Monthly Archives: June 2013

Brain injury may increase stroke risk

People who have a traumatic brain injury may be more likely to suffer a stroke, a large new study suggests.

And while the chances of having a stroke are still small, incurring a traumatic brain injury (TBI) may be as big a risk factor as is high blood pressure, said study author Dr James Burke.

While stroke risk is usually tied to older adults, about 20% occur in those under 65, said Burke, a research fellow in the neurology department at the University of Michigan Medical School. “Stroke is not typically associated with young people, and why younger people have strokes is not well understood.”

But when younger adults do suffer a stroke, the effects can be daunting.

Only 45

Dr John Volpi, co-director of the Eddy Scurlock Stroke Center in Houston, recalled a patient who had a minor bike accident and seemed just fine. But after just a few days, the man – who was only 45 – had a stroke. “It was a slow recovery, getting back to walking and talking, and because he was an ophthalmologist, it took him a long time to be able to go back to work,” Volpi said.

While study author Burke said stroke prevention has come a long way in the last 20 years or so, acute stroke treatment has seen only one significant advance, the administration of a powerful blood clot destroyer called tissue plasminogen activator (tPA).

Intravenous tPA is used in the first hours after a stroke to help break up blood clots associated with ischemic stroke, in which blood flow to part of the brain is blocked. Ischemic stroke accounts for about 87% of all cases, according to the American Heart Association.

“The next place to hit a potential home run [in preventing stroke] is to find other risk factors that could be playing a key role, especially in younger people,” Burke said.

It is unclear how a traumatic brain injury might raise a person’s stroke risk, he added. “TBI patients may have more headaches, more fear of seizures, diet changes, genuine brain rewiring, or they may be affected by the stress of TBI, or atherosclerotic plaques may be activated.”

Significant difference

The study tapped several databases of adults in California who went to the emergency department or were discharged from a hospital between 2005 and 2009. More than 400 000 people with traumatic brain injury and more than 700 000 people with trauma but no brain injury were included in the study. The average age of all participants was about 50.

About 28 months after the injury, more than 11 000 people – 1.1% – had an ischemic stroke. But among those who had trauma but no brain injury, only 0.9% had a stroke. While that difference may seem small, it is significant because the overall risk of stroke for people this age is so tiny, Burke explained.

After taking into account factors that can affect the risk of stroke, such as heart disease, high blood pressure, high cholesterol, the severity of the trauma and age, the scientists found that those with TBI were 30% more likely to develop a stroke than were those with trauma but no brain injury.

Volpi said the study involved a large number of patients with robust results and high-quality data. Yet, he noted that the connection between trauma and stroke is still unclear. “It could be a cause-and-effect relationship, but we don’t know for sure. It is possible that an injury to the head could lead to an artery being injured,” he said.

“The most likely answer to the connection might be that when the inner tube within the vessel comes apart because it gets a tiny tear from trauma, it allows the blood to push its way into the two layers and stopping or slowing down the flow of blood, which can cause blockage,” Volpi suggested.

He had some practical advice for those at risk for sports injuries. “I’d be asking my doctor, trainer or coach about what kinds of head injuries they expect and what they are doing to prevent head injury,” he said.

Study author Burke remained sceptical about how much his own research really confirms. While there are a fairly sizable number of strokes in people under 65, the risk factors are still quite unclear, he said. “The most I can honestly say is that this study is helping to inform what we should pursue next in research.”

*Courtesy of: http://www.health24.com/Medical/Stroke/News/Brain-injury-may-increase-stroke-risk-20130627

Boston’s Free Fitness Extravaganza

Mayor Menino launches more free fitness classes in the city.

Get outside this summer and take one of the many free fitness classes offered around the city. Outdoor fitness class photo via Shutterstock.

Boston is having a free fitness moment. If you’ve ever wanted to try Zumba, yoga, Pilates, bootcamp, or a run club, this summer is your chance to do it free of charge. There are free classes on the Esplanade, free classes in Post Office Square, free classes on the Greenway, yoga at the Frog Pond, and now, free classes at City Hall Plaza.

