Every day in the U.S., more than four children die because of abuse. Of those, more than 70 percent are 2 years old or younger.
In response to this issue, two UPMC physicians are developing and disseminating a child abuse clinical decision support (CA-CDS) system within the electronic health record (EHR). The goal is to rapidly identify potential abuse that might otherwise be overlooked in a busy emergency department. The development team includes Dr. Srinivasan Suresh,pediatric emergency physician and chief medical information officer at Children’s Hospital of Pittsburgh of UPMC, and Dr. Rachel Berger, chief of the Children’s Child Advocacy Center and the director of child abuse research at the Safar Center for Resuscitation Research at the University of Pittsburgh.
“Emergency physicians care for patients who present with a wide spectrum of symptoms,” Suresh said. “The signs of abuse are not always clear. Triggers and visual alerts in an EHR can address this gap.”
The CA-CDS system, which includes a trigger system, provider alerts and a physical abuse order set, has been successfully developed and deployed at Children’s. When a child presents to the emergency department with a physical injury that could have come as a result of abuse, an alert pops up in the EHR to immediately notify the physician and the rest of the care team, bringing the possibility of abuse to their attention.
“The aim of this trigger is to increase the sensitivity of our suspicion for physical child abuse,” Suresh said.
Since the system is standardized, it can also eliminate biases.
“Our gut is not always right as it relates to child abuse,” Berger said. “By standardizing and reminding people to think about abuse, racial and other disparities can be decreased.”
Originally funded by the Patient-Centered Outcomes Research Institute, the CA-CDS project recently received a $99,900 grant from The Beckwith Institute, specifically through its Bench at the Bedside program. Bench at the Bedside allows doctors to take what they know and transform it into ideas that will further improve clinical practice.
The grant has helped the researchers expand the value of the toolkit.
“We have successfully implemented the decision support tool here in Pittsburgh,” Suresh said. “This grant now enables us to integrate the toolkit into the EHRs of a few large children’s hospitals across the country.”
“This is a powerful tool in helping doctors and nurses recognize the signs of abuse, intervene in a timely fashion and avoid having to treat the same children repeatedly for abuse,” Berger said. “The children are vulnerable and don’t have a voice. It’s our job to protect them.”
To learn more about The Beckwith Institute or the grants the organization offers, visit www.beckwithinstitute.org.
Each fall, chefs from across Pittsburgh come together to share their best dishes and compete for “Dish of the Year.” The competition is called Savor Pittsburgh, and all proceeds benefit research at Magee-Womens Research Institute (MWRI).
We asked Michael Annichine, chief executive officer of MWRI, for details on the event, which takes place Thursday.
A. Savor Pittsburgh celebrates its 12th anniversary this year. The event started when neonatal intensive care unit (NICU) families were grateful for the world-class care they received at Magee-Womens Hospital of UPMC and decided to host a fundraiser to support the hospital. Last year, we had more than 1,500 people in attendance. Due to event growth, we’ve moved to larger space and hope to welcome an even larger crowd at the Peterson Events Center.
What can attendees expect?
A. Savor Pittsburgh attendees support a worthy cause and enjoy some of Pittsburgh’s finest delicacies. Chefs from 30 restaurants prepare amazing appetizers, fabulous entrees, decadent desserts and signature cocktails. This year’s event features the band No Bad Juju, with Chris Jamison from “The Voice.” Additionally, we’ll have a raffle and a silent auction.
What’s the importance of this event?
A. Proceeds benefit MWRI and Magee, and have an enormous impact on the lives of mothers and babies. MWRI is the largest independent research institute in the nation focused exclusively on women’s health. The funds from Savor Pittsburgh help bolster our research on a wide variety of women’s health issues including reproductive biology, breast cancer genomics, fertility preservation, and many other areas. Our researchers are also very focused on how pregnancy and fetal development can affect population health for future generations. In addition to purchasing supplies for the NICU, we will use the proceeds of the event to award grants to researchers.
Every year, thousands of athletes gather in various cities across the country to participate in a 2.4-mile swim, 112-mile bike, and 26.2-mile run, better known as an Ironman Triathlon.
For Dr. Gregory Reed, professor and director of the University of Pittsburgh’s Center for Energy and the GRID Institute, training and participating in triathlons is nothing new. What’s new is his battle with Crohn’s disease, though, that hasn’t ended his 24-year experience as a triathlete.
Reed knew that Crohn’s disease ran in his family since his older brother battled it his entire adult life. It wasn’t until Reed was traveling in the spring of 2014 and experienced severe pain requiring an emergency room visit that he was diagnosed with the disease.
He had planned to train for Ironman Maryland 2015 as a Crohn’s and Colitis Foundation (CCF) Team Challenge Athlete, something his sister-in-law had gotten involved in years earlier. However, just months before the triathlon, he found himself back in the hospital. The severe pain had returned. He underwent a successful ileocecectomy, and recovered.
Reed started training again in early 2016.
“The most trying part was getting my energy back – a frustrating process for someone like me,” he said.
He set his sights on Ironman Maryland 2016 and started to raise funds to be a CCF Team Challenge Athlete.
