Articles Posted in Brain Injury

nhlDo the leaders of professional hockey need to spend some time in the penalty box? It might seem so based on a report in the New York Times that the National Hockey League, as it battles its own players in court over the harms caused by repetitive head injuries, is adopting the dubious legal playbook used by pro football, Big Tobacco and Big Sugar.

The $4-billion-a-year NHL, it seems, has taken off its mitts, thrown them on the ice, and is throwing blows to challenge the ever-mounting, evidence-based research that finds that concussions are detrimental to brain health and can lead to the disease known as chronic traumatic encephalopathy or CTE.

The National Football League, after years of CTE denial, including efforts to undercut its medical science and to attack its researchers, conceded that repeated head trauma harmed its players, and pro football settled with them for more than $1 billion.

harlanYes, there can be progressive steps in health care—and with all the controversy and change going on in the sector it’s worth spotlighting some of these:

Patients should get access to own health records, researchers say

  • Three researchers—Dr. Harlan Krumholz of Yale Medical School (photo right), Connecticut lawyer Jennifer L. Cox, and Yale student Austin W. Jaspers—deserve credit for publishing a pointed opinion piece in the JAMA Internal Medicine detailing the costs and needless obstacles patients confront when they want copies of their own health records. As Krumholz told Reuters of the study’s message about excessive records fees charged by doctors and hospitals:  “Higher costs are a higher barrier for people to get their own information. Without that information it is not possible to correct errors in the record, get informed second opinions, donate your data to research – or share with others what is happening with your care.”  That’s spot on, doctor, as I have written recently and in my book,  The Life You Save: Nine Steps to Getting the Best Medical Care, and Avoiding the Worst. Uncle Sam has stepped in and tried to make it easier and more affordable for patients to get their own records, which Krumholz and company point out should be even more available now that they are digitized (he’s working on software to help, too). But states aren’t doing enough to help, except for Kentucky, which requires a free first copy on request, he and his colleagues say. My firm’s site contains information that may be helpful to those struggling to get their records. Here’s hoping that doctors, hospitals, and other caregiving facilities read the Jaspers, Cox, and Krumholz viewpoint, and, because it appears in one of their publications and Krumholz is a physician-researcher of growing influence, they heed it more.

US_Congress_02It’s almost 1,000 pages,   culminates at least three years of work, and provides a $6.3 billion boost for an array of health-related agencies and initiatives. Will the U.S. Senate join the House in bipartisan passage of the 21st Century Cures Act, a sweeping measure that some say could affect American health care as much as the Affordable Care Act aka Obamacare?

After the bitterly divisive presidential campaign, House members surprised many with their swift consideration of the health funding bill, which passed 392-26. Congressional leaders then crowed about how they can work together and how the legislation will help. The act now has moved to the Senate for consideration. Senators, notably Massachusetts Democrat Elizabeth Warren, have been far more critical of components of the measure, particularly how Big Pharma and device-makers may benefit.

I’ve written how Congress, around this time last year, provided holiday cheer by approving the framework of the 21st Century Cures Act, an omnibus bill that took a year for funding details to get worked out. Because the legislation covers so many health areas and still must be acted on by the Senate and signed by the president, it still needs wary watching. Lobbyists for many different causes already have had a field day on this bill, and they will continue to do so.

braintraumaIt may sound macabre. But advocates say a critical step to address important gender disparities in the care and research on concussions’ harms may rest in convincing more women to donate their brains to science. This has already  helped to prove the debilitating and deadly effects of head trauma among men in pro sports.

In contrast to the many and growing number of male athletes (especially pro football players) and their families who have allowed post-mortem brain studies, far fewer elite female players have agreed to similar research. Stat, the online health information site, says soccer stars Brandi Chastain, Abby Wambach, and Megan Rapinoe are among the public few.

Autopsies are often the only way, for now, for experts to definitively diagnose debilitating conditions like chronic traumatic encephalopathy (CTE) that result from repeated head trauma (concussions).

NL_DifferenceThere’s  more encouraging news about dementia rates, which a new study has found fell 24 percent between 2000 and 2012, decreasing among Americans 65 and older from 11.6 percent to 8.8 percent. The experts aren’t sure why the rates declined. But it means that 1.5 million or so seniors will be spared the severe cognitive declines that would have been expected from earlier rates of the tragic disease.

