Is Your Student Safe?

teacher-running-with-aedThe beginning of another school year means the beginning of school sports including football, soccer, cross country and swimming. All too often, school sports result in injuries to athletes and, in some cases, incidents of sudden cardiac arrest (SCA). Although SCA in athletes makes the headlines, it’s important to know that SCA can happen to anyone including a seemingly healthy child.

Sudden cardiac arrest in a young person usually stems from a structural defect in the heart or a problem with the heart’s electrical circuitry. The most frequent cause, accounting for about 40% of all cases, is hypertrophic cardiomyopathy or HCM.

HCM is a genetic heart condition that affects 1: 500 individuals, including men, women and children of all ages. HCM is characterized by a thickening of the heart muscle and can lead to sudden cardiac arrest.

sca incidenceApproximately 50% of individuals with HCM experience no symptoms, and don’t even know they have the condition, until tragically, sudden cardiac arrest occurs.  In 9:10 cases the outcome is fatal, resulting in unimaginable grief for families and fellow students.  Yet better outcomes can be achieved with early electrical stimulation of the heart – delivered by a small, fully automated, easy to use box.

Given that educational institutions house more than 20% of the American population every day, you’d think they would be fully prepared for this eventually. But sadly, they are not.

At the time of writing, only 19: 50 states in the U.S. require that at least some of their schools have automated external defibrillators [AED’s].  In some states, AEDs are required in public, but not private schools. In other states, AEDs are required in high schools, but not elementary schools. Some states require AEDs only in schools offering athletics. Only two states – Hawaii and Oregon – require AEDs in colleges.

To find out whether your state requires AEDs in schools, click here to view an interactive map.

Chain of Survival full sizeAlthough schools and colleges are ideal and obvious locations for AED deployment, concerns regarding legal liability and litigation have been perceived as a barrier to purchasing and deploying AEDs.  Fortunately this is slowly changing.  Recognition of the need to protect youth from sudden cardiac arrest is gaining momentum in many states:

In Pennsylvania, Sen. Andrew Dinniman has sponsored Senate Bill 606, Aidan’s Law, named for Aidan Silva, a seven-year-old Chester County resident who succumbed to SCA in September 2010.  Aidan had no symptoms of a heart condition prior to his death. Aidan’s Law will help ensure that every public school in Pennsylvania has an AED that is up to date and ready to use.

Rep. Connie Pillich, of Cincinnati, has introduced a bill focused on SCA in student athletes. House Bill 180 requires the Ohio Department of Health and the Ohio Department of Education to jointly develop guidelines and materials to educate students, parents and coaches about SCA. The measure bans a student from participating in a school-sponsored athletic activity until the student submits a signed form acknowledging receipt of the guidelines and materials created by the health and education departments. Individuals would not be allowed to coach a school-sponsored athletic activity unless the individual has completed, within the previous year, a sudden cardiac arrest training course approved by the health department.

John Ellsessar, whose son Michael died during an Oxford High School football game in 2010 from cardiac arrest, believes automated external defibrillators should be as readily available at school settings as fire extinguishers.

Ellsessar, is pushing for legislation to require all schools to have defibrillators, said he and his wife were horrified when they learned that at most schools that have the medical devices, but they are locked away in nurses’ offices, instead of being ready for emergencies.

CPR-AED-lgAnd in Rhode Island, high school seniors will be required to be trained in CPR and the use of a defibrillator before they can graduate. Under the legislation signed into law by Gov. Lincoln Chafee, students will receive training that includes a hands-on course in cardiopulmonary resuscitation and an overview of the use of an AED.

The National Parent Teacher Association has also adopted a resolution calling for public schools to develop emergency response plans that include summoning help, performing CPR and using automated external defibrillators to save lives. The PTA also called for ongoing CPR-AED training in schools and legislation that would fund placement of AEDs in every school, while providing immunity for people who use the lifesaving devices in good faith.

