Archive for July, 2009
Researchers from the University of Rochester in Rochester, New York have discovered that injecting large amounts of the food dye Blue Dye No. 1 into rats shortly after spinal injuries reduces the chances for paralysis and other spinal injury complications. There is a catch, however; the injection of the dye made the rats turn blue.
This research was developed on earlier studies by the same team, which demonstrated that ATP, the body’s cellular energy molecules, floods into the injured area in the spinal column. The high concentration of ATP destroys healthy motor neuron cells and increases the severity of the injury.
First, the team of scientists attempted to use oxidized ATP to block the effects of ATP. It showed positive results, but at the risk of dangerous side effects. The team then found that an injection of blue food dye had similar results without the side effects of oxidized ATP.
The amount of blue dye needed to achieve the desired therapeutic effects is far greater than the amounts consumed in food, so don’t expect an immediate application. There is still a lot to be done before blue dye can be tested and approved for human use in treating traumatic spinal cord injuries.
Medical tourism⎯a term created by travel agencies and mass media outlets to describe the process of traveling across international borders to receive health care⎯offers spinal cord injury (SCI) and traumatic brain injury (TBI) patients a global buffet of treatment options, usually at a fraction of the cost of similar treatments in the United States.
Over 50 nations, including Cuba, South Africa, Canada, Panama, China, Korea, Brazil, Mexico, and India, recognize medical tourism as a national industry. In 2007 over 750,000 Americans traveled outside of the U.S. seeking medical procedures in other nations, while the number of American medical tourists will likely number in the millions in 2009.
The reasons behind traveling internationally to receive care are many; however, most medical tourists seek foreign care due to vastly higher costs of care in their home country, restrictive insurance coverage and lack of coverage for certain procedures, and excessively long wait times for local care. These motivators, in addition to improvements in technology, increasing standards of care in many countries, and increasingly cheap and easy travel, make medical tourism appealing to millions of patients each year.
Humans have engaged in medical tourism since the times of ancient Greece, when Greek travelers sought spas and health care in their travels around the Mediterranean. Modern patients seeking international medical care usually engage in the following process. First, a patient seeks a medical tourism provider and provides them with their medical history. Then, a team of health care professionals reviews the case and gives a recommendation for a location, procedure, and a medical visa. Finally, the patient travels to their destination, receives their treatment, and either stays in the country or returns home for recovery.
While medical tourism offers many benefits, including massively cheaper prices for care, a wider range of treatment options, and much faster service, critics raise important concerns about the potential problems involved in medical tourism. Some of the downsides to medical and health tourism include: heightened exposure to exotic and foreign diseases, lower quality of care, travel-related stress for recovering patients, difficulty in filing international malpractice suits, unethical organ harvesting practices, first world preferential treatment and loss of care for local citizens, loss in revenue for first world medical care providers, uncertain and/or lacking regulatory and legal oversight, and widely varying standards of patient safety and care.
A litany of international accreditation and regulatory bodies have cropped up to provide consumers with a sense of safety and security while traveling abroad for medical purposes. The Joint Commission International (JCI), Trent International Accreditation Scheme, the Society for International Health Care Accreditation (SOFIHA), Health Care Tourism International, the International Medical Travel Association, and the Alliance for Patient Safety provide regulatory services for both patients and health care professionals worldwide, to insure patients receive safe, high quality, state-of-the-art patient care when traveling internationally.
These organizations provide assistance to foreign hospitals in raising their levels of care to receive accreditation, as well as assisting patients in connecting with the best possible facilities at the lowest prices available worldwide.
Wooridul Spine Hospital in Seoul, Korea has recently presented itself as one of the most advanced and high quality hospitals in the world. The hospital offers innovative treatments for a range of conditions including advanced spinal surgeries, treatments for metastatic spinal cancers, and other advanced treatment and technology for spinal injuries.
Since many advanced forms of treatment and rehabilitation strategies for TBI and SCI are not covered by domestic insurance plans, medical tourism offers a vast expansion of treatment options for SCI and TBI patients. Medical tourism offers a way around the formerly insurmountable obstacles presented by extremely high treatment costs and restrictive insurance coverage. While medical tourism is not without risk, millions of patients worldwide receive high quality medical care they may not have otherwise been able to afford.
Medical tourism has also had an effect on the development on insurance policy and modernization of medical care around the globe. Many U.S. insurance companies offer international health care options, and hospitals and clinics in prime medical tourist destinations have drastically improved their technology, staff, and facilities to meet the high standards of care first world patients have come to expect.
Links specific to SCI and TBI patients:
A highly qualified Indian Neurosurgeon:
http://www.healthbase.com/resources/doctors/neurosurgery/dr-s.s.praharaj.html
Neurosurgery in Panama: http://www.hospitalpuntapacifica.com/specialties/neurosurgery.php?specialties=open&cat=self
Neurological Treatments in Thailand:
http://www.meditourinternational.com/medicalpartners/thailand_bhmc.php
Neurosurgery in Israel:
http://www.shemere.co.il/treatment.php?actions=show&id=194&instance_id=6
Neurosurgery in Kerala
http://www.keralatraveltourism.com/medical-tourism-in-kerala/neurosurgery-in-kerala.html
Recent advances in the treatment and therapy for traumatic brain injury (TBI) hold promising results for the 1.4 million in the U.S. with TBIs. Researchers hope to make cognitive therapy more available to patients who have suffered brain injuries from car and playground accidents, domestic violence, war injuries, and even simple falls.
