UPMC Physician Resources
Archives for Neurosurgery
Children’s Hospital of Pittsburgh of UPMC & Pitt Public Health Researchers Receive NIH Grant to Study Pediatric Traumatic Brain Injuries
Brain Abnormalities Found in Concussion Patients Similar to those in Alzheimer’s Patients, Pitt Study Finds
Pitt Researchers Find No Increase in Brain Cancer Related to Working at Connecticut Jet Engine Manufacturing Plant
Child Neurodevelopmental and Mental Health Disabilities on the Rise, Children’s Hospital of Pittsburgh of UPMC Study Finds
PITTSBURGH, May 5, 2013 – More children have disabilities now than a decade ago, and the greatest increase is among children of higher-income families, according to a Children’s Hospital of Pittsburgh of UPMC study presented today at the Pediatric Academic Societies(PAS) annual meeting in Washington, DC.
Results of the study, led by Amy Houtrow, M.D., Ph.D., M.P.H., chief, Division of Pediatric Rehabilitation Medicine at Children’s Hospital, also showed that while disabilities due to neurodevelopmental and mental health problems have increased sharply, disabilities related to physical health conditions have decreased. This trend was most noteworthy among children under 6 years of age whose rate of neurodevelopmental disabilities nearly doubled during the study, from 19 cases to 36 cases per 1,000 children.
“A century of health care improvements and social changes have altered the face of childhood chronic disease and disability,” said Dr. Houtrow, who also is an associate professor of physical medicine and rehabilitation and of pediatrics at the University of Pittsburgh School of Medicine. “Nearly six million kids were considered disabled in 2009 and 2010—almost one million more than in 2001 and 2002.”
Dr. Houtrow said that while previous studies have found an increase in the prevalence of childhood disability, she and the research team wanted to look more closely at the specific conditions and socio-demographic factors associated with disabilities.
The researchers studied data from the National Health Interview Survey conducted by the U.S. Centers for Disease Control and Prevention from 2001 to 2002 and from 2009 to 2010. Participants included more than 102,000 parents of children up to age 17.
The research team assembled a composite of disability indicators to identify disabled children and their associated underlying chronic conditions. Conditions were categorized into three groups: physical, neurodevelopmental/mental health, and other.
The overall rate of disability for children under age 18 increased 16.3 percent between the 2001 to 2002 study period and the 2009 to 2010 study period.
Children living in poverty represented the largest numbers of overall children with disability in both time periods but not the highest growth rates. The largest increase in growth rates of disabilities was seen among children living in households with incomes at or above 300 percent of the federal poverty level—about $66,000 a year for a family of four in 2010.
“We are worried that children living in lower income families may be having problems accessing diagnostic and treatment services,” Dr. Houtrow said.
Since the study could not pinpoint why the disability rate is increasing, more research is needed, the author concluded.
Co-investigators were: Kandyce Larson, Ph.D., American Academy of Pediatrics; Paul Newacheck, Dr.P.H., Professor of Pediatrics and Health Policy, University of California San Francisco; Neal Halfon M.D., M.P.H., Professor of Pediatrics, Health Policy and Management, UCLA.
For more information on Dr. Houtrow and the Division of Pediatric Rehabilitation Medicine, visit http://www.chp.edu/rehab.
UPMC Celebrates 25th Anniversary of First Gamma Knife Procedure to Treat Brain Lesions Non-Invasively
PITTSBURGH – UPMC rose to 10th place in U.S. News & World Report’s annual Honor Roll of America’s Best Hospitals – making it the highest-ranked medical center in Pennsylvania. U.S. News & World Report ranked UPMC first in the state and first in Pittsburgh.
“This national recognition is a testament to the skill and dedication of our physicians, nurses and staff and to the superb care they provide every day at UPMC. Our patients and our community have come to expect this level of excellence and we are committed to assuring we deliver. Our proudest achievements come when we make a difference in the lives and health of our patients,” said Elizabeth Concordia, executive vice president of UPMC and president of the Hospital and Community Services Division. “When patients require care, the choice is clear; the nation’s best care is here at UPMC.”
Nationally, UPMC is ranked for excellence in 15 adult specialty areas and is among the top 10 in nine specialty areas: Ear, Nose & Throat; Gastroenterology; Geriatrics; Gynecology; Nephrology; Neurology and Neurosurgery; Orthopaedics; Psychiatry and Pulmonology.
Last month, U.S. News named its 2012 Honor Roll of America’s Best Children’s Hospitals, on which Children’s Hospital of Pittsburgh of UPMC ranked ninth. This year marks UPMC’s 13th appearance on the Honor Roll. Last year, the list placed UPMC 12th nationally.
“A stellar ranking such as this validates what we know to be true – that UPMC is one of the very few academic medical centers in the nation that brings together the best in patient care, top-notch facilities and superior scientists,” added Steven Shapiro, M.D., senior vice president and chief medical and scientific officer, UPMC. “The exceptional clinical services that UPMC provides, fortified by Pitt’s academic research, work hand-in-hand to help us care for patients when they need us.”
UPMC is a $10 billion global health enterprise with more than 55,000 employees headquartered in Pittsburgh, Pa., and is transforming health care by integrating more than 20 hospitals, 400 doctors’ offices and outpatient sites, a health insurance services division, and international and commercial services. Affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC is redefining health care by using innovative science, technology and medicine to invent new models of accountable, cost-efficient and patient-centered care. For more information on how UPMC is taking medicine from where it is to where it needs to be, go to UPMC.com.
