May 17, 2020

Best US Children’s Hospital rankings have been revealed

Paediatrics
USA
USA
Paediatrics
Catherine Sturman
4 min
Running for over 10 years, US News’ Best Children's Hospitals rankingsfor 2018-2019 have been announced. The rankings are the only comprehensive sourc...

Running for over 10 years, US News’ Best Children's Hospitals rankings for 2018-2019 have been announced. The rankings are the only comprehensive source of quality-related information on US paediatric centres across the US, with 86 hospitals ranked among the top 50 in at least one specialty.

We take a look at the top five.

5. Children's National Medical Center, Washington, D.C.

In fifth place, The Children's National Medical Center in Washington, D.C has been nationally ranked in 10 paediatric specialties.

A children's general facility and teaching hospital, it is known for its operational excellence in clinical care, driving positive patient outcomes. Its clinically integrated paediatric health network has also sought to enable community providers to deliver higher quality care by strengthening connections between primary and specialty care experts.

4. Texas Children's Hospital, Houston

One of the first hospitals in the US to treat paediatric respiratory failure with home mechanical ventilation, Texas Children’s Hospital has become home to a number of medical breakthroughs and has undergone a significant expansion.

World renowned for its focus on paediatric and women’s health, with the launch of the Texas Children’s Pavilion for Women, as well as a obstetrics and gynaecology facility, the hospital also houses one of the largest paediatric lung transplant programmes worldwide. It is one of only two institutions globally to perform an average of 10 paediatric lung transplants each year.

Its Jan and Dan Duncan Neurological Research Institute remains dedicated to researching and developing treatment for childhood neurological diseases and became the first to harness real-time MRI-guided thermal imaging and laser technology to destroy lesions in the brain that cause epilepsy and uncontrollable seizures in young children.

“Each year, our Texas Children’s team exhibits incredible strength and kindness, as well as passion, caring for the inspirational children and families we serve. I believe this is one reason why we continue to maintain the respect and reputation as one of the best hospitals in the nation, and the destination for paediatric care in Texas,” said Mark A. Wallace, President and CEO of Texas Children’s.

3. Children's Hospital of Philadelphia

One of the oldest hospitals in the US, Children’s Hospital of Philadelphia (CHOP) has expanded to cater to the increased demands, and is set to undergo further growth with the development of its King of Prussia Campus.

Establishing the CHOP Research Institute, as well as its paediatric rehabilitation centre, Children’s Seashore House, the organisation has also launched the largest paediatric healthcare network in the US, the CHOP Care Network.

See also

Specialising in cardiac, genetics, cancer, foetal surgery, neonatology and automobile safety, the non-profit organisation was responsible for providing the first formal medical training for paediatric professionals and paediatric emergency medicine in the US, and was home to the first neonatal surgical and paediatric intensive care units in the US.

Additionally, it was the first hospital to discover the cause of infectious mononucleosis, and provide the first vaccines for mumps, whooping cough, influenza and rotavirus

2. Cincinnati Children's Hospital Medical Center

Ranked in all 10 subspecialties, from cancer, neurology and neurosurgery, to cardiology and heart surgery, Cincinnati Children’s Hospital Medical Center has now taken the second spot for the first time.

Established in 1883, the paediatric hospital delivers comprehensive clinical services, as well as exceptional education and training through an affiliation with the University of Cincinnati College of Medicine.

Since its establishment over a century ago, the organisation has been responsible for a number of medical breakthroughs. From developing a method to preserve and transport blood to serve those wounded on the battlefield in WWII, to the development of the oral polio vaccine.

Additionally, individuals at the hospital created the first functional heart-lung machine, leading to the establishment of open heart surgery, and much more.

1. Boston Children's Hospital

Retaining its position as the top paediatric hospital in the US, Boston Children’s Hospital is one of the largest paediatric hospitals, with approximately 25,000 inpatient admissions each year

“Boston Children's Hospital has been named the #1 children's hospital in the nation by U.S. News and World Report for the fifth year in a row!” said Sandra L. Fenwick, President and CEO at Boston Children’ Hospital.

“On behalf of every member of our Boston Children's team, thank you for inspiring us to be bolder, dream bigger, and make the impossible possible for our patients and families.”

Housing over 200 specialised clinical programmes, the organisation provides family-centered care, performing over 26,500 surgical procedures and 214,000 radiological examinations, last year.

Housing Brain, Orthopaedic, Paediatric, Paediatric Transplant and Heart Centres (of which was ranked #1 in the rankings), the organisation delivers the highest quality health care, delivering clinical excellence and promoting innovation through its research enterprise.

Additionally, it is home to one of the largest paediatric endocrinology programmes and paediatric pulmonary services in the country.  The study ranked its paediatric Urology Department as #1 in the US.

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Jun 14, 2021

Long haul Covid, the brain and digital therapies

#longcovid
#digitaltherapy
#neuroplasticity
#covid19
4 min
Neuroplasticity expert Ashok Gupta tells us about the symptoms of long Covid, how it affects the brain, and digital therapies

It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain. 

Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain. 

What is long Covid exactly? 

Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.

How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!

When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover. 

If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus. 

The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.

What symptoms does this cause? 

These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.

In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.

This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.

How does long-haul Covid affect mental health? 
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.

How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.” 

We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain. 

We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and  running half marathons again.

At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response. 

The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival. 

What digital therapies or apps are proving effective at treating long-haul Covid? 
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy. 

What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and  become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.

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