10/24/2009

Rotary president-elect speaks out about polio


Attorney Ray Klinginsmith, from Kirksville, Mo., President-Elect of Rotary International, spoke to nearly 400 Rotarians and guests at the Abilene Christian University Hunter Welcome Center on Thursday evening.
The event was in conjunction with hundreds of other Rotary Clubs throughout world as they work together to wipe out polio. Guests came from Dallas, Fort Worth, Midland, and Big Spring in a concerted effort to raise money for eradication of polio in Afghanistan, Pakistan, India, and Nigeria. While the polio vaccine has virtually eradicated the disease in the United States, it is still a problem in some countries.Dr. Bob Hunter said he thought the dinner would raise at least $50,000.Klinginsmith said Bill and Melinda Gates have pledged $355 million for the new project. He said so far the Rotarians have raised about $97 million toward their new goal of 200 million. The Rotarians have raised more than $800 million from the time they started their immunization program several years ago. The Rotarians have played a major role in getting governments to contribute over $4 billion to their effort not only in the four selected countries, but in other countries as well.“World Polio Day is on Saturday, October 24,” Hunter said. “Rotary Clubs throughout the world are having dinners like this during this week.”Klinginsmith told the audience that Afghanistan had only 23 cases of polio in 2009, Nigeria 381 and Pakistan 62.
“India had 464 cases in 2009,” Klinginsmith said. “Our next immunization campaign will target 55 million children under five in India.” According to Hunter, this is the first time for an official of this stature in Rotarian International to visit Abilene. “Having the President-Elect of Rotary International is a great honor,” Hunter said. “It is also for a good cause.” Before the meeting, former Abilenian Heather Green Wooten, PhD, signed copies of her book, “The Polio Years in Texas,” published by Texas A&M Press. The book sold for $20. and a portion was donated to the Rotarian fund. Klinginsmith travels all over the world.
“There are 32,000 Rotary Clubs in more than 200 countries,” he said. “I will leave here for Chicago and then go to England, New Zealand, and Argentina.”
When he assumes the office of the president in July 2010, Klinginsmith will be traveling all year.
Tumbleweed Smith of Big Spring is a past district Rotary Governor.
“I have been speaking throughout Texas to raise funds,” the newspaper journalist and radio personality said. Klinginsmith reminded the group of how important it is to finish the job they started on polio years ago. The Rotarians team with the World Health Organization and other agencies to provide vaccines to young children in poor countries.
As the guests milled around for the reception before the speech, pictures of young children were exhibited in the hallway. The children were shown with crutches or taking therapy. When the polio hit Texas in 1930 through the 1950s, many children and adults died or were crippled.
Dr. Charles Nelson, and his wife, Betty, of Abilene know about polio first hand. Charles was stricken with polio in 1946 when he was twenty-two and a sophomore in college in Denton. He is now confined to a wheelchair, but it has not kept him from achieving his goals in life.
“I was in good health,” Charles said. “I had just returned from the Army in World War II and we were expecting our first child.” Charles said the vaccine was not available at that time, but when it came along we were elated. “We did not have to worry about our three children getting polio,’ he said. Charles spent six months in a hospital. “I was always active before polio hit,” he said.
Hunter said great strides had been made in getting rid of this disease.
“The Rotarians plan to rid the world of polio in our lifetime,” he said.
Klinginsmith said the total polio cases for 2009 were 1,198 as compared to 2008 with 1,651.
“We can see light at the end of tunnel,” Klinginsmith said.

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Klinginsmith, Ray is an attorney in Kirksville, Missouri, USA, who now works primarily in the areas of commercial and corporate law, real estate, and estate planning.  He retired in August of 1995 as General Counsel and Professor of Business Administration for Truman State University (formerly Northeast Missouri State University) in Kirksville after 22 years of service.  During his tenure at the University, he also served as Dean of Administration for a period of five years during the University’s transition to a liberal arts and sciences institution.  Since his retirement from the University, he served a four-year term as a county commissioner for Adair County from 2001 thru 2004.
 
Ray’s wife, Judie, is a former elementary school teacher in Macon and Kirksville and a former consultant for the Child Development Assistant program at the Kirksville Area Vocational Center.  Ray and Judie have two children, Leigh and Kurt, and three grandchildren, Morgan, Grant, and Sydney Perkins.  Ray is a graduate of the business school and the law school of the University of Missouri at Columbia.  He is a member of The Missouri Bar and has practiced law since 1965.  He was awarded the Thomas D. Cochran Community Service Award by the Young Lawyers Section of The Missouri Bar in 1983.
 
Ray has served as a director of the Macon Atlanta State Bank in Macon, Missouri, since 1971, and he was one of the initial trustees for the Missouri Family Trust, which was created by the Missouri legislature in 1989.  He has been the president of Chariton Valley Association for Handicapped Citizens since its organization in 1982, and he was accorded the 1988 Parent/Caretaker Award by the Missouri Planning Council for Developmental Disabilities.  He is a former member of the Executive Board for the Great Rivers Council of the Boy Scouts of America and the holder of its Silver Beaver Award for adult volunteers.  He is a member of the First United Methodist Church in Kirksville and a former lay speaker for the church. 
A Rotarian for more than 40 years, Ray is currently a member of the Kirksville Rotary Club.  He studied at the University of Cape Town as a Rotary Foundation ambassadorial scholar in 1961, and when he was elected to the board of directors for Rotary International in 1984, he became the first recipient of a Rotary Foundation award to serve on the RI board.  He served as a Trustee of The Rotary Foundation from 2002 to 2006 and as vice chairman of the Trustees in 2005-06, and he has been awarded both the Citation for Meritorious Service and the Distinguished Service Award by the Foundation.
In other Rotary assignments, Ray served as moderator of the 1989 International Assembly in Phoenix, chairman of the 1998 Council on Legislation in New Delhi, and vice chairman of the 2005 Chicago Convention Committee.  He has served in a variety of assignments for the codification of RI policies and the simplification of RI bylaws and similar documents.  He served as a member of the Future Vision Committee for The Rotary Foundation, chairman of the TRF Alumni Advisory Committee, and chairman of the 2008 RI Convention Committee for the convention held in Los Angeles on 15-18 June 2008.

RI President Elect (2010-11) :


Klinginsmith, Ray is an attorney in Kirksville, Missouri, USA, who now works primarily in the areas of commercial and corporate law, real estate, and estate planning. He retired in August of 1995 as General Counsel and Professor of Business Administration for Truman State University (formerly Northeast Missouri State University) in Kirksville after 22 years of service. During his tenure at the University, he also served as Dean of Administration for a period of five years during the University's transition to a liberal arts and sciences institution. Since his retirement from the University, he served a four-year term as a county commissioner for Adair County from 2001 to 2004.

Ray's wife, Judie, is a former elementary school teacher in Macon and Kirksville and a former consultant for the Child Development Assistant program at the Kirksville Area Vocational Center. Ray and Judie have two children, Leigh and Kurt, and three grandchildren, Morgan, Grant, and Sydney Perkins. Ray is a graduate of the business school and the law school of the University of Missouri at Columbia. He is a member of The Missouri Bar and has practiced law since 1965. He was awarded the Thomas D. Cochran Community Service Award by the Young Lawyers Section of The Missouri Bar in 1983.

Ray has served as a director of the Macon Atlanta State Bank in Macon, Missouri, since 1971, and he was one of the initial trustees for the Missouri Family Trust, which was created by the Missouri legislature in 1989. He has been the president of Chariton Valley Association for Handicapped Citizens since its organization in 1982, and he was accorded the 1988 Parent/Caretaker Award by the Missouri Planning Council for Developmental Disabilities. He is a former member of the Executive Board for the Great Rivers Council of the Boy Scouts of America and the holder of its Silver Beaver Award for adult volunteers. He is a member of the First United Methodist Church in Kirksville and a former lay speaker for the church.

A Rotarian for more than 40 years, Ray is currently a member of the Kirksville Rotary Club. He studied at the University of Cape Town as a Rotary Foundation ambassadorial scholar in 1961, and when he was elected to the board of directors for Rotary International in 1984, he became the first recipient of a Rotary Foundation award to serve on the RI board. He served as a Trustee of The Rotary Foundation from 2002 to 2006 and as vice chairman of the Trustees in 2005-06, and he has been awarded both the Citation for Meritorious Service and the Distinguished Service Award by the Foundation.

In other Rotary assignments, Ray served as moderator of the 1989 International Assembly in Phoenix, chairman of the 1998 Council on Legislation in New Delhi, and vice chairman of the 2005 Chicago Convention Committee. He has served in a variety of assignments for the codification of RI policies and the simplification of RI bylaws and similar documents. He served as a member of the Future Vision Committee for The Rotary Foundation, chairman of the TRF Alumni Advisory Committee, and chairman of the 2008 RI Convention Committee for the convention held in Los Angeles on 15-18 June 2008.
A Rotarian for more than 40 years, Ray is currently a member of the Kirksville Rotary Club. He studied at the University of Cape Town as a Rotary Foundation ambassadorial scholar in 1961, and when he was elected to the board of directors for Rotary International in 1984, he became the first recipient of a Rotary Foundation award to serve on the RI board. He served as a Trustee of The Rotary Foundation from 2002 to 2006 and as vice chairman of the Trustees in 2005-06, and he has been awarded both the Citation for Meritorious Service and the Distinguished Service Award by the Foundation.

In other Rotary assignments, Ray served as moderator of the 1989 International Assembly in Phoenix, chairman of the 1998 Council on Legislation in New Delhi, and vice chairman of the 2005 Chicago Convention Committee. He has served in a variety of assignments for the codification of RI policies and the simplification of RI bylaws and similar documents. He served as a member of the Future Vision Committee for The Rotary Foundation, chairman of the TRF Alumni Advisory Committee, and chairman of the 2008 RI Convention Committee for the convention held in Los Angeles on 15-18 June 2008.

The Polio Crusade

THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/

Erradicación de La poliomielitis

Polio Tricisilla Adaptada

March Of Dimes Polio History

Dr. Bruno

video

movie

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A 41-year-old man developed an acute illness at the age of 9 months during which, following a viral illness with headache, he developed severe weakness and wasting of the limbs of the left side. After several months he began to recover, such that he was able to walk at the age of 2 years and later was able to run, although he was never very good at sports. He had stable function until the age of 18 when he began to notice greater than usual difficulty lifting heavy objects. By the age of 25 he was noticing progressive difficulty walking due to weakness of both legs, and he noticed that the right calf had become larger. The symptoms became more noticeable over the course of the next 10 years and ultimately both upper as well as both lower limbs had become noticeably weaker.

On examination there was wasting of