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Eight-year NFL veteran Jacob Bell has decided to walk away from the game of football, partially due to the recent suicide of former linebacker Junior Seau.  Despite signing with the Cincinnati Bengals last month, the 31-year-old has used this new tragedy as motivation to walk away from the game he loves while he still can.  

However, Bell does not plan on ending his involvement with the sport.  With his retirement, he hopes to make life after football better for retired players by increasing awareness of the health risks that await them down the road, particularly concussions.  

Although he currently says he feels healthy and his mind is clear, NFL.com reports that he cites future health concerns for his retirement decision.  Bell took an active interest in his post-NFL health and frequently reached out to retired players to understand their challenges. 

As a result, he has a full grasp of the realities that former players face and understands that his own health may not last forever.  “It's a blessing to be able to retire and walk away on my own instead of being forced out of it," Bell said.

Fully aware of the tradeoffs NFL players make, he questions the wisdom of sacrificing your brain for “a couple million bucks.”  “We're giving our lives to the game of football for a price,” Bell said.  At the moment, researchers have only started putting together information on the long-term effects of frequent hits to the head and concussions.    

Bell intends to become one of the few players who come forward to present this issue, though he admits his retirement may have made this outspokenness easier.  The league report explains that Bell has offered the following additional suggestions to help protect players by preventing these brain injuries:

• Rookies begin careers with a brain scan-Although players receive a thorough medical examination to give teams a complete overview of their health, a brain scan is not included.  Bell feels rookies should know of any possible brain trauma they suffered before entering the league.  Ideally, Bell would like the results of these scans to be for the players’ eyes only, although this might be a challenge.    
• Include concussion awareness education during the rookie symposium-Bell criticizes his own rookie symposium in 2004, saying all the information provided revolved around money.  While he admits this was useful, he also believes a panel of doctors should be brought in to discuss the health risks.  He said that to learn about brain health issues, he had to independently research the risks by speaking to retired players.  
• Incorporate psychologist education-With the recent number of former NFL player suicides, the depression risks of brain injuries has become a major topic.  By forcing young players to develop a relationship with psychologists early on, it may make it easier for them to seek help if they do begin experiencing depression issues later. 

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The Journal of Neurosurgery published a case report this week on an emerging procedure which allows doctors to transfer working nerves to other locations in the body where nerve function has been lost, thus restoring movement.  The study highlights the treatment’s success by describing one patient who underwent this procedure to regain hand function after a 2008 vehicle accident left him with a crushed spinal cord at the C7 vertebrae. 

This spinal cord injury (SCI) severed the nerves that would normally send signals from his brain to the muscles in his hands, leaving him unable to use them.  However, the accident spared nerves that were close, enabling doctors to utilize those to restore hand function. 

ABC News explains that those with C7 spinal cord injuries lose the ability to move their hands, although they retain shoulder, elbow, and wrist movement due to nerves that begin above the injury.  In this patient’s procedure, they cut the nerve which controls the brachialis, an arm muscle that helps bend the elbow.  Doctors then “attached it to the non-working nerve projecting out to his hand with a tiny stitch the size of a hair,” ABC explains. 

Doctors said this nerve could be sacrificed because other muscles would compensate for the missing brachialis function.  After six months, this borrowed nerve grew another six inches along the path of the non-functioning nerve and reached the muscles of the hand.  Following intense physical therapy, this patient learned to once again move his fingers with this borrowed nerve. 

This technique seizes on the peripheral nerves’ ability to regenerate, which nerves inside the spinal cord cannot do.  Peripheral nerves are those which transmit signals between muscles and the spinal cord.

Researchers and surgeons believe this process could offer up a new option to restore some of the lost independence of SCI patients.  Despite the adaptive strategies many of these patients may have developed, this procedure could help many surpass previous physical limitations due to nerve damage.   

However, ABC points out that this procedure cannot help all SCI patients.  For those with injuries higher up on their spinal cord, doctors do not have the extra muscles to borrow nerves from because so many no longer work.    

The authors also note that despite the positive findings with the focus patient, further research is needed to “assess reliable clinical outcomes and optimal timing for surgical intervention.”  Nevertheless, the researchers point out that for those who undergo brachialis nerve transfer, they tend to continue recovering increasing amounts of motor power after their surgery.

As the summer months approach and the weather improves, the U.S. Consumer Product Safety Commission (CPSC) has announced the recall of two dangerous products and released a safety warning on a third.  All these recent safety alerts primarily concern children, who are highly vulnerable to defective and potentially hazardous outdoor toys and sporting goods like those included in these CPSC announcements.   

Portable Pool Dangers

In a late-April report, the CPSC warned of the dangers portable pools pose.  A cheaper, movable option, these can be just as dangerous as any other pools.  In fact, CPSC explains that each year they receive 35 death reports of children 5 years old and younger due to these pools. 

Portable pools make up 11 percent of all pool drownings for that age group.  However, CPSC explains these deaths are highly preventable when the following safety precautions are taken:

• Fence off portable pools and ask neighbors to do the same
• If fencing is not possible, use smaller pools, empty all water, and turn them upside down when supervision is not possible
• Never leave children near a pool or spa unsupervised
• When larger pools are not supervised, remove pool ladders and enclose with a cover that meets the latest safety standards
• Install door alarms to send an audio warning when someone leaves the house to enter the pool or spa area
• Train children how to swim and float and instruct them on any other basic water safety skills they need
• Never consider young children safe to leave unsupervised in a pool just because they have had basic swimming instruction

For more pool safety information, visit the government’s official website. 

Inflatable Pool Slide Recall

CPSC, in cooperation with both Wal-Mart Stores Inc. and Toys R Us Inc., has announced the recall of about 21,000 Banzai in-ground pool water slides.  CPSC explains that these inflatable slides have been deemed responsible for two serious injuries and one death. 

According to the recall announcement, this pool slide can deflate as it is used.  This deflation allows users to hit the ground underneath the slide and sustain injuries.  The woman who was killed, a 29-year-old mother, fractured her neck after hitting her head on the edge of a concrete pool while going down the partially deflated slide.  

The other two injuries CPSC is aware of occurred in a similar manner, with one man becoming a quadriplegic and another woman breaking her neck.  In addition to the deflation risk, these slides are also unstable, posing a toppling over risk in both calm and windy conditions.  Furthermore, the CPSC says the product carries inadequate warnings and user instructions.  

Manufactured in China by Manley Toys, Ltd, these slides were sold in Wal-Mart and Toys R Us stores nationwide from January 2005 through June 2009.  They cost about $250.  

Owners of the slide are instructed to immediately stop using it and return it to the nearest Toys R Us or Wal-Mart for a full refund.  Instead of bringing the entire slide to retailers for a refund, CPSC explains consumers can simply cut the two safety warning notices off the slide and return those pieces.  

Trampoline Recall over Fall Hazard

In cooperation with the product’s manufacturer, Sportsman Limited, CPSC has announced the recall of about 92,000 Sportspower BouncePro 14’ Trampolines.  These products have brown mesh netting around them that can break, allowing children to fall through and be injured. 

The manufacturer has received 11 injury reports due to this six-foot net breaking.  In all, 17 reports of net failure have been reported.  Injuries to children include back and neck injuries, broken bones, and contusions.  

These products were sold at Wal-Mart stores across the nation from February 2009 through February 2012 and cost about $275.  Consumers are instructed to immediately stop using these trampolines and contact the manufacturer to receive replacement netting. 

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A recently published study on the number of sports-related concussions in the United States found, not surprisingly, that football leads the list with the majority of these injuries.  However, what is surprising about the results is that girls’ soccer came in with the second greatest number of these injuries.

Furthermore, the study published in The American Journal of Sports Medicine found with “gender-comparable sports, girls had a higher concussion rate (1.7) than boys (1.0).”  The research explains that player to player contact accounted for the greatest number of these injuries, while player to playing surface contact was the second most common cause.

An NBC Sports article reports that according to Dr. Robert Cantu, a leading sports medicine professional, girls in particular are more prone to concussions due to their weaker necks.  Cantu explains that the same amount of force delivered to a boy’s and a girl’s head will cause the girl’s to spin much more, increasing the harm.  He said that new research also suggests those with longer, thinner necks may have an even greater risk.   

The article also cites other studies which have said that heading the ball in soccer can lead to brain damage as well.  According to one study, youth soccer largely accounts for the 58 percent increase in the diagnosis of pediatric concussions seen from 2001 to 2010.

According to a FOX News report from last November, one study found that although heading a soccer ball does not create the impact needed to “lacerate nerve fibers in the brain,” over time the repetitive heading may “set off a cascade of responses that can lead to degeneration of brain cells."  Researchers for these studies found that those who headed the ball more frequently did worse on verbal memory and psychomotor speed tests.  

However, soccer officials are not ready to place all the blame on heading the ball.  According to the article, experts were not satisfied enough with the specificity of the data to believe that heading is the cause of these injuries.  They believed other impacts could account for the damage seen.

What is undeniable about recent sports study findings is that the belief that concussions only happen to males, and generally only in football, has been disproven.  Although concussion research has generally focused on full-contact sports like hockey and football, we now know these injuries can occur across a wide range of high school sports. 

The recent sports medicine study explains that the “understanding of concussion rates, patterns of injury, and risk factors can drive targeted preventive measures and help reduce the risk for concussion among high school athletes in all sports.”

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Reuters reports that a new safety trial suggests that when a small electronic device is implanted into the brains of Alzheimer’s patients, beneficial brain activity may be stimulated.  

Although Reuters is careful to note that the results do not indicate that the small, pacemaker-like device has any hope in acting as a cure, “it may restore some measure of activity in areas of the brain whose decline is linked to Alzheimer's symptoms like memory loss, depression and agitation,” the article reports.   

This study, published online in the Archives of Neurology this week, was undertaken to test whether deep brain stimulation (DBS) “would increase cerebral glucose metabolism in cortical and hippocampal circuits and [if] that increased metabolism would be correlated with better clinical outcomes.”   

Gwenn Smith, PhD., the study’s lead author noted that despite the encouraging changes seen in the brains of the participants of this safety study, the technique needs to be tested in a larger population.  This trial involved five patients (four men and one woman) with mild, probable Alzheimer’s disease. 

This implant is already frequently used in Parkinson’s disease patients to alleviate tremors and help control their movements.  Continuous electrical impulses are delivered into the brain with this device.

The patients involved in the study had these devices implanted close to the brain region believed to be important in memory storage.  Two weeks later, the researchers turned the devices on and kept the settings and patient medications constant for a year. 

To test the effectiveness of this implant, the patients received PET scans at the one, six, and 12-month treatment periods.  What they found was an overall increase in brain activity in all of the patients with the implants.       

According to Smith, the patients in the trial still experienced decline, though it was less than would be expected.  Cognitive function declined in all but one patient, while quality of life actually remained static. 

However, researchers note it is not the cognitive measurements that interest them, but rather evidence of increased brain cell activity.  Brain cell activity impacted the blood flow and those with better blood flow seemed to have less cognitive decline.      

This treatment resembles a study published in the New England Journal of Medicine earlier this year which also used electric stimulation and showed promise in improving the mental abilities in those with chronic pain, Parkinson's, and Alzheimer’s.  The Wall Street Journal explains that when implanted electrodes stimulated a specific region of the brain known as the entorhinal area, memory improvements were noted.  

At this point, few effective Alzheimer’s treatments exist, making these studies very exciting for the medical community.  Although researchers in both studies admit the benefits of DBS need further study with far larger test populations, these preliminary results provide much-needed direction in the future treatment of Alzheimer’s and related diseases.

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As we enter late spring and start facing the risk of increasingly violent storms, notably tornadoes, the Centers for Disease Control and Prevention (CDC) have released a statement clarifying the proper response to an approaching twister.  

The Mother Nature Network explains that the tornado season varies by region, though it “tends to move northward from late winter to mid-summer.”  Those regions that have disproportionately higher tornado occurrences are Florida and the infamous Tornado Alley.  Tornado Alley comprises the strip of land running from north Texas through Oklahoma, Kansas, Nebraska, Iowa, eastern Colorado, southwest South Dakota, and southern Minnesota.        

The CDC statement comes after a January University of Alabama at Birmingham (UAB) Injury Control Research Center commentary which suggested that helmets are “an essential addition to an individual’s tornado-safety preparations.”  The UAB report explains that any kind of safety helmet, including hard hats, bike, or football helmets, offer an important additional measure of protection during these storms. 

According to Scott Crawford, MPH, who is the commentary’s lead author, head injuries are a major cause of tornado-related deaths in the U.S.  The UAB cites the 21 fatalities that resulted from the April 27, 2011 tornado outbreak in Alabama.  According to the Jefferson County medical examiner, at least 11 of those fatalities resulted from head or neck injuries.      

However, the CDC explains that looking for a helmet in the moments before a tornado strike can actually put individuals at a greater risk of injury or death by delaying them from finding adequate shelter.  Although the CDC stands by their recommendations for people to protect their heads during these storms, they also explain that nothing should come before the primary goal: finding a safe place to ride out the storm. 

The CDC recommends finding a shelter or tornado-safe room, such as a basement.  If a heavy table, workbench, or other sturdy piece of furniture is present, individuals are encouraged to get under it.  If stranded outdoors when a tornado hits, they recommend lying down in a ditch or gully. 

Although the CDC recognizes the value of head protection in the event of a tornado, they explain that people choosing to use a helmet should know where it is located and have it readily available.  Nothing should come before finding a safe place to seek shelter.  

Furthermore, the CDC notes that “these helmets should not be considered an alternative to seeking appropriate shelter.”  Rather, helmets should be part of a family’s total tornado emergency plan.  

For more CDC recommendations on how to stay safe this tornado season, visit their Emergency Preparedness and Response page. 

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A new article published in Nature reports that British researchers have discovered a process that results in brain cell death and may have the drug that can treat a range of related diseases.  

According to the British Broadcasting Corporation (BBC), researchers at the University of Leicester have discovered how the “build-up of proteins in mice with prion disease resulted in brain cells dying.”  Prion diseases are progressive neurodegenerative disorders that result in the impairment of brain function, memory problems, personality changes, intellectual function decline, and increased movement problems.  

Alzheimer’s, Parkinson’s, and Huntington’s disease are all conditions that result from the build-up of these proteins.  A Reuters Report explains it is these misshapen proteins that form the plaques that characterize Alzheimer’s disease and the Lewy bodies in Parkinson’s disease patients.      

According to the BBC, researchers have found that as misfolded protein levels rise in the brain, “cells respond by trying to shut down the production of all new proteins.”  

This protein production shutdown is the same process that cells use to stop the spread of viruses.  “However, shutting down the factory for a long period of time ends up killing the brain cells as they do not produce the proteins they actually need to function,” the article explains.

The research team found that when they prevented brain cells from dying, it helped mice in the testing live longer.  It is this brain cell death that explains how diseases like Parkinson’s and Alzheimer’s damage the nerve cells. 

Reuters explains that although researchers have known that neuron death in the brain causes the effects seen in these neurological disorders, they now know why the neurons are dying in the first place.  Understanding why neurons die has been the major barrier in developing treatments and diagnosing illnesses at earlier stages when treatments may be more effective. 

Now researchers have discovered that by injecting a protein to block the “off” switch that led to the shutting down process of all new protein production, they are able to “restore the production of the survival proteins and halt the neurodegeneration.”    

After injecting this protein, researchers found that “brain cells were protected, protein levels were restored and synaptic transmission - the way brain cells signal to each other - was re-established.” 

Researchers noted that although these scientific findings are still in their early stages, the results show great promise.  Furthermore, the variety of diseases that this research helps us understand means that this breakthrough has the potential to change the lives of many millions of patients worldwide who previously had little hope for treatment. 

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Junior Seau, a former star NFL linebacker, committed suicide on Wednesday, leaving behind questions of whether the head trauma he suffered throughout his 20-year career caused symptoms that led him to take his own life.  He was just 43.   

Although a note was not found with his body, depression and suicide are two common hallmarks seen in former football players who endured a career filled with hard hits.  A Fox News report explains Seau’s is just the latest in a series of suicides by former NFL players.  These athletes include Terry Long, Andre Waters, and Dave Duerson.  

Duerson even left specific instructions to donate his brain to science in order to study the damage done by the repeated concussions he suffered during his playing days.  In order to preserve his brain for researchers, Duerson shot himself in the chest last year.  

Though it appears Seau left no such instructions to have his brain studied, he also died of a self-inflicted gunshot wound to the chest.  The coroner’s office has received family approval to examine Seau’s brain for signs of long-term damage.     

Scientists who study the brains of these athletes are looking for signs of chronic traumatic encephalopathy (CTE).  

Boston University’s Center for the Study of Traumatic Encephalopathy explains that CTE is a “progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.”  Players in a highly violent position, such as linebacker, have the highest risk of developing this condition. 

A Reuters report explains that over 1,500 former players have sued the NFL for head injuries they sustained.  These suits allege that the league concealed the link between football and brain injuries.  

In its defense, the NFL has directed attention to its recent efforts to take into account these health and safety issues.  According to Reuters, the league “has cracked down on hits to the head, and stiffened rules that bar players from using their helmets as a weapon through head-first contact, which is subject to fines and suspension for repeat offenders.”

However, these recent moves come after decades of trauma suffered by former players.  Just last month, former NFL safety Ray Easterling also took his life after suffering from what his wife said were the effects of his playing days with the Atlanta Falcons.  Easterling suffered from depression, insomnia, a loss of focus, an inability to organize his thoughts, and trouble relating to others.  

USA Today reports that he was the lead plaintiff in a group of seven former players who sued the NFL last August.  That suit also claimed the league “failed to properly treat players for concussion and tried to conceal for decades any links between football and brain injuries.”  

Although experts are conflicted as to whether Seau’s suicide was related to head injuries he sustained during his playing days, virtually everyone agrees more research into the connection between head injuries and the risk for depression and suicide needs to take place.  

MSNBC reports that these suicides have helped expose the lasting dangers of concussion and repeated head trauma.  Today there is a far greater awareness and appreciation for the seriousness of these injuries, and changes to the way athletes are protected, treated, and screened are likely to continue.

 

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A small Bethesda, Maryland-area medical company may have developed a treatment for brain injury, stroke, or concussion patients who still experience speech, cognition, muscle, and memory problems after traditional treatments and rehabilitation.   

This start up, Relox Medical, has developed an infusion therapy which is designed to deliver the maximum amount of oxygen possible to the brain.  Local Bethesda news source, WUSA9, explains this treatment delivers a solution of magnesium chloride to patients through an IV in order to introduce the medication into the blood stream. 

Once in the body, this solution causes the blood vessels in patients to expand, allowing more oxygen to reach the brain.  While this vessel expansion occurs, patients simultaneously inhale extra oxygen through a mask. 

Dr. Bert Spilker, a Relox Medical scientist, explains that stroke or traumatic brain injury (TBI) causes brain cells to die.  Although these dead cells can never be brought back to life, injured cells around them can be rejuvenated, which is what this therapy aims to do. 

The news source explains that this extra oxygen produces adenosine triphosphate (ATP), which repairs injured brain cells. With the enlarged blood vessels, the ATP can pass through and make its way to those injured cells. 

Relox Medical has tested their therapy in clinical trials with over 80 patients.  However, before they launch a phase 3 study, the news source explains that the small company is looking for another pharmaceutical company to partner with. 

In April, we reported on a similar therapy that places TBI patients in an oxygen tank to submerge them in 100 percent oxygen under high pressure.  According to a First Coast News report, researchers believe this therapy may help the neurons and small blood vessels heal. 

Dr. Stephen Xenakis, a psychiatrist and retired Army brigadier general who recommends this treatment, says that patients undergo 40 sessions of this one-hour treatment.  Known as hyperbaric oxygen therapy (HBO2), Xenakis claims patients start to see improvements in their mood, headaches, alertness, and focus about halfway through. 

Xenakis says that the therapy is particularly useful for returning soldiers who have sustained IED blast injuries.  These patients often come home with attention and memory problems and struggle to feel normal.  

One study into this treatment has already been completed, while another is in the recruitment phase.  Although it costs about $250 per treatment and insurance does not cover it, the article explains veterans are being worked with for free.  

Both this HBO2 therapy and Relox Medical’s treatment are promising advances for patients who may have believed they could never recover the quality of life they lost.  We will continue to report any updates in the approval process for these treatments. 

Ten years ago, Jason Padgett was mugged after coming out of a karaoke club in Tacoma, Washington.  ABC News reports the muggers violently kicked and beat him. 

Padgett likely suffered a closed head injury, meaning he received trauma that results from a blow to the head or a violent, quick jolt that causes the brain to knock against the skull.  Other causes of closed head injuries include automobile accidents, falls, and work or sports-related accidents.    

At first, doctors believed he had a concussion.  However, Padgett soon realized that he was “obsessed with drawing intricate diagrams, but didn’t know what they were.”  The injury left him seeing complicated mathematical formulas wherever he looked.   

Padgett said he now sees “bits and pieces of the Pythagorean theorem everywhere.”  Channeling this mathematical fixation through his drawings, he creates fractals, which he describes as “a shape that when you take the shape a part into pieces, the pieces are the same or similar to the whole.” 

For example, Padgett explains this would be like taking 1,000 small pictures of you and placing them in such a way that creates the exact same image, only larger.  He is believed to be the only person in the world with this skill. 

Examples of his work include a visual representation of the formula of Pi, which is the infinite number beginning with 3.14.  Researchers have compared his gift to that of John Nash, the mathematical genius portrayed in the 2001 film, “A Beautiful Mind.”  

With no math background or college degree, Padgett’s acquired gift baffled scientists.  To get an answer, Berit Brogaard, a neuroscientist and philosophy professor at the Center for Neurodynamics at the University of Missouri-St. Louis, flew him to Finland to undergo testing. 

ABC reports that researchers found “Padgett’s brain showed damage that was forcing his brain to overcompensate in certain areas that most people don’t have access to.”  This turned him into an acquired savant, meaning he is “brilliant in a specific area.”

A Yahoo News article points out that there are other famous savants who also had brain damage, including Orlando Serrell.  After being struck in the left side of the head with a baseball at age 10, Serrell could then do complicated calendar calculations and “remember the weather every day from the day of the accident.” 

Currently a furniture store employee, Padgett hopes to teach others what he has learned about the beauty of math since his accident.  Although he admits this gift can sometimes become a burden because he can never stop seeing the mathematical formulas, he says the benefits have easily outnumbered the drawbacks. 

His profile on Fine Art America explains Padgett is now studying at Washington state in order to learn traditional mathematics “so he can better describe what he sees in a more traditional form. “  To see Padgett’s works, you can visit his online portfolio.

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The U.S. Department of Health & Human Services’ Administration on Aging explains that each May marks Older Americans Month, a celebration used to “honor and recognize older Americans for the contributions they make to our families, communities and society.”  Every year, the administration releases a new theme which helps promote the health and wellness of older Americans.  

This year’s theme is “Never Too Old to Play” and older Americans are encouraged to “stay engaged, active and involved in their own lives and in their communities.”  Most past themes of this celebration promote healthy living and continued happiness, and this year’s event is no different. 

This year older Americans are encouraged to get physically active by engaging in gentle physical exercise.  These exercises can improve balance and strengthen muscles while putting minimal strain on the body.  This helps prevent falls which can result in broken bones and head or spinal cord injuries.  

The organization website also explains that due to a number of structural and activity changes in the brain accompanying aging, movement and thought can be affected.  However, studies indicate certain exercises can train and stimulate the brain, “improving its efficiency and perhaps even reducing the risk of Alzheimer’s disease and other forms of dementia.”  

Other activities promoted during this year’s Older Americans Month include a call to “Bridge the generation gap” and “Get creative.”  By bridging the generation gap, younger American’s get to learn from their elders, while older Americans enjoy the increased activity and sense of self-worth that accompanies spending time with younger people.  When older Americans embrace creativity, they get to express themselves in a “creative and healing process of self-expression.”   

Finally, a major goal of Older Americans Month is to build community. The organization’s website allows participants to mark their events on a community calendar and share videos, stories, and photographs from their celebrations.  

The website also includes ideas for events, games, and other activities to help mark this month’s celebrations.  This year participants are also encouraged to “Host a Day of Play” and promote the event through both social media and more traditional tools including posters and newsletters.

This May’s Older Americans Month follows last month’s Safe Kids Week, which is put on by Safe Kids USA and aims to promote childhood injury prevention.  This year’s event was celebrated from April 21 to April 28 and included a number of separate campaigns to ensure playground and sports safety.  

Both Safe Kids Week and Older Americans Month share a common goal of safeguarding the most vulnerable citizens from preventable accidents and injuries.

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The Armed Forces membership organization, Military.com, explains that traumatic brain injury (TBI) is frequently known as the “signature wound of the Iraq and Afghanistan wars.”  Causes of TBI include falls and vehicle accidents, though improvised explosive devices (IEDs) are responsible for most of these reported injuries.        

Soldiers who suffered undetected brain injuries early in the Iraq and Afghanistan wars generally rejoined the fight without any treatment or rest.  However, as the war in Iraq ended and engagement in Afghanistan continues to decline, more attention is being paid to these brain injuries, particularly more mild ones like concussion.      

The American Statesman reports that over 200,000 U.S. service members, or about 10 percent of troops who served in Afghanistan and Iraq, have suffered a TBI.  These injuries can lead to long-term problems like depression, mood swings, and difficulty thinking. 

To address the later issues these injured soldiers face, the Craig Joint Theater Hospital at Bagram Air Base in Afghanistan offers a concussion care center where soldiers receive swift treatment and rest after a head injury.  Medical experts have found that the soothing care they receive at this clinic can help prevent the long-term problems associated with a TBI.

Air Force Maj. Katherine Brown, the officer in charge of the clinic, explains that TBI rehabilitation protocols have not yet been well-researched.  Therefore, she is working with the Department of Defense to make sure these rehabilitation challenges are met. 

When soldiers first arrive at the clinic, they are often confused, disoriented, and struggle with their balance.  Therefore, during the first day these soldiers are encouraged to do nothing but sleep. The article explains this rest period is probably the most important part of their recovery process, especially because quiet areas are so hard to find around combat area bases.  

Following this full day of rest, servicemen and women move to a day room to relax by watching relatively low-stimulation comedies, opposed to the action and war movies most soldiers favor.  Although some soldiers request to return to their units at this point, Brown keeps them longer, telling them that returning would not yet be safe for them or their teammates. 

Finally, improving soldiers move to a third building to take part in cognitive reasoning exercises and eye movement practice.  The article explains that brain injuries can impact quick eye movement, which is particularly dangerous in a war zone where so much depends on the rapid response to threats. 

Following their completion of this course, soldiers might receive referral to counselors in the combat stress department of the hospital, or undergo more physical rehabilitation.  However, most soldiers return to their units, the article says.   

Military.com explains that brain injury recovery depends on the individual and degree of damage.  However, the military resource also points out that immediate medical treatment remains “essential for stabilizing, preventing further damage and physical/mental rehabilitation.”  With this concussion care clinic, soldiers in Afghanistan now have a location and program to receive the immediate medical care that will help them avoid the long-term consequences of a TBI. 

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The U.S. National Highway Transportation Safety Administration (NHTSA) reports that Motorcycle Safety Awareness Month returns this May.  NHTSA explains this annual event is “a national initiative aimed at getting motorists and motorcyclists to ‘share the road’ with each other.” 

Much of the focus of this awareness month centers on the importance of helmet use to prevent serious injuries and death.  According to NHTSA estimates, helmets saved 1,829 motorcyclists’ lives in 2008 alone.  If every rider had been wearing a helmet that year, NHTSA believes 823 additional lives might have been saved.  

Traumatic brain injury (TBI) is a leading cause of motorcycle injury death.  Fortunately, a NHTSA publication reports that motorcycle helmets are 27 percent effective at preventing traumatic brain injury. 

According to NHTSA statistics, motorcyclists are about 37 times more at risk of dying in a traffic crash per vehicle mile traveled than passenger car occupants.  Motorcyclists are also 9 times more likely to be injured. 

The Motorcycle Safety Foundation, a national nonprofit dedicated to promoting motorcycle safety, notes that a DOT-approved motorcycle helmet is an essential part of the safety equipment every rider and passenger needs.  The other pieces of important motorcycle safety equipment include:

• Over-the-ankle footwear
• Long pants
• Long-sleeved jacket
• Full-fingered motorcycle gloves

The safety group also notes that past helmet myths, such as the belief that they cause neck breaks, block driver vision, and impair hearing, have been disproven.  In fact, the group notes that wearing a helmet while riding actually increases rider enjoyment by cutting down on wind noise, limiting gusts to the face and eyes, and deflecting bugs and other road debris. 

For more information on choosing the proper helmet, caring for it, and buying a replacement, read the Motorcycle Safety Foundation’s guide, “What You Should Know About Motorcycle Helmets.”   

Another NHTSA publication, “Costs of Injuries Resulting from Motorcycle Crashes: A Literature Review,” reports motorcycles’ high speeds and minimal occupant protection makes them the most hazardous highway vehicle to operate.  In addition, motorcycle crashes have the highest crash cost per person mile.  

The report also claims that because many motorcyclists value a high degree of independence, safety regulations have been met with strong resistance.  As a result, protective equipment, most notably helmets, are not required in many states. In fact, federal laws designed to promote helmet regulations have previously been enacted and then repealed.

According to an October 2009 NHTSA report, “Motorcycle Helmet Use and Head and Facial Injuries,” in the ten-year period from 1997 to 2007 the number of motorcycle fatalities increased every year.  Based on these statistics, May’s Motorcycle Safety Awareness Month remains an essential tool in the fight against preventable motorcycle deaths. 

The Centers for Disease Control and Prevention (CDC) explains that stroke is among the leading causes of death in the U.S.  Risk factors for stroke include inactivity, obesity, high blood pressure, smoking, high cholesterol, and diabetes.  At the moment, doctors have no medications to offer stroke victims to help them recover faster.  

Around 795,000 Americans suffer a stroke each year, which makes it one of the leading causes of long-term disability.  Furthermore, we become more susceptible to stroke and recover slower as we get older, which is bad news for our aging baby boomer population. 

However, neuroscientists at the Stanford University School of Medicine demonstrated in a recent study that a compound has the ability to speed the growth of new nerve cells in mice that have had strokes.  The study’s mice also recovered quicker and saw the return of their athletic ability sooner. 

Furthermore, the article points out that this compound was not even given to the mice until three days after their strokes.  “This means that the compound works not by limiting a stroke’s initial damage to the brain, but by enhancing recovery,” the research review explains.  

This compound, LM22A-4, mimics “a key activity of a hefty, brain-based protein” that helps the brain generate new neurons.  Furthermore, this is a small molecule less than one-seventieth the size of the brain protein it mimics.       

The article notes that although stem cell therapy holds much promise, its cost and invasiveness make it a less attractive way to “replace lost or damaged tissue.”  The use of this compound to stimulate the “brain’s own stem cells to form new neurons” would be a completely new approach to treating stroke patients, Frank Longo, M.D., Ph.D., co-author of the study pointed out.   

The study’s senior author, Marion Buckwalter, M.D., Ph.D., notes that the one approved stroke drug available today can only “bust up clots that initially caused the stroke,” not help with the recovery of brain tissue and function.  In addition, this medication needs to be administered within four and a half hours after a stroke for it to work, which is an unrealistic time frame for most patients. 

The CDC reports that in 2010 alone, strokes cost the U.S. an estimated $53.9 billion.  This includes the cost of health care, medication, and missed work.

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Safe Kids USA, a national network of organizations dedicated to preventing unintentional childhood injury, announced that National Playground Safety Week is taking place this week from April 23 to April 27.  The safety group notes that this awareness event “is a time to focus on your children's outdoor play environments.”

Safe Kids USA explains that unintentional childhood injuries, like those sustained on unsafe playgrounds, are the leading cause of death and disability for children between the ages of 1 and 14.  In order to ensure playground safety, the national safety group provides parents with the following safety tips:

• Use playgrounds with a ground covering of shredded rubber, mulch, wood chips, or sand.  Soil and grass are not considered safe surfaces. 
• The playground surfacing materials should extend 6 feet around equipment and be at least 12 inches deep.
• Ensure playground equipment receives frequent inspection and is kept in good repair.  Report issues to the local parks and recreations office if it appears this is not the case. 
• Do not let children wear helmets, necklaces, purses, or scarves on the playground and remove hood and neck drawstrings from their clothing and outerwear before taking them. 
• Do not allow toddlers under the age of five to play on equipment designed for older children.
• Give children your undivided attention while they use playground equipment by actively supervising them. 

The importance of playground safety was driven home this February with the U.S. Consumer Product Safety Commission’s recall of the Slalom Glider, a playground slide which has been blamed in the injury of 16 children under the age of eight.  About 900 of these slides, which lack a transition platform and chute sides, were recalled after injury reports that included bone fractures, bruises, and even a bruised spleen. 

However, National Playground Safety Week is just a component of Safe Kids Week, which is celebrated this year from April 21 through April 28.  Initiated in 1988, this annual nationwide event helps parents and caregivers “understand a different part of childhood injury prevention.”  

Initiatives that take place during Safe Kids Week include:

• Public Education and Coalition Activities-these include school safety fairs, parent education workshops, and other events. 
• Legislative Advocacy-child safety laws are promoted and strengthened during these activities.  
• Research-new research about preventing injuries related to the year’s theme is published.  
• Media Outreach-media strategies are formed to help inform the public of the important injury prevention topics presented during this event. 
• Retail Promotions and Advertising Partnerships-media partnerships allow Safe Kids to distribute their message of child injury prevention to millions of homes during this safety awareness week. 

This year’s events also feature an emphasis on concussion prevention and sports safety.  Safe Kids Oregon, that state’s affiliate of Safe Kids USA, reports that every year more than 3.5 million children receive medical care for sports injuries.  

Fortunately, the group explains that most of these injuries are preventable.  In order to protect children nationwide, Safe Kids USA offers the following “C-O-A-C-H-E-S” tips to coaches, parents, and sport organizers:

• C-Condition kids with a warm up before games and practice, followed by stretching.
• O-Overuse Injury Prevention needs to occur due to the risk of injuries brought on when children do not get the proper amount of rest after practices and games.
• A-Advanced Planning allows coaches to prepare for emergencies.  This includes pre-participation physicals for children, storing parent contact information, having a first aid kit, and developing a plan in the event of a medical emergency. 
• C-Concussion Awareness due to the seriousness and difficulty in recognizing these injuries. 
• H-Hydrating before, during, and after games and practices.  Regular hydration breaks need to be a part of coaching.  
• E-Equipment needs to be in good condition, properly fitted, and worn during every game and practice. 
• S-Safety Training is essential and easier to come by than coaches may believe.  Safe Kids Worldwide provides free sports safety tip sheets to parents and coaches in both Spanish and English.   

A recent Chicago Tribune article emphasized the need for better youth sport injury tracking after the death of a 12-year-old boy who was struck in the head with a baseball while practicing with a teammate.  Although careful injury records are kept for athletes at both the college and high school level, no such records are kept for the youngest athletes in the U.S. 

According to researchers, by tracking and monitoring youth sport injuries better, accident trends can be identified, equipment can be improved, and rule changes can take place to increase safety for young athletes.  These changes, along with the efforts of Safe Kids USA, are helping to extend the focus of childhood injury prevention past this week’s events and ensure as many of these injuries are avoided in the future as possible.

