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Jack Sisson's TBI Blog

A hug is duct tape for the soul.

 
From The Chicago Tribune:
The growing concern over concussions has ushered in new products designed to prevent or treat the mild traumatic brain injuries. But do any of them really work? Here's a look at some of the most common claims:

Mouthguards
After a blow to the jaw, the force travels upward toward the base of the brain. The makers of Brain-Pad mouthguards says its "dual arch" design "secures and cushions" the jaw, protecting it from brain-damaging impacts.

The reality:
No published evidence exists to show that any mouthguard prevents concussions, said Jason Mihalek, an expert in the biomechanics related to head trauma at the University of North Carolina. Nor have mouthguards been shown to reduce the severity of a head blow, he said. Two mouthguard manufacturers, Shock Doctor and Battle Sports Science, have backed away from claims that they may prevent concussions. "Anecdotally we think they do, but there's no scientific proof," said Jay Turkbas, Shock Doctor's senior vice president of product development and marketing.

The bottom line: Wear mouthguards because they can prevent dental and facial injuries.

Football helmets

The claim: The Xenith X1, which has a series of specially placed shock absorbers, "provides outstanding protection to minimize the likelihood of a concussive episode."

The reality: For years, manufacturers focused on protecting the skull from fractures, and guidelines from the National Operating Committee on Standards for Athletic Equipment don't specifically address concussion risk. Still, a recent biomechanical impact study by Virginia Tech researchers found that new football helmets were better than older models at reducing the risk of concussions that some offered more protection than others.

The bottom line: Football helmets are getting better at reducing concussion risk, but not every team can afford new helmets. The Virginia Tech researchers also found that more expensive helmets didn't necessarily offer more protection. Ratings can be found at http://www.sbes.vt.edu through the National Impact Database; the Xenith X1 earned four of five stars.

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From Army Times:

The Army wants soldiers to get the message: Mild traumatic brain injury is a physical wound, not a behavioral issue. So it has launched a new campaign to reverse its “cultural attitude” against the injury, one of the signature wounds from the Iraq and Afghanistan wars, according to a recent Army message.

Since 2000, soldiers have suffered more than 91,000 concussions, the highest number of any service, as of May 16, according to military figures. The injury can have long, debilitating effects if gone untreated.

During the campaign, the Army is looking to teach soldiers and units how to identify, care for and track cases of mTBI. The Army has called for all units to immediately adopt the plan, according to the message.

1. IN THE KNOW

A newly required annual class called “TBI awareness for soldiers” is designed to teach troops the basics about the injury. A second class for deploying soldiers will emphasize why it’s important to detect head trauma, judge its severity, offer first-level care and protect soldiers from multiple concussions.

Training for medics will include more advanced ways to identify head injuries, such as measuring speech fluency, motor skills and memory, as well as methods of patient triage and transport.

2. KEEPING TRACK

Recording what the Army calls “mandatory events” is necessary to protect soldiers against the danger of multiple head injuries. Concussions in rapid succession can compound damage done to the head, according to the message. “Mandatory events” encompass being within 50 feet of a blast, surviving a vehicle rollover or collision and suffering a direct blow to the head.

3. SPOTTING SIGNS

To help soldiers remember mTBI indicators, the Army created “HEADS.” “H” stands for headaches or vomiting; “E” for ear ringing; “A” for amnesia, or altered or loss of consciousness; “D” for double vision or dizziness; and “S” is a catch-all, short for “something feels wrong or is not right,” according to the message.

4. GET YOUR HEAD CHECKED

One rule of thumb for the program is, if soldiers experience a “mandatory event,” they must be assessed for a head injury before returning to duty. Second, a soldier who demonstrates signs of head trauma should in most cases be pulled from duty and given a 24-hour recovery period until evaluated by medical personnel, who can determine when troops are fit to return.

