2012-03-15
2012-03-14
Advertise on NYTimes.com Surgery for Epilepsy Gains Urgency in Trial
Researchers studied a group of 38 epilepsy patients, randomly assigning 15 to brain surgery and 23 to continued medical treatment. The surgery involves the removal of a piece of tissue about the size of a walnut from the temporal lobe, the part of the brain just above the ear. The surgery has been performed for many years, but the institution of high-resolution M.R.I. and microsurgical techniques have greatly improved its safety and efficacy.
...The patients in both groups were similar in age, duration of epilepsy, the number of antiepileptic drugs used and the number of seizures they had had. All had been taking drugs for one to two years without relief. The participants were seen at the study site every three months for two years after the start of the study. A group of specialists who did not know which patients had had surgery evaluated them for seizure type and severity as recorded in patient diaries. The study appears in the March 7 issue of The Journal of the American Medical Association.
None of the 23 patients in the medication group and 11 of 15 in the surgical group were free of seizures during the second year of follow-up. Almost all of the surgical patients continued their drug regimen after their operations, which is the standard approach. After that point, if there are no seizures, patients can taper off the medicine...
...The patients in both groups were similar in age, duration of epilepsy, the number of antiepileptic drugs used and the number of seizures they had had. All had been taking drugs for one to two years without relief. The participants were seen at the study site every three months for two years after the start of the study. A group of specialists who did not know which patients had had surgery evaluated them for seizure type and severity as recorded in patient diaries. The study appears in the March 7 issue of The Journal of the American Medical Association.
None of the 23 patients in the medication group and 11 of 15 in the surgical group were free of seizures during the second year of follow-up. Almost all of the surgical patients continued their drug regimen after their operations, which is the standard approach. After that point, if there are no seizures, patients can taper off the medicine...
2012-03-13
Who Should Treat Stroke?
David Sacks, Journal of Neurointerventional Surgery: ...There is no question that acute stroke is a major health problem, with about 800 000 strokes per year in the USA alone. Most stroke victims do not have a good recovery. US stroke healthcare costs are $41 billion a year.[1] Dollar amounts do not capture the suffering of the patient, family and friends for the death, disability and loss of independence caused by strokes. There is again no question that strokes are best prevented, but 800 000 strokes a year creates a huge need for emergency stroke treatment, including by endovascular means...
The Bottom Line is Patient Care
IA stroke therapy is highly beneficial if performed well by adequately trained physicians on appropriately selected patients. Take away any one of these three elements and benefit may become harm. Not every hospital should offer an IA stroke program. It requires tremendous resources, organization and commitment. Institutional competency is as important as physician competency. There is general (although not uniform) agreement that IA stroke is underserved within communities—24×7×365 coverage requires additional manpower. A training curriculum, combined with mastery of training and documentation of satisfactory clinical outcomes compared with national benchmarks, will confirm the skill of the endovascular stroke physician. It is time to stop looking from the perspective of an individual specialty. Vascular surgeons, cardiologists, IR, interventional neuroradiologists, interventional neurologists and neurosurgeons treat carotid disease. Endoscopy is performed by gastroenterologists, general surgeons and colorectal surgeons. Vertebral augmentation is performed by IR, interventional neuroradiologists, orthopedic surgeons, neurosurgeons and anesthesiologists. IA stroke revascularization already is, and will continue to be, performed by physicians from multiple specialties. Our commitment needs to be focused on adequate training and confirmation of good outcomes.
...
The Bottom Line is Patient Care
IA stroke therapy is highly beneficial if performed well by adequately trained physicians on appropriately selected patients. Take away any one of these three elements and benefit may become harm. Not every hospital should offer an IA stroke program. It requires tremendous resources, organization and commitment. Institutional competency is as important as physician competency. There is general (although not uniform) agreement that IA stroke is underserved within communities—24×7×365 coverage requires additional manpower. A training curriculum, combined with mastery of training and documentation of satisfactory clinical outcomes compared with national benchmarks, will confirm the skill of the endovascular stroke physician. It is time to stop looking from the perspective of an individual specialty. Vascular surgeons, cardiologists, IR, interventional neuroradiologists, interventional neurologists and neurosurgeons treat carotid disease. Endoscopy is performed by gastroenterologists, general surgeons and colorectal surgeons. Vertebral augmentation is performed by IR, interventional neuroradiologists, orthopedic surgeons, neurosurgeons and anesthesiologists. IA stroke revascularization already is, and will continue to be, performed by physicians from multiple specialties. Our commitment needs to be focused on adequate training and confirmation of good outcomes.
