Brain Injuries May Raise Risk of Early Death

People who have suffered a traumatic brain injury appear to have a much higher risk of dying prematurely, a new study suggests.

These risks include having another brain injury, being assaulted and suicide. The risks are even higher for those with a psychiatric or drug abuse problem, the researchers added.

“After a traumatic brain injury, patients have a threefold increased risk of dying prematurely,” said lead researcher Dr. Seena Fazel, a Wellcome Trust senior research fellow in clinical science at the University of Oxford in England.

“Fifty percent of the early deaths are due to either accident or suicide or being assaulted,” he said. “That seems to be related to psychiatric illness and substance abuse.”

The study found that 61 percent of these patients had psychiatric or substance abuse problems, Fazel said. In some cases, these problems were present before the injury, while some developed after the injury, he added.

The dangers of developing psychiatric or drug abuse problems after an injury may be caused by a variety of factors, including biological and social changes.

These risks might be a particular problem for soldiers and athletes who have had a traumatic brain injury, Fazel suggested.

“A large number of vets have suffered traumatic brain injuries, and we know a lot of vets are dying from suicide. Traumatic brain injury may be one of the factors that increases their risk,” he said.

Fazel believes that after a traumatic brain injury, patients need to be monitored for risk factors that may put them at risk for dying prematurely.

“Some of these problems, like psychiatric illness and substance abuse, can be treated,” he said.

While the study found an association between traumatic brain injury and early death, it did not establish a cause-and-effect relationship.

The report was published online Jan. 15 in JAMA Psychiatry.

One expert said he thinks certain personality traits play a part in the phenomenon.

“The people that are dying earlier have personality characteristics that make them vulnerable to have brain injury,” said Dr. Robert Robinson, a professor of psychiatry at the University of Iowa and author of an accompanying editorial.

“These people are being injured because they’re impulsive and thrill-seeking. These vulnerable personality characteristics are getting them not only into their first head injury, but into a subsequent head injury and that’s causing this premature death,” he said.

Another expert agreed.

“It makes sense that people who suffer a brain injury are more likely to repeat behavior over time, and have more injuries and be at risk for premature death,” said Dr. Jamie Ullman, director of neurotrauma at North Shore University Hospital in Manhasset, N.Y.

“A lot has to do with behaviors that would get them involved in injuries in the first place. We need to focus on the underlying behaviors that have resulted in these injuries, and see if these behaviors can be modified after the injury,” she said.

Source: web md

Alcohol consumption – 80,000 yearly deaths in the Americas

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Alcohol consumption is the direct cause of nearly 80,000 deaths in the Americas each year, according to a new study.

Published in the journal Addiction, the study analyzed yearly mortality rates from 16 countries in North and Latin America. The researchers focused on deaths that were specifically attributed to alcohol, meaning death would not have occurred without some form of alcohol consumption.

“Our purpose was to obtain more detailed information about alcohol mortality from countries in the region,” study co-author Dr. Maristela Monteiro, senior advisor on alcohol and substance abuse for the Pan American Health Organization, told FoxNews.com. “There are statistics from all these countries, but very few regions have specific alcohol mortality data, meaning [the information] we used usually is not reported or not collected.”

After combing through each country’s death statistics, Monteiro and her co-author Dr. Vilma Gawryszewski found that, between 2007 and 2009, alcohol was a ‘necessary’ cause of death for an average of 79,456 cases each year in North and South America. The researchers found that the biggest causes of these deaths included liver disease and alcohol poisoning.

“One important thing we knew from the medical literature but we also found in our data is that alcohol consumption is a cause of premature mortality,” Gawryszewski said. “The highest rates are among people in early age [dying before] the life expectancy in their countries.”

The countries with the highest rates of alcohol-related deaths were mostly in Central America, including El Salvador (27.4 out of 100,000 deaths each year), Guatemala (22.3 out of 100,000) and Nicaragua (21.3 out of 100,000).

