Tips to Celebrate Halloween Safely From The Scariest Place of All - The Emergency Department

Each year, 9.2 million babies, children, and teens are injured severely enough to need treatment in emergency departments all across America, reports the Centers for Disease Control and Prevention. "Nothing is scarier than a trip to the emergency room," said Mark Cichon, DO, chair, Department of Emergency Medicine, Loyola University Health System. "In a season devoted to frights, it is our goal to keep everyone safe."

Here are Dr. Cichon's top tips to avoid going bump in the night and for a healthy, happy Halloween:
Invest in a pumpkin carving kit and avoid knives. "Manipulating a sharp knife in a rigid pumpkin rind without injury is almost impossible for an adult or child," said Dr. Cichon. "Proper tools make sure you carve the jack o' lantern and not yourself or a loved one."

Supervise anything that is burning, from scented candles to carved pumpkins to firepits. "Fires can happen in a flash and get quickly out of control," said Dr. Cichon. "The colder temperatures invite the warm glow of candles to the excitement of an end-of-season bonfire. Watch out for burning leaf piles."

Use extra precaution when climbing ladders to hang decorations inside and outside. "Falls from ladders are one of the top reasons adults come to the emergency room and they are largely avoidable," said Dr. Cichon. "Use the right-sized ladder, and one that is safe, and work with a partner to do the job right."

Make sure Halloween costumes offer visibility and ease of movement. "Masks, hats, wigs, glasses, hoods -- costumes often include headgear that can obstruct vision and lead to trips and falls," said Dr. Cichon. "And make sure it is easy to walk in the costume without tripping or catching on things."

Dress for the weather. "It is easy to get overheated or too cold in the Midwest at this time of year, without the addition of wearing a costume," said Dr. Cichon. "Check skin temperature and watch for signs such as shivering or lethargy. Don't forget to wear waterproof footgear that has treads for sure footing."

Have one adult in the trick-or-treating group wear a reflective safety vest and give each child a glow stick or flashlight to increase visibility. "You want to be able to see where you are going and also for others to see you, especially around moving vehicles," said Dr. Cichon. Stay in a group and put kids on the buddy system.

Avoid alcohol use when supervising children. "Don't drink and accompany your kids as they trick-or-treat," said Dr. Cichon. "If you choose, enjoy a beer or cocktail at the end of the night after kids are safely indoors, or better yet, in bed."

Avoid over-tiring children. "Fatigue can lower resistance, leading to illness and injury," said Dr. Cichon. Make sure a good night's sleep starts Halloween day and rest up before the night's activities. Eat healthy meals and drink plenty of water to stay hydrated. Maintain regular bedtimes.

Inspect treats when you get home. "Make sure candy and goodies are age-appropriate; avoid smaller pieces for younger children that could be a choking hazard," said Dr. Cichon.

Balance candy consumption with healthy foods. "When my four children were younger my wife and I would hide their candy and allow them each to choose two pieces after dinner to limit over-consumption," said Dr. Cichon.

Be aware of the potential for loud and scary noises. "Playful scaring antics by enthusiastic celebrants and even barking dogs can frighten children and cause them to react suddenly," said Dr. Cichon. "Falling down porch stairs, tripping over curbs and even colliding with others can result in harm."

Drive vehicles slowly and cautiously on Halloween, especially on sidestreets. "Watch for trick-or-treaters but also be aware of any flying eggs or other debris that could impede vision," said Dr. Cichon.

Since 1995, annual patient volumes in Loyola's emergency division have increased from 29,000 to 53,000 patients. The Loyola emergency medicine division is classified as a Level 1 Trauma Center, providing the highest level of surgical care to trauma patients. The division also has been recognized by groups such as The Joint Commission, the Commission on Accreditation of Medical Transport Systems, the American College of Surgeons for Trauma and the Illinois Department of Public Health for Trauma, Burns, Pediatric and Emergency departments.

Cell Growth Discovery by UCSF Team Has Implications for Targeting Cancer

 to support growth, to repair damaged tissues, or simply to maintain our healthy adult functioning — is controlled in previously unsuspected ways UC San Francisco researchers have discovered. The findings, they said, may lead to new ways to fight cancer.

