Research Analyzes Level of Protection Provided by Children’s Bicycle Helmets
Bicycle accidents are a common cause of traumatic injury in the United States. The most recent statistics indicate that there were an estimated 500,000 bicycle-related injuries treated in U.S. hospital emergency rooms in 2004. Of those, 69,500 were head injuries, and of the 600 bicycle-related deaths, about two thirds were attributed to traumatic brain injury (TBI).
Between 1984 and 1988, 557,936 visits to emergency rooms were related to bicycle accidents. About 6 percent (33,500) of these were serious enough to require hospital admission. In those same years, an average of 962 deaths annually resulted from these injuries. TBI caused 62 percent of all deaths resulting from bicycle accidents. Forty percent of deaths occurred in children age 15 and younger. Clearly, children are at the greatest risk of sustaining these injuries. Boys age 10 to 14 are at the highest risk. It is estimated that bicycle-related injury and death cost society $8 billion annually. Bicycle helmets are widely touted as a protective step against head injury. However, the degree of protection that they provide has not been widely investigated.
Researchers recently assessed the level of protection provided by children’s bike helmets. The results of this study, Quantification of the Protection Granted by Children’s Bicycle Helmets Using Engineering Tools and Experimental Design, will be presented by Chris A. Sloffer, MD, MBA, 4:30 to 4:40 p.m. on Tuesday, April 25, 2006, during the 74th Annual Meeting of the American Association of Neurological Surgeons in San Francisco. The co-author of this study is Julian J. Lin, MD.
Epidermal Growth Factor Receptor Status Offers Potential for Meningioma Treatment
Meningioma is typically a benign tumor of the meninges, the tissue that covers and surrounds the brain and spinal cord. It is one of the most common intracranial tumors and accounts for up to 26 percent of all adult brain tumors. Based on examination of tumor tissue microscopically, pathologists distinguish three different grades of meningioma that help predict the clinical behavior of the tumor, facilitate treatment planning, and enable an estimate of overall patient prognosis. These include grade I (benign), grade II (atypical), and grade III (malignant), comprising approximately 80 percent, 15 percent, and 5 percent of meningiomas, respectively.
In the vast majority of meningiomas studied, receptors for specific growth factors have been identified on the surface of the tumor cells. These growth factors are normally produced by the body and facilitate growth and maintenance of normal cells. However, tumor cells can overexpress the same receptors, which contribute to their abnormal growth by enabling these cells to utilize the corresponding growth factors. Because multiple growth factor receptors have been identified on subsets of meningiomas, neurosurgeons recently studied whether the presence or absence of these receptors on atypical meningioma tumor specimens may help predict whether the corresponding tumors will follow an indolent or aggressive clinical course.
The results of this study, Absence of Epidermal Growth Factor Receptor Immunoreactivity Defines a Subset of Atypical Meningiomas with a Distinctly Poor Prognosis, will be presented by Justin S. Smith, MD, PhD, 5:03 to 5:15 p.m. on Wednesday, April 26, 2006, during the 74th Annual Meeting of the American Association of Neurological Surgeons in San Francisco. Co-authors are Anita Lal, PhD, Mianda Harmon-Smith, BS, and Michael W. McDermott, MD.
Research Compares Two Diagnostic Methods for Subarachnoid Hemorrhage
Cerebrovascular disease is a leading cause of serious long-term disability, affecting as many as 700,000 people every year. The interruption of blood flow to the brain can be caused by a blockage, leading to the far more common ischemic stroke, or by bleeding in the brain, leading to the more deadly subarachnoid hemorrhage (SAH). The latter condition affects approximately 30,000 Americans every year. Of those, about one half will not survive beyond 30 days, and an additional 25 percent will have some form of neurological deficit.
About 90 percent of all cases of SAH are caused by cerebral aneurysms. A cerebral aneurysm is a weakened part of an artery in the brain that results in a bulging or ballooning out of part of the vessel wall. Identifying the exact location, size and configuration of the aneurysm is critical to prevent rehemorrhage, which occurs in about 20 percent of cases within the first 14 days after the initial rupture. The current “gold standard” for identification is the diagnostic cerebral angiogram, which involves temporarily inserting a tube (catheter) into the artery of the leg (the femoral artery) and navigating it to the vessels of the brain (the two carotid arteries and the two vertebral arteries). Though very sensitive and very specific in identifying these potentially lethal aneurysms, the procedure is invasive and carries a small risk of causing ischemic stroke.
