This year has started badly for C-S-X, a Jacksonville-based railway. It's trains have been involved in four accidents. Three are being investigated by the Federal Railroad Administration's main office. An 80-car freight train had come off the track, sending 12 cars filled with hazardous chemicals into front yards in this residential neighborhood in Bullitt County, Kentucky, about half an hour south of Louisville. That crash followed an accident in central Kentucky the day before in which four cars slipped onto the mainline, running for miles before hitting locomotives that the company had put out to stop them. That crash released some 30-thousand gallons of flammable butyl acetate. The fuel floating on the Kentucky River caught fire. On February Sixth there was a crash in West Virginia in which 18 cars, 10 of which were carrying hazardous chemicals, derailed in West Virginia. No chemicals spilled.

The one accident being investigated by C-S-X and not the Federal Railroad Administration is one of January Fourth. A C-S-X car carrying 28-thousand gallons of methanol caught fire in the rail yard in Selkirk, New York.

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Charles Stafford is a self-acknowledged peanut butter addict, a "serious" eater of the Peter Pan brand in particular, who grew up in a poor home where "if you didn't like peanut butter, you starved." But Stafford's lifelong love of the spread was tested recently when he became infected with salmonella during a nationwide outbreak linked to the Peter Pan and Great Value brands of peanut butter, he said. Stafford bought the contaminated Peter Pan in January, ate the peanut butter every day and soon became ill, experiencing nausea, vomiting and diarrhea, the lawsuit said. His physician diagnosed him with a likely case of salmonella poisoning, according to the suit. He missed several days of work. As of Wednesday, 329 people infected with the outbreak strain had been reported to the CDC. They reside in 41 states. No deaths have been attributed to the infection.

Stafford has since sued the products' manufacturer, Nebraska-based ConAgra Foods Inc., seeking class-action status on behalf of all Florida residents who bought jars from the contaminated batches. Stafford is seeking unspecified monetary damages, but he said it's not about the money. "What made me mad about it was the amount of time it took them to acknowledge what this was," said Stafford. "I felt that something more should have been done about it." Stafford's lawsuit, filed by the Broward County-based law firm Wites & Kapetan, claims that ConAgra failed to provide adequate notice of the recall to Florida consumers and failed to fully compensate affected residents for damage caused by the contaminated peanut butter. The company's conduct in selling the affected peanut butter was "reckless and wanton" with "such reckless disregard of human life or rights" that it was equivalent to an intentional act, the suit said.

The link to tainted peanut butter was revealed Feb. 14 when ConAgra and the Food and Drug Administration announced a product recall. On Feb. 15, Stafford learned of the contamination and stopped eating Peter Pan. His symptoms subsided, but he says he still doesn't feel normal. On February 23, the Centers for Disease Control and Prevention correlated the batches of peanut butter with confirmed cases of the salmonella strain. It was the first laboratory evidence confirming that the recalled peanut butter is the source of the salmonella, health officials said. Investigators have not determined how the product became contaminated. Health officials said four salmonella cases in Florida have been linked to the national outbreak. Stafford's case is not among them. He said he has not spoken with any health officials.

Posted by Kerry N. Jardine at 09:43 PM | Permalink | Comments (0) | TrackBacks (0)

The US Department of Veteran affairs has been a long recognized leader in treating brain injuries in the past, but recently the VA has been faced with a great deal of criticism. The Washington Post released a 2-part series revealing the poor conditions of Walter Reed, and Bob Woodrow released a book and a documentary criticizing the medical care received by Iraq and Afghanistan veterans. Amid this sea of criticism, the Department of Veteran Affairs announced that all Iraq and Afghanistan vets who seek medical care will now be screened for traumatic brain injuries (TBI's). The VA made the announcement yesterday and say the mandatory checks will begin this spring.

All 155 veteran medical centers in the US will participate, and all VA health care providers will be receiving mandatory training on how to diagnose brain injuries. The mandatory training is extremely important because signs of TBI are often overlooked and patients can go months before the symptoms worsen and they are finally diagnosed. In addition to mandatory training, the VA is creating a panel of outside experts. The VA hopes to use the panel to review their current practices in detecting and treating TBI's to better serve veterans of war.

The VA's announcement on Tuesday may not be a direct reaction to the criticism but it is a long-awaited response to the Iraq War's signature wound. TBI's have been coined the signature wound of the war as more and more explosives and roadside bombs are used. Secretary of Veterans Affairs R. James Nicholson said the VA is adapting to the changing times. VA is a nationally recognized leader in health care, and our system is dynamic. We are constantly striving to improve the care we provide to our veterans, Nicholson said.

Although the VA is taking this important step toward improving medical care for vets, many are still skeptical. Sen. Patty Murray, D-Wash., a Veterans Affairs Committee member, said, My real worry is that this administration continues to be slow to react to these problems and rarely, if ever, takes proactive measures to stop the many problems before they even begin. From sending our troops to war without the critical armor they need to protect themselves, to housing them in squalor at Walter Reed . . . to leaving them to fend for themselves when they need mental health care, this administration is utterly failing our service members, our veterans, and all of their families.

Posted by Kerry N. Jardine at 09:41 PM | Permalink | Comments (0) | TrackBacks (0)

The state Supreme Court is being asked to decide whether hundreds of doctors are immune from negligence suits in the care they provide at Virginia's three teaching hospitals. At issue is the largely abandoned, decades-old protection of charitable immunity, remnants of which are being used by tax-exempt foundations and the doctors they employ to plead immunity from malpractice suits. Lower courts across the state have issued opposite opinions on the defense. In a rare effort to settle the conflict before trial, lawyers representing physicians employed by the University of Virginia Health Services Foundation and lawyers for two former patients, one who died in the hospital and another who was permanently injured, have asked the state's highest court to intervene. The court is expected to decide whether to hear the case this spring.

The two cases before the high court have far-reaching implications for medical care and malpractice issues at the state's three teaching hospitals, where more than 1,100 physicians are employed by legally separate but service-related, tax-exempt organizations. The charitable-immunity defense has been used successfully by doctors at Eastern Virginia Medical School in Norfolk and with mixed results at the University of Virginia Health System. Doctors affiliated with the Virginia Commonwealth University Health System in Richmond have not used the defense. If the hospital-related foundations and doctors are determined to have charitable immunity under Virginia law, injured patients may be barred from bringing malpractice suits against the foundations and their individual doctors. Without immunity, doctors and state hospitals could have a harder time absorbing the rising costs of indigent care and the steeply rising costs of malpractice insurance.

In papers filed this week, plaintiff lawyers in two Charlottesville negligence cases claim that high salaries and bonuses paid to doctors and limited losses suffered from nonpaying patients destroy the notion that the U.Va. foundation operates as a charitable organization. "The public should be offended that well-paid physicians treating mainly paying and insured patients are claiming entitlement to charitable immunity because they make a nominal contribution to the poor," argue Matthew B. Murray and Gerald Walsh, lawyers for a Waynesboro family. Murray and Walsh represent 5-year-old Hunter Morris, who was permanently injured when physicians at the hospital failed to respond to his deteriorating condition before birth, according to the family's lawsuit. A second case before the court involves the death of an Albemarle County girl, Cara Leigh Searcy, 4, who died six years ago at the University of Virginia Health Center during a kidney operation. Both cases are in limbo, awaiting the Supreme Court decision on the immunity issue. A circuit court decision last year denied defense pleas of charitable immunity in both cases.

Posted by Scott J. Eldredge at 07:50 AM | Permalink | Comments (0) | TrackBacks (0)

Everyone has experienced boredom at least once every day of their lives. Whether it be while stuck in traffic on the way home or listening to a talkative neighbor yammer away about pulling weeds. This feeling of boredom usually passes quickly as your brain moves on to the next task at hand. Although most bouts of boredom are quick and fleeting, chronic boredom can be a sign of worse things to come.

An article published in Scientific American reveals that people that are easily and chronically bored are at a higher risk for psychological disorders such as depression, anxiety, substance abuse, eating disorders, compulsive gambling, bad grades, and low work performance. Boredom and its negative effects are now known but scientists have yet to discover exactly why boredom is linked to such destructive behaviors.

A study conducted by neuroscientist James Danckert of the University of Waterloo has uncovered clues to the underlying causes to boredom. Danckert studied patients who suffered from a traumatic brain injury (TBI). TBI patients were observed because brain injury victims often exhibit risky behaviors that are out of character after a brain injury event. Danckert's theory suggests that the massive amounts of endorphins and pain medications that are needed during the TBI recovery period raise an individual's threshold for psychological pleasure and reward. "Anything that used to give you pleasure now has to be ramped up in order to succeed," says Danckert.

In order to further support his theory Danckert plans to develop a tool that can measure levels of boredom.

Posted by Kerry N. Jardine at 09:38 PM | Permalink | Comments (0) | TrackBacks (0)

ConaAgra said the recall of tainted peanut butter made at a Georgia plant will cost between $50 and $60 million. Federal officials linked the peanut butter made in Sylvester to a salmonella outbreak. The salmonella has affected over 300 people nationwide including 14 reported in Georgia, since August. No deaths have been reported. Three people have already filed lawsuits claiming the peanut butter made them sick.

A Seattle attorney has filed a class-action lawsuit on behalf of people who reported getting sick after eating contaminated peanut butter. It's one of at least three lawsuits filed against ConAgra Foods, which is recalling all Peter Pan and Great Value peanut butter made at its Sylvester, Georgia, plant. The Seattle firm Marler Clark says it has been contacted by 2,500 people. Attorney William Marler says the lawsuit seeks compensation for people who got sick, but were not hospitalized. Marler says the more serious cases will be handled separately.

Posted by Kerry N. Jardine at 09:35 PM | Permalink | Comments (0) | TrackBacks (0)

In a verdict that may go down as the largest medical malpractice award in Lee County history, Lee Memorial Hospital on Friday was ordered to pay more than $30 million to a former Cape Coral couple whose son endured a lifelong crippling brain injury because of the hospital's negligence. The family had filed a lawsuit in 1999 in which it said the hospital ignored its own policies during Aaron Edwards' birth. Edwards is now 9 and can do little on his own said the family's attorney Jack Hill. Hill said a labor nurse ignored warning signs in Edwards' mother, Mitzi Roden, who was experiencing strong, long contractions that led to a decrease in the blood flow to Aaron's brain. He said the nurse also ignored the hospital's policies for births regarding protection of the patient while administering Pitocin, a medication that induces and speeds up labor. Per hospital policy, nurses are supposed to recognize three factors in which a patient should be taken off Pitocin and two were present in Mitzi Roden, Hill said.

"They should have turned the Pitocin off," he said. Hill says the hospital's defense was that the hospital's rules are mainly suggestions and that brain injuries are unforeseeable. "Brain injuries happen," he said. "In this case, it was clearly avoidable."

Lee Memorial attorney Doug Lumpkin said the circumstances leading to the brain injury were unexpected. In his statement, he said a "bradycardic event" required the emergency C-section that resulted in the physical injuries. "We continue to support our doctors, midwives and nurses, not only in this case but for the valuable service they provide daily to our community." Counsel for Lee Memorial said an appeal would be filed. "We believe that the verdict is contrary to the overwhelming evidence presented and that the care provided was appropriate and did not cause this unfortunate injury," said Lumpkin "We will pursue all post trial remedies available to us, including an appeal."

Since the judgment is against a corporation that is a special taxing district, it must be approved by the Legislature during the session that begins in March, according to a release from the plaintiff's attorneys. Fort Myers malpractice attorney Jeff Garvin said Lee Memorial's nonprofit status also could result in a cap on the malpractice award unless the Legislature passes a special act and the governor signs the matter into law.

Posted by Scott J. Eldredge at 07:46 AM | Permalink | Comments (0) | TrackBacks (0)

From chilling accounts of the roadside attack in Iraq that nearly took his life to a shocking investigation into the plight of military families dealing with injuries to their loved ones, Bob Woodruff returns to ABC News Tuesday night Feb. 27 with a hard-hitting look at the human cost of war.

Thirteen months after suffering a traumatic brain injury when a roadside bomb struck his Iraqi army transport vehicle in Taji, Iraq, the ABC News anchor is back reporting, with the hour long documentary "To Iraq and Back," airing Tuesday at 10 p.m. ET. Amid highly personal stories of tragedy and triumph, Woodruff delves into the crisis of care faced by so many injured soldiers and their families, uncovering important new information about veterans suffering from brain injuries and the care the U.S. government provides. Woodruff meets soldiers who, after fighting in Iraq and Afghanistan, must fight bureaucratic red tape before receiving the treatment they need, and others who may not even know they're injured, as traumatic brain injury can go unrecognized.

While everyone with symptoms of a brain injury may not need extensive treatment, Woodruff learns that the Department of Defense is not screening all returning soldiers, despite recommendations from the Defense Department's own Defense and Veteran's Brain Injury Center. Woodruff says that he and others at ABC News will continue to report on this story because "the human cost of war is sometimes overlooked," and injured veterans "need support that matches their sacrifice."

Posted by Kerry N. Jardine at 09:31 PM | Permalink | Comments (0) | TrackBacks (0)

Product testing by several states has now confirmed that Peter Pan peanut butter and certain Great Value brand peanut butter are the sources of the foodborne illness outbreak of Salmonella Tennessee that began in August 2006. To date 329 individuals have become ill from consuming the contaminated peanut butter, and 51 of those persons were hospitalized. The outbreak is ongoing. All products containing Peter Pan brand peanut butter and all jars of Great Value brand peanut butter bearing a product code that begins "2111" are potentially contaminated. Potentially contaminated products include 3/4 ounce and 1.1 ounce single serving packs of Peter Pan brand peanut butter. All of these products contain peanut butter that was manufactured in ConAgra's Sylvester, Georgia plant. Retailers and institutions possessing the products described should not serve or sell them. Any consumer possessing any of these products should discard them.

Symptoms of foodborne illness caused by salmonella include fever, diarrhea, and abdominal cramps. In persons with poor underlying health or weakened immune systems, salmonella can invade the bloodstream and cause life-threatening infections. Individuals who have recently eaten any products containing Peter Pan peanut butter or Great Value brand peanut butter from a jar bearing a product code beginning 2111 and who have experienced any of these symptoms should contact their doctor or health care provider immediately and report the illnesses to their state or local health authorities. Similarly, institutional food establishments and other food service providers who have received reports of illness from consumers after they consumed one of these products are encouraged to share that information with their local health department.

ConAgra has recalled these products from stores and ceased production in their Sylvester, Georgia processing plant until the exact cause of contamination can be identified and eliminated. FDA is continuing to work closely with the Centers for Disease Control and Prevention, and with states and local officials to identify how the contamination occurred in order to prevent similar foodborne illness outbreaks.

Posted by Kerry N. Jardine at 09:25 PM | Permalink | Comments (0) | TrackBacks (0)

A father who says he and his son became violently ill after eating tainted Peter Pan peanut butter filed suit in Miami on Wednesday against the manufacturers and Publix, which sold him the product. Lazaro Aleman, of Cutler Bay, Fla., said the jar of peanut butter he bought was part of a batch of Peter Pan and Great Value brand peanut butter made by Nebraska-based ConAgra Foods at a Sylvester, Ga. plant. Last week, ConAgra voluntarily recalled those jars, with product code 2111 on the lid, after federal officials linked the peanut butter to a salmonella outbreak that sickened almost 300 people. Salmonella is a bacterial infection that causes fever, diarrhea and abdominal cramps. The lawsuit filed in Miami-Dade Circuit Court is at least the fourth since the recall. Aleman's attorney, John H. Ruiz, said he will ask a judge to grant class action status to include people who bought and ate the peanut butter, whether they became sick or not. Ruiz said more than 100 people from around the state, including Broward and Palm Beach counties have contacted him and might become part of the suit.

"I would not wish this situation on my worst enemy," Aleman said. "My son suffered a great deal." Aleman, 32, said his son, Matthew, 5, became sick in late January with vomiting, bloody diarrhea and hives. According to Aleman, one doctor said his son's illness was not serious, but a second doctor believed the boy was suffering from a serious allergic reaction and asked Aleman to refrain from giving Matthew peanuts until doctors could determine if that was true. "It saved his life, in essence, because it kept me away from giving him any kind of peanuts," Aleman said. Matthew improved, but Aleman said he ate a large spoonful of the peanut butter late last week and became sick the next day with some symptoms similar to his son's. Aleman later discovered the peanut butter in his house had been recalled, he said. Doctors have not yet diagnosed Aleman or his son with salmonella poisoning.

Ruiz said U.S. Food and Drug Administration and private experts will analyze the contents of the jar of peanut butter in the Aleman home and a doctor will examine Aleman Thursday. ConAgra spokeswoman Stephanie Childs said Wednesday the company had not seen the lawsuit and could not comment on it. "However, the potential that anyone could have been made ill by our product is very concerning to us and that's why we continue to work closely with the FDA on its investigation of this matter," she said. A Publix spokeswoman said the company was unaware of the lawsuit.

Posted by Kerry N. Jardine at 09:21 PM | Permalink | Comments (0) | TrackBacks (0)

How are the cognitive and communication problems assessed?

The assessment of cognitive and communication problems is a continual, ongoing process that involves a number of professionals. Immediately following the injury, a neurologist or another physician may conduct an informal, bedside evaluation of attention, memory, and the ability to understand and speak. Once the person's physical condition has stabilized, a speech-language pathologist may evaluate cognitive and communication skills. A neuropsychologist may evaluate other cognitive and behavioral abilities. Occupational therapists also assess cognitive skills related to the individual's ability to perform "activities of daily living" (ADL) such as dressing or preparing meals. An audiologist should assess hearing. All assessments continue at frequent intervals during the rehabilitative process so that progress can be documented and treatment plans updated. The rehabilitative process may last for several months to a year.

What research is being done for the cognitive and communication problems caused by traumatic brain injury?

Researchers are studying many issues related to the special cognitive and communication problems experienced by individuals who have traumatic brain injuries. Scientists are designing new evaluation tools to assess the special problems that children who have suffered traumatic brain injuries encounter. Because the brain of a child is vastly different from the brain of an adult, scientists are also examining the effects of various treatment methods that have been developed specifically for children. These new strategies include the use of computer programs. In addition, research is examining the effects of some medications on the recovery of speech, language, and cognitive abilities following traumatic brain injury.

Posted by Kerry N. Jardine at 09:17 PM | Permalink | Comments (0) | TrackBacks (0)

The sleep aid Ambien has been blamed for numerous instances of unconscious, zombie-like behavior, including a congressman's car crash on Capitol Hill. Rep. Patrick Kennedy, D-Rhode Island, said he took Ambien and an anti-nausea drug before swerving his Ford Mustang convertible into a barrier in May. Kennedy, who later underwent treatment for addiction, said he did not remember "getting out of bed, being pulled over by the police or being cited for three driving infractions." In recent years, news reports have recounted incidents in which Ambien users walked, cooked, ate and drove in their sleep, and a class-action lawsuit filed last year alleged the drug was responsible for a Texas woman's arrest after she drove into two vehicles and left the scene. Wisconsin police said Ambien was found in 187 drivers arrested between 1999 and 2004, and it was linked to 99 traffic accidents reported to the Food and Drug Administration between 1998 and 2005, according to a university professor's analysis. A June 2005 article in the medical journal Sleep reported that an Ambien user ate almost an entire tub of margarine in her sleep. Two other Ambien users started small fires while cooking in their sleep, the article said.

Ambien, the commercial name for zolpidem tartrate, belongs to a class of drugs called "sedative/hypnotics." It is a fast-acting medicine used mainly for short-term treatment for people who have trouble falling asleep, staying asleep or waking too early. The drug was first marketed in 1993, but sales soared in recent years after advertising that included a commercial saying it "works like a dream." The U.S. Air Force dispenses Ambien as "no go" pills to help pilots sleep before or after missions, according to published reports. The drug's manufacturer, French pharmaceutical company Sanofi-Aventis, says Ambien is safe when used according to directions, which include taking it only before a full night's sleep and a prohibition on drinking alcohol. The most common side effects include drowsiness, dizziness and light-headedness, but Ambien's product information also warns of uncommon side effects that include agitation, hallucinations, worsening of depression and suicidal thoughts. "How often these effects occur depends on several factors, such as a person's general health, the use of other medicines, and which sleep medicines are being used," the information warns.

Posted by Peter W. Burg at 07:53 AM | Permalink | Comments (0) | TrackBacks (0)

The makers of drugs such as Ritalin, Adderall, Strattera, and other drugs for attention-deficit hyperactivity disorder (ADHD) were advised by the government Wednesday to give patients and their parents additional warnings that those medications could cause serious psychiatric and heart problems, as well as sudden death. Patients would receive a two-page "Medication Guide" every time their prescriptions were filled. The guide would warn about potential side effects such as chest pain, shortness of breath, fainting, or hallucinations, and would urge patients to contact their doctors if they have these or any other symptoms of heart or psychiatric problems.

Dr. Thomas Laughren of the FDA says that the new warnings are "precautionary" and should not frighten patients away from taking the drugs. Still, more than 2,500 children who took ADHD drugs went to emergency rooms in 2004, and about one-fourth of them had heart or blood pressure problems. According to FDA reports, twenty-five deaths were linked to the drugs, 19 of which involved children. Fifty-four strokes, heart attacks and other heart issues were also reported; some of those patients had previous heart problems.

Dr. Richard Gorman, a pediatrician who served on an FDA advisory panel, said that parents must pay close attention to their children's reactions to the drugs, because children might take them for years.

Posted by Seth A. Katz at 10:22 PM | Permalink | Comments (0) | TrackBacks (0)

Steroid medications commonly used to reduce inflammation caused by traumatic head injuries may actually boost the risk of death a new report suggests. British researchers evaluated the results of more than 10,000 patients with brain injury. They found that those treated with corticosteroids after traumatic head injury were more likely to die from the injury than those who did not take the drugs. Corticosteroids are hormones used to treat inflammation, whether it results from asthma or joint injury or other conditions.

Among those who received steroid treatment, 21 percent or 1,052 of the 4,985 patients treated died, the authors reported, compared to 18 percent who received a placebo. "There is a 3 percent absolute increase in the risk of death such that 21 percent of patients die with steroids and 18 percent die without," said lead researcher Dr. Ian Roberts, a professor of epidemiology at the London School of Hygiene & Tropical Medicine. Roberts and his colleagues looked at 17 studies on steroid use. They noted that corticosteroid use is widespread after serious brain injury. The report appears in the current issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research. Roberts said the study would inevitably change the way physicians think about and treat head injury.