The steps leading a quiet cell to make and divvy up new parts to form daughter cells rely on some of the cell’s most complex molecular machines. Different machines play key roles at different stages of this cell cycle. Each of these cellular machines consists of many proteins assembled into a functioning whole. They carry out such tasks as repairing DNA in the newly replicated gene-bearing chromosomes, for instance, or helping pull the chromosomes apart so that they can be allocated to daughter cells. 

In a study published online on October 10, 2013 in the journal Molecular Cell, UCSF researchers led by molecular biologist Davide Ruggero, PhD, associate professor of urology, and computational biologist Barry Taylor, PhD, assistant professor of epidemiology and biostatistics, found that the production of entire sets of proteins that work together to perform such crucial tasks is ramped up together, all at once — not due to the transcription of genes into messenger RNA, a phenomenon scientists often study to sort out cellular controls — but at a later stage of gene expression that occurs within the cell’s protein-making factories, called ribosomes.

“We have found that these proteins are regulated specifically and exquisitely during the cell cycle,” Ruggero said. When this regulation falters, it wreaks havoc in the cell, he added. “Cell-cycle control is a process that is most often misregulated in human disease,” he said. 

More specifically, the researchers found that this coordinated timing of protein production during the cell cycle is largely governed at the tail end of gene expression, within the ribosome, where cellular machinery acts on messenger RNA to churn out the chains of amino acids that eventually fold into functional form as proteins.

In 2010 Ruggero reported key evidence suggesting that this stage of protein production, called “translation,” might be an often-neglected process in many tumors, ranging from lymphomas, multiple myeloma and prostate cancer.

In the new study, the researchers examined translation of messenger RNA into protein at the classic phases of the cell cycle, before the cell actually divides. These are the G1 phase, when cells grow and make lots of proteins before replicating their DNA; the S phase, when cells replicate their DNA; and the G2 phase, when cells make internal components known as organelles, which they divvy up along with the chromosomes when the cell actually divides during mitosis.

The scientists used a technique know as ribosome profiling, originally developed for yeast cells in the lab of Jonathan Weismann, PhD, Howard Hughes Investigator at UCSF and professor of cellular and molecular pharmacology, to figure out which messenger RNA was being translated into protein by the ribosome during human cell division. They then used computational techniques developed by Taylor’s lab team along with the lab team of Adam Olshen, PhD, professor of epidemiology and biostatistics, to better quantify which genes had been translated into proteins.

By conducting a genome-wide investigation of translation and interrogating the data with sophisticated computer algorithms, the researchers discovered that different groups of protein were made in abundance at a particular phase, only to be quieted during another phase of the cell cycle. Previous studies of translation of messenger RNA into protein focused on only one or just a few genes at a time, according to Ruggero and Taylor.

“We hope these methods will be helpful to others who study gene regulation at the translational stage in various diseases, and those who want to identify specific targets for drug development based on discoveries of aberrant translation,” Taylor said.

Ruggero has been a pioneer in probing the ability of tumor cells to make extraordinary amounts of protein to sustain their rapid growth and immortality. He also is exploring ways to therapeutically target this excess protein production in cancer.

One striking finding from this new UCSF study is the discovery that production of a protein called RICTOR is boosted due to increased translation during the S phase of the cell cycle. RICTOR serves as a signal to help the cell cycle run like finely tuned clockwork, but several studies suggest that RICTOR often is constitutively turned on in cancer, Ruggero said.

The biochemical signaling cascade within the cell that RICTOR is a part of is under extensive investigation for experimental cancer therapies, and these new findings may point to novel strategies for drug development Ruggero said. Ruggero and Craig Stumpf, PhD, a postdoctoral fellow with his lab and the first author of the Molecular Cell paper, now are tracking down the upstream trigger that coordinates timing of many of the other suites of proteins that are produced simultaneously during the different cell-cycle phases.

UCSF technician Melissa Moreno also worked on the study. The research was funded by grants from the National Institutes of Health.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital.