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News Article | November 8, 2016
Site: www.sciencedaily.com

Scientists from Children's Health Research Institute, a program of Lawson Health Research Institute, and Western University have developed a new blood test that identifies with greater than 90 per cent certainty whether or not an adolescent athlete has suffered a concussion. Diagnosis of a clinically significant concussion, or a mild traumatic brain injury, can be difficult as it currently relies on a combination of patient symptom assessment and clinician judgement. Equally problematic are the decisions to stop play or activities, or when patients who have suffered a concussion can safely return to normal activities without risking further injury. In the new study, researchers have demonstrated that a blood test can now accurately diagnose a concussion using a form of blood profiling known as metabolomics. Dr. Douglas Fraser, a physician in the Paediatric Critical Care Unit at Children's Hospital, London Health Sciences Centre and Lawson scientist, led the study with his co-investigator Mark Daley, a professor in the Departments of Computer Science, Biology and Statistics & Actuarial Sciences at Western University. In the relatively inexpensive test, blood is drawn from an individual that may have suffered a concussion as the result of a sudden blow to the head (or from transmitted forces from a sudden blow to the body) within 72 hours of the incident. The scientists measure a panel of metabolites -- small molecules that are the products of the body's metabolism -- in the blood to search for distinct patterns that indicate a concussion has occurred. "This novel approach, to use blood testing of metabolites as a diagnostic tool for concussions, was exploratory and we were extremely pleased with the robustness of our initial results," says Dr. Fraser, also an Associate Professor in Western's Departments of Paediatrics, Physiology & Pharmacology and Clinical Neurological Sciences at the Schulich School of Medicine & Dentistry. "We looked at a host of patterns and it appears that those who suffered a concussion have a very different pattern than those who have not had a concussion." This new method, fully funded by the Children's Health Foundation and conducted by the Western Concussion Study Group, is unique in that previous attempts have looked unsuccessfully for a single highly accurate protein biomarker that can distinguish concussed from non-concussed adolescent patients. In this latest successful attempt, the researchers took a different approach and investigated a full spectrum of 174 metabolites. "We looked at all of these metabolites in concussed male adolescent patients and in non-concussed male adolescent patients and it turns out that the spectrum is really different," explains Daley, who is also Western's Associate Vice-President (Research) and a principal investigator at Western's Brain & Mind Institute. "There is no one metabolite that we can put a finger on but when we looked at all of them, those profiles are different enough that we could easily distinguish concussed patients from non-concussed. In fact, with fine tuning we can now look at sets of as few as 20-40 specific metabolites and maintain the diagnostic accuracy level of the test over 90 per cent." Concussion is a major public health concern, often resulting in significant acute symptoms and in some individuals, long-term neurological dysfunction. "The discovery of a blood test that can aid in concussion diagnosis is very important," says Dr. Fraser. "With further research, we anticipate that our blood test will also aid clinicians in predicting concussion outcome, as well as aid rehabilitation after concussion." The findings were recently published in the international journal Metabolomics. The technology is subject to a patent application filed through WORLDiscoveries®, the joint technology transfer office of Lawson and Western. "This relatively quick and inexpensive blood test for concussion is by far the most accurate reported with tremendous potential for clinical management and commercialization," says Kirk Brown, Manager of Business Development for Lawson.


News Article | November 7, 2016
Site: www.eurekalert.org

LONDON, ON - Scientists from Children's Health Research Institute, a program of Lawson Health Research Institute, and Western University have developed a new blood test that identifies with greater than 90 per cent certainty whether or not an adolescent athlete has suffered a concussion. Diagnosis of a clinically significant concussion, or a mild traumatic brain injury, can be difficult as it currently relies on a combination of patient symptom assessment and clinician judgement. Equally problematic are the decisions to stop play or activities, or when patients who have suffered a concussion can safely return to normal activities without risking further injury. In the new study, researchers have demonstrated that a blood test can now accurately diagnose a concussion using a form of blood profiling known as metabolomics. Dr. Douglas Fraser, a physician in the Paediatric Critical Care Unit at Children's Hospital, London Health Sciences Centre and Lawson scientist, led the study with his co-investigator Mark Daley, a professor in the Departments of Computer Science, Biology and Statistics & Actuarial Sciences at Western University. In the relatively inexpensive test, blood is drawn from an individual that may have suffered a concussion as the result of a sudden blow to the head (or from transmitted forces from a sudden blow to the body) within 72 hours of the incident. The scientists measure a panel of metabolites - small molecules that are the products of the body's metabolism - in the blood to search for distinct patterns that indicate a concussion has occurred. "This novel approach, to use blood testing of metabolites as a diagnostic tool for concussions, was exploratory and we were extremely pleased with the robustness of our initial results," says Dr. Fraser, also an Associate Professor in Western's Departments of Paediatrics, Physiology & Pharmacology and Clinical Neurological Sciences at the Schulich School of Medicine & Dentistry. "We looked at a host of patterns and it appears that those who suffered a concussion have a very different pattern than those who have not had a concussion." This new method, fully funded by the Children's Health Foundation and conducted by the Western Concussion Study Group, is unique in that previous attempts have looked unsuccessfully for a single highly accurate protein biomarker that can distinguish concussed from non-concussed adolescent patients. In this latest successful attempt, the researchers took a different approach and investigated a full spectrum of 174 metabolites. "We looked at all of these metabolites in concussed male adolescent patients and in non-concussed male adolescent patients and it turns out that the spectrum is really different," explains Daley, who is also Western's Associate Vice-President (Research) and a principal investigator at Western's renowned Brain & Mind Institute. "There is no one metabolite that we can put a finger on but when we looked at all of them, those profiles are different enough that we could easily distinguish concussed patients from non-concussed. In fact, with fine tuning we can now look at sets of as few as 20-40 specific metabolites and maintain the diagnostic accuracy level of the test over 90 per cent." Concussion is a major public health concern, often resulting in significant acute symptoms and in some individuals, long-term neurological dysfunction. "The discovery of a blood test that can aid in concussion diagnosis is very important," says Dr. Fraser. "With further research, we anticipate that our blood test will also aid clinicians in predicting concussion outcome, as well as aid rehabilitation after concussion." The findings were recently published in the international journal Metabolomics. The technology is subject to a patent application filed through WORLDiscoveries®, the joint technology transfer office of Lawson and Western. "This relatively quick and inexpensive blood test for concussion is by far the most accurate reported with tremendous potential for clinical management and commercialization," says Kirk Brown, Manager of Business Development for Lawson. Western delivers an academic experience second to none. Since 1878, The Western Experience has combined academic excellence with life-long opportunities for intellectual, social and cultural growth in order to better serve our communities. Our research excellence expands knowledge and drives discovery with real-world application. Western attracts individuals with a broad worldview, seeking to study, influence and lead in the international community. As the research institute of London Health Sciences Centre and St. Joseph's Health Care London, and working in partnership with Western University, Lawson Health Research Institute is committed to furthering scientific knowledge to advance health care around the world. http://www. Children's Health Foundation is dedicated to raising and granting funds to support Children's Hospital at London Health Sciences Centre, Thames Valley Children's Centre and Children's Health Research Institute. Since 1922, funds raised have helped deliver exceptional care and support for children and their families by providing specialized paediatric care, equipment, education programs, therapy, rehabilitation services and research. Get to know how you can help save and improve kids' lives at http://www.


Soto-Rivera C.L.,Harvard University | Agus M.S.D.,Harvard University | Sawyer J.E.,University of Cincinnati | Macrae D.J.,Paediatric Critical Care Unit
Pediatric Critical Care Medicine | Year: 2016

Objective: To provide an overview of the current literature on the use of hormone replacement therapies in pediatric cardiac critical care. Data Sources: PubMed, EMBASE, and the Cochrane Library were searched using keywords relevant to the hormonal therapy, with no limits on language but restricting the search to children 0-18 years old. Study Selection: All clinical studies believed to have relevance were considered. Where studies in children were sparse, additional evidence was sought from adult studies. Data Extraction: All relevant studies were reviewed, and the most relevant data were incorporated in this review. Data Synthesis: All authors of this review contributed to the appraisal of the data extracted. Challenges and revisions by the authors were conducted by group e-mail debate. Conclusions: Glycemic control: although it is likely that some children could benefit, the routine use of tight glycemic control cannot be recommended in children after cardiac surgery. Thyroid hormone replacement: routine use of thyroid hormone replacement to normalize levels after cardiac surgery cannot be recommended on current evidence. Until further evidence from adequately powered studies is available, therapeutic decisions should be based on individual patient circumstances. Corticosteroids: 1) cardiopulmonary bypass: although studies seem to favor steroid administration during surgery with cardiopulmonary bypass, a large randomized controlled trial is required before strong recommendations can be made; 2) refractory hypotension: the evidence for the use of steroid replacement in refractory hypotension is poor, and no firm recommendations can be made; and 3) abnormal adrenal function after cardiac surgery: there is inadequate evidence on which to make recommendations on the use of corticosteroid replacement in children with critical illness-related corticosteroid insufficiency in children following cardiac surgery. © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.


Researchers have developed a new blood test with more than 90 percent accuracy to determine whether an adolescent athlete has concussion. Diagnosing a mild brain injury is quite a tough task, as it involves a combination of accurate clinical judgment and patient symptom assessment. Meanwhile, making decisions on whether a patient can start or stop physical activities after the injury is also a difficult task altogether. To resolve this issue, the researchers have developed a novel blood-profiling test to determine whether an individual has suffered a concussion recently. The blood test is referred to as metabolomics. For the purpose of the blood-profiling test, blood is drawn from a person who has suffered a severe blow to the head within 72 hours of the accident. The metabolites, resultant molecules of the body's metabolic processes, present in the blood are measured. When a distinct pattern is obtained while measuring a panel of metabolites, it is an indication that a concussion has occurred. Dr. Douglas Fraser, a physician in the Paediatric Critical Care Unit at Children's Hospital, noted that making simple blood test for assessing the metabolites in order to find the presence of concussion is a very new approach. He also noted that the initial results were very encouraging. Fraser said that when a host of patterns of metabolites were analyzed, it was observed that the pattern varied distinctly between concussed and non-concussed individuals. It is noted that this method of testing for mild brain injury is "unique" since it involves analyzing a host of 174 metabolites while a number of methods developed earlier looked into one or the other highly accurate protein biomarker. Mark Daley, a professor at Western University, noted that when all the 174 metabolites were tested in both non-concussed and concussed adolescent males, it was found that the metabolites' spectrum was much different between the two groups. Daley also noted that no one specific metabolite could help in determining whether a patient had concussion. However, their patterns as a whole is useful in distinguishing the non-concussed people from concussed patients. It is observed that analyzing sets of 20 to 40 metabolites would help in diagnosing concussion with about 90 percent accuracy. "The discovery of a blood test that can aid in concussion diagnosis is very important," said Fraser in a press release. "With further research, we anticipate that our blood test will also aid clinicians in predicting concussion outcome, as well as aid rehabilitation after concussion." The study is published online in the journal Metabolomics on Oct. 28. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.

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