Landmark Study May Pave the Way for Personalized Treatment of Lupus and Other Complex Autoimmune Diseases

Landmark Study May Pave the Way for Personalized Treatment of Lupus and Other Complex Autoimmune Diseases

by | Apr 4, 2016 | Research & Innovation

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Dallas researcher, Virginia Pascual, M.D., publishes new findings in prestigious Cell journal

DALLAS (March 31, 2016): New research that may dramatically improve drug development for systemic lupus erythematosus patients will be published on April 21 in Cell, the most prestigious scientific journal among biologists. The paper, “Personalized Immunomonitoring Uncovers Molecular Networks That Stratify Lupus Patients,” is authored by Dr. Virginia Pascual, principal investigator of the study and researcher at Baylor Institute for Immunology Research, part of Baylor Scott & White Research Institute.

“This achievement reflects Dr. Pascual’s commitment to excellence and to continuous improvement of quality care for patients with lupus,” said Donald Wesson, senior vice president of medical education and research for Baylor Scott & White Research Institute. “For many investigators, simply getting a publication in Cell is the highlight of their career, but for Dr. Pascual, it’s another great honor in a career that has brought prestige to her work and to Baylor Scott & White Health.”

Lupus is a chronic disease that causes the body’s immune system to attack its own tissues, causing inflammation, pain, and organ damage. It’s a complicated condition that’s difficult to diagnose – no single test can definitively detect it – and complex to treat since no two cases are alike. Clinical trials for effective drug treatments have had limited success. In this study, Dr. Pascual and her team aimed to understand the molecular diversity of the disease in an effort to make future drug development easier and more effective.

“The results included in this paper provide an explanation for why clinical trials fail in lupus, and open the door for true personalized approaches to drug discovery and treatment in this disease,” Dr. Pascual said.

Researchers studied the transcription of genes in 924 blood samples from 158 pediatric lupus patients from Texas Scottish Rite Hospital for Children clinics and other children’s hospitals for up to four years. This personalized immunomonitoring approach, which measures gene expression activity of different cell types, allowed researchers to classify patients into seven groups with similar molecular disease structure at the time of both disease flares and remissions.

Dr. Marilynn Punaro, medical director of rheumatology at Scottish Rite Hospital, and members of her team are co-authors of the study, which may improve clinical trial design and implementation of tailored therapies in lupus and other genetically and clinically complex autoimmune diseases.

“This is a landmark study that has the potential to dramatically improve treatment and quality of life for the hundreds of thousands of people suffering with lupus,” Dr. Pascual said.

Learn more about studies conducted at Baylor Scott & White Research Institute.

About Baylor Scott & White Health
Formed from the 2013 merger between Baylor Health Care System and Scott & White Healthcare, the system referred to as Baylor Scott & White Health is the largest not-for-profit health care system in the state of Texas. With total assets of $9 billion* and serving a population larger than the state of Georgia, Baylor Scott & White Health has the vision and resources to provide its patients continued quality care while creating a model system for a dramatically changing health care environment. The system now includes 48 hospitals, more than 900 access points, 6,000 active physicians, and 40,000 employees, plus the Scott & White Health Plan, Baylor Scott & White Research Institute and Baylor Scott & White Quality Alliance — a network of clinical providers and facilities focused on improving quality, managing the health of patient populations, and reducing the overall cost of care. For more information visit: BaylorScottandWhite.com

*Based on unaudited 2015 fiscal year statements.

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For more information, view an article on Baylor’s website.

Getting back to sports after an ACL Reconstruction

Getting back to sports after an ACL Reconstruction

by | Apr 1, 2016 | Spotlight

After an anterior cruciate ligament (ACL) tear, many young athletes choose to have surgery to replace the ACL. In very active kids, the knee is often unstable and at risk of injury without this important ligament. Returning to sports after this procedure takes time and a lot of work.
The “new” ACL, called a graft needs time to be ready for certain activities. The length of time depends on several things including:

Type of Graft – Age – Gender – Sport – Position – Level of Competition
Because very young patients need a different surgery, they need more healing time. Read more about ACL reconstruction for athletes with open growth plates.

Early exercises focus on preventing swelling and stiffness. The graft can tolerate more and more stress over time. Throughout recovery an athlete is allowed to progress from simple exercises for the leg to complex movements that challenge the whole body. We refer to the later stage of rehabilitation as functional training.

The goals of this stage are often shaped by the patient’s sport-specific needs. Research has shown there are also some principles that apply to many athletes. The athlete’s ability to perform certain movements has been shown to help identify patients at risk of an ACL injury or re-injury. We use several different tests to help determine when a patient is ready to return to sports after an ACL reconstruction.

