The National Survey on Doctor-Industry Relationships reports the last two decades has seen a flurry of writing and research about the relationship between doctors and pharmaceutical, medical device, and other medically related industries. The authors of this survey mention a review of 16 studies published between 1982 and 1997 that suggests doctors and industry reps, on average, met four times a month, and accepted six gifts a year from them. Dr Eric Campbell at the Institute for Health Policy, Boston, and colleagues, used information about the doctors' financial links with industry and then tried to predict the factors that influence them. They surveyed 3,167 doctors from six specialties: anesthesiology, cardiology, family practice, general surgery, internal medicine, and pediatrics. The response rate was over 50 per cent. The study authors review the results of a survey of US doctors that was conducted by the Institute on Medicine as a Profession (IMAP) and address three questions:

(1) What do doctors actually receive (including financial incentives) from industry reps and their companies?
(2) How often do they meet with industry reps?
(3) What characterizes the relationship between doctors and these industries?

The results showed that:

-- 94 per cent of doctors reported some type of relationship with the pharmaceutical industry.
-- 83 per cent said these relationships involved receiving food in the workplace.
-- 78 per cent said they involved receiving drug samples.
-- 35 per cent received reimbursement for costs of going to professional meetings or continuing medical education (CME).
-- 28 per cent received payments for consulting, giving lectures, or enrolling patients in trials.
-- Cardiologists were more than twice as likely to receive payments as family doctors.
-- Family doctors met with industry reps more often than did doctors in other specialisms.
-- Doctors who practised on their own or in group practices met with reps more often than those working in hospitals and clinics.

In conclusion, the researchers said these results show that: "Relationships between physicians and industry are common and underscore the variation among such relationships according to specialty, practice type, and professional activities."

Posted by Scott J. Eldredge at 11:52 AM | Permalink | Comments (0) | TrackBacks (0)

A woman who says she suffered life-threatening blood clots from a birth control medication wants the Ohio Supreme Court to declare the state's cap on pain-and-suffering awards unconstitutional. The court planned to hear arguments in the lawsuit filed by Melisa Arbino of Cincinnati over the Ortho Evra Birth Control Patch, which she contends caused permanent physical damage and threatens her ability to have children in the future. The challenge to a 2005 law limiting pain-and-suffering awards is the first to reach the court. It is being closely watched by companies who support the concept of caps and attorneys representing injured people. The GOP-controlled Legislature approved the caps two years ago, limiting pain-and-suffering awards at between $350,000 and $500,000 for less severe injuries. The bill also put limits on jury awards meant to punish companies for wrongdoing in faulty product cases. Businesses long said they needed such a bill in part because of rising insurance rates as a result of high jury verdicts. Attorneys for Arbino contest that argument, saying insurance companies have raised their rates because of investment losses, not expensive jury verdicts. "Is it constitutional to deprive someone of their right to a trial by jury simply to promote the private economy?" said Janet Abaray, a Cincinnati attorney representing Arbino. Johnson & Johnson, makers of the patch, countered that companies need the predictability that caps bring to doing business in Ohio.

Arbino, 26, said she first used the patch shortly after her son was born in 2005. Within days she suffered from severe headaches and was throwing up and was hospitalized with a blood clot on her brain. She was discharged, only to return two weeks later with blood clots in her lungs. She must still be treated by a doctor. She still has a blood clot lodged in her brain and would have to go on blood thinners if she ever became pregnant again.

Posted by Seth A. Katz at 11:47 AM | Permalink | Comments (0) | TrackBacks (0)

In October of 1996 an accident changed Sandra Shampang's life. She was driving to work when she was struck by a large truck 100 feet from her employer's driveway. She hit her head on the headliner while she was wearing an automatic shoulder seat belt and a lap belt. After being transferred to the hospital she was examined by a physician's assistant and was sent home. The physician's assistant said, "Take the rest of the week off and we'll see you on Monday." Shampang didn't go back to the hospital and her symptoms worsened. She couldn't get out of bed and she wasn't able to walk well. After four weeks of Tylenol for headaches and sleeping all the time, she was in a fog. Her then-husband insisted she see a neurologist, so she made an appointment. "He immediately put me on medication and got me into physical therapy. His diagnosis was post-concussive syndrome or traumatic brain injury." The injury was caused on impact during the accident. Shampang spent six years in recovery. "I had a long working history. I was very frustrated. I had been a business owner and business manager. I couldn't remember anything." Her organic brain damage resulted in a seizure disorder, anxiety and panic disorder and obsessive-compulsive disorder. She improved after her doctor prescribed the right meds. Six months afterward, she was able to drive. She hadn't driven in six years because she couldn't concentrate.

The Center for Independence invited Shampang to a meeting. The agency had two job openings. She applied for the position of outreach peer counselor and got it. "I so wanted to give back for what the agency had done for me." Since November 2001, she has worked for the agency from her home. A normal working environment is too loud, too distracting and has too much input for her. Her work includes benefits advisement, providing advice and education to people with disabilities who are considering pursuing paid employment. "There are individuals wanting to transition back into the community. We're giving them the information they need to do that."

Posted by Kerry N. Jardine at 11:43 AM | Permalink | Comments (0) | TrackBacks (0)

Researchers at the University of Rochester Medical Center have made an alarming discovery that may affect millions of Americans who suffer from migraine headaches. Approximately 26 million Americans suffer from migraines and researchers have studied the severe headaches for years in search of better treatment options.

In search of the cause of migraine headaches and treatment options, the Rochester researchers found that migraines cause symptoms that are commonly associated with strokes and traumatic brain injuries (TBI's). They found that migraines leave certain areas of the brain depleted of oxygen - a common characteristic of transient strokes. As the brain is deplete of oxygen, signs of brain damage can be seen.

"Normally, the focus of migraine treatment is to reduce the pain. We're saying that migraines may be causing brain damage, and that the focus should be on prevention, which will stop not only the pain but also minimize potential damage," said Maiken Nedergaard, M.D., Ph.D., the neuroscientist who led the research team.

The research team used imaging technology to study the events that occur in a mouse's brain during a migraine episode. They found that the brain develops an unusually high demand for energy as it tries to restore the chemical imbalance that is lost during the onset of a migraine. During this time, the brain's arteries expand and make more oxygen rich blood available to the brain, but some parts still do not receive sufficient amounts of oxygen. The lack of oxygen leads to hypoxia (extreme oxygen shortage) which leads to brain cell deterioration similar to what is found in strokes and TBI's.

"It's long been known that patients having a migraine attack are functionally impaired from the pain. It's also been shown recently that with repeated migraines, a person's cognitive abilities decrease. But actually doing damage to the brain - that is a surprise," said Takahiro Takano, author of the study's first paper.

The study's researchers hope that their study will shift migraine research toward more prevention of migraines, as opposed to treatments.

Posted by Kerry N. Jardine at 11:36 AM | Permalink | Comments (0) | TrackBacks (0)

Three papers published recently examine ties between industry and doctors in the US. They suggest that drug and other companies invest heavily in encouraging doctors to use and recommend their products and that despite recently published ethical guidelines by various professional bodies, many doctors are overstepping the mark when accepting reasonable favors, education and "freebies", ostensibly in the interests of patients. One paper, by a former drug rep and a physiology professor who researches drug marketing, looks at how drug reps are trained to influence doctors to buy their drugs and is published in PLoS Medicine. Another paper in the same edition of the journal looks at the impact of sales visits for one drug in particular. A third paper publishes the results of a national survey on doctor-industry relationships and suggests these are very common and vary according to specialists, type of practice and professional activity. It is published in the New England Journal of Medicine (NEJM).

The first article describes in great detail the type of training that a drug rep goes through to learn how to change the prescribing behavior of the doctors in their sales territory. The tactics for how to relate to each doctor depends on the physicians' category. For instance with the outgoing and friendly types the emphasis is on friendship development; with the aloof and skeptical, the emphasis is on collecting and presenting journal articles that counter the doctor's view on the drug. It describes how reps are trained to "assess physicians' personalities, practice styles, and preferences, and to relay this information back to the company. Personal information may be more important than prescribing preferences. Reps ask for and remember details about a physician's family life, professional interests, and recreational pursuits." In conclusion, the authors say that: "Every word, every courtesy, every gift, and every piece of information provided is carefully crafted, not to assist doctors or patients, but to increase market share for targeted drugs." Their recommendation to the medical profession is: "In the interests of patients, physicians must reject the false friendship provided by reps. Physicians must rely on information on drugs from un-conflicted sources, and seek friends among those who are not paid to be friends."

Posted by Scott J. Eldredge at 10:57 PM | Permalink | Comments (0) | TrackBacks (0)

Popular belief in medical communities is that juries in medical malpractice cases tend to side with plaintiffs, even where the case against a doctor is a weak one. However, jurors actually tend to believe doctors more than they do plaintiffs, says a law professor who examined numerous data on medical malpractice litigation, including cases in New Jersey. Philip Peters Jr., of the University of Missouri-Columbia School of Law, concluded that juries treat doctors favorably, "perhaps unfairly so," and are more likely than even fellow physicians to defer to a doctor's opinion. In an examination of win rates, Peters found that 27 percent to 30 percent of filed medical malpractice suits end in a plaintiff's verdict, the lowest success rate of any type of tort litigation. Peters researched the data to test the assumption that juries lack capacity to evaluate medical malpractice suits fairly, an assumption implicit in legislation pending in Congress that would create specialized courts for such cases. "Politicians and critics of jury performance should think twice before concluding that doctors will be treated more favorably in health courts," wrote Peters, whose report will be published in May in the Michigan Law Review.

The New Jersey study compared jury verdicts in individual cases with independent findings by medical or legal experts. The result was that the odds of a plaintiff's verdict increased in cases with greater evidence of negligence. The correlation was not perfect, especially where the independent expert believes the patient was injured by physician negligence. Plaintiff wins were in the minority even in the most meritorious cases. New Jersey's study showed generally that patients whose claims were deemed weak by reviewers were unlikely to win a jury verdict; that patients with borderline cases were twice as likely to win as those with weak cases; and that patients with claims deemed strong were most likely to prevail before a jury. Juries were surprisingly deferential to doctors, Peters said. While they were very likely to find for the defendant in cases where the reviewer felt the plaintiff's evidence was weak, they were just as likely to return a defense verdict when the evidence was deemed strong. Peters concludes that juries may be skeptical of patients who sue their doctors, and finds that doctors have a significant advantage in front of juries.

Posted by Scott J. Eldredge at 10:55 PM | Permalink | Comments (0) | TrackBacks (0)

The common wisdom in "shaken-baby'' cases was that the last person with the child before symptoms appeared was the guilty party. A Wisconsin jury convicted babysitter Audrey Edmunds, a mother of three young girls, of first-degree reckless homicide and sentenced her to 18 years in prison. In the decade since her conviction, Edmunds' lawyers say, many experts have studied the physics and biomechanics of shaken-baby syndrome and have concluded that shaking alone could not have produced the baby Natalie's injuries without leaving other evidence of abuse. Among those now questioning the diagnosis is Dr. Robert Huntington, the forensic pathologist whose testimony helped put Edmunds away. If the trial were held today, Huntington said recently, "I'd say she died of a head injury, and I don't know when it happened . . . There's room for reasonable doubt.''

The American Academy of Pediatrics declares shaken baby syndrome to be a "clearly definable form of child abuse.'' The National Institute of Neurological Disorders and Stroke says SBS bears a "classic triad'' of signs; brain hemorrhaging, retinal hemorrhaging and brain swelling., which can lead to permanent, severe brain damage or death. An estimated 1,500 cases of shaken baby were reported in the United States last year. More than 30 years after the term was first used, there are still skeptics within the medical community. "It doesn't exist,'' contends Dr. John Plunkett, a pathologist who began openly questioning shaken-baby syndrome 10 years ago.”You can't cause the injuries said to be caused by shaking, by shaking.'' Pediatrician Robert Reece, who is on the international advisory board of the National Center on Shaken Baby Syndrome, says while he believes shaking alone can cause death, the term has no place in a courtroom. The term "implies a mechanism of injury that I don't think we can prove in court,'' says Reece, who uses terms such as "abusive head trauma'' or "inflicted traumatic brain injury'' in court testimony. In a 2001 article in the American Journal of Forensic Medicine & Pathology, Plunkett concluded that an infant could suffer a fatal head injury from even a short fall, and that symptoms might not immediately follow the injury. He also concluded that there were other, accidental sources for one of the "classic'' signs of shaken baby syndrome. In a 2003 study at the University of Pennsylvania, researchers found that vigorous shaking of a "biofidelic'' model of a baby produced "statistically similar'' results to a fall from 30 centimeters onto concrete, or concrete with a carpet pad. Other studies have suggested that the hemorrhaging and swelling thought to prove shaking can have myriad causes, from dehydration and infection to oxygen deficiency.

Some judges in other cases have broadly agreed. Last year, a judge in Manatee County, Fla., barred use of the term "shaken baby syndrome'' because of its possible prejudicial influence on jurors. In two separate cases, Circuit Judge Lewis Nicholls of Kentucky decided he could not admit expert testimony on a theory whose foundation may amount to "merely educated guesses'' about the cause of death. "The best the court can conclude is that the theory of SBS is currently being tested, yet the theory has not reached acceptance in the scientific community,'' Nicholls ruled. "To allow a physician to diagnose SBS with . . . no other evidence of manifest injuries, is to allow a physician to diagnose a legal conclusion.''

Posted by Kerry N. Jardine at 10:50 PM | Permalink | Comments (0) | TrackBacks (0)

John Mackey was a tight end for the Baltimore Colts (1963-1971) and San Diego Chargers (1972), five-time Pro Bowler, Member of the National Football League (NFL) 1960s All-Decade Team and the second tight end to enter the NFL Hall of Fame. He has frontotemporal dementia, a degenerative disease caused by the rapid deterioration of the frontal and temporal lobes of the brain, which Mackey injured on a goal post while playing professional football. Each year in the United States, about 300,000 athletes experience sports-related traumatic brain injuries. In the NFL, approximately 100 players suffer concussions resulting from collisions averaging 98 times the force of gravity. The issue of safety, brain injury, and athletics is in the spotlight, much due to action by the families of NFL veterans. The league has begun to take responsibility for the declining health of its players. When Mackey's wife, Sylvia, wrote to then-NFL commissioner Paul Tagliabue about the financial burden that can result from the rapid decline of retired players'health, the league and the NFL Players Association responded by creating the "Number 88 Plan." Named after John Mackey's jersey number, the plan will pay up to $88,000 for each former player's treatment of assorted types of dementia.

Facing a growing number of football veterans with deteriorating health, the NFL is beginning an extensive study of the connection between sports-related concussions and chronic brain dysfunction. Currently there are plans in place to address the devastating side-effects of a professional football career. After former Philadelphia Eagle Andre Waters, whose extreme brain damage was caused by repeated concussions, committed suicide, was when the NFL promised to begin studying retired players later this year. Embarking on a study that may cost as much as $3 million over several years co-chairman of the NFL's Mild Traumatic Brain Injury (MTBI) Committee, Dr. Ira Casson, said the study aimed to determine "whether or not a career in the NFL results in any kind of chronic brain injury." This plan is a noteworthy step on the part of the NFL to help remedy the consequences of an NFL career, but it appears that the league neither has been nor is being as proactive with regard to encouraging and protecting the safety of players on the field. Past and current players suggest that playing despite injury is implied and expected. The league has historically resisted admitting the dangers exposed by predominant scientific findings. Yet a 2003 study of 2,905 National Collegiate Athletic Association players by North Carolina's Center for the Study of Retired Athletes found that 91.7 percent of repeat injuries came within ten days of the first injury, and 75 percent came within seven days. Dr. Kevin Guskiewicz, the research director for the Center, states, "Some say we're trying to paint this ugly picture... My goal is to help improve the game to make it a more safe game, regardless of what level it is."

Many fear that if the NFL's attitudes toward safety do not change, the reverberations will be felt not just by professional football players, but by athletes of every sport and level. The NFL finds itself in the powerful position to set an example that can improve the quality of life of many a future athlete. Many insist that the game of football must fundamentally change to ensure safety. Possible initial policies as simple as requiring follow-up examinations after injury and sending players off the field long enough for thorough treatment and recovery, in accordance with research findings and physician recommendations, make a difference. The league should seize this opportunity to reconsider and revamp its approaches to athlete safety.

Posted by Kerry N. Jardine at 10:48 PM | Permalink | Comments (0) | TrackBacks (0)

As the war in Iraq continues to intensify, more and more veterans are returning with devastating mental health issues. There has be a marked rise in mental health issues in Iraq veterans because of the war's signature injury - traumatic brain injury (TBI).

The parents of an Iowa vet who committed suicide urged the Senate to improve the VA's efforts in TBI and mental health care. Their son spent 11 months in Iraq and shot himself in front of his mother a few months after his return. Joshua suffered from post-traumatic stress disorder - a disorder that went undetected upon his return. During their plea in front of the senate, the veteran's parents voiced their disappointment in the VA's lack of a preventative treatment program to deal with devastating mental health issues.

"We need to give all veterans the opportunity to live the best life they possibly can," Randy Omvig said, the veteran's father.

Jan Kemp, a VA associate director for education who works on mental health, said that there are up to 1,000 suicides a year among veterans within the VA system, and as many as 5,000 a year among all living veterans.

She said the VA is developing ways to prevent suicide. Efforts include an education campaign aimed at making sure all providers identify veterans who are at risk. Newer veterans are coming in with PTSD and traumatic brain injuries that both carry a high suicide risk rate. Kemp hopes that her educational campaign and the VA's recent efforts to improve TBI detection and treatment will help lower the number of veteran suicide.

Posted by Kerry N. Jardine at 10:35 PM | Permalink | Comments (0) | TrackBacks (0)

The U.S. Consumer Product Safety Commission (CPSC) has received hundreds of complaints concerning magnets that have fallen out of a number of toys. There have been at least 33 reported cases in which children have swallowed a loose magent and had to receive emergency surgery. There has been one reported fatality of a 20-month-old-boy from Seattle, Washington. In nearly all of the cases reviewed by CPSC, each child had suffered intestinal perforations.

Magnets pose a unique danger to children because most magnets will not pass through the digestive system as most loose objects do. When 2 or more loose magnets and/or metal objects are swallowed, the objects are attracted to one another in the intestinal walls. The attraction causes the magnets to become trapped inside the body and cause blockage, infection, or blood poisoning. All these conditions can lead to a child's death.

The threat of loose magnets must be taken seriously, and the CPSC has recalled with more than eight million products containing magnets that could come loose and fall out of the product. Even though products such as Magnetix Magnetic Building Sets have been recalled since March 2006, several children are still being admitted to ER's across the nation due to loose magnets. The CPSC urges all parents to beware of any toys or products that may have magnets that can become loose.

The CPSC is working with manufacturers in the toy industry to protect children from the dangers of magnets. New voluntary standards requirements were approved on March 15th. Additional requirements will be considered by the voluntary standards group over the next year.

Posted by Kerry N. Jardine at 10:32 PM | Permalink | Comments (0) | TrackBacks (0)

Drug therapies are an obviously important segment of medical care, and the increasing complexity of today's drug therapies heightens the risk for prescribing errors and other drug-related problems. Physicians are faced with the enormous challenge of trying to keep up with a growing and ever-changing array of prescription drugs. Fortunately for doctors and their patients, however, there are specialists who focus solely on drugs and their role in healthcare--pharmacists.

Well-trained pharmacists do much more these days than just dispense medications; one quarter of them work in hospital settings, participating in patient care and complex clinical issues. Many studies have shown that pharmacists can improve patient safety and outcomes by recommending optimal therapies and dosages, thereby minimizing adverse events.

Unfortunately, pharmacists' critical role in patient care is not always acknowledged by physicians, and their expertise remains underutilized. A recent article emphasized this problem when a panel of doctors discussing resources on prescription drugs neglected to even mention pharmacists!

From the pharmacy profession's perspective, interdisciplinary collaborations would be highly desirable; but physicians remain unconvinced. Medscape (www.medscape.com) is one place where pharmacists are learning alongside physicians and other healthcare professionals. They complete many of the same continuing education programs as physicians and share an interest in many of the same topics, such as pain management and clinical treatment guidelines.

Everyone, most especially patients, reap benefits when pharmacists and physicians combine their respective knowledge bases and skills, complementing each other for the benefit of the patients who trust and rely on them both.

Posted by David P. Hersh at 10:40 PM | Permalink | Comments (0) | TrackBacks (0)

New rules within the F.D.A. will prohibit an expert adviser from voting on whether a drug gets approved if the adviser has been paid $50,000 or more in the prior year from the drug's maker or competitor.

The F.D.A.'s acting deputy commissioner Randall W. Lutter, said that "a significant number" of the F.D.A.'s current advisers would be affected by the new rule, though he wouldn't say how many. Dr. Lutter explained, "The $50,000 threshold is something that we think strikes an appropriate balance between" getting competent advisers and reassuring the public that their advice is not biased. This rule is one of the first major changes made by the FDA's new commissioner, Dr. Andrew C. von Eschenbach.

The new rule responds to critics who contend that drug companies have hijacked the FDA's approval process by payments to its expert advisers. In a famous example from 2005, 10 of 32 advisers who voted to allow Bextra to stay on the market, and allowed Vioxx to return to the market in spite of safety concerns, had received payments from those drugs' manufacturers. Had the new rule been in place at that time, their votes would not have counted, and the committee would have voted to keep those drugs off the market.

Responses from Congress were mixed. Representative Maurice Hinchey (D-NY) was delighted with the change, saying "The F.D.A. is now moving back to where it was supposed to be, a principled agency that protects the people." But Representative Rosa DeLauro (D-CT) was more cautious, stating "I am skeptical, given their recent track record of putting political and corporate interests above science."

Past versions of conflict of interest rules have been ineffective because most conflicts were subject to waiver, and were commonly waived, by the FDA. Disclosures were private, and the public never knew whether the expert had received $10 or $10,000. Although the new rule still allows waiver of conflicts, such waivers now have to be approved by the F.D.A.'s commissioner, which some feel will be rare. Many advisers are likely to welcome the clarity this new rule brings, even though it may mean dropping off their committees.

Daniel Troy, a former F.D.A. general counsel, said "F.D.A. is trying to strike a balance here, and they would rather strike it themselves than have it struck for them."