While it's not certain why corticosteroids may boost death risk, some experts have suggested the drugs may somehow interfere with the function of the adrenal glands. They are located on top of the kidneys and produce hormones such as cortisone, cortisol and adrenalin. Dr. Wally Ghurabi, medical director of the emergency center at Santa Monica-UCLA Medical Center, called the new study "an eye-opener." At his institution, he said, "we use very little" corticosteroids for head injury patients. And, he noted, when they are used, the corticosteroids are given in small doses, a fraction of what was used in some of the studies reviewed. "I question the use of mega-doses," Ghurabi said.

Posted by Kerry N. Jardine at 10:19 PM | Permalink | Comments (0) | TrackBacks (0)

How are the cognitive and communication problems treated?

The cognitive and communication problems of traumatic brain injury are best treated early, often beginning while the individual is still in the hospital. This early therapy will frequently center on increasing skills of alertness and attention. They will focus on improving orientation to person, place, time, and situation, and stimulating speech understanding. The therapist will provide oral-motor exercises in cases where the individual has speech and swallowing problems.

Longer term rehabilitation may be performed individually, in groups, or both, depending upon the needs of the individual. This therapy often occurs in a rehabilitation facility designed specifically for the treatment of individuals with traumatic brain injury. This type of setting allows for intensive therapy by speech-language pathologists, physical therapists, occupational therapists and neuro-psychologists at a time when the individual can best benefit from such intensive therapy. Other individuals may receive therapy at home by visiting therapists or on an outpatient basis at a hospital, medical center, or rehabilitation facility.

The goal of rehabilitation is to help the individual progress to the most independent level of functioning possible. For some, ability to express needs verbally in simple terms may be a goal. For others, the goal may be to express needs by pointing to pictures. For still others, the goal of therapy may be to improve the ability to define words or describe consequences of actions or events. Therapy will focus on regaining lost skills as well as learning ways to compensate for abilities that have been permanently changed because of the brain injury. Most individuals respond best to programs tailored to their backgrounds and interests. The most effective therapy programs involve family members who can best provide this information. Computer-assisted programs have been successful with some individuals.

Posted by Kerry N. Jardine at 10:16 PM | Permalink | Comments (0) | TrackBacks (0)

US Health officials have confirmed the presence of salmonella bacteria in jars of peanut butter that were involved in a nationwide recall last week. The Centers for Disease Control and Prevention reported that the count of those sickened has risen to 329 in 41 states. The CDC reported that 51 of the 249 patients for whom clinical information is available have been hospitalized and that there have been no deaths. The FDA is warning consumers not to eat any Peter Pan peanut butter or Wal-Mart house brand Great Value peanut butter with a product code beginning with 2111 purchased since May 2006. Symptoms of salmonella poisoning include fever, diarrhea and abdominal cramps.

Posted by Kerry N. Jardine at 10:15 PM | Permalink | Comments (0) | TrackBacks (0)

The first class-action lawsuit against peanut butter maker ConAgra was filed by Orlando-based lawyers February 22, after floods of people reported getting sick from the tainted products and two deaths may be linked to eating the food. Lawyers with Morgan and Morgan out of Orlando filed the 12-page document in response to a flood of phone calls from peanut butter eaters. It could be legal relief for what could be at least 1,000 people in Florida who may have at one point since last summer fallen sick from Peter Pan or Great Value peanut butter. Attorneys said they are looking at two deaths possible linked to the peanut butter. "In one particular case, we have a client who ingested the peanut butter and then died as a result of a certain form of meningitis, a meningitis that can be linked to salmonella poisoning," Morgan and Morgan attorney Alexander Clem said.

One lawsuit was filed in Florida, and another was filed in Seattle-based federal court. Both suits claim thousands of victims who want their medical bills paid for and the company that may have made them sick held responsible. A week-old recall triggered customers' nerves after the Food and Drug Administration announced certain jars of peanut butter may have salmonella, a stomach disease that hits people hard who have weak immune systems.

"They are suffering from bouts of nausea, diarrhea and incredible gastrointestinal sicknesses that last for many, many weeks," Clem said. "When did ConAgra know there was a problem?" Clem said. "How did it happen? Why didn't they tell the consuming public earlier?"

Posted by Kerry N. Jardine at 10:13 PM | Permalink | Comments (0) | TrackBacks (0)

The National Transportation Safety Board today determined that the cause of a fatal bus fire in Texas was insufficient lubrication in the right-side tag axle wheel bearing assembly of the motorcoach resulting in increased temperatures and subsequent failed wheel bearings, which led to ignition of the tire and a catastrophic fire. Global Limo, Inc. failed to conduct proper vehicle maintenance, do pre-trip inspections, and complete post-trip driver vehicle inspection reports, thereby allowing the insufficient wheel bearing lubrication to go undetected. The Board's report revealed that Global did not retain vehicle maintenance and repair records as required by Federal Motor Carrier Safety Regulations (FMCSRs). In addition, there was no maintenance program to properly service the vehicle in place. Therefore the NTSB concluded in the report that the disregard for such a program led to the failure to detect vehicle defects that resulted in a catastrophic fire and loss of life. "We will not cease our efforts to push for change to prevent these kinds of accidents from occurring," said NTSB Chairman Mark V. Rosenker. "However, unless there is adequate oversight, I am afraid we will continue to see motorcoach accidents that contribute to the unacceptable number of deaths on our nation's highway."