Philip Wilson, M.D., tells us that “as a practice, we are passionate about functional retraining as a means to avoid a second injury.  Mounting research has shown that athletes in our pediatric and adolescent age groups are at an extremely high risk for injury to the surgical or opposite leg. Additional research has shown that increasing the time prior to return to sports, and demonstrating documented muscle strength and control are the best ways to avoid these new injuries.”

Because many sports require stability on a single leg in activities like running, pivoting, stopping, kicking, and throwing, the tests challenge athlete’s ability to stand on one leg. Additionally, these functional movements challenge the strength and flexibility throughout the body.  A comprehensive rehabilitation program incorporates these concepts from the beginning:

Flexibility – strength – stability – muscle activation – balance – control – body awareness

For this, and many other injuries, surgery is only the first step on the road back to sports. An athlete must also be committed to the rehabilitation and functional training required to return to sports. We encourage athletes to use these concepts in their training programs before they sustain game-changing injuries.

For information about injury prevention and pediatric sports medicine, please visit our website at Scottish Rite.

Tips to Keep Safe on the Slopes

Tips to Keep Safe on the Slopes

by | Feb 17, 2016 | Uncategorized

When hitting the slopes, it’s important to have the right equipment. Staying safe while skiing is a top priority for the 35th Annual Texas Scottish Rite Hospital for Children Amputee Ski Trip. In honor of this special event, we’ve put together some important safety tips for fun in the snow.

  • Wear Sunscreen– Even if the day is overcast and freezing cold, you can still get sunburned on the slopes. The bright white snow reflects the sun’s rays and can cause major burns. To avoid getting sunburned, wear plenty of sunscreen and don’t forget to re-apply throughout the day.
  • Stay Hydrated– Drinking lots and lots of water is the best protection against altitude sickness. Altitude sickness is caused when the body struggles to adjust to higher altitudes with thinner oxygen. Our ski trip participants are equipped to stay hydrated this year with personalized water bottles from our friends at Saint Bernard. Having water on hand as you transition to a higher altitude is the best way to avoid getting sick.
  • Wear a Helmet– Wearing a helmet on the slopes is the best way to protect your head in the event of a fall. Helmets can help prevent concussions and other major head trauma. Thanks to our friends at Giro, the teens on this year’s trip will have helmets to protect them as they learn how to ski.
  • Stay Warm– It’s important to stay warm while you ski. Hypothermia happens when the body loses heat faster than it can produce heat. This results in low body temperature, which can cause organs to function improperly. The teens on the ski trip will stay warm and safe thanks to our friends at Obermeyer while they ski.
  • Warm Up and Cool Down– When participating in strenuous physical activity, especially when learning a new sport, it’s critical to stretch and cool down properly. Stretching before starting the day can help keep the body loose and flexible for exercise. Cooling down at the end of the day with more stretching or a soak in the hot tub can prevent fatigue for the day ahead.

We hope these tips help inspire safety on the mountain. We wish the teens on this year’s trip a fun time in Colorado.

Thanks again to our friends at Saint Bernard, Giro and Obermeyer for keeping our skiers safe and warm on the Annual Amputee Ski Trip.

Learn About Our Center for Pediatric Bone Biology and Translational Research

Learn About Our Center for Pediatric Bone Biology and Translational Research

by | Jan 22, 2016 | Research & Innovation

A core mission of the Texas Scottish Rite Hospital for Children is to conduct research that improves the care of children. Since 1921, the hospital has developed a deep reservoir of medical history, renowned expertise in treating pediatric orthopedic disorders, and a robust research program that fosters a strong collaboration between clinic and laboratory. Through patient-centered research, our scientists strive to define the fundamental causes of pediatric orthopedic disorders.

Watch this video to learn more about our Center for Pediatric Bone Biology and Translational Research.

The Gold Standard: Celebrating 50 Years of Pioneering Dyslexia Care

The Gold Standard: Celebrating 50 Years of Pioneering Dyslexia Care

by | Nov 6, 2015 | Other Conditions

Fifty years ago, a man with an unwavering conviction to help children joined Texas Scottish Rite Hospital for Children’s staff. His name was Lucius “Luke” Waites, Jr., M.D., and his pioneering work changed the world of learning disorders forever.

In 1924, Lucius Waites, Jr. was born in Hattiesburg, Mississippi, during a formative time in the study of learning disorders, such as dyslexia. The condition is characterized by a difficulty connecting letter symbols to sounds. It makes reading challenging and affects roughly 10 percent of all public school children.