To learn more about sudden cardiac arrest and how you can help please visit http://www.sca-aware.org

SRxA-logo for web

Sleep Better, Look Better

wake up beautifulGetting treatment for a common sleep problem may do more than help you sleep better – it may help you look better too. So says new research study from the University of Michigan Health System and Michigan Technological University.

And it’s more than just being being bright-eyed after a good night’s rest.  For the first time, researchers have shown specific improvement in facial appearance after at-home continuous positive airway pressure [CPAP] treatment for sleep apnea.

Sleep apnea affects millions of adults, many of them undiagnosed.  It is a condition marked by snoring and breathing interruptions and can put sufferers at higher risk for heart-related problems and daytime accidents.

Using a sensitive “face mapping” technique usually used by surgeons, and a panel of independent appearance raters, the researchers detected changes in 20 middle-aged apnea patients just a few months after they began using CPAP to help them breathe better during sleep and overcome chronic sleepiness. CPAP also helps to stop snoring, improve daytime alertness and reduce blood pressure.

patient_cpap_frustratedWhile the research needs to be confirmed by larger studies, the findings may help sleep apnea patients comply with their treatment.  Compliance is a challenge for some because of the cumbersome breathing mask they have to wear to bed.

Sleep neurologist Ronald Chervin, M.D., M.S., director of the U-M Sleep Disorders Center, led the study, which has just been published in the Journal of Clinical Sleep Medicine.

Chervin says the study grew out of the anecdotal evidence that sleep center staff often saw in sleep apnea patients when they came for follow-up visits after using CPAP.

The common lore, that people ‘look sleepy’ because they are sleepy, and that they have puffy eyes with dark circles under them, drives people to spend untold dollars on home remedies,” notes Chervin. “We perceived that our CPAP patients often looked better, or reported that they’d been told they looked better, after treatment. But no one has ever actually studied this.”

They teamed with U-M plastic and reconstructive surgeon Steven Buchman, M.D., to use a precise face-measuring system called photogrammetry to take an array of images of the patients under identical conditions before CPAP and again a few months after.

The technology used in this study demonstrates the real relationship between how you look and how you really are doing, from a health perspective” says Buchman.

sleepyfacehires1The researchers also used a subjective test of appearance. 22 independent raters were asked to look at the photos, without knowing which were the “before” pictures and which the “after” pictures of each patient. The raters were asked to rank attractiveness, alertness and youthfulness – and to pick which picture they thought showed the patient after sleep apnea treatment.

About two-thirds of the time, the raters stated that the patients in the post-treatment photos looked more alert, more youthful and more attractive. The raters also correctly identified the post-treatment photo two-thirds of the time.

Meanwhile, the objective measures of facial appearance showed that patients’ foreheads were less puffy, and their faces were less red, after CPAP treatment. The redness reduction was especially visible in 16 Caucasian patients.

However, they didn’t see a big change in facial characteristics often associated with sleepiness. “We were surprised that our approach could not document any improvement, after treatment, in tendency to have dark blue circles or puffiness under the eyes,” says Chervin. “Further research is needed, to assess facial changes in more patients, and over a longer period of CPAP treatment.”

I don’t have sleep apnea but if CPAP makes you look younger, more attractive and alert, tell me where do I sign up?!?

SRxA-logo for web

School is in Session and So Too Are Germs

calculusWhile many parents don’t remember much algebra or calculus, most know all too well that school + kids = sick days.

And with more than 200 cold viruses identified,  it’s no wonder parents feel like they are fighting a losing battle when it comes to keeping their kids healthy.

Kids will be exposed to germs and inevitably get colds, even with the best preventive measures, and that’s OK,” said Jessica McIntyre, MD, family physician at Loyola University Health System and assistant professor in the Department of Family Medicine at Loyola University Chicago Stritch School of Medicine.

According to McIntyre, young children will get between 7 and 8 colds a year and school-age children will average 5-6 colds a year. Kids tend to get more colds during the school year because they are in an enclosed classroom surrounded by other children who are sharing these very common viruses.

