Standardisation of data collection in traumatic brain injury: key to the future?

Great variability exists in data collection and coding of variables in studies on traumatic brain injury (TBI). This confounds comparison of results and analysis of data across studies. The difficulties in performing a meta-analysis of individual patient data were recently illustrated in the IMPACT project (International Mission on Prognosis and Clinical Trial Design in TBI): merging data from 11 studies involved over 10 person years of work. However, these studies did confirm the great potential for advancing the field by this approach. Although randomized controlled trials remain the prime approach for investigating treatment effects, these can never address the many uncertainties concerning multiple treatment modalities in TBI. Pooling data from different studies may provide the best possible source of evidence we can get in a cost efficient way. Standardisation of data collection and coding is essential to this purpose. Recommendations hereto have been proposed by an interagency initiative in the US. These proposals deserve to be taken forward at an international level. This initiative may well constitute one of the most important steps forwards, paving the road for harvesting successful results in the near future.     

Modified anthropometry in prepubertal Israeli children while excluding the head’s weight and height

Aim: A methodological inadequacy in anthropometric measurements of children exists because of an age‐dependent decelerating contribution of the head to body weight (Wt) and height (Ht). Hence, we aimed to assess the contribution of head measurements to anthropometry (Ht, Wt and BMI) in healthy prepubertal children. Methods: This prospective study was conducted in 300 2‐ to 9‐year‐old typically growing children. Head‐excluded (HE) Ht was determined by a stadiometer that measured the distance from the foot plate to the lower margin of protuberance occipitalis externa. Head’s weight was calculated from the head volume using three different measurements of the head circumference. Results: In the typically growing children, the HE/standard (STD) ratios for Wt and Ht increased significantly with age (p < 0.001 for both), but the HE/STD ratio for BMI did not increase with age. Conclusion: Measurement of body Wt and Ht while excluding the head’s Wt and Ht provides a new dimension to standard anthropometry by eliminating the age‐dependent head bias with its unique pattern of growth and minimal adipose tissue.     

Biological evaluation of intervertebral disc cells in different formulations of gellan gum‐based hydrogels

Gellan gum (GG)‐based hydrogels are advantageous in tissue engineering not only due to their ability to retain large quantities of water and provide a similar environment to that of natural extracellular matrix (ECM), but also because they can gelify in situ in seconds. Their mechanical properties can be fine‐tuned to mimic natural tissues such as the nucleus pulposus (NP). This study produced different formulations of GG hydrogels by mixing varying amounts of methacrylated (GG‐MA) and high‐acyl gellan gums (HA‐GG) for applications as acellular and cellular NP substitutes. The hydrogels were physicochemically characterized by dynamic mechanical analysis. Degradation and swelling abilities were assessed by soaking in a phosphate buffered saline solution for up to 170 h. Results showed that as HA‐GG content increased, the modulus of the hydrogels decreased. Moreover, increases in HA‐GG content induced greater weight loss in the GG‐MA/HA‐GG formulation compared to GG‐MA hydrogel. Potential cytotoxicity of the hydrogel was assessed by culturing rabbit NP cells up to 7 days. An MTS assay was performed by seeding rabbit NP cells onto the surface of 3D hydrogel disc formulations. Viability of rabbit NP cells encapsulated within the different hydrogel formulations was also evaluated by Calcein‐AM and ATP assays. Results showed that tunable GG‐MA/HA‐GG hydrogels were non‐cytotoxic and supported viability of rabbit NP cells. Copyright © 2012 John Wiley & Sons, Ltd.     

Pheochromocytoma and paraganglioma: comparison of MR imaging with CT and I-131 MIBG scintigraphy

To ascertain the magnetic resonance (MR) imaging characteristics of pheochromocytomas and paragangliomas and to compare MR with computed tomography (CT) and iodine-131 metaiodobenzylguanidine (I-131 MIBG), 19 patients (18 with pheochromocytomas, one with a paraganglioma) were studied. The 18 patients with pheochromocytomas had had positive findings with I-131 MIBG scintigraphy. Abdominal pheochromocytomas were generally hypointense compared with normal liver on T1-weighted MR images and extremely hyperintense on T2-weighted MR images. MR imaging was preferable to CT in the evaluation of primary pheochromocytomas due to superior tissue characterization, particularly in the patient with hypertension and borderline catecholamine levels. For patients with recurrent or metastatic disease, the data suggest that I-131 MIBG scintigraphy is the examination of choice.