Childhood Cancers Increasing!
Sources: National Cancer Institute; US Centers for Disease Control & Prevention (CDC)
ON AVERAGE 1 to 2 out of every 10,000 children in the United States are diagnosed with some form of cancer. Cancer is the leading cause of death by disease among U.S. children 1 to 14 years of age. Over the past 20 years, there has been some increase in the incidence of children diagnosed with all forms of invasive cancer, from 11.5 cases per 100,000 children in 1975 to 14.8 per 100,000 children by 2004. In 2007, approximately 10,400 children under age 15 were diagnosed with cancer and about 1,545 children were expected to die from the disease. Although this makes , cancer is still relatively rare in this age group. On the positive side, the 5-year survival rates for all childhood cancers combined increased from 58.1 percent in 1975–77 to 79.6 percent in 1996–2003.
Long-term trends in incidence for leukemias and brain tumors, the most common childhood cancers, show patterns that are somewhat different from the others. Incidence of childhood leukemias appeared to rise in the early 1980s, with rates increasing from 3.3 cases per 100,000 in 1975 to 4.6 cases per 100,000 in 1985. Rates in the succeeding years have shown no consistent upward or downward trend and have ranged from 3.7 to 4.9 cases per 100,000. For childhood brain tumors, the overall incidence rose from 1975 through 2004, from 2.3 to 3.2 cases per 100,000.
Despite advances in detection, the causes of childhood cancers remain largely unknown. Some genetic conditions, such as Down syndrome and ionizing radiation exposure, explain a small percentage of cases. A number of studies are examining suspected or possible risk factors for childhood cancers, including early-life exposures to infectious agents; parental, fetal, or childhood exposures to environmental toxins such as pesticides, solvents, or other household chemicals; parental occupational exposures to radiation or chemicals; parental medical conditions during pregnancy or before conception; maternal diet during pregnancy; early postnatal feeding patterns and diet; and maternal reproductive history. Researchers are also studying the risks associated with maternal exposures to oral contraceptives, fertility drugs, and other medications; familial and genetic susceptibility; and risk associated with exposure to the human immunodeficiency virus (HIV).
Current treatments for pediatric cancers continue to lag. Most children’s cancers are treated primarily with chemotherapy over the course of one to several years. Some cancers also require radiation therapy, surgery, and/or bone-marrow transplants. Chemotherapy is a group of highly toxic chemical drugs that were developed to kill fast-replicating cells. These drugs are non-specific -they don’t distinguish between diseased and healthy tissuess and result in severe reactions such as hair loss, nausea, significant weight loss and weakness associated with thier toxicity. As if that weren’t enough, most pediatric cancer protocols suggest combination chemotherapy which involves the infusion of several different toxic drugs over the course of time to kill cells at differing levels of development. Radiation therapy, while it can be targeted, is also an indiscriminate killer of healthy tissue and organs. Even if a cure or remission is obtained, children can develop long-term medical problems, including the development of secondary cancers from the chemotherapy or radition itself.
The Lewis Law Firm has a long history of representing children with cancers, and their families in Phildelphia, PA and New Jersey. If you or a loved one have been diagnosed with liver cancer, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Vitamin D May Help with Alzheimer’s Disease
Sources: Journal of Alzheimer’s Disease; Medscape
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. One of it’s hallmarks is the presence of amyloid plaques which show up on imaging of the brain. Amyloid plaques are sticky buildup which accumulates outside nerve cells, or neurons. Amyloid is a protein that is normally found throughout the body. In AD, the protein divides improperly creating a form called beta amyloid, which is toxic to neurons in the brain. AD seems to affect women disproportionally.
Vitamin D has been looked at with hope by researcheds for its possible beneficial effect against the amyloid plaques that are key in Alzheimer’s disease. A new study shows just how they may work in clearing the plaques.