“If I was going to do it, I wanted to do something that had an impact,” Reed said.
He completed the event and raised $23,500, which was the third highest fundraiser of all Ironman team challengers nationwide. After that success and having no restrictions with training, Reed is at it again, training for Ironman Chattanooga 2017 on Sept. 24, and dedicating both races to his brother.
“This year, I’m even healthier,” he said. “I’m stronger and I feel better – I’m much further along than last year.”
Confident in his training and abilities, he predicts that he’ll finish in under 12 hours.
“I continue to be very thankful for the UPMC Inflammatory Bowel Disease Center and my specialist, Dr. Miguel Regueiro, who has helped me continue my journey in endurance athletics, despite my Crohn’s,” Reed said. “It is one way of beating the disease, but more work needs to be done to find cures.”
To make a contribution to Reed’s Ironman Chattanooga CCF Team Challenge efforts, click here.
A woman diagnosed with a severe form of type 1 diabetes recently underwent a rare procedure to regulate her blood sugar level at ISMETT, a leading transplant center managed by UPMC in Palermo, Sicily.
The 52-year-old woman was transferred to the center for a transplant of pancreatic islets, clusters of endocrine cells in the pancreas that contain insulin-producing cells.
“This method has several advantages, including avoiding major surgery such as a pancreas transplant, reducing the patient’s hospital stay and resuming a good quality of life a few days after the operation,” said Dr. Anna Casu, director of the ISMETT Diabetology Unit.
Doctors rarely perform this transplant due to the difficult pancreatic cell processing and the limited availability of appropriate laboratories. Only a few such transplants have ever been performed in Italy.
The cell transplant involved collaboration among ISMETT, the Ri.MED Foundation and the Diabetes Research Institute at the University of Miami. Led by director Dr. Camillo Ricordi, the Diabetes Research Institute is highly experienced in the field of pancreatic cell transplantation.
A joint team of doctors and biologists at ISMETT and the Ri.MED Foundation worked on cell processing, with Casu as the lead coordinator. She was in contact with Ricordi throughout the entire process.
The intervention, which followed the procurement of pancreatic cells from a deceased donor, consisted of two phases. The first involved separating and extracting the insulin-producing cells from the donor’s pancreas and purifying them. Using the “Ricordi Method,” the pancreatic cells that produce insulin were isolated from the procured graft during a process that lasted several hours.
After the cell processing and isolation, the second phase involved the infusion of the cells into the patient through the vein that carries blood to the liver. This allows cell colonization in the patient’s pancreas.
“Thanks to telescience, a technology similar to telemedicine, staff at the Diabetes Research Institute are in constant contact with all centers producing pancreatic islets,” Ricordi said. “That includes centers like ISMETT, who are members of the institute’s federation, a global alliance of centers collaborating with no barriers to cure diabetes in the fastest and most efficient way possible.”
Scientists at the world’s top universities have collaborated to develop a device that, by sifting tiny particles from blood samples, could be a boon to both scientific research and medical applications by allowing researchers to study hard-to-reach tissues — such as the human placenta — through a blood sample.
Combining acoustic and microfluidic technologies, the scientists from the Magee-Womens Research Institute (MWRI) at the University of Pittsburgh, Duke University, Massachusetts Institute of Technology (MIT), Carnegie Mellon University (CMU) and Nanyang Technological University in Singapore, developed the prototype, which is designed to be used at the patient point-of-care.
It sifts blood nanoparticles, called exosomes, which are released from every cell type in the body and which are thought to play a large role in cell-to-cell communication and disease transmission. Exosomes have been researched since their discovery three decades ago, and because they contain biomolecules that reflect their tissue of origin, they open the door to sophisticated diagnostic testing of tissues previously out of reach.
In a paper published in the Proceedings of the National Academy of Sciences USA, the researchers demonstrated a better method based on acoustofluidics — the fusion of acoustics and microfluidics. The prototype provides a gentle, automated, point-of-care system that allows a single-step, on-chip isolation of exosomes from whole biological fluids with a high rate of purity and yield.
Casual Meeting Turns into Scientific Pursuit
The idea for the research that led up to this prototype device originated in a casual meeting at a conference in Washington, D.C., in 2014 between Drs. Yoel Sadovsky, executive director of MWRI, and Subra Suresh, then president of CMU. Suresh had been working with Drs. Tony Jun Huang, then professor of bioengineering science and mechanics at Pennsylvania State University, and Ming Dao, director of the nanomechanics laboratory at MIT, to isolate tumor cells from the blood to enhance cancer diagnostics.
A conversation between the two Pittsburgh researchers about how exosomes could be used as a window into tissue health turned into an intense scientific pursuit, with the idea of scaling down the assays already engineered by Huang, Suresh and Dao. The results, representing the engineering development lead by Huang and colleagues with additional testing in Sadovsky’s lab at MWRI, could help researchers and clinicians learn more about exosomes and form the foundation for diagnostic or therapeutic devices.
Tissue injury, cancer and other diseases in relatively inaccessible organs — such as the placenta, brain, kidney and liver — could, in theory, be diagnosed and monitored through a simple blood draw, dubbed a “liquid biopsy.”