Archive for the ‘medical’ Category

Brain-injured troops face unclear long-term risks

December 4, 2008

Many of the thousands of troops who suffered traumatic brain injuries in Iraq and Afghanistan are at risk of long-term health problems including depression and Alzheimer’s-like dementia, but it’s impossible to predict how high those risks are, researchers say.

About 22 percent of wounded troops have a brain injury, concluded the prestigious Institute of Medicine — and it urged precise steps for studying how these patients fare years later so chances to help aren’t missed.

The Veterans Affairs Department, which requested the report, and the Pentagon already are taking some of the recommended steps. But a report out Thursday highlights the urgency.

By LAURAN NEERGAARD, AP Medical Writer

An Afghan soldier keeps watch at a checkpoint in Kabul in August ...

“I don’t think we really knew how big a hole in scientific knowledge there is about blast-induced brain injuries,” said Dr. George Rutherford of the University of California, San Francisco, the report’s lead researcher.

Traumatic brain injury, or TBI, is a signature injury of the Iraq war. Most do not involve penetrating head wounds but damage hidden inside the skull caused by an explosion’s pressure wave. It can range from a mild concussion to severe injury. And because symptoms may not be immediately apparent, troops may not seek care.

“If you have a gunshot wound to some specific part of your brain, I can tell you the consequences,” Rutherford said. But with blast concussions, it’s not even possible to say “if you have six of these, are you six times more likely to have something bad happen to you than if you’ve had one?”

Returning soldiers have reported headaches, dizziness, memory loss, confusion, irritability, insomnia and depression. The military has said most of the TBI-injured troops recover with treatment.

“There’s clearly a whole bunch of people who have mild TBI who have no negative outcomes,” Rutherford agreed.

Related:
PTSD, psychological health and traumatic brain injuries

Read the rest:
http://news.yahoo.com/s/ap/20081204/ap_on_he_me/med_brain_injury

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PTSD, psychological health and traumatic brain injuries

December 3, 2008

The number one question we see here at Peace and Freedom is: how can we better help soldiers returning from wars in Iraq and Afghanistan?  Dealing appropriately with psychological health and traumatic brain injuries is the watchword…

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The military finally is getting ahead in the head business — tackling the psychological health and traumatic brain injuries of soldiers and their families in a comprehensive way.

It’s happening at the moment under the leadership of an energetic, Shakespeare-quoting Army psychiatrist, Brig. Gen. Loree K. Sutton. Gen. Sutton holds a medical degree from Loma Linda University in Loma Linda, Calif. She completed her internship and residency in psychiatry at Letterman Army Medical Center in San Francisco.

By Ann Geracimos    
The Washington Times

Brig. Gen. Loree K. Sutton is director of the Defense Centers of Excellence, an arm of the Department of Defense dealing with the health and wellness of soldiers. The department seeks to care for troops before and after they suffer trauma. (Rod Lamkey Jr./The Washington Times)

Above: Brig. Gen. Loree K. Sutton is director of the Defense Centers of Excellence, an arm of the Department of Defense dealing with the health and wellness of soldiers. 

Gen. Sutton, 49, is director of the year-old Defense Centers of Excellence (DCoE), an arm of the Department of Defense dealing with health matters. The concept is to find the means of caring for troops and their leaders before, as well as after, service members and their relations suffer the debilitating effects of trauma.

The game plan focuses on building up what is being called “resilience” among the military’s many warrior volunteers as well as providing more and better treatment options for visible and invisible injuries of this type in a totally integrated program for recovery and reintegration. Gen. Sutton describes it as a network “like the Internet — a collaborative global network” functioning in a partnership, which is expected to take four years to put fully in place.

The plan, and its three R’s — resilience, recovery, reintegration — had a big workout at a recent three-day DCoE symposium, “Warrior Resilience Conference: Partnering With the Line,” and attended mainly by service members involved in health matters. Billed as the first of its kind, the event at the Fairfax Marriott at Fair Oaks typified what the organization sees as its mandate: promoting a shift of emphasis in the military away from what is known, in jargon terms, as an “illness-based medical model” toward a “wellness-centric resilience continuum.”