Posted by Seth A. Katz at 10:09 PM | Permalink | Comments (0) | TrackBacks (0)

A recent study at Fort Carson in Colorado found that 18 percent of troops serving in Iraq suffer at least some one traumatic brain injury (TBI) brain damage from the blasts of improvised explosive devices. In response, Fort Carson has announced that it will implement new scanning cameras at their post to detect brain injuries in returning soldiers. "They are taking head injuries seriously," said Dr. P. Stephen Macedo, a Washington, D.C.-based neurologist and former doctor with the Veterans Administration.

Currently, doctors at Army post must rely on questioning soldiers to determine if they've suffered brain damage in battle. Many experts believe that the current questioning process is not good enough. Many injured soldiers show no symptoms of TBI's, and other symptoms often mirror other conditions.

Past studies have shown that verbal tests are effective in diagnosing TBI's. They are subject to failure for many reasons: the soldier may not remember, may deliberately withhold information to avoid being discharged, or may not yet be feeling the effects of an injury.

Fort Carson plans to use soldiers who have already been diagnosed with TBI's to test the new scanning camera's accuracy and effectiveness. An Army review board will review the results.

The announcement comes after Veterans Affairs Secretary Jim Nicholson released a report Tuesday saying injured soldiers and veterans will get more screenings for TBI's.

Posted by Kerry N. Jardine at 10:06 PM | Permalink | Comments (0) | TrackBacks (0)

Looking like a battering ram, a helmeted dummy crashes headfirst into a steel plate at 13 mph, barely the speed of a bicycle. Sensors embedded in the dummy's head and neck show that the helmet would have saved a person from head trauma. What about the spinal cord? Even at these speeds, St. Louis University biomechanist Jack Engsberg said, it would have snapped. Engsberg and researchers in the university's physical therapy department are designing a shield that would protect both the head and neck. With motorcycle deaths on the rise, the shield could be a boon for the safety conscious. However, it's unclear how many self-respecting Harley riders would don the unwieldy device, a rigid exoskeleton that runs from head to waist. The shield is a molded fiberglass sheath, reinforced with steel rods that shepherd impact forces from a skullcap to the shoulders, bypassing the neck.

There are some benefits to the design. Most helmets tightly wrap the head and, moreover, require the head to hold up the helmet. With the shield, on the other hand, there's about an inch of space separating the head and the skullcap, offering greater freedom of movement. Engsberg said a refined version could be made more breathable with an apple-pie lattice of fiberglass strips. The researchers say the shield also could help horse riders. In a 1995 equestrian event, actor Christopher Reeve was thrown from his horse and landed on his head. He broke his neck and suffered a severe spinal cord injury even though he was wearing a helmet and protective vest. It was also a horse-riding accident that motivated Washington University neurologist William Landau to design the shield, after his granddaughter was paralyzed in a fall. Landau was awarded a 1998 patent for a brain and spinal cord protector. Landau later approached Engsberg, who runs a motion analysis laboratory at St. Louis University. The researchers recently smashed up eight Bell Zephyr motorcycle helmets, collecting data that would be compared with earlier tests on their prototype shield.

Motor vehicle accidents cause nearly half of the estimated 11,000 annual spinal cord injuries in the United States, according to the National Spinal Cord Injury Database. Those who die from spinal cord injuries at the scene of an accident are not counted.

Over the last decade, motorcycle deaths per vehicle-mile traveled have almost doubled, even as automobile death rates have declined, according to the National Highway Transportation Safety Administration.

Posted by Kerry N. Jardine at 10:01 PM | Permalink | Comments (0) | TrackBacks (0)

In Farmington, New Mexico it's almost time to see how several local attorneys perform in a different court during the upcoming 21st annual Doctors vs. Lawyers basketball game. Each year, several local health care officials and attorneys compete against each other to help benefit Friends Helping Friends, Inc., a support group for people with traumatic brain injuries, spinal chord injuries and those who suffer from strokes. The friendly competition always gathers a considerable crowd of nearly 500 to 800 people. It's a straight basketball game with the typical rules. Local dance companies will also provide entertainment during the game's halftime show. Everything is volunteered and the proceeds from the game benefit an upcoming disabilities conference in Albuquerque.

The Southwest Disabilities Conference allows people associated with Friends Helping Friends, Inc., to learn about coping and living skills, facts and fallacies, rehabilitation resources, therapy following brain injury, legislative issues, Social Security and Disability issues and advocacy. Friends Helping Friends, Inc., originally was created as a support group for people with brain and spinal chord injuries.

Posted by Kerry N. Jardine at 09:58 PM | Permalink | Comments (0) | TrackBacks (0)

Life changed for the Chiefari family last October. Mary's 29-year-old son David flipped his car and hit a pole head-on. David suffered a traumatic brain injury. He fractured his left temporal bone and right frontal lobe. Mom Lynn Lettieri said, "He was bleeding from both ears, and he had tubes down his mouth, and they had put a chest tube in because his lung had collapsed." Brother Jim Chiefari said, "They were doing certain tests, and they didn't get responses from him, and at the time he was not showing them reflex responses." The coma lasted two and a half months. The recovery is a traumatic process in itself. Shock and disbelief changes to coping before the final stage of moving on. The biggest challenge is understanding the healing time.

Traumatic Brain Injury Program Director Brenda Nixon said, "In that frontal lobe area, unfortunately that is the area where we have a lot of the qualities and characteristics to make up who we are, our ability to have inhibition and our ability to have self control. David still has bouts of confusion, some bouts of memory loss and of course minimal amount of agitation that comes along with that."

David's getting stronger and working at getting more of his memory back. For a few more weeks he will get more physical and cognitive rehab and then he will head home and will get outpatient rehabilitation. His brother sees David as a source of inspiration as he overcomes so many challenges. Chiefari said, "There are answers I won't get for asking why things happen. So what can I do to make it better? To make myself stronger and appreciate that I have to make a life to live and make it the best that I can." Chiefari said, "I know that he is still in there. I know he is getting stronger, so I want to see him pursue his interests again." Before the accident, David was applying for his Ph.D. A full recovery is hopeful.

Posted by Kerry N. Jardine at 09:56 PM | Permalink | Comments (0) | TrackBacks (0)

Senators Joe Lieberman and Barbara Boxer introduced The Mental Health Care for our Wounded Warriors Act of 2007. This legislation addresses two significant challenges facing the Department of Defense (DoD): the absence of designated, centralized facilities called "Centers of Excellence" to research and coordinate all aspects of military mental health policies and services, and the shortage of mental health professionals to provide care to members of the Armed Forces. "We have no greater obligation than to care for our wounded service members," Lieberman said. "This legislation would designate Centers of Excellence to coordinate military mental health services and research efforts, and would address the shortage of mental health professionals to provide high quality care to our service members." Senator Boxer said, "Our troops are risking their lives for this country, and we owe them nothing less than the best care in return. These Centers of Excellence will be hubs of scientific research where professionals can determine how best to treat mental health conditions and traumatic brain injuries afflicting combat veterans."

The bill would establish Centers of Excellence within the DoD to research and guide the development and implementation of comprehensive strategies to prevent, identify, and treat combat-related mental health conditions, emphasizing Post-Traumatic Stress Disorder (PTSD) and traumatic brain injuries. The centers would also develop, identify, and disseminate best practices for treatment of combat-related mental health conditions and brain injuries and develop measures to reduce the stigma surrounding mental health illnesses. The bill would also require the DoD to report back to Congress within 45 days on the need for Congressional intervention to provide financial incentives to reduce mental health workforce shortages, Congressional intervention to amend the duration of service obligation to increase the recruitment of mental health professionals, and increasing the use of scholarship and financial assistance to recruit qualified mental health professionals.

An estimated one in six returning service members has a diagnosable condition of post-traumatic stress disorder (PTSD) and one in ten service members involved in the Iraq and Afghanistan conflicts may suffer a traumatic brain injury. Over one-third of the Iraq and Afghanistan veterans treated by the VA have been diagnosed with a mental health condition, including PTSD, depression, and substance abuse, among others.

Posted by Kerry N. Jardine at 09:53 PM | Permalink | Comments (0) | TrackBacks (0)

Despite a flawed police investigation and a justice system that caused her grief, a teacher, Nadia McLean-Gagnon has transformed being the victim of a horrendous crime into a positive experience she wants to share with others. On Jan. 29, 2006, Nadia McLean-Gagnon's life was altered forever when a 13-year-old boy dropped a piece of concrete through her car windshield. She shared her healing story with delegates to the Manitoulin Northshore Victim Crisis Assistance and Referral Service conference. In her presentation, entitled Putting all the pieces back together, she detailed how she has overcome her catastrophic injuries, which included a broken nose, split palate, broken teeth, major muscle and nerve damage, as well as how she has come to embrace the young offender who is now a part of her life. The night of the overpass attack, the youth and an 18-year-old accomplice had been out stealing speakers. When he targeted the car, the youngster was acting on a dare from his older friend. "I almost died for a set of speakers," she said. "Kids often do things for the smallest reward."

Bringing the perpetrator to justice was not easy. Although she harbors "no ill feeling" against the police in general, she criticizes one individual for not doing a proper job. "In the first five days, valuable time was lost. The officer did not take the proper measures to collect evidence. No effort was taken to find the aggressor. DNA samples were not taken until one-and-a-half months after the incident and many people had handled it by then," she pointed out. When the OPP finally took over the case, more progress was made. The suspect was turned in by an informant. He was charged with five counts of mischief endangering life and one count of aggravated assault. After plea bargaining, the youth pleaded guilty to one count of criminal mischief.

Because the teenager was the same age as her own students, McLean-Gagnon opted to participate in the victim/offender rehabilitation program. However, she felt frustrated in her efforts to make the process meaningful. The workers initially refused to let her show the youth photographs of her injuries. She felt victimized again because she thought it was important for him to see the pictures of her injuries and to understand the extent of the damage caused by his actions. Eventually, she was able to confront her attacker. In the 2.5-hour session, she discovered he came from a disadvantaged background. In fact, his mother had coached him to lie about the true facts of the case. "He did feel bad," she said. "He looked at the pictures and he was trembling. He looked like he was going to be ill. He did accept what he had done. "But he wasn't the big thug I had expected him to be. I don't think he's a bad kid; I just think he made a bad choice. I wanted to hug him." McLean-Gagnon said it is counterproductive to send youngsters to jail where they are surrounded by criminals. She believes it only makes them continue on a criminal path, and is convinced errant teens can be saved. "I want the offender to better himself and to become a productive member of society. He's part of my life now and I want to be an inspirational pointer in his life so he can learn from the experience." Today, McLean-Gagnon counsels victims to talk openly about their struggles and to convert trauma into an opportunity for personal growth.

Posted by Kerry N. Jardine at 09:48 PM | Permalink | Comments (0) | TrackBacks (0)

According to an annual national ranking of state civil justice systems, California's class action law ranks 46th in the nation in fairness and reasonableness. The rankings were released by the U.S. Chamber of Commerce's Institute for Legal Reform. John H. Sullivan, president of the Civil Justice Association of California says, "Simply put, California has the fifth-worst class action law in the country and it's time for the Legislature to install balance and clarity and make this part of the civil justice system work for all Californians. Until the Legislature does, consumers will continue to pay for these lawsuits through higher prices of everyday goods and services." CJAC claims other states and Congress have passed reforms to improve their class action laws, yet California statutes have remained largely unchanged, giving neither judges nor lawyers clear guidelines for handing these cases. California is increasingly seen as a safe haven for opportunistic class action lawsuits, the group said.

CJAC is sponsoring bill AB 1505 to better protect the rights of discrimination victims and harmed consumers. The group says the bill, which is scheduled to be heard in the Assembly Judiciary Committee on May 8, will make class action law more fair, predictable, and efficient, and would give judges clear statutory rules for handling class action cases and greatly reduce the legal uncertainty that makes these lawsuits expensive and time-consuming. The U.S. Chamber of Commerce's Institute for Legal Reform was based on a poll conducted by Harris Interactive Inc. "The 2007 State Liability Systems Ranking Study" was conducted for the U.S. Chamber Institute for Legal Reform among in house general counsel and other senior litigators to explore perceptions of state liability systems.

Posted by Kerry N. Jardine at 09:45 PM | Permalink | Comments (0) | TrackBacks (0)

A class action lawsuit involving hundreds of Labrador City women who were exposed to tainted gynecological instruments appears to be resolved. The suit involved 327 women and was launched after they were told they would need to be tested for diseases such as HIV and hepatitis A and C. Lawyer Ches Crosbie says it's not certain that participants in the class action suit would have received more compensation. The women were informed in 2003 that they may have been exposed to infectious diseases while they underwent tests at the gynecological clinic at Capt. William Jackman Memorial Hospital in Labrador City. Brenda Rideout, a Labrador City resident who joined the action, said it's important for women to not be complacent about the care they receive. "We should make sure this kind of thing shouldn't happen," she said. "Just going and getting a simple test done isn't something where you should be putting yourself at risk for losing your life."

Under the terms of the agreement, which must still be approved by a judge in a hearing expected in June, each woman in the action will receive $450. Her spouse will receive $100. Ches Crosbie, the St. John's lawyer who represented them, said he anticipated he may receive some complaints about the monetary settlement. However, he said the maximum amount in such cases is only $1,000. "We got about half that, and in order to get that, you were probably looking at another year or two, with things like a psychiatrist being hired by the defendant," Other terms of the settlement include publication, in a local paper, of changes in policy and procedure at the Jackman hospital. As well, a woman from the community will be allowed to join a team that keep an eye on such procedures.

Posted by Kerry N. Jardine at 09:42 PM | Permalink | Comments (0) | TrackBacks (0)

A man who suffered serious brain injuries when his head struck an overpass while on the roof of a Kansas State football fan bus spoke publicly this week to thank his supporters. Christian Orr suffered a brain injury so severe doctors gave him almost no chance of survival. Orr and another man were standing on the upper deck of the Cat Tracker double-decker bus Nov. 18 on the way to a Kansas State-Kansas football game in Lawrence when their heads struck a pedestrian bridge under which the bus had driven. Orr was in critical condition and in a coma for a month, and John Green, 27, died at the scene. Now, Orr's going through rehabilitation three times a week and has been at home with his wife. Orr said he's picking up and moving on. His brain injury is getting "a heck of a lot better," but there are still some things he can't do, such as maintain his balance and his memory is spotty at times. His rehabilitation includes speech therapy, physical therapy and occupational therapy.

Orr said his wife, Stacey, his two sons, and the rest of his family have been an inspiration for him through his rehabilitation. "My wife, who is seeing me through all this, has been beside me and has been awesome," he said. "My little boys are behind me 100 percent. They come up and give me hugs, and that is very meaningful. He said he wants to be a sports writer again. He had previously worked for the Dodge City Daily Globe and The Salina Journal newspapers. "When all this gets behind me, I would love to be a sports writer again."

Posted by Kerry N. Jardine at 09:37 PM | Permalink | Comments (0) | TrackBacks (0)

A bill being considered by the Colorado General Assembly would either provide more transparency about medical malpractice insurance for consumers or would drive doctors out of Colorado. Senate Bill 248 is known as the "disclosure bill" to the Colorado Trial Lawyers Association, which is supporting the bill. It would require insurance companies that serve more than 65 percent of the market to publicly announce rate changes of more than 5 percent. "Any qualified person" could request a public hearing at the Department of Insurance to challenge the rate adjustment. The Trial Lawyers Association said the bill will benefit doctors, making medical malpractice premiums more transparent. But most doctors oppose the bill, said John Suits, associate administrator of business and government affairs at Memorial Health System. "Physicians haven't asked for this bill," he said. "And the majority of physicians at Memorial are opposed to it. My opinion is that they want to encourage litigation."

Only one insurance company, Colorado Physicians Insurance Co. (COPIC), has that large of a market share. "They might as well have said COPIC. It would have saved paper," said COPIC President Ted Clarke, who also is a physician. COPIC says the lawyers are targeting it because the company aggressively defends clients in malpractice suits. COPIC said it has not been ordered to pay damages in about 62 percent of the cases filed against its clients. COPIC was created in the early 1980s andthe board is made up enirely of doctors and since COPIC has no shareholders, it operates more like a nonprofit than an insurance company. Last year, the company gave more than $10 million in refunds to its clients, and has returned more than $112 million since its inception. COPIC insures 6,000 of the roughly 13,000 licensed doctors in Colorado. Colorado is one of eight states ranked as "stable" by the American Medical Association. Since it has enacted tort reforms it has seen malpractice premiums stabilize.

The trial lawyers deny they are targeting COPIC. "This bill makes sure that consumers, doctors, and the insurance industry can all see how rates increase, and why," said Sara Odendahl, communications director for the Trial Lawyers Association. "It's intent was not to target COPIC, it targets any Type 1 insurance provider controlling more than 65 percent of the market." Odendahl denies the bill is designed to affect competition between insurance groups. "Everyone should be aware of why insurance malpractice premiums are going up," she said. Additionally, she said the bill will have no effect on recruitment or retention of specialists. "This bill will prevent this insurance industry from fleecing doctors with excessive premiums," she said. "Secondly, it will not increase insurance rates or drive doctors out of state. It's not designed to do that."

Posted by Scott J. Eldredge at 10:18 PM | Permalink | Comments (0) | TrackBacks (0)

The President of Oregon Health & Science University made an unprecedented acknowledgment, admitting that $200,000 is simply not enough compensation in some malpractice cases. "We believe it is too low," said Dr. Joe Robertson, OHSU President. "We believe it should be raised." OHSU has a state-legislated tort liability cap of $200,000 in malpractice cases because they receive a portion of their funding from the state.

Last year, KATU News investigated the case of Jordaan Clarke, a Longview boy who was treated at OHSU as an infant for a heart defect and left the hospital permanently disabled after an admitted medical mistake. Today, Clarke requires a feeding tube and around-the-clock care. It is estimated that the cost of his lifetime care will be $11 million, but OHSU is only liable for $200,000. His case against OHSU was argued two months ago before the Oregon Supreme Court.

Currently, lawmakers are taking up the issue of the legal protection that shields OHSU and state agencies from such lawsuits, trying to decide whether to raise the cap and if so, how much. Current proposals on the table include increasing the cap from $500,000 to $875,000. Other agencies, such as individual cities and counties, are concerned that raising the cap would overexpose them to lawsuits they cannot afford. Also, OHSU doctors would be forced to pay malpractice insurance just like doctors at private hospitals. Sen. Vicki Walker, D-Eugene, calls into question the very idea that OHSU deserves this kind of protection, given its $1 billion plus operating revenue and the only 3 percent of its budget that comes from state funding. "You expect you are going to a high quality institution, which they are, but they make mistakes like every other institution," she said. "Yet they are able to hide under that veil of sovereign immunity because they get a teeny weeny portion of their budget from the state." There will obviously be a lot more discussion before any changes are made, but one thing OHSU is already doing differently is that they are notifying patients about the tort liability cap before they begin treatment.

Posted by Scott J. Eldredge at 10:14 PM | Permalink | Comments (0) | TrackBacks (0)

According to the National Highway Traffic Safety Administration, sleepy drivers are responsible for at least 1,500 deaths every year and cause more than 100,000 accidents. "A drowsy driver on the road can look a lot like a drunk driver," said AAA's Justin McNaull. "They have trouble keeping their car between the lines. Speed will vary." The danger exists long before drivers fall asleep; nodding off even for three seconds at 70 mph equals traveling the length of a football field with your eyes closed.

At a gas station and convenience store in Danville, W.V., a driver fell asleep at the wheel and his car went out of control, causing an explosion at a gas pump. No one was seriously hurt. Even professional drivers are not immune. Two-time Daytona 500 winner Michael Waltrip nodded off and crashed a mile from his home. "I guess I relaxed a little bit and looking forward to getting here and ran off the road," he said. "I woke up [with] the gravel hitting under my tires."

New Jersey is currently the only state with a law to combat drowsy driving, something other states are now considering. States are also looking into high- and low-tech solutions. Rumble strips, or ruts in the pavement that rattle drivers awake if they veer off the road, have dramatically reduced crashes. Computerized lane departure warning systems are also in development to keep drivers inside the lines. Engineers are also developing devices that sound an alarm after tracking driver's eye and facial muscles to detect driver fatigue.

Posted by Kerry N. Jardine at 09:32 PM | Permalink | Comments (0) | TrackBacks (0)

Saving human memory is one of highest level of care sought by modern medicine. The concept is integral in the treatment and care of individuals suffering from a traumatic brain injury or Alzheimer's. New research suggests the discovery of a protein that controls the odds of memory formation may lead to an entirely new approach for preserving memory. The finding, by scientists from UCLA/University of Toronto is important because until now, scientists knew little about how the brain assigns cells to participate in storing memories. As reported in the April 20 edition of Science, a new approach for preserving memory in people suffering from Alzheimer's or other brain injury may be forthcoming. "Making a memory is not a conscious act," explained Alcino Silva, principal investigator and a professor of neurobiology and psychiatry at the David Geffen School of Medicine at UCLA. "Learning triggers a cascade of chemicals in the brain that influence which memories are kept and which are lost. Earlier studies have linked the CREB protein to keeping memories stable," added Silva, a member of the UCLA Brain Research Institute. "We suspected it also played a key role in channeling memories to brain cells that are ready to store them." Silva and his colleagues used a mouse model to evaluate their hypothesis. They implanted CREB into a virus, which they introduced into some of the cells in the animal's amygdala, a brain region critical to emotional memory. Next they tested the mouse's ability to recall a specific cage it had visited before. To visualize which brain cells stored the mouse's memories about the cage, the scientists tracked a genetic marker that reveals recent neuron activity. When the team examined the animals' amygdalas after the experiment, they found substantial amounts of CREB and the marker in neurons.

"We discovered that the amount of CREB influences whether or not the brain stores a memory," said Silva. "If a cell is low in CREB, it is less likely to keep a memory. If the cell is high in CREB, it is more likely to store the memory." Human implications of the new research could prove profound. "By artificially manipulating CREB levels among groups of cells, we can determine where the brain stores its memories," he explained. "This approach could potentially be used to preserve memory in people suffering from Alzheimer's or other brain injury. We may be able to guide memories into healthy cells and away from sick cells in dying regions of the brain." "A memory is not a static snapshot," he said. "Memories serve a purpose. They are about acquiring information that helps us deal with similar situations in the future. What we recall helps us learn from our past experiences and better shape our lives."

Posted by Kerry N. Jardine at 09:28 PM | Permalink | Comments (0) | TrackBacks (0)

Researchers have recently discovered that heart patients who have stents implanted to keep their arteries open have no lasting benefit compared to those treated only with drugs. The five-year study found that patients treated with stents in addition to statins and other drugs did have a better blood flow to the heart than patients treated only with drugs, but they did not live longer or have fewer heart attacks. This study confirmed the results of previous, smaller studies.

