Archive for April, 2009
Up until this month, the general consensus estimated the amount at 250,000 and about four million, respectively. Large numbers indeed, but according to a study just released by the Christopher & Dana Reeve Foundation, they fall far short of reality.
Add 40% to the number of those living with paralysis and multiply four million spinal cord injuries by five and you will have a better idea of the actual numbers: 1.275 million spinal cord injuries and 5.6 million who live with some kind of paralysis.
The study (that surveyed more than 33,000 households) was simplified by the president and CEO of the Reeve Foundation to mean “one in 50 Americans is living with some form of paralysis, whether caused by disease, spinal cord injury or neurological damage…someone you know is living with paralysis – a family member, a friend or a work colleague”.
Some key findings:
- Paralysis and spinal cord injuries are a great deal more widespread than previously assumed.
- Stroke, followed by spinal cord injuries are the top causes of paralysis.
- “Household income for those with paralysis is heavily skewed towards lower-income brackets and is significantly lower than household income for the country as a whole. Roughly 25 percent of households with a person who is paralyzed earn less than $10,000 per year, compared with only seven percent of households in the general population.”
This survey is the first of its kind and the data that it collected will help this population obtain the health care that they need. In response to this study, the Reeve Foundation plans to launch a campaign to change public policy for the better – stay tuned for more details!
Diabetic gastric stasis and gastroesophageal reflux aren’t much fun. Patients afflicted with these two conditions often experience nausea, vomiting, heartburn, persistent fullness after meals, and anorexia. A prokinetic agent called Reglan (metoclopramide) has been added to the list of suggested short-term therapies for use after conventional therapy fails. Reglan helps by increasing the frequency of gastric contractions and relaxing the pyloric sphincter, a ring of muscle that lets food pass from the stomach to the duodenum (the first section of the small intestine).
While this drug has been shown to provide relief from gastric stasis and gastroesophageal reflux, consumers need to be aware of one of Reglan’s more insidious side effects.
Tardive Dyskinesia, most often linked to the use of antidepressants and antipsychotic drugs, causes the patient’s nerve cells to misfire. This creates involuntary movements such as grimacing, pacing in place, picking at clothes, rocking, and twitching. Long-term or high-level use of Reglan greatly increases the risk of developing this disorder.
The FDA now requires products with metoclopramide in them to add a warning to their labels. “The chronic use of metoclopramide therapy should be avoided in all but rare cases where the benefit is believed to outweigh the risk,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research in a February, 2009 press release.
The FDA also states that the movement disorder Tardive Dyskinesia is often irreversible and that the potential increases with duration and accumulation. Women and the elderly are especially at risk, and the warning applies to all forms of Reglan administration, including oral and injected.
With a 20% chance of developing Tardive Dyskinesia from taking Reglan for more than three months, it definitely makes sense to weigh the potential costs with the gastrointestinal benefits. Make sure to communicate with your doctor about the absolute length of administration as well as the amount you need to take.
For more details on Tardive Dyskinesia, click here.
Image from here.
Apple’s App Store, well known for its tight strictures and uptight policies regarding the iPhone applications it chooses to accept, has stepped in it this time.
The Baby Shaker, a $.99 application for the iPhone that requires users to shake their phone in order to quiet crying babies, incited outrage from brain injury organizations and children’s groups, causing it to be removed two days after its release.
“See how long you can endure his or her adorable cries before you just have to find a way to quiet the baby down!” read the iTunes description.
Apple has apologized for the mistake, though they have yet to address how Baby Shaker, created by Sikalosoft, made it into the App Store in the first place.
“This application was deeply offensive and should not have been approved for distribution on the App Store,” Apple said in a statement.
Visit the Sikalosoft web site and you will find a statement acknowledging the app’s poor taste, “Yes, the Baby Shaker iPhone app was a bad idea. You should never shake a baby! Even on an Apple iPhone Baby Shaking application. In case you are unaware Baby Shaker was an Apple iPhone application that was greatly lacking in taste. It was approved by Apple for download upon the iPhone”.
Apple reviews hundreds of apps every day, a number that argues for the occasional error in judgment, and their quick action to remove the game bodes well for their reputation. Yet the choice to approve the game in the first place points out a glaring flaw in their procedures – “bad taste” may have a variety of definitions depending on the audience, but when in doubt, error on the side of caution.
Never, ever shake a baby. And while we realize that a game is just that – a game, the inference that there is something entertaining about the act is enough, in our opinion, to justify the removal of this app.
The National Center on Shaken Baby Syndrome lists multiple consequences of shaking a baby, from seizures and permanent brain damage to death. With close to 1,500 U.S. children experiencing severe or fatal head trauma from child abuse every year, we’d rather see applications underlining proper education. Rock your child to sleep, don’t shake it to death.
Over the last couple of years we have been hearing of the push to digitize health records, in hopes of streamlining a patients data for easy access across medical facilities. Yesterday the Mayo clinic announced a partnership with Microsoft’s HealthVault to launch the Mayo Clinic Health Manager, a tool that gives people the ability to store their medical records online as well as sign up for alerts and reminders. This is only the latest in a procession of new online storage services being offered to interested patients.
