Boston Children's Hospital

Boston Children's Hospital formerly known as Children's Hospital Boston until 2012 is a nationally ranked, freestanding acute care children's hospital located in Boston, Massachusetts, adjacent both to its teaching affiliate, Harvard Medical School, and to Dana–Farber Cancer Institute. Dana–Farber and Children's jointly operate the Dana–Farber/Boston Children's Cancer and Blood Disorders Center to deliver comprehensive care for all types of childhood cancers. The hospital is home to the largest hospital-based pediatric research program in the world. The hospital features 485 pediatric beds and provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21 throughout Massachusetts, the United States, and the world. The hospital also sometimes treats adults that require pediatric care. The hospital uses the Brigham and Women's Hospital's rooftop helipad and is an ACS verified level I pediatric trauma center, one of three in Boston. The hospital features a regional pediatric intensive-care unit and an American Academy of Pediatrics verified level IV neonatal intensive care unit.

Boston Children's Hospital has been ranked as best pediatric medical center by ''U.S. News & World Report'' more times than any other hospital and is currently ranked as the best children's hospital in the United States. Its research enterprise is the world's largest and most highly-funded pediatric hospital. In 2022, Children's received more funding from the National Institutes of Health than any other children’s hospital in the nation.

Overview

One of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age. Its Advanced Fetal Care Center can begin interventions at 15 weeks gestation, and, in some situations (e.g., congenital heart disease and strabismus), Children's also treats adult patients. The institution is home to 40 clinical departments and 258 specialized clinical programs.

From October 1, 2017, through September 30, 2018 (fiscal year 2018), the hospital recorded:

* 622,000 outpatient visits
* 60,000 emergency department visits
* 28,000 inpatient and day surgical cases
* 5.4-day average length of stay
* a 2.13 average case-mix

The hospital's clinical staff includes approximately 2,000 active medical and dental staff, 475 residents, fellows, and interns, and over 2,700 nurses. In addition to clinical personnel, Boston Children's has the largest pediatric research enterprise with 3,000 researchers and scientific staff and more NIH funding than any other children's hospital. A trained team of more than 460 volunteers devote thousands of hours each year to support the hospital staff and patients. Kevin B. Churchwell serves as the hospital's current CEO.

The International Center at Boston Children's Hospital serves over 2,500 patients from more than 140 countries. Services provided including coordination of visits, medical records, travel, accommodation, and immigration. The hospital offers a global medical second opinion program in partnership with Grand Rounds, Inc.

In 2019, Boston Children's Hospital was ranked the top pediatric hospital by ''U.S. News & World Report'' for the sixth year in a row. Boston Children's was the first stand-alone pediatric hospital in New England to be awarded Magnet status by the American Nurses Credentialing Center.

Boston Children's Hospital is home to the United States' first pediatric and adolescent transgender health program.

History

Children's was founded on July 20, 1869, by Dr. Francis Henry Brown, a Civil War surgeon, who traveled to Europe in 1867 to study the pioneering specialized approach to treating children. Brown was impressed with the treatments he witnessed and he wanted to bring that level of care to Boston. Brown opened a 20-bed facility in a small townhouse at 9 Rutland Street in Boston's South End.

Approximately one year after opening, the hospital was moved to the corner of Rutland and Washington Streets. Children's Hospital stayed at this location until 1871 when the hospital moved to Huntington Avenue before its final move to what would become the Longwood Medical and Academic Area.

In 1891 Thomas Morgan Rotch, Children's chief physician, established the nation's first laboratory for the modification and production of bacteria-free milk. Before the establishment of this laboratory, breast milk was often the carrier of many deadly diseases that children were especially susceptible to.

Harvard Medical School affiliated itself with Boston Children's in 1903.

Boston Children’s Hospital moved to an area of more than 130,000 square feet on Longwood Avenue in 1914, where the Ebenezer Francis farm was located. The cost of the area was $120,000.

Dr. William Ladd, a doctor with Children's, devised procedures for correcting various congenital defects such as intestinal malformations in 1920, launching the specialty of pediatric surgery.

Dr. Robert E. Gross, a surgeon at Children's and later a professor of child surgery at Harvard Medical School, performed the world's first successful surgical procedure to correct a congenital heart defect with the "ligation of a patent ductus arteriosus" in 1938, ushering in the era of modern pediatric cardiac surgery.

Dr. Sidney Farber, pediatric pathologist, requested Dr. Yellapragada Subbarow (of Lederle lab and his friend and colleague at Harvard Medical School) to supply Aminopterin and later Amethopterin (Methotrexate) to conduct trials on to children with leukemia, a diagnosis that was deemed a "death sentence," in 1948. He achieved the world's first partial remission of acute leukemia. He went on to co-found the Dana-Farber Cancer Institute in 1950.

Dr. John Enders, his assistant Thomas Weller, and colleague Frederick Robbins, successfully cultured the polio virus in 1949, making possible the development of the Salk and Sabin vaccines for polio. They won the Nobel Prize for their work in 1954. Enders and his team went on to culture the measles virus.

Dr. Judah Folkman published "Tumor angiogenesis: Therapeutic implications" in the 1971 November issue of the ''New England Journal of Medicine''. It was the first paper to describe Folkman's theory that tumors recruit new blood vessels to grow.

The Boston Brace, a new, lower profile brace for patients with scoliosis was developed by Chief of Orthopedics John E. Hall and orthotist Bill Miller at the Boston Children's scoliosis clinic in 1972.

Boston Children's conducted a widespread study on donated teeth from children living in Chelsea and Somerville in the 1970s to study how lead effected children's behavior, development and IQ. The results showed that "children whose teeth had the highest lead levels were far behind those with the lowest on measures including IQ, motor coordination and attentiveness in class."