Implanted stents are shown to reduce symptoms such as shortness of breath and chest pain, but the effects don't last, and the advantage disappears over time. In fact, one surprising finding in the new trial was that after five years, more than 70 percent of the patients in both groups (stent-plus-drugs and drugs-only) were free of angina pains, the common symptom caused by reduced blood flow to the heart.

The study included about 2,300 patients who all had a relatively stable form of coronary artery disease that usually progresses slowly. Dr. William E. Boden, a cardiologist at the University of Buffalo School of Medicine and Biomedical Sciences, was a lead author of a report on the study, and said that a majority of Americans who receive stents are in the same category of relative stability. "When I saw the results, I was incredulous," said Dr. Boden.

In the past, doctors have believed that stents performed better than drugs at relieving symptoms over the long run. "It's very intuitive that fixing the narrowing with a stent will yield important long-term benefits, but it didn't," said Dr. Steven E. Nissen, past president of The American College of Cardiology.

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

Traumatic brain injury (TBI) is one of the leading causes of death in the children ages 0-14. Each year, approximately 475,000 children ages 0-14 suffer from a TBI. Although there have been great improvements over the years in the area of TBI treatments, there have not been significant advances in treatments options available for children.

The majority of serious injuries found in pediatric TBI patients are related to the increase in intracranial pressure (ICP) found in the brain. The increase of intracranial pressure is mostly due to blood clots, swelling of the brain, and intracerebral hemorrhages that result from severe brain trauma. Medical experts have proposed a method to relieve the increase in ICP that involves the removal of bone form the skull - decompressive craniectomy.
Experts believe that craniectomies may help children with TBI's because the removal of bone from the skull allows the brain to expand beyond its regular confines. Giving the brain more room to expand improves cerebral pressure, reduces ICP, reduces the risk of midline shift and the potential for brainstem compression and herniation.

Over the past 10 years, researchers at the Department of Neurological Surgery at the University of Virginia Health Sciences Center investigated the results of decompressive craniectomies in 23 pediatric patients with TBI's. They found that 9 had mild residual neurological deficits, 13 were able to resume school, and only 3 are dependent on specialized care givers. Of the 7 patients now over the age of 18, 3 live independently and 4 have gainful employment.

"The overall outcomes indicate a net 65 percent favorable outcome in pediatric patients following craniectomy (good recovery or moderate disability), with 9 percent of the patients having severe disability on long-term follow-up," stated Dr. Jay Jagannathan, one of the key researchers. "While pediatric craniectomy has often been viewed as a last resort in the pediatric population, it can be an effective method of controlling ICP and providing reasonable quality of life postoperatively," concluded Dr. Jagannathan.

Posted by Kerry N. Jardine at 09:20 PM | Permalink | Comments (0) | TrackBacks (0)

Ann and Tom Cook have become advocates for wooden bats over aluminum. Their son Matt was struck by a ball off an aluminum bat during practice March 30. A ball hit the left side of his head as he pitched a varsity batting practice. The accident fractured his skull, caused substantial bleeding and swelling in his brain, dulled sensation down his right side, and severely impaired his ability to speak. He faces many months of intense physical, occupational, and speech therapy. He spent two days in the intensive care unit at Children's Hospital Boston and is now in the pediatric unit at Spaulding Rehabilitation Hospital. His is the most recent incident of a batted ball leading to serious injury on the field, but his parents have few statistics to back their fight against the use of aluminum bats. The frightening ordeal has prompted Cook's parents to advocate that schools switch from aluminum to wooden bats echoing a debate that has long simmered among high school baseball teams and in Little League, where aluminum bats predominate. "There's no empirical evidence, no data that says wooden bats are any safer than metal bats," said Paul Wetzel, spokesman for the Massachusetts Interscholastic Athletic Association.

Dr. Frederick Mueller has seen several stories similar to Cook's pass over his desk at the National Center for Catastrophic Sport Injury Research at the University of North Carolina. But he said that while the data he collects can quantify the injuries, it can't say whether the injuries are related to the equipment used. "Nobody's ever really done any research," Mueller said, "so I can't say one way or the other, because there's no data out there to say that one's better than the other." Such research is difficult because injuries like Cook's simply don't happen that often, Mueller said. According to a study the center completed in 2004, there were only 14 catastrophic cases of high school and college pitchers being struck by batted balls reported between 1982 and 2002.

Posted by Kerry N. Jardine at 09:16 PM | Permalink | Comments (0) | TrackBacks (0)

Tuskegee student Ralph Squire had paid five dollars for the fishing lure the same day that the crankbait became entangled in a bush while he fished later, it was only natural that he wanted it back. "I had just bought the lure at the Wal-Mart at Auburn and right off the bat I threw it up in a bush," the Texas native remembers of the incident. "I kept pulling on it with the fishing line, trying to pull it loose from the bush." The lure eventually came loose and struck Squire in the face. When several of his friends rushed to his side to see if he was OK, they made a gruesome discovery. A treble hook from the lure was buried deep in Squire's right eyeball. Squire became another of an ever-growing number of anglers who have suffered catastrophic eye injuries from fishing lures, according to Birmingham surgeons Dr. Robert Morris and Dr. Douglas Witherspoon of the Callahan Eye Foundation at the University of Alabama at Birmingham. The two surgeons can offer no reason for the increase in eye injuries from fishing, but they have hard data to back up their beliefs that such injuries are on the rise. Data from the Helen Keller Foundation show that nationwide, fishing injuries now make up about 9 percent of all sports eye injuries, Witherspoon said. A hook to the eye makes up about 38 percent of those injuries, while 44 percent come from a sinker or the body of a lure striking an eye. "People tend to think that a weight or sinker in the eye isn't as bad as a hook in the eye, but it can be just as bad," Morris said. "In a lot of cases the eyeball ruptures. In about half those cases the person is left permanently blind in that eye."

Since 1982, emergency rooms and clinics across the nation have reported all eye injuries to a U.S. Eye Injury Registry at the Birmingham-based Helen Keller Foundation. Two years ago, eye injuries from fishing surpassed eye injuries from basketball as the No. 1 sports-related eye injury, the doctors say. "Basketball has always produced the most eye injuries because of elbows and fingers," Morris said. "Racquet sports like racquetball and squash were next. Fishing injuries to the eye have now surpassed them all." The two doctors say eye injuries from fishing have now reached such a level that they are urging the fishing industry to get the word out about the dangers. The Helen Keller Foundation is working with Bass Pro Shops to create ads warning fishermen not to pull on lures that get hung up in debris.

For Squire, any such warning comes too late. "The worst part was that I was wearing sunglasses and I tilted them up so I could see better," he said. "I gave the lure a big pull and it came loose and like a bullet it hit me in the face. "It knocked me down, but I only felt the pain of the lure hitting me. When I stood up I could hear the lure rattling in front of my face and I knew it was bad. My friends came over and saw what I had done and they freaked out." Squire's friends rushed him to a hospital in Opelika where he was sedated. He then was put aboard a helicopter and airlifted to Birmingham. The injury was gruesome, but nothing the two surgeons at the UAB Callahan Eye Foundation hadn't seen before. The surgeons carefully cut off the barbs of the treble hook and removed it. Three surgeries later, Squire can see light, colors and movement through the eye. "It's about like looking through an empty Gatorade bottle," Squire said almost a year after the injury. "I can see people's faces and hands when they are close, but everything far away is just a blur." Squire eventually will have surgery to replace the lens in the eye. That should allow the eye to work well, Morris said. "My answer to anyone wanting to know how to get a lure loose is to just cut the line and leave it," he said. "There's no lure worth what I've gone through."

Posted by Kerry N. Jardine at 09:12 PM | Permalink | Comments (0) | TrackBacks (0)

The military in its latest survey estimates that as many as one in five soldiers and Marines will suffer "mild" traumatic brain injuries in Iraq. Seventy percent are better by the time they return stateside, but for others, symptoms persist. As military and veterans' doctors confront TBI they find more questions than answers about how to help. Diagnosing mild brain injuries is not simple. And the best treatments aren't yet clear. "We're still trying to figure out exactly what this injury is, what exactly is the problem in the brain," said Col. Jonathan Jaffin, acting commander of the U.S. Army Medical Research and Materiel Command at Fort Detrick , Maryland

Technology can't yet clarify matters. Mild brain injuries rarely get detected on MRIs and other imaging tools. In North Carolina, Veterans Administration mental health researchers are trying to find clarity. At the W.G. Hefner Medical Center in Salisbury, doctors will take MRI scans of veterans who were and were not exposed to explosions, including those with brain injury symptoms and those without. They hope patterns of differences will emerge. They are collaborating with researchers at the Massachusetts Institute of Technology. Scientists there are using laboratory studies with brain tissue and computers to better predict how the force of an explosion affects various parts of the brain, particularly delicate axons that are brain cell endings needed for one cell to communicate with another. In Salisbury, researchers are also trying to sort out differences between patients with brain injuries and those with post-traumatic stress disorder. "They can look the same, but we're looking for distinctions," said Dr. Robin Hurley, a neuropsychiatrist who is acting chief of staff at the veterans medical center in Salisbury. Scientists used to think the number of brain cells was finite. But that's not true so soldiers with mild traumatic brain injuries may require therapy that doesn't merely adapt to a deficit but tries to heal it, stimulating new brain cell growth or strengthening other connections in the brain, Jaffin said. "We now find that new brain cells grow and new connections are always being made. The question is can we influence that and if so, how?" he said.

For reasons that are not clear, people with such injuries are more susceptible to alcohol. A few drinks can hit them harder than others and drinking can slow healing. In addition, they are more sensitive to pseudoephedrine, an ingredient in some cold medicines. Dr. Harold Kudler a psychiatrist, is asking the VA to distribute cards with that warning and with medical contact information to veterans who may have mild brain injures. Military doctors are working on many fronts to step up treatment of brain injuries in Iraq and in the United States, said Jaffin, the acting medical commander.

Posted by Kerry N. Jardine at 09:10 PM | Permalink | Comments (0) | TrackBacks (0)

Cyclists in Austin are seeing an increase in collisions with cars due to lack of awareness of their riding. It was once hailed as the second-best city in the country in which to ride a bicycle. Austin has a huge cycling community. Al Bastidos of Be Kind to Cyclists was in a serious accident five years ago. Now, he spends his time trying to raise awareness and remind drivers to share Austin's roads. "It is happening all the time because we have more cars and no awareness," Bastidos said. Recently Joe Blakistone was hit by an 18-wheeler on the side of the road while he was training for an MS race. He stopped to change the rear tire of his bicycle and was on the roadside when he was hit by a semi truck that, based on the skid marks, was driving on the shoulder of the road. "There was a lot of bleeding, I lost a lot of blood, got a concussion...pretty much have a headache all the time, but I hear that's supposed to go away in a couple weeks," Blakistone said. Blakistone walked away with his life, which is more than some can say, but his experience has added value. "Motorists need to understand that I'm not just a cyclist, I'm a son, boyfriend, grandson. People out there love us too and people want us to come back from our rides. Everyone can share the road together and be respectful," Blakistone said.

Most cyclists do admit that it is a two-way street. They said doing their part to follow the rules, be courteous to drivers and training at non-peak hours are all a part of being a cyclist in the fast-growing city of Austin. Joe Blakistone's case is still under investigation by the Austin Police Department. So far, neither of the drivers in this story have faced charges.

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

The Shearer family will always remember Friday, Jan. 27, 2006. That was the day they almost lost their youngest child, Blair, to a snowboarding accident. They believe the 8-year-old owes his life to the helmet he was wearing. The Shearer family has two rules for skiing and snowboarding. One is that each member of the family must wear a helmet and the second rule is that each person must stay with a buddy, either a family member or a friend. "I just don't like them being alone in case something happens to them," Cindy said.

Blair was skiing on an easy trail with his father and had gone around the first turn when he detoured onto a smaller trail that cuts through the woods. "Steve missed that trail, but he walked himself back up the hill in order to follow Blair," Cindy said. "Then I saw Steve run in front of me with one ski and I knew something was wrong. Blair had failed to navigate the turn and fell over an embankment. No one knows what happened after that, but trauma team members at Gesinger Medical Center, Danville, later told the Shearers that Blair must have hit a tree for the accident to cause so much damage. "My husband saw Blair's accident, which was a blessing because if he hadn't we would not have known where he was," Cindy said. Steve jumped down the roughly 20-foot embankment, found Blair and carried him out of the woods and onto the main trail, where Cindy was. "Blair was a rag doll and his face was covered in blood." Cindy said.

Blair was flown by emergency helicopter to Geisinger. Cindy and Steve went home and got a blanket and one of his favorite stuffed toys, items would be comforting and familiar to Blair. When the couple arrived at the hospital in Danville, they found out Blair was in critical condition. He had two skull fractures, one in the left temple and one behind the ear, and multiple fractures of his left eye socket and sinus cavity. He also had facial abrasions and bruises to the brain. Blair was eventually moved out of critical care and into a room at the Janet Weis Children's Hospital, a part of Geisinger. Blair stayed only a few days in the hospital but it took about four weeks until he was able to go back to school. Blair was also on restricted activity for six months because it was so crucial that he not take another blow to the skull.

Posted by Kerry N. Jardine at 07:17 PM | Permalink | Comments (0) | TrackBacks (0)

A new report on American hospitals concluded that the death of nearly 250,000 Medicare patients might have been prevented if healthcare workers made fewer errors. Medicare beneficiaries who had one or more patient-safety incidents had an alarming one-in-four chance of dying during their hospitalization, said the study. The fourth annual Patient Safety in American Hospitals Study, conducted by HealthGrades, Inc., a healthcare ratings organization, determined that safety incidences in hospitals across the country rose three percent over the years studied, 2003 to 2005. HealthGrades examined 40.56 million Medicare hospitalization records in the 2003-2005 period, finding a great disparity in the quality of care from system to system. Top-performing hospitals had a 40 percent lower rate of medical errors compared with the country's poorest performers.

The report is the most recent of such studies that have gained in public interest ever since the 1999 report by the federal nonprofit Institute of Medicine. The IOM found that medical errors were responsible for the deaths of as many as 98,000 patients, yearly. According to the HealthGrades study, the patient safety incidents with the highest prevalence continue to be failure to rescue, decubitus ulcer, and post-operative sepsis which worsened by 25 percent over the study period. It has been partially blamed on the inability to distribute antibiotics as often because of bodily resistance due to the exposure to dirty hospitals.

Posted by Scott J. Eldredge at 08:59 PM | Permalink | Comments (0) | TrackBacks (0)

Lawyers representing disgruntled sick people repeated their arguments to an appeals court saying San Diego County is illegally denying them medical care. The group appeared to win a battle against the county last year when a Superior Court judge ruled that the County Medical Services program could not refuse to pay for treatment to persons earning more than $802 a month, however, the court later approved a new income limit when county supervisors upped the threshold to $1,078 a month.

Lawyers for the Western Center on Law and Poverty, representing more than 20 class-action ill clients, filed an appeal to overturn that ruling in June. They argued that there should be no income limit, and that patients who earn more than the county's income threshold should be allowed to pay for a part of their treatment and still receive it. County officials argue that opening up the system to "sliding-scale" payments would make all county residents eligible, and could bankrupt the system. Officials said the appeals court, which listened to lawyers for both sides Tuesday, is expected to issue its own ruling within the next 90 days.

Posted by Scott J. Eldredge at 08:56 PM | Permalink | Comments (0) | TrackBacks (0)

An elderly doctor has come out of retirement to keep the sole hospital in Pike County open after it lost a three-member medical staff. Drs. Phillip White and Mark Floyd announced they could no longer continue seeing patients at Pike County Memorial because their malpractice insurer had discontinued coverage for their hospital work. A third doctor had retired previously.

Dr. Hiram Ward, 81, who began his practice in the rural Arkansas county five years before Pike County Memorial Hospital was built in 1958, became the hospital's only medical staff member in January. Ward provided doctor's care to patients at the 32-bed hospital by himself until last week when Dr. Tommy Gray, who lives 148 miles away at Conway, heard about the hospital's plight and began helping out temporarily, says hospital administrator Rosemary Fritts. "I volunteered to come out of retirement," Ward says. "Nobody asked me to. I came back so that our hospital would stay open." The hospital employs 55 people and is the second-largest employer in Murfreesboro.

Although the hospital's patient referral list has declined with patients referred to larger hospitals in Hot Springs, Nashville and Texarkana, Ward says there is no substitute for the kind of care people get at the hospital in Murfreesboro. "We have a coronary care unit and we do stabilize people who have heart attacks and send them off to get bypasses and stents put in," Ward says. "Quite a few of them would lose their life if the hospital wasn't here." He says some physicians in the new generation don't know patients. "They don't know how to correlate the problem with the patient's environment and their family setting," Ward says. "The family setting means a lot: what kind of job you're doing and the situation you are in. We've known these people forever. It's like taking care of them at home," he says. "It's important to people and you feel much more secure. A big part of getting better is the faith you have in the doctor." Ward plans to retire, again, as soon as the hospital signs contracts with two physicians to work there. Hospital officials say Pike County Memorial will continue to have physician coverage 24 hours a day, seven days a week as they actively recruit physicians to the area.

Posted by Scott J. Eldredge at 07:54 PM | Permalink | Comments (0) | TrackBacks (0)

On the night of Dec. 22, 1988, Drew Covell, who was in his first semester at Manchester Community College studying law enforcement, was working at his part-time job as a security guard. It was about 5:45 p.m. and Covell was in the road, guiding a truck that was leaving the parking lot. The truck was blocking the southbound lane of traffic, which caused the driver of a car in that lane to swerve around the truck and hit Covell. The car carried Covell 100 feet before he was thrown another 100 feet from the car. He was flown by helicopter to the hospital where he lay in a coma. Covell was later transferred to another hospital that was a rehabilitation and special care facility. It was there that he came out of his six-week coma on Feb. 9, 1989. Covell had sustained numerous injuries, including a traumatic brain injury. Covell remained bedridden for several weeks afterwards, but in two months he was walking again and four months after the accident he was discharged from the hospital. The accident may have changed everything but, Covell says, "I was lucky to have survived it."

Covell continued his outpatient rehabilitation for about three years at various hospitals in the region. During his recovery period, Covell's family contacted the Brain Injury Association of Connecticut, which was then known as the Connecticut Traumatic Brain Injury Support Group. Covell soon became actively involved in the association, and is presently a co-facilitator of the Manchester support group. According to Julie Peters, executive director of BIAC, the association was incorporated in 1982 by a group of parents who were concerned about the welfare of their children who suffered from brain injuries. After lobbying state legislators, the state Department of Social Services gave the group a $15,000 grant, funds that were used to launch the non-profit organization, which is now affiliated with the Brain Injury Association of America. "Sadly, there's no cure for brain injuries," Peters says, but there are programs available for people to learn to adapt to their situation and learn skills. In Covell's case, he initially had difficulty in spontaneous recall and had to relearn "life skills," such as tying his shoelaces and buttoning his shirt. While undergoing rehabilitation, Covell continued his studies and graduated from MCC in 1995 as a disability specialist, assisting people with rehabilitation needs. That same year Covell transferred to the University of South Carolina to pursue a degree in psychology.

Posted by Kerry N. Jardine at 07:05 PM | Permalink | Comments (0) | TrackBacks (0)

Three times a week, Vince Stankoski is lifted from his wheelchair onto a stationary bicycle. Electrodes are attached to three of his muscle groups, coaxing his paralyzed legs to pedal. It is the highlight of his workout. "I like that I can look down at my legs and still see muscles there," says the Allentown, Pa., man who lost the use of his legs after falling from a tree in 1998. Apart from the bike, he also likes using the upper body weights, which come equipped with a seat that swivels away so he can move his wheelchair into position and lift. Stankoski is one of the fortunate ones. He belongs to a gym specifically designed to accommodate people with disabilities. Few other disabled people have that option. The basics of good health; diet and exercise often present challenges for people with disabilities, a situation made more difficult by a common assumption that disability and poor health go hand in hand. The result, according to the federal Centers for Disease Control and Prevention, is that people with disabilities (roughly 19 percent of all Americans) are far less healthy than the average American. Since those with disabilities are the biggest users of medical services, that disparity could be costing hundreds of millions of tax dollars a year. Those costs are likely to increase as the baby boomer generation grows older and more susceptible to disabilities. "There's an enormous number of barriers that people with disabilities face when they try to become healthy," says Dr. James Rimmer, director of the National Center on Physical Activity & Disability, and a professor at the University of Illinois at Chicago. Those barriers range from health clubs that view people with disabilities as potential liabilities to public health campaigns that bypass them entirely. "There's a mind-set that people with disabilities are also ill and they shouldn't be exercising," says Jerry McCole, who heads the National Disability Sports Alliance. The group promotes athletic competition and physical activity among people with cerebral palsy, traumatic brain injury, stroke and other physically disabling conditions. "It's like any minority group; out of sight, out of mind," McCole says.

Regardless, people with disabilities are increasingly hard to overlook. In a first-of-its-kind study released last fall, the CDC found that those with disabilities were more than four times more likely to be in fair or poor health than those who are not disabled. Those with disabilities were also more likely to smoke and to be obese and physically inactive. In West Virginia, the numbers are even worse. Deborrah Pittman, head of the computer science department at Bluefield State College in West Virginia, was diagnosed with multiple sclerosis in 1997 and sometimes uses a wheelchair. She lives in a state where one in four adults is disabled, the highest rate in the country. Pittman says she's lucky that a gym in Bluefield, near the Virginia border, has one or two pieces of equipment she can use to get an upper body workout. Part of the problem, according to experts, is the common assumption that people with disabilities are simply unable to take on physical tasks. "People with disabilities can be healthy, and people without disabilities can be unhealthy," says John Crews, a lead scientist for the CDC's Disability and Health Team. But the perception persists, even in public health, that the opposite is true. "Public health has a kind of uncomfortable relationship with disability. People with disabilities tend to be viewed by people in public health as a failure of primary prevention," Crews said.