Using these services you can import your health records from your doctors, hospitals, labs, prescription drug plans, and other healthcare providers by typing them in yourself or uploading data directly from devices such as blood-pressure monitors. Now with just a couple clicks of your mouse, you can view your entire medical history – what medications you have taken, which ones you are currently on, adverse reactions, operations, diagnosis, and even childhood diseases. What’s online is up to you and, if he is a participant in the government supported push for electronic records, your doctor.
We aren’t going to advocate for or against the digitizing of your healthcare history, but we do want to make sure you are taking into consideration the potential dangers of such a move. While the convenience of hopping online to find out what date you started a particular medication may make the process of filling out your insurance claim easier, keep in mind that what’s easy access for you is just as easy for someone else. Yes, we are talking about hackers. Those information pirates that keep developing more and more insidious data-mining processes.
What does it matter if some stranger is copying your medical information? What can it hurt besides your feelings of privacy? A lot, actually.It isn’t just insurance claims that are affected by your medical history, your reputation is also potentially at risk.
M. Eric Johnson, director of the Glassmeyer/McNamee Center for Digital Strategies at Dartmouth’s Tuck School of Business, released a paper in which he said he and his fellow researchers “were able to uncover a number of medical records and other files with medical information online, using file-sharing services generally associated with song-swapping, like LimeWire and Kazaa”. He went on to note that many of our records are already in electronic form on computers in small clinics and laboratories whose security can’t begin to match that offered by the larger data storage facilities.
Johnson cites numerous instances of leaked records leading to identity theft, medical insurance fraud, and even financial fraud. Don’t forget, your social security number is more often than not is included in your medical records, and adding that information to identifying data such as your date of birth, address, and full name give thieves everything they need to make a profit from your information.
When you are considering making your records electronic, make sure you choose a company that has multiple safeguards in place. While there are always ways around even the toughest Internet security, the likelihood of keeping your information private greatly increases depending what program provider you go with. Google Health has partnered with Medco, as Microsoft’s HealthVault has teamed up with the Mayo Clinic, giving the resulting storage systems more clout than lesser known companies such as iHealthRecord or myPHR, but before you make a choice, research them well – your private data is on the line!
Image from here.
Amazon’s Kindle e-book reader has a feature that allows users to set it up so that it “reads” their books aloud. A handy application for those with disabilities that limit their reading capabilities, such as paralysis or blindness, this feature has surprisingly gained some heat.
Researchers at the Eli and Edythe Broad Center for Regeneration Medicine and Stem Cell Research at UCSF have developed a way to reverse the age of adult stem cells (fibroblast cells), using microRNAs to effectively turn them back into embryo-like cells. While not quite a Benjamin Button scenario, these new findings have the potential to aid in brain injury repair by replacing damaged cells in areas affected by a traumatic impact.
These newly “young” cells have the ability to do what the controversial cells from embryos can – they are able to become any cell type (a state known as “pluripotency”). This makes it possible for scientists to stop their use of retroviruses that have been employed to create this cell flexibility, making stem cell therapy safer.
According to the study, previous methods for creating cells similar to embryonic stem cells used DNA to influence the production. The issue with this method is that three of the four genes promote an uncontrolled growth reaction in the cells, much like cancer.
The use of microRNAs has further benefits as reprogramming a patients cell instead of introducing a foreign one prevents it from being rejected, an issue that scientists have long been working to find a way around.
You can read more in the April 12, 2009 advanced online edition of the journal Nature Biotechnology.
Image from emergentarchitecture.com.
The tragic death of Natasha Richardson has brought the need for traumatic brain injury (TBI) awareness into stark relief. As with many things in life, we tend to look around, look over, and look through dangers that haven’t directly touched our lives. Like the child whistling in the dark, we skim over the short news piece that notes another life irrevocably changed by a brain injury and we think “that could never happen to me”.
This perspective shifts when when the injured person suddenly become someone we are familiar with, who we can in some way identify with. In an article by Bryan Brown, Carlin Flora who is a senior editor for Psychology Today, said that we can develop this identification with someone we have no personal knowledge of because “we see their faces over and over” in the media. “Our brains are tricked into thinking we know these people.”
A study by researchers at the University of Illinois at Urbana-Champaign explain it this way: celebrity identification allows us to feel a connection with some of the ideals they embody and that we consider our own, or as Matthew Hutson, news editor for Psychology Today puts it, “When they die, their memory lives on, and, by proxy, so does yours.”
When Richardson’s death was splashed across the media the people who had felt this connection to the actress, no matter how slight, were suddenly made aware of just how real this type of injury was. Articles were written about the dangers of TBIs, bloggers relayed the details in post after post, and readers found themselves wondering how to keep this from happening to themselves and their loved ones. But, as with even the most incredibly painful experiences, time has started to dim this tragedy. People go on with their lives, they push the uncomfortable emotions down and after a while, they start to forget.
What needs to be realized from this is that while yes, people will and DO forget, the cause of Richardson’s untimely death made an impact and it will, often in subtle ways, affect the lives, choices, and actions of many – hopefully for the better.
