While spending one day a week at the Yale Craniofacial Center, medical student Peter Hashim saw a number of parents with concerns about the flattened shape of their babies’ heads. John A. Persing, M.D., section chief and the Irving and Silik Polayes Professor of Surgery (plastic) and professor of neurosurgery; told him that ever since the Back to Sleep Campaign was launched in 1994 to reduce the risk of Sudden Infant Death Syndrome by placing babies on their backs for sleep, he’d seen an increase in this condition, known as deformational plagiocephaly.
Hashim and Persing wondered how this might affect the brain. Were there risks for long-term problems? From these questions, a clinical research project was born, the results of which were showcased along with 87 other posters presented on May 7 at Student Research Day in The Anlyan Center.
Hashim, with Persing as his mentor, set out to examine brain development by measuring the brain waves of infants in response to language. They tested a dozen infants in three groups: normal children, those with deformational plagiocephaly, and a third group with craniosynostosis, another flattened-skull deformity, but one that requires surgery.
“In the healthy brain, one hemisphere specializes in language, and it’s most commonly the left,” Hashim said. So, using electrodes on a spongy skull cap, the researchers measured the babies’ brain waves in response to audible language. “The good news,” Hashim said, is that “as in the normal infants, the infants with deformational plagiocephaly, showed the same left-sided pattern for language.” The babies with craniosynostosis didn’t show any hemispheric specialization, which, Hashim says, reinforces the results “by providing a stark contrast and showing us the patterns of abnormal brain development.” Hashim’s conclusion is that a flattened skull due to positioning “seems to be a cosmetic issue, but I don’t think it means any damage to the brain, based on our results, which should be reassuring to parents and pediatricians.”
Matthew Webb, a former varsity rower, is interested in orthopaedics. For his research project, mentored by Kristaps Keggi, M.D. ’59, HS ’63, Elihu Professor of Orthopaedics and Rehabilitation, he looked at hip replacement surgeries. Specifically, Webb wanted to know if cutting the nerves in the fibrous capsule around the hip joint could be as effective as hip replacement surgery in pain management but spare the patient the risks (the most serious being a pulmonary embolism) and arduous recovery of hip replacement surgery.
Webb contacted 25 patients four years after they had the nerve-cutting procedure. Six of the patients had died of unrelated causes after having hip replacement surgery. Of the 19 others, 13 had gone on to have hip replacement surgery, but six had not.
“With only 25 study subjects, we can’t conclude anything statistically significant,” Webb says, “but we’re encouraged. The procedure seems to work and may prove to be safer. It’s a way to alleviate hip pain without drugs or major surgery. It’s a way to get people back to work or sport or hobby, and if they need hip replacement surgery down the road, this doesn’t preclude that.”
The beauty of the annual event, said Nancy R. Angoff, M.P.H. ’81, M.D. ’90, HS ’93, associate dean for student affairs, is the range and spectrum of projects that are showcased. “Every area of medicine and science is represented here: basic, translational, clinical, psycho-social, policy. We tell our students to go explore their interests, their passions.”
Keynote speaker Elizabeth Nabel, M.D., who delivered the Farr Lecture, traced her career journey from a girlhood in Minnesota, where, as a student, she deliberately got questions wrong on tests because “girls weren’t supposed to be good at science” to her current position as president of Brigham and Women’s Health Care in Boston. Nabel is a board-certified cardiologist who is internationally recognized for her research in the molecular genetics of cardiovascular disease, and is a former director of the National Heart, Lung and Blood Institute at the National Institutes of Health. Nabel described her life of science as an “extraordinarily stimulating career,” and she urged the students in attendance to “think about their skills, passions, and talents” as they begin their own journeys as leaders in science and medicine.
Five students gave oral presentations and were honored for their top award-winning theses from 30 recommended for honors by departments: Benjamin Himes, for “siRNA Therapy in Glioblastoma Stem Cells: Identification of Target Genes and Potential Therapeutic Implications”; Sounok Sen, for “Understanding Costs, Value, and Patterns of Care of New Radiation Technologies Among Older Women with Breast Cancer”; Kevin Koo, for “Male-Partner Participation in the Prevention of Mother-to-Child HIV Transmission in South Africa”; Michael Peluso, for “Biological and Clinical Markers of Neuronal Injury in Primary and Chronic HIV-1 Infection”; Rachel Rosenstein, for “Innate Immune Sensing of Allergens”.
John N. Forrest Jr., M.D., director of the office of student research, said student research and the required thesis at Yale underscores the medical school’s message to its students: “All physicians are scientists and are expected to contribute throughout their lives to new knowledge in the scientific literature.”