The latter phrase is a mouthful, with good reason, covering as it does a range of approaches that almost directly counter traditional military culture and practices.

“It’s ironic how the military trains us to overcome discomfort but not how to deal with invisible injuries,” Gen. Sutton notes. “As soldiers, we keep a lid on our feelings while we do our job. But nobody tells us when to take the lid off or how to deal with it when we do.”

Read the rest:
http://www.washingtontimes.com/news/2008/dec
/02/military-marches-toward-wellness/

Military Bases Brace for Surge in PTSD, Stress-Related Disorders

November 29, 2008

Some 15,000 soldiers are heading home to this sprawling base after spending more than a year at war in Iraq and Afghanistan, and military health officials are bracing for a surge in brain injuries and psychological problems among those troops.

By LOLITA C. BALDOR, Associated Press Writer

Facing prospects that one in five of the 101st Airborne Division soldiers will suffer from stress-related disorders, the base has nearly doubled its psychological health staff. Army leaders are hoping to use the base’s experiences to assess the long-term impact of repeated deployments.

The three 101st Airborne combat brigades, which have begun arriving home, have gone through at least three tours in Iraq. The 3rd Brigade also served seven months in Afghanistan, early in the war. Next spring, the 4th Brigade will return from a 15-month tour in Afghanistan. So far, roughly 10,000 soldiers have come back; the remainder are expected by the end of January.

Army leaders say they will closely watch Fort Campbell to determine the proper medical staffing levels needed to aid soldiers who have endured repeated rotations in the two war zones.

“I don’t know what to expect. I don’t think anybody knows,” said Gen. Peter Chiarelli, vice chief of staff of the Army, as he flew back to Washington from a recent tour of the base’s medical facilities. “That’s why I want to see numbers from the 101st’s third deployment.”

What happens with the 101st Airborne, he said, will let the Army help other bases ready for similar homecomings in the next year or two, when multiple brigades from the 4th Infantry Division and the 1st Cavalry Division return.

Read the rest:
http://news.yahoo.com/s/ap/20081129/ap_on_go_ca_st_pe/sol
dier_stress;_ylt=AmE8_PG3c.WU2jnAbvUzG3Ss0NUE

Vietnam Envoy In Africa Arrested: Dealing in Banned Rhino

November 19, 2008

Vietnam says it will recall one of its diplomats from South Africa after she was filmed in an apparent illegal purchase of a rhinoceros horn.

A TV crew accompanying government investigators filmed an agent for a gang of poachers meeting the woman outside Vietnam’s embassy in Pretoria.

BBC

They filmed the agent handing the horn to the diplomat, who then took it inside the embassy building.

Vietnam’s Foreign Ministry said it had recalled her to “clarify the affair”.

Vietnam’s ambassador to South Africa, Tran Duy Thi, told the BBC that action had to be taken.

Rhinoceros (file image)
Crushed rhino horn is prized in some traditional East Asian medicine

“She did it right at the front steps of the embassy,” he said. “You see, they filmed the Vietnamese flag as she was doing it – how shameful! There must be a sanction.”

More than 40 rhinos are said to have been killed in South Africa this year.

Conservationists say Vietnamese syndicates are heavily involved in the illegal trade of their horns.

Crushed rhinoceros horn is a prized ingredient in traditional East Asian medicine, where it is used to treat fever and high blood pressure.

Nosorožec

Half of primary-care doctors in survey would leave medicine

November 18, 2008

Nearly half the respondents in a survey of U.S. primary care physicians said that they would seriously consider getting out of the medical business within the next three years if they had an alternative.

By Val Willingham
CNN Medical Producer

The survey, released this week by the Physicians’ Foundation, which promotes better doctor-patient relationships, sought to find the reasons for an identified exodus among family doctors and internists, widely known as the backbone of the health industry.

A U.S. shortage of 35,000 to 40,000 primary care physicians by 2025 was predicted at last week’s American Medical Association annual meeting.

In the survey, the foundation sent questionnaires to more than 270,000 primary care doctors and more than 50,000 specialists nationwide.

Of the 12,000 respondents, 49 percent said they’d consider leaving medicine. Many said they are overwhelmed with their practices, not because they have too many patients, but because there’s too much red tape generated from insurance companies and government agencies.

Read the rest:
http://www.cnn.com/2008/HEALTH/11/17/primary.care.
doctors.study/index.html

Japan police to question man on China organ transplants

November 12, 2008

Japanese police plan to question a man on suspicion of illegally brokering organ transplant operations in China for Japanese patients, reports said Wednesday.

Police plan to grill Hiroyuki Nagase, 52, on suspicion of violating Japan’s organ transplant law, which bans the brokering of organ transplants for profit, the Yomiuri Shimbun and other media reported.

A police spokesman declined to comment, but the health ministry confirmed it had received inquiries from the police linked to the case.

“They have told me that there was information that Mr. Nagase might be deported to Japan, and that they wanted to know which case would be illegal organ trading,” said Yoichi Hiratsuka, an official at the health ministry.

Nagase, who headed the China International Organ Transplant Centre in the northeast city of Shenyang, was arrested last year by the Chinese police for allegedly brokering human transplant operations on the Internet.

But the Chinese authorities changed the charge to false advertising when he was indicted, the Yomiuri said.

On October 30, a court in Shenyang sentenced Nagase to 14 months in prison, including time already served in custody, followed by deportation, it said.

Nagase, who flew back to Tokyo on Tuesday, told the Yomiuri that it was not illegal to broker organ transplants for profit in China and he was only doing what other doctors also did.

There is a severe shortage of organ donors in Japan and hundreds of patients go abroad each year for transplants.

Health, Fitness of Top Candidates: Too Many Unknowns

October 20, 2008

Senator Barack Obama, 47, the Democratic presidential nominee, released a one-page, undated letter from his personal physician in May stating that he was in “excellent” health. Senator John McCain, 72, is a cancer survivor, and Senator Joe Biden has had emergency surgery on a brain aneurysm.

By LAWRENCE K. ALTMAN, M.D.
The New York Times

Fifteen days before the election, serious gaps remain in the public’s knowledge about the health of the presidential and vice-presidential nominees. The limited information provided by the candidates is a striking departure from recent campaigns, in which many candidates and their doctors were more forthcoming.

The scars on John McCain’s puffy left cheek are reminders of the extensive surgery he underwent in 2000 to remove a malignant melanoma.

Barack Obama, who started smoking at least two decades ago, has had trouble quitting. Mr. Obama says he quit last year but has “bummed” cigarettes.

In past elections….

Read the rest:
http://www.nytimes.com/2008/10/20/us/
politics/20health.html?_r=1&hp&oref=slogin

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Healthy Chief Executive? What Do We Know?

By Robert Dallek
The Washington Post
Sunday, October 19, 2008; Page B03

The American public seems pretty sure that it knows everything it needs to know about whether John McCain and Barack Obama are healthy enough to be president. I’m not. And whenever I think about whether both men are fit to serve, physically speaking, I think about the sinking feeling I had one lovely spring afternoon in 2002 when an archivist at the John F. Kennedy Presidential Library wheeled out the cartload of files showing how badly we had all been deceived about JFK’s health.

The secret details of Kennedy’s medical history were buried in 10 beat-up old cartons of records the library had held for 40 years. Past requests for access to these materials had all been refused by a committee of loyalists that included one of JFK’s closest advisers, speechwriter Ted Sorensen. To my surprise, the committee had given me the chance to read the files; I had to agree not to photocopy them but was free to take notes or read passages into a tape recorder. Now I — along with a physician friend, Jeffrey Kelman — felt as if I were breaching a wall of secrecy. Here were not the usual neat boxes of presidential records, preserved in red-blue-and-silver-trimmed containers, but musty cardboard cartons that seemed to have sat untouched in some corner of the library since Janet Travell, one of Kennedy’s physicians, had given them to the library after JFK’s assassination in November 1963.