5. FIND OUT MORE

The “All Army Activities” message, numbered 214/2011, was sent on behalf of the Office of the Surgeon General. Commanders with questions can call 703-325-6170, a line to a representative from the Army Medical Command. For training packages, visit the Army Training Network at https://atn.army.mil and search for “TBI.”

Read original article.


 
CaringBridge is a unique online resource that provides an opportunity for families in crisis (usually medical) to create a free, private web site to keep family and friends updated about the patient's condition, while offering family and friends the opportunity to post words of encouragement and support throughout the ordeal. It has proven to be a valuable resource for many families. The following information was taken from the CaringBridge web site.

CaringBridge History
In 1997, founder Sona Mehring’s close friend suffered a life-threatening pregnancy. To keep family and friends informed about the critical situation, Sona created a website.The site allowed family members to communicate information to a wide circle of people without disturbing the mother’s need for rest or placing additional demands on hospital staff.

Fighting for their lives
Baby Brighid was born almost three months premature. With her mother in critical condition, the one-pound preemie was quickly rushed to the Newborn Intensive Care Unit at Children’s Hospital in St. Paul, Minn. The family posted daily news about mom and Brighid on the website. An accompanying online guestbook enabled visitors to send the family messages of love and encouragement.

Sadly, Brighid’s story does not have a happy ending. After a nine-day struggle against tremendous odds, she died in surgery.

An outpouring of love
The website allowed the family to convey this saddest of news without the painful burden of several emotional phone calls. The parents also had a place to post a final message to honor Brighid and their supportive online community.

Brighid’s death prompted an outpouring of loving messages to the family. They immediately understood that other patients dealing with the birth of a premature baby, childhood cancer or other critical illness would benefit from the same web resource.

A memorial fund, created in Brighid’s memory, enabled Children’s Hospital in St. Paul to dedicate a computer and Internet access for patients and families wishing to create their own online communities.

And CaringBridge was born.

A CaringBridge website helps keep loved ones informed during a significant health challenge.
  • Reduces time and emotional energy spent on repeated phone calls and e–mail
  • Keeps everyone informed with the same, accurate information
  • Connects a patient’s entire community, creating a network of support for everyone involved
  • Family and friends can post messages of love, hope and compassion from around the world
Every free, personal and private CaringBridge website includes:
  • Patient care journal to update family and friends
  • Guestbook for messages of love and support
  • Photo gallery
  • Free online support for using the service
You can create a web site for yourself or someone you love.
It’s a meaningful way to help family and friends during life-changing events such as:
  • Cancer treatment
  • Chronic illness
  • Hospice care
  • Hospitalization
  • International adoption
  • Military deployment
  • Organ transplant
  • Premature birth
  • Recovery
  • Rehabilitation
  • Spinal cord injury
  • Stroke
  • Traumatic brain injury
  • War injury
Your site provides a private space for the personal, sensitive conversations that take place during significant health challenges. CaringBridge was created for personal health sharing and is more appropriate than social networks that are more open, broadly focused or intended for socializing and entertainment. We understand how important these personal conversations are and will not allow them to be interrupted by commercial advertising or distracting banner ads.

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From Medical Xpress:
Oxford University researchers have succeeded in using stem cell technology to grow nerve cells in the laboratory from initial skin samples taken from Parkinson’s patients. It’s the first large-scale effort of its kind in the UK.

The advance will allow that are just like those of the people with Parkinson’s to be studied intensively in the laboratory in ways that weren’t possible before.

The study aims to investigate what processes are making specific nerve cells, called dopamine neurons, die off as the disease progresses.

"We can’t take bits of people’s brains when they are alive, of course," says Dr. Richard Wade-Martins of the Oxford Parkinson’s Disease Centre, who led the work. "So we never have been able to study dopamine neurons from a patient."

"We now have a platform to understand what happens in the cells in disease and identify new pathways that could lead to potential targets for new therapies."

BBC News followed the steps in the process with one patient from Oxfordshire. A skin biopsy was provided by Mr Derek Underwood, who used to work for a manufacturer of MRI scanners before his early retirement through Parkinson’s.