The Research. published in the Journal of Alzheimer’s Disease, shows that vitamin D3 may work by activating certain genes and cell signaling networks to ramp up the immune system, which then clears away a key component of amyloid plaques called amyloid-beta protein. “This new study helped clarify the key mechanisms involved, which will help us better understand the usefulness of vitamin D3 and curcumin as possible therapies for Alzheimer’s disease,” sais study researcher Dr. Milan Fiala, of the David Geffen School of Medicine at UCLA and the Veterans Affairs Greater Los Angeles Healthcare System.
Researchers conducted the study by taking blood samples from people with and without Alzheimer’s disease, and isolating particular immune cells from the blood that are responsible for clearing away the amyloid-beta protein. These same scientists also published in the Journal of Alzheimer’s Disease in 2009. In that earlier study, they found that vitamin D3, together with the spice curcumin, work together to get the immune system to have its effects against amyloid-beta protein in the brain. They reported that vitamin D3 mainly comes from sunshine. There’s a nice thought.
Posted by: Gayle R. Lewis, Esquire
Tort Reform -The Big Lie
Source: Public Citizen Report -Congress Watch Division (Public Citizen is a national non-profit consumer organization with more than 300,000 members and supporters).
Medical malpractice payments were at their lowest level on record in 2011
In contrast to the hundreds of thousands of annual avoidable adverse events (and tens or hundreds of thousands of deaths) that major studies attribute to medical mistakes, only 9,758 medical malpractice payments were made on behalf of doctors in 2011. However, policymakers and leaders of physician groups have spent the past two decades championing efforts to restrict patients’ legal rights, calling for Tort Reform and arguing of a crisis. There is no evidence that patients have received any benefits in exchange for ceding their legal remedies. Instead, the evidence suggests that litigation restrictions have suppressed meritorious claims, forcing malpractice victims and ordinary patients to absorb the costs of treating injuries caused by uncompensated medical errors.
Despite suggestions by those seeking to reduce patients’ legal rights that medical malpractice lawsuits are largely “frivolous,” the vast majority of payments compensate for extremely serious harms. 80% of the money paid for medical negligence in 2011 compensated victims or their surviving family members for harms defined by the NPDB as significant permanent injuries; major permanent injuries; quadriplegia, brain damage, or injuries requiring lifelong care; or death. The latter two categories (quadriplegia, brain damage, or injuries requiring lifelong care; and death) accounted for 44 percent of the dollars spent to compensate victims of medical malpractice.
Declines in Litigation Do Not Translate into Lower Costs for Consumer
Between 2000 and 2011, the value of medical malpractice payments fell 11.9 percent while healthcare spending nearly doubled, increasing 96.7 percent (both calculations in unadjusted dollars). These figures debunk claims that medical malpractice litigation is responsible for rising healthcare costs, as well as promises that patients should expect savings from litigation restrictions.
There Is No Evidence that the Decline in Medical Malpractice Payments Is Due to Safer Medical Care
For years, observers of healthcare safety issues referred to the 1998 Institute of Medicine (IOM) report, “To Err Is Human,” for guidance on the prevalence of medical errors. That study concluded that 44,000 and 98,000 patients were dying every year because of avoidable medical errors. In 2010 and 2011, three major studies reached conclusions on medical errors at least as shocking as those in the IOM report. The administrator of the Centers for Medicare and Medicaid Services (CMS), found that the number of adverse events could be 10 times greater than originally thought.
Comparing the well-recognized prevalence of medical errors with the relatively small numbers of malpractice payments leads to the inescapable conclusion that the overwhelming majority of medical errors do not lead to litigation. Harvard School of Health’s Michelle M. Mello and her co-authors in 2007 wrote in analysis of existing literature that only “2 to 3 percent of patients injured by negligence file malpractice claims … The findings of our analysis indicate that the overwhelming proportion of the costs of hospital medical injures are shifted to parties other than the hospital.”15
Uncompensated Medical Errors Are Costing Both Victims and Taxpayers Significantly
To put this figure in perspective, the total number of payments made in 2011 equaled only a little more than 1 percent of the number of Medicare patients that the Department of Health and Human Services estimates to suffer serious, avoidable injuries in a given year—and that’s just Medicare patients. This demonstrates that the vast majority of medical malpractice errors are not resulting in malpractice compensation payments for patients.