Parents sometimes worry that they have done something wrong to cause frequent colds, or that their child is not healthy. Actually, cold viruses help build a child’s immune system and are an unavoidable part of growing up,” McIntyre said.

smackdown_school_germs-e1317828551255Nevertheless, we bring you some tips to help keep your child’s sick days to a minimum

  1. You’ve taught your kids their ABCs –  now teach them their CCCs?
    a. Clean – wash your hands and make sure your kids wash their hands frequently
    b. Cover – cover your cough and sneeze, preferably with a tissue, but if one is not available, cough or sneeze into your elbow
    c. Contain – stay at home if you are sick; germs are one thing that aren’t good to share
  2. Family flu vaccines. Everyone who is 6 months or older should be vaccinated. Talk to your physician about which type of vaccine is right for your family members.
  3. Have your children wash their hands as soon as they get home from school.
  4. Change into “home clothes and shoes.”  It helps keep germs, allergens and dirt out of the house making it easier to keep clean. Plus, you won’t be searching the house for shoes that were kicked off under the couch.This is especially beneficial if you have a young infant at home
  5. Wash their lunch box daily. Lunch boxes carry more than veggies and fruit to and from school. They also carry A LOT of germs. If they’re dishwasher safe, run them through the sanitizing cycle at the end of each day. If not, spray them down with vinegar and water and wipe them clean before packing a new lunch
  6. Backpacks are another huge germ culprit. They make their way onto tables, beds and desks and can transfer nasty germs to all of these surfaces. Wash backpacks once a week to minimize the spread of germs.
  7. Reduce consumption of sugary foods before and during school. Consuming just a teaspoon of sugar weakens the immune system for up to 4 hours. To help the body fight germs, make sure to offer a low sugar breakfast and low sugar lunch. Avoid processed foods as much as possible. They are generally loaded with sugars.

big-stinky-germsAnd if you’d still like to do more to keep your little darlings safe, there is some evidence that certain  products can be effective in cold prevention if taken regularly:
(i) Probiotics: 1 gram mixed with milk twice daily
(ii) Vitamin C: 1 gram daily
(iii) Zinc sulfate: 15 mg syrup or 10 mg tablet daily

Despite all that, if they do develop a cold, don’t stress about it!  Everyone gets sick sometimes. And while we all hate to see  kids feeling bad, just remember, when they get sick their bodies are building up their ability to fight future infections.

SRxA-logo for web

A Call to End Religious Nutrition

lowcarbQ: “How can you tell if a friend is on a gluten-free diet?”

A: “They’ll tell you.”

Again and again and again… Same joke goes for paleo, low-carbvegan and pretty much any organized dietary strategy that has a defining name and movement behind it.

Along with politics, gun rights, religion and abortion, is one of those areas where people feel comfortable not only sharing their views but do so with incredible conviction, passion and certainty. And yet, nutrition is anything but certain.  Sure, we know there are patterns of eating that help in minimizing the risk of various chronic diseases, but those patterns are far broader and less drilled down than most nutrition gurus and zealots believe.

So, we were very interested in fellow blogger –Yoni Freedhoff’s – recent blog in which he calls for an end of nutrition as religion.  More so, because Yoni is not just another disillusioned dieter. No siree!  He is the Medical Director of the Bariatric Medical Institute and assistant professor of family medicine at the University of Ottawa.  Dr. Freedhoff has also been called Canada’s most outspoken obesity expert and his award winning blog, Weighty Matters, has at times been ranked the world’s top health blog by blog ranking service Technorati.

So what does Dr Freedhoff have to say?

First, he suggests that practitioners of dietary religion risk alienating friends through strict adherence to their religious commandments.  Second, he states that diet adherents tend to use their online platform to frown upon any and all dietary strategies beyond their house of worship. To question their program or guru’s plans is akin to questioning their religious beliefs; and yet, unlike actual religious questioning (which would almost certainly lead to a thoughtful discussion), question dietary dogma online, and you can bet it will lead to a highly heated debate where anger and indignation can easily descend into name calling and personal attacks.

jesus toastAnd even if you religiously avoid all cyber nutrition nuts, you may still be at risk. According to Freedhoff, although you may not have a stranger’s zealous scrutiny to watch out for, you’ve still got yourself. Dietary dogma, almost by definition, dictates blind faith and absolute loyalty, where breaking a dietary commandment is akin to committing a sin. And with sin, comes guilt. And if you feel guilt often enough, you might well decide to abandon your entire healthier-living, guilt-inducing effort.

Nutrition as religion demands perfection, yet perfection is an impossible goal. Remember, food is not simply fuel. Since the dawn of humankind, food has been used for comfort and celebration, and if your newly found dietary religion forbids foods you enjoy, my bet is you’re not long for that diet.

diet tapemeasureSo what’s the solution?  Freedhoff advises : the easiest question to evaluate any dietary plan or religion is simply, “Could I happily live like this for the rest of my life?” where the most important word in that question is “happily.” If the answer’s “No,” you’ve either got to get comfortable with adding in some sinning, or find another way to go.

Add in some sinning in the form of thoughtful, “worth-it,” dietary imperfections, and suddenly new lifestyles may transform from the merely tolerable to the actually enjoyable. Enjoy your lifestyle, albeit imperfectly, and maybe you’ll even stick with it.

Nutrition isn’t religion. Eat the healthiest diet that you can enjoy, because if you’re not enjoying it, it isn’t going to last, and tolerable isn’t good enough.

Go on, sin a little, on us. The good doctor will forgive you enough to forgive yourself.

SRxA-logo for web

Shining a New Light on Cardiac Arrhythmias

light-bulb-idea-300x240With a few flicks of a light switch Stanford University’s Oscar Abilez is one step closer to changing the lives of millions.

Currently, four million Americans suffer from some degree of cardiac arrhythmia. In some, the heart beats too slowly, in others, too quickly or at irregular intervals, resulting in shortness of breath, fainting and even death.

While pacemakers and implanted defibrillators can be used to correct arrhythmias, these small mechanical devices come with risks. Patients must undergo invasive surgical procedures to permanently implant the devices, which can cause cardiac tissue damage. There are other challenges too, such as lifestyle limitations and the occasional battery malfunction.

It’s like using a cannon to kill an ant,” says Leon Esterowitz, director of the National Science Foundation’s Directorate for Engineering’s Biophotonics program.

Doctors and patients alike have been searching for a better solution.

optics heartAnd now they may have one.  Abilez, a cardiovascular physician with a doctorate in bioengineering, and his team have demonstrated that they can control the rhythm of the heart using light alone. In laboratory experiments the Stanford scientists are able to make heart cells expand and contract simply by switching light on and off.

This novel biological pacemaker was one of 40 new projects funded by the National Science Foundation’s INSPIRE initiative.

The project, Optogenetic Control of the Human Heart-Turning Light into Force, involves two seemingly disconnected and developing technologies: optogenetics and stem cells.

At first glance optogenetics seems more like a magic trick than science, using just flashes of light to control a targeted group of cells.

Only a few organisms, such as algae, have naturally light sensitive cells. In 2002, however, scientists in Germany were able to isolate the genes for the proteins – called opsins – responsible for cells’ light sensitivity and modify the genetic code of other cells so that they too would produce opsins.

Once produced, the opsins act like small hatches on the surface of a cell. When light shines on them, the hatches either open or close depending on the type of opsin they are. If the hatches open, electrical signals are able to flow through the cell and be translated into some action, such as regulating a heart.  In 2005, Karl Deisseroth MD, PhD and colleagues, also at Stanford, were able to genetically introduce opsins into neurons and control these cells with light; this work and subsequent work has led to the field of optogenetics.

optogeneticsAbilez’s grand vision is to take stem cells from a person suffering from cardiac arrhythmia and convert the cells into light sensitive cells that are responsible for pacemaker functions in the heart. These genetically modified cardiomyocytes would then be grafted onto a person’s heart and enable doctors to control the heart’s rhythm using light.

