War Concussions Linked to Stress

About one in six combat troops returning from Iraq have suffered at least one concussion in the war, injuries that, while fleeting, could heighten their risk of developing post-traumatic stress disorder, researchers are reporting.

The study, given early release on Wednesday by The New England Journal of Medicine, is the military’s first large-scale attempt to gauge the effect of mild head injuries — concussions, many of them from roadside blasts — which some experts worry may be causing a host of unrecognized neurological deficits.

The new report finds that soldiers who had concussions were more likely than those with other injuries to report a variety of symptoms in their first months back home, including headaches, poor sleep and balance problems. But they were also at higher risk for the stress disorder, known as PTSD, and that accounted for most of the difference in complaints, the researchers concluded. Symptoms of the disorder include irritability, sleep problems and flashbacks.

Experts cautioned that the study was not designed to detect subtle changes in mental performance, like slips in concentration or short-term memory, that might have developed in the wake of a concussion and might be unrelated to stress reactions. Many returning veterans are still struggling with those problems, which can linger for months after a severe concussion.

The findings are in line with previous research linking concussions to post-traumatic stress disorder after frightening events like car accidents; concussions from athletic collisions rarely lead to the disorder.

“This study is a very good first step, and an important one, but like any first step it should lead us to ask further questions about these injuries,” said Brian Levine, a neuropsychologist at the Rotman Research Institute and the University of Toronto, who was not involved in the study.

Now that the prevalence is known, Dr. Levine said, the next step should be to assess troops’ cognitive functioning early on and track it over time, before and after combat.

“These injuries should not be underestimated,” he said. “You can’t work, you can’t do anything, at least initially, and the symptoms can linger for weeks to months.”

In the study, military psychiatrists had 2,525 soldiers from two Army infantry brigades fill out questionnaires asking about missed work days and dozens of physical and emotional difficulties, as well as symptoms of PTSD. The soldiers had been back home for three to four months.

The questionnaires also asked about concussions and their severity. A concussion is an injury from a blow or shock to the head that causes temporary confusion or loss of consciousness, without any visible brain damage. The investigators found that 384 of the soldiers, or 15 percent, reported at least one concussion. One-third of them blacked out during the injury and two-thirds did not.

The severity of the concussion was related to the risk of the stress disorder, the survey showed. Nearly 44 percent of the soldiers who blacked out qualified for the diagnosis — about three times the rate found in soldiers with other injuries.

Among soldiers who did not black out, the rate of PTSD was 27 percent, significantly higher than the 16 percent rate among veterans with other kinds of injuries.

“There’s a lot we don’t know about these injuries, but we do know that context is important,” said the lead author, Dr. Charles W. Hoge, director of the division of psychiatry and neuroscience at the Walter Reed Army Institute of Research. “Being in combat you’re going to be in a physiologically heightened state already; now imagine a blast that knocks you unconscious — an extremely close call on your own life, and maybe your buddy went down. So you’ve got the trauma and maybe the effect of the concussion is to make it worse.”

In an editorial that accompanied the study, Richard A. Bryant, a psychologist at the University of New South Wales in Australia, stressed that “soldiers should not be led to believe that they have a brain injury that will result in permanent damage.”

On the contrary, he and other experts say, the link to post-traumatic stress suggests that mild brain injuries have a significant psychological component, which can improve with treatment.

Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America, said the study — and interest in brain trauma by doctors and military officials — was long overdue.

“The I.E.D. is the signature weapon of the war, and traumatic brain injury is the signature injury, but the system is not ramped up to handle it, and there are a lot of misdiagnoses, and nondiagnoses,” Mr. Rieckhoff said. “At the end of the day, you hope that this report will serve as a warning, that we need to learn more about these injuries and quickly.”

Source : http://www.nytimes.com

Second-hand smoke harm assessed in cystic fibrosis

Second-hand smoke worsens lung function in people with cystic fibrosis, especially those with a specific gene, researchers said on Tuesday.

Researchers at Johns Hopkins University School of Medicine in Baltimore showed how genetic and environmental factors can interact to harm lung function in cystic fibrosis patients, said Dr. Garry Cutting who worked on the study.

Cystic fibrosis is an inherited chronic disease that affects the lungs and digestive system of about 30,000 children and adults in the United States, according to the Cystic Fibrosis Foundation.

It causes thick, sticky mucus to build up, leading to life-threatening lung infections and major digestion problems.

The researchers studied 812 people with the disease whose average age was 19 of whom 188 were exposed to second-hand cigarette smoke at home.

Lung function in those exposed to second-hand smoke was reduced by about 10 percent compared to those not exposed, the researchers found. Lung function was determined by how much air a person could breathe out in the first second of expiration.

