Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

The Lou Ruvo Las Vegas Medical Center, part of the Cleveland Clinic, will participate in a multi-center Alzheimer's Study.  

The study will be to advance early detection and treatment for Alzheimer's.  Dr. Kate Zhong, the senior director of clinical research and development at the Cleveland Clinic Lou Ruvo Center for Brain Health, will direct a clinical trial aimed at finding an inexpensive blood test to detect Alzheimer's disease.

 The Las Vegas Review Journal revealed:

 The first multi-site clinical trial in the United States aimed at trying to identify Alzheimer's disease through an inexpensive blood test will be directed by researchers at the Cleveland Clinic Lou Ruvo Center for Brain Health.

Currently the only definitive way to diagnose the disease is by direct examination of brain tissue after the patient dies.   This obviously does little to prevent the disease from advancing while the patient is alive.

Some experts have put the cost of a blood test at $200. Current sophisticated brain imaging costs $2,000 or more.

PAUL HARASIM reports

Last month, Robert Nagele, a professor at the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, said he developed a blood test that is more than 90 percent accurate at identifying antibodies in the blood specific to the disease.

Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease (AD), is one form of dementia that gradually gets worse over time. It affects memory, thinking, and behavior.

Memory impairment, as well as problems with language, decision-making ability, judgment, and personality, are necessary features for the diagnosis.

 Las Vegas Nevada Receives Attention as Serious Medical Research and Treatment Center

Since establishing the Cleveland Clinic Lou Ruvo Brain Injury Center in Las Vegas, the city is a viable contender with other national brain specialty centers.  Cleveland Clinic's Lou Ruvo Center for Brain Health (CCLRCBH) provides state-of-the-art care for cognitive disorders and for the family members of those who suffer from them. The physicians and staff at the CCLRCBH are working towards:

• Early diagnosis
• Providing excellent care to patients
• Offering care for the caregivers
• Development of new, powerful treatment options

Another recent advance in brain health in Las Vegas is the union of Stanford University and St. Rose Hospital in the neurosurgery field.  This year , U.S. News & World Report named Stanford Hospital and Clinics one of the top 17 hospitals in America.

 Another Las Vegas Review Journal piece quotes Maureen Peckman's views on the new neurosurgery center:

Maureen Peckman, chief emerging business officer for the Cleveland Clinic, which oversees the operations and development of the Lou Ruvo Center for Brain Health, welcomed the partnership.

"I think that any time our community can attract top-level medical partners in the valley, it's a boon for patient care, boon for raising quality, a boon for everyone engaged in health care in the community," she said.

It is wonderful to see Las Vegas diversifying itself as the great recession continues to swell.  The addition of quality medical facility alliances may be the silver lining to the City's failed reliance on the one industry it historically relied on.  This may be especially true for brain health.

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 Currently there are no drugs with which to treat and cure brain injury. Standard treatment is supportive: stabilizing the patient, maintaining other vital functions such as blood pressure and breathing, treating other injuries, minimizing infections, and monitoring swelling.

Blogger David S. Casey writes about a new study.  

A promising new treatment for traumatic brain injury, the first significant advance in 30 years, is now being tested in a large scale, multi-center clinical trial. Over the next three to four years, 17 participating trauma centers in 15 states will enroll more than 1100 patients with severe TBI. Half of the patients with severe head injuries will be given an infusion of the hormone progesterone as well as all standard treatment for TBI; the other patients will be given a placebo infusion, which contains no active agents, and as well as all standard treatment. The study will evaluate the protective effect of the hormone progesterone when it is administered within four hours of the injury. The study is double-blinded, meaning neither patients nor treatment staff will know which infusion the patient receives.

Read more from David S. Casey here.

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Las Vegas Traumatic Brain Injury Law Blog

When you have depression, it's more than feeling sad. Intense feelings of sadness and other symptoms, like losing interest in things you enjoy, may last for a while. Depression is a medical illness - a condition - not a sign of weakness. And it's treatable.

If you're depressed, it might not be easy to figure out why. In most cases, depression doesn't have a single cause. Instead, it results from a mix of things -- your genes, events in your past, your current circumstances, and other risk factors.

In cases I handle depression is typically associated with brain injury.  There is organic-based depression which is a result of insult to the brain itself and the chemical processes.  Other depression, more psychological, can be serious as well.  When one of my clients learns of their limitations, due to injury, and the process of trying to overcome them, depression becomes a factor.  Both types are compensable but different in how they are proved.

The following are causes of depression commonly encountered:

• Biology. While we still don't know exactly what happens in the brain when people become depressed, studies show that certain parts of the brain don't seem to be working normally. Depression might also be affected by changes in the levels of certain chemicals in the brain, called neurotransmitters.
• Genetics. Researchers know that if depression runs in your family, you have a higher chance of becoming depressed.
• Gender. Studies show that women are about twice as likely as men to become depressed. No one's sure why. The hormonal changes that women go through at different times of their lives may be a factor.
• Age. People who are elderly are at higher risk of depression. That can be compounded by other factors -- living alone and having a lack of social support.
• Health conditions. Permanent Conditions such as cancer, heart disease, thyroid problems, chronic pain, and many others increase your risk of becoming depressed.
• Trauma and grief. Trauma, such as violence or physical or emotional abuse -- even if it's early in life or more recent -- can trigger depression. So can grief after the death of a friend or loved one.  Job changes, moving into a new home and other life changes can also contribute to depression.
• Changes and stressful events. It's not surprising that people might become depressed during stressful times -- such as during a divorce or while caring for a sick relative. Yet not as well known is that even positive changes -- like getting married or starting a new job -- can trigger depression.
• Medications and substances. We all take some medication at some point in our lives.  Many of us take medication more or less for life.  Many prescription drugs can cause symptoms of depression. Alcohol or substance abuse is common in depressed people. It often makes their condition worse.

Brain Injury

Depression is typically associated with brain injury.  Feeling like there is nothing you can do to make you like you were before the brain injury brings on emotional and organic depression.

Post Traumatic Stress Disorder  

People with post-traumatic stress disorder (PTSD) often re–live the traumatic event in flashbacks, memories or nightmares. Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD - post traumatic stress disorder - include violent personal assaults, natural or human-caused disasters, auto accidents, falls, assaults, or military combat.

Other symptoms of post traumatic stress disorder include irritability, anger outbursts, intense guilt, and avoidance of thinking or talking about the traumatic ordeal. In a National Institute of Mental Health (NIMH)–funded study, researchers found that more than 40 percent of people with PTSD also had depression at one-month and four-month intervals after the traumatic event.

Talk to your doctor or traumatic brain injury lawyer if you have depression you suspect was caused by trauma and injury. Getting treatment is critical to recovery.

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MSNBC covered a piece on brain injury recently.  With reference to Congresswoman Gifford, and other notable survivors of traumatic brain injury, the story looks at the progress we have made concerning the identity of brain injury and how to treat it.  Even with the progress, however, there remains much more about the brain we do not know than what we do.

Click here to be directed to the piece by MSNBC.

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Rear End Truck Collision

A jury awarded $9,000,000 to two people injured in early 2008.  A refrigerator truck made an unsafe lane change that forever changed the lives of driver's of two other cars.

Susan Lutz, 51, of Fresno,was awarded nearly $2 million in damages.  Lutz suffered a brain injury in the April 2008 collision and has vertigo for the rest of her life.

The panel awarded $7.3 million to Clarice Brewer, 56, also of Fresno. Brewer can no longer walk because of the collision and uses a wheelchair.

Read more: http://www.fresnobee.com/2010/10/21/2127053/fresno-jury-awards-9-mil-in-damages.html#ixzz13agmsCRC

Tractor Trailer Rear End Collision

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Detecting Brain Injury, especially in trauma cases, is difficult.  Usually emergency medical technicians and emergency room physicians focus on the most pressing and visible injuries: blood gushing wounds and the like.

When a person comes to the ER with a TBI, doctors must determine if there is any bleeding in the brain.  Bleeding can cause a pool of blood that puts pressure on the surrounding brain tissue, causing more damage. Subdural and epidural hematoma being most common.  Currently, the best, quick way to look for intracranial bleeding is with a CT scan.  Unfortunately this test provides little resolution to actually see anything other than big masses of blood.

 CT scans are used to detect a number of potential problems for ER patients. So the demand for the units is often high and the wait for a scan for a TBI patient can be long. In addition,  in 95 percent of patients with mild TBI, the CT scans are normal.  So CT is not the best detector of brain injury, it is simply practical in that it is least invasive to the injured patient, takes realtively less time then other tests such as MRI, EEG, DTI and PET.

 Researchers are looking at another way to detect potential brain damage from a TBI, using a blood test instead of an imaging technique. The blood test looks for a marker, called S-100B, a type of protein from a type of brain cell known as an astrocyte. Studies show this marker is elevated in patients with a brain bleeding after a TBI.

 The blood test takes about 20 minutes to perform. However, studies suggest that the test must be done within three hours to ensure accuracy. If the test is negative, it’s most likely the patient doesn’t need a CT scan.

 The S-100B test is approved for use in Europe, but it is still under study in the U.S. Researchers are still enrolling patients in the US trial. In the future, a portable screener may be developed so that rescue workers can administer the test before the patient gets to the hospital. That will save time in the emergency room and enable doctors to start appropriate treatment faster.

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In a new book titled "Religion and Psychiatry: Beyond Boundaries," the author considers why and how, when and where religion (and spirituality) are at stake in the life of psychiatric patients.  The interface between psychiatry and religion is explored at different levels, varying from daily clinical practice to conceptual fieldwork.

Religion is one subject that many people around the world feel extremely passionate about, either feeling strongly in their belief of a certain religion, or being against religions generally or specifically. Other people do not engage with religion at all. These choices represent a part of who we are, and as such it is essential for psychiatrists to understand and be able to relate to their patients' decisions and beliefs in this area.

Religion and Psychiatry is recommended reading for residents in psychiatry, postgraduates in theology, psychology and psychology of religion, researchers in psychiatric epidemiology and trans-cultural psychiatry, as well as professionals in theology, psychiatry and psychology of religion.

Religion (and spirituality) is very much alive and shapes the cultural values and aspirations of psychiatrist and patient alike, as does the choice of not identifying with a particular faith.  Patients bring their beliefs and convictions into the doctor-patient relationship.  The challenge for mental health professionals, whatever their own world view, is to develop and refine their vocabularies such that they truly understand what is communicated to them by their patients.

"The boundary between religious belief and the practice of psychiatry is becoming increasingly porous," say the editors in the Preface to Religion and Psychiatry: Beyond Boundaries. "No longer can psychiatrists in a multi-faith, multi-cultural globalized world hide behind the dismissal of religious belief as pathological, or behind a biomedical scientism, as they are more frequently confronted by distressed patients for whom religious belief may determine their choice of symptoms and their compliance with treatment."

Published on behalf of the World Psychiatric Association, Religion and Psychiatry: Beyond Boundaries, addresses the impact that religion and spirituality have on shaping cultural values, as well as the choice of not identifying with a particular faith. With this book, Peter Verhagen and colleagues provide a framework to understand the importance of these factors in mental well-being, and how to develop and refine their vocabularies to ensure they truly understand what their patients are telling them.

This is the first time that so many psychiatrists, psychologists, and theologians from all parts of the world and from so many different religious and spiritual backgrounds have worked together to produce a book addressing these important issues.

The book discusses what religious traditions can learn from each other to assist the patient, as well as the neurological basis of religious experiences. It describes training programmes that successfully incorporate aspects of religion and demonstrates how different religious and spiritual traditions can be brought together to improve psychiatric training and daily practice.

In the Foreword to Religion and Psychiatry Mario Maj, President of the World Psychiatric Association, states "The WPA welcomes this comprehensive and multifaceted volume, produced by one of its most active Scientific Sectors, hoping that the effort will continue to clarify the issue and stimulate further reflection and research."
 

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A boater who was killed when a ray jumped out of the water in the Florida Keys and hit her face died of skull fractures and brain injuries, not from the animal's poisonous barb, a medical examiner said Friday.

Judy Kay Zagorski, 57, a community leader around her hometown of Pigeon, Mich., was in the front of a boat going 25 mph on Thursday when a 75-pound spotted eagle ray leapt from the water and hit her in a freak collision.

Monroe County's medical examiner, Dr. Michael Hunter, determined that the cause of death was "blunt force" head injury and that the collision with the ray killed her off Marathon, about 50 miles northeast of Key West.

Hunter's report noted she suffered "multiple skull fractures and direct brain injury resulting in sudden death," said Jorge Pino, spokesman for the Florida Fish and Wildlife Conservation Commission.

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