That's starting to change. In January, Rimmer and a group of doctors and advocates launched the Inclusive Fitness Coalition to urge private health clubs and gyms to make universal accessibility part of their basic service. At places such as Optimal Finess, where Stankoski works out, that's already happening. Optimal Fitness is part of Good Shepherd, an acute care rehabilitation hospital. The fitness center is open to hospital patients and employees, but also to anyone with a qualifying disability. There's no nearby exercise alternative for people like Stankoski. The next nearest place is 60 miles away in Philadelphia. "Things changed really fast for me," Stankoski says, recalling the accident that paralyzed him. But rehabilitation and regular fitness have helped him to stay trim and muscular. "Since I started here, everything's been going good," he says

Posted by Kerry N. Jardine at 07:00 PM | Permalink | Comments (0) | TrackBacks (0)

Whiskers provide a mouse with essential information to negotiate a burrow or detect movement that could signal a predator's presence. These stiff hairs relay sensory input to the brain, which shapes neuronal activity. In a first, studies of this system by Carnegie Mellon scientists show just how well a mouse brain can compensate when limited to sensing the world through one whisker. Published April 4 in the Journal of Neuroscience, the results should help shape future studies of sensory deprivation that results from stroke or traumatic brain injury, say the authors. "Our findings are the first to show this degree of brain adaptability in a setting with significantly limited sensory input," said Alison Barth, assistant professor of biological sciences and a member of the Center for the Neural Basis of Cognition (CNBC). "This finding tells us that brain function is plastic, or reparable, when a sense like touch has been profoundly diminished. Plasticity is an important indicator that the brain is reorganizing to compensate for an injury or deficit." For a decade, neuroscientists have known that the brain can increase its plasticity, or adapt, in response to injury that limits bodily motion. This latest study is the first to show such an impressive enhancement of brain activity in an animal with sensory loss. Losing sight, hearing, taste, smell or touch are common disabling side effects of traumatic brain injury and stroke.

In her study, Barth recorded brain activity in mice with various degrees of whisker removal. As a first step in her research, Barth removed all but one whisker and recorded neural activity in a brain region located on the opposite side of the animal. (Flicking a whisker on one side of a mouse stimulates a part of the brain on the animal's opposite side). Over the course of a week, Barth found that one whisker could not only stimulate a predicted cluster of neurons inside the brain; it could also activate nearby neurons. While some degree of plasticity would be expected, the growth of brain activity seen in the experiments was striking, Barth says. "What this tells us is that the parts of the brain processing sensory information are extremely adaptive and can strengthen in the presence of limited sensory input," Barth said. In another experiment, Barth found something more surprising; a single-whiskered mouse was more likely to generate new brain activity than a mouse with a whisker on one side of its head and a full complement of whiskers on the other side. "These findings show us that a fully functioning set of whiskers on one side of the body dramatically inhibits the ability of a single whisker to remodel the brain," said Barth. "This finding suggests that we could boost the brain's plasticity if we 'turn off' sensory input from the opposite side of the body."

Hypothetically, in a clinical setting, doctors could temporarily remove a patient's ability to see, hear, smell or touch on one side of the body to force the same sense on the other side of the body to expand its activity within the brain, thereby remodeling it to perceive a limited sensation much better. This kind of "forced use" therapy is already applied in the clinic for patients with motor deficits. For example, a patient who suffers a brain injury is made to use a poorly performing arm with the expectation that the brain may be plastic enough to assist that arm in recovering motion. "We think that our well-designed model is extremely good for future in-depth studies of brain plasticity in response to changes in how an animal senses its environment. Ultimately, we want to understand at the molecular level the dynamic between sensory use and neural plasticity," Barth said.

Posted by Kerry N. Jardine at 06:53 PM | Permalink | Comments (0) | TrackBacks (0)

Crested Butte Mountain Resort may have to pay a fine of $67,500 because of a recent citation from the Occupational Safety and Health Administration in the death of a snow-grooming-machine operator in January. The ski company was fined $63,000 for a "willful" violation because safety switches for automatic braking had been altered on the Bombardier BR 350 snow-grooming machine that ran over and killed 23-year-old Christopher Mikesell on Jan. 21. The company was fined an additional $4,500 because it failed to report the fatal accident within eight hours of its occurrence. The maximum penalty for a willful violation is $70,000, but Crested Butte Mountain Resort was given a 10 percent break because it had no previous citations, said John Healy, area director for OSHA. According to the citation signed by Healy, armrest and driver-door safety devices designed to start an automatic braking system "had been bypassed making the safety switches inoperative." If the safety switches had been working properly, Mikesell probably would still be alive, according to OSHA. "If the equipment had been properly maintained, most likely there wouldn't have been an accident," Healy said.

Crested Butte Mountain Resort owner Tim Mueller said Mikesell's death was a tragic accident, but he disagrees there was a willful violation. "I don't think we or our employees did anything willful, and we will discuss that with them," he said. "There were other contributing factors as well that were not in the report. "Unfortunately, the way OSHA defines it, willful is the next one above serious, and it sounds bad." The ski company had several options to pursue after receiving the citation last week, Healy said, and took the most common action, to request an informal hearing. That hearing will be in Healy's office in Denver on April 25. "It's possible the fine could change," Healy said. "Sometimes in informals those things do change." Healy said conclusions from the hearing may not be reached for several days.

Posted by Kerry N. Jardine at 06:51 PM | Permalink | Comments (0) | TrackBacks (0)

A new review of several studies shows that laws that require children to wear helmets reduce the risk of traumatic brain injuries (TBI's) in bicyclists. Many studies have show that helmet laws decrease the occurrence of TBI's but most have not been found to be statistically sound.

Anneliese Spinks and other researchers at University of Griffith School of medicine systematically reviewed 5 studies to test the relationship between helmet laws and TBI's. Systematic reviews draw conclusions about medical hypotheses based on evidence found in the studies, as well as the content and quality of the clinical trials found in the studies.

"We searched to find the highest-quality evidence and it shows that with bicycle helmet legislation, head injuries decreased. By relying only on the highest-quality evidence, we hope to reduce some of the controversy over the issue," said Spinks, co-author of the new study review.

Three out of the 5 studies were conducted in the US and the other 2 were conducted in Canada. All 5 studies were restricted to the use of helmets in children. Two of the largest studies found that after the implementation of a bike helmet law, there was an 18% - 27% decrease of TBI occurrences.

Most scientists support the need for bike helmet laws, but there are still many skeptics. Spinks and her colleagues hope that their study review will change skeptics' minds and build a stronger case for the need of helmet laws.

Posted by Kerry N. Jardine at 09:03 PM | Permalink | Comments (0) | TrackBacks (0)

The US Defense Department has been faced with public scrutiny and criticism regarding the care of veterans over the past few months. In response to the harsh criticism, the Pentagon announced yesterday that new programs will be implemented to improve veteran care . New measures include an increased number of health screenings, improvements in the records keeping system, and a new disability claims system.

More specifically the Pentagon plans on implementing the following measures:

New senior military leader group focused on disability claims. (To make decisions regarding individual veteran's disability claims more quickly and efficiently).

New testing systems that will allow all VA Hospitals to share medical records. (To alleviate complaints of long waits, multiple visits, and lost paperwork).

New, improved health screenings focused on the 3-6 month period after a soldier returns from combat. (To catch missed signs of post-traumatic stress syndrome and traumatic brain injuries).

The Army's acting general surgeon also announce that Army was taking steps to speed up follow-up medical appointments as a result of its probe of 11 other military hospitals around the country to determine whether problems existed. The recently completed review found that more resources were being put into rehabilitative work but more efforts are urged to improve veteran healthcare even more.

Posted by Kerry N. Jardine at 05:50 PM | Permalink | Comments (0) | TrackBacks (0)

The trial of a medical malpractice suit filed four years ago is under way for the parents of a child born under the care of Integris Bass Baptist Health Center, Dr. Richard E. Staerkel and Women's Health and Wellness. They are suing on behalf of their child, whom they allege suffered fetal and/or maternal distress while in the defendants’'care. According to the suit, Sharla Gould was in the care of Staerkel up to the time of the birth of their daughter, Josie Belle. The suit claims nurses at the hospital under direction of Staerkel administered a toxic dose of the labor inducer drug, Cytotec. The suit also claims the defendants were negligent in caring for abnormal bleeding during Sharla’s delivery, and Josie was not delivered in a timely manner and “was severely neurologically depressed at the time of birth.” Additionally the suit alleges the hospital failed to maintain records needed for the plaintiff’s investigation into its claim of malpractice. Staerkel is accused of failing to properly monitor and evaluate Sharla and Josie, failing to diagnose fetal and/or maternal distress, failing to perform a timely Cesarean section and failing to retain a skilled resuscitation team to treat Josie. The Goulds are seeking compensation for damages suffered by Sharla and Josie and for mental anguish, grief, loss of comfort, support and joy of Josie, as well as medical, rehabilitative and other costs of care until Josie is 18. They also seek damages for grief, physical and mental impairment, disfigurement, pain, loss of enjoyment of life, medical, rehabilitative and other costs of care throughout the girl’s life.

In a response to the Goulds’ suit, the hospital denied negligence claims. In its answer, an attorney for the hospital responded, “... this defendant states that all hospital care rendered to the plaintiffs was at all times proper and in accordance with accepted standards and was not negligent.”

Posted by Scott J. Eldredge at 06:07 PM | Permalink | Comments (0) | TrackBacks (0)

A state appeals court on 16 April reinstated a former transplant patient's medical negligence lawsuit against a University of California hospital. The 4th District Court of Appeals restored Elodie Irvine's lawsuit against the University of California, Irvine Medical Center, whose liver transplant program was shut down in November 2005. The program voluntarily closed after a federal report found that more than 30 people died while waiting for liver transplants during a two-year period.

Irvine, who was diagnosed with a deadly kidney and liver disease, waited four years for organ transplants at the hospital before she went to another hospital and got the desperately needed procedures within two months. She filed the malpractice suit and settled with the hospital for $50,000. But she later tried to get the settlement overturned after she suspected her lawyer, Lawrence Eisenberg, mishandled her case and pressured her into accepting the settlement. Irvine also sued Eisenberg, claiming he didn't tell her about serious problems with the transplant program that could have won her a larger settlement. Irvine claimed Eisenberg learned about a systemic problem at the UCI program while researching her case but failed to tell her until after she had agreed to settle. When university officials sent her the settlement check, Irvine refused it and asked that the judgment be set aside. She argued the settlement, which was reached in private mediation, was unenforceable because she hasn't sign a release form. A judge denied her motion to vacate the settlement and Irvine appealed that decision. The appeals panel ruled that Irvine's argument "demonstrated good cause to restore the case."

Posted by Scott J. Eldredge at 06:04 PM | Permalink | Comments (0) | TrackBacks (0)

A panel of advisors to the FDA voted 20 to 1 last week to reject Merck's application to sell its pain medication Arcoxia amid concerns that the drug could cause up to 30,000 heart attacks per year if the drug became widely used.http://www.burgsimpson.com/defective_drugs.html

Some panel members harshly criticized the drug. "What you're talking about is a potential public health disaster," said Dr. David Graham, an FDA safety officer. Studies have shown that Arcoxia, which is similar to the banned drug Vioxx, caused nearly three times as many heart attacks, strokes and deaths as naproxen (sold as Aleve), but was no more effective in managing pain. Patients on Arcoxia also experienced worrisome increases in blood pressure.

Arcoxia's maker, Merck, argued that the nation's 21 million arthritis sufferers need new therapy options. But some of the panelists said that patients need BETTER drugs, not simply MORE of them. Dr. David Felson, a panel member from Boston University, said, "There is nothing special about this drug that would warrant giving it to patients and putting them at risk of cardiovascular death."

Indeed, the FDA and its advisors have become far less tolerant of risks in drugs that offer few life-saving benefits, and last week's vote could put a stop to the possibility of any new drugs similar to Vioxx or Arcoxia being approved in the United States.

Posted by Seth A. Katz at 05:57 PM | Permalink | Comments (0) | TrackBacks (0)

Legal experts say proving causation in the Ortho Evra cases will be easy because blood clots in young women are almost unheard of. Once this was recognized and lawsuits began to be filed against J&J they quickly began settling cases out of court for a substantial amount of money, possibly trying to keep the public from knowing that women were being injured by the patch. As the number of lawsuits grew the strategy of quietly settling out of court could not continue. J&J's Annual Report filed with the SEC in February 2007, states that, as of December 31, 2006, "there were approximately 1,500 claimants who have filed lawsuits or made claims regarding injuries allegedly due to ORTHO EVRA."

Documents revealed in litigation, prove that J&J knew about the high rate of blood clots because they show the company had been analyzing the FDA's reports on injuries and deaths in women using the patch. They even went so far as compiling charts showing the higher rates of clots and deaths when compared to women taking birth-control pills. One memo from 2003, reveals that the company refused to conduct a study to compare the rate of adverse events with the patch to its Ortho-Cyclen pill because there was "too high a chance that study may not produce a positive result for Evra" and a "risk that Ortho Evra may be the same or worse than Ortho-Cyclen." Newly released documents show that instead of warning consumers and prescribing physicians about the clot problems, they had been doing everything in their power to stop the negative information about the patch from becoming public. J&J had previously obtained a court order to keep them sealed so the public would not learn about the extent of the company's damage control efforts. In granting a motion by the plaintiffs' attorneys to unseal the documents, Judge Garruto said they were not entitled to a protective order because the information did not constitute trade secrets that would benefit J&J's competitors.

According to FDA records obtained by the Associated Press with a FOIA request in 2005, in one 18-month period, there were 9,116 adverse events reported by women using the patch, a rate 7 times higher than women taking oral contraceptives. A factor that must always be considered when assessing the number of people who may have been harmed by a product is that the FDA estimates that only 1% to 10% of adverse events are ever reported, which means the number of women harmed by the patch is definitely much higher. In 2005 alone, doctors wrote more than 9.4 million prescriptions for the patch, according to the pharmaceutical industry-tracking firm, IMS Health. The review of records by the Associated Press revealed that the FDA knew that blood clots were at least 3 times more common with the patch before the device was approved. The records show that, in 2000, FDA doctors reviewing J&J's clinical trials warned that clots could be a problem with the patch after finding that 2 women were treated for serious conditions where blood clots had traveled to their lungs. One reviewer said, "The label should clearly reflect this reviewer's safety concern about a potential increased risk." But in the end, the label did not contain the warning, and there was no requirement for follow-up studies other than ordinary reviews of voluntary reports.

Posted by Seth A. Katz at 05:54 PM | Permalink | Comments (0) | TrackBacks (0)

A study conducted by researchers at Carnegie Mellon may shed new light on how the brain compensates and adapts after a traumatic brain injury (TBI). The researchers studied how whiskers provide mice with essential sensory information to see how well the brain can compensate when sensory inputs are limited. Carnegie Mellon researchers hope that the study's results will help in future studies of sensory deprivation due to TBI's.

Neuroscientists discovered over a decade ago that the brain can increase its ability to adapt in response to injury that limits bodily movement. Carnegie Mellon's new study is the first to show this adaptability in an animal with sensory loss.

"Our findings are the first to show this degree of brain adaptability in a setting with significantly limited sensory input," said Allison Barth, assistant professor of biological sciences. "This finding tells us that brain function is plastic, or reparable, when a sense like touch has been profoundly diminished. Plasticity is an important indicator that the brain is reorganizing to compensate for an injury or deficit."

In the study, the brain activity of mice with varying degrees of whisker removal was recorded. Particular attention was paid to neural activity in the opposite side of the brain (since the stimulating one side of the body activates the opposite side of the brain). Researchers found that a fully functioning pair of whiskers on one side of the body drastically inhibits the ability of a single whisker to remodel the brain. The results suggest that the brain's plasticity could be boosted if sensory input on the opposite side of the body were "turned off."

"We think that our well-designed model is extremely good for future in-depth studies of brain plasticity in response to changes in how an animal senses its environment. Ultimately, we want to understand at the molecular level the dynamic between sensory use and neural plasticity," Barth said.

Posted by Kerry N. Jardine at 05:49 PM | Permalink | Comments (0) | TrackBacks (0)

In January 2005 Barbara Romer is 18 and she accidentally dyed her hair purple and needs to fix it right away. She jumps into the car and heads to the store, but makes a wrong turn. She thinks she's found a turn-off along the road and has pulled over to turn around. When Barbara pulled out she never saw the red pickup truck as it headed for her car. She lay unconscious, upside down, dangling from the stranglehold of a seat belt inside the car. A witness to the crash rushed to the wreckage and cut the seat belt constricting her neck. If he hadn't, who knows what could have resulted. Morphine kept Barbara in a comatose state for 27 days. The doctors hoped her injured brain would heal. If you looked at the MRI images of Barbara's brain you wouldn't see an injury because it was microscopic. MRIs rarely detect brain injuries like Barbara's.

Barbara awoke from her coma three weeks after the crash. Her rehabilitation lasted nearly three weeks. She spent seven hours each day learning how to be normal again. She couldn't coordinate her legs to navigate a small step. She couldn't place the Scrabble letters into the game board squares. When her speech therapist gave her three words to recite, then recall minutes later, she couldn't do it. It's amazing how far she's come. The 19-year-old returned to the New York Institute of Technology at the end of January to resume her studies. She feared the brain injury would have wiped out her design skills. Her therapists are amazed that Barbara can even commute regularly to the Big Apple. "A near-full recovery," says her occupational therapist, Katie Kelly, "is very rare." To look at her, you'd never know she has to keep a detailed accounting of every little thing she has to do every day. You wouldn't know that just a year ago, she couldn't name more than three animals. Not everybody comes back the she did says her speech therapist. She is one of the lucky ones.

Posted by Kerry N. Jardine at 05:46 PM | Permalink | Comments (0) | TrackBacks (0)

In light of recent news coverage on football players and head injuries, Symbex has joined with several college teams to create a revolutionary new helmet. In recent months, the news has been filled with the detrimental effects multiple traumatic brain injuries (TBI's) have on football players. One of the major reasons the effects are so detrimental is that coaches and players fail to see the effects of TBI's immediately and do not give the injuries the treatment and attention they need.

Symbex has developed a new helmet that measures the brain and traumatic impacts in real-time. The head impact telemetry system (HIT system) is the only one of its kind on the market. The HIT system contains a sensor/encoder mechanism that monitors brain impacts and transmits them to a separate data processor. This mechanism can be put into any helmet to transform it into a brain injury monitor. The data processor constantly receives information from the encoder and has the ability to monitor several individuals at a time. The data processor alerts of any traumatic impacts by comparing sensory information to key impact indicators.

Symbex has been researching the HIT system for over 10 years now and is in the process of conducting tests on college and high school players. So far, Symbex has recorded over 250,000 impact readings. The creators of the HIT system have also partnered with other research institutions to help unveil the biomechanical causes of TBI's. Researchers hope their studies will lead to innovative advancements in protective head gear for athletes and soldiers.

Posted by Kerry N. Jardine at 05:39 PM | Permalink | Comments (0) | TrackBacks (0)

A Statement from the Center for Science in the Public Interest (CSPI) Food Safety Director Caroline Smith DeWaal reports that the CDC’s latest report shows that infections from E. coli O157:H7, Salmonella, and Vibrio are all on the rise. E. coli cases reported to CDC’s FoodNet rose 50 percent since 2004, and Vibrio, another potentially deadly pathogen in shellfish, rose 78 percent since FoodNet began (1996-1998). The new data show that federal food safety agencies are failing in their job to protect Americans from foodborne illness. In the last six months outbreaks associated with spinach, tomatoes, peanut butter and lettuce have shaken the Americans confidence in the safety of the food supply. Even pet food has been recalled after an outbreak affecting thousand of cats and dogs. The Government Accountability Office recently put food safety on the list of high risk programs. Clearly, these programs are failing and need to be fixed.

Consider the 78 percent hike reported today in illnesses due to Vibrio, a dangerous, often deadly bacteria found in raw oysters and other raw shellfish. The Food and Drug Administration leaves it to an industry-dominated Interstate Shellfish Sanitation Conference to keep shellfish safe. That approach has obviously failed. Food safety in Washington is a shell game, with one cabinet secretary in charge of E. coli on beef and another cabinet secretary in charge if it shows up on spinach. The food safety programs are under funded and minimally staffed. Vacancies and reductions in force are rampant. CDC’s report clearly shows that the programs aren’t working, and Congress should intervene to provide increased funding to the FDA in the short run and ultimately dismantle this regulatory hodgepodge and create a single, strong agency to ensure the safety of our food.

Posted by Kerry N. Jardine at 08:32 AM | Permalink | Comments (0) | TrackBacks (0)

In the 23 years since 2004-05, eight catastrophic high school lacrosse injuries have been directly related to the sport. Of those, two were fatal, four were considered nonfatal catastrophic injuries and two were labeled "serious." There have been only six lacrosse fatalities at all levels in the past two decades. Each of the fatalities were caused by a blow to the player's chest, changing the electrical rhythm of the heart and causing cardiac arrest, a condition known as commotio cordis. Lacrosse players must wear certain safety equipment, although girls wear much less. High school male lacrosse players must wear a helmet with full face guard, a mouthpiece, lightweight shoulder pads, padded gloves, elbow pads, upper arm padding and genital protective cups. Girls are required to wear only a mouthpiece and as of 2005, protective eyewear. Girls are not required to wear helmets unless they're goalies. Girls are not required to wear helmets because the game is different for them. Men's lacrosse is a game of purposeful high-speed contact. The women's game is high-speed but only incidental contact. Body contact is against the rules for girls and women, and there are severe limits on checking. Injury data hasn't demonstrated a need for female lacrosse players to wear helmets.

Helmet standards were developed in the 1960s and 70s when there were epidemic levels of deaths from severe brain injury in contact sports, according to US Lacrosse. "No helmet can reduce the risk of neck injuries," the organization says in its latest position statement on helmet use.

Posted by Kerry N. Jardine at 08:24 AM | Permalink | Comments (0) | TrackBacks (0)

As Congress prepares to vote on the most significant prescription drug safety legislation in 45 years, a new Consumer Reports poll finds that the American public strongly backs a number of key safety reforms. Nine out of 10 agree that all clinical drug trial results should be made public and that the government should have the power to require warning labels and follow-up studies on drugs with safety problems. In general, the survey found consumers support the government taking whatever steps necessary to ensure the safety of prescription drugs. 84 percent agree that the government should "have the authority to take any action necessary" to ensure drug safety, with 50 percent strongly agreeing. Also, more than 60 percent of Americans agree that the Food and Drug Administration and Congress have failed to adequately protect consumers from harmful prescription drugs.

"The message we're hearing from consumers couldn't be clearer, they want strong laws to ensure our prescription drugs are as safe and effective as possible," said Jim Guest, CEO of Consumers Union, publisher of Consumer Reports, "Right now drug companies can game the system by touting the positive results from their drug studies, while downplaying information about harmful side effects," Guest added. "Americans are fed up with being kept in the dark about critical health and safety information, and they overwhelmingly want change."

