Having conclusively demonstrated an increase in peanut allergy in the Montreal population, MUHC/MCH investigators are involved in testing treatment stategies that may be useful in long term prevention of allergies in children. This group of researchers has also determined improved diagnostic accuracy for sesame allergy.
MCH research has demonstrated that written action plans tailored to individual patients based on their symptoms are an effective mode of providing self-management to control asthma symptoms in children.
Early intervention results in improved outcomes for children with autism. Fortunately, the age of diagnosis for autistic children has been decreasing due to more systematic screening of toddlers with adequate tools, along with increased awareness by health professionals and the public. One such study of toddlers initiated by an MCH investigator has found that 25% of babies born very prematurely had signs of autism on an early screening test.
At the MCH, studies of autistic children are ongoing to explain the genetic causes and/or environmental mechanisms involved in autism. To date, studies have ruled out the role of childhood immunizations as a risk factor and dispelled the supposed link between mercury and autism. This has alleviated concerns related to childhood thimerosal-containing vaccines, dental amalgams and methymercury in food.
Breastfeeding - IQ
An MCH study has found that children breastfed exclusively for the first three months of life or longer scored nearly six points higher on IQ tests at the age of 6 than children who weren't breastfed exclusively.
Although the incidence of invasive cancer in children has increased slightly over the past 30 years, mortality has declined dramatically for many childhood cancers. In the past two decades, remarkable progress in the treatment of childhood cancers has been reported. The combined 5-year survival rate for all childhood cancers has improved from less than 50 percent before the 1970s to nearly 80 percent today, and the 10-year survival rate is over 75 percent.
Concurrently, developments in the laboratory have improved our understanding of the biology of childhood malignancies. Advances in molecular biology have provided new insights into events surrounding the process of malignant transformation, as well as new tools for the diagnosis, staging, and detection of residual disease.
The availability of new imaging techniques–advances in magnetic resonance imaging, in particular–permit more accurate assessment of tumor extent and staging, and the optimization of surgical approaches. Such imaging techniques are now routinely used in radiotherapy planning to maximize treatment of tumor sites, while minimizing the exposure of normal tissues.
Progress in surgery has led to better reconstructive techniques to repair defects created by tumor resections. The availability of hematopoietic cytokines and advances in supportive care permit the administration of increasingly intensive therapies. Advances in our understanding of hematopoietic stem cells have resulted in the significant extension of bone marrow transplantation techniques.
One research program at MCH is focused on deadly brain tumors called pediatric astrocytomas. These tumors are the first cause of cancer-related mortality and morbidity in children, yet they are largely unstudied. Our researchers' premise is that they possess unique molecular signatures distinct from adult astrocytomas, which they are characterizing with the goal of improving the dismal outcome seen in patients receiving current treatments. Their novel findings about these tumors are beginning to offer possibilities in determining new targets and tools to test the drugs targeting them, potentially improving the outcome of children with a devastating cancer.
MCH investigators have uncovered a new mechanism involved in cancer. The study shows that cancer causing proteins (oncoproteins) are not only able to act from within the cancer cell, as was previously thought, but can also migrate from cell to cell and be shed into the blood, as "passengers" on tiny membrane bubbles that pinch out of the cancer cell surface. Based on this work, MCH investigators are planning to develop a new blood test for cancer.
MCH researchers have determined that children who have had cardiac surgery are at risk of developmental and learning difficulties. The MCH now uses a new method of brain oxygen monitoring which has been shown to improve patient monitoring during cardiac surgery.
An MCH surgeon has used Botox injections for saving the life – and guaranteeing the quality of life – of an infant born with Charge syndrome. This complex disorder affects the infant's ability to swallow and ultimately leads to a surgical tracheotomy with all its accompanying risks of mortality. This was the first time that Botox was used for so young a patient affected with this disorder.
Congenital heart defects
An MCH study has found that abnormalities in the metabolism of the vitamin folate are an important cause of congenital heart defects.
Enhanced longevity and quality of life for patients with cystic fibrosis occurs by slowing down the rate of the decline of lung function in these patients. A study conducted at the MCH has demonstrated that high-dose Ibuprofen slows down the progression of lung disease in these patients.
Ongoing studies of the complex genetic causes of diabetes at the MCH will permit not only the detection of high diabetes risk, but will also lead to interventions tailored specifically to the patient's genetic profile.
Leber's Congenital Amaurosis
Two genes responsible for Leber's Congenital Amaurosis, the most common cause of congenital blindness in infants and children, have been identified at the MCH, and studies of the genetic basis for inherited forms of blindness are ongoing. It is hoped that this work will lead to gene therapy for these conditions.
Obstructive sleep apnea
Work at the MCH has demonstrated that use of nasal corticosteroids can significantly diminish symptoms in children withobstructive sleep apnea caused by enlarged tonsils and adenoids.
At the MCH, ongoing studies are determining the efficacy of several vaccines in children such as pneumo13-valent, a new meningococcal vaccine for infants, and pertussis. In addition, epidemiological studies of hospital-borne infections are leading to a better understanding of risk factors for these infections. This information will result in the implementation of preventive measures.