Archive for October, 2009
The world’s 4 billion cell phone users have new reason to examine the widely unquestioned acceptance of cell phone use as innocuous and safe. While some previous studies and reviews of research have found no link between cell phone use and health concerns, an article on MedicineNet reported that, “when the spotlight was turned on only the more methodologically rigorous studies, a potentially harmful association was found.”
The article did also note that the study released in the October 13 edition of the Journal of Clinical Oncology did not reveal an overall link between cell phone use and brain cancer. However, many trusted and respected studies reviewed in the current research have shown associations between instances of brain tumors and cell phone use.
The director of the Center for Family and Community Health at the University of Berkeley, Joel Moskowitz, also served as the study’s senior author. He told MedicineNet that, “clearly there is risk.” Moskowitz recommended that children either be required to use a headset when using cell phones, or not be allowed to use the phones at all. He admonished, “It seems fairly derelict of us as a society or as a planet to just disseminate this technology to the extent that we have without doing a whole lot more research of the potential harms and how to protect against those harms. Clearly, we need to learn a whole lot more about this technology.”
Industry representative John Walls of CTIA-The Wireless Association pointed out that the American Cancer Society, the World Health Organization, the US Food and Drug Administration, and the National Cancer Institute do not recognize any risk or danger associated with the use of cell phones.
The current study was composed of data gathered by searching medical databases and compiling the results of 23 studies involving over 37,000 participants. The entire group of studies taken as a whole did not show any statistical risk of increased cancer danger, but a set of more rigorous studies, conducted mainly by a group of Swedish scientists, showed an 18% increased risk of brain tumors in cell phone users who had been using their phones for 10 years or more.
Not surprisingly, a set of industry-consortium-funded studies, when analyzed separately, showed that cell phones had a protective effect on the brain. While the current study as a whole did not reveal massive and imminent danger, the scientists involved encouraged serious caution and the use of hands-free devices while more studies are conducted. Moskowitz also mentioned the possibility of danger to the genitals from keeping cell phones in pockets.
Since such a huge portion of the human population on the planet use cell phones, the scientists and researchers involved in producing the current research are pushing for more rigorous and comprehensive research on the long-term health effects of cell phone usage before making any conclusions about the safety of the technology. Buyer beware.
(pic from flickr.com/photos/ksiniy)
With healthcare reform dominating the news lately, many brain and spinal cord injury patients have to be pondering the question- what does this all mean for those of us with existing injuries? Will we get improved coverage? Or will we be left in the dust, worse off than we were before? Will Obama deliver on his promise to provide affordable health care for all Americans? The recent bill passed by the Senate Finance Committee may provide some answers. The bill, if passed into law by the Senate and the House of Representatives, would restrict insurance companies from being able to reject or charge higher premiums to those with pre-existing conditions.
While the Senate Finance Committee healthcare reform plan was fully expected to pass in last Tuesday’s vote, which it did, a new insurance-industry-funded report leaked over the weekend tried to convince voters that the Senate legislation would substantially increase premiums for individuals. A White House Spokesman told the Washington Times that the report, commissioned by America’s Health Insurance Plans (AHIP), was a “self-serving analysis from the insurance industry.”
The bill, if passed, would require all Americans to obtain health insurance, and would issue penalties to those who did not obtain it. Maine’s senator, Olympia J. Snowe, is the only republican senator on the committee who voted in favor of the health care reform bill. Snowe also helped by adding an amendment to the bill to reduce the penalties recommended for those who did not obtain health insurance in time, according to a Washington Times article. The amendment to reduce penalties was passed unanimously by the committee.
Since the bill was not stalled by the Senate Finance Committee, it now remains in the hands of the Senate to determine whether or not it will move closer to becoming law in a vote expected to occur later this month.
Republicans used the AHIP report to bolster their case against what some have termed, “Obamacare.” Senate minority leader Mitch McConnell, R-Ky, told USA Today that the health care plan in question will lead to, “higher premiums, higher taxes, and more government.” Senator Jay Rockefeller, D-W.Va said to USA Today that, “The [insurance] industry stands today as the greatest impediment to health care reform.”
The AHIP, who commissioned the controversial report, responded by saying, “We don’t see comprehensive cost control in any piece of legislation.”
While the Senate Finance Committee passed the healthcare reform bill on Tuesday, there still remains much work and compromise between democrats and republicans before a bill will be voted on and agreed upon between both the Senate and House of Representatives. They will all have to come to an agreement or a compromise before any serious overhaul of the health care system will be possible.
If passed into law, the bill passed to the Senate by the Senate Finance Committee would extend health insurance coverage to the over 30 million Americans currently without health insurance. The over 20 million illegal immigrants currently working in the United States would still remain without health insurance, as article in the Guardian reported.
The Senate Finance bill will cost $829 billion over ten years if passed into law, and will require all individuals to purchase health care if it costs 8% or less of their total income, and it will offer tax credits to individuals and families under 400% of the poverty line. The bill will also disallow insurance companies from denying coverage to or charging higher premiums for pre-existing conditions or gender.
The details of other proposed healthcare legislation currently being considered in various parts of congress, including President Obama’s personal recommendations, can be found in this article published in the New York Times.
(pic from metric.files.wordpress.com)
The NFL and high school football have come into focus in the traumatic brain injury world lately, as studies pile up demonstrating the serious risk of degenerative brain disease to players who suffer multiple concussions. The Boston Globe reported that the NFL’s own study showed that retired football players from age 30 to 49 had dementia rates 19 times greater than normal, and that retirees 50 and older had 5 times more incidence of memory-related disorders.
The Boston Globe also mentioned a University of North Carolina study saying that players who had suffered multiple concussions had “several times more prevalence of cognitive impairment” than those players who had never suffered brain injuries. The Boston Globe reported that 1.14 million kids play high school football and 3.2 million more play in youth leagues. New studies continue to be released revealing the serious danger inherent to the violent crashes between players in the sport.
Since it seems that football is not going to stop being a hugely popular sport, parents of young athletes are faced with the task of making the sport somehow safer for their young boys, or removing them from the sport altogether. After all, no matter how glorious it may feel to win games and make fantastic plays, living with degenerative brain disorder with a failing memory in a wheelchair is not glorious at all.
One solution some coaches and parents agree on is to not let boys continue playing after a concussion or head injury occurs until the child’s brain has had time to heal. The Globe article reported on a study from the journal Brain Injury that said 16% of student players in high school were returned to play after losing consciousness during a game. They added that most high school games do not have a certified athletic trainer in attendance on the sidelines.
A Harvard epidemiologist said to the Globe that the NFL should use footage of plays when injuries occur to make rule changes to ensure the safety of all players. Scientists at Boston University’s Center for the Study of Traumatic Encephalopathy told the Globe of incidents of degenerative brain disease in 18-year-old football players. They added that the brain continues to mature and develop well into the 20s and that football will have to change to make it safer for the youth.
60 Minutes reported that the impacts between football players, who can run at up to 20 miles per hour, are akin to a car hitting a brick wall at 40 miles per hour. Unfortunately, human heads are much more delicate than car bumpers. As the studies pile up that prove how dangerous football can be to the brains of the players, one must wonder what changes, if any, will be made to the sport to protect its players from serious injury.
Many times, athletes and their coaches and families are unaware that their brains have suffered serious injuries. Since degenerative brain disease eats away at brain cells slowly over time, it is easy to mistake the symptoms for psychological disorders or other issues. It is not until after a person dies and an autopsy is done on their brain that traumatic brain injuries and subsequent degeneration are revealed. Some scientists are working to improve diagnostic tools to better identify serious brain injuries in living patients while successful treatment remains possible.
It seems that football’s popularity will continue to remain high, but with 60 Minutes reporting that “sports related concussions are an epidemic in this country,” one can only hope that parents take the lead in keeping their children’s developing brains safe from traumatic brain injuries, and that NFL players and coaches will take the hint and stop putting players with concussions back in the game.
Each player has to ask himself, “Is it worth losing my brain functions later in life to continue playing now?” If the answer is no, changes to the game and how concussions are dealt with will have to be made.