Back pain forced President Kennedy to use an Air Force lift to board his plane.  Voters never knew the extent of his ailments.

The picture of health: Back pain forced President Kennedy to use an Air Force lift to board his plane. Voters never knew the extent of his ailments. (AP Photo/Harold Valentine)

Between May 1955 and October 1957, Kennedy had been hospitalized nine times for a total of 44 days, including one 19-day period and two week-long stretches. Despite his public image of “vigah,” as his accent rendered it, he suffered from bouts of colitis, accompanied by abdominal pain, diarrhea and dehydration; agony in his back triggered by osteoporosis of the lumbar spine; prostatitis, marked by severe pain and urinary infections; and Addison’s disease, a form of adrenal insufficiency. Some of his difficulties, such as his back pain and Addison’s, were open secrets among the press corps during his 1960 run for the White House, but the extent and severity of his problems — to say nothing of the promiscuous variety of medications and doctors he relied upon to maintain his health — had remained undisclosed. That’s largely because the Kennedy campaign made every effort to hide his health problems — obviously convinced that these disclosures, combined with his youth and Catholicism, would sink him.

Read the rest:
http://www.washingtonpost.com/w
p-dyn/content/article/2008/10/1
7/AR2008101702058.html?hpid=opinionsbox1

Nearly 1 in 5 troops has mental problems after war service

April 17, 2008

By PAULINE JELINEK, Associated Press Writer

WASHINGTON – Roughly one in every five U.S. troops who have survived the bombs and other dangers of Iraq and Afghanistan now suffers from major depression or post-traumatic stress, an independent study said Thursday. It estimated the toll at 300,000 or more.
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As many or more report possible brain injuries from explosions or other head wounds, said the study, the first major survey from outside the government.

U.S. troops search for Taliban forces during a patrol in Afghanistan's ... 
U.S. troops search for Taliban forces during a patrol in Afghanistan’s Shamal district of Khost province April 16, 2008. About 300,000 U.S. troops returning from Iraq and Afghanistan suffer symptoms of post-traumatic stress disorder or depression, but about half receive no care, an independent study said on Thursday.REUTERS/Rafal Gersza

Only about half of those with mental health problems have sought treatment. Even fewer of those with head injuries have seen doctors.

Army Surgeon General Eric Schoomaker said the report, from the Rand Corp., was welcome.

“They’re helping us to raise the visibility and the attention that’s needed by the American public at large,” said Schoomaker, a lieutenant general. “They are making this a national debate.”

The researchers said 18.5 percent of current and former service members contacted in a recent survey reported symptoms of depression or post-traumatic stress. Based on Pentagon data that more than 1.6 million have deployed to the two wars, the researchers calculated that about 300,000 are suffering mental health problems.

Nineteen percent — or an estimated 320,000 — may have suffered head injuries, the study calculated. Those range from mild concussions to severe, penetrating head wounds.

Read the rest:
http://news.yahoo.com/s/ap/20080417/ap_on_go_ca_
st_pe/troops_mental_health;_
ylt=AkKRKrcCTNidVr3yzaBFe.es0NUE

Related:
Crisis: Soldiers, Marines Returning from War with Mental Health Issues

Physician prolific at writing prescriptions

March 30, 2008

By Tim Carpenter
Topeka Capital-Journal
March 27, 2008

Stephen Schneider knew the high volume of drug overdoses among his clinic patients was attracting the wrong kind of attention.A piece of the proof emerged in 2006 while Schneider underwent questioning by attorney Larry Wall, who filed a malpractice lawsuit against the physician on behalf of a deceased patient. The interrogation was lengthy and, at times, heated. But the owner of the high-traffic, pain-management clinic was ready.
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“Have patients died at the clinic?” Wall asked.

“Upon advice of counsel,” Schneider replied, “I assert my Fifth Amendment rights.”

“Have you experienced overdoses at the clinic where a patient would receive an injection of narcotic drugs and they would become comatose?”

“Upon advice of counsel, I assert my Fifth Amendment right.”