Posted by Seth A. Katz at 07:58 AM | Permalink | Comments (0) | TrackBacks (0)

Bleeding inside the head or Intracranial hemorrhage (ICH) increases the risk of brain damage, which can cause neurological disabilities in surviving patients. There have been many studies dedicated to predicting overall clinical outcome in TBI patients. More than half of the patients brought to the hospital with TBI are intoxicated and many have cardiovascular disease requiring them to be on blood-thinners such as aspirin. Yet no prior studies have examined the potential effects of alcohol and aspirin consumption on worsening ICH in patients with TBI. Researchers at Elmhurst Hospital Center performed a one-year observational study on 150 patients treated at this Level 1 Trauma Center.

Aspirin thins the blood and reduces the risk of clots forming in key blood vessels, yet can cause bleeding problems in people with certain conditions. Theoretically, TBI patients who are aspirin users could be prime candidates at risk for increased hemorrhaging associated with aspirin consumption. Excessive alcohol consumption damages brain structure and function and there are physical changes that may result from moderate to heavy drinking of long duration. One concern is brain atrophy, which leaves more room inside the cranium for blood to collect during a brain injury. Alcohol weakens the walls of blood vessels and makes them more susceptible to rupture and bleeding. It is theorized that the combination of these factors can lead to an increase of ICH.

The study included 150 patients with a mean age of 49, admitted to the hospital with ICH after acute TBI. All important patient information including history of blood-thinner usage was recorded. Initial alcohol levels were measured in all patients suspected of intoxication. Other labs were drawn including those used to assess the clotting ability of the blood. All patients underwent two sequential CT scans within 6-12 hours after admission. The CT scans were evaluated by the investigative team and the on-call radiologist for worsening brain hemorrhage. High blood alcohol levels were present in 56.2 percent of the patients. Patients taking aspirin comprised 8.2 percent of this study population. It was found that neither alcohol nor aspirin were significantly associated with worsening ICH. However increased age showed a significant correlation with worsening hemorrhage. Overall outcome was negatively associated with worsening ICH and was measured by mortality (3 percent) and discharges to home (78.1 percent), a rehabilitation center (16.4 percent), or a skilled nursing facility (2.3 percent).

Posted by Kerry N. Jardine at 07:55 AM | Permalink | Comments (0) | TrackBacks (0)

Pediatric TBI outcomes have improved over the past 30 years due to improvements in automotive engineering, recreational helmets and car seat technology. Medical options for the treatment of pediatric TBI, however, have not seen similar advances in this timeframe. TBI patients may develop increased intracranial pressure (ICP) as a result of edema (brain swelling), blood clots, subdural hematomas (bruises), or other intracerebral hemorrhages. Controlling ICP is of great importance when treating the severely head-injured pediatric patient. Some experts have suggested that in these patients, removing variable amounts of bone from the skull (decompressive craniectomy) early after injury can improve the ability to control ICP and improve long-term outcomes.

Newswise reports after a study for the rationale of decompressive craniotomy is that by removing a variable amount of bone from the skull, the brain can expand beyond its confines. This improves cerebral pressure and reduces ICP, midline shift and brainstem compression and herniation. Records of 23 pediatric patients treated with decompressive craniectomy between January 1995 and April 2006 were compiled from a database of over 500 trauma patients treated during this period. Patient radiographs were examined to evaluate extent of intracranial injury and records were reviewed to determine the admission Glasgow Coma Scale (GCS), extent of systemic injuries, timing to craniectomy, and the indications for craniectomy.

The overall outcomes indicate a 65 percent favorable outcome in pediatric patients following craniectomy (good recovery or moderate disability), with 9 percent of the patients having severe disability on long-term follow-up. In conclustion, while pediatric craniectomy has often been viewed as a last resort in the pediatric population, it can be an effective method of controlling ICP and providing reasonable quality of life.

Posted by Kerry N. Jardine at 07:52 AM | Permalink | Comments (0) | TrackBacks (0)

Over the past year, homeless shelters across the nation have noticed a marked increase in the number of Iraq and Afghanistan veterans in need of their services. More and more vets are returning with traumatic brain injuries (TBI's) that lead to severe mental issues and addictions. These debilitating conditions result in unemployment and eventually homelessness.

The US Department of Veterans Affairs reports a relatively small number of homeless veterans from the two current wars over the past two years, but other groups and even the government say the number is short of reality.

The VA recently completed a study on homeless veterans of the Iraq and Afghanistan wars. They found that many homeless vets are not accounted for because they are not taken in by affiliates of the Veterans Affairs Homeless Services Division. "We know that number has got to be a lot smaller than the number that is out there based on a number of factors," said Amy Fairweather, director of the Iraq Veterans Project in San Francisco.

Many veterans turn to private programs and churches because the VA does not have sufficient facilities in most cities to house homeless veterans. Many also live out of their cars or take temporary refuge at a friend or relative's until a more permanent solution is found.

Experts do not expect the rising number to decrease any time soon. As the 1.5 million military personnel return from Iraq and Afghanistan, more and more are expected to add to the estimated 195,000 homeless veterans. Advocates for improved veteran conditions hope that the recent headlines about inappropriate treatment of vets will cause the government to take more action.

Posted by Kerry N. Jardine at 09:44 PM | Permalink | Comments (0) | TrackBacks (0)

August 2006 — First cases of Salmonella Tennessee, the rare strain linked to this outbreak, are reported.

August 2006 — Moisture invades ConAgra plant in Sylvester through a roof leak and the building's fire sprinkler system, which goes off twice because of a faulty sprinkler head. Company officials would later blame this moisture for helping salmonella bacteria grow in the plant.

Feb. 14, 2007 — The Centers for Disease Control and Prevention announce that the salmonella outbreak is linked to Peter Pan peanut butter. The CDC and state health agencies had noticed a spike in cases of people sickened with the Salmonella Tennessee strain, and interviews with victims revealed peanut butter as a link.

Feb. 14, 2007 — ConAgra announces a recall of all Peter Pan and Great Value peanut butter made at the plant. The affected jars all carried a product code beginning with "2111."

Feb. 20, 2007 — ConAgra estimates that its nationwide recall of peanut butter will cost between $50 million and $60 million.

March 7, 2007 — CDC announces that 425 people in 44 states have become ill with Salmonella Tennessee. The onset dates for most of those cases range between Aug. 1, 2006, and Feb. 16, 2007. Two-thirds of those cases were reported between Dec. 1 and Feb. 16.

April 5, 2007 — ConAgra releases findings of its investigation and blames moisture for helping salmonella spread. Company also announces plans to renovate the plant.

Posted by Kerry N. Jardine at 08:21 AM | Permalink | Comments (0) | TrackBacks (0)

Contrary to popular belief, juries actually sympathize more with doctors and less with their patients according to the Columbia School of Law. The statement was made based on an extensive review of numerous studies examining malpractice cases from 1989 to 2006 and focused on all medical specialties including evaluations of expert medical opinions and the merits of malpractice claims. The research involved medical negligence cases from New Jersey, Michigan and North Carolina, some cases of national significance and others involving major insurers.

The data showed that defendants and their hired experts were generally more successful than plaintiffs and their hired experts at persuading juries to reach verdicts that are contrary to the evidence. Plaintiffs have more success in toss-up cases and better outcomes in cases with strong evidence of medical negligence. Juries seem to recognize weak cases and agree with independent legal experts 80 to 90 percent of the time. Doctors are victorious in 50 percent of the cases where independent legal experts expected plaintiffs to win; medical defendants seemed to be favored in the courtroom and factors supporting that favor included superior resources, the social standing of physicians, social norms against "profiting" by injury and the jury's willingness to give physicians the "benefit of the doubt" when evidence of negligence was conflicting.

Posted by Scott J. Eldredge at 08:10 AM | Permalink | Comments (0) | TrackBacks (0)

Lawmakers in Rhode Island and eight other states are considering bills that would allow physicians to apologize when things go wrong without having to fear that their words will be used against them in court. At least 27 other states have passed similar laws, nearly all of them in the past four years, according to the American Medical Association. The wave of "I'm sorry" laws is part of a movement in the medical industry to encourage doctors to promptly and fully inform patients of errors and, when warranted, to apologize. Some hospitals say apologies help defuse patient anger and stave off lawsuits. Apology laws vary by state. In Arizona, Connecticut, Idaho, Maine and 11 other states, doctors can safely apologize to or commiserate with patients or their families about an undesirable or unexpected outcome, according to the AMA. A law in Vermont exempts only oral statements of regret or apology, not written ones. Illinois gives doctors a 72-hour window to safely apologize after they learn about the cause of a medical mistake.

At the same time, many doctors are trained or warned never to admit errors in case a patient sues. Surgeon Dr. Michael Migliori said that he realizes an apology could come back to haunt him but that he considers saying "I'm sorry" essential to preserving doctor-patient trust. Otherwise, "patients think I'm hiding something, I must have done something wrong," he said. Providence lawyer Steven Minicucci, who handles malpractice suits, said displays of compassion are rarely useful in building such cases. An apology and an admission of error could be key evidence and he opposes the Rhode Island legislation. "I like to call it the 'I'm-sorry-I-killed-your-mother'" bill, Minicucci said. "If a doctor comes out and says something like that, he shouldn't be able to immunize himself against statements like that by couching it in an apology."

Posted by Scott J. Eldredge at 10:00 PM | Permalink | Comments (0) | TrackBacks (0)

Neuroscientists at UCLA have conducted research that may change current traumatic brain injury (TBI) treatment options in the future. Currently glucose is administered to TBI patients during the critical hours after the injury, but the UCLA research team has revealed lactate as a viable, more efficient alternative.

"The prevailing theory for the brain after traumatic injury is that, just as in normal circumstances, glucose is the primary source for energy," said Thomas Glenn, adjunct assistant professor of neurosurgery at UCLA. "Further, it was thought the brain's metabolic process produces lactate, long considered a harmful waste product of a dysfunctional metabolism, one that causes further cell death via acidosis, an abnormally high buildup of acid in blood and tissue."

The UCLA study found that the same substance that is responsible for stiff muscles and fatigue after intense physical activity may be a more efficient source of energy for the brain. Results of the study showed that the brain takes up and consumes more lactate during the first 12-48 hours after a TBI than any other time. By measuring the levels of lactate in the blood in the brain, the UCLA research team came to a conclusive hypothesis. Their hypothesis states that the brain is not able to use glucose after injury because of dysfunction and because glucose is diverted to other metabolic pathways during trauma for other uses of energy. The researchers state that lactate is a more efficient use of energy because is has fewer enzymatic steps to produce energy than glucose.

"If we can confirm our hypotheses by these studies," said Glenn. "These concepts would force a reconsideration of the standard use of glucose solutions as the foundation for metabolic/nutritional support to the brain in the intensive care unit."

Posted by Kerry N. Jardine at 09:40 PM | Permalink | Comments (0) | TrackBacks (0)

Sleep-deprived air traffic controllers had a role in at least four nearly fatal incidents on the nation's runways. The controller on duty in the during Comair Flight 5191 crash in Lexington, Ky got only two hours of sleep, federal accident investigators said. "Fatigue decreases aviation safety," the National Transpiration Safety Board (NTSB) said in a letter urging reform in air traffic scheduling and training. The NTSB said the problem of tired controllers is exacerbated by scheduling two eight-hour shifts within 24 hours. The safety board said the Federal Aviation Administration, which employs controllers and regulates aviation, does "not adequately consider the potential impact of work scheduling on fatigue and performance." It also found that controllers interviewed after incidents often admitted that they didn't make it a priority to get enough sleep.

The FAA will study the recommendations, agency spokeswoman Laura Brown said. The FAA requires at least eight hours between shifts, and "we expect controllers to be responsible and make sure they are adequately rested," Brown said. Schedules are negotiated with the controllers' union, so changes would require approval from employees, she said. National Air Traffic Controllers Association spokesman Doug Church said the union welcomes the NTSB report. "This is the number one problem in the controller ranks," Church said. "There are not enough of us. The FAA is stretching their controller resources too thin." Relations between the FAA and the union soured following a bitter fight over changes in work rules and a contract that reduced controller compensation.

The controller on duty shortly before dawn on Aug. 27 when Comair Flight 5191 crashed, told investigators he did not see the jet taxi to a closed runway because he turned away to perform paperwork. The controller said he had slept two hours the previous afternoon before reporting to work at 11:30 p.m. for his second eight-hour shift that day. The agency said four other completed investigations highlighted the problems that tired controllers can create. Among them, the controller who ordered a passenger jet to take off directly into the path of another jet at Chicago's O'Hare International Airport last year told investigators he had slept only four hours before reporting to work at 6:30 a.m. He said he was "not as sharp as (he) could have been," the NTSB reported. Additionally, a controller who cleared a cargo jet for takeoff on a closed runway in Denver in 2001 told investigators she had gotten 60 to 90 minutes of sleep before working an overnight shift. She told investigators she was "probably tired, not alert enough."

Posted by Kerry N. Jardine at 09:36 PM | Permalink | Comments (0) | TrackBacks (0)

Commercial Realtor Art Seiden and his wife Julie started PUSH, an auction and dinner to benefit Craig Center for Spinal Cord Injury Research. Julie received catastrophic injuries in a horseback riding accident and was treated at Craig. The couple said that Craig Hospital was so helpful and compassionate that they vowed to do whatever they could to help raise money and awareness for research. This year the sixth edition of the benefit raised more than $1 million dollars for research, surpassing attendance and income from previous years. Past auctions and dinners have enabled Craig to become a world leader in the treatment of spinal cord and brain injuries.

The leadership team includes, chairman Steve Hochhauser, the president, chairman and CEO of Johns Manville, and honorary chair John Lynch of the Denver Broncos - worked with a committee that included Larry Atler, Ron Branish, Leslie Fishbein, Sandy Loeffler, Janet Lozow, Steve Mandel, Joel Rosenstein, Saul Rosenthal, Tim Schmidt and Robert Silverberg.

Posted by Kerry N. Jardine at 09:29 PM | Permalink | Comments (0) | TrackBacks (0)

Internationally renowned experts in brain trauma will meet April 25-27 for the seventh annual Galveston Brain Injury Conference at Moody Gardens in Texas. This invitational event is sponsored by the Center for Rehabilitation Sciences and the School of Allied Health Sciences at the University of Texas Medical Branch at Galveston in collaboration with the Transitional Learning Center at Galveston, which provides rehabilitation for those who have suffered an acute brain injury. “Despite the fact that annually over 200,000 Americans become disabled from a traumatic brain injury, it is an ‘orphan’ disease, largely ignored by the public and the medical field,” said Dr. Brent Masel, TLC president. The 2007 conference will focus on best practices and clinical applications involving pediatric traumatic brain injury. Six experts will present their research at the conference, and the proceedings will be published in the Journal of Head Trauma Rehabilitation in 2008. The conference will be facilitated by Roberta DePompei, a past recipient of the Robert L. Moody Prize and an expert in pediatric brain injury, recognized for her research and development of clinical techniques for cognitive-communication and school reintegration issues for youth.

During the conference, John Corrigan will receive the 2007 Robert L. Moody Prize for Distinguished Initiatives in Brain Injury Research and Rehabilitation. Corrigan directs the TBI Network, a program providing community-based services for substance abuse after brain injury. Corrigan has received local and national awards for his service and research in the field, including the Brain Injury Association of America’s William Fields Caveness Award. Corrigan will join about 45 of the nation’s top educators and physicians at the conference, said Elizabeth Protas, acting dean of the UTMB School of Allied Health Sciences.

“Children with traumatic brain injury present the medical community with a wide range of challenges, and we’re excited about reconvening the world’s premier experts in rehabilitation to discuss ways to meet those special challenges,” Protas said.

Posted by Kerry N. Jardine at 09:26 PM | Permalink | Comments (0) | TrackBacks (0)

Boston Scientific/Guidant and the FDA announced today that a subset of cardiac defibrillators within the Contak Renewal 3 & 4, Vitality and Vitality 2 families have been recalled. The recall includes about 73,000 implantable cardiac defibrillators and cardiac resynchronization therapy defibrillators because of faulty capacitors that may cause depletion of the batteries sooner than would normally be expected.

Except in rare cases, Guidant does not expect that the recalled devices will have to be removed from patients. Patients who have a device affected by this recall are advised to:

1) Contact their doctor;
2) Contact Boston Scientific Technical Services at 1-800-CARDIAC;
3) Go to Guidant's Product Performance Resource Center website at: http://guidant.com/ppr/advis/2007_04_05.shtml. You'll need to know your defibrillator's model and serial number to use this website.

In most cases, a routine follow-up may be all that is required; in some cases, more frequent device checks may be advised.

Posted by David P. Hersh at 05:23 PM | Permalink | Comments (0) | TrackBacks (0)

Last week there was a report that a bill to exempt the practice of medicine from the Kansas Consumer Protection Act was mired in legislative limbo. It has now been approved by the Kansas Legislature. The legislation, originally designated House Bill 2530, would change the Consumer Protection Act so it would not apply to the “rendering of or failure to render professional services by a physician or other health-care provider.” The bill was introduced at the request of the Kansas Medical Society after the Kansas Supreme Court recently ruled that the protection act could apply to a physician’s conduct in providing treatment.

“The Supreme Court for the first time in 34 years decided that the language of the Consumer Protection Act was broad enough to include medical malpractice actions,” Rep. Mike O’Neal said in an interview after the legislators went home. “The effect of this would have been to increase the cost of malpractice insurance for doctors and the cost of health care for Kansans.” The Senate version of the bill, SB 55, was modified to make it clear that the Kansas attorney general still has the authority to prosecute Consumer Protection Act claims against health providers for issues involving business practices, O’Neal said. Jerry Slaughter, the executive director of the Kansas Medical Society, said consumers still would be able to file Consumer Protection Act claims against physicians or other health-care providers “for those things that are traditional claims, such as deceptive billing, deceptive advertising or unconscionable billing practices.”

The legislation had aroused heated debate. “The Kansas Trial Lawyers Association is profoundly disappointed with the Kansas Legislature’s decision to pass Senate Bill 55,” Terry Humphrey, executive director of the association, said in a statement last week. “SB 55 fundamentally changes current law by eliminating consumer rights. The health-care industry has not made the case to consumers why their rights under the Consumer Protection Act should be eliminated to protect those that intentionally lie about health-care treatment.”

Posted by Scott J. Eldredge at 09:58 PM | Permalink | Comments (0) | TrackBacks (0)

We often think of India as a magnet for customer call centers and high-tech development, but we don't think of India in terms of cutting edge health care. Yet India, Thailand and Cuba are luring visitors from around the world seeking reduced-cost medical treatment. It is particularly attractive to Canadians who want to avoid long waiting lines caused by government-run health care. For Americans, it has become a cheaper alternative. Someone in need of open-heart surgery can schedule that procedure in one of India's best hospitals. In our country, that procedure would cost up to $150,000, but in India it may ring up at $10,000. India is the leading promoter of medical outsourcing. Another plus for these countries is a big cost savings on malpractice insurance, according to the Pacific Research Institute in San Francisco. PRI analysis shows that doctors practicing beyond our borders pay as little as $4,000 a year for malpractice insurance while American doctors can pay 25 times that amount.

Drawbacks exist. PRI research shows the U.S. dollar is more valuable in underdeveloped countries where pay is low and patient numbers are high. If people are concerned about quality of care or patient safety, many of these hospitals have U.S. hospital accreditation and U.S. certified surgeons. With those stamps of approval, Bangkok and Phuket in Thailand and India experienced a 30 percent rise in American patients. Cost savings have not escaped lawmakers' attention, either. In West Virginia, a bill is pending in the Legislature that would allow private insurance companies to provide incentives for consumers to have cheaper surgeries in accredited hospitals abroad.

Outsourcing medical services is no panacea. It has its problems. If a government or private medical health plan won't cover the costs, patients have to come up with the cash for the procedures. Patients are usually in the hospitals for only a few days in a strange land far from their physician, family and friends. There is little follow-up care, and if there are complications or side effects, or if additional postoperative care is required, then the patient has to find that care back home. Medical malpractice laws in many nations are weak. While our laws are costly, too aggressive and restrictive, foreign laws may be too lax. Finally, we have to find ways to ensure that America's medical providers remain competitive. One way is to find the balance in the courts and regulatory system and fully realize that medicine, too, is a globally competitive industry.

Posted by Scott J. Eldredge at 09:51 PM | Permalink | Comments (0) | TrackBacks (0)

According to Newswise, hospital admissions for the most serious category of head injury, Type 1 traumatic brain injury, increased nearly 38 percent between 2001 and 2004 after a decade of decline, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. In 2004, there were nearly 204,000 hospitalizations for traumatic brain injury at a cost of $3.2 billion, and seven of 10 of these involved patients with a Type 1 injury. Inpatient hospital care for these patients cost $2.7 billion. Forty percent of patients’ injuries were caused by falls, such as down stairs, off ladders, or on ice. Other common reasons for hospitalizations included motor vehicle accidents (26 percent), being hit while playing sports or having a falling object hit the head (8 percent), bicycle or other transportation accidents (4 percent), and shootings (2 percent). People age 65 and older accounted for nearly 36 percent of hospitalizations followed by people age 18 to 44 (about 31 percent). People ages 45 to 64 comprised 19 percent of the cases and adolescents and children accounted for 15 percent. About 13 percent of patients died while hospitalized and nearly 28 percent were transferred to a nursing home or other type of rehabilitation facility. By comparison, less than 1 percent of other head injury patients died while hospitalized and about 8 percent were discharged to a nursing home or other type of rehabilitation facility.

This News and Numbers is based on data in Hospital Admissions for Traumatic Brain Injuries, 2004. The report uses statistics from the Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of all short-term, non-federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type as well as the uninsured.

Posted by Kerry N. Jardine at 09:22 PM | Permalink | Comments (0) | TrackBacks (0)

In May 2006, nephrologists at a hospital in St. Louis, Missouri, reported to CDC and the Missouri Department of Health and Senior Services (MoDHSS) a cluster of NFD among patients treated in their dialysis units. CDC and MoDHSS conducted an investigation to determine the number of affected patients and identify risk factors for NFD. Thirty-three patients with NFD were identified in St. Louis, 28 of whom had been treated at the hospital. A matched case-control study was conducted at the hospital. This is a summary report of the preliminary results of that study, which indicated that exposure to gadolinium-containing contrast agents during magnetic resonance imaging (MRI) studies was independently associated with NFD. Clinicians have been encouraged to be aware of the potential for NFD, and when possible, should avoid use of gadolinium-containing contrast agents in patients with advanced renal disease.