The applications can be of very high reward,” says Natalia Trayanova, director of John Hopkins University’s Computational Cardiology Lab. “Current high-energy defibrillation is painful, traumatic and has been associated with a higher rate of mortality. Wouldn’t it be nice to be able to shine a light on someone’s chest and defibrillate them painlessly?”

Abilez has already successfully grown light sensitive cardiomyocytes. His next step is to test whether the lab-grown cells are accepted when coupled with a larger body of non-stem cell derived heart cells. If they are, then Abilez will be on his way to creating a less-invasive, longer-lasting treatment for arrhythmias.

Moreover, Abilez will have paved the way for optogenetic success in other fields. If he can successfully couple light-sensitive cells with normal cells, then his method of creating light-sensitive stem cells could be used by other researchers to grow any type of light-sensitive cell they wanted, from brain to pancreatic cells.

mice light brainOptogenetics has huge implications for medicine. Researchers have already shown that they can stop a seizure, cure anxiety and even implant fake memories into the minds of mice.

There still are risks involved in cardiac optogenetics. Such risks, exist not with the treatment itself but with the feasibility of its development and there are still major hurdles to overcome before any applications can be realized.

Abilez acknowledges such risk, saying that there is a chance the team will discover that their light-sensitive stem cells cannot control the heart as well as they hope. A large part of the research’s difficulty is that the team is in uncharted waters – they have no prior research on which to base their efforts.

We have to invent things along the way. We don’t have any precedent,” Abilez says.

So although we won’t be seeing these biological pacemakers anytime soon we think we speak for all cardiac arrhythmia patients when we say “Let there be light!”

SRxA-logo for web

The Spread of Superbugs

superbugs on the riseThe U.S. Centers for Disease Control and Prevention has just published a first-of-its-kind assessment of the threat the country faces from antibiotic-resistant organisms.

And the news is not good.  In fact it’s downright scary. The agency’s overall conservative assessment of the problem includes frightening statistics such as:

  • Each year, in the U.S., 2,049,442 illnesses caused by bacteria and fungi that are resistant to at least some classes of antibiotics
  • Each year, out of those illnesses, there are 23,000 deaths
  • Each year, those illnesses and deaths result in $20 billion of additional healthcare spending
  • Each year, an additional $35 billion lost to society in foregone productivity.

The report marks the first time the agency has provided hard numbers for the incidence, deaths and cost of all the major resistant organisms. It also represents the first time the CDC has ranked resistant organisms by how much and how imminent a threat they pose, using seven criteria:

  • health impact
  • economic impact
  • how common the infection is
  • how easily it spreads
  • how much further it might spread in the next 10 years
  • whether there are antibiotics that still work against it
  • whether things other than administering antibiotics can be done to curb its spread

antibiotic resistant bacteriaOut of that matrix, their top three “urgent” threats they identified were:

multi-drug-resistant-pseudomonas-aeruginosa-horizontal-galleryIn addition, the CDC identified 12 resistant bacteria and fungal infections which the agency dubs “serious” i.e., requiring “prompt and sustained action.”  They include the hospital-acquired infections  Acinetobacter, Pseudomonas aeruginosa, and Vancomycin-Resistant Enterococcus (VRE) ; the foodborne organisms CampylobacterSalmonella and Shigella; MRSACandida and TB.

The last category, “concerning” i.e., requiring “careful monitoring and prevention” includes rare but potent vancomycin-resistant staphylococcus aureus  (VRSA), as well as strains of streptococcus resistant to two different categories of drugs.

For each organism, the report explains why it is a public health threat, where the trends are headed, what actions the CDC is taking, and what it is important for health care institutions, patients and their families, and states and local authorities to do to help.

Commenting on the report, Ed Septimus MD, professor of internal medicine at Texas A&M Health Sciences Center in Houston says “It’s up to us to make the recommendations in this report happen. If we do nothing but say, ‘Here’s the problem,’ then the problem will continue to grow.”