Neurosurgeons recently studied a relatively new method of testing, called computed tomographic angiography (CTA). This is performed by injecting a volume of contrast agent, similar to that used in the conventional angiogram, through a vein in the patient’s arm. The results of this study, Three-Dimensional Computed Tomographic Angiography (3D CTA) vs. Digital Subtraction Angiography (DSA) in the Detection of Intracranial Aneurysms in Spontaneous Subarachnoid Hemorrhage, will be presented by Charles J. Prestigiacomo, MD, senior author of the study, 2:45 to 3:00 p.m. on Monday, April 24, 2006, during the 74th Annual Meeting of the American Association of Neurological Surgeons in San Francisco. Co-authors are Aria Sabit, MD, Pinakin Jethwa, BS, and Jonathan Russin, BS.
Researchers Discover Gene for FOP, Profound Skeletal Disorder
Researchers at the University of Pennsylvania School of Medicine have located the “skeleton key,” a gene that, when damaged, causes the body’s skeletal muscles and soft connective tissue to undergo a metamorphosis into bone, progressively locking joints in place and rendering movement impossible. Identifying the gene that causes fibrodysplasia ossificans progressiva (FOP), one of the rarest and most disabling genetic conditions known to humans and a condition that imprisons its childhood victims in a “second skeleton,” has been the focus at Penn’s Center for Research in FOP and Related Disorders for the past 15 years. This important discovery is relevant, not only for patients with FOP, but also for those with more common skeletal conditions.
Senior authors Eileen M. Shore, PhD, and Frederick S. Kaplan, MD, both from the Penn Department of Orthopaedic Surgery, and their international consortium of colleagues, report their findings in the April 23 advanced online edition of Nature Genetics. “The discovery of the FOP gene is relevant to every condition that affects the formation of bone and every condition that affects the formation of the skeleton,” says Kaplan.
The discovery of the FOP gene was the result of painstaking work by the Penn scientists and their colleagues in the International FOP Research Consortium over many years. It involved the identification and clinical examination of multigenerational families, often in remote regions of the world; genome-wide linkage analysis; identification of candidate genes; and finally, the DNA sequencing and analysis of those candidate genes. The team found that FOP is caused by a mutation of a gene for a receptor called ACVR1 in the bone morphogenetic protein-signaling pathway.
Team to Examine Impact of Genetics and Exposure to Secondhand Smoke
Whether exposure to secondhand smoke increases the chance that children with a family history of cardiovascular disease will develop the disease themselves is under study at the Medical College of Georgia.
If those children also have a variation in at least one of four genes responsible for metabolizing nicotine, their risk may increase even more because nicotine might stay in the body longer and do more damage, an interdisciplinary research team says.
Researchers will study 585 children age 15-20 who have a parent, grandparent or both with essential hypertension and/or a heart attack by age 55.
Concerns for inexpensive fertility drug appears to be unfounded
Concerns about the use of letrozole, an easy-to-use and inexpensive drug for the treatment of infertility, appear to be unfounded, according to a major study.
The study was co-authored by Dr. Togas Tulandi, Director of Division of Reproductive Endocrinology and Infertility, McGill University Health Centre (MUHC) and Chief of Obstetrics and Gynecology at the Jewish General Hospital, and Professor of Obstetrics and Gynecology at McGill University. Their findings, which are currently available in an early online edition of Fertility and Sterility, showed that babies whose mothers were treated with letrozole had the same rate of birth defects as those whose mothers were treated with clomiphene citrate - the low-risk, first-line treatment for infertility for more than 40 years.
“We found no statistically significant difference in the overall rates of major and minor malformations or chromosomal abnormalities between newborns in the two groups,” says Dr. Tulandi. “Our findings indicate concerns about a link between letrozole and birth defects are unfounded. This is significant because it confirms that letrozole can indeed be used in the treatment of infertility without increasing risk to the fetus.”
