Pediatric Annals

Editorial Free

Saving Lives: Children’s and Adults’

Stanford T. Shulman, MD


In this issue of Pediatric Annals, I want to highlight a few recent life-saving reports. An interesting study by Quinlan et al.1 of Northwestern University Feinberg School of Medicine published recently in Pediatrics reported that about 20% of child passenger deaths in the U.S. involve an alcohol-impaired driver, and 65% of those children who died were actually riding with that impaired individual. From 2001 to 2010, 2,344 children under the age of 18 were killed in accidents involving an alcohol-impaired driver, and 1,512 of those were riding with an impaired driver. This finding can only highlight the importance of efforts to help prevent such tragedies, including greater use of ignition locks, tougher driving under the influence (DUI) laws and enforcement, sobriety checkpoints, and increasing prosecution of drunken individuals in fatal cases. The impaired drivers in this study were more likely to be male, lack a valid driver’s license, and to have had a DUI conviction within the past 3 years. Another problem to warn the parents of our patients about!

Remaining on the topic of saving lives, a recent analysis by Sommers and colleagues2 from the Harvard School of Public Health, Brigham and Woman’s Hospital, and the Urban Institute in the Annals of Internal Medicine clearly demonstrated that providing increased access to health care coverage actually improved health and saved lives. The investigators analyzed adult mortality rates in Massachusetts before and after the introduction of statewide health care reform in 2006. They compared those rates to mortality rates in 513 U.S. counties with similar poverty rates, demographics, and baseline rates of health coverage. Overall, mortality declined 2.9% in Massachusetts from 2006 to 2010 but rose slightly in the comparative areas. The data show that one death was prevented for every 830 Massachusetts individuals who obtained health coverage. This experience may predict that the Affordable Care Act (aka, “Obamacare”), which was modelled after the Massachusetts plan, will also save lives because its implementation has reduced the percentage of working age adults without coverage from 18% to 13.4% in the past 6 months.

A third recent report presented data on a placebo-controlled trial of a new once-daily oral monoclonal antibody, evolocumab, in patients with hyperlipidemia.3 When added to diet alone, to low-dose atorvastatin, or to high-dose atorvastatin with or without ezatinibe, the new agent significantly reduced LDL cholesterol levels (by 57%) and lowered levels of apoprotein B, non-HDL cholesterol, lipoprotein (a), and triglycerides. One would hope that this would also lead to reduced cardiovascular mortality rates, qualifying as a life-saver.

Taken together, these three diverse modalities all have great potential for improving health and saving lives, in very different ways, and provide a basis for optimism going forward.

This Month’s Stamps

The stamps chosen for this issue honor a potpourri of individuals. The 2013 red and gray Greek souvenir sheet honors the 2,400th anniversary of the founding of the Platonic Academy by Plato (428-348 B.C.E.) in Athens around 387 B.C.E. The term “academy” was named for Akademos, a mythologic figure of Attica; the Academy was an intellectual center of study with lectures, problems to be studied and solved, mathematics, philosophy, and scientific research related to the movement of the heavenly bodies. The Academy, where Aristotle studied for 20 years from 367 to 347 B.C.E., ended in 83 B.C.E. but was revived briefly from 410 to 529 A.D. Its site in a suburb of Athens was rediscovered in the 20th century.

A red and gray Greek souvenir sheet from 2013 honors the 2,400th anniversary of the founding of the Platonic Academy by Plato (428-348 B.C.E.) in Athens around 387 B.C.E.Images courtesy of Stanford T. Shulman, MD.

A red and gray Greek souvenir sheet from 2013 honors the 2,400th anniversary of the founding of the Platonic Academy by Plato (428-348 B.C.E.) in Athens around 387 B.C.E. Images courtesy of Stanford T. Shulman, MD.

The 2013 stamp of the Czech Republic honors Otto Wichterle (1913–1998), a Czech chemist who invented the soft contact lens. Wichterle was a plastics expert who was imprisoned for several months by the Gestapo but invented a synthetic fiber (silon) in 1941 and was interested in developing cross-linked plastic gels suitable for contact with living tissues. Because of his pro-democratic politics he could not hold an academic job and was forced to conduct his research on the development of contact lenses in a home laboratory. By 1961, he produced the first hydrogel contact lens with homemade apparatus in his kitchen. Without his permission, the Czech Academy of Sciences sold the patent, and mass production occurred in the U.S. Wichterle was finally recognized after the Velvet Revolution of 1989, and in 1990 became President of the Czech Academy of Science and then of the Academy of Sciences of the Czech Republic.

The 2013 Italian stamp features Rita Levi-Montalcini (1909–2012), the only Nobel Laureate (in 1986 with Stanley Cohen for the discovery of nerve growth factor) to live longer than 100 years. She was born in Turin, graduated from University of Turin Medical School in 1936, and studied the nervous system until 1938, when Mussolini banned Jews from academic and professional careers. During WWII, she conducted experiments on the growth of neurons in chick embryos in her home, with a genetics lab in her bedroom. In 1943, Levi-Montalcini fled to Florence, where she was a volunteer medical worker, and set up a research lab in her apartment. From 1946 to 1976, she worked at Washington University in St. Louis, discovering nerve growth factor in 1952, becoming the tenth woman elected to the U.S. National Academy of Sciences, and in 1986, was named the fourth Nobel Prize winner from Italy’s relatively small Jewish community.

A 2013 stamp of the Czech Republic honors Otto Wichterle (1913–1998), a Czech chemist who invented the soft contact lens.

A 2013 stamp of the Czech Republic honors Otto Wichterle (1913–1998), a Czech chemist who invented the soft contact lens.

A 2013 stamp from Italy features Rita Levi-Montalcini (1909–2012), the only Nobel Laureate (in 1986 with Stanley Cohen for the discovery of nerve growth factor) to live longer than 100 years.

A 2013 stamp from Italy features Rita Levi-Montalcini (1909–2012), the only Nobel Laureate (in 1986 with Stanley Cohen for the discovery of nerve growth factor) to live longer than 100 years.

References

  1. Quinlan K, Shults RA, Rudd RA. Child passenger deaths involving alcohol-impaired drivers. Pediatrics. 2014May5. [Epub ahead of print] doi:10.1542/peds.2013-2318 [CrossRef]
  2. Sommers B, Long SK, Baicker K. Changes in mortality after Massachusetts health care reform. Ann Intern Med. 2014;160(9):585–593. doi:10.7326/M13-2275 [CrossRef]
  3. Blom DJ, Hala T, Bolognese M, et al. DESCARTES Investigators. A 52-week placebo-controlled trial of evolocumab in hyperlipidemia. N Engl J Med. 2014;370(19):1809–1819. doi:10.1056/NEJMoa1316222 [CrossRef]
Authors

Pediatric Annals Editor-in-Chief Stanford T. Shulman, MD, is the Virginia H. Rogers Professor of Pediatric Infectious Diseases at Northwestern University Feinberg School of Medicine and Chief of the Division of Infectious Disease at the Ann & Robert H. Lurie Children’s Hospital, Chicago, IL.

An avid stamp collector, Dr. Shulman chooses relevant stamps from his personal collection to accompany his column each month.

Reach Dr. Shulman via email: pedann@Healio.com.

10.3928/00904481-20140417-01

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