Well said Doctor, well said.

SRxA-logo for web

Damping Down Diabetes

PrevalenceSRxA’s Word on Health was very excited to learn of some amazing new research coming out of UC San Francisco.  Scientists there have identified a new way to manipulate the immune system and keep it from attacking the body’s own molecules in autoimmune diseases such as type 1 diabetes, rheumatoid arthritis and multiple sclerosis.

More than 100 different autoimmune diseases have been discovered and they disproportionately affect women.  Of the 50 million Americans living and coping with autoimmune disease  more than 75% are women.  Autoimmune diseases are one of the top 10 leading causes of death of women under the age of 65 and are responsible for more than $100 billion in direct health care costs annually.   Crohn’s disease, ulcerative colitis, lupus, multiple sclerosis, rheumatoid arthritis, psoriasis and scleroderma by themselves account for > $50 billion.

eTACBut now, researchers, led by immunologist Mark Anderson, MD, PhD, a professor with the UCSF Diabetes Center, have discovered a type of immune cell called an extrathymic Aire-expressing cell (eTAC), which puts a damper on immune responses.  eTAC’s are a type of  dendritic cell – which make up less than 3% of the cells in the immune system. And, eTAC cells themselves account for a small fraction of all dendritic cells. eTACs reside in lymph nodes and spleen in both humans and mice.

In this study, Anderson’s team determined that eTAC’s can counteract the overactive immune response in autoimmune diseases and, in a mouse model of diabetes, can be manipulated to stop the destruction of the pancreas.

By displaying “self” molecules to T cells that target them, and permanently turning off these T cells, eTACs help the immune system tolerate the molecules naturally present within us.  “The mouse model we are working with involves using T cells that normally attack the islet cells of the pancreas, specifically by recognizing a molecule called chromagranin A that is present on islet cells,” Anderson said. “But if the eTACs can get to the T cells first and display chromagranin A, they can prevent T cells from attacking the islets.”

mouse diabetesAnderson aims to exploit eTACs therapeutically by finding out how to grow them in large numbers outside the body. “We need to figure out how to grow a lot of these cells, to load them up with whatever molecule it is that we want to induce tolerance to, and then to load them back into a patient,” he said. “Such a strategy could help selectively shut down an unwanted immune response, such as the anti-islet immune response in type 1 diabetes.”

Dendritic cells work with T cells a bit like a sheriff working with a bloodhound.  But instead of presenting an article of clothing, dendritic cells present a specific molecule. If the molecule displayed by the dendritic cell matches the one the T cell was born to target, then that T cell would be activated to expand its numbers and to attack cells or tissues where the molecule is present.

When the interaction is between eTACs and T cells, however, the targeted T cell instead is turned off forever, and never seeks its molecular prey.

Diabetes wordcloudGiven that the prevalence and incidence of and type 1 diabetes and other autoimmune diseases, such as Crohn’s, lupus and celiac disease are on the rise, this new research is extremely important, both from a public health and economic perspective.  With as many as three million Americans having type one diabetes and the incidence growing by more than 3% per year a cure is desperately needed.

SRxA-logo for web

Drinking our way to brain fitness

alcohol related dementiaAs we reported last week, drinking the occasional glass of wine might help to stave off depression. This week we learned how to better protect ourselves from that wine we’ve been drinking!

Previous studies have shown that long-term alcohol abuse increases the risk of dementia. But according to new research from Loyola University Chicago Stritch School of Medicine, omega-3 fish oil might help protect against alcohol-related dementia.

The Loyola study found that in the brain cells of rats exposed to high levels of alcohol, a fish oil compound protected against inflammation and cell death.

fish oilThe study by Michael Collins, PhD, and colleagues was reported Sept. 8 at the 14th Congress of the European Society for Biomedical Research on Alcoholism.  An earlier analysis by Collins and Loyola colleague Edward Neafsey, PhD, which pooled the results of 143 studies, found that moderate social drinking may reduce the risk of dementia and cognitive impairment.