Mayor Tom Menino is launching ”Fitness in the City”, which are free fitness classes that are open to the public, as part of Boston Moves for Health. The classes start Friday June 28th with bootcamp at 6:30 a.m. that will continue for the rest of the summer. Meta Movements will also be holding a special community salsa dance event Friday night on the Plaza from 5:30 p.m. to 8:30 p.m. Bootcamp is rain or shine, but the salsa event has a rain makeup date (July 12). The Fitness in the City classes will include Zumba, Pilates, and bootcamp.

“Our Fitness on the Plaza classes were more popular than we expected last summer, and we want to build on that success by offering even more options in more places this year,” Mayor Menino said in the press release. “Getting people out and active adds to the vitality of our city, and it’s a great way to promote healthy habits. We know that a lot of the participants in last year’s classes found out about them just by walking by, so we want to keep encouraging folks to let the city be their gym.”

Bootcamp classes will be sponsored by Beantown Bootcamp, Boston Sports Club, Ultimate Bootcamp, and the Hyde Park YMCA.  Zumba classes sponsored by the Z Spot Zumba and the East Boston YMCA, and the Pilates classes are sponsored by the East Boston YMCA. “Thanks to all of our partners for their support in this fantastic program,” said Dr. Barbara Ferrer, Executive Director of the Boston Public Health Commission, in the press release. “We hope that the classes attract people of all ages and abilities to help show off how healthy Boston is. It’s a great time to exercise outside, and we think people will have a lot of fun with these options.”

According to the press release, a complete schedule is available at BostonMovesForHealth.org. The Boston Public Health Commission will also be tweeting about upcoming classes from @HealthyBoston, using the #BostonMoves hashtag. No advanced sign-up is necessary, and everyone is free to just drop-in. With this many free fitness classes available this summer, there are no excuses for not giving them a try.

Myth and Facts about Lightning

Summer is the peak season for lightning-related deaths and injuries, though people are struck by lightning year-round. 

The National Weather Service provides a wide range of information about lightning, including these facts and tips:


General Tips

  • No outdoor area is safe when you hear thunder.
  • If you hear thunder, find a safe indoor shelter (a substantial building or enclosed, metal-topped vehicle with the windows up).


Indoor Safety Tips

  • Stay off corded phones, computers, and other electrical equipment.
  • Avoid plumbing, including sinks, baths, and faucets.
  • Stay away from porches, windows, and doors.
  • Never lie on concrete floors or lean against concrete walls.


Outdoor Safety Tips

No outdoor area is safe during a thunderstorm, but if you’re caught outside with no safe shelter options, take these steps to reduce your risk of being struck by lightning:

  • Come down from elevated areas.
  • Never lie flat on the ground.
  • Never shelter under an isolated tree.
  • Never use a cliff or rocky overhang for shelter.
  • Immediately get out and away from ponds, lakes, and other bodies of water.
  • Stay away from objects that conduct electricity, such as wire fences.

Read some interesting myths and facts about lightning: 

Myth: Lightning never strikes the same place twice.
Fact: Lightning often strikes the same place repeatedly, especially if it’s a tall, pointy, isolated object. The Empire State Building is hit nearly 100 times a year.

Myth: If it’s not raining or there aren’t clouds overhead, you’re safe from lightning.
Fact: Lightning often strikes more than three miles from the center of the thunderstorm, far outside the rain or thunderstorm cloud. “Bolts from the blue” can strike 10-15 miles from the thunderstorm.

Myth: Rubber tires on a car protect you from lightning by insulating you from the ground.
Fact: Most cars are safe from lightning, but it is the metal roof and metal sides that protect you, NOT the rubber tires. Remember, convertibles, motorcycles, bicycles, open-shelled outdoor recreational vehicles and cars with fiberglass shells offer no protection from lightning. When lightning strikes a vehicle, it goes through the metal frame into the ground. Don’t lean on doors during a thunderstorm.

Myth: A lightning victim is electrified. If you touch them, you’ll be electrocuted.
Fact: The human body does not store electricity. It is perfectly safe to touch a lightning victim to give them first aid. This is the most chilling of lightning Myths. Imagine if someone died because people were afraid to give CPR!

Myth: If outside in a thunderstorm, you should seek shelter under a tree to stay dry.
Fact: Being underneath a tree is the second leading cause of lightning casualties. Better to get wet than fried!

Myth: If you are in a house, you are 100% safe from lightning.
Fact: A house is a safe place to be during a thunderstorm as long as you avoid anything that conducts electricity. This means staying off corded phones, electrical appliances, wires, TV cables, computers, plumbing, metal doors and windows. Windows are hazardous for two reasons: wind generated during a thunderstorm can blow objects into the window, breaking it and causing glass to shatter and second, in older homes, in rare instances, lightning can come in cracks in the sides of windows.

Myth: If thunderstorms threaten while you are outside playing a game, it is okay to finish it before seeking shelter.
Fact: Many lightning casualties occur because people do not seek shelter soon enough. No game is worth death or life-long injuries. Seek proper shelter immediately if you hear thunder. Adults are responsible for the safety of children.

Myth: Structures with metal, or metal on the body (jewelry, cell phones,Mp3 players, watches, etc), attract lightning.
Fact: Height, pointy shape, and isolation are the dominant factors controlling where a lightning bolt will strike. The presence of metal makes absolutely no difference on where lightning strikes. Mountains are made of stone but get struck by lightning many times a year. When lightning threatens, take proper protective action immediately by seeking a safe shelter – don’t waste time removing metal. While metal does not attract lightning, it does conduct it so stay away from metal fences, railing, bleachers, etc.

Myth: If trapped outside and lightning is about to strike, I should lie flat on the ground.
Fact: Lying flat increases your chance of being affected by potentially deadly ground current. If you are caught outside in a thunderstorm, you keep moving toward a safe shelter.

*Courtesy of the National Weather Service

Summer Safety Tips for Children from the Department of Public Health!

BOSTON – Thursday, June 27, 2013 – As schools across the Commonwealth release for the summer, the Department of Public Health would like to remind families and caregivers about important information that will help keep young children safe this summer.

Infants, toddlers and young children (ages 0-5 years) are generally not aware of dangers around them and depend on adults to keep them safe. During warm weather, take steps to encourage water safety, especially around pools, prevent falls from windows and keep children safe in cars. Simple safety steps can prevent injury.

Water and Pool Safety 1, 2

Children have a natural curiosity and attraction to water. However, drowning is a leading cause of death among young children, both nationally and in Massachusetts.

Backyard pools, whether inground or above ground are the highest risk for children under the age of 5.  To help prevent water-related injury and drowning:

  • Children should be supervised in and around water at all times.
  • Designate an adult “water watcher.”  When it is your turn as “water watcher” you should not be involved in any other distracting activity, including talking on the phone, not even for a moment.
  • Whenever infants and toddlers are in or around water, including the bathtub, an adult should be within an arm’s length at all times providing “touch supervision.”
  • Do not drink alcohol while supervising children.
  • Install a four-sided pool fence that completely separates the house and play area of the yard from the pool area.
  • After the children are done swimming, secure the pool so they cannot get back in.
  • Consider additional barriers such as automatic door locks or alarms to prevent access or notify you if someone enters the pool area.
  • Remove floats, balls and other toys from the pool after use so that children are not tempted to reach for them.
  • Keep rescue equipment (such as a shepherd’s hook or life preserver) and a telephone by the pool.
  • For children who cannot swim, use Coast Guard approved life jackets.  Do not use air-filled or foam toys, such as “water wings,” “noodles” or inner-tubes, in place of life jackets.  These toys are not designed to keep swimmers safe.
  • Learn cardiopulmonary resuscitation (CPR). The Red Cross offers a wide selection of CPR/AED, first aid, lifeguarding, swimming and water safety, caregiving, disaster response and emergency preparedness training. For information on classes, visit www.bostonredcross.org.

Additionally, when swimming in public swimming areas:

  • Select swimming sites that have lifeguards, whenever possible.
  • Swim only in designated swimming areas.
  • Do not use air-filled or foam toys, such as “water wings,” “noodles” or inner-tubes, in place of life jackets (personal flotation devices). These toys are not designed to keep swimmers safe.
  • Always swim with a buddy.

Teach your children to swim.  Although swimming classes are not a primary means of drowning prevention, teaching children to swim can provide important protection as well as a fun way to exercise.

Window Safety

Falls are the leading cause of injury to children, and falls from windows involving young children are especially serious. Window falls are preventable. In order to prevent window falls, parents and caregivers should:

  • Keep low furniture and anything a child can climb on away from windows.
  • Open windows from the top, not the bottom, when possible.
  • Lock all unopened doors and windows.
  • Be sure children are always supervised.
  • Install quick release window guards; screens do not protect children from falling out of windows. You can buy quick-release window guards in most hardware stores.

Car Safety 3

Cars can be unsafe – and not just because of car crashes. Children left in a hot car can die from overheating. The National Highway Traffic Safety Administration estimates that a closed car, sitting in the summer sun, quickly turns into an oven, with temperatures rising from 78 degrees to 100 degrees in just three minutes and to 125 degrees in six to eight minutes. In addition, children can be injured while getting out of moving cars or be run or backed over by motor vehicles. To assist in keeping your young children safe in and around cars:

  • Never leave children alone in a parked vehicle, even when they are asleep or restrained, and even if the windows are open.
  • Make a habit of looking in the vehicle – front and back – before locking the door and walking away.
  • If a child is missing, check the vehicle first, including the trunk.
  • Do things to remind yourself that a child is in the vehicle, such as placing your purse, briefcase or something else you need in the back seat so that you will have to check the back seat when you leave the vehicle.
  • Always lock your car and keep the keys out of children’s reach.
  • Ensure adequate supervision when children are playing in areas near parked motor vehicles.
  • Ask your childcare provider to call you if your child does not show up for childcare.

If you see a child alone in a hot vehicle, call the police. If they are in distress due to heat, get them out as quickly as possible. Cool the child rapidly. Call 911 or your local emergency number immediately.

Please remember, all children ages 12 and younger should ride in the back seat. Be sure they are properly restrained every time they ride with you – even during those quick trips to the corner market. Infants and toddlers should remain in rear-facing car seats until they reach the highest weight or height allowed by their car safety seat’s manufacturer. At a minimum, children should ride rear-facing until they have reached at least one year of age and weigh at least 20 pounds.

References

1. Centers for Disease Control and Prevention. Water-related Injuries: Fact Sheet. Accessed at http://www.cdc.gov/HomeandRecreationalSafety/Water-Safety/waterinjuries-factsheet.htm.

2. American Academy of Pediatrics, Committee on Injury, Violence, and Poison Prevention, Policy Statement Prevention of Drowning in Infants, Children, and Adolescents, PEDIATRICS Vol. 112 No. 2 August 2003, pp. 437-439.

3. National Highway Traffic Safety Administration, Keeping Kids Safe, Hyperthermia and Heat Stroke. www.nhtsa.dot.gov/portal/site/nhtsa. Accessed June 18, 2009.

PTSD linked to a doubling in heart disease risk later in life

With many people in the Boston now grappling with post traumatic stress disorder after the marathon bombings, a new study suggests that the condition is associated with an increased heart disease risk down the road.

A growing body of research has found that those currently suffering from chronic panic attacks, flashbacks, and sleeplessness related to a previous trauma—all signs of PTSD—have higher rates of heart problems. But the new research, funded by the National Heart Blood and Lung Institute, was designed to see whether PTSD does long term damage to the heart that manifests itself years later.

The Emory University researchers recruited volunteers from a database of male twins who served in the Vietnam War where one twin in the pair had PTSD at some point after the war while the other twin did not. The researchers found that those who had PTSD were more than twice as likely to have developed heart disease during the 13 year study than their twin who never had PTSD.

Nearly 23 percent of the PTSD sufferers had a heart attack, hospitalization for a blocked artery, or signs of heart disease on imaging tests compared to 9 percent of those who never had PTSD.

“Our results were similar whether we were comparing fraternal or identical twins, which suggests that genetic factors don’t really play much of a role in this connection,” said study author Dr. Viola Vaccarino, an epidemiologist and internist at Emory University’s Rollins School of Public Health. The study didn’t include women, so it’s not known whether they would experience the same increase in heart risks associated with PTSD.

Researchers still aren’t certain how PTSD would lead to heart problems but it’s likely due to chronically high levels of stress hormones that increase blood pressure and pulse and may lead to artery damage and heart arrhythmias over time.

While Vaccarino does not think those with PTSD need to have extra heart screenings, she emphasized that they should be vigilant about having regular physicals with their primary care physician to assess heart disease risks like high blood pressure and elevated cholesterol and to keep these at healthy levels with medications if necessary.

“They should also think about ways of reducing stress using breathing exercises and meditation to calm their heart rate,” she said. “Engaging in regular physical activity is also beneficial for both their heart and their mind.” 

*Courtesy of Boston.com 

State House News – Device ban proponents say drivers need to go hands-free

Boston —

Supporters of a bill banning drivers from using handheld cell phones told lawmakers Wednesday it would make it easier to enforce the state’s texting while driving ban.

The Legislature’s Transportation Committee supported a handheld phone ban during the last legislative session, but the proposal died before making it to a vote in the full House or Senate. Lawmakers are again considering several bills, including one outlawing handheld cell phones while driving in school zones.

Rep. Denise Provost, a Somerville Democrat, said the existing texting ban is extremely difficult for police to enforce because drivers are still allowed to use their cell phones. Police who see someone punching keys on their phone cannot discern if the driver is texting, dialing a number, or typing on the Internet.

“As a pedestrian, I see a lot of bad driving that would probably improve if people would put down their cell phones and pay attention to the road,” Provost said.

Rep. Cory Atkins, a Concord Democrat, said if people are not holding the phone, “you eliminate the guessing by public safety officials who have to decide are they texting or are they dialing?”

Both Transportation Committee chairs said Wednesday they support a ban on handheld phones while driving.

“The committee has been clear in favor of this kind of limitation in the past, and we’ll see where we go,” committee co-chair Rep. William Straus (D-Mattapoisett) said during the hearing.

Committee Co-chair Sen. Thomas McGee (D-Lynn) said phone technology has advanced so much there is no need for someone to hold the device to use it.

“It makes sense we go to hands-free use in cars,” McGee told the News Service.

September marks the third anniversary of the state law banning texting while driving.

The law bans the act of sending or receiving mobile phone text messages while operating a vehicle, and also prohibits drivers under the age of 18 from using a mobile phone in any way while operating a motor vehicle. Police are allowed to pull over drivers if they suspect them of texting, without needing another suspected offense.

After its passage, some police officials said the law was going to be difficult to enforce since it allows adult drivers to type in numbers to make a phone call. If the Legislature had banned the use of all handheld devices, police officials said at the time, enforcement would have been easier.

When he signed the legislation in July of 2010, Gov. Deval Patrick called it “a step in the right direction,” and added he thought a full debate on whether to restrict all handheld cell phones should be the next step.

Atkins, who said she perennially testifies in favor of banning handheld cell phone use, acknowledged studies that point to distracted driving stemming from many sources, including children in the car. She argued there are levels of distraction.

“When I drive by people and they are in there reading away, that is a scary sight,” Atkins said.

Atkins, who is advocating for legislation she filed (H 3005), said she worries about young drivers who are more adept at using cell phones, “and they are on it all the time. And that really troubles me.”

In her years of driving, Atkins said, she has avoided accidents because she was taught to drive by a World War II history teacher who insisted “your hands are supposed to be at 10 and 2.” Atkins said she was able to turn the wheel fast during several dangerous situations because her hands were in the right position.

Atkins asked Transportation Committee members to move the proposal forward again. Rep. Joseph Wagner (D-Chicopee) filed similar legislation (H 3169) requiring hands-free mobile telephones while driving. Sen. Cynthia Creem (D-Newton) also filed a bill (S 1647) relative to hands-free cell phone devices, as did Sen. Mark Montigny (D-New Bedford) to prohibit mobile telephones while operating a motor vehicle (S 1682).

If lawmakers are hesitant to institute a total ban, Provost suggested her colleagues should push the idea forward incrementally by backing the ban on handheld phones while driving in school zones (H 3125). Another bill (H 3123), filed by Rep. Elizabeth Poirier, a Republican from Attleboro, would also prohibit cell phone use in school zones.

“At least consider prohibiting the use of cell phones in school zones where we have extremely vulnerable individuals,” Provost said.

Read more: http://www.wickedlocal.com/weymouth/newsnow/x986308876/State-House-News-Device-ban-proponents-say-drivers-need-to-go-hands-free#ixzz2XQH65s65
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