Conclusion
The juxtaposition of declining medical malpractice payments, skyrocketing medical costs, and consistent findings of rampant medical errors discredit the underlying promises of those who have campaigned to reduce patients’ access to legal remedies. The only sensible response is for policymakers and physicians to dedicate themselves to pursuing patient safety measures with the same vigor they have applied to limiting patients’ legal rights. That is a solution we could all live with.
The Lewis Law Firm has a long history of standing up for injured patients and their families. If you or a loved one have been the victim of physician or hospital malpractice, please contact the Lewis Law Firm for a FREE consultation and case review, today.
~Posted by: Gayle R. Lewis, Esquire
You are Not Too Young to Have a Stroke -or to be Misdiagnosed
Journal of Stroke & Cerebrovascular Diseases Volume 20, Issue 6 , Pages 523-527; Wall Street Journal Health Blog
THE vast majority of strokes will occur in people over the age of 65, however, 10-15% of the stroke victims in the United States are of age 45 and younger! A study of 57 young stroke victims published in the Journal of Stroke & Cerebrovascular Diseases from researchers at the Wayne State University-Detroit Medical Center’s Stroke Program found that 1 in 7 were misdiagnosed and sent home without being properly treated for stroke. Among the various misdiagnoses were: vertigo; migraine; alcohol intoxication; seizure; and inner ear dysfunction.
Why is this so important in the case of stroke? Medical experts agree that there is a limited window for treatment of an acute stroke, beyond which the opportunity for thrombolysis (TPA or “clot busting” medications) is lost. According to Dr. Seemant Chaturvedi, the neurologist at Wayne State who led the study, “Although young stroke victims benefit the most from early treatment, it must be administered within four and a half hours,” and, “After 48 to 72 hours, there are no major interventions available to improve stroke outcome.”
In the study, 8 patients (14%; 4 men and 4 women; mean age, 38 years) were misdiagnosed. 7 of these 8 patients were discharged from the emergency department initially. Patients age <35 years (P = .05) and patients with posterior circulation stroke (P = .006) were more likely to be misdiagnosed. All 8 misdiagnosed patients were initially evaluated at hospitals that were not certified primary stroke centers. Patients presenting with vertebrobasilar territory ischemia have a greater rate of misdiagnosis. Our study demonstrates the increasing need for “young stroke awareness” among emergency department personnel.
Patients seen by a qualified neurologist in the emergency room and patients who received an MRI are less likely to be diagnosed. But regardless of your age, you should be aware of the risk potential for a stroke. The Centers for Disease Control and Prevention have reported a steep increase in strokes among people in their 30s and 40s. Risk factors include: obesity; diabetes; and, high blood pressure. Women on birth control and people who smoke are at greater risk.
Awareness and immediate action are key. “Only 20 to 30 percent of patients get to the emergency room within three hours of symptom onset,” Dr. Chaturvedi said. “They tend to wait to see if the symptoms will go away spontaneously, and they show up in the E.R. 12 to 24 hours later.” Stroke is distinguishable from a chronic illness by the sudden onset of symptoms The distinguishing characteristic of stroke symptoms is their sudden onset. The sudden appearance of any of the following symptoms should prompt a trip to the hospital as quickly as possible:
- Numbness or weakness of the face, arm or leg, especially on one side of the body.
- Confusion, trouble speaking or understanding speech.
- Trouble seeing in one or both eyes.
- Difficulty walking, dizziness or loss of balance or coordination.
- Sudden, severe headache with no known cause.
Unlike symptoms associated with a heart attack, most strokes are completely painless. Further, even if these symptoms go away, if you are at risk then you should get evaluated. Insist on a nuerologist and insist on an MRI. You need to be your own health care advocate in the Emergency Room.
The Lewis Law Firm represents patients who have been misdiagnosed with stroke and cerbrovascular accidents. If you or a loved one were misdiagnosed with symptoms consistent with a stroke and harmed as a result, contact the Lewis Law Firm for a FREE consultation and case evaluation, today.