It appears that small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate amounts stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia.

However, as always, moderation is the key! Too much alcohol overwhelms the cells, leading to inflammation and cell death. The study authors defined moderate as one drink per day for women and two for men.

mouse & fish oilIn the new study, Collins and colleagues exposed cultures of adult rat brain cells to amounts of alcohol equivalent to more than four times the legal limit for driving. These cell cultures were compared with cultures of brain cells exposed to the same high levels of alcohol, plus a compound found in fish oil called omega-3 docosahexaenoic acid (DHA).  Researchers found there was about 90% less neuroinflammation and neuronal death in the brain cells exposed to DHA and alcohol than in the cells exposed to alcohol alone.

Of course, being a health blog we should point out that the best way for an alcohol abuser to protect their brain is to quit drinking or to cut back to moderate amounts.  But as Collins says: “Fish oil has the potential of helping preserve brain integrity in abusers. At the very least, it wouldn’t hurt them.”

SRxA-logo for web

Kudos to Canada

HamiltonOntarioSkylineCThis morning, SRxA’s Word on Health salutes the Canadian city of Hamilton, Ontario, for its pioneering lead in anaphylaxis safety. Hamilton is destined to become the first city in the world to require all food service outlets to have life-saving epinephrine auto-injectors on hand for people with severe food allergies.

The move is being led by Hamilton Councillor  – Lloyd Ferguson, in hopes of avoiding sudden and tragic deaths like one this past spring of a Stoney Creek girl.

MaiaTwelve-year-old Maia Santarelli-Gallo had what her doctor said was a mild allergy to eggs and milk that had only ever caused her a runny nose. But last March, while eating an ice cream cone at a Hamilton-area mall with her father and older sister, Maia experienced a sudden, severe allergic reaction.

Her sister found someone with an epinephrine injector, but by the time it was administered, it was too late. Emergency crews took Maia to hospital but she was pronounced dead.

epipen dispenserWhen Councillor Ferguson heard about Maia’s death, he decided to draft a ground-breaking motion to get epinephrine auto-injectors in every restaurant and mall in the city.

He says it’s high time that food providers have access to medicines that could help their customers who develop allergic reactions. He says if automated external defibrillator (AEDs) are now being installed in arenas and other community centers, it makes sense to have epinephrine injectors in areas where food allergy reactions are most likely to occur.

AEDs in schoolsIt took us about 40 years to get defibrillators into public facilities and they have been a great success. This is the next step,” he says.

Allergy specialist Dr. Mark Greenwald, Allergist, and Chief Medical Officer of EpiCenter Medical would like to go further and see public awareness campaigns that would train the public on how to use epinephrine injectors, just as there have been campaigns encouraging people to learn CPR.

Greenwald has developed an online course called EpiPenTraining.com, to offer training on how to recognize allergic reactions, and how to use the injectors. He says such training is vital because during anaphylaxis, seconds count.

And anaphylaxis isn’t rare.  Allergic disease is the 5th most prevalent chronic disease among all ages, and the 3rd most prevalent among children. Every 3 minutes in North America, a food allergic reaction sends someone to the Emergency Room. Every 6 minutes, that Emergency Room visit is for anaphylaxis, that’s 10 patients per hour!

In 25% of people requiring treatment, the reaction is their first episode, and they are completely unprepared.  And for 50% of the people who die from anaphylaxis, the victims had life-saving epinephrine, but it wasn’t used or it wasn’t used in time. The other 50% didn’t carry epinephrine despite their previous allergic episodes.

SAVE certificateParticipants in the online course become SAVE certified – Save Anaphylaxis Victims in an Emergency.

Debbie Bruce of the Canadian Anaphylaxis Initiative was part of a program this past spring to get epinephrine injectors on all fire trucks in Mississauga. She says that like Maia, up to one-third of people who have allergic reactions outside the home did not realize they had a severe allergy and didn’t carry an epinephrine injector. She is now petitioning politicians  to come up with a national allergy plan.