Overall, men accounted for 84 percent of alcohol-necessary deaths, though the male-to-female ratio varied from country to country. In El Salvador, the risk of a man dying from an alcohol-necessary cause was 27.8 times higher than that of a woman, while in the United States and Canada, the risk was 3.2 times higher.

There were also differences in age groups for alcohol mortality between countries. In Argentina, Canada, Costa Rica and the U.S., the highest mortality rates occurred in individuals between 50 and 69 years of age. In Brazil, Ecuador and Venezuela, the highest mortality rates were seen in individuals between 40 and 49 years of age.

While these statistics may seem concerning on their own, Monteiro and Gawryszewski maintain their findings reveal that the overconsumption of alcohol is an even bigger issue than previously thought.

“This is just the tip of the iceberg,” Monteiro said. “Of course there are many more alcohol-related deaths from injuries, traffic accidents, violence, and also chronic conditions – where alcohol has a role but is not the only cause. But the data does not cover that. We’re only getting the most severe cases.”

With this in mind, the researchers argue that more needs to be done to control the amount of alcohol individuals consume in North and South America.

“We know how to reduce mortality – with population-based policies, controlling availability and increasing price,” Monteiro said. “We need to prevent people from getting to that stage where you have alcohol dependence or you die.”

Source: Fox news

Half kg hairball removed from girl’s stomach

Doctors have removed a mass of impacted hair weighing half a kg from the stomach of a 12-year-old girl in China’s Henan province.

Doctors at the First Affiliated Hospital of Henan University of Science and Technology in Luoyang, Henan province, surgically removed the hairball from the stomach of the girl Jan 11

The mother of the girl in Luoyang was shocked when doctors revealed the reason why her daughter had been inexplicably losing her long hair and weight over the past year.

Doctors said the girl suffers from pica, a pathological disorder where a person develops an appetite for clay, dirt, chalk or other similar substances that are considered socially unusual to eat.

A CT scan taken at the hospital revealed that the mass of 30 cm long clump occupied 70 percent of the girl’s stomach.

“The mass of hair was shaped like her stomach and is solid,” said Chen Ye, deputy director of gastrointestinal tumor surgery department at the hospital.

“I’ve seen her put hair in her mouth but I thought she was just playing and didn’t think much about it,” said the girl’s mother, who sought treatment when she discovered a lump in her daughter’s stomach two weeks ago.

Chen advised parents to pay close attention to their children’s behaviour and recommend timely treatment after any such discovery.

Source: Zee news

Doctors remove large cockroach from man’s ear

A man in Australia had to be rushed to hospital in terrible pain after a large cockroach crawled into his ear as he slept, and an attempt to suck it out with a vacuum cleaner failed.

Medical treatment initially only caused the inch-long insect to burrow further into the head of Hendrik Helmer.

The unwelcome invader was eventually extracted by a doctor with forceps, but only after Helmer had endured the unpleasant sensation of it being in the “throes of death-twitching.”

His ordeal began in the early hours of Wednesday morning when he was woken by a sharp pain in his right ear, according to Australian TV.

He said: “I was hoping it was not a poisonous spider … I was hoping it didn’t bite me.”

Source: Fox news

Positive thinking may increase effectiveness of migraine drugs

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Boston researchers recruited 66 migraine patients in an attempt to quantify how much of their pain relief came from a medication and how much was due to what’s called the placebo effect, the healing power of positive belief.

More than 450 headaches later, they reported Wednesday that it’s important for doctors to carefully choose what they tell patients about a powerful medicine – because the message could help enhance its benefits, or blunt them.

“Every word you say counts, not only every gram of the medication,” said Harvard professor Ted Kaptchuk, who led the new study with a team at Boston’s Beth Israel Deaconess Hospital.

Here’s how it worked. First, the patients who suffer regular migraines agreed to forgo pain relievers for several hours during one attack, recording their symptoms for comparison with later headaches.

Then for each of their next six migraines, the patients were given a different pill inside an envelope with a different message. Sometimes they were told it was an effective migraine drug named rizatriptan, a positive message. Other times they were told it was a placebo, a dummy pill, suggesting no benefit. Still other times they were told the pill could be either one, a neutral message.

