SOUTH BEND, Ind. (AP) — When a child arrives in her Rhode Island emergency room with suspicious bruises, Dr. Susan Duffy knows which seem more likely to be common badges of childhood and which might be signs of something more sinister.
"One of the big dilemmas that you have when you're trying to document child abuse is that people don't walk in the door and say, 'I have abused my child,'" says Duffy, a pediatric emergency room physician for Hasbro Children's Hospital in Providence and a Brown University associate professor.
Bruises happen when capillaries are broken and blood spills into surrounding tissue and begins to change. As one element of blood -- hemoglobin -- begins to break down, its levels rise, and the bruise begins to form. As a result, the levels of the red hemoglobin drop and more bilirubin is produced, rendering the skin more yellow.
Duffy says a Brown colleague about five years ago was working to develop a way to measure the amounts of hemoglobin in the eye to determine anemia without doing a blood test, which would be especially useful in Third World countries.
"So I came up with the idea that, 'Gee ... wouldn't it be great if there could be some kind of device to measure those products (in bruises)?'" Duffy told the South Bend Tribune (http://bit.ly/RDdRs6 ).
Doing so in cases of suspected child abuse would allow investigators to better determine whether an adult's version of events line up with the timeline of the bruise.
One of those researchers was Gregory Crawford, a physicist who later came to the University of Notre Dame. As Notre Dame's dean of the College of Science and Physics, Crawford oversees the physics, biology, math, applied math and statistics, chemistry and pre-med departments.
At Notre Dame, Crawford, applied math professor Mark Alber, graduate student Collin Lines and postdoctoral fellow Oleg Kim set out to use math and light to develop a way to help doctors better date a bruise.
Pulling a thin spectrometer connected to a laptop by a long tube, Lines touches the end to an arm bruise he earned the day before while pulling around a golf bag.
Comparing the waves of light reflected off the bruise to unbruised skin nearby, the laptop screen creates a graph outlining the changing levels of hemoglobin and then of bilirubin over minutes, hours, days.
The setup is a little bulky now, Crawford says, but they're working on ways to build the technology into something handheld and affordable for doctors to carry around.
Duffy is eager for a refined, smaller device the researchers are about to deliver so that her team can continue to study the potential on real kids and real bruises.
A few years ago, Duffy's team of research assistants back at Hasbro began a pilot test on child and adult volunteers, mostly staff and their children.
Gerber then became interested in funding the project, emphasizing the possibilities for babies. But, Duffy says, babies aren't generally patient enough for even the 15 minutes of holding still to measure their bruises, and parents often don't recall when babies are bruised.
A new, larger study is about to begin there, Duffy says, using young patients who are there for some types of surgery to be bruised while there. Their stay allows them to be observed over a period of time, allowing staff to better measure a bruise, as well.
She says more money is needed for more scientific study.
Crawford is optimistic that once the field studies are finished, perhaps in a couple of years a company can begin making and distributing the devices. Maybe Notre Dame will step in and sponsor the project, and a startup can make the device in nearby Innovation Park.
"It's perfect for the Notre Dame mission," Crawford says. "It sort of exemplifies how we think of our research in the context of societal problems or humane problems."
Using math and physics in the same way might lead to research into how bruises are made, he says, or help determine with more certainty what happens with shaken baby cases, where sometimes bleeding in the retina results.
Duffy is more cautiously optimistic that the device could be a breakthrough.
Parents have been willing to enroll their children in the study, she says; it's non-invasive and not very painful.
Besides, "they have an opportunity to help us," Duffy says. "They might help prevent child abuse."
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Information from: South Bend Tribune, http://www.southbendtribune.com
