Unique Bone Marrow Transplant Said to Cure Sickle Cell

A unique form of bone marrow transplantation is the only safe and effective cure for sickle cell disease, researchers at Children’s Hospital of Pittsburgh report.

Traditional bone marrow transplants rely on heavy doses of chemotherapy prior to transplant in order to destroy a recipient’s bone marrow so it won’t reject the donated marrow. But that makes patients vulnerable to dangerous complications, something that’s viewed as an unnecessary risk, because sickle cell disease typically isn’t life-threatening, the researchers said.

This new transplant method relies on reduced intensity conditioning (RIC) regimens, which are less toxic to patients and eliminate life-threatening side effects generally associated with bone marrow transplantation. This means transplants can be offered to patients with severe sickle cell disease.

The researchers at Children’s Hospital, part of the University of Pittsburgh Medical Center, reported that six of seven sickle cell patients who received RIC bone marrow transplants in the last decade now have donor marrow and are free of sickle cell disease symptoms.

The report was published in the November issue of the journal Biology of Blood and Marrow Transplantation.

“Bone marrow transplant is the only known cure for sickle cell disease. But doctors have avoided performing them in these patients, because complications from a traditional bone marrow transplant can be life-threatening,” Dr. Lakshmanan Krishnamurti, a pediatric hematologist/oncologist and director of the Sickle Cell Program at Children’s Hospital, said in a hospital news release. He helped develop RIC bone marrow transplants.

“Through the reduced-intensity approach we developed, the potential for complications is dramatically lessened. This study offers hope for a cure for thousands of patients with severe sickle cell disease,” Krishnamurti said.

Sickle cell disease, an inherited blood disorder, affects about 80,000 people in the United States, primarily blacks. The disease can cause agonizing pain, strokes, damage to internal organs, and a shortened life expectancy.

Violent video games tied to teen aggression

Adolescents who play violent video games may become increasingly aggressive over time, a new study of Japanese and U.S. teens suggests.

Researchers found that among three groups of 9- to 18-year-olds followed over several months, those who regularly played violent video games were more likely to get into more and more physical fights over time. The study is among the first to chart changes in gamers’ aggressive behavior over time, lending weight to evidence that violent video games can encourage violence in some kids. And it’s the first to show that the effects are seen across cultures, researchers report in the journal Pediatrics.

“Basically what we found was that in all three samples, a lot of violent video game play early in a school year leads to higher levels of aggression during the school year, as measured later in the school year — even after you control for how aggressive the kids were at the beginning of the year,” lead researcher Dr. Craig A. Anderson, of Iowa State University in Ames, explained.

An argument has been made that video games cannot be directly contributing to aggression because violence rates are low in Japan where video games are highly popular, Anderson said in a written statement.

“By gathering data from Japan,” he said, “we can test that hypothesis directly and ask, ‘Is it the case that Japanese kids are totally unaffected by playing violent video games?’ And of course, they aren’t. They’re affected pretty much the same way American kids are.

The findings are based on two separate groups of teenagers from Japan — 1,231 teens in all — and 364 9- to 12-year-olds from the U.S. At the outset, participants estimated how often they played violent video games, then their own aggressive behavior was followed for up to six months afterward.

The Japanese teens reported on their own violent behavior using questionnaires, while teachers’ and peers’ reports were used to estimate the U.S. group’s aggressive behavior.

In general, Anderson’s team found that kids who habitually played violent video games were more likely than their peers to become increasingly involved in physical fights — even when their behavior in the months leading up to the study was taken into account.

Of course, not all kids who play aggressive video games act them out in real life. Nor is media violence alone to blame for teenagers’ aggression, the researchers point out.

But what these video games may do, the investigators say, is feed the idea that violence is a normal and acceptable way to react to everyday conflicts, like getting bumped in the school hallway. “It is important to realize that violent video games do not create schools shooters,” Dr. Douglas A. Gentile, another researcher on the study, said in the statement.

“Violent games are certainly not the only thing that can increase children’s aggression,” he added, “but these studies show that they are one part of the puzzle in both America and Japan.”

Younger Men Fare Best After Hip Joint Resurfacing

Age and gender are important to the success of hip resurfacing, say U.S. researchers who reviewed more than 500 surgeries and found the majority of serious complications occurred in women of all ages and men over age 55.

Hip resurfacing offers an alternative to hip replacement, in which the ball of the hip joint is removed and replaced with a metal stem inserted into the thigh bone. In hip resurfacing, the ball of the hip joint remains, but its surface is reshaped to accept a rounded cap with a short stem that sits in the thigh bone, or femur.

Study lead author Dr. Craig Della Valle, a joint reconstruction specialist at Rush University Medical Center, and colleagues looked at the first 537 hip resurfacing surgeries performed in the United States using the Birmingham Hip Resurfacing implant, approved by the Food and Drug Administration in October 2006.

Serious complications occurred in 32 of the cases, including 10 cases in which the femoral neck fractured after surgery. These types of fractures, which don’t occur in hip replacements, required additional surgery.

Nine of the 10 femoral neck fractures occurred in either female patients or those older than 55. Eight of the fractures occurred in cases where the surgeon was relatively inexperienced with the procedure (10 or fewer hip resurfacing surgeries).

“Patients who are older or who are female tend to have softer bone. Also, men on average have larger bone structures, with a greater surface area for securing the implant,” Della Valle explained in a Rush University news release. Males under the age of 55 are the ideal patients for hip resurfacing, the experts said.

“Patients may be eager to take advantage of technological innovations, but for older individuals, a conventional hip replacement is generally more appropriate,” Della Valle advised.

The study was released online and was expected to be published in the January print issue of the journal Clinical Orthopaedics and Related Researc