On the Pulse

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Seattle Children’s Tackles Tourette’s, OCD with Innovative Therapies

At least 138,000 children in the United States are estimated to have Tourette’s syndrome,  a condition which causes  urges that lead to repeated involuntary movements (motor tics) and sounds (phonic tics).  For decades, research suggested pharmaceutical therapies were the only effective treatments for tics, but clinical psychologist Dr. Geoffrey Wiegand  is having success using a new, innovative behavior intervention to treat tics. Wiegand is also offering highly effective behavior therapy to children with Obsessive Compulsive Disorder (OCD) to help them manage their worries and compulsions.

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Jules Brown’s OCD made her afraid to leave her house. Now that she has has effective treatment, she tries new things like inner tubing.

Meet Jules

Jules Brown appeared to be a happy, healthy child until she was 5 years old, when her parents began noticing odd behaviors. She was constantly changing her clothes out of fear of being dirty and would wash her hands until they bled. It took the family hours to leave the house because Jules was terrified she would have an “accident” and would insist on visiting the bathroom repeatedly. At school, she spent many days in the nurse’s office, afraid of various illnesses or injuries that she did not have.

“As her mom, I wanted to protect her, so we were constantly doing anything we could to reassure her,” Christie Brown said. “But the impulsive behaviors just got worse.” Read full post »

Integrating Mental Health Treatment into Primary Care May Reduce Teen Depression

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Dr. Laura Richardson, adolescent medicine specialist at Seattle Children’s Hospital and principal investigator in the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute.

A new study from Seattle Children’s Research Institute suggests integrating mental health treatment into primary care may reduce depression symptoms in teens.

Challenges accessing treatment

While 14% of teens experience serious depression, few receive evidence-based treatments for mental illness. This puts them at greater risk of suicide, substance abuse, early pregnancy, low educational attainment, recurrent depression and poor long-term health.

Accessing mental health treatment can be challenging for patients and their families. In the typical clinic, teens diagnosed with depression by a primary care doctor are referred to mental health specialists for treatment, requiring their families to identify an available specialist, set up an appointment and travel to a new care setting. Dr. Laura Richardson, an adolescent medicine specialist at Seattle Children’s Hospital and principal investigator in the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute, said she often sees patients who have not been able to connect with a mental health provider return to her with worse depression symptoms. Read full post »

A Recipe for Better Health: 7-5-2-1-0

75210Obesity is a health problem that affects 15% of children and teens in the U.S. According to the American Academy of Pediatrics (AAP), obesity is a national health emergency. However, Victoria Garcia, manager of Community Benefit at Seattle Children’s Hospital, says there are small, simple steps families can take to reduce the risk of obesity.

“Obesity is an epidemic in the U.S., but making healthy lifestyle choices is about more than just obesity prevention,” said Garcia. “When children are healthy, they are also happy. We want families to take small steps toward a healthier lifestyle. Being active and eating well is a positive message that can apply to anyone and everyone.”

Garcia advises parents to set children up for success by incorporating a simple formula into everyday life: 7-5-2-1-0. Below, Garcia decodes what each number means. Read full post »

Brain Discovery Could Lead to Improved Treatments for Depression

iStock_000036067988SmallFinding mental health treatments without unwanted side effects can be challenging, but scientists at Seattle Children’s Research Institute (SCRI) have discovered an area of the brain that could one day be targeted to treat depression more effectively.

Dr. Eric Turner, a principal investigator in Seattle Children’s Research Institute’s Center for Integrative Brain Research, together with lead author Dr. Yun-Wei (Toni) Hsu, also from Seattle Children’s Research Institute, learned that a tiny region of the brain – the dorsal medial habenula –controls the motivation to exercise and participate in other rewarding activities in mice, and potentially in humans. Exercise is one of the most effective non-pharmacological therapies for depression, so determining which part of the brain may be responsible for exercise motivation could help researchers develop more targeted treatments.

“Changes in physical activity and the inability to enjoy rewarding or pleasurable experiences are two hallmarks of major depression,” Turner said. “But the brain pathways responsible for exercise motivation have not been well understood. Now, we can seek ways to manipulate activity within this specific area of the brain without impacting the rest of the brain’s activity.” Read full post »

Infectious Disease Epidemics May Not Influence Vaccination Rates

Doctor giving a child an intramuscular injection in arm, shallow DOFExperts have long believed that when the risk of a disease is high, people are more likely to accept a vaccine to prevent that disease. But recent research suggests that might not be uniformly true. Dr. Elizabeth Wolf, an investigator in Seattle Children’s Research Institute’s Center for Child Health, Behavior and Development, led a study that determined Washington’s recent pertussis (whooping cough) epidemic did not influence the number of infants who were vaccinated against the disease.

Pertussis is an extremely contagious bacterial disease that can lead to pneumonia, seizures, brain damage and death. In 2012, the United States experienced the largest pertussis epidemic since the 1950s. There were 20 deaths reported nationally, the majority of which were infants. Washington reported one of the highest incidence rates of pertussis. The state also has one of the highest nonmedical vaccination exemption rates from required kindergarten vaccinations.