The researchers then looked at lung function in those who also had a specific version of a gene called TGFbeta1 that affects the severity of this disease and asthma.

Having this gene variant doubled the negative effects of second-hand smoke on lung function, the researchers wrote in the Journal of the American Medical Association.
Source :http://www.reuters.com

Tumor recently removed from Nuggets' Nene malignant

The Brazilian magazine Epoca has reported, and the Denver Nuggets have confirmed, that the tumor recently removed from the right testicle of their power forward Nene was indeed malignant.


The team said the tumor was discovered early and tests showed the cancer was isolated

"The recovery rate is extremely high. In addition, the odds of a recurrence are very small," the Nuggets said in a written statement.


It said Nene was doing well but there was no timeline for him to resume playing.


Nene underwent surgery on Jan. 14 to remove the tumor.

The Epoca article is based on a lengthy interview with the doctor who performed the procedure, Fernando Kim. Dr. Kim further explains that the cancerous tumor was caught early. There is no evidence that the cancer had spread, and the likelihood of recurrence, he says, is small after a successful procedure to remove the cancerous testicle.

Further, the doctor adds that the player is recovering extremely well both physically and mentally. The doctor does not speculate about when Nene might be able to return, although normal recovery from this procedure is said to be two months.

The Brazilian article, by Andre Fontenelle, says the tumor was first detected when a routine league-mandated drug test, which reportedly showed the abnormal presence of a hormone that is normally found in pregnant women. In men, that hormone can be the marker of a tumor.


The Brazilian player's Web site had posted a statement last week saying the tumor was benign, but that announcement was later removed.


A statement posted on the Web site and distributed by Nene's Brazilian publicist said, "According to reports presented by doctors, the exams show that the tumor is benign."


Nene took an indefinite leave of absence on Jan. 11.

Asked if the team has reason to be optimistic last week, center Marcus Camby said, "We hope so, for him as a teammate, as a friend and as a brother.

"Basketball is secondary right now. Even without being cancerous, he's still going to be out a significant amount of time."

Dr. Kim, who performed the surgery at Denver Health Medical Center, said earlier that a "right testicular mass was found incidentally and it was managed surgically."


Nene had said the tumor was found at an early stage.

"I want to thank my fans, my teammates, the Nuggets organization and everyone that's been supporting me," he said in a statement released earlier last week. "My victory will represent their victory as well."

Nene is averaging 6.4 points and 6.4 rebounds. He missed 22 games earlier this season after undergoing left thumb surgery. He was out for all but one game of the 2005-06 season after tearing a knee ligament, and he was sidelined for 27 games the season before with a variety of ailments.
Source :http://sports.espn.go.com

Study Reveals That Surgical Abortions Nosedive In The U.S.

Surgical abortions in the U.S. have reduced by 25 per cent, according to a recent study. American women are preferring to end unwanted pregnancies through medical abortions. Medical abortion involves taking two pills under medical supervision to induce miscarriage.

The USA Today quotes the report as stating, "Medical abortion, which uses RU-486, known as Mifepristone and sold as Mifeprex to induce abortion, is rising. Medical abortions more than doubled since federal approval of the non-surgical method in 2000, from 6 % of all abortions that year to 13 % in 2005."

The pills were approved in 2000 by the Food and drug Administration for use before within the seventh week of pregnancy. By 2005 they have become the most popular method of abortion with 13 per cent women opting for it.

The study, conducted by the Guttmacher Institute, a New York based non profit organization that deals with reproductive issues, also reveals that where in the 1980s 1 in 3 pregnant women chose abortion, the figure has now come down to 1 in 5.
Source :http://www.allheadlinenews.com

Study Reveals That Surgical Abortions Nosedive In The U.S.

Surgical abortions in the U.S. have reduced by 25 per cent, according to a recent study. American women are preferring to end unwanted pregnancies through medical abortions. Medical abortion involves taking two pills under medical supervision to induce miscarriage.

The USA Today quotes the report as stating, "Medical abortion, which uses RU-486, known as Mifepristone and sold as Mifeprex to induce abortion, is rising. Medical abortions more than doubled since federal approval of the non-surgical method in 2000, from 6 % of all abortions that year to 13 % in 2005."

The pills were approved in 2000 by the Food and drug Administration for use before within the seventh week of pregnancy. By 2005 they have become the most popular method of abortion with 13 per cent women opting for it.

The study, conducted by the Guttmacher Institute, a New York based non profit organization that deals with reproductive issues, also reveals that where in the 1980s 1 in 3 pregnant women chose abortion, the figure has now come down to 1 in 5.
Source :http://www.allheadlinenews.com