Skin cells from Mr. Underwood’s biopsy were then grown up in the lab. At the appropriate point, using an approach recently developed by Japanese scientists, the skin cells were ‘reprogrammed’ to revert back to a stem-cell-like state.

The great power of these induced pluripotent , or iPS cells, is that they are able to form just about any of the specialised types of cell present in the body. That allowed the Oxford team to guide the iPS cells to develop, or ‘differentiate’, into nerve cells that are essentially identical to the Mr. Underwood’s own nerve cells in his brain.

Some of the nerve cells generated are dopamine neurons, the ones involved in Parkinson’s disease.

Continue reading.

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Here's an online book you might find helpful. It's the TRAUMATIC BRAIN INJURY SURVIVAL GUIDE by Dr. Glen Johnson, Clinical Neuropsychologist.

Here's what Dr. Johnson has to say about the book:
This online book came from materials that I wrote for my patients and their family members. I basically used a copy machine and gave copies away for free. This book became very popular and over a thousand copies have been given out. It costs about $6 to copy the book another $3 to $4 to mail to people. The costs and time to send the books got out of hand. I decided not to publish the book. Few people would have access to the material and I would not be able to "update" or improve the material easily. Using the Internet, anyone with a computer could access this information. It is my sincere hope that the Internet version of my book would help the greatest number of people. Go to each chapter heading and click on it. Use your web browser to print any information that you find helpful. There is no charge for the information you copy.
And here is the Table of Contents:
  • Common Indicators of a Head Injury
  • How the Brain is Hurt
  • Understanding How the Brain Works
  • Coping with Common Problems:
Memory
Headaches
Problems Getting Organized
Getting Overloaded
Sleep Disorders
Fatigue
Anger and Depression
Word-finding
  • Dealing with Doctors
  • Family Members: What You Can Do In the Hospital
  • Emotional stages of Recovery
  • Returning to School
  • When Will I Get Better?
  • Who Are All These Professionals?
Click here to check out the Traumatic Brain Injury Survival Guide.

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The Board of Directors for The Brain Trauma Foundation contains some names you might recognize, Sarah Jessica Parker and George Soros among them. Founded in 1986 by Dr. Jamshid Ghajar and the board of the Sunny von Bulow Coma and Head Trauma Research Foundation, it's primary mission is to support research on traumatic brain injury (TBI). The foundation's web site tag line is "We don't deliver the care, we make it better."

The site has information on concussions, comas, research, a TBI glossary, a FAQ on TBI news, statistics, the military, professional guidelines and links. I'm ashamed to say I've never heard of it before today, but it sure looks like they're doing some good work. Definitely worth a visit.

Visit the Brain Trauma Foundation.

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From The Independent:

People who suffer from Parkinson's disease face up to twice the risk of developing deadly skin cancer, an analysis of 12 studies on the topic showed on Monday.

Previous research has shown mixed results, but the meta-analysis by the National Institute of Environmental Health Sciences and published in the journal Neurology showed a significantly higher risk of melanoma in Parkinson's patients.

Men with Parkinson's are twice as likely to develop melanoma, the most dangerous form of skin cancer, and women with Parkinson's were 1.5 times as likely to receive the same diagnosis.

There was no link observed between non-melanoma skin cancer and Parkinson's in the dozen studies which spanned 1965 to 2010.

Since the studies were small in size, most showing fewer than 10 cases of people with both conditions, it was difficult to draw individual conclusions. However, the meta-analysis showed a distinctly increased risk.

"Parkinson's disease patients in general have a lower risk for cancer, smoking-related cancers in particular, but they may have a higher risk for melanoma," said study author Honglei Chen.

"One possible explanation for the link between Parkinson's and melanoma is that the two diseases may share some genetic or environmental risk factors," Chen said. "However, our understanding of this link is very preliminary."