“Vaccination rates are below public health goals, both locally and nationally,” Wolf said. “We need to better understand what factors might impact vaccine acceptance.”  Read full post »

‘Boot Camp’ Designed to Prevent ACL Injuries Keeps Derby Girls Rolling

Seattle Derby Brats WebWatch the derby girls from the Seattle Derby Brats, the largest junior roller derby league in the Northwest, whiz around the roller rink at high speeds, weaving meticulously between skaters and occasionally crashing to the ground, and it’s understandable why safety is a priority for the league. When the Seattle Derby Brats, reached out to Seattle Children’s Hospital’s Athletic Trainers Program, they were hoping to implement a program that would keep the girls safe at practices and matches. But what they got was much more than that.

Seattle Children’s athletic trainers provide an innovative type of customized care that not only treats injuries, but reduces them as well. For the derby girls, that customized care helped prevent a common injury they’re at greater risk for sustaining: tearing their anterior cruciate ligament (ACL). Read full post »

Camp Inside-Out Aims to Improve the Odds for Teens in Foster Care

Dr. Kym Ahrens (left) with Camp Inside-Out colleagues (left to right), Heather Spielvogle, Mavis Bonnar and Alexis Coatney.

Dr. Kym Ahrens (left) with Camp Inside-Out colleagues (left to right), Heather Spielvogle, Mavis Bonnar and Alexis Coatney.

This month, Dr. Kym Ahrens is going to camp with 24 teenagers.

Some people would call that an adventure; others, a challenge.

Ahrens calls it research.

Ahrens, an adolescent medicine specialist and researcher within Seattle Children’s Research Institute’s Center for Child Health, Behavior and Development, is studying whether an intensive, five-day “dose” of a specially designed camp can give teens in foster care the skills they need to steer clear of risky sexual behaviors.

It’s a big deal because teens in foster care are at much higher risk than their peers for unwanted pregnancies and sexually transmitted infections (STIs).

Read full post »

Transplant Saves First ‘Bubble Boy’ in Wash. State Detected with Newborn Screening

This is a special guest post from JoNel Aleccia, staff writer at Fred Hutchinson Cancer Research Center. See the original article and photos here.

Rachel Dixon holds her son Ezra, who was born with severe combined immunodeficiency. SCID affects about 1 in every 50,000 babies born in the U.S. Nearly two months after having a life-saving bone marrow transplant from his brother, Judah, he's doing well. Photo courtesy of  Bo Jungmayer / Fred Hutch News Service

Rachel Dixon holds her son Ezra, who was born with SCID. Nearly two months after having a life-saving bone marrow transplant from his brother, he’s doing well. Photo courtesy of Bo Jungmayer / Fred Hutch News Service

Ezra Dixon was born April 7, four months after the state of Washington first starting screening newborns for the disorder commonly known as “bubble boy disease,” which leaves its patients at the mercy of common germs.

Some 22,610 babies were tested before him and more than 28,000 have been tested since, all negative, health records show. But Ezra is different.

The bald, blue-eyed boy is the only child in the state so far diagnosed with severe combined immunodeficiency, or SCID, detected through the program.

When staff at the Washington State Department of Health Newborn Screening Lab analyzed the drop of blood pricked from his heel shortly after birth, they found none of the T-cells that protect the body from infection, a certain sign of the rare disorder.

Read full post »

Remembering Daniel and the Legacy He Left Behind

Daniel Mar

Daniel Mar

In my last post about “The Fault in Our Stars,” I made a comment about how most patients live, if not thrive after their cancers. I am deeply grateful for the readers who correctly commented that some patients also die.

There are no words to express how tragic, painful, or unjust, the death of a young person from cancer can be. I particularly appreciated these comments because they came a day after the death of one of my own, and very beloved, patients. I wrote this memoir the day he died. With his parents’ permission, I am sharing a few pieces of his story, his legacy, with you.

Remembering Daniel

Daniel Mar died early this morning at the age of 20. He was one of my first patients as an independent oncologist. For that alone, I could say he will not be forgotten. Daniel was a “patient” simply because he happened to have cancer; terrible cancer that ultimately took his life. But beyond that, he was so much more. He was an advocate. A son. A brother. A devoted friend. To me, he was my muse. My teacher. And, through it all, my friend.

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Researchers Combine Therapies to Find a Better Way to Treat Brain Injury in Infants

Complications that can arise around the time of birth may reduce oxygen and blood flow to a baby’s brain, causing hypoxic-ischemic encephalopathy (HIE), a leading cause of death or neurological impairment among infants. In the past eight years, cooling therapy (hypothermia) has become the standard form of care for HIE, as it’s been found to be effective in reducing brain injury, but doctors say it’s not enough – about half of affected infants still have a poor outcome.

For this reason, researchers have launched a nationwide study, called the Neonatal Erythropoietin and Therapeutic Hypothermia Outcomes in Newborn Brain Injury (NEAT-O), to see if using the hormone erythropoietin (Epo) in conjunction with cooling therapy may further reduce the risk of neurologic deficits in full-term infants (at least 36 weeks gestation) with HIE.

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