Simple test, big implications

Recent work done at Children's Hospital Boston and Brigham and Women's Hospital (BWH) offers a new way to assess heart attack risk. Nader Rifai, PhD, a Children's researcher, and Paul Ridker, MD, a BWH cardiologist, validated a simple blood test that measures levels of C-reactive protein (CRP), an indicator of inflammation in blood vessel walls. Ridker and Rifai found that people with significant cardiovascular risk and high CRP levels were nearly twice as likely to suffer a heart attack or stroke, need a heart operation or die from cardiovascular disease than those with low CRP levels. The American Heart Association now recommends that physicians measure CRP levels in patients with heightened risk. -CM

New cancer's genetic mechanism

Pathologists at Children's and the Dana-Farber Cancer Institute discovered a new type of childhood kidney cancer and the genetic mechanism that makes it tick. They were examining a kidney tumor under a microscope and recognized that its features were biologically distinct from typical renal carcinoma. The cancer had a unique chromosomal mix-upÑand identifying that abnormality led researchers to the culprit gene behind the tumor's growth. The discovery, say researchers Sara Vargas, MD, and Ian Davis, MD, PhD, will allow scientists to identify more types of cancer in the future and may result in new therapies.-CM

Easing the pain of sickle cell

Carlo Brugnara, MD, Debra Weiner, MD, PhD, and their colleagues found that inhaled nitric oxide gas appears to ease the debilitating "pain crises" endured by people with sickle cell disease, a genetic disorder that impairs oxygen delivery to tissues. A key factor in pain crises, which are caused by blood vessel blockage, is thought to be a shortage of nitric oxide, a gas produced by cells throughout the body that dilates blood vessels, prevents abnormal clotting and controls inflammation. Doctors found that patients on nitric oxide required less morphine to manage pain and tended to have shorter hospital stays. -CM

Sure signs of abuse

Children's researchers recently reported that young children brought to the emergency room with serious but poorly explained head injuries are likely the victims of child abuse. Joeli Hettler, MD, David Greenes, MD, and their colleagues reviewed hundreds of patient charts and found that in cases of neurological damage, abuse turned out to be the cause whenever parents or caregivers initially claimed there was no history of trauma, that there had only been low-impact trauma, that injuries were caused by their own vigorous attempts to resuscitate the child, or when they changed their story. These conclusions, says Andrea Vandeven, MD, director of Children's Child Protection Team, should help identify cases of abuse.