Sometimes the doctor’s message was true – they were told they got rizatriptan and they really did. Sometimes it was false because researchers had secretly switched the pills.

Mixing up the possibilities allowed researchers to tease out how the same person’s pain relief differed from migraine to migraine as his or her expectations changed.

Of course the real migraine drug worked far better than the dummy pill. But remarkably, people who knew they were taking a placebo still reported less pain than when they’d left their migraine untreated, the researchers found.

The surprise: Patients’ reports of pain relief more than doubled when they were told the migraine drug was real than when they were told, falsely, that it was a fake, the team reported Wednesday in the journal Science Translational Medicine.

In fact, people reported nearly as much pain relief when they took a placebo that they thought was the real drug as they did when they took the migraine drug while believing it was a fake.

“The more we gave a positive message to the patient, the bigger the placebo effect was,” Kaptchuk said.

He said that effect probably isn’t purely psychological, saying the ritual of taking a medication may trigger some subconscious memory that could leave people feeling better even if they knew they’d taken a fake drug.

Scientists have long known that some people report noticeable improvements in pain and certain other symptoms when they’re given a placebo, which can be a sugar pill or sham surgery or some other benign intervention. Some studies even have documented that a placebo actually can spark a biological effect.

But scientists don’t know why the placebo effect works or how to harness its potential benefit.

The new research is an interesting attempt to answer some of those questions, at least for one kind of pain, said Dr. Mark Stacy, vice dean for clinical research at Duke University Medical Center, who wasn’t involved with the work. And learning how much of an impact it makes could help design better studies of new drugs, to ensure the phenomenon doesn’t skew the results, he added.

For now, it shows “the power of positive thinking may be helpful in taking care of your migraine,” he said

Source: airing news

Birth control through surgery

Birth control through surgery

Laparoscopic tubal ligation is an elective surgery performed on women who want to prevent pregnancy.

The surgeon begins by making a tiny incision near the bellybutton, and another just above the pubic bone.

Carbon dioxide is administered through a tube in the upper incision. This inflates the abdominal cavity, allowing the surgeon to clearly see and work around your internal organs.

Next, a lighted instrument called a laparoscope is placed through one of the incisions.

The laparoscope projects images of the inside of the abdomen, onto a monitor.

The fallopian tubes are grasped with surgical instruments to close them off, using the cutting, tying, blocking, or sealing technique.

After the carbon dioxide is released from the abdomen, the incisions are closed with dissolving stitches.

For most women, recovery usually takes less than a week.

Source: Fox news

ENT specialist treats burn injury patient, fined Rs 4 lakh for negligence

The National Consumer Disputes Redressal Commission (NCDRC), while setting aside an order of the Bihar State Consumer Disputes Redressal Commission, held a doctor guilty of medical negligence and directed him to pay a compensation of Rs 4 lakh to a man who lost his hand due to his treatment.

NCDRC president D K Jain and members Vineeta Rai and Vinay Kumar, while hearing the revision petition, held that the Bihar State Commission erred in not correctly assessing and appreciating the evidence before them and erroneously concluding that there was no medical negligence.

The aggrieved, Jai Prakash Mehta, a resident of Bihar sustained serious burn injuries on his right arm due to electric shock while working on the electrification of a railway line as a contract labourer on June 26, 1998. He was taken to Dr B N Rai, an ENT specialist, under whom the aggrieved underwent treatment for over two weeks following which there was further deterioration of the burn injuries in his right arm.

Dr Rai then referred him to the Institute of Medical Sciences and Sir Sunderlal Hospital, Banaras Hindu University (BHU), Varanasi, where he was informed that gangrene had set in which could not be reversed and his arm had to be amputated.

Distressed by the medical negligence on the part of Dr Rai, which had very adverse and serious financial and emotional consequences for him, Jai Prakash approached the District Consumer Disputes Redressal Forum, Rohtas, Sasaram on grounds of medical negligence and deficiency in service and requested for compensation.