I think it is a new reality,” she says. “Reactions happen and we need to be prepared.”

Maia’s mother, Leah Santarelli, backs all efforts to make the public more aware of anaphylaxis and hopes the Hamilton city council passes Ferguson’s motion.

There’s no guarantee that an EpiPen will save your life 100 per cent of the time, just like a defibrillator won’t save you 100 per cent of the time, but it is there as a safety measure,” she says.

The motion is currently being reviewed by the city’s health team; if approved, it should go before Hamilton city council in October.

We certainly hope that it does and that this trend will rapidly spread across the borders.  As Greenwald says – every second counts!

SRxA-logo for web

Heads Up on i-Concussion

NAU footballThere is a new face at Northern Arizona University (NAU) football games this fall.  No – not a new quarterback or coach – but a robot on wheels!

Making its debut at the season kick-off game against the University of Arizona in Tucson last Friday, the robot has the ability to assess a player for symptoms and signs of a concussion and to consult with sideline medical personnel thanks to a specialized camera system, remotely operated by a Mayo Clinic neurologist.

teleconcussion robot Mayo Clinic will be working with NAU to test the feasibility of using a telemedicine robot to assess athletes with suspected concussions during football games as part of a research study. With sophisticated robotic technology, use of a specialized remote controlled camera system allows patients to be “seen” by the neurology specialist, miles away, in real time.

Athletes at professional and collegiate levels have lobbied for access to neurologic expertise on the sideline. As we seek new and innovative ways to provide the highest level of concussion care and expertise, we hope that teleconcussion can meet this need and give athletes at all levels immediate access to concussion experts,” said Bert Vargas, M.D., a neurologist at Mayo Clinic who is heading up the research.

This study is the first to explore whether a remote neurological assessment is as accurate as a face-to-face evaluation in identifying concussion symptoms and making return to play decisions. Mayo Clinic physicians will not provide medical consultations during the study, they will only assess the feasibility of using the technology.

But, if it appears feasible, this may open the door for countless schools, athletic teams, and organizations without access to specialized care to use similar portable technology for sideline assessments.

teleconcussion robot 2As nearly 60% of U.S. high schools do not have access to an athletic trainer, youth athletes, who are more susceptible to concussion and its after-effects, have the fewest safeguards in place to identify possible concussion signs and symptoms at the time of injury. Teleconcussion is one way to bridge this gap regardless of when or where they may be playing.” Says Dr Vargas.

Others involved collegiate sports agree.

At NAU, our primary goal is to provide an outstanding student-athlete experience culminating in graduation,” says Dr. Lisa Campos, vice president for Intercollegiate Athletics at Northern Arizona University. “We charge our staff to research the most current and best practices to ensure the safety and care of our students. Partnering with the Mayo Clinic in its telemedicine study will further this research and potentially improve diagnosis for rural areas that may not have access to team doctors or neurologists. The study allows the NAU Sports Medicine Staff and team doctors to continue to make all diagnoses and return to play decisions for our students, while investigating the effectiveness and efficiencies of telemedicine. We are excited to have the teleconcussion robot on our sideline this fall.”

concussion_footballThere were a number of examples last football season where college football players clearly demonstrating concussion-like symptoms were quickly thrown back in games or weren’t even taken out of the game for an evaluation,” said Ramogi Huma, executive director of the National College Players Association. “College football players are in desperate need for independent concussion experts on the sidelines, and this study could help make that safeguard a reality.”

Telemedicine is not new to the Mayo Clinic in Arizona.  They first used the technology with the telestroke program in 2007, when statistics revealed that 40% of residents in Arizona did not live in an area where they were availed of stroke expertise. Since the telestroke program began nearly 3,000 emergency consultations for neurological emergencies have taken place.

We’ll be following the results of this study and will let you know the results as soon as they’re in.

SRxA-logo for web