(pic from flickr.com/photos/aheram)
The Accreditation Association for Ambulatory Health Care (AAAHC) recently recognized and accredited Laser Spine Institute (LSI) Tampa as a facility that provides the “highest quality of care for patients and a safe work environment for medical staff and employees,” said a recent PRNewswire release. LSI are industry leaders in providing elite care, and resort-like rehabilitation amenities to patients who can benefit from minimally invasive spinal surgeries.
With surgical facilities in Tampa, Florida and Scottsdale, Arizona, as well as consultation facilities in San Diego, California and The Villages, Florida, LSI performs endoscopic outpatient procedures to correct painful spinal issues stemming from bulging and herniated discs, pinched nerves, spinal stenosis, degenerative disc disease, foraminal stenosis, bone spurs, spinal arthritis, and failed open back or neck surgeries.
The AAAHC conducted their usual two-day rigorous on-site survey and both the Tampa and Scottsdale facilities and required LSI to undergo a self-assessment of all of their procedures, policies, and processes. The AAAHC found that LSI met or exceeded all the qualifications necessary for them to receive the highly coveted accreditation.
The LSI facility in Scottsdale has four cutting edge operating rooms, and the Tampa flagship facility has seven. Both locations also provide patient access to MRI, radiology, physical therapy, and examination rooms with state of the art technology and equipment.
All of the surgeries performed at LSI facilities require an incision less than one inch long. Patients undergo examination, surgery, and recovery all at the same location. The PRNewswire release said, “From pre-operative imaging and diagnostic testing, to endoscopic laser surgery and post-operative physical therapy, patients receive the highest quality care combined with the most advanced treatments.”
Cheryl Harper, a former patient of LSI and mother of two young boys had only glowing praise for the treatment she received at the LSI facility. She was quoted in the article as saying, “The pain took over my life from morning to night. I have two little boys and I was always tired. After surgery, I feel like I’ve added 10 to 20 years onto my life. Now I’m active and spending time with my family, especially my two little boys.”
Potential patients of LSI who suffer from back or neck pain can get more information by visiting LSI’s website at http://www.laserspineinstitute.com or by calling 1-877-205-7498.
(pic from flickr.com/photos/andreanna)
A senior at Troy High School in Detroit, Gayathri Kollipara, is the recipient of an immensely powerful and educational gift from assistant professor Christian Kreipke. Kreipke is employed as a cell biologist at Wayne State University’s medical school. In March, Kreipke began conducting a study on a new drug that may prove useful in the treatment of traumatic brain injuries (TBI). He invited Kollipara, whose long time dream has been to become a brain surgeon, to shadow him throughout the duration of his drug study.
The drug Kreipke was testing in animal trials is Clazosentan. It proved successful in the animal studies at preventing vasospasms blood vessel constrictions in the brain, which occur when the head has been impacted in an accident or other trauma.
Kollipara was extremely excited to have such a unique opportunity to observe up close the kinds of work she is looking forward to after another decade or so of schooling. She told the Chicago Tribune that her father’s death of lung cancer two years ago cemented her lifelong wish to become a brain surgeon. She said it has always been her dream to go into the medical field, but she knew for certain she would pursue it after her father died.
Over the course of Kreipke’s Clazosentan study, Kollipara was able to observe the surgeries the scientist performed on lab animals. She was also enlisted to assist Kreipke in the behavioral study portion of the research to measure the effectiveness of the novel drug.
Kreipke reported to the Tribune that he had a lot of trouble choosing a major and a career path – he changed his major seven times before completing his studies – so he was more than happy to grant Kollipara the chance to witness his research, since she knew exactly what career path she wanted to pursue, even at such a young age.
While other high schoolers go out partying or searching for minimum wage jobs, Kollipara was granted the opportunity to get a head start on her way to her dream career as a neurosurgeon.