In all, Schneider invoked his privilege to avoid self-incrimination 352 times in that deposition. Linda Schneider, his wife and business manager of the clinic south of Wichita, raised the same constitutional shield 281 times in a deposition with Wall.

The Kansas Board of Healing Arts, which regulates medical professionals, was also on the Schneiders’ trail. The agency confirmed instances of negligence in 2004, 2005 and 2006 and filed a disciplinary case against Stephen Schneider in May 2006.

“Things were put on a very fast track,” said Mark Stafford, the board’s lead attorney.

Then, the board’s case….

Read the rest:
http://cjonline.com/stories/032808/kan_262505465.shtml

St. Patrick’s Day Celebration Can Be Too Costly

March 16, 2008

By John E. Carey
Peace and Freedom
Saint Patrick’s Day

When graded by your local police, Saint Patrick’s Day is a more troublesome day for alcohol abuse than even New Year’s Eve.  In fact, except for Super Bowl Sunday, St. Patrick’s Day is the number one “holiday” for arrests, citations and emergency room admissions. 
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All because we Americans sometimes think it is OK to drink and over-drink until we are drunk.  On these three holidays and others, including Independence Day on July 4th we act as if we had a license to drink – a mandate from God to allow drunkenness and bad behavior.

Saint Patrick

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA),alcohol abuse and its related problems cost society many billions of dollars each year.

Estimates of the economic costs of alcohol abuse attempt to assess in monetary terms the damage that results from the misuse of alcohol. These costs include expenditures on alcohol-related problems and opportunities that are lost because of alcohol.

This Alcohol Alert addresses issues pertaining to estimates of the costs of alcohol abuse, focusing on the types of costs considered and on the various problems associated with their estimation.

While many difficulties in cost estimation are common to cost-of-illness studies in other health fields, two problems are particularly relevant to the case of alcohol abuse. First, researchers attempt to identify costs that are caused by, and not merely associated with, alcohol abuse, yet it is often hard to establish causation. Second, many costs resulting from alcohol abuse cannot be measured directly. This is especially true of costs that involve placing a dollar value on lost productivity. Researchers use mathematical and statistical methods to estimate such costs, yet recognize that this is imprecise. Moreover, costs of pain and suffering of both people who abuse alcohol and people affected by them cannot be estimated in any reliable way, and are therefore not considered in most cost studies.

These difficulties underscore the fact that although the economic cost of alcohol abuse can be estimated, it cannot be measured precisely. Nevertheless, estimates of the cost give us an idea of the dimensions of the problem, and the breakdown of costs suggests to us which categories are most costly. In the most recent cost study, Rice and co-workers estimated that the cost to society of alcohol abuse was $70.3 billion in 1985; a previous study by Harwood and colleagues estimated that the cost for 1980 was $89 billion.

By adjusting cost estimates for the effects of inflation and the growth of the population over time, Rice projected that the total cost of alcohol abuse in 1988 was $85.9 billion, and Harwood projected that the cost in 1983 was $116 billion.

Some clinicians, working closely with economy analysts, today estimate the total cost of alcohol abuse in America as in excess of $300 billion annually.

Although these figures are staggering, they have little deterrent impact on a drinker headed out for a night on the town.

So let’s just bottom line this beast alcohol right now.Attend any Alcoholics Anonymous (AA) meeting and you are likely to hear a story of how alcohol lead someone to total professional and personal ruin.  Many successful men and women succumb to the disease of alcoholism.  They can tell stories about losing their spouse, kids, job, fortune, house (or houses) and car (or cars). 

I personally know people who, after being highly successful and relatively wealthy, ended up living in shopping carts.  I even have a friend that was thrown out of a bridge overpass and his “home” in a cardboard box.  It seems his excessive drinking was too much for his wino “roommates – who asked him to leave.

And every reader (just about) who has made it this far will say: “I am not an alcoholic.  I just drink.”

Everyone says this at first.  AA calls it “denial.”  Honest self assessment and a desire to be sober are essential to AA – and are in fact the only entry ticket you need to go to any AA meeting.

Related:
Why Americans love the Irish (St. Patrick’s Day in Monday)