Much of the current research is based on recent studies which have shown that the brain has an immense capability to repair itself after an injury. Many of the innovations in cognitive therapy seek to assist the brain in repairing itself, as opposed to simply treating symptoms. One doctor, according to a MSN Health and Fitness article, has reported that over 70% of his most severely injured patients have regained much of their independent functioning over time.
While cognitive therapy still attempts to retrain patients in basic functions such as reading and writing, therapists and doctors also apply custom designed therapy strategies focused on the needs and aspirations of each individual patient. Doctors have also recognized the importance of including emotional rehabilitation as part of their treatment strategy. Patients derive great benefit and peace of mind by adopting emotional coping tools to keep functioning through difficulties and confusion inherent in many TBI cases.
Since the brain maintains an ability to repair and rewire itself throughout the entire human lifespan, new cognitive therapy approaches lend hope to 55 and older TBI patients as well. While the brain manages its own healing processes, scientists seek to assist it in rebuilding new pathways by teaching patients how to think through tasks.
Many health insurance plans do not cover cognitive therapy, but scientists, doctors, and researchers are busy gathering data in support of its vast potential for rehabilitation after TBI. They hope to establish cognitive therapy as a proven, widely available, and accepted part of recovery strategies, with research in MRI, brain mapping, and analysis of patient recoveries.
A new study published in the July 15 issue of the Journal of Neuroscience reported that researchers from UC Berkeley, California (UCB) and Ben Gurion University (BGU) discovered a treatment to prevent the development of post brain-damage epilepsy in rats.
The team of researchers built their hypothesis on earlier award winning studies, performed by Alon Friedman and Daniela Kaufer at The Hebrew University, which determined that breaches of the blood-brain barrier are the cause of epilepsy in patients who have sustained traumatic brain injuries.
The current study was conducted by first inducing epilepsy in rats by breaching the blood-brain barrier with serum albumin, which not only triggers the expression of latent genes that diminish the brain’s ability to prevent inflammation and inhibition of the firing of neurons, but also binds to transforming growth factor-beta (TGF-beta) receptors.
The earlier research demonstrated a correlation between epilepsy and the uninhibited firing of neurons after the blood-brain barrier had been breached. After initiating the breach of the protective blood-brain barrier, the scientists used drugs to block the TGF beta pathways, thereby preventing the physiological chain reaction that leads to epilepsy.
This research holds promise for reducing symptoms and preventing further brain damage in patients with persistent epilepsy, including that which results from a traumatic brain injury.
Doctors from the University of Washington in Seattle recently reviewed recovery and follow up data on 342 patients treated for spinal cord injury with halo vest immobilization (HVI). They found that although complications were relatively high, as many as 35 percent of patients experienced difficulties such as pneumonia with the HVI, the treatment proved effective in up to 85 percent of cases.
The complications arose due to pin site infections and instability issues. The doctors also found that the use of HVI in cervical spine injuries can replace the need for surgery in many cases.
The medical team who reviewed the cases concluded that the use of the HVI to treat spinal injuries remains highly effective, in spite of the challenges presented to both patients and their caregivers.
Halo vests, also called halo rings or halo crowns, are used to stabilize the cervical spine following fracture or dislocation of the spine.
Image from here.
Health Science Center and the University of Texas Southwestern Medical Center began a clinical trial last week at the Parkland Memorial Hospital in Dallas, Texas to determine the effects of administering a one-time dose of estrogen to traumatic brain injury patients. The researchers hope to establish the use of estrogen worldwide in cases of severe brain trauma.
This study follows on the tail of earlier research which demonstrated that estrogen, when administered within 2 hours after the injury, reduced long-term neurological damage and increased the survival rate in rats with brain injuries.
Scientists have also observed that women with naturally high levels of estrogen suffer less severe brain damage and have a higher survival rate than both men and women with lower levels of estrogen.
The current study presented researchers with ethical difficulties due to the impossibility of confirming informed consent from patients, as estrogen must be administered within 2 hours of sustaining a brain injury in order to be effective.
Earlier studies show that the damage to the brain is more permanent after 6 to 10 hours have passed, thus they are forced to treat patients in the study without their consent. While consent is impossible to attain from an unconscious patient, doctors and researchers said they would make every effort to contact loved ones, family members, and/or guardians to gain consent.
The study focuses on 50 men from age 18 to 50 who have sustained severe brain injuries. Participants will receive either estrogen or a placebo to determine the benefits of estrogen in protecting the brain immediately following trauma. Tens of thousands of accident victims die each year due to severe brain injuries. Researchers hope that this and future studies and clinical trials will allow doctors treating severe brain injuries to reduce both the amount of long term brain damage and the number of patient deaths.