For a child with dyslexia, the world can be a daunting place. Feelings of failure or isolation can often accompany the condition. Little did anyone know that one day Waites would not only study dyslexia, but he would also help define it and ultimately change perceptions, treatment approaches, education, legislation and the lives of countless children in the process.

While playing football for Ole Miss, Waites gained a reputation for being a fierce competitor, playing in the era of no protective facemasks. That fearless spirit and drive to succeed would serve him well throughout his career. He graduated from the University of Tennessee College of Medicine in 1947 and began his work as a neurologist. He came to Dallas in 1961 to join the faculty at UT Southwestern Medical Center. From 1961-65, he also assisted the Texas Scottish Rite Hospital for Children medical staff in the area of neurology.

During that period, Waites began to investigate the phenomenon of smart children who struggled to read. This condition was initially described as “word blindness” and “twisted symbols” (aka: Strephosymbolia). Research into this condition was considered fringe medicine at the time and often mocked as “quackery,” but the determined football player from Mississippi refused to give up. Then Scottish Rite Hospital Chief of Staff Brandon Carrell, M.D., observed the positive effect Waites’ methods were having on his patients and stood by his efforts. In 1965, Waites moved to Scottish Rite Hospital full time and the Luke Waites Center for Dyslexia & Learning Disorders was born. With the support of Scottish Rite Hospital and the Masonic community, Waites set out to build a program dedicated to diagnosing and treating children with the condition. Along with language therapist Aylett Royall Cox, Waites developed the hospital’s first dyslexia curriculum called Alphabetic Phonics. This new approach, with its dramatic and positive results, made waves in Dallas, across Texas and beyond.

“The support of the hospital, the administration and the board of trustees continues to be strong and crucial to our work,” says Gladys Kolenovsky, the center’s administrative director and a 39-year staff member. “From the beginning, they believed in what this center could do for children.”

In 1968, Waites organized a meeting of the World Federation of Neurology at the hospital, at which the medical term “developmental dyslexia” was defined. For the first time, dyslexia was recognized as a medical condition that called for an educational treatment.

But Waites did not stop there. In 1985, he enlisted the help of two equally tenacious colleagues — Kolenovsky and Geraldine “Tincy” Miller, a former staff member who has gone on to serve more than 26 years on the Texas State Board of Education. Together, they facilitated two major changes in Texas education laws — separating dyslexia from special education programs and requiring dyslexia screening and testing in all public schools. As a result of their efforts, Texas became a leader in public policy for learning disorders.

“Because of this incredible group of individuals who were willing to take a chance, so many people are able to stand on the shoulders of their legacy and their bravery,” says Karen Avrit, the center’s educational director, who recently helped pass House Bill 866. This bill ensures that all undergraduate education majors in Texas learn how to recognize, identify and make basic accommodations for children in their classrooms who may be dyslexic.

In 1990, Jeffrey Black, M.D., joined the Scottish Rite Hospital medical staff and the crusade, alongside Waites. Where Waites drew from clinical knowledge and child-focused intuition, Black revels in the scientific process. He set a high bar for data collection, results-driven experimentation and extensive research.

Black used precise, quantifiable measurements to prove that dyslexia could be remediated. From there, he proceeded to improve and adjust the existing curriculum based on his findings. It was through his unflinching dedication to data analysis that a new curriculum, Take Flight: A Comprehensive Intervention for Students with Dyslexia, was developed.

The curriculum allows children to learn the course material faster, with a higher retention rate. The first edition was printed in 2006. Today, Take Flight is used across America, in Canada and as far away as Dubai. The morning Avrit got a call from the Middle East inquiring about the program, she recalls saying, “Wow, we’ve gone international!”

The future of Take Flight looks bright, as Black and the team embark on the next journey in dyslexia education. Together with The University of Texas at Dallas, they are taking the curriculum into the digital arena. Through interactive technology, they will share the program with the next generation of children as well as increase its reach and scope for teachers.

Black is also pushing dyslexia research into the world of genetics. In collaboration with Jerry Ring, Ph.D., the center’s research scientist, and Scottish Rite Hospital’s remarkable genetics research team, work is being conducted to better understand dyslexia on a genetic level.

In 2013, the strong-willed Waites passed away at the age of 89, leaving behind a legacy that has changed the lives of individuals with dyslexia forever.

“It is wonderful to recognize Luke Waite’s legacy, while also paying tribute to the core values of the dyslexia department and the hospital,” Kolenovsky says. “The child comes first – always.”

**This article appeared on the cover of our Rite Up 2015: Issue 3 magazine. Read more from the magazine online.