On September 23, 2005, the 54- passenger motorcoach, operated by Global Limo Inc., of Pharr, Texas, was en route from Bellaire to Dallas, Texas, as part of the evacuation in anticipation of Hurricane Rita. The motorcoach was carrying 44 assisted living facility residents and nursing staff. A motorist passing by the motorcoach alerted the driver that the right-rear tire hub was glowing red. The driver and nursing staff exited the motorcoach and observed flames emanating from the right-rear wheel well. As they initiated an evacuation, with the assistance from passersby, heavy smoke and fire quickly engulfed the entire vehicle. Twenty-three of the 44 passengers were fatally injured, 2 were seriously injured and 19 received minor injuries. The driver also received minor injuries. Another contributing factor to the rapid propagation and severity of the fire and subsequent loss of life was the lack of motorcoach fire retardant construction materials adjacent to the wheel well. The report states that the most likely point of initial entry of fire into the motorcoach was burn through of the combustible exterior composite materials and through the HVAC ventilation and the windows. The Safety Board concluded that as the fire intensified, it spread up the side of the motorcoach and burnt through the fiberglass sidewall above the wheel wall and through the motorcoach windows, creating an entry path for the smoke and fire into the passenger compartment.

Posted by Kerry N. Jardine at 09:04 PM | Permalink | Comments (0) | TrackBacks (0)

Every year, about 1.5 million Americans will suffer a traumatic brain injury. "There is no magic pill or treatment for traumatic brain injury in terms of salvaging brain tissue. There is no way that we know of now to keep brain tissue alive," Dr Bruce Speiss from Virginia Commonwealth University in Richmond, Virginia said. Oxygen is a vital nutrient the brain can't survive without. When a brain is injured, swelling keeps the red blood cells from carrying enough oxygen to the brain. Spiess is studying a new way to deliver oxygen to vital organs called Oxycyte.

"Some of the biochemical markers, they were tending to look like severe damage to the brain within an hour to two hours after getting the Oxycyte, they came down almost completely to normal," Spiess said. In severe brain injuries, one out of every three people will die. In Spiess' study, only two out of the nine patients died. The seven survivors all walked out of the hospital, and Spiess said they appear to be neurologically intact.

"We think Oxycyte could be a major breakthrough. The sooner you get the Oxycyte into the patient, the more brain tissue will survive," Spiess said. Brain injuries aren't the only injuries that could benefit from Oxycyte. Early research by Spiess' team also shows the compound can preserve spinal cord function. "If you have a spinal cord injury, the same situation goes on, that is, how much oxygen you get to those neurons in the immediate few hours after they have been injured as to how many neurons you can salvage," Spiess said. Oxycyte could also preserve brain tissue after a stroke, and get needed oxygen to the heart during a heart attack

Posted by Kerry N. Jardine at 09:02 PM | Permalink | Comments (0) | TrackBacks (0)

TBI: Cognitive and Communication Disorders

What are the cognitive and communication problems that result from traumatic brain injury?

Cognitive and communication problems that result from traumatic brain injury vary from person to person. These problems depend on many factors which include an individual's personality, pre-injury abilities, and the severity of the brain damage. The effects of the brain damage are generally greatest immediately following the injury. The newly injured brain often suffers temporary damage from swelling and a form of "bruising" called contusions. These types of damage are usually not permanent and the functions of those areas of the brain return once the swelling or bruising goes away. Therefore, it is difficult to predict accurately the extent of long-term problems in the first weeks following traumatic brain injury. Focal damage, however, may result in long-term, permanent difficulties. Improvements can occur as other areas of the brain learn to take over the function of the damaged areas. Children's brains are much more capable of this flexibility than are the brains of adults. For this reason, children who suffer brain trauma might progress better than adults with similar damage.

In moderate to severe injuries, the swelling may cause pressure on a lower part of the brain called the brainstem, which controls consciousness or wakefulness. Many individuals who suffer these types of injuries are in an unconscious state called a coma. A person in a coma may be completely unresponsive to any type of stimulation such as loud noises, pain, or smells. Others may move, make noise, or respond to pain but be unaware of their surroundings. These people are unable to communicate. In conscious individuals, cognitive impairments often include having problems concentrating for varying periods of time, having trouble organizing thoughts, and becoming easily confused or forgetful. Some individuals will experience difficulty learning new information. Still others will be unable to interpret the actions of others and therefore have great problems in social situations. For these individuals, what they say or what they do is often inappropriate for the situation. Many will experience difficulty solving problems, making decisions, and planning. Judgment is often affected.

Language problems also vary. Problems often include word-finding difficulty, poor sentence formation, and lengthy and often faulty descriptions or explanations. These are to cover for a lack of understanding or inability to think of a word. Many have difficulty understanding multiple meanings in jokes, sarcasm, and adages or figurative expressions. Individuals with traumatic brain injuries are often unaware of their errors and can become frustrated or angry and place the blame for communication difficulties on the person to whom they are speaking. Reading and writing abilities are often worse than those for speaking and understanding spoken words. Simple and complex mathematical abilities are often affected. The speech produced by a person who has traumatic brain injury may be slow, slurred, and difficult or impossible to understand if the areas of the brain that control the muscles of the speech mechanism are damaged. This type of speech problem is called dysarthria. These individuals may also experience problems swallowing. This is called dysphagia. Others may have what is called apraxia of speech, a condition in which strength and coordination of the speech muscles are unimpaired but the individual experiences difficulty saying words correctly in a consistent way. For example, someone may repeatedly stumble on the word "tomorrow" when asked to repeat it, but then be able to say it in a statement such as, "I'll try to say it again tomorrow.

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An estimated 55,000 people die each year from brain injuries. A hormone could help those with head injuries not lose functionality. Progesterone is a natural hormone made in the brain. About 17 years ago, Donald Stein discovered the neuro-protective properties of progesterone. His research revealed male and female rats with brain injury had less swelling and more complete recoveries when they received progesterone after their injury.