Posted by: Gayle R. Lewis, Esquire
MARCH WAS BRAIN INJURY AWARENESS
By The Jere Beasley Report, April 2011
Each year, millions of people in the United States sustain traumatic brain injuries (TBI) from falls, motor vehicle traffic crashes, collisions with moving or stationary objects, and assaults. The Centers for Disease Control and Prevention (CDC) estimates TBI will affect 1.7 million people, resulting in 1.365 million emergency room visits: 275,000 hospitalizations, and 52,000 deaths every year. In order to bring awareness to brain injury and the lives of those affected by it, March is designated as national Brain Injury Awareness Month. This year, for the first time, Alabama has also specifically designated March as Brain Injury Awareness Month in the state, with a proclamation from Gov. Robert Bentley. Statistics show what nearly 10,000 people in Alabama receive a brain injury every year, resulting in 500 deaths and 1,500 disabilities among children and adults.
“Brain Injury Awareness Month honors the millions of survivors who, with proper acute care, therapeutic rehabilitation and adequate long-term supports, are living with brain injury every day,” said Susan H. Connors, president and CEO of the Brain Injury Association of America. Goals for the statewide recognition of Brain Injury Awareness Month include honoring Alabama’s citizens with Traumatic Brain Injury and their families, and increasing awareness to the general population about brain injury through the Alabama Head Injury Task Force.
The Task Force is a statewide advisory board for TBI, established in 1989 by the commissioner of the Alabama Department of Rehabilitation Services (ADRS). Its mission is to develop the ideal service delivery system for Alabamians who experience a TBI. Brain injury affects people in ways that are invisible, that no one understands and it is often called the hidden disability. Carol Stanley, who is an employee with our firm, began crusading for awareness about TBI after her son, Jason, was injured during a violent crime. Carol is active with the Alabama Head Injury Task Force and we at Beasley Allen are proud of her. Carol had this to say:
A brain injury is a forever life-altering experience for the TBI survivors and their families. Many characteristics of the brain injury impairment are not always familiar, and are not obvious to the general public, medical system, education system, legal system, judicial system, law enforcement and so on. My son’s TBI journey has taken us down all those avenues, and this is why I feel TBI education and awareness for all people is so very important.
Members of the Task Force include people with TBI, their family members, the Alabama Head Injury Foundation, the University of Alabama at Birmingham (UAB) TBI Model System, the Alabama Disabilities Advocacy Program, and the Coalition of Domestic Violence. The group also includes such state agencies as the Department of Human Resources, the Department of Mental Health, the Department of Senior Services, and the Alabama Medicaid Agency. According to Charles Priest, executive director of the Alabama Head Injury Foundation (AHIF):
Due to recent events including concussions in the NFL, the assassination attempt on Congresswoman Giffords and the return of our “wounded warriors”, the awareness of traumatic brain injury is increasing. The Alabama Head Injury Foundation is responding with a new focus on safety and prevention through care seat campaigns and sports concussion education. We welcome the opportunity to coordinate the activities for Brain Injury Awareness Month in Alabama.
A person who has sustained a brain injury may access a specialized statewide network of staff who can work with the individual and his or her family to educate them about the brain injury and provide services and support. For more information, contact Maria Crowley, State Head Injury Coordinator, at 205-290-4590 or email her at maria.crowley@rehab.alabama.gov. Information about TBI also was featured throughout the month of March on our firm’s Personal Injury and Product Liability website at www.southerninjurylawyer.com.
Low Apgar Scores and ADHD.
Source: Journal Pediatrics, 2011.
A recent study by Danish researchers of the Department of Epidemiology, School of Public Health, University of Aarhus, concludes that a low Apgar score is associated with an increased risk of ADHD in childhood. What does it all mean?