Researchers, who published their latest findings in the peer reviewed and respected Journal of the American Medical Association, said that greater educational attainment and improved heart health may have led to the decreases in the prevalence of the condition associated with loss of memory or other mental abilities so severe it interferes with daily life. Alzheimer’s disease is most commonly linked to dementia. Vascular dementia is the second most common type of dementia and occurs after a stroke.

The new study, funded by the National Institutes of Health and on Aging (NIH and NIA), produced continuing surprises as experts have projected an explosion in cases among Americans, who are increasingly gray, obese, and diabetic—factors that significantly increase dementia risks.

INGLEWOOD, CA - 1988: Kareem Abdul Jabbar #33 of the Los Angeles Lakers holds his goggles during an NBA game at the Forum in 1988 in Inglewood, California. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and/or using this Photograph, user is consenting to the terms and conditions of the Getty Images License Agreement. Mandatory Copyright Notice: Copyright 1988 NBAE (Photo by Andrew D. Bernstein/NBAE via Getty Images)

INGLEWOOD, CA – 1988: Kareem Abdul Jabbar #33 of the Los Angeles Lakers holds his goggles during an NBA game at the Forum in 1988 in Inglewood, California. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and/or using this Photograph, user is consenting to the terms and conditions of the Getty Images License Agreement. Mandatory Copyright Notice: Copyright 1988 NBAE (Photo by Andrew D. Bernstein/NBAE via Getty Images)

Basketball legends Kareem Abdul-Jabbar and James Worthy donned them, as did pro football superstar Eric Dickerson, and onetime Reds third-baseman Chris Sabo. Goggles may make athletes look goofy, but new research suggests that young players and their parents and coaches might want to give these and other protective eye-wear a second look.

That’s because caregivers in emergency rooms across the country treat 30,000 sports-related eye injuries annually, a large majority of them in patients younger than 18 and a few younger than 10.

Now that the Labor Day holiday has passed, it’s a perfect time to remind youngsters and their parents: Sports are supposed to be leisure and pleasure activities. And they need to be safe.

Ryan Basen, a tutor to kids and a medical writer, has put together a pointed piece in the Washington Post about youngsters and athletic over-use. He cites facts, scientific studies, and his own painful experiences to chide parents gently about the widespread mania for youngsters to spend huge chunks of their lives in games that not only may not be fun but painful and harmful.

headsupfootballAs a former president used to say with finger pointed and head cocked: Well, there they go again. That same angry but resigned tone should be applied to the National Football League, and its dissembling use of data. The NFL keeps damaging its own reputation as it seeks to persuade the public that it recognizes the major, lasting health damage that head injuries inflict, and that the league is doing something about it−especially when it comes to kids who idolize the game and its athletes.

The New York Times has caught yet another instance of league officials’ duplicity, and summed it up well in its Page One headline: N.F.L.-Backed Youth Program Says It Reduced Concussions. The Data Disagrees.

To dwell on the details is only to get enraged by league officials’ attempts to play fast and loose with data, research, and supposed evidence−and to the detriment of kids. The Times drills down on Head’s Up, the NFL’s flagship initiative to educate kids, parents, coaches, and schools on protecting football players from the risks of head trauma, especially concussions. As the paper reports:

aquatics-synchronized-swimming-panam-1Two sports that could not be more extreme to each other─balletic  synchronized swimming and bombastic professional wrestling─share an ugly health peril: dangerous head injuries. Interest groups in both  are taking steps to better protect athletes, including through litigation in the civil justice system.

Although many fans long may have winked about whether shenanigans in the wrestling ring are faked, pro wrestling does require its stars to engage in athletic moves, many of which subjected them to concussions and long-term neurologic damage, dozens of participant-plaintiffs have asserted in a lawsuit filed against World Wrestling Entertainment Inc., the pro league best known as the WWE.

wweThe one-time wrestling pros, ages 34 to 84, assert that WWE knew of the health risks, especially of head injuries it subjected its performers to, and that it failed to provide adequate safety, protection, and care, leaving many stars with sustained cognitive and other harms.

As the world mourns the death of Muhammad Ali, this remarkable public and sporting figure left two more key lessons as part of his legacy:

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