It's incredible that Robert Smith can even walk. "I was partially ejected out the back window," Robert says. He was in a coma for two months after a car crash. "They didn't think I was really going to make it," he says. Robert is a computer network engineer. After having the hormone injection, he still has some lingering physical issues, but says he's as sharp as ever. "I believe with this medicine, a lot of prayers and this medicine progesterone, it helped regenerate those cells and brought me back to where I need to be," says Robert. Another benefit of this potential breakthrough, the hormone is inexpensive and safe. Progesterone for brain injury has been studied in animals for nearly 20 years, but this is the first study in humans. Doctors say they don't know yet how it works, but it somehow protects and rebuilds the brain.

In 2004, researchers at Emory University in Atlanta launched a study of 100 patients to look at the effects of progesterone in humans. "Our findings, first and foremost, were that it appeared to be safe in the small number of patients we studied. We didn't find any increase in significant adverse events or adverse events between the group that didn't get progesterone and the group that did," Dr. David Wright said. They also found the mortality rate in the severe head injury group dropped 50 percent, and the moderate group had fewer functional disabilities. Wright says there were relatively few side effects, and the cost of the medicine is low. He hopes the larger study will be launched nationally in 2007, involving more than 1,000 patients.

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Virginians could soon have a new tool to help them choose their doctors. Both the Virginia House and Senate have passed versions of a bill to require the state Board of Medicine to post information online about medical malpractice suits and disciplinary action against doctors. Before going under the knife or just in for a routine checkup, patients might like to know if their doctor has a propensity for mishaps. Patients understandably might wish to stay away from them. The bill making its way toward law would ensure patients have access to that critical information. A Web resource would list medical malpractice judgments and settlements within the last 10 years, as well as disciplinary actions. No one likes to have his mistakes aired publicly, especially when it could affect business. Doctors' discomfort, however, is small reason to leave patients in the dark when choosing to whom they will entrust their health.

Doctors work hard to preserve health, but accidents happen. Sometimes they are due to negligence, sometimes they are just unforeseeable complications. Many in the medical establishment encourage patients to make decisions about their health care needs all the time. Patients weigh in on what drugs or treatments they wish to receive despite not being doctors themselves. The ideal situation has all the facts on the table and a dialogue between doctor and patient leading to an informed decision.

One argument against providing such information is that patients do not have the medical training to judge the outcomes of alleged bad doctoring. It's a legitimate concern, but more data is almost always better than less. Patients who see a decision against their doctor can discuss it with him to clarify the situation. The medical board could go one step beyond the law, too. When malpractice information appears online, the board could also provide explanatory notes about the decision and how a particular doctor's rate of complaints compares to others in his specialty. Some specialties are more prone to litigation than others.

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Traumatic brain injuries (TBI's) are among the most common injuries admitted to emergency rooms in the US. Nationally, 1.2 brain injuries occur each year and more than 50,000 TBI sufferers die each year. The large number of TBI's coming into ER's is frustrating for doctors because there are currently few treatments available. Currently the only options available are simple protection and long recoveries. There have been hundreds of studies conducted over the years to find a simple treatment, but a successful solution has yet to be found.

A new solution may be on the way for TBI victims thanks to a hormone commonly found in birth control pills - progesterone. Nearly 20 years ago, Dr. Donald Stein conducted a study that investigated the effect of progesterone in the brains of rats. Male and female rats with TBI's were injected with progesterone immediately following their brain injury. Results of Stein's study revealed that the rats experienced less brain swelling and had better recoveries when progesterone was administered. Although results of progesterone have been found to be promising in rats, no conclusive studies of progesterone in humans with TBI's has been conducted.

Researchers at Emory University launched a study to see the effects of progesterone in humans. One-hundred TBI victims were injected with progesterone. The study found that progesterone can be safely injected into humans and the mortality rate dropped by 50%. Although the results were promising, Emory University researchers hope to launch a larger study later this year to solidify their findings.

Progesterone is a hormone produced in the brain but scientists are still unsure how the hormone works to protect and heal the brain. Researchers hope that further studies will lead to advancements in progesterone use in TBI victims. The hormone has very few side effects and is low in cost.

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The halls of the Mologne House at Walter Reed are filled with amputees moving in their wheelchairs, wounded soldiers with lacerations and bruises so bad that their faces are unrecognizable, and confused brain injury victims who wander the halls because they can't remember where they are. The Mologne House was built in 1997 on the grounds of the Walter Reed Veteran Medical Center in Washington D.C. It was originally built as a short-term facility for military families to stay at as military officials were treated for minor ailments. Since 9/11, the facility now houses over 300 wounded soldiers, marines, and their family members.

Staff from the Washington Post recently spent hundreds of hours at the Mologne House to interview wounded soldiers and observe life after war. The Mologne House has all of the amenities of a 4-star hotel with front-desk clerks and concierges, room service, daily maid service, and a full-service bar. Behind the glitz and glamour is a village of desperate, wounded soldiers. One soldier with an amputated arm went up to the bar and said he wanted 1 drink but he would have ordered 2 if he still had his other arm.

The majority of the soldiers at Walter Reed are victims of bomb blasts and over 60% suffer from a TBI. Some TBI victims have been at the Mologne House for over 18 months as doctors appointments and treatments are pushed back and dragged out. These setbacks can result in a harder road to recovery as their TBI's continually damage their cognitive abilities. Some TBI victims must also battle the military for benefits. One wife of a TBI victim just found out that her husband is not eligible for anymore military medical benefits. Doctors concluded that her husband's brain injury condition was not due to injuries sustained in war, but rather they are due to a pre-existing brain condition. "They said, 'Well, he was in Title I math,' like he was retarded," the wife said. "Well, y'all took him, didn't you?"

