Medical Center wins $2.8 million grant for Shaken Baby Syndrome prevention, education

Monday, October 15, 2007

Hershey, Pa. -- A program to educate parents and other caregivers of children of the dangers of abusive head trauma got a major boost in central Pennsylvania recently thanks to a $2.8 million grant from the Centers for Disease Control (CDC) and the continued efforts of a Penn State Milton S. Hershey Medical Center team of medical professionals.

Mark Dias, a pediatric neurosurgeon, leads the Penn State team, implementing an education and awareness campaign in Pennsylvania to prevent Shaken Baby Syndrome, a cause of severe brain damage or death for hundreds of children each year. Dias started the program in 1998 in upstate New York. His program has reduced cases of Shaken Baby Syndrome in that state by more than 50 percent since it began almost nine years ago. Early indicators show his program's success in Pennsylvania could make it a national model for other states.

On Monday, Dias and his team, representatives from the state Department of Health, and the parents of a child who was a victim of Shaken Baby Syndrome came together at Penn State Hershey Medical Center for the announcement of the recent grant award from the CDC. The Medical Center's program is one of just two in the nation to receive CDC support for education and preparedness of this disorder.

"We are so pleased that the CDC, by awarding this money to our program, has recognized that abusive head trauma in young children is a problem that can be addressed by programs such as ours," Dias said. "This grant award lets us expand our program, measure its successes and costs, and continue helping to reduce the number of baby shaking cases we see all too often."

Dias started the Pennsylvania program as a pilot study in 2002, following on the success in New York. That year, the state passed The Shaken Baby Syndrome Education Act. With initial funding from the Pennsylvania Commission on Crime and Delinquency and subsequently from the state Department of Health, nurse educators provided training and prevention materials to staff of the state's 118 birthing and children's hospitals.

Since May 2006, all new parents giving birth at these institutions received information about preventing Shaken Baby Syndrome. More than 90 percent of those parents participated in Dias' program by signing a statement of commitment acknowledging receipt of the educational materials.

The CDC grant will allow Dias' program to enter a new phase. Nurse educators will begin training staff at physicians' offices that provide pediatric care in 16 counties in central Pennsylvania -- 15 other counties in the region were randomly selected to not receive this training or materials -- and provide materials to be presented to parents at two-, four- and six-month immunization visits. The team will then compare participation rates among the counties as well as compare data on abusive head trauma cases reported in those counties.

The study should indicate whether the education and prevention materials help reduce incidence rates, as it has in New York, and also allow them to estimate costs for implementing the program in a community.

Shaken Baby Syndrome occurs when an adult shakes an infant or young child, typically in response to frustration over the child crying. Since babies' heads are large in comparison to their underdeveloped neck muscles, the shaking causes their heads to whip back and forth, allowing the brain to repeatedly strike the inside of the skull. Blood vessels are damaged, and bleeding and swelling follow, which cause the long-term neurological damage or death of the child.

Nationwide, between 1,000 and 3,000 children become victims of Shaken Baby Syndrome each year; about 25 percent die from their injuries.

Public release date: 11-Oct-2007

1st successful treatment for chronic TBI

New Orleans, LA ¨C A research team led by Dr. Paul Harch, Assistant Professor of Clinical Medicine at Louisiana State University Health Sciences Center New Orleans and Director of the LSU Hyperbaric Medicine Fellowship Program, has published findings that show hyperbaric oxygen therapy (HBOT) improved spatial learning and memory in a model of chronic traumatic brain injury. HBOT is the use of greater than atmospheric pressure oxygen as a pharmacologic treatment of basic disease processes/states and their diseases. The paper is reported in the October 12, 2007 issue of Brain Research. (Paper available upon request.)

The research team adapted a well-known acute animal model of focal traumatic brain injury to chronic brain injury to evaluate the ability of low-pressure hyperbaric oxygen therapy (HBOT) to improve behavioral and neurobiological outcomes. The 64 rat subjects were divided into three groups¨C an untreated control group (22), an HBOT group treated with a human protocol (19), and a group treated with sham hyperbaric pressurization(23).

The subjects were tested pre and then 31-33 days post HBOT using the Morris Water Task ( MWT), a behavioral test which measures learning and memory. The HBOT group received low pressure twice daily therapy, and the sham-treated normobaric air group the identical schedule of air treatments using a sham hyperbaric pressurization. All groups were subsequently retested in the MWT. Post experiment, blood pressure density was measured in the brain and was correlated with MWT performance. HBOT caused an increase in vascular density in the injured hippoca mpus (p < 0.001) and an associated improvement in spatial learning (p < 0.001) compared to the control groups. The increased vascular density and improved MWT in the HBOT group were highly correlated (p < 0.001). In conclusion, a 40-day series of 80 low pressure HBOTs caused an increase in vascular density and an associated improvement in cognitive function. These findings reaffirm the clinical experience of HBOT-treated patients with chronic traumatic brain injury and write the authors, represent the first demonstration of noninvasive improvement of chronic brain injury in an animal model.

Traumatic brain injury (TBI) is a disorder of major public health significance. According to the National Institutes of Health, each year in the United States alone there are 100 new cases/100,000 population and 52,000 deaths. Most patients survive and add to an increasing prevalence of chronic TBI, estimated at 2.5¨C6.5 million individuals in 1998. Direct and indirect costs have been estimated at $56 billion/year in 1995. Unfortunately, there is no cure for chronic TBI and only a few previous studies suggest effectiveness under limited conditions.

These new findings could hold enormous significance not only for the million+ who sustain TBI from falls, motor vehicle accidents and assaults in this country each year, but also for returning US military veterans. # # #