The District Forum dismissed the complaint on the grounds that there was no credible evidence to prove that there was any medical negligence on the part of the doctor and further that he was not a ‘consumer’ since no fees were taken from him by the doctor. Jai Prakash filed another appeal before the State Commission, which in its order upheld the findings of the District Forum.

Jai Prakash then filed a revision petition in the NCDRC, challenging the order of the Bihar State Commission.

The NCDRC in its observation stated, “The finding of the State Commission that no medical evidence was produced, including expert opinion, to prove that the medicines prescribed were not effective or incorrect is not tenable because this is a case of res ipsa loquitur, wherein the facts speak for themselves. If Petitioner had been properly treated for his serious burn injuries and referred in time to an appropriate health facility by the doctor, then gangrene and consequent loss of his right arm could have well been avoided.”

It noted, “Clearly the doctor, who was an ENT specialist, did not have the professional competence and skills to treat the patient for burn injuries and instead misled him by assuring that the medicines mainly in the form of first aid treatment would lead to his recovery. It is clear that the Petitioner got wet gangrene because of the burn injuries which were not properly and adequately medically treated for over two weeks by the doctor.”

Source: India Medical Times

`Poppy` family plant may hold key to relieving arthritis pain

A new pill made from natural painkillers may help relieve arthritis pain.

Scientists from the University of California have found a plant, which belongs to the poppy family, could be the key as it contains a powerful pain-relieving compound in its roots which could make it a side-effect-free remedy.Researchers identified the compound dehydrocorybulbine in corydalis, which was effective against the three types of pain, which are, acute, inflammatory and neuropathic or chronic.

However, researchers have warned that DHCB needs further toxicity testing before it can be used to relieve the crippling agony of arthritis.

Source: Zee news

FDA approves diabetes pill that eliminates excess sugar through urine

The Food and Drug Administration on Wednesday approved a new diabetes drug from Bristol-Myers Squibb and AstraZeneca that uses a novel approach to reduce blood sugar.

Farxiga is a once-a-day tablet designed to help diabetes patients eliminate excess sugar via their urine. That differs from older drugs that decrease the amount of sugar absorbed from food and stored in the liver.

The drug is the second product approved in the U.S. from the new class of medicines known as SGLT2 drugs. In March the FDA approved Johnson & Johnson’s Invokana, which also works by eliminating excess sugar through patients’ urine.

The agency cleared Farxiga tablets for patients with type 2 diabetes, which affects about 24 million people in the U.S. The approval marks a comeback for the drug, which was previously rejected last year after studies raised concerns about links to bladder cancer and liver toxicity.

Ten cases of bladder cancer were found in patients taking the drug in clinical trials, so Farxiga’s label warns against using it in patients with the disease. A panel of FDA advisers last month said that the uptick in cancers was likely a statistical fluke, and not related to the drug. But the FDA is requiring Bristol and AstraZeneca to track rates of bladder cancer in patients enrolled in a long-term follow up study. The companies will also monitor rates of heart disease, a frequent safety issue with newer diabetes medications.

The most common side effects associated with Farxiga included fungal and urinary tract infections. The drug can be used as a stand-alone drug or in combination with other common diabetes treatments, such as insulin and metformin.

People with type 2 diabetes are unable to properly break down carbohydrates, either because their bodies do not produce enough insulin or have become resistant to the hormone, which controls blood sugar levels. Diabetics often require multiple drugs with different mechanisms of action to control their blood sugar levels.

New York-based Bristol-Myers Squibb Co. and London-based AstraZeneca PLC already co-market the diabetes drug Onglyza, which increases insulin production while reducing glucose production.

Source; Fox bangor

Laser Hair Removal’s Risks

The first two laser hair-removal sessions went smoothly, but the third ended with burning pain that persisted for weeks, a 26-year-old Brooklyn woman recalled. Then the marks appeared: long red stripes along the backs of her legs. Over the next few months, the stripes turned dark brown.