Hypoplastic left heart syndrome, a defect in which an infant is born without a functioning left ventricle was first treated via surgical palliation in 1983. The procedure was the first to palliate what had been a fatal condition. Three years later, in 1986, Children's surgeons performed the hospital's first heart transplant. Later in the year, a 15-month-old patient became the youngest person in New England to receive a heart transplant.

Boston Children's Chief of Hematology and Oncology David Nathan recommended for Claudia De Pass, a young patient with sickle cell disease, to try Hydroxyurea, a drug used to treat blood cancer, to treat her sickle cell disease. The treatment worked and Hydroxyurea is now broadly used to treat sickle cell disease.

Researchers in neurology and genetics discover the toxicity beta amyloid, a protein that accumulates in the brains of people with Alzheimer's disease, to neurons in 1989. This discovery indicates beta amyloid as the possible cause of the degenerative disease.

Endostatin, one of the most potent inhibitors of blood vessel growth, is discovered by Drs. Michael O'Reilly and Judah Folkman in 1997. In mice, endostatin has shown promise in slowing some cancers to a dormant state. Phase I clinical trials began at three centers in 1999.

Dr. Evan Snyder clones the first neural stem cells from the human central nervous system of a fetus in 1998, offering the possibility of cell replacement and gene therapies for patients with neurodegenerative disease, neural injury or paralysis.

In 1998 Children's establishes its Advanced Fetal Care Center to provide diagnostic services, genetic and obstetrical counseling, and prenatal or immediate postpartum intervention for fetuses with complex birth defects. The same year
Larry Benowitz
PhD grows nerve cells in the damaged spinal cords of rats, a significant step in the treatment of spinal cord injuries. The next year, Benowitz discovers that inosine is important in controlling axon regeneration in nerve cells.

Since 2000

In 2002 Dr. Scott Pomeroy and Dr. Todd Golub use microarray gene expression profiling to identify different types of brain tumors and predict clinical outcome. This allows radiation and chemotherapy to be tailored to kill cancer cells while leaving healthy tissue alone. Also in 2002, Dr. Nader Rifai helps to author a paper showing that cholesterol levels and LSD use are less accurate predictors of predisposition to strokes and heart attacks then presence of a C-reactive protein that can be found in blood test results.

Dr. Heung Bae Kim and Dr. Tom Jaksic develop, test and successfully perform the world's first serial transverse enteroplasty (STEP) procedure for patients with short bowel syndrome in 2003. The next year, Children's surgeons perform New England's first multi visceral organ transplant when 11-month-old Abdullah Alazemi receives a stomach, pancreas, liver, and small intestine from a single donor.

In 2005, in the best-documented effort to date, Drs. Felix Engel and Mark Keating get adult heart-muscle cells to divide and multiply in mammals, the first step in regenerating heart tissue. Also in 2005, neurosurgeo
Benjamin War
f brought a technique back to Boston Children's for shuntlesly treating hydrocephalus, the condition of excess fluid around the brain.

In 2006, Dr. Dale Umetsu, Dr. Omid Akbari and colleagues reported that a newly recognized type of immune cell, NKT, may play an important role in causing asthma, even in the absence of conventional T-helper cells. In addition, NKT cells respond to a different class of antigens that are currently recognized to trigger asthma. In that same year, Dr. Larry Benowitz and colleagues discovered a naturally occurring growth factor called oncomodulin that stimulates regeneration in injured optic nerves, raising the possibility of treating blindness due to optic-nerve damage and the hope of achieving similar regeneration in the spinal cord and brain.

Norman Spack co-founds Boston Children's Hospital's Gender Management Service (GeMS) clinic in 2007; it is America's first clinic to treat transgender children. The clinic provides " counseling and resources in the years before medical intervention is appropriate, along with psychological support and a stepwise approach to medical treatment."

In order to re-oxygenate blood, Dr. John Kheir and Dr. Tahir Saleem N. Jutt (Cardiac) develop particles that can be injected into a bloodstream in 2012.

In collaboration with Life Technologies, Boston Children's spins out its genetic diagnostic lab in January 2013 to a new firm called Claritas Genomics. The goal of the partnership is to develop genetic and genomic tests for inherited pediatric diseases. Five years later, in January 2018, Claritas ceases operations. The hospital remains Claritas' majority shareholder during its existence, and a Series B funding round was completed in 2015, raising at least .

In 2016, the hospital receives approval by the Massachusetts Public Health Council for a $1 billion expansion to the Longwood Medical and Academic Area. The hospital plans to build an 11-story building with 71 new beds, renovate part of the current campus, and build a new outpatient clinic in Brookline, Massachusetts.

Controversies

Justina Pelletier controversy

In 2013, Boston Children's Hospital became part of a dispute concerning the treatment of minor Justina Pelletier, which ultimately involved the Massachusetts Department of Children and Families. In February 2012, Pelletier was taken to the emergency-room at Boston Children's Hospital, a trip prompted by severe stomach pain and difficulty walking, For a variety of symptoms, Pelletier had previously been taken by her parents to see doctors across multiple states, receiving multiple diagnoses. She had most recently been diagnosed with mitochondrial disease while a patient at Tufts Medical Center. The BCH doctors doubted that difficult-to-confirm diagnosis, owing to the lack of abnormal blood markers and the fact that there had been no finding of an accumulation of mitochondria in the cell membranes of skeletal muscles, often called the “hallmark of mitochondrial disorders". (Dr. Mark Korson, Pelletier's Tufts doctor, had not performed a muscle biopsy.) Dr. Jurriaan Peters, a pediatric neurologist at BCH who evaluated Pelletier, suspected somatoform disorder

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