Worldwide estimates of the number of people living with Parkinson's, a brain disease that causes physical tremors and difficulty with movement and balance, range from five to 10 million.

About 132,000 melanoma skin cancers occur globally each year, according to the World Health Organization.

Original post.


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From The Telegraph:

They asked 24 people with the degenerative brain disease to take part in a series of classes where they learnt the steps to Rudolph Nureyev's Romeo and Juliet.

Over the course of 12 weeks they were temporarily transformed, rising out of wheelchairs during classes, smiling and rediscovering confidence on their feet.

Their progress was monitored by Sarah Houston and Ashley McGill from Roehampton University in west London.

Dr Houston said: "One of the most noticeable aspects of the project was how it supported participants’ confidence, as well as improving their bodily awareness."

Danielle Jones from the ENB, who helped with the classes, said: "They came into class after perhaps having a difficult day, shaking or stiff and maybe in a wheelchair.

"But as the class progressed, the music started and the exercises picked up tempo, that disappeared.

"They found walking across the room, which they would usually find really difficult, really easy."

Rather than concentrating on the disease, it was "a chance for them to have fun", she added.

Continue reading.

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From MedPage Today:
Neuron damage in explosion-related "mild" traumatic brain injuries can be more extensive than previously thought and is not necessarily related to the severity of clinical symptoms, researchers said.

Among 63 U.S. soldiers evacuated from Iraq or Afghanistan and diagnosed clinically with blast-related mild traumatic brain injury, diffusion tensor imaging (DTI) revealed significant damage to neuronal axons that was not evident on CT or conventional MRI scans, according to David L. Brody, MD, PhD, of Washington University in St. Louis, and colleagues.

Statistical analysis of the DTI scans showed that abnormalities were significantly more common in the middle cerebellar peduncles, cingulum bundles, and right orbitofrontal white matter in these soldiers than in 21 others with blast exposure but no diagnosis of brain injury.

Yet only 18 of the 63 brain-injured soldiers had definitively abnormal findings from the DTI scans when analyzed individually, suggesting that the extent of axonal damage did not correlate strongly with clinical symptoms.

"Traumatic brain injury remains a clinical diagnosis," Brody and colleagues wrote in the June 2 issue of the New England Journal of Medicine.

However, they also argued that DTI could be included in triage and treatment planning if clinical utility is eventually established, because it is easy to perform with ordinary MRI machines.

Previous imaging studies that used CT or conventional MRI scans had largely failed to find axonal damage in individuals with clinical brain injuries related to blasts.

Continue reading.

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From U.S. News & World Report:

California study finds higher Parkinson's risk among non-agricultural workers

People who work near fields sprayed with pesticides face an increased risk for Parkinson's disease, a new study has found.

Not just agricultural workers but teachers, firefighters, clerks and others whose workplaces are near fields in California's Central Valley are at greater risk for the degenerative disorder of the central nervous system, according to researchers from the University of California, Los Angeles.Click here to find out more!

"This stuff drifts," the study's senior author, Dr. Beate Ritz, an epidemiology professor at the UCLA School of Public Health, said in a university news release. "It's borne by the wind and can wind up on plants and animals, float into open doorways or kitchen windows -- up to several hundred meters from the fields."

The study focused on three pesticides used on the fields: the fungicides maneb and ziram and the herbicide paraquat. The researchers estimated the exposure of 703 people who lived or worked in the area over a 25-year span, taking into account how far they were from the fields sprayed with the chemicals. About half of the people in the study had Parkinson's.

The risk for Parkinson's rose threefold for those who worked near fields sprayed with the three pesticides, the study found. Exposure to just ziram and paraquat raised risk by 80 percent. Earlier analysis by the researchers had found a 75 percent jump in risk for people who lived near fields where maneb and paraquat were sprayed.

The findings suggest that the chemicals act together in increasing the risk for Parkinson's, according to the study, published online in the European Journal of Epidemiology.

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