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Last week we reported on a new technology which uses biopolymer scaffolding to treat acute spinal cord injuries.   In tests of that technology, animals that had undergone acute spinal cord injuries regained the ability to move their legs again.   

ScienceNOW, a leading general science journal, reports that a new study has demonstrated a way to re-establish the links between the brain and the muscles that move limbs after they have been severed.  In this study, scientists implanted electrodes in the brain’s movement control center and wired them to muscles in the arm.  These electrodes allowed the researchers to restore movement to monkeys that had temporarily lost the ability to move their hand. 

During the study, researchers injected the monkeys with a nerve-blocking drug to temporarily cause hand paralysis.  After the shot, the science publication explained the monkeys were unable to do “a simple task they'd previously learned, picking up a rubber ball and dropping it into a tube to earn a reward of juice.”  However, once these electrodes were switched on, they regained much of their lost ability, succeeding with this task about 80 percent of the time. 

This study represents the combination of two approaches which make up the emerging field of neuroprosthetics.  This field combines prosthetics, which help paralyzed patients interact with the world, with methods that have recently been developed to “decode signals from electrodes implanted in the brain so that a paralyzed person can control a cursor on a computer screen or manipulate a robotic arm with their thoughts alone.”   

Although the article notes that the brain implant technology remains experimental and few have received it, it explains that “several hundred patients have received a different kind of neural prosthetic that uses residual shoulder movement or nerve activity to stimulate arm muscles, allowing them to grasp objects with their hands.”    

With this new study, scientists have effectively joined these two techniques.  After implanting “electrode grids into the primary motor cortex of two monkeys,” the scientists were able to record the electrical activity of about 100 neurons that control the hand.  They then implanted electrodes in the arm muscles used for making the hand grasp objects.  

“By recording simultaneously from the brain and muscle electrodes as the monkeys gripped various objects,” the researchers were able to develop “computerized decoding algorithms that predicted how signals from the brain translated into electrical activity in each of the three muscles,” the article explains.  With the use of these algorithms, the researchers interpreted the brain commands from the paralyzed monkeys’ brains needed to stimulate the right muscles to produce the intended movement. 

According to one of the researchers, Neuroscientist Lee Miller, Ph.D., of the Northwestern University Feinberg School of Medicine in Chicago, Illinois, with their system they are “going back to the brain and eavesdropping on the signals that normally occur.”  With this technology, Miller hopes paralyzed individuals will soon be able to move their hand with just a thought, instead of using “current muscle-stimulating prostheses, which rely on residual movement in other body parts and require patients to learn unnatural movements such as moving a shoulder up and down to grasp and release.”  

Although Miller explains there are not many “technical hurdles” to experimenting with this technology in humans, getting approval and recruiting patients will take several years.  Furthermore, many spinal injuries cause more widespread paralysis in patients than seen with these test monkeys, which would require a greater number of muscles to be stimulated.  

Nevertheless, Miller remains optimistic about their chances of achieving the dexterity needed in humans.  Another approach he and his team are looking into is the stimulation of the nerves controlling muscles in the arm and hand, rather than the muscles themselves.  

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A press release for a new study carried out by members of the American Academy Of Neurology (AAN) reports that there appears to be a threshold at which head trauma or blows received during combat sports start to take their toll on brain function.  The AAN is an association of over 25,000 neurologists and neuroscience professionals who are dedicated to promoting the highest quality neurologic care possible.     

The study looked at 43 mixed martial arts athletes and 35 boxers who had an average age of 29.  After undergoing tests to determine their memory and thinking skills and an MRI brain scan, the athletes were split into two groups: those who had been fighting for nine years or less and those with over nine years of experience.      

Researchers found that in both groups, “those with more years of fighting and more fights per year were more likely to have lower brain volumes in three areas of the brain.”  For those with less than nine years of fighting, though, no relationship existed between the years of fighting or number of fights per year and memory and thinking test results.  

However, the study found that for athletes with more than nine years of fighting experience, “those with more fights per year performed worse on the thinking and memory tests than those with fewer fights per year.”  This indicates that changes in memory and thinking begin to appear after fighters reach this nine-year threshold, despite changes in brain volume that can be found earlier.   

The press release reports that this head trauma, which causes memory and thinking problems, can also lead to chronic traumatic encephalopathy (CTE) in the brain.  According to Boston University’s Center for the Study of Traumatic Encephalopathy, CTE is a “progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.”  

The AAN press release explains that autopsy is the only way to diagnose CTE, though symptoms of the disease include aggression, memory loss, and difficulty thinking.  Other athletes at risk for developing CTE are football and hockey players.    

After identifying this brain damage threshold, doctors believe they can help athletes by introducing better guidelines to protect them.  Some options include fight limits or mandatory brain evaluations.  The results of this research will be presented at the AAN’s 64th Annual Meeting in New Orleans, which takes place April 21 through April 28, 2012.  

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Last week Business Wire reported that the Cambridge, Massachusetts-based medical device developer, InVivo Therapeutics Corporation, expects to begin a human study into their new technology to treat spinal cord injuries soon.  This technology uses “biopolymer scaffolding to treat acute spinal cord injuries,” the news source reports. 

This technology represents a potentially unprecedented ability to treat spinal cord injury patients.  At the moment, no spinal cord injury treatment options exist.  

To treat these spinal cord injuries, doctors insert this polymer medical device into the area of the injury.  Results of the testing of this method were published in a 2010 issue of the Journal of Neuroscience Methods.  That study used four African green monkeys to test the treatment.  

According to a recent WFMY News article, monkeys who received this treatment have shown the most progress, with one being able to walk again after only a few days.  These results have been replicated in other animal testing research, including studies using rats. 

During their meeting with the U.S. Food and Drug Administration (FDA), InVivo discussed “the Investigational Device Exemption (“IDE”) application previously filed by InVivo for its biopolymer scaffolding to treat acute spinal cord injuries.”  The FDA must approve the IDE filing before clinical studies can begin with humans.  However, Business Wire reports that “the FDA has agreed to an open dialogue as part of the final process toward gaining approval.” 