A confirmed case was defined as clinical findings (i.e., skin thickening or hardening) and skin biopsy findings consistent with NFD in a person with renal disease in St. Louis during January 2000–August 2006. Suspected cases met either the clinical or the biopsy criteria but not both. Hospital staff members manually searched a logbook of dermatology biopsies to identify diagnoses consistent with NFD from January 2000 onward. Study investigators searched the hospital pathology database for diagnoses of NFD and potentially related diagnoses from the same period. Investigators searched for additional cases that would not have been identified at the hospital by contacting eight pathology referral centers in St. Louis and requesting information on all patients who had NFD diagnosed since January 2000.

The maximum erythropoietin (epoetin alfa) dose received during the preceding 6 months and the dose received at the time of disease detection (for case-patients) were classified as high or low relative to the median weekly dose received by all patients in the study. The case-control study included confirmed cases from the hospital. Three controls per case-patient were selected randomly from a group of patients who were treated in the same hospital dialysis clinic or treatment center on the same day that a case was diagnosed. Twenty-eight cases were identified during December 2002–August 2006, including 25 confirmed and three suspected cases. The NFD attack rate estimated for persons undergoing outpatient chronic dialysis in the hospital system for the 4 years in which cases were identified was 4.6 cases per 100 peritoneal dialysis patients and 0.61 cases per 100 hemodialysis patients.

Further documentation of a causal relationship between gadolinium contrast agents and NSF. Cases are being reported with more frequency across the world now; a case-controlled study is expected to be published in the near future. With the causal relationship be more firmly established what is now becoming clearer is the legal liability of the manufacturers for gadolinium is a toxic and several of the contrast agents were obviously defectively designed and manufactured. All patients diagnosed with NSF should search for a law firm with the expertise in handling NSF cases and who has retained the world-experts on the disease and gadolinium.

Posted by Kerry N. Jardine at 08:28 AM | Permalink | Comments (0) | TrackBacks (0)

Toshiba America Medical Systems, Inc. has developed three imaging techniques for its MR product line that allow for contrast-free imaging during MRA procedures. Contrast-free imaging is particularly important because gadolinium, the common contrast agent used for magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) exams, recently has been directly linked to nephrogenic systemic fibrosis/dermopathy (NSF/NFD). "Toshiba has been at the forefront of contrast-free imaging since 1998 - long before reports of the negative effects of gadolinium," said Bob Giegerich, director, MR Business Unit at Toshiba. "With Toshiba's contrast-free imaging techniques, physicians can perform MRA procedures and capture images superior to those acquired through techniques that require contrast agents."

Toshiba's equipment utilizes three proprietary contrast-free imaging techniques that can successfully perform MRA - fresh blood imaging (FBI), contrast-free improved angiography (CIA) and Time-SLIP. FBI makes it possible to image the arteries and veins at the same time, but displays them separately, which allows physicians to more accurately diagnose diseases that may have both arterial and venous components. CIA is the second generation of FBI techniques developed by Toshiba and allows for imaging of small vessels, making it possible to diagnose disease before it manifests in the larger vessels. Time Spatial Labeling Inversion Pulse (Time-SLIP) is a unique method that allows for noninvasive imaging of the vasculature.

Today, a number of sites are using Toshiba's contrast-free imaging techniques. "Contrast-free imaging has gone from a research and investigational tool to a practical application and continues to grow," said Dr. Mark Winkler, M.D., professor of Health Sciences at the University of Nevada, Las Vegas and founding partner of SDMI. "Specifically, Toshiba's Time-SLIP technique produces much higher quality renal MRAs than conventional contrast enhance techniques. This is important because these studies are often performed in patients with impaired renal function."

Posted by Kerry N. Jardine at 08:22 AM | Permalink | Comments (0) | TrackBacks (0)

May 1st oral arguments will be heard in two cases that could shape the future of consumer protection lawsuits in the state. Twenty-four organizations filed amicus curiae briefs in the case of Arbino v. Johnson & Johnson, et al., in the Ortho Evra case and another eight did the same in the General Assembly's suit against Secretary of State Jennifer Brunner. Melisa Arbino is seeking an advisory ruling on the constitutionality of 2005's Senate Bill 80, a tort reform law that puts a cap on non-economic damages. She seeks more than what is allowed, though her case has not yet been decided.

Arbino's case, Augsburger said, is the first major challenge to Senate Bill 80. Arbino, of Cincinnati, alleges in her complaint that her use of the birth control patch Ortho Evra caused four blood clots by the time she was 24. Blood clots, she says, were not an expressed side effect of the patch. With liability not yet determined, Arbino's attorneys already want to test the amount of damages she can recover. "Specifically, by purporting to limit the amount of compensatory damages for non-economic injury that may be awarded in a non-catastrophic case, Senate Bill 80 infringes upon the right to trial by jury, unconstitutionally empowers a court to reexamine a jury's award, interferes with the constitutional right to a remedy, and violates due process," the complaint says before making the same point regarding punitive damages.

Posted by Seth A. Katz at 08:20 AM | Permalink | Comments (0) | TrackBacks (0)

Arizona Legislature will be reviewing senate bill SB 1032 that will impact emergency health care. Arizona has a shortage of physicians and other health-care providers. It is a shortage that is attributed to false claims of malpractice. Through this bill, in order to prove malpractice in emergency situations, the level of evidence to prove liability would be changed from "a preponderance of evidence" to "clear and convincing evidence," meaning that it would have to be proven with virtually 100 percent of the evidence against the health-care team that malpractice occurred. This will not ban valid lawsuits against anyone on the health-care team. Currently, if a patient arrives in a medical facility needing emergency medical care, federal law states that a hospital and health-care team must care for the patient. At the same time, professional and legal standards mandate that a proper history and physical, lab workups, et cetera, should be completed prior to providing optimal care for that patient. This situation creates a dilemma, as the health-care team cannot provide optimal care based on their training and professional standards while at the same time required to care for that patient.

The House of Representatives will soon be debating this bill in the full assembly, but one important aspect of this bill continues to be ignored, which is exactly who this bill will benefit. It is true that the bill will protect physicians and hospitals throughout the state and reform such as this is needed to attract qualified physicians to the state. This bill also protects all health-care workers involved in emergency care, making it more difficult to bring a frivolous and malicious lawsuit that can damage these valuable health-care workers financially and professionally, affecting their records to a point in which employment can be difficult to obtain. This bill will protect nurses, emergency medical technicians, surgical technologists, physician assistants and all other healthcare workers. SB 1032 will not safeguard negligent health-care workers, but it will protect those working hard to ensure quality health care for all of Arizona. Gov. Janet Napolitano has stated that she would support legislation such as this after a nonpartisan committee reviewed previous legislation and supported the idea of these changes.

Posted by Scott J. Eldredge at 08:16 AM | Permalink | Comments (0) | TrackBacks (0)

The Associate Press reports that a 14-year-old boy preparing for a national snowboarding championship during his first season of competition was paralyzed from the neck down when he fell during a practice run. Tyler Eklund was practicing for the USA Snowboard Association National Championships happening this week at Northstar at Tahoe resort in Truckee, Calif. The eighth-grader from Bend slid smoothly through the turns, landed his jumps and nailed his tricks Sunday during a practice run to cap his season finale at the world's biggest amateur snowboarding competition. His coach, Hans Hibbard, and teammates said they watched him ride all the way down the run but they could not see what happened next.

Tyler apparently made it to the flats and was heading toward the chairlift when his board caught an edge in softening snow. He must have fallen quickly and hard, his coach said. Someone summoned the ski patrol and they found him unconscious. Tyler was transported by helicopter from the resort to Renown Regional Medical Center in Reno, Nev. Hibbard said it was still unknown whether the teen will be able to breathe without the aid of a machine. Eklund underwent surgery to replace a broken vertebra in his neck and received other treatment for swelling. Hibbard said that Eklund was wearing a helmet at the time of the accident.

Posted by Kerry N. Jardine at 08:11 AM | Permalink | Comments (0) | TrackBacks (0)

The journey taken by Jessica Clements since she suffered a traumatic brain injury in Iraq has brought her national recognition. The retired Army staff sergeant from Plain Township has been named spokesperson for the 10 in 10 Project, a new nonprofit group dedicated to helping the 5.3 million Americans, military and civilian, who are unable to afford post-injury assistance. Clements, 30, was wounded in May 2004 in a roadside bombing while serving in Iraq with an Army Reserve unit from Mansfield. The group is named the 10 in 10 Project because it is estimated that only two out of 10 people who suffer a traumatic brain injury will get the help they need to return to a meaningful life. The project aims to change the number to 10 in 10, or 100 percent. The nonprofit group, formed in December, hopes to raise money by selling Tickets of Hope at $600 apiece. Through Tickets of Hope, the group plans to provide support and assistance to people with brain injuries and their families. From the sale of each ticket, the group provides: A Brain Injury Recovery Kit that is shipped to the individual's home; a support program for use of the kit through the Brain Injury Association New Mexico (BIANM); and membership in the chartered affiliate Brain Injury Association in the individual's state. Once the 3,000 soldiers in need of help receive their Ticket of Hope, the group wants to begin identifying and helping other brain-injured people. “It is extremely important that soldiers have the support they need after suffering a traumatic brain injury,” Clements said. “The very hardest part of recovery is trying to return to your previous life. Having the Brain Injury Recovery Kit and the support provided by 10 in 10 makes sure that I have the tools necessary to move on with living.'' Clements said the Brain Injury Recovery Kit has helped her tremendously. She said she hopes the 10 in 10 group can help not only wounded soldiers but also civilians who suffer traumatic brain injuries.

Clements spoke of her injury and recovery on Oprah Winfrey's show last year. There are still pieces of shrapnel lodged in Clements' brain. As part of her treatment, part of her skull was removed and placed in her abdomen while the swelling in her brain subsided. The piece of skull was replaced three months later. Clements continues to suffer seizures and migraine headaches. She said she was hospitalized for two weeks in February, and doctors have determined she is having two types of nighttime seizures. One type, she said, is from scarring in the brain as a result of the injury from the bomb blast. The other type, she said, is the result of post traumatic stress disorder. Because of the seizures, Clements had to withdraw from the University of Akron this semester, but she said she hopes to take a class this summer and possibly sign up for online classes that would not require her to drive

Posted by Kerry N. Jardine at 08:08 AM | Permalink | Comments (0) | TrackBacks (0)

A team of engineers at Princeton University, Columbia University and the University of Cambridge have developed flexible electronic membranes that feature microelectrodes that are able to withstand the sudden stretching that is used to simulate severe head trauma. The development will help brain researchers to overcome the long-lasting dilemma of how to replicate injuries in the lab without destroying the electrodes that monitor how brain cells respond to physical trauma. The advance could allow far more refined studies of brain injury than previously possible and may lead to superior healing in the minutes and hours immediately following the injury. Present techniques to study shocking brain injury have been inadequate because it is almost impossible to insert an electrode into a cell to find a recording, remove the probe, injure the cell, and then reinsert the probe into the same cell, Morrison said. Because of this drawback, researchers rely on other replacement markers of injury, such as cell death. "In terms of traumatic brain injury, there can be a lot of functional damage to the brain in other ways than just killing a cell," Morrison said. "Neurons can still be alive, but not properly firing," which leads to problems ranging from comas to epilepsy.

These improperly functioning neurons can now be gauged by the electrodes in the stretchable membranes. After brain cells have been placed on the flexible surface and allowed to nurture, the researchers measure their normal activity. The membrane is then suddenly stretched and returned to its original form. Having survived the shock, the electrodes rooted in the membrane continue to examine the cellular activity, providing a before and after picture of traumatic brain injury.

Posted by Kerry N. Jardine at 07:52 AM | Permalink | Comments (0) | TrackBacks (0)

The Food and Drug Administration said it will increase the frequency of investigations at plants that make peanut butter and similar products, saying this year's salmonella outbreak showed peanut butter is riskier than health officials had thought. "Up until this point, peanut butter has not been considered a high-risk food," said Dr. David Acheson, chief medical officer of the FDA's Center for Food Safety and Applied Nutrition. "We now know peanut butter can be a vehicle for salmonella." Peanut butter will almost certainly move up on the FDA's list of high-risk foods, and the agency bases its inspection schedule on the relative risk of foods. "For anybody who makes peanut butter, we've now learned that if there's salmonella in the environment there could be a problem," Acheson said. That's why salmonella infections could happen at other peanut butter plants, but he believes the industry has been paying attention. "I would be pretty certain that every other peanut butter producer is having the same thought we are and is paying a lot of attention to it to make sure that it doesn't happen," he said. The basic process used at all peanut butter plants is similar. They all bring raw peanuts in, roast and grind them, mix and blend them, and put the product in bottles or cans. "It's a call to all of us to be thinking about if it can happen in the ConAgra plant in Georgia, why couldn't it happen in some other peanut butter plant? And I think the answer is it could," Acheson said.

Officials at Unilever, the company that makes Skippy peanut butter, say they have been monitoring the FDA investigation at ConAgra's plant. "While we do have very strict manufacturing and supply chain protocols in place, we constantly review them to ensure consumer safety," Unilever spokeswoman Anita Larsen said. The explanation for the salmonella outbreak ConAgra officials offered fits with what the FDA found, but the government investigation has not been completed. FDA officials will decide whether to pursue any sanctions against ConAgra after the investigation. "It doesn't automatically follow that a company, just because they had a recalled product that made people sick, did anything wrong that they could have done differently and did it deliberately," Acheson said. The FDA last inspected the ConAgra plant in 2005 and did not find any problems.

Posted by Kerry N. Jardine at 07:49 AM | Permalink | Comments (0) | TrackBacks (0)

Conventional wisdom considered lactate to be responsible for little more than stiff muscles and fatigue, and the "sour" in sour milk. It turns out that view may have been too narrow. Neuroscientists at UCLA are now looking at lactate differently, considering it a possible replacement "fuel" for the brain in the immediate hours after a traumatic brain injury instead of the current standard, glucose. Previous work by Dr. Neil Martin, professor and chief of neurosurgery at the David Geffen School of Medicine at UCLA, and Thomas Glenn, a UCLA adjunct assistant professor in the department of neurosurgery, showed that the brain takes up lactate after traumatic injury. Thanks to a $275,000 grant from the National Institute for Neurological Diseases and Stroke at the National Institutes of Health, the investigators will determine why the brain does this. Is it actually using lactate to help it recover after injury? "The prevailing theory for the brain after traumatic injury is that, just as in normal circumstances, glucose is the primary source for energy," Glenn said. "Further, it was thought the brain's metabolic process produces lactate, long considered a harmful waste product of a dysfunctional metabolism, one that causes further cell death via acidosis, an abnormally high buildup of acid in blood and tissue." Instead, the researchers found that in the first 12 to 48 hours following traumatic injury, the brain takes up and apparently consumes more lactate than at any other time. They discovered this by measuring the levels of lactate in blood entering and leaving the brain.

To determine if lactate was being used by the brain, the researchers, labeled lactate with a non-radioactive and stable isotope then added it to the patient's standard intravenous solution. The isotope served as a marker they could follow to see if the lactate molecule had produced carbon dioxide, the byproduct of lactate after use by the brain as fuel. "Our preliminary tracer-based studies demonstrated the novel and unexpected finding of both lactate uptake and its utilization as fuel in traumatic brain injury," Glenn said. "These results have led us to challenge the current conventional wisdom concerning the type of fuel the brain uses after injury to generate the energy for recovery." They suspect that following injury the brain may not be able to use glucose because it is diverted to other metabolic pathways for other uses. Additionally using glucose requires more than 10 enzymatic steps before it generates energy, while lactate requires much fewer steps, making it under these circumstances a faster and more efficient source of fuel. The researchers will seek 20 to 30 additional brain-traumatized patients over the next two years to further confirm their hypothesis, which will require receiving the approval of a patient's family before proceeding. It's a delicate and diplomatic effort under such conditions, and Glenn is grateful that people understand that the bottom line is to improve care after a traumatic brain injury. "If we can confirm our hypotheses by these studies," said Glenn, "these concepts would force a reconsideration of the standard use of glucose solutions as the foundation for metabolic/nutritional support to the brain in the intensive care unit.

Posted by Kerry N. Jardine at 07:46 AM | Permalink | Comments (0) | TrackBacks (0)

Ten attorneys were allowed inside the Sylvester, Georgia ConAgra Foods plant to see how salmonella bacteria ended up inside peanut butter jars. Lawyers, photographers and engineers walked the roof of ConAgra Foods, photographing the roof leak believed to be the source of salmonella bacteria inside the plant. "We represent almost five thousand people across the nation and we have service members in Iraq, we have people from foreign countries, we represent about half the people that are officially counted," said Seattle attorney Bill Marler. "Micro-biologists, roofing experts, engineers, lots of photographers, lots of videographers, we even have a guy in there that sort of does this laser, GPS thing to figure out where the vats are in relation to the roof to various areas," Marler said.

Attorneys will compare their information along with the FDA and ConAgra's files. The information will help determine who has a legitimate injury claim. The Sylvester plant can't begin cleanup until attorneys get what they need. While attorneys have reached an agreement for the company to pay medical expenses for the uninsured sick, it has not been determined what compensation they might offer others. At the CDC's last count, 425 people in 44 states were confirmed sickened by salmonella bacteria in Peter Pan and Great Value Peanut Butter. Now as part of the class action lawsuits, lawyers will conduct their own tests.

Posted by Kerry N. Jardine at 07:43 AM | Permalink | Comments (0) | TrackBacks (0)

Researchers from MIT, Harvard Medical School, and Massachusetts General Hospital have developed a new computer module to study folds found in the outermost layer of the brain. All large mammals' brains have an outer layer that consists of intricate folds. The folds' functional significance has been a mystery in the neuroscience field for years, but this new model may unveil the eluding mystery.

The researchers applied computer graphics techniques to brain images collected using magnetic resonance (MR) imaging. The computer graphics techniques were used to created a set of tools to track and measure the folds in the brain over time. The model serves as a biomarker, or biological indicator, and could someday aid in the discover of the causes of neurodegenerative diseases such as autism and Alzheimer's.

To develop the model, MR images of 11 developing brain were obtained. The 11 participants ranged in age from newborn to 7 years old. The MR images were analyzed and computationally marked to allow for identification of the age and development of each fold. It was found that course, large folds develop earlier and more slowly than fine-grained folds.

Now that the initial model has been developed, the research team plans to compare normal brain scans to the brains of patients with neurodegenerative diseases.

“We now have some idea of what normal development looks like. The next step is to see if we can detect abnormal development in diseases . . . by looking at folding differences,” said Bruce Fischl, lead researcher on the model and associate professor of radiology at Harvard Medical School.

Posted by Kerry N. Jardine at 07:39 AM | Permalink | Comments (0) | TrackBacks (0)

At the FDA's request, drugmaker Novartis has agreed to stop marketing Zelnorm (generic: tegaserod) after an analysis of the drug's safety record revealed an increased risk of heart attack, angina, stroke and death. Novartis' analysis, requested by a Swiss health agency, found that 13 of 11,614 patients taking the drug had a cardiac event, including one death, compared with one case of 7,031 patients taking a placebo. After reviewing that data, the FDA determined that the drug's risk-to-benefit ratio was no longer favorable enough to keep Zelnorm on the market.

Zelnorm was first approved in 2002 for the short-term treatment of women with irritable bowel syndrome whose primary symptom was constipation. In 2004, Zelnorm was approved for treatment of chronic constipation in men and women under 65.

Dr. Roshini Rajapaksa, a gastroenterologist at New York University Medical Center, said, "This is very big and disturbing news, because Zelnorm was really the only effective and approved drug available for irritable bowel syndrome (IBS) with constipation."

The FDA advises patients taking Zelnorm to contact their health care providers to discuss treatment alternatives. Seek emergency medical care if you experience severe chest pain, shortness of breath, dizziness, sudden onset of weakness or difficulty walking or talking, or other symptoms of a heart attack or stroke.

Posted by Seth A. Katz at 09:29 PM | Permalink | Comments (0) | TrackBacks (0)

http://familydoctor.org/736.xmlA healthcare rating company reported recently that patient safety incidents in U.S. hospitals increased by three percent from 2003 to 2005. After analyzing over 40 million Medicare hospitalization records at almost 5,000 hospitals from 2003 to 2005, the group also reported that the gap between the best-performing and worst-performing hospitals is widening. The top-performing centers had 40 percent fewer medical errors than the worst-performing centers studied.

Other findings documented during the three-year period:

- There were 1.6 million patient safety incidents among Medicare patients. That's an incidence rate of 2.86 percent.

- There were 247,662 potentially preventable deaths in U.s. hospitals. Medicare patients involved in one or more safety incidents had a 25 percent chance of dying.

- The excess cost to Medicare associated with patient safety incidents was $8.6 billion.

- The greatest increases in safety incidents involved post-operative sepsis, post-operative respiratory failure, and selected infections due to medical care.

- The most common incidents were decubitus ulcer, failure to rescue, and post-operative respiratory failure.

- If all hospitals studied had performed as well as the best facilities in the study, about 206,286 patient safety incidents and 34,393 Medicare patient deaths could have been avoided, and $1.74 billion could have been saved.

Posted by Scott J. Eldredge at 09:24 PM | Permalink | Comments (0) | TrackBacks (0)

One of the biggest problems that has hindered traumatic brain injury (TBI) research is how to simulate TBI's in the lab without destroying the electrodes that monitor how brain cells respond to trauma. Current techniques used to study TBI's are limited and have frustrated researchers for years. In the most commonly used technique an electrode is inserted into a cell to obtain a recording and then must be removed to injure the cell with another probe. After the cell is injured the electrode must be reinserted in the same exact cell to obtain post-injury recordings - a procedure found to be nearly impossible.

Engineers and researchers at Princeton University, Columbia University, and the University of Cambridge may have found a solution to this dilemma. They developed an electronic membrane that consists of microelectrodes that can withstand sudden stretching used to simulate TBI's. The electronic membranes allow for more detailed studies of brain injury and could lead to better treatments for the critical moments after a TBI.

To monitor improperly functioning neurons brain cells are placed on the electronic membranes and allowed to grow. The normal activity of the brain cells are then measured. After normal measurements are made, the membrane stretched to simulate brain injury and then returned to a normal state. The electrodes in the membrane continuously monitor the cellular activity in the brain to proved a before and after picture of a brain suffering physical trauma.