Estrogen has been used safely and successfully for years in treating patients with prostate cancer and uterine hemorrhaging. Before the study began, researchers were required to seek consent from the Dallas community and to offer opt-out bracelets to those not wishing to receive estrogen in the event of sustaining a life-threatening brain injury. It was not reported how consent was attained, nor how many people chose to opt out of the study.
Image from here.
Alexandra Carmichael, a scientist who has back pain in her family, is conducting a study on back pain through the website she co-founded, CureTogether. Specifically, she is gathering self-reported data on symptoms, treatments, and triggers for back pain. Her goal is to discover associations in this data to help characterize which treatments work best for patients with different groups of symptoms. If you are someone with a spinal cord injury who has been dealing with chronic pain, this study may be of interest to you.
There are currently 224 people with back pain who have joined the CureTogether study. At this time Alexandra is calling for more people with back pain to join the study. Participation is entirely voluntary, anonymous, and completely confidential. It involves joining the CureTogether study at the website provided, then checking off and rating symptoms and treatments. It should take 15-20 minutes to complete. Statistics for the study are posted live so you will be able to see them after completing your entry.
About CureTogether: CureTogether helps people anonymously track and compare health data, to better understand their bodies, make more informed treatment decisions and contribute data to research.
If you are interested in learning more about the study or to participate, please visit CureTogether or email Alexandra at alexandra@curetogether.com.
Image from here.
Brain researchers at Boston University and the Sports Legacy Institute in Massachusetts are conducting studies to explore potential links between brain dysfunction in combat veterans and similar cognitive decline experienced by football players.
Researchers posit that combat veterans who experience symptoms of traumatic brain injuries (TBI) may have sustained severe damage to their brains, not from physical damage, but from shockwaves caused by explosions.
The research teams are looking for specific kinds of long-term brain damage signified by the build up of toxic proteins and neurofibrillary tangles, which do not show up in CT scans and MRIs. In order to gather the necessary data, the scientists must collect and analyze the donated brains of more than 20 combat veterans.
They will compare their findings with data on brain damage in football players’ brains to investigate how forces from bomb blasts can lead to physical brain damage, even in the absence of physical impacts to the head.
This research on the brains of military personnel promises to shed some light on the mystery of Post Traumatic Stress Disorder (PTSD), as well as other mental and emotional struggles of veterans long after their tours of duty.
The study was inspired by the observation that many of the symptoms of PTSD and cognitive dysfunction in veterans were similar to those experienced by football players who had sustained repeated head impact over their careers.
By comparing the actual brains of veterans and football players, the two research institutes hope to discover the nature of the physical damage sustained by soldiers in non-impact explosions.
If the institutes do prove that shockwaves from explosions cause physical brain damage, combat veterans could be rewarded not only purple hearts, which are currently given only to soldiers injured physically in battle, but also proper recognition, expanded disability benefits and more advantageous treatment of their conditions.
While the focus remains on the brains of combat veterans, the benefits of such studies may ripple out into the general population in the form of greater knowledge of how the brain responds to trauma and injury and possible treatments for resulting conditions.
Even though the scientists are eager to continue their research, it advances slowly due in part to the difficulty and sensitivity involved in collecting brains from donors upon their deaths.
Boston University and the Sports Legacy Institute are paying for the studies, and while the U.S. military supports them, they have not yet contributed to the research financially.
Image from here.
ScienceDaily reports new findings that may explain why acquired epilepsy is sometimes a result of a traumatic brain injury..
The study’s lead author, CU-Boulder’s psychology and neuroscience Professor Daniel Barth, believes that this new information can be used to prevent acquired epilepsy (also called adult epilepsy). The researchers found that the seizures are possible linked to the chemicals the brain releases when it attempts to heal a damaged area after a head injury.
Up until now, the most prevalent theory has attributed seizures to “electrical storms” in the brain, caused by “excessive or synchronous neuronal activity in the brain” – overactive neurons. Barth’s research may change this notion, instead pointing to micro-glial cells as the culprits.
“When there has been serious damage to the brain, such as a head injury or infection, the immune system is activated and tries to counteract the damage and repair it,” Barth said. “These glial cells migrate to the damaged area and release chemicals called cytokines that, unfortunately, also profoundly increase the excitability of the neurons that they are near.
“In our new study, we showed for the first time that glial cells moving in and secreting these cytokines cause the neurons in the area to become excitable enough to cause seizures.”
The theory is that temporarily switching off the brain’s immune system soon after a traumatic brain injury is incurred will prevent the development of acquired epilepsy.
“After a traumatic brain injury, there is often a period of several months where nothing seems to be happening,” Barth said. “And then suddenly the person may start having seizures, which often develop into chronic epilepsy.”
The CU research team believes that the initial seizures are caused by the brain’s immune response to the injury and that they are then cemented through actual structural changes to the brain. There are drugs that can be used to suppress this glial cell response, hopefully preventing the changes that lead to epilepsy.
Image from here.