(pic from ucdmc.ucdavis.edu)
Researchers at University College London (UCL), London, UK, published new brain wave research findings online October,1 in Current Biology, a Cell Press publication. The scientists were astounded to discover the powerful influence that brain waves exert on voluntary human motor functions. The EurekAlert report quoted Peter Brown of the Sobell Department of Motor Neuroscience and Movement Disorders in the Institute of Neurology, UCL, as saying, “At last we have some direct experimental proof that brain waves influence behavior in humans, in this case how fast a movement is performed,” … “The implication is that it is not just how active brain cells are that is important, but also how they couple their activity into patterns like beta activity.”
The team of scientists at UCL used an injection of a tiny electrical current through the scalps and into the brains of 14 study participants while the subjects moved a spot around a computer screen. The subjects were instructed to move the spot around the screen with a joystick as fast as they could.
The specific current employed by the scientists increased the normal beta brainwave activity in the subjects’ brains. Beta brainwaves have been linked in previous studies to prolonged muscle activities, such as holding up a book, the article reported.
The new study differed from similar studies in the past in that the scientists used an oscillating current similar to the currents in operation in normal brain activity. In earlier studies, constant brain stimulation current has been employed. Although the participants were unable to sense the tiny electrical current, the effects is produced were profound. The participants’ fastest times recorded on the computer and joystick task were 10% slower when the electrical current was administered.
Earlier studies have also shown that altered brain waves have an effect on memory, but not until this groundbreaking study has it been demonstrated conclusively that a causal link between and increase in beta waves and the slowing of voluntary movement in all study participants. The researchers hope their findings will lead to possible treatments for conditions that involve slowed or uncontrolled movements., perhaps even those caused by traumatic brain injuries.
Brown was further quoted in the article as saying, “If we know what patterns of brain activity slow voluntary movement, then we can try and boost these patterns in conditions like chorea and dystonia, where there is excessive and uncontrolled movement,” … “Conversely, we can try and suppress beta activity in conditions like Parkinson’s disease typified by slow movement.”
(pic from zatma.org)
Manufacturers of dynamic spine stabilization systems may be sent back to the proverbial drawing board to improve their devices after a recent Food and Drug Administration (FDA) injunction ordered them to conduct new studies to insure the safety of their products. The FDA ordered the manufacturers to conduct post-market surveillance studies to monitor fusion rates and other possible safety issues related to the stabilization products. The FDA order also requires manufacturers to gather pre-market clinical data on not-yet-released products. The order may result in labeling changes on future devices.
The FDA’s concern arose due to a lack of substantial clinical data to show how well the devices in question provide support for complete spinal fusions. Their concern is that there is not enough data to conclusively demonstrate that the devices are strong enough. The FDA worries that the dynamic stabilization systems may loosen, break, or bend under pressure over time. If the devices do happen to be faulty, spinal injury patients would be at great risk of suffering additional injuries and may require further surgical procedures. The FDA order does not affect the methods by which the stabilization devices are employed.
Older conventional spinal stabilization systems consist of screws and metal rods anchored into the spine during bone fusion spinal surgeries. Dynamic systems are different. They employ flexible polymer cords, springs, and movable screw heads to allow patients the freedom to bend and rotate their spine, which the conventional systems do not.
The FDA order insists that post-market studies investigate: the rate of fusion in the dynamic systems compared to traditional rigid systems; details, rates, and severity of any side effects, also compared to rigid systems; additional surgeries and types of surgeries required for dynamic systems vs. the rigid models; and finally, any and all causes of failure of any systems leading to a surgical removal of the devices from patients’ spines.
Since bone fusion devices are classified as class II devices in FDA labeling regulations, newer-model devices are allowed to be developed and manufactured if they are demonstrated to be substantially equivalent to predecessor devices already approved on the market.
Dynamic stabilization systems first received approval from the FDA in 1997, and they will likely continue to be used in the future. The FDA mandate promises to improve the effectiveness and safety of such devices.
(pic from drsharma.ca)
In early September of 2009, The Department of Defense (DOD) Congressionally Directed Medical Research Programs (CDMRP) hosted the Military Health Research Forum (MHRF) in Kansas City, MO. The forum was dedicated to exploring new research on traumatic brain injury (TBI).
