May 23, 2024

A Spotlight on Surgical Innovation with Dr. Seth Goldstein

In the latest episode of the In Pursuit podcast, surgeon, engineer, scientist, and innovator, Seth Goldstein, MD, MPhil, discusses the impact of research and innovation in pediatric surgery. From using near-infrared light technology to detect intestinal ischemia in necrotizing enterocolitis, a critical disease in premature newborns, to pioneering fluorescence-guided surgery, Dr. Goldstein shares insights into the unique challenges and solutions in the field.

Investigating Healthcare Deserts for Pediatric Emergency Service

Access to specialized pediatric emergency services can lead to better health outcomes for children, but this access is becoming more scarce. Most hospitals with specialized pediatric services are in large cities, leaving rural areas and smaller cities with limited or no access. This care gap is exacerbated by hospital systems that are moving away from the business of providing definitive care for children who need hospitalization. In the latest Manne Research Institute President’s Message, President and Chief Research Officer Patrick Seed, MD, PhD, introduces us to Kenneth Michelson, MD, MPH, an attending physician in our emergency department and an investigator whose big data research is generating insights into the drivers of this progressive concentration of pediatric expertise within large cities, the effects on health outcomes of pediatric patients, and potential solutions to ensure that all children have access to pediatric emergency care.

Catch up on other noteworthy investigators and research support teams in previous editions of the Manne Research Institute President’s Message.

SCIENCE SHOWCASE

Neeraj Patel Receives the 2024 Roshen N. Irani Research Grant 

The Pediatric Orthopaedic Society of North America recently awarded the 2024 Roshen N. Irani Research Grant to Neeraj Patel, MD, MPH, an attending physician in the Division of Orthopaedic Surgery and Sports Medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago. 

The grant will be funded in the amount of $20,000 for a period of up to two years beginning June 1, 2024. It will support Dr. Patel’s research RED KARD: Reducing Disparities in Knee Arthroscopy for Adolescents. 

NEWS FROM THE RESEARCH PILLARS

Daily immunotherapy delivered via a dermal patch reduced the risk of reactions, including anaphylaxis, in children with an immunoglobulin E (IgE)–mediated cow’s milk allergy, according to a recent clinical trial published in JAMA Pediatrics.  

“This treatment, which does not involve ingesting the allergen daily, is a promising development in the food allergy therapeutics space,” said co-author Melanie Makhija, MD, Allergy and Immunology physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

Understanding Medical Complexity and Language Use to Reduce Healthcare Disparities

New insights into the association between use of language other than English, medical complexity, and disparities in outcomes in the pediatric intensive care unit (PICU) may help inform targeted efforts to improve care for children with medical complexity who use a language other than English so as to reduce healthcare disparities, according to researchers at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine. They published their study in Pediatrics. 

Lead author Mary Pilarz, MD, a critical care fellow at Ann & Robert H. Lurie Children’s Hospital of Chicago, explains that the study was prompted by an unexpected finding from a prior study she conducted at Lurie Children’s. That study was about outcomes for patients who use a language other than English, and the researchers found that there was a higher rate of technology dependence among children admitted to the general pediatric service whose families use a language other than English. For the current study—a single-site retrospective cohort study of PICU encounters from September 1, 2017, to August 31, 2022—Dr. Pilarz investigated the association between language other than English and medical complexity. The researchers performed univariable and multivariable analyses between demographic factors and medical complexity for unique patients and for all encounters, and examined clinical outcomes of initial illness severity, length of stay, and days without mechanical ventilation or organ dysfunction using a mixed effects regression model, controlling for age, sex, race and ethnicity, and insurance status.

A national survey led by Ann & Robert H. Lurie Children’s Hospital of Chicago found that parents have insufficient knowledge of newborn screening in general and of cystic fibrosis (CF) in particular. Researchers asked specific questions about CF based on studies showing that initial CF follow-up visits after a positive newborn screening often occur after 4 weeks of age, which is later than the recommended timeframe for best outcomes. Later follow-up is associated with worse nutrition in childhood, a predictor of long-term health in CF. Parents reported difficulties in understanding abnormal newborn screening results and uncertainty as to what to do next.

An abstract of the findings was presented at the Pediatric Academic Societies (PAS) meeting in Toronto, Canada, on May 5, 2024, by Ashley Hayes, MPH, from Lurie Children’s.

