Turull stated 96 percent of polling stations remained as open. Many supporters from the election spent the night time in polling booths inside a bid to ensure that they’re open.

Related:

Catalan Independence Referendum: What’s Behind Divisive Spanish Election?

He known as around the worldwide community to acknowledge that Catalonia was witnessing “human legal rights violations” and required the resignation from the Spanish government’s representative in the area.

“This violence isn’t proportional,” Turull added later in a press conference. He blamed Spanish Pm Mariano Rajoy for that violence, saying it might not have happened had he permitted the election to go forward.

Meanwhile Raul Romeva, Catalonia’s foreign matters minister, stated they’d be asking Europe to consider the attack.

Earlier Sunday Puigdemont, the mind from the regional government, advised Catalans to follow along with their convictions. “Everybody who wants to election can perform so. Do what convinces you most: all of the choices are just like legitimate. Let us get it done using the usual calmness!” he published on Twitter after casting his election.

The location in northeastern The country includes a population of seven.5 million and is among the country’s powerhouses, comprising around a fifth of Spain’s economy.

It features a distinct language and culture, that have been covered up under Franco, a conservative monarchist whose regime dominated The country for 40 years.

Saphora Cruz reported from London.

In the center of Disaster, Puerto Rico Now Faces a money Shortage

Image: People wait in line to withdraw cash at a bank in San Juan

People wait to withdraw cash in a bank as a direct consequence of Hurricane Maria, in San Juan, Puerto Rico on Sept. 27, 2017. Gerald Herbert / AP

FEMA has arrived at to all Puerto Rico’s 78 municipalities “and delivered some goods to these,Inches John Rabin, FEMA Region II acting regional administrator, stated throughout a teleconference Thursday mid-day.

FEMA stated on its website Thursday it has “provided countless meals and countless liters water to Puerto Rico and U.S. Virgin Islands. Additional meals and water still arrive towards the islands daily.”

Meanwhile, the White-colored House announced Thursday it had temporarily

waived the Johnson Act — a virtually century-old shipping law many have stated is hampering relief efforts in hurricane-ravaged Puerto Rico.

“At @ricardorossello request, @POTUS has approved the Johnson Act be waived for Puerto Rico. It’ll get into effect immediately,” the White-colored House press secretary, Sarah Huckabee Sanders, tweeted Thursday morning.

The acting Homeland Security secretary, Elaine Duke, confirmed the move, stating that the temporary waiver can last for ten days so they cover all products being shipped to Puerto Rico.

Officials in Puerto Rico as well as on the U.S. landmass have been contacting the administration to waive the act.

Related:

Up To 50 % of Puerto Rico Lacks Clean Consuming Water

But because the island’s residents ongoing to develop eager for fundamental requirements, a large number of containers for local neighborhoods are relaxing in Puerto Rico’s ports.

“Overall within the ports of Puerto Rico you will find over 9,500 containers” filled with necessary supplies, Jose Ayala, v . p . of Puerto Rico services at Crowley Maritime Corporation, told MSNBC on Thursday.

Greater than 3,000 have been in the main harbour of San Juan alone, he stated.

Ayala stated the island’s numerous issues, varying from communications problems, broken roads, people not able to really make it for their workplaces, low diesel were developing a distribution crisis.

Alejandro En Campa, director of FEMA’s Caribbean Area Division, stressed throughout the teleconference Thursday these goods known goods already in ports that local entities and business were unable access due to complications in the hurricane.

“All FEMA goods are moving once we receive them, they’re being deployed towards the distribution centers once we receive them. They’re being deployed,” he stated, adding that “not just one trailer” from FEMA of other federal responders appeared to be held at Puerto Rico’s ports or airports.

Mariana Atencio reported from San Juan, Puerto Rico, and Daniella Silva reported from New You are able to City.