...
2012-03-01
Understanding the brain on dance
How does the brain perceive and interpret beautiful movement?
Dr Emily Cross' research focuses on the relatively new field of science called neuroaesthetics which looks at how the brain perceives artistic endeavours.
Contemporary dancer Riley Watts was filmed dancing in a variety of settings, including a 3D motion-capture studio. He then underwent a functional MRI brain scan while simultaneously watching videos of himself dancing.
The pilot experiment will provide a window into what Mr Watts' brain is doing as he watches the videos of himself dancing.
The fMRI data will show what the professional dancer actually perceives when he sees himself moving in very complex ways; whether he is happy with that movement or not, and how his brain differentiates between the various different dancing contexts.
Think Like a Doctor: Doubled Over in Pain
The summary of a patient suffering from horrible abdominal pain that sent him to two different hospitals three times in two weeks.
Some of the laboratory reports and images ordered by the doctors who originally were faced with this medical mystery are provided.
Some of the laboratory reports and images ordered by the doctors who originally were faced with this medical mystery are provided.
2012-02-09
Four Steps to Erase Chronic Pain without Toxic Addictive Medications
Institute of Medicine estimates, that some 116 million Americans have moderate to severe chronic pain.
Dr. Josh Wagner, a Manhattan chiropractor and founder of The Life House Chiropractic suggests simple steps which help relieve and eliminate chronic pain—safely and naturally:
1. Honor the Spine: Unlocking the spine and de-stressing the nervous system so it can run at its full potential is the key to naturally healing the body of chronic pain.
2. Posture Matters: Poor posture doesn’t just look bad, it can result in backaches, headaches, and nerve irritation that leads to even more pain throughout the body. Here’s a simple but powerful way to improve your posture: visualize the posture of a person who’s feeling optimistic and energized (rather than someone who’s depressed or lethargic), and let your body re-align to that good feeling.
3. Drink Up: Dehydrated muscles become more stressed and tense, which can exacerbate any pain you’re feeling. Be sure to drink at least half your body weight in pure water each day (i.e., if you’re 150 lbs, drink 75 ounces) to greatly enhance your overall well being and body functioning. Reminder: Drinking caffeine or alcohol dehydrates the body, so increase your daily water intake accordingly.
4. Lay Off Daily Pain Killers: Pain is like your body’s fire alarm, warning you that something is wrong. Taking daily pain killers is like unplugging the fire alarm, instead of putting out the fire. Worse, the pain is telling you what Not to do.
Dr. Josh Wagner, a Manhattan chiropractor and founder of The Life House Chiropractic suggests simple steps which help relieve and eliminate chronic pain—safely and naturally:
1. Honor the Spine: Unlocking the spine and de-stressing the nervous system so it can run at its full potential is the key to naturally healing the body of chronic pain.
2. Posture Matters: Poor posture doesn’t just look bad, it can result in backaches, headaches, and nerve irritation that leads to even more pain throughout the body. Here’s a simple but powerful way to improve your posture: visualize the posture of a person who’s feeling optimistic and energized (rather than someone who’s depressed or lethargic), and let your body re-align to that good feeling.
3. Drink Up: Dehydrated muscles become more stressed and tense, which can exacerbate any pain you’re feeling. Be sure to drink at least half your body weight in pure water each day (i.e., if you’re 150 lbs, drink 75 ounces) to greatly enhance your overall well being and body functioning. Reminder: Drinking caffeine or alcohol dehydrates the body, so increase your daily water intake accordingly.
4. Lay Off Daily Pain Killers: Pain is like your body’s fire alarm, warning you that something is wrong. Taking daily pain killers is like unplugging the fire alarm, instead of putting out the fire. Worse, the pain is telling you what Not to do.
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