Chief of Pediatric Neurosurgery at Children’s Hospital of Pittsburgh of UPMC’s Brain Care Institute Receives Prestigious Award for First-of-its-kind Study of Peptide Vaccine
PITTSBURGH, April 30, 2012 – Millions of stem cells derived from the bone marrow of healthy adult donors have been implanted in the brains of two stroke survivors at UPMC, one of two sites conducting a safety and dose escalation study of the technique.
Led locally by Douglas Kondziolka, M.D., Peter J. Jannetta Professor and vice-chairman, Department of Neurological Surgery, and Lawrence Wechsler, M.D., professor and chair, Department of Neurology, University of Pittsburgh School of Medicine, the trial is the first step in determining whether bone marrow stem cells injected into the brain have therapeutic value in the healing of stroke lesions.
Funded by Mountain View, Calif.-based SanBio, Inc., the project will evaluate stroke therapy using SB623 cells, which are stem cells that are isolated from bone marrow and modified using recombinant DNA methods. The other testing site is at Stanford University.
“Lab and animal testing of these cells have shown that they are not replacing the neurons that have been lost,” explained Dr. Kondziolka. “Eventually, the transplanted cells disappear. But while they’re present, they appear to secrete factors that encourage the brain to repair itself by rebuilding neural connections or helping existing ones work better.”
The researchers are seeking participants between the ages of 18 and 75 who have had an ischemic stroke between six months and three years before study entry. Ischemic strokes occur when a blocked artery interrupts the flow of blood and oxygen in the brain, leading to cell death. Study candidates will undergo brain scans and be evaluated to ensure they have plateaued in their recovery from the stroke.
Participants receive local anesthetic and light sedation for the surgical procedure, Dr. Kondziolka said. Small incisions are made in the scalp and skull and, using scans and brain mapping technology, a probe is guided to the stroke area for deposition of the SB623 cells. Participants will be evaluated periodically for the next two years.
The first six patients received 2.5 million cells; the next six will receive 5 million cells; and the final six, 10 million cells, Dr. Wechsler said. Between each dose escalation, the participants will be carefully monitored to verify the process is safe.
He noted that every year, 800,000 Americans have strokes, making it the fourth leading cause of death and the leading cause of adult disability. Even small changes in neurological function can lead to a big effect on function.
“A little gain in leg strength could mean the difference between requiring a wheelchair and walking. The ability to grip could mean being able to feed yourself,” Dr. Wechsler said. “Cell therapy for stroke and other neurological disorders holds great promise, but first we must methodically test these techniques to ensure safety before we can determine their effectiveness.”
For more information on the SanBio study, contact study coordinator Julia Billigen at 412-605-3959 or BilligenJB@upmc.edu.
First-of-its-kind Study of Peptide Vaccine by Pittsburgh Researchers Shows Evidence of Immunological Response in Children with Gliomas
PITTSBURGH, April 2, 2012 – In a first-of-its-kind study, researchers from Children’s Hospital of Pittsburgh of UPMC and the University of Pittsburgh Cancer Institute (UPCI) Brain Tumor Program have demonstrated that peptide vaccines in children with gliomas, the most common type of brain tumor, not only were well-tolerated but also showed evidence of immunological responses. The results of the study will be presented during a press conference today at the AACR Annual Meeting 2012 in Chicago.
The study, led by Ian F. Pollack, M.D., F.A.C.S., F.A.A.P., chief, Pediatric Neurosurgery at Children’s Hospital’s Brain Care Institute and co-director of UPCI’s Brain Tumor Program, and Dr. Regina I. Jakacki, M.D., director of Pediatric Neuro-Oncology, enrolled 27 children with gliomas, including 16 with newly diagnosed brainstem gliomas, five with newly diagnosed cerebral high-grade gliomas and six with recurrent gliomas. Each child received serial doses of a peptide vaccine, which stimulates an immune response to a protein fragment present on their tumor cells.
“We’ve found that this vaccine is tolerated well with limited systemic toxicity, but we’ve also observed that there are some patients who have immunological responses in the vaccine target in the brain that can cause swelling and transient worsening and, subsequently, some of those children can have very favorable responses,” said Dr. Pollack, the Walter Dandy professor of neurological surgery and vice chairman for academic affairs in the department of neurological surgery at the University of Pittsburgh School of Medicine. “We’ve also demonstrated immunological responses in the majority of the kids.”
Children with eligible tumor types received a vaccine targeting glioma-associated antigen (GAA) proteins, including EphA2, IL13Rα2 and survivin, every three weeks, for a total of eight doses.
“These kids, who, for the most part, have intact and very strong immune systems, seem to mount an immune response against the vaccine very effectively at rates that may be even higher, I think, than have been noted in studies in adults,” Dr. Pollack said.
Among the 22 cases evaluated, three children had rapidly progressive disease, 15 had stable disease for more than three months, three had sustained partial responses, and one had prolonged disease-free status after surgery. An immune response analysis, which was completed in seven children, revealed responses in six children: to IL13Rα2 in five cases, EphA2 in three and survivin in three.
“This was the first study of its type that examined peptide vaccine therapy for children with brain tumors like this,” Pollack said. “The fact that we’ve seen tumor shrinkage in children with very high-risk tumors has been extremely encouraging and somewhat surprising.”
The study was funded by the National Institutes of Health and the Pediatric Low-Grade Glioma Initiative.
For more information about Dr. Pollack, Dr. Jakacki, or Children’s Hospital, visit www.chp.edu.