Military interest in brain injury research has increased dramatically over the past few years due to an alarming rate of servicemen and women who have suffered from TBI due to close range, non-impact exposure to explosive blasts and other combat-related injuries. The CDMRP estimates that about 20% of combat soldiers suffer from TBI.
Two programs of the CDMRP, the Psychological Health and Traumatic Brain Injury Research Program (PH/TBIRP) and the Peer Reviewed Medical Research Program (PRMRP), funded studies on various issues surrounding TBI in combat soldiers, such as prevention, diagnosis, and treatment of the condition. The researchers and funding agencies also hope the research will lead to improved care for civilians with TBI.
What follows is a summary of the research presented at the MHRF.
The US Army Aeromedical Research Laboratory presented research that demonstrated the value of new Advanced Combat Helmets. Their research revealed that paratroopers wearing the older Personnel Armor System for Ground Troops Helmet were 2.3 times more likely to suffer brain injuries than those wearing the Advanced Combat Helmets. The researchers said further research to improve helmets and armor systems is underway.
Clemson University researchers presented data on their development of an injectable hydrogel to promote brain tissue regeneration at lesion cavity sites in rats given TBIs. Researchers funded by CDMRP also performed neural stem cell transplantation into the injury sites and used the hydrogel, which mimics native brain tissue, as a carrier. They reported that functional recovery was significant after eight weeks of treatment.
Finally, researchers at Duke University presented research on their testing of three different biomarkers used to better evaluate the severity of and diagnose mild traumatic brain injury (mTBI). Many patients with mTBI show no external signs of brain injury, thus a new method is needed to better diagnose the presence of brain injury in these cases. The researchers found that two of the three biomarkers, brain natriuretic peptide (BNP) and D-Dimer, showed a 92% sensitivity rate in determining the presence of intracranial abnormalities in diagnostic CT scans.
The vast and expansive collaboration of research and funding that went into all of the data presented at the MHRF will likely provide demonstrable advances toward the prevention, diagnosis, and treatment of TBI not only in military personnel, but in civilian populations as well.
A double-blind study release on August 5, 2009 in the New England Journal of Medicine showed that vertebroplasty a procedure that involves the injection of medical cement into the spines of patients who have spinal fractures proved only equally effective as simulated vertebroplasty with no spinal cement injection. One group of patients received the actual vertebroplasty procedure, and the control group received a mock procedure including everything but the cement injections into their spines.
The study’s leader, Dr. David Kallmes, said that while vertebroplasty has been long accepted and utilized as a treatment option for many years, there has been no data or research to verify its effectiveness. The findings of the study conducted by a team of researchers at the Mayo Clinic in Rochester, MN showed that relief of pain and improvement in dysfunctions related to the pain proceeded similarly in both the group of patients who received the vertebroplasty and the control group who did not. The progress of the patients involved in the study will continue to be monitored over the course of one year, after which the comprehensive results of the study will be published.
The study was partially motivated by doctors’ concerns that the cement injections into patients’ spines could potentially increase the risk of future spinal cord injuries. Dr. Kallmes was careful to add that vertebroplasty does actually work. However, scientists and doctors may be able to achieve similar results without the potentially dangerous cement injections.
Kallmes was quoted in a EurekAlert article speculating that the improvements recorded in the control group could be the result of, “…local anesthesia, sedation, patient expectations, or other factors.” He also advised patients to seek professional advice before deciding on treatment options. Many other studies related to treatment for spinal fractures are currently underway at the Mayo Clinic. They will be reported on as the studies and their findings are published.
Many other institutions were involved in the vertebroplasty study, including: the University of Washington, Seattle; Nuffield Orthopaedic Centre NHS Trust, Oxford, UK; St. George Hospital, University of New South Wales, Sydney, Australia; Gartnavel General Hospital, Glasgow, UK; Department of Social Medicine, Bristol, UK; Nottingham University Hospital NHS Trust, UK; and Western General Hospital, University of Edinburgh, UK.
The huge amount of global attention dedicated to improving conditions for spinal cord injury patients is encouraging. Their dedication is producing constant improvements in the quality of care and effectiveness of treatments around the world.
(pic from spineuniverse)