The Apgar score was devised in 1952 by Dr. Virginia Apgar (an anesthesiologist) to simply and repeatably assess the health of a newborn in the delivery room. While it has come under question in some circles as to whether an Apgar score means anything at all, the score is a subjective number assignment (0 to 10) of Appearance (color, etc.), Pulse, Grimace (facial movements or crying), Activity (movement) and Respiration (breathing). It is usually taken at 5 minutes of life. And repeated.
While it is clear that a score of zero is incompatible with describing life, it is debatable what a low Apgar score (say a 4) means to an infant’s future development. It is after all their first graded test.
Enter the Danes. The researchers decided to determine whether low Apgar scores at 5 minutes are associated with increased risks of attention deficit hyperactivity disorder (ADHD) in the future. The study was a nationwide (Denmark for the Euro-ignorant) population-based cohort study of 980,902 babies born in Denmark from 1988 to 2001. All children were monitored from 3 years of age until a first International Classification of Diseases diagnosis of hyperkinetic disorder, a first medication for ADHD, migration, death, or the end of 2006, whichever came first.
Their results? Compared with children with Apgar scores of 9 or 10 at 5 minutes, the risk for ADHD was 75% higher in children with Apgar scores of 1 to 4 (hazard ratio 1.75; 95% CI: 1.15-2.11) and 63% higher for those with Apgar scores of 5 to 6 (95% CI: 1.25-2.11). Consider that 5% of all children are diagnosed with the disorder.
But why? There the research is not as complete. Speculation includes: poor maternal nutrition and prenatal (prior to birth) medical care; asphyxia (lack of oxygen); small brain hemorrhage; shock or trauma -any one of which could result in a subjectively lower score by the observer.
Post: David M. Schwadron, Esquire
Brain Cooling for Strokes?
Source: BBC Health News -Scotland
And you thought all the Scots were good for was Scotch and skirts? Dr. Malcolm Macleod (of the clan Macleod) is one of several Scottish physicians supporting the idea of cooling the brains of stroke victims –a process which a growing body of research suggests may dramatically improve recovery of brain function.
That’s correct, inducing hypothermia in some patients can boost survival rates and reduce brain damage. To date, studies have involved the body of patients being cooled using ice cold intravenous drips and cooling pads applied to the skin.
This lowers the body temperature to about 35C, just a couple of degrees below its normal level.
At such low temperatures, the body into a state of artificial hibernation, where the brain can survive with less blood supply, giving doctors vital time to treat blocked or burst blood vessels.
Dr Malcolm Macleod, head of experimental neuroscience at the Centre for Clinical Brain Sciences at the University of Edinburgh, said: “Every day 1,000 Europeans die from stroke – that’s one every 90 seconds – and about twice that number survive but are disabled. And, “Our estimates are that hypothermia might improve the outcome for more than 40,000 Europeans every year.”
Dr. Macleod and his Highlander Scottish team are joining a consortium of clinicians from across Europe to seek funding for a trial involving 1,500 stroke patients. The European research project, will also include hospitals in Germany, Italy and France.
~Posted by D.M. Schwadron, Esquire
From across the Pond -IQ and infant resuscitation
A little too close to home here, but results of a recent British cohort study suggest that infants who required resuscitation are at increased risk for low IQ scores by 8 years of age.
Significantly, the results were said to be similar for those infants with and without encephalopathy. The theory advanced to explain this is called “continuum of reproductive casualty” meaning that even mild perinatal events may have long term effects on cognition. The study ultimately examined the IQ scores of 5887 children in a British school who were around 8.6 years of age on average.
Up to 14% of neonates may require resuscitation after delivery. Mine did. It should be noted that children delivered more than 8 years ago were more likely to receive 100% oxygen during resuscitation. Such a level of forced oxygenation was associated with poorer outcomes, forcing a practice change. Still, in calling the results “surprising” clinicians have noted some limitations of the study in that only 51% of the original cohort group of 10,609 children were followed to school age (British system school age) and that the mean (average) IQ scores among the resuscitated and asymptomatic children were not different from the control group.
My neonate is currently 5.6 years of age. One to follow.
posted by David Marc Schwadron, Esq.