“It was horrifying,” said the woman, who asked not to be identified in order to preserve her privacy. “It wasn’t something you would see on a normal person.”

Laser hair-removal procedures have become immensely popular in recent years. Nearly half a million such treatments were performed by dermatologic surgeons in 2011, the last year for which figures are available, according to the American Society for Dermatologic Surgery. But an unknown number of procedures are performed each year by nonphysicians who may have minimal training.

The treatments are not without risk. Performed improperly, they can cause disfiguring injuries and severe burns in sensitive areas, like the bikini line and the mustache area above the lips, and, rarely, even death.

The percentage of lawsuits over laser surgery that involved a nonphysician operator rose to 78 percent in 2011 from 36 percent in 2008, according to a study published in JAMA Dermatology in October. Laser hair removal was the most commonly performed procedure cited in the litigation. Another popular treatment, intense pulse light, is used to “rejuvenate” aging skin and get rid of wrinkles.

“Not a week goes by that I don’t see a complication from a laser,” said Dr. Tina Alster, founding director of the Washington Institute of Dermatologic Laser Surgery. She and other physicians worry about the proliferation of nonmedical facilities like so-called medical spas that offer laser treatments and other cosmetic treatments but may not have licensed medical personnel on site.

“There’s a perception by the public that anybody can do this,” Dr. Alster said. “People need to remember, it’s not the laser doing the work, it’s the operator.”

In the case of the Brooklyn woman, the laser operator, who was not a doctor, scheduled repeat treatments of her legs four weeks apart instead of the 10 to 12 weeks for legs and the back recommended in a treatment protocol, according to her lawyer, Harry Rothenberg. She sued and reached a confidential settlement with the laser operator.

The licensing and training of laser hair-removal operators varies from state to state, resulting in a patchwork of rules and regulations, said Dr. Mathew M. Avram, director of the Massachusetts General Hospital Dermatology Laser and Cosmetic Center and an author of the new study.

In laser hair removal, pulses of light are used to destroy hair follicles. The treatment is considered to be the practice of medicine in some 35 states; however, nonmedical personnel who offer the treatment are required to have on-site medical supervision in only 26 states.

New York, Virginia and Georgia do not consider laser hair removal to be a medical treatment, and 11 states simply don’t have laws regulating it.

“It’s basically the Wild West of medicine,” Dr. Avram said. “Some states are legislating and protecting patients, but a great many are not. The average person walks into a spa and sees someone with a white coat on and may assume they’re a physician.”

Even doctor-owned facilities may not have one on the premises when procedures are being done, Dr. Avram said. And states that require medical supervision may not require training and licensing of laser operators; training often is left up to the manufacturers that sell the laser equipment.

But the operator makes critical assessments of an individual’s skin type and how far apart to schedule treatments, as well as other decisions. Among those with the greatest risk of complications are people with more natural pigment in their skin or those who are tan.

A laser operator with no medical training also may treat something that looks like a sun spot but is actually a skin cancer, obscuring the disease until it is much more advanced, Dr. Avram said.

Allan Share, president of the International Medical Spa Association, agrees that there is very little oversight of medical and day spas, and he urges consumers to do research before seeking treatment. “It’s always important for a consumer to do their own due diligence,” he said.

For those considering laser hair removal, here are some factors to consider:

Ask whether the facility is owned by a medical doctor and whether he or she is immediately available during procedures. Ask the provider to review your medical history. Ask what procedures are in place in case of an emergency.

Ask who will actually perform the procedure. What licensing and training does the operator have? How many times has the operator performed laser hair removal? Has he or she done it on the part of the body that you want treated?

Ask whether laser treatment is appropriate for your skin type, hair color, complexion and body area. Suggest that the operator test a small patch of skin before you undergo the procedure. Consumers with conditions like diabetes, a difficulty with wound healing, or a tendency toward keloid scarring may be especially vulnerable to complications and should talk to a doctor before undergoing laser treatment.

If you experience pain or discoloration after a procedure, don’t wait — call your doctor right away.

Source: The Newy York times