The flexible electronic electrodes may also someday be used to provide electrical input to brain tissue and may be used to induce learning in brain cells damaged by trauma. The research team hopes to conduct further studies to refine the technique so it can be used in other tissues as well.

Posted by Kerry N. Jardine at 09:20 PM | Permalink | Comments (0) | TrackBacks (0)

A coalition of people looking out for Kansas consumers is sounding an alarm about a bill currently in the hands of the Senate Judiciary Committee. The bill exempts a physician or other health care provider from the authority of the Kansas Consumer Protection Act with respect to professional services. According to opponents of the bill, the exemption would have extensive ramifications and would take away the right of individuals to collect damages when they have been misled by people who provide any sort of medical services. As defined in the bill, “professional services” does not include billing, advertising or other business services. It does include “any service, treatment, operation, prescription, communication or practice related to the care, treatment, diagnosis, ascertainment, cure, relief, palliation, adjustment, or correction of any disease, condition, ailment, deformity, or injury.” The House passed the bill, sending it to the Senate. The Senate introduced the bill and sent it to the Judiciary Committee for a hearing. If the bill is approved by the committee, it will then be incorporated into a committee report and returned to the floor of the Senate for a vote.

The bill arose quickly on the heels of a Feb. 9 Kansas Supreme Court ruling that physicians are indeed subject to the Kansas Consumer Protection Act. In that case, Williamson v Amrani, Tracy Williamson sued orthopedic surgeon Jacob Amrani, claiming in part that he’d violated the Consumer Protection Act by telling her “the surgery he was recommending had a high likelihood of successfully relieving her pain when, in fact, that surgery had been unsuccessful in the majority of cases where Dr. Amrani had utilized the same procedure,” the Supreme Court wrote in its decision. “Williamson alleged that Dr. Amrani had willfully misrepresented or concealed material facts in that he knew or should have known that the surgery he was recommending had produced ‘bad results’ for a majority of his patients.” The Kansas Supreme Court agreed with Williamson’s claim.

The consumer protection law is designed to protect the public from being victimized by intentionally deceptive and unconscionable acts during business transactions. As such, opponents believe, it should be left alone. “Where can I get that kind of exemption?” asked Hays attorney Greg Schwartz. “First and foremost, the intent behind the bill is to carve out a special exemption for a certain segment of society. The flip side of all of this is, if they’re not deceiving their patients, why do they need it?” Schwartz said. Schwartz pointed to the special remedies the Consumer Protection Act provides Kansas citizens. The issues are much broader than malpractice, Schwartz said. Besides providing consumers with specific remedies when they are victimized by fraudulent, deceptive, unconscionable acts, the Consumer Protection Act also provides a mechanism for the attorney general’s office to get involved, Schwartz said. “It’s a very consumer-friendly law that provides some protection from people who set out to do those things,” Schwartz said. “That law’s there to protect the consumers, and when you start gutting out certain sections of the law, you’re weakening it and taking away the protections there under.”

Posted by Scott J. Eldredge at 10:54 AM | Permalink | Comments (0) | TrackBacks (0)

According to a study published in the April 3, 2007 issue of Neurology a mild head injury can increase chances of developing a sleep disorder. Researchers say these findings highlight the need for improved diagnosis and treatment of sleep disorders in mild traumatic brain injury patients who complain of insomnia. "As many as 40 to 65 percent of people with mild traumatic brain injury complain of insomnia," said study author Liat Ayalon, PhD, with the University of California, San Diego. "This is concerning since sleeping problems may exacerbate other brain injury symptoms such as headache, emotional distress, and cognitive impairment, making the rehabilitation process much harder."

For the study, researchers assessed 42 people with complaints of insomnia after mild traumatic brain injury. Those suspected of having a circadian rhythm sleep disorder (CRSD) (i.e. problems with the timing of sleep) underwent scans, sleep studies, and had their oral temperature and saliva melatonin measured. The study found 15 of the 42 patients (36%) had a CRSD. Of those, eight people had problems falling asleep and seven people had irregular sleep-wake patterns. "The frequency of sleep disorders in this study is considerably higher than the rate of these disorders among people attending sleep clinics for insomnia, which is seven to 10 percent," said Ayalon.

Ayalon said these findings suggest that sleep disorders that involve changes in the timing of sleep may be relatively frequent among brain injury patients and should be considered when these patients report sleeping problems to avoid misdiagnosis. "Misdiagnosis of these patients as insomniac may lead to prescription of medications, which help people fall asleep but don't help normalize the sleep-wake cycle," said Ayalon. In addition, Ayalon said since circadian rhythm sleep disorders are often associated with cognitive and psychological problems, treatment might ultimately lead to improvement in other brain injury related symptoms. Ayalon said further studies are needed to explain the mechanism behind CRSDs in people with brain injury.

Posted by Kerry N. Jardine at 10:51 AM | Permalink | Comments (0) | TrackBacks (0)

ConAgra Foods said Thursday April 5th, that moisture from a leaky roof and faulty sprinkler was the source of the salmonella bacteria that contaminated peanut butter at its Georgia plant sickening more than 400 people nationwide. The Omaha-based company conducted a nearly two-month investigation into the contamination and pledged to ensure that Peter Pan peanut butter is safe when it returns to stores in mid-July. The plant's roof leaked during a rainstorm, and the sprinkler system went off twice because of a faulty sprinkler, which was repaired. The moisture from those three events mixed with dormant salmonella bacteria in the plant that spokeswoman Stephanie Childs said likely came from raw peanuts and peanut dust. She said the plant was cleaned thoroughly after the roof leak and sprinkler problem, but the salmonella remained and somehow came in contact with peanut butter before it was packaged.

Peanuts grow underground and salmonella is present in the dirt, but generally any bacteria are killed when raw peanuts are roasted. When making peanut butter, the nuts are again heated above the salmonella-killing temperature of 165 degrees as they are ground into a paste and mixed with other ingredients before being squirted into jars and quickly sealed. Experts had speculated that salmonella would be most likely to contaminate the peanut butter as it cools and is placed in jars. At most plants, those steps take just minutes.

The company plans to redesign the plant to provide greater separation between raw peanuts and the finished product, Childs said. The plant will also receive a new roof. ConAgra plans to reopen the plant in early August. While renovations are being done, Peter Pan would be made at another company's plant. In addition to peanut butter, the company has other brand names, such as Healthy Choice, Chef Boyardee and Orville Redenbacher.

Posted by Kerry N. Jardine at 10:46 AM | Permalink | Comments (0) | TrackBacks (0)

Three bills aimed at helping service members and their families have been introduced by Sen. Hillary Clinton, a member of the Senate Armed Services Committee. Bill S 1063 improves death and survivor benefits. Bill S 1064 would change the physical evaluation process for getting a disability retirement rating from the military. Bill S 1065 is aimed at improving the diagnosis and treatment of traumatic brain injury in combat veterans. It is unlikely the three bills will be passed as free-standing measures, but her ideas could be considered as Congress works on the 2008 defense budget, on the 2007 wartime supplemental spending bill and on a package of legislation aimed at helping wounded combat veterans.

S 1063, the Protecting Military Family Financial Benefits Act of 2007, would provide pre-deployment counseling for all service members to ensure all paperwork dealing with families and dependent children is complete. The bill also includes, as an option, the ability to designate the guardian or caretaker of dependent children as a beneficiary for the $100,000 “death gratuity” paid to survivors of troops who die on active duty, which would close a loophole in current law. The issue might be addressed by a provision of the 2007 wartime supplemental appropriations bill, which could become law before Clinton’s bill gets full consideration by the Senate Armed Services Committee.

Her disability retirement bill, S 1064, is called the Restoring Disability Benefits for Injured and Wounded Warriors Act of 2007. It would make legal help more available to service members who are appealing the disability ratings decisions of their physical evaluation boards. Additionally, it would order a review of the current disability process by the U.S. Comptroller General, including whether the current rating schedule is fair. The bill also proposes a review of all previous cases in which service members received a lower disability rating than they expected, in addition to an independent review of the military’s new traumatic injury insurance program than pays up to $100,000 to service members with life-changing disabilities.

S 1065, which she calls the Heroes at Home Act of 2007, would build on a similarly titled bill that passed Congress last year. The new measure, cosponsored by Sen. Susan Collins, R-Maine, is aimed at returning combat veterans who could have traumatic brain injuries or mental health issues, Clinton said. Under the bill, service members would receive pre-deployment cognitive screening that would help diagnose problems after they return, she said. “This baseline test will help detect mild and moderate cases of TBI and distinguish them from PTSD,” Clinton said. The bill would create a training program for family members to become certified caregivers, allowing them to be paid for their work caring for their injured troops. “Family members of returning soldiers with TBI are often ill-equipped to handle the demands of caring for their loved one, which in some bases can become a full-time responsibility,” Clinton said.

Posted by Kerry N. Jardine at 10:38 AM | Permalink | Comments (0) | TrackBacks (0)

The Hyperbaric Medicine Center in Honolulu has been treating patients with brain injuries for nearly five years. The center prides itself on its 3 hyperbaric chambers available to patients. Hyperbaric chambers provide patients with oxygen at levels higher than the normal atmospheric pressure to prevent brain damage.

The Hyperbaric Medicine Center will join 20 other medical centers in a study to improve treatments for autistic children. Autism is generally diagnosed in children at a very young age. Children diagnosed with autism are believed to have a genetic predisposition to the disorder or were exposed to an environmental trigger. Environmental triggers include exposures to certain chemicals such as childhood vaccines, high fevers, head injuries, or other incidences common in early childhood.

Previous studies have shown that autistic children experience decreased oxygen-flow to the brain which may cause permanent brain damage. Hyperbaric oxygen therapy (HBOT) increases oxygen content in the brain by increasing blood flow to the damaged area. These efforts help in reducing inflammation in the brain that can lead to permanent brain damage.

The autism study begins this month with 20 children. Each child will be treated with 20 hours of hyperbaric oxygen therapy. Each child will also be tested by experienced clinicians in the community both before and after their 20 hours of therapy, and the results are expected to be published by late June, 2007.

Posted by Kerry N. Jardine at 10:30 AM | Permalink | Comments (0) | TrackBacks (0)

Some of the New York City's most frequently sued doctors are still practicing with the blessing of the state Health Department despite numerous litigations against several doctors for such offenses as possibly setting off an outbreak of hepatitis C. The state Department of Health and Mental Hygiene considers them to be worthy of approval.

In the incident that triggered the most litigation, the Health Department never took disciplinary action against anesthesiologist Dr. Marvin Chiumento even though a city Health Department probe in 2002 found that his faulty "infection-control practices" during injections likely caused an outbreak of the hepatitis C virus in a Brooklyn clinic. The agency lists Chiumento as in good standing, but at least 41 medical malpractice suits were filed against the doctor and the owner of the clinic at the center of the 2001 outbreak. All the cases were settled for an undisclosed amount. The number of malpractice cases settled by Chiumento was the highest among New York's most sued doctors, according to a New York Post review of legal cases tracked by the medical watchdog group HealthGrades, which used state Health Department data to compile its findings.

Guy Vann, the chief lawyer for many plaintiffs in the case, confirmed the settlement but could not comment on specifics because of a confidentiality agreement. "We have not taken any disciplinary against [him]," a state Health Department spokesman admitted. Health-care advocates are astounded that Chiumento is still practicing. "This sounds really, really bad," said Judy Wessler, director of the Commission on the Public's Health System. Chiumento is now practicing at a medical office in Belleville, N.J. He defended his actions, "This was based on one incident," Chiumento said of the hepatitis C outbreak. "We complied with all the investigative regulations done at the time. There were no actions taken. "Why wouldn't I be practicing?"

Posted by Scott J. Eldredge at 10:58 AM | Permalink | Comments (0) | TrackBacks (0)

Victims of peanut butter salmonella poisoning hire Masry & Vititoe and Girardi & Keese in lawsuit against ConAgra. The lawsuit represents 76 injured individuals including two wrongful death claims. 26 different states are represented in this action including individuals from Texas, Missouri, Indiana, Florida, Kansas, and California. The team will seek, among other relief, general damages, special damages, and punitive damages.

Jeffrey Bell, lead attorney for Masry & Vititoe said that his firm has been contacted by hundreds of individuals who want to know why they have become sick after consuming Peter Pan peanut butter and/or Great Value peanut butter.

Posted by Kerry N. Jardine at 10:43 AM | Permalink | Comments (0) | TrackBacks (0)

Thomas Fox is a certified hyperbaric technologist, chief operator and physiologist of a mobile hyperbaric oxygen therapy unit. The unit is used as an alternative treatment for brain and nerve injuries and disorders, such as cerebral palsy, stroke and traumatic brain injury. According to Fox, hyperbaric oxygen therapy treatment with traditional rehabilitation programs can work to improve brain function of those who have been diagnosed as having permanent brain damage. While this alternative treatment has not been definitively and scientifically proven to improve the functioning of individuals who have been diagnosed with chronic brain injuries, Fox said that his personal experiences and that of other doctors throughout the world have shown that progress can often be made. "What we are finding is that many of these injuries are not permanent, over time, you can try and normalize [them] with hyperbaric treatment," Fox said.

Hyperbaric therapy as an alternative method for treatment of brain injuries and disorders first came to Fox’s attention when he sent his 4-year-old twin sons diagnosed with cerebral palsy at birth, to England for the treatment. Fox, who had been trained in hyperbaric therapy with the United States Army, was interested in its possible merits for affecting long-term and apparently irreversible brain damage. Within six weeks of the regular treatment, Fox said, one son, who was confined to a wheel chair, was walking and the other was speaking in full sentences and feeding himself. His experiences with his sons led Fox to devote more of his time to getting hyperbaric treatment to more children.

The treatment focuses on the use of a hyperbaric "deck decompression chamber" typically used to treat divers or pilots who return too quickly from areas with inconsistent pressure from that of the surface. By artificially increasing pressure on patients and filling the lungs with pure oxygen, added levels of oxygen will reach areas of the brain that have been damaged, possibly causing an increase of blood flow and, in turn, nerve growth, to the affected areas, Fox said. "What this does it returns energy to parts of the brain … to reawaken dying cells," Fox said. If hyperbaric therapy is found to be effective, Fox said, its widespread use in treatment of certain brain conditions could alleviate several billions of dollars in pharmaceutical and medical treatment costs, as well as cut down on care costs and improve the overall quality of life of those who have undergone extensive brain injuries.

Posted by Kerry N. Jardine at 10:34 AM | Permalink | Comments (0) | TrackBacks (0)

A recent study conducted by researchers at the University of California, San Diego (UCSD) linked insomnia to mild brain injuries. The results showed that people who suffer from mild brain injuries may be at increased risk for sleep disorders.

In the study 42 people who complained of insomnia after a mild traumatic brain injury (TBI) were observed. 36% of the patients were found to have a problem with the timing of sleep - a condition known as circadian rhythm sleep disorder (CRSD). Of those patients, 50% had problems fall asleep and waking up; all experienced irregular sleep patterns.

"The frequency of sleep disorders in this study is considerably higher than the rate of these disorders among people attending sleep clinics for insomnia, which is seven to 10 percent," said head researcher in the study Liat Ayalon.

CRSD's are often associated with cognitive and psychological problems and proper treatment of these disorders is imperative. Early diagnosis and proper treatment may lead to improvements in other brain injury-related symptoms in these patients.

"As many as 40 to 65 percent of people with mild traumatic brain injury complain of insomnia. This is concerning, since sleeping problems may exacerbate other brain injury symptoms such as headache, emotional distress, and cognitive impairment, making the rehabilitation process much harder," said Ayalon.

The study's results were published in the April issue of Neurology.

Posted by Kerry N. Jardine at 10:32 AM | Permalink | Comments (0) | TrackBacks (0)

Johnson & Johnson bought dozens of disparaging Internet domain names about its Ortho Evra birth control patch according to company documents released in state court in New Brunswick, New Jersey. It bought and registered such domain names as: Orthoevrakills.com and Deathbypatch.com. Johnson & Johnson faces hundreds of personal injury suits around the U.S. over the patch, which the company still sells. The company has not disclosed its revenue for the patch or any reserves to deal with the litigation.

"Women have died as a result of this patch," said attorney Jason Mark, who filed a legal motion for patch users that led to the release. "The communications raise some obvious questions about the company's priorities. They're looking to monopolize the flow of information that's released. They're looking to prevent women from receiving information from other sources.'' One Johnson & Johnson document outlined a nine-step plan called "Defensive actions to minimize impact of negative presence." It included buying domain names, monitoring blogs and purchasing the top five key words about the patch on search engines run by Google Inc. and Yahoo! Inc. "The documents that were released have nothing to do with the litigation," said Kent Jarrell, a spokesman for patch maker J&J's Ortho McNeil Pharmaceutical Inc. "The purchase of the domain names is a standard and accepted business practice for companies that are trying to prevent product disparagement and to safeguard the defendant's reputation."

Superior Court Judge Bryan Garruto released the five documents, ruling they are no longer subject to protective orders that sealed them from public access. He is overseeing 309 lawsuits claiming injuries caused by the patch.
A study in February 2006 showed the patch doubled clot risk compared with the pill. Garruto released a 13-page opinion saying the five documents were not subject to protection because they did not contain trade secrets, and
information about the purchase of domain names "is of little to no value to Johnson & Johnson's competitors." The documents include a series of e-mails about the price and details of buying the various domain names. J&J has
produced more than 6 million documents in the pre-trial exchange of information known as discovery. "Plaintiffs' lawyers have been purchasing their own domain names and have created Web sites which masquerade as
repositories for health news for women," Jarrell said. "They really offer incomplete and out-of-context information as part of a campaign to attract plaintiffs to their law firms.''

Posted by Seth A. Katz at 08:36 PM | Permalink | Comments (0) | TrackBacks (0)

A Central Florida woman who lost her arms and legs after contracting a flesh-eating bacteria after childbirth is suing Orlando Regional South Seminole Hospital, alleging medical malpractice. 23 year old Claudia Mejias
originally went to Orlando Regional South Seminole Hospital for the delivery of her son. After she gave birth, doctors told Mejias that she had contracted a flesh-eating bacteria and amputation was the only option available to her. "I remember it was Mother's Day and they told me, 'We got to amputate your legs and arms if you want to live,'" Mejias said. Mejias' future husband, Tim, told her they would make it and they got married at the hospital after the amputations.

After the amputations, Mejias and her attorneys said they wanted the hospital to release details that might explain why she lost her arms and legs. The hospital revealed limited information about seven cases of strep in the 10 months leading up to Mejias' requested information. The hospital told the court that the information might be more forthcoming if Claudia filed a medical malpractice lawsuit. Claudia Mejias and her attorneys filed the lawsuit in Seminole County on Monday. The hospital, two doctors and three nurses are named as defendants. The suit not only seeks unspecified damages, it seeks explanations, Cooper reported.

Posted by Scott J. Eldredge at 08:32 PM | Permalink | Comments (0) | TrackBacks (0)

Arizonans suffer the highest rate of traumatic brain injuries of states surveyed. Especially tragic is how the young people are affected. Infants, teens and young adults in Arizona suffer higher traumatic brain injury rates than in any other state investigated, according to a newly-released survey by the federal Centers for Disease Control and Prevention. Arizona's problem emerged in a recent two-year study conducted by the CDC in an effort to get an idea of how extensive traumatic brain injury is in the U.S. Among 12 states surveyed in 2002, Arizona's rate of hospitalizations for such injuries topped all others, at 96.7 per 100,000 people. The average rate of these was 79 and lowest state, Nebraska, was 50.6. 2003 is the most recent year surveyed and the problem worsened, with Arizona's rate rising to 105 per 100,000 people.

"An injury to the brain is unlike any other," Tucsonan Barbara Stahura wrote in an essay about her husband's brain injury from a motorcycle crash three years ago. "Along with physical functions, the brain controls awareness,
personality, temperament, and cognitive processes like memory all those things that form a 'self.'" An avid motorcyclist, her husband, Ken Willingham, was fully helmeted when a sedan turned suddenly in front of him.
Shortly after he woke up at University Medical Center, Willingham started talking like a toddler, repeating nonsensical phrases in a sing-song voice, badly frightening his wife. Even after he started speaking in full
sentences, his thoughts were completely delusional, his short-term memory shot, his gaze distant and unconnected. Her brilliant husband a computer programmer at Raytheon Missile Systems had "disappeared," as Stahura describes this horror. It took nearly two years of intense physical, occupational and speech therapy to bring Willingham back to reality and to her. "He's probably 97 percent recovered now. We were very lucky," his wife said. What lingers, and may for the rest of his life, is some confusion when a lot of people are talking at once, as in meetings, and occasional difficulty finding the right words. Even so, Willingham, now 60, has successfully returned to Raytheon.

This type of motor-vehicle accident, involving cars, trucks or motorcycles, causes the largest portion of Arizona's traumatic brain injuries; a full 40 percent, according to the Arizona Department of Health Services. Another 20
percent are the result of assaults, suicide and homicide attempts. About 16 percent happen in accidental falls, especially among the very elderly. Considering that assaults account for so much of this damage in Arizona is
especially alarming, according to the CDC report. In most other states, falls among the elderly are a much bigger factor than assault. Arizona ranks 15th in the nation for aggravated assaults, and we have the 15th-highest risk of dying in a traffic accident, according to the most recent statistics from the FBI and the U.S. Department of Transportation. "These findings underscore the need for states to monitor the occurrence, external causes and risk factors for traumatic brain injury, and to design and implement more effective prevention programs," the CDC report concludes.

Posted by Kerry N. Jardine at 08:27 PM | Permalink | Comments (0) | TrackBacks (0)

Survivors of traumatic brain injuries such as car-crash victims and soldiers wounded in Iraq face an extra hurdle as they recover. Thousands of them will develop epilepsy months or years later. The risk is especially high for
certain kinds of war injuries. Studies of Vietnam veterans suggest up to 50 percent develop the condition, says Dr. Nancy Temkin of the University of Washington. New research is beginning to predict exactly who is most at
risk and how to protect their vulnerable brains. Among the efforts are pilot studies to see whether the newer seizure-treating drugs Topamax or Keppra might actually prevent epilepsy if they're taken immediately after a
serious brain injury. "It is among the most frustrating things in medicine to know that someone's at risk ... and be unable to do anything about it," says Dr. Marc Dichter of the University of Pennsylvania, who is leading the
Topamax study and pushing for better recognition of such patients.