All of the residents of the Mologne House are there for different reasons but daily life begins and ends the same way everyday. Residents are awoken by the cries of war protesters holding signs and doctors wait at the entrance for buses full of newly wounded soldiers. At the end of the day Walter Reed closes its gates and waits for another day to begin.

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Women who use a transdermal contraceptive system are more than twice as likely to develop venous thromboembolism as those who use an oral contraceptive, new research shows. Three patch users and seven pill users experienced a myocardial infarction, a difference that wasn't statistically significant. No patch users experienced a stroke, but 10 pill users did, the investigators report. Due to the rarity of events, the researchers were unable to determine if use of the contraceptive patch increases the risk of MI and stroke, according to the report in the February issue of Obstetrics and Gynecology.

The study involved 49,048 women who used the norelgestromin/ethinyl estradiol patch (Ortho Evra) and 202,344 who used norgestimate-containing oral contraceptives with ethinyl estradiol between April 2002 and December 2004. The researchers found that the venous thromboembolism rate in patch users was 2.2-times higher than in pill users: 40.8 vs. 18.3 cases per 100,000 woman-years. In a nested case-control analysis, which excluded high-risk factors, the risk was elevated 2.4-fold.

Dr. Alexander M. Walker and colleagues, from i3 Drug Safety in Auburndale, Massachusetts, note that at the study's inception, it was not known if users of the transdermal system ran the same risk of stroke, MI and venous thromboembolism as users of oral contraceptives. They do point out that the FDA changed the labeling in 2005 to warn of a possible increased risk of thrombotic events because of a higher average circulating estrogen level with the transdermal contraceptive system.

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Life changed drastically for a Lubbock teen this past summer. On June 18th, 19 year old Mark Stargel was critically injured in a weekend boating accident at Buffalo Springs Lake. Authorities say 56-year-old James Greg Renegar lost control of his boat and hit Mark who was riding on a jet ski. Mark lost his left leg and broke his right one. Renegar received minor injuries. Mark's outlook on life changed drastically. "I was screaming oh God ya know. But I mean after I let all my shock out on the boat, I just calmed down. I saw my dad. I could hear my mom screaming in the background and something compelled me to tell them that I was going to be okay," says Mark. Mark says it's a moment in time he will never forget.

The road to recovery proved to be a tough one. Mark went through three operations and spent 21 days in the hospital. Doubt of the promise to his parents that he was going to be okay was starting to weigh on his mind. "There was one night I laid in the hospital and I cried for about 20 to 25 minutes," says Mark. Mark's family knew he needed hope and that message came from Matthew Brown who understood Mark's suffering. "I felt something, that I needed to go and be there for him and support him and mentor him," says Brown. Brown, a fellow amputee, lost his leg on the job after a pipe line exploded. His story allowed Mark to see that life would go on and his visit inspired Mark and his family to develop a plan.

"We thought we need to help other people. They need somebody to share with them and just be there when they need them and talk to them and listen to them," says Bobby and Nancy Stargel, Mark's parent. After months of planning, The Lubbock Area Amputee Support Group held its first meeting in December. Once a month fellow amputees gather to share their struggles, successes and their dreams for the future. "We need peers. We need people who've gone through the same thing we have because in a sense you are in a different world but you're not, so it's nice to see these people who've struggled right along beside you," says Mark. While the fellowship is a plus, the main goal the group shares is to receive Peer Visiting and Certification so they can provide encouragement to others in their loneliest hour. "That would be my main thing - to be able to let somebody know you can get to this point and you don't have to talk in past tense about your life. You know you're still living and no matter how much you struggle eventually you'll be able to look back on what you accomplished," says Mark. Now eight months after his accident it's a change in "tune" that Mark's parents say make him a young man who's wise beyond his years.

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Army Maj. Gen. George W. Weightman, commander of Walter Reed Army Medical Center has acknowledged that the staff responsible for tracking patients after they receive treatment was overwhelmed by the number of wounded when violence spiked in Iraq two years ago. The undermanned staff may have led to wounded veterans falling through the bureaucratic and medical cracks. He said the number of outpatient soldiers reached a high of 872 in summer 2005, up from about 100 before the war, leaving the military and medical staff responsible for monitoring their well-being unable to keep on top of critical cases. "We found that the platoon sergeants that we had for accountability and the case managers that we had, they were literally managing 125 patients each," Weightman said. "That's too many to do [oversight] effectively." Weightman insisted he has also ordered his staff to focus on "high-risk" cases, such as veterans with post-traumatic stress disorder or traumatic brain injuries, to insure they are more closely monitored once they become outpatients.

Less well-known is the care soldiers receive as outpatients, which has stretched to an average of 10 months. Two months longer than Army guidelines call for. A period Weightman said can be even more frustrating. "When you're an inpatient, you're literally a captive in our organization," Weightman said. "When you're an outpatient, there's a lot more options that you have as a patient as far as where you can go and who accounts for you." Weightman's acknowledgment came ahead of a Washington Post investigation to be published that details multiple cases of soldiers who accused Walter Reed of neglecting them and forcing them to live in substandard wards on the medical center's campus once they became outpatients.

Weightman, who took command of Walter Reed in July, said he has quadrupled the number of staff responsible for serving as liaisons between outpatients and the review boards charged with deciding whether to discharge outpatients or return them to active duty. He also said he is increasing the number of military officers and case workers handling individual outpatients so that every caregiver will only have to handle 30 to 35 veterans. According to the Post, even with the changes many of the substandard living conditions and bureaucratic problems still exist. Paul Rieckhoff, an Iraq war veteran who heads Iraq and Afghanistan Veterans of America, said his friend who had suffered "catastrophic injuries" in Iraq was forced to "carry his paperwork through the snow" when he became an outpatient. "They didn't plan properly for the war," Rieckhoff said. "If it even happens to one veteran, then it's shameful. None of these guys should ever fall through the cracks."

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