“Although all U.S. States screen for at least 33 metabolic and genetic disorders using blood spots collected in the first days of life, we found that parents don’t know enough about newborn screening and need more support from clinicians if their infant has an abnormal test result,” said Marie Heffernan, PhD, lead author on the abstract and Survey Science Lead at Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children’s Research Institute at Lurie Children’s, and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Our main message to parents is to know your baby’s newborn screening results and follow-up immediately if the test is abnormal. Not all babies with an abnormal screening test have the disease that is identified, but timely treatment can make a huge difference for the baby’s health, development and survival. This is certainly true if newborn screening identifies cystic fibrosis.”

Using Machine Learning to Predict Unplanned Return to the Operating Room for Early-Onset Scoliosis Patients

Surgical treatment of early-onset scoliosis allows the spine to grow and preserves pulmonary function, but it often involves a high rate of complications that may require an unplanned return to the operating room. Researchers have created and validated a machine learning model that predicts which early-onset scoliosis patients will end up requiring an unplanned return to the operating room and gives surgeons a better understanding of the factors that lead to this. Their study is published in Spine Deformity. 

“It is helpful to know which patient factors contribute to unplanned returns to the operating room because we can control some of them pre-operatively,” says Brett Lullo, MD, an attending physician in the Division of Orthopaedic Surgery and Sports Medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago and lead author of the study. “Though we cannot change a patient's underlying disease, we can delay surgery and allow them to gain weight and grow taller. We can also choose a more appropriate surgical construct for the patient.” 

Ann & Robert H. Lurie Children’s Hospital of Chicago is pleased to announce the first pediatric use of the novel fluorescent agent CYTALUX during surgery to remove lung metastases. The drug allows surgeons to better visualize cancer in the lung, as well as potentially detect additional cancerous nodules missed by preoperative imaging. This drug is FDA-approved in adult patients, but Lurie Children’s is the first-in-pediatrics to have an Investigational New Drug application with the FDA to study the drug’s safety and feasibility in children.

“We are thrilled to be the first children’s hospital to offer this novel technology that lights up cancer in the lung during surgery, and helps us see and remove nodules that we might have missed otherwise,” said Tim Lautz, MD, Director of Surgical Oncology at Lurie Children’s and Associate Professor of Surgery at Northwestern University Feinberg School of Medicine. “While lung cancer is rare in children, about 20 percent of kids with solid tumors will have lung metastases. The most common conditions for which we remove lung nodules are osteosarcoma and soft tissue sarcoma, and at times this surgery is also needed in children with liver and kidney tumors.”

Disability, Mental Health, Policy, and Motherhood

FCHIP's 2024 Mother's Day Report

This May, FCHIP celebrates its third annual Mother’s Day Report. This report highlights important issues for mothers and families including maternal mental health, disability, and a new focus on policy changes that can impact mothers in 2024. We also highlight innovations in maternal and child health initiatives happening across the country. In this report, FCHIP also highlights images from the Lurie Family Photobook, an ongoing project compiling images of Lurie Children’s families in the hospital and in the community.

MANNE RESEARCH INSTITUTE IN THE MEDIA

• Prospects for Crohn's Relief Brighten with New Advancements - WebMD
• Experts Find Cardiometabolic Risk Signs in Kids Young as 3. Here Is the Food They Say Is Linked - CNN
• Death of Teen Who Ate a Spicy Chip Has Experts Rethinking Capsaicin and Its Effects - NBC News
• Lurie Takes Charge in Studying Drug That Glows in Presence of Lung Cancer Cells - Crain's Chicago Business
• Parents of Infants with Cystic Fibrosis Often Feel Confused, Unsupported: Survey - U.S. News & World Report
• Psych Staffing Linked to Shorter Stays in Pediatric Emergency Observation Unit - MedPage Today
• High Blood Pressure in Kids Doubles Their Risk of Cardiovascular Disease, Study Finds, Bringing a Call for Routine Screening - STAT News
• Chicago's Lurie Children's Hospital Has Clinical Study for Peanut Allergy Sufferers and a Patch That Could Help - CBS News

Don't miss Manne Research Institute news as it happens.

Follow us on X and LinkedIn today.