Frank Reynolds, InVivo’s Chief Executive Officer, explains that after their meeting, he is “encouraged by the communication we have had with the FDA to this point, and pending approval of the IDE, we expect the clinical trial for our treatment of acute spinal cord injuries to commence during the second half of 2012.”  The business report explains that InVivo also plans to “submit hydrogel-based applications to the FDA for the treatments of SCI and chronic pain” later this year.  

InVivo Therapeutics was founded in 2005 by Reynolds, who sustained a paralyzing spine injury in 1992.  According to the company, it prides itself on what it calls an “unmatched development portfolio composed of platform technologies for the treatment of both spinal cord injury and other application.” 

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For patients left immobilized due to spinal cord damage or other injuries, the risk of chronic wounds brought on by pressure ulcers is an everyday reality.  These wounds, commonly called bedsores, develop in areas of the skin or tissue that lost blood flow and are dead or dying.  

When patients remain in one position too long, these wounds can develop.  The U.S. Library of Medicine points out common wound locations include areas where the bone is close to the skin, such as ankles, the back, elbows, heels, and hips. 

The University of Alabama Spinal Cord Injury Information Network explains that although anyone can develop a pressure sore, it is estimated that up to 80% of those with a spinal cord injury (SCI) will develop this wound at some point during their life.  Furthermore, 30% of those with an SCI will have more than one. 

However, The Wall Street Journal reports that an innovative new program may have the answer to decreasing those startling statistics.  This program, launched at Montefiore Medical Center in New York City, takes a proactive and holistic approach to patient care to ensure these potentially life-threatening infections never occur in the first place. 

Unlike other hospitals, which often take a reactive approach to treating pressure sores on bedridden patients, at Montefiore’s wound center “the sickest patients are seen more frequently, receive more aggressive debridement, and are more closely monitored for wound infection,” the Wall Street Journal explains.  Debridement refers to the process of removing dead, damaged, or infected tissue so remaining healthy tissue has a better chance to heal.    

Furthermore, Montefiore’s staff is trained in wound care and prevention, which may not be the case at other facilities.  At Montefiore, doctors, nurses, and other medical staff rely on preventative screening, early detection, and aggressive treatments to fight these wounds.    

The Wall Street Journal reports that bed sores represent a serious and growing threat to both public health and the economy.  As our nation’s baby boomers age and diabetes and obesity continue to plague more and more citizens, the risk of these chronic wounds also increases.  According to a 2009 study, treating bedsores costs the country about $25 billion a year. 

Many new wound clinics and novel treatments, like cultured skin cells that stimulate tissue to heal and pumps that drain wounds using sealed dressings, have appeared in the last 10 years to treat these patients. However, some experts feel that taking a holistic and comprehensive approach to patient health is the real answer.    

Though Montefiore’s wound center uses some of the latest treatments, like oxygen therapy and tissue regeneration, Director Anna Flattau says they also hope to “reduce the need for more expensive technologies by treating wounds earlier and better so they have the best chance of healing.”  The approach she promotes involves coordinating care among “doctors, physician assistants and nurses to prevent wounds like bedsores or diabetic foot ulcers before they develop, and aggressively treat them if they do start.”  

However, the risk of a chronic wound does not end after hospital discharge, particularly for many SCI patients.  The article explains that many of these patients with limited mobility cannot make it to an outpatient wound clinic for later treatments, which is why Montefiore created a home-care follow-up program.  

“As part of the home-care program, family caregivers are taught to deal with issues that can arise,” the article explains.  Furthermore, nurses who come into patients’ homes offer support, clean new wounds, and discuss medications and strategies that will help ensure continued healing. 

According to the University of Alabama at Birmingham, 95% of all pressure sores can be prevented.  With hospitals like the Montefiore Medical Center taking the lead with innovative programs, SCI patients now have access to the preventative programs they need to protect them from the potentially lethal risks posed by confinement to a bed or wheelchair. 

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Diagnosing cognitive decline in patients may have just gotten easier.  Earlier this week, the U.S. Food and Drug Administration (FDA) approved the new imaging drug, Amyvid.  

This drug is used in Positron Emission Tomography (PET) imagining scans of the brain in patients who are being tested for Alzheimer’s disease and other forms of cognitive decline.  It allows medical professionals to identify the presence of amyloid plaques in the brain, which experts believe is the cause of Alzheimer’s.   

Amyvid will be used to help rule out the development of Alzheimer’s disease-related dementia, the FDA explains, as these patients always “have an increased brain content of plaque.”  In the past, the only way to identify these plaques was to carry out a biopsy or during autopsy.   

However, the press release explains this test may also come back positive in patients who have other types of neurological conditions and older patients who suffer no cognitive impairment.  While researchers believe all Alzheimer’s patients have these plaques, not everyone with these plaques has Alzheimer’s.  Nevertheless, researchers say this drug will allow them to better study this plaque and how to treat it.  

Alzheimer’s is a devastating disease and the Centers for Disease Control and Prevention (CDC) explains it is the most common form of dementia in older adults, with 5 million estimated to have it in the U.S.  This disease impacts the parts of the brain which control decision making, thinking, and memory, seriously disrupting patients’ ability to function normally.  

Unfortunately, scientists still do not yet understand all the factors that contribute to the development of Alzheimer’s, though age and family history are identified as two major ones.  Other possible contributors to this disease include high blood pressure, high cholesterol, and diabetes.  

What Amyvid will not do is predict the likelihood of developing Alzheimer’s or help monitor patient response to treatments.  Furthermore, the FDA notes Amyvid does not act as a replacement for other diagnostic tests “used in the evaluation of cognitive impairment.”    

The press release explains that common side effects to this medication include “headache, musculoskeletal pain, fatigue, and nausea.”  Other safety concerns are the risk of radiation and dangers “associated with image misinterpretation.”   

Nevertheless, this drug offers doctors a greater understanding of a disease which has no cure and can take such a huge toll on families.  Furthermore, with the aging baby boomer population, doctors expect an explosion of new Alzheimer’s patients in the future.  However, with the approval of this drug, medical professionals have another tool to help the millions that will develop this disease in the coming years.