Jan 29, 2015
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Do Words Matter in Concussion Diagnoses?

Researchers at McMaster University heard a line from parents so frequently they made it the title of their study on concussion terminology. “My Child Doesn’t Have a Brain Injury, He Just Has a Concussion,” published in the Feb. 2010 issue of the journal Pediatrics, found that children whose parents were told their child had suffered a “concussion” spent less time in the hospital and resumed normal routines sooner than kids whose parents were told they had sustained a “brain injury.”

The study followed 434 children with traumatic brain injuries admitted to the McMaster Children’s Hospital in Hamilton, Ontario. Doctors gave 32 percent of them a diagnosis of concussion, and the rest variants of traumatic brain injury (TBI). Those in the concussion group were 1.5 times more likely to be discharged from the hospital in the days after their injury. On average, these children also went back to school sooner than those told they suffered a TBI.

“Our research suggests the label ‘concussion’ conveys something that may not be accurate,” says Carol DeMatteo, MSc, OT, the study’s lead author and an occupational therapist and childhood disability researcher at McMaster. “Why don’t we call it a brain injury? After all, that’s what it is. We’re finding that the term concussion is taken pretty lightly.”

The label seems to influence everyone involved in the child’s care. “Our interpretation was that it affects both parents and the physician,” says DeMatteo. “The kids given a concussion diagnosis were more likely to be discharged sooner, even when adjusting for the severity of the injury. That led us to believe the medical clinicians were also considering it to be less significant. And the families were the ones making the decision to send the kid back to school.

“I’m not sure what the added value of using the term concussion is,” she continues. “People have a belief about concussions, and if we can’t re-educate them about that, maybe we need to call it something different to make them take it seriously.”

Senate Considering New Supplement Law

In early February, Sen. John McCain of Arizona introduced the Dietary Supplement Safety Act of 2010. If passed, the legislation would require dietary supplement manufacturers to register with the Food and Drug Administration (FDA) and disclose all their products’ ingredients to the agency. It would also give the FDA the power to issue a mandatory recall if a product was deemed unsafe.

The bill is supported by the United States Anti-Doping Agency, and McCain says it will protect athletes of all ages from supplements containing harmful ingredients. “We’ve had amateur athletes die,” he told the Associated Press. “It’s not as if it isn’t dangerous.”

The legislation would amend the Dietary Supplement Health and Education Act (DSHEA), which was first enacted in 1994. The DSHEA prohibits the FDA from banning supplements or reclassifying them as drugs if they are food products that have been in the food supply and are not chemically altered or were sold as supplements prior to 1994. McCain’s proposal would repeal those provisions, giving the FDA more regulatory power.

The act would also require supplement manufacturers to report to the FDA all minor adverse events relating to their products. Currently, they must report only adverse events that are brought to their attention by healthcare providers or consumers.

To read the full text of the bill and check its status, go to: thomas.loc.gov and enter “supplement safety” in the search window.

Nanoscopic Material Helps Grow Cartilage

Scientists at Northwestern University have created a bioactive nanomaterial that enables new cartilage growth. Injected through a minimally invasive procedure that activates bone marrow stem cells, the material functions without the aid of expensive added growth factors and its creators say it is the only therapy of its kind.

Once the gel-like substance is injected into a damaged joint, it forms into a solid. The material binds with natural growth factors to promote cartilage growth–something the body can’t do naturally. Details on the therapy were published online in early February in the Proceedings of the National Academy of Sciences.

“Unlike bone, cartilage does not grow back, and therefore clinical strategies to regenerate this tissue are of great interest,” Samuel I. Stupp, PhD, a professor at Northwestern and Director of the Institute for BioNanotechnology in Medicine, said in a press release.

When cartilage is damaged, it causes joint pain and can lead to decreased function and osteoarthritis. The new material could help prevent these outcomes by creating type II collagen–the major protein in articular cartilage.

“Our material of nanoscopic fibers stimulates stem cells present in bone marrow to produce cartilage containing type II collagen and repair the damaged joint,” first author Ramille N. Shah, PhD, Assistant Professor of Orthopaedic Surgery at Northwestern and Assistant Professor of Materials Science and Engineering, explained in the press release. “A procedure called microfracture is the most common technique currently used by doctors, but it tends to produce a cartilage having predominantly type I collagen, which is more like scar tissue.”

The researchers tested the effects of microfracture surgery alone, microfracture with the material and exogenous growth factor, and microfracture with the material but without the growth factor. They found the material performed better than microfracture and just as well without the growth factor as with it. The material takes about a month to produce cartilage.

To view the study, “Supramolecular Design of Self-Assembling Nanofibers for Cartilage Regeneration,” go to: pnas.org and enter “supramolecular design” in the search window.

Top Speed in the Human Race

A new study shows it may be possible for humans to run much faster than Jamaican sprinter Usain Bolt did when he reached nearly 28 mph at the 2008 Olympics and broke several world records. In fact, researchers suggest that biological limits determining running speed could allow an athlete to someday reach 40 mph.

The new findings, published in the Jan. 2010 issue of the Journal of Applied Physiology, focus on the two main limiting factors for running speed: the force a runner applies to the ground with their legs and the amount of time available to apply that force. The main finding was that humans might be capable of generating more force than originally thought.

“If one considers that elite sprinters can apply peak forces of 800 to 1,000 pounds with a single limb during each sprinting step, it’s easy to believe that runners are probably operating at or near the force limits of their muscles and limbs,” Peter Weyand, PhD, one of the study’s authors and an Associate Professor of Applied Physiology and Biomechanics at Southern Methodist University, said in a press release. “However, our new data clearly show that this is not the case. Despite how large the running forces can be, we found that the limbs are capable of applying much greater ground forces than those present during top-speed forward running.”

Participants in the study ran forward and backward on treadmills, and hopped on one leg at top speed. The treadmills measured the force of each stride and researchers found that hopping on one leg at top speed produced 30 percent more force than top-speed forward running. Active muscles in the runners’ legs also generated 1.5 to two times more force in single-leg hopping than forward running. If future generations of athletes could create these ground forces while running, the study suggests they have the hardware to reach speeds as high as 40 mph.

Elite sprinters’ feet touch the ground for less than one-tenth of a second, and the maximum ground contact forces occur within less than one-twentieth of a second when the foot first touches the ground. The research found that minimal ground contact times were almost the same for both forward and backward running.

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