Epilepsy may not begin with the classic jerking seizures, but instead with memory loss, attention problems or other more subtle symptoms that doctors can mistakenly attribute to the original brain injury, post-traumatic stress or some other factor. Almost 3 million Americans have epilepsy. The brain essentially suffers periodic electrical storms and when its circuits misfire fast enough, a seizure results. About 5 percent of the nation's epilepsy was caused by traumatic brain injury. Approximately 25 percent of survivors of moderate to severe brain injury will develop epilepsy. Injuries that cause bleeding inside the brain are the riskiest. About 1.4 million children and adults suffer serious brain injuries every year from car or bike crashes, falls, gunshot wounds and other trauma.

Posted by Kerry N. Jardine at 08:21 PM | Permalink | Comments (0) | TrackBacks (0)

The pain began in Gary Rushford's foot and slowly moved up from his heel to his thigh. For months doctor after doctor downplayed the pain, disregarded the injury's progress, and Gary's insistence that something could be seriously wrong. Instead of ordering a minor medical test, which would have discerned the problem, they kept sending him home with painkillers. As a result Gary Rushford lost his leg above the knee.

A third call to the doctor was made when the pain had crawled to his thigh and would hurt badly whenever he exerted it. He was given Vicodin and Motrin. Gary and Sharon asked his doctor if she thought he should be examined. He had a history of phlebitis and they thought his problem might have something to do with a blood flow problem. The doctor, without seeing Gary, sent him to a podiatrist. The podiatrist looked at the foot only, said Gary was fine, and referred Gary to a physical therapist, thinking the difficulty might stem from a hypothetical back problem. By now the pain was radiating up to his buttocks and lower back. Four months after he felt the first tingling, he drove himself to the ER. Doctors checked for a pulse on Gary's right foot, and found none. He had a blood clot in his artery. Even then the doctors sent him home, scheduling a consultation a week later. During an angiogram at that meeting, an anesthesiologist suggested a thrombolysis procedure. It was a success, but the doctor inexplicably gave Gary no blood thinners, so another clot developed. After a second successful thrombolysis procedure, Gary was sent home on a half-dose of blood thinners, but clotted again. Gary began to suffer 'rest pain,' a sign of tissue death. He was scheduled for bypass surgery the next day. It was successful at first, but then clotted as well. The doctor cut open the leg to relieve the pressure, but opened only one of the four compartments, which sealed the fate of Gary's leg. He told the Rushfords he would have to amputate below the knee. The news was devastating, but it got worse: after letting Gary wait for surgery for another 50 hours, the doctor took the knee as well. A week later, Gary was discharged with Sharon stopping on the way home to pick up crutches and a walker at a medical supply store that the insurance didn't cover.

In September, Gary fell on his stump, went in for treatment and discovered he had a another blood clot, running from the stump across the abdomen to his left leg and up to his inferior vena cava, the major artery to the heart and lungs. In October, doctors finally put Gary on coumadin, a blood thinner. The Rushfords began to ask themselves why that step had taken so long. Had it happened earlier he might not have lost his leg. Sharon and Gary began to seek legal recourse with the state's medical-legal establishment and sued for malpractice. Unfortunately, Gary had signed a form agreeing to binding arbitration. He was soon to find out that that game is rigged in favor of the doctors and insurers. Gary and Sharon had damages in excess of $5 million. The arbitrator said the 'balance of evidence' was equal, and therefore he would not rule for the Rushfords. No other recourse was available to them.

Posted by Scott J. Eldredge at 08:04 PM | Permalink | Comments (0) | TrackBacks (0)

A North Dakota man has filed a federal class-action lawsuit as part of a national body parts scandal claiming he received transplanted bone tissue in South Dakota that might be diseased. Charles Geigle of Oliver County, N.D., had back surgery April 30, 2004, at Sioux Valley Hospital in Sioux Falls. He received a letter in December 2005 from a doctor at the hospital telling him the bone tissue might have been illegally acquired and that he could be at risk of getting a disease. Geigle said in his lawsuit that he and perhaps thousands of others now live in fear that they or their spouses have been exposed to a deadly disease. The now defunct New Jersey supplier was Biomedical Tissue Services and is accused of collecting body parts from cadavers without donor consent and selling them for use in transplants across the country. BTS supplied bone, skin and tendons to various processors, who in turn provided them to distributors. The Food and Drug Administration is concerned those parts could be infected with the AIDS virus, syphilis and hepatitis, but has said the risk of infection is small. The FDA will not say whether any patients have ailments that might be linked with suspect tissue. The FDA has refused to reveal how many people received BTS tissue. The FDA and Centers for Disease Control also urged people who received BTS tissue be tested for infectious disease.

Geigle's lawsuit seeks more than $5 million in damages for patients who received BTS tissue from 2002 to 2005. BTS obtained the tissue from more than 1,000 bodies, many of which were not eligible to be donors because of age, disease or illness, and that put recipients at risk for disease such as HIV, hepatitis and syphilis. Geigle received tissue from BTS that was processed and packaged by Regeneration Technologies Inc., and distributed by SpinalGraft Technologies, a division of Minneapolis-based distributor Medtronic Inc. All three are also listed as defendants. BTS was owned by former New Jersey dentist Michael Mastromarino and New York embalmer Josh Nicelli, who formed the company in 2002 and without permission, started dissecting bodies from funeral homes and harvesting body parts. The lawsuit states that when a funeral was scheduled to be 'open casket,' harvested bone taken from the deceased was replaced with PVC pipe and other objects so the bodies would still appear normal during the funeral proceedings. BTS also changed the names of the donors, the medical records, the death certificates and other information in order to conceal the lifestyle and medical history of the donors. Mastromarino and Nicelli, who have been charged with violating New York and New Jersey laws on the handling of dead bodies and then selling millions of dollars worth of body parts to the other defendants. The FDA ordered BTS to stop operating because of the serious nature of the violations and ordered a recall of all products which the defendants have complied with.

Posted by Scott J. Eldredge at 08:01 PM | Permalink | Comments (0) | TrackBacks (0)

Veterans facing medical troubles are trying to deal with their injuries and find that they can't get the care they want because they've been forced out of active duty. Colonel Gary Wilson retired last year after 30 years in the Marine Corps. He survived countless attacks during 17 months and two tours in Iraq. The last one left him disabled and with traumatic brain injury. In the months since, he claims the military has let him down, forcing him off active duty before his injuries were properly taken care of. "In my particular case I felt abandoned. I felt my service had broken faith with me. There's an old saying in the Corps: 'The Corps will screw you every time. But your fellow marines won't.' That's exactly how I feel," said Colonel Wilson.

Army Staff Sergeant Jarod Behee signed his medical discharge papers last month. Jarod's experience is similar to Wilson's. A sniper's bullet pierced Behee's helmet and left him seriously disabled. Behee's wife Marissa fought to keep him on active duty as long as possible. She now says the Army tried to medically retire her husband while he was still hospitalized. "It seemed there was a lot of pressure. I felt if he was injured he was the military's responsibility. And he needed to stay on active duty as long as it took him to get better. That is not really the way they look at it."

Colonel Wilson and Marissa Behee believe there's a rush to push people off active duty and onto the military health care plan, TRICARE, or into the VA system. Wilson thinks active duty military get better medical care than retirees. "I think there's a lot of patient dumping going on and it comes from administrators and it results from personnel people making medical decisions," said Col. Wilson. Marissa Behee agrees and points out that TRICARE does not cover what she and many medical experts consider an important component of rehab for brain injuries. That's cognitive therapy, which her husband received while he was still on active duty. He was treated at a private facility called Casa Colina. “Now that he is retired, if he were to go back to Casa Colina, or whatever rehab, he would no longer be covered by TRICARE," said Marissa Behee. A spokesman for TRICARE said, "The use of cognitive therapy is not normally covered by TRICARE because it is currently considered an unproven procedure." However, Marisa says Jarod would still be getting cognitive therapy if he were still on active duty.

Posted by Kerry N. Jardine at 07:57 PM | Permalink | Comments (0) | TrackBacks (0)

After suffering a serious brain injury in the Iraq war, Army Specialist Evan Mettie, was declared "killed in action." Mettie, 23, survived the New Year's Day explosion in 2006 but was left dependent on a veterans health-care system that has transferred him to several hospitals and could soon send him home. Mettie's mother, Denise, signed away her son's health-care options without realizing it, agreeing to a medical retirement for her son only weeks after the explosion outside of Baji, Iraq, north of Baghdad.

At a Senate hearing, she said her family's story is typical of what families of returning veterans face. "At the very beginning, there was a (Veterans Administration) doctor who said, 'You know, he's not going to come any further, let's put him in a nursing facility and let you get on with life,' " Mettie said. "I was not ready to give up on him then, and I'm not now. If there is a private rehab that will take him, I'm going to get him there and finagle the finances by hook or by crook." Mettie said senators should know that patients with traumatic brain injury and their families "need time to adjust to the reality of their situations." She said it was unfair for the Army to begin the retirement process just 17 days after Evan's injury, especially since retirement limits health-care options. "Give us time to get our feet under us and understand what we are dealing with," she said.
TBI patients and families also need more options, she said. While the VA is improving programs for brain injuries, many private hospitals have years of experience in treating and rehabilitating such patients. "It is unfair to deny us access to the same level of care that you would choose for your children," she told members of the Senate Veterans Affairs Committee. Sen. Patty Murray, D-Wash., told Mettie, "Our country owes you and your son an apology. Your son fought a war for our country. You shouldn't have had to fight every day to get him the care he deserves."

Posted by Kerry N. Jardine at 07:54 PM | Permalink | Comments (0) | TrackBacks (0)

Millions of Americans living with diabetes have insulin to thank for saving their lives everyday. However, the same life-saving drug may cause serious brain injuries and comas. Insulin works by lowering blood glucose levels which can lead to a dangerous side-effect: hypoglycemia.

Hypoglycemia occurs when the body's blood glucose levels reach dangerously low levels. Most hypoglycemia cases can be reversed by increasing glucose levels by using insulin injections. Prolonged periods of hypoglycemia are far more serious can have been found to cause neuronal death which leads to permanent brain damage.

Researchers at the University of California, San Francisco (UCSF) recently found that the flood of glucose into the body during treatment may cause neuronal death linked to hypoglycemia. This negates previous findings that the hypoglycemia itself caused neuronal death. UCSF's study found that the rapid infusion of glucose to treat hypoglycemic mice caused extensive neuronal death in the mice.

UCSF's findings suggest that hypoglycemia treatments should be changed. Instead of flooding the system with glucose to treat hypoglycemia, UCSF researchers say glucose should be administered gradually to prevent shock to the brain. Their findings have not been clinically tested.

Posted by Kerry N. Jardine at 07:50 PM | Permalink | Comments (0) | TrackBacks (0)

In a letter dated December 22, 2006 Larry Bell, MD, Vice President, Global Head of Regulatory and Pharmacovigilance at GE Healthcare wrote a letter to healthcare professionals stating the latest information regarding OmniscanT contrasting agent used in MRIs and MRAs. In it, Bell informs the healthcare professional establishment of new case reports strengthening the association between OmniscanT (gadodiamide) injections and the development of the serious medical condition known as Nephrogenic Systemic Fibrosis (NSF) a.k.a. Nephrogenic Fibrosing Dermopathy (NFD). Since June 2006, when GE Healthcare issued the safety advisory regarding OmniscanT and NSF, they have received additional reports of over 50 cases.

NSF was first identified in 1997 and has only been observed in patients with kidney disease. While most affected patients have advanced to end-stage kidney disease, a few patients with moderate renal dysfunction have recently been reported. NSF leads to excessive formation of connective tissue in the skin and internal organs. The skin becomes thickened, coarse and hard, sometimes leading to disabling contractures. NSF may be progressive and fatal cases have been reported. Larry Bell, MD further advises the side affects associated with the contrasting agent, such as: the possibility of swelling, hardening and tightening of the skin, reddened or darkened patches on the skin, burning or itching of the skin and yellow spots on the whites of the eyes. Additionally, stiffness in the joints, problems moving or straightening arms, hands, legs or feet. Pain deep in the hip bone or ribs and weakness of the muscles

The FDA issued a Public Health Advisory in June and December 2006 on NSF (www.fda.gov/cder/drug/advisory/gadolinium_agents.htm). FDA recommends that "gadolinium-containing contrast agents, especially at high doses, should be used only if clearly necessary in patients with advanced kidney failure (those currently requiring dialysis or with a glomerular filtration rate (GFR) = 15 cc/min or less)" and that "it may be prudent to institute prompt dialysis in patients with advanced kidney dysfunction who receive a gadolinium contrast MR". GE Healthcare is closely following reported cases and working with hospitals and experts in the field to conduct a thorough investigation. GE Healthcare is engaging with the FDA and other global regulatory authorities who are making further inquiries about the occurrence of this disease after the administration of Omniscan or other gadolinium-based MR contrast media.

Posted by Kerry N. Jardine at 02:12 PM | Permalink | Comments (0) | TrackBacks (0)

Of the nearly 3 million Americans who suffer from epilepsy, 5% have suffered a traumatic brain injury (TBI). Approximately 25% of TBI survivors live with epilepsy. Since over 1.4 million Americans suffer from a TBI each year, this means that 375,000 develop epilepsy as a result. This estimate does not even take into account the increasing number of veterans returning from war with TBI's. Veterans with TBI's have a 50% chance of developing epilepsy after a TBI.

The National Institutes of Health (NIH) and the US Defense Department have launched major research efforts in response to new TBI and epilepsy trends. Both organizations have focused their research on seizure-controlling drugs to see if they can also prevent epileptic seizures. The drugs Topamax and Kepra have shown the most promising results. Both are newer seizure drugs that work by inhibiting cell-harming chemicals that are released after a TBI occurs. Initial study results show that TBI patients who are given either of the drugs 1-3 hours after initial injury have no negative side effects. Whether either drug actually prevents seizures from happening in the future has yet to be determined.

Researchers at the NIH and Defense Department hopes their new studies raise awareness for the risk of seizures in TBI survivors. Epilepsy in TBI victims is often not diagnosed until it is too late. After a TBI, victims often experience a "silent period" in which no serious symptoms occur. During this time the initial symptoms of epilepsy are overlooked or mis-diagnosed. Epilepsy does not always begin with the classic jerking seizures. Instead epilepsy may begin with memory loss, attention problems or other more subtle symptoms that doctors can mistakenly attribute to the original brain injury.

Posted by Kerry N. Jardine at 07:37 PM | Permalink | Comments (0) | TrackBacks (0)

Working quietly for years, Dr. Andreas Theodorou has put together a vital system of care for brain-injured children in Tucson. As a result, children who suffer head injuries, even those thought to be "mild", no longer fall through the cracks here as they struggle with school, social relationships and physical limits that can last a lifetime. For that achievement, Theodorou a pediatric intensive care specialist at the University of Arizona has won the "Care Award" from the Brain Injury Association of Arizona. His work has been critical in a state that suffers among the highest rates of traumatic brain injuries in the nation. Theodorou shared the stage at the recent awards ceremony in Phoenix with some of those suffering these catastrophic head injuries, including two soldiers hit in Iraq. They are the tragic face of one of this war's lasting effects.

"The terrible impact of this is going to become even more obvious now, with our soldiers coming home with traumatic brain injuries," Theodorou said. "This is one of the major issues we will have to deal with for many years." Even without the war's casualties, Arizona tops all states surveyed for such injuries, with 105 head-injured patients hospitalized per 100,000 population, according to a recent study by the Centers for Disease Control and Prevention. As a physician who specializes in the critical care of children, Theodorou realized as soon as he arrived in Tucson 15 years ago that there was "a bit of a void" in the care of brain-injured youngsters here. "Not in the acute care of these injuries, in the ERs, the neurosurgeons, that care is great," he said. "What was missing was a coordinated team approach, care across the spectrum that's needed in the recovery effort. That means teachers, school nurses, rehab therapists, social workers, a whole multidisciplinary team to handle the lasting effects of a head injury."

In response Theodorou joined every group and project he could find working on this issue, serving for six years on the Governor's Council on Spinal and Head Injuries, chairing the Tucson-based Traumatic Brain Injury Interest Group, and lecturing health-care professionals throughout the state to raise awareness. As a result the following has been accomplished. A multidisciplinary traumatic brain injury team meets four times a year at University Medical Center to ensure Tucson's brain-injured children are receiving the long-term care they need. The family of every Tucson child who suffers even a mild head injury is referred for help with navigating the complex system of services. The UA has recruited experts in this field and now operates a clinic dedicated to the follow-up care of these patients. A proposal is under way to design a form letter to send to the school of a head-injured child, requesting close observation of the child for difficulties that may develop. Teaching UA medical students about traumatic brain injuries will be enhanced by following three case histories of brain-injured children from the point of injury through recovery during a three-year period, so new physicians will fully understand the long-lasting impact of the problem.

Posted by Kerry N. Jardine at 07:33 PM | Permalink | Comments (0) | TrackBacks (0)

For decades cheerleaders have been a fixture on America’s sporting sidelines. However, today’s young cheerleaders, who perform tricks once reserved for trapeze artists, may be in more peril than any female athletes in the country. Emergency room visits for cheerleading injuries nationwide have more than doubled since the early 1990s, far outpacing the growth in the number of cheerleaders, and the rate of life-threatening injuries has startled researchers. Of 104 catastrophic injuries sustained by female high school and college athletes from 1982 to 2005, more than half resulted from cheerleading, according to the National Center for Catastrophic Sports Injury Research. All sports combined did not surpass cheerleading.

With more than four million participants cheering at local youth football games to the N.C.A.A. men’s basketball tournament, female cheerleaders now commonly do tricks atop pyramids or are tossed 20 feet in the air to perform twists and flips. If all goes well, the airborne cheerleader, known as the flier, is caught by other cheerleaders. Jessica Smith, an 18-year-old cheerleader at Sacramento City College, broke her neck in two places five months ago when a botched stunt dropped her headfirst from a height of about 15 feet. “They make you sign a medical release when you join a cheerleading team,” Smith said in a telephone interview last week. “They ought to tell the girls that they are signing a death waiver.” She was the flier during a practice in October, when the team was attempting a new maneuver that called for her to be thrown upside down into a handstand, where she would be caught by a male cheerleader perched on two other cheerleaders’ thighs. After trying the stunt once, Smith said, she was uncomfortable trying it again. She relented when coaxed by her teammates. “But as I was thrown in the air, the cheerleader who was supposed to catch me lost his balance and fell back,” Smith said. “I was inverted and in the air with nothing to stop me from coming straight down on my head. I hit and heard my neck crack. I was screaming after that.” Smith fractured two vertebrae. “They tell me I missed being in a wheelchair by one millimeter,” she said.

Although the number of cheerleaders nationwide has grown an estimated 18 percent since 1990, researchers did not examine injury rates until recently. There were 22,900 cheerleading-related injuries treated in emergency rooms in 2002, up from 10,900 in 1990, according to the Columbus study. The Consumer Product Safety Commission, meanwhile, reported there were nearly six times as many emergency room visits for cheerleaders in 2004 than in 1980. Noting that many other injuries probably occur but are treated by private physicians without an emergency room visit, Dr. Frederick Mueller, director of the National Center for Catastrophic Sports Injury Research, said, “The real number of cheerleading injuries could be twice as high.”

Posted by Kerry N. Jardine at 07:29 PM | Permalink | Comments (0) | TrackBacks (0)

In Indiana cell phones have been blamed for 2,054 traffic accidents in past 4 years. A ringing cell phone caused an accident that killed a 17-year-old girl and the cell phone wasn't in her car. Jessica Oliver was killed two years ago when the 59-year-old driver of another car looked down at her ringing cell phone. The driver lost control of her car, crossed over the median on Interstate 65 and struck Oliver's car. It is one of 2,054 traffic accidents in Indiana in the past four years, including at least two fatal crashes, in which cell phones were listed as the primary cause. While that number represents only a fraction of 1 percent of the total Indiana crashes since 2003, the fact that cell phone use is now listed on the state crash form is an indication it is a recognizable factor, state police Sgt. Brian Olehy said. "I'm surprised at how many admitted the cell phone distracted them," Olehy said. Police say drivers should never converse on the phone while driving. "When it comes to telephones, I think you will find that even with a hands-free device like a speaker phone, a Bluetooth or On-Star, drivers are still not devoting their full attention to the road," Olehy said. Distracted driving is becoming such a big problem that state Legislatures around the country are looking at the issue.

Vermont lawmakers are considering a measure that would ban eating, drinking, smoking, reading, writing, personal grooming, playing an instrument, "interacting with pets or cargo," talking on a cell phone or using any other personal communication device while driving. The punishment: a fine of up to $600. Similar bills are under consideration in Maryland and Texas, and Connecticut has passed one that generically bans any activity that could interfere with the safe operation of a motor vehicle. In Indiana, proposals banning the use of cell phones while driving have been introduced in both the House and Senate. In recent years similar bills have gone nowhere because of a lack of interest.

Posted by Kerry N. Jardine at 07:22 PM | Permalink | Comments (0) | TrackBacks (0)

Shortages in general surgeons, family doctors and some specialists will make finding a doctor increasingly difficult in Palm Beach County as the population grows and the number of practicing physicians shrinks, according to a survey to be released. The survey by the Palm Beach County Medical Society points to the county's aging physician population and the lack of new recruits as primary factors. Doctors younger than 35 represent about 4 percent of the physician population of about 3,700; nationwide they account for 16 percent. In the long run there will be fewer doctors here to replace those who retire.

High malpractice premiums, low reimbursement rates and little protection from lawsuits have made the county an inhospitable place to practice, officials said. These conditions prompted specialists such as neurosurgeons and hand surgeons to stop taking emergency calls in recent years and led officials to conduct this first comprehensive physician census. Survey results have some suggesting options including a new tax to ensure care. "I see the problem getting worse if nothing changes," said Rick Cameron, a consultant who worked on the census. "Access is going to get worse and people will be less satisfied. The quality of care will deteriorate."

About 20 percent of county residents are uninsured, so physicians taking emergency calls say they often have little hope of getting paid. Unlike in the past, physicians don't need to take emergency calls to build their patient base and younger doctors are less willing to expose themselves to what they see as a risk. The solution to such overlapping issues could be a new tax to pay for care, Collins suggested. "We may need to start looking at emergency care as a public service, just like police and fire," he said. "People think hospitals and physicians are supposed to work for free."

Posted by Scott J. Eldredge at 08:39 PM | Permalink | Comments (0) | TrackBacks (0)