Vaccine Safety, Emotions and Driving, Concussion Discussions, Surgical Excellence Award

It has been a whirlwind week for most Americans, so if you need to break away from political news to catch up with your science news, you’ve come to the right place. This installment of In the News starts with an important study for patients with rare primary immunodeficiency diseases at risk of side effects from the rubella vaccine. Next, a new Research in Action blog post reminds all drivers — and especially young, inexperienced ones — to not flip out when they encounter stressful driving situations. And then a pediatric concussion expert takes us on a tour of her recent educational opportunities that furthered her understanding of concussion diagnosis and treatment. We end with the exciting news that CHOP’s surgeon-in-chief won a Surgical Excellence award for advancing the care of children with congenital hyperinsulinism. Read on for more details.

Some Immune-Deficient Patients at Risk of Adverse Effects From Rubella Vaccine

Although the vaccine for rubella (German measles) has an established record of safety and effectiveness in the general population, patients with severe deficiencies in their immune defenses may be susceptible to side effects from the vaccine, according to a study led by Kathleen E. Sullivan, MD, PhD, chief of the division of Allergy and Immunology at CHOP, that appeared in the Journal of Allergy and Clinical Immunology. It is highlighted as an “Editor’s Choice” article.

“Up to now, the risk of adverse effects from rubella vaccine has been a theoretical concern for many immune-deficient patients,” Dr. Sullivan said. “The vaccine’s package insert states that it shouldn’t be given to immune-deficient individuals. Our new study found genuine evidence of harm in a subset of patients with these rare disorders.”

Dr. Sullivan and colleagues analyzed data from 14 patients with primary immunodeficiency diseases (PIDD) who had skin lesions called cutaneous granulomas. PIDDs include a diverse group of rare, chronic disorders with genetic origins, characterized by malfunctions in the body’s immune system. Of the 14 patients, seven had evidence of rubella virus antigen in their granulomas. The team’s findings suggest that because PIDDs compromise a patient’s immune system, patients are unable to clear out the weakened rubella virus contained in the vaccine.

“This research reinforces the warning already found in rubella vaccine package inserts,” Dr. Sullivan said. “It gives additional guidance to physicians and families as to who should be restricted from the MMR (measles-mumps-rubella) vaccine.”

Encourage Young Drivers to Chill Out Behind the Wheel

You’re stuck in traffic trying to get home after a busy day, when suddenly another driver cuts in front of you. It’s difficult to stay cool and levelheaded in such stressful driving situations, and it is especially important for young drivers who have the highest crash risk to learn to manage their emotions while driving, according to a new Research in Action blog post  by Flaura K. Winston, MD, PhD, scientific director and founder of the Center for Injury Research and Prevention at CHOP.

Dr. Winston recently co-authored a study published in Transportation Research Part F: Psychology and Behavior and funded by the Center for Child Injury Prevention Studies to validate a simulator protocol for studying the impact of emotions on teen driving. The study explored whether newly licensed teen drivers who were more affected emotionally by stressful traffic events reacted by exhibiting more unsafe behaviors.

“What we found is that all the drivers experienced changes in their emotions; those with the strongest negative reactions had the most unsafe driving behaviors,” Dr. Winston wrote. “In particular, they did not cope well with the presence of slow-moving or braking cars in front, causing them to brake or react in a short time.”

One way to help young drivers to keep their negative emotions in check, Dr. Winston pointed out, is to help them understand that it is unlikely that other drivers intentionally put them at risk and give them the benefit of the doubt. Read more in the Research in Action blog.

CHOP Pediatric Concussion Expert Travels Near and Far to Gain New Insights

Fall is a busy time for sports medicine pediatricians, as school and recreational sports programs are in full swing. For Christina L. Master, MD, FAAP, CAQSM, a sports medicine pediatrician in the divisions of Orthopedics and General Pediatrics at CHOP, the season also is packed with professional educational activities. She traveled from Bethesda, MD, to San Francisco to Berlin all in October, as reported in a Clinical Journal of Sports Medicine blog.

Dr. Master shared highlights from the proceedings of the National Institutes of Health (NIH) Pediatric Concussion Workshop (Bethesda), the American Academy of Pediatrics (AAP) Council on Sports Medicine & Fitness meeting (San Francisco), and the Fifth International Consensus Conference on Concussion in Sport (Berlin). At the NIH workshop, Dr. Master presented on the topic of “point of injury identification” in a session about acute management of concussion. Part of an AAP session focused on a CHOP research group’s work on the potential utility of functional near infrared spectroscopy in concussion assessment. And Dr. Master also participated in discussions at the Berlin meeting to refine the Consensus Guidelines on Concussion in Sport, which are used around the world by clinicians, researchers, and educators.

Read more about Dr. Master’s concussion research on Cornerstone.

N. Scott Adzick, MD, Receives CHI Be My Sugar Award for Surgical Excellence

N. Scott Adzick, MD, MMM, FACS, FAAP, one of the leading pediatric surgeons in the world, has performed more than 400 surgeries with his team at CHOP’s Center for Fetal Diagnosis and Treatment on babies with the rare genetic disorder, congenital hyperinsulinism (HI). HI occurs when the insulin cells in the pancreas, called beta cells, secrete too much insulin. Excess insulin causes low blood sugar which, if left untreated, can lead to seizures, brain damage, and possibly death.

Congenital Hyperinsulinism International (CHI) advocates, educates, and provides resources to children affected with HI. This year, Dr. Adzick, CHOP’s surgeon-in-chief, received the CHI Be My Sugar Award for Surgical Excellence at the third annual Sugar Soiree in the Seaport neighborhood of Boston.

In 1999, Dr. Adzick helped world renowned HI pioneer, Charles A. Stanley, MD, a pediatric endocrinologist, create the Congenital Hyperinsulinism Center at CHOP. The Center, which cares for an estimated 80 percent of children in the U.S. who require surgery for HI, offers evaluation, diagnosis, treatment and follow-up care for children with HI and advances HI research.

“It is an honor to have received such a distinction,” Dr. Adzick said. “CHI does a wonderful job of bringing the HI community together so that families feel supported. It is also essential to raise awareness so that children affected by HI have access to an expert multidisciplinary team, like we have at CHOP, and the treatment options to reduce brain damage and death.”

Read more in the CHOP press release.

ICYMI

In case you missed it, this week on Cornerstone we discussed the changes and challenges that converge as adolescents with chronic conditions age out of the pediatric health system. A quality improvement study team at CHOP and the University of Pennsylvania Health System is implementing a bundle of programs and interventions to safely transition this vulnerable population, focusing on those with epilepsy, to adult care.

Last week’s In the News post featured Diane Spatz, PhD, RN-BC, director of the Breastfeeding and Lactation Program at CHOP, who was honored with the Lifetime Achievement in Neonatal Nursing Award from the National Association of Neonatal Nurses. And a major news report about lead paint poisoning in Philadelphia included a CHOP expert’s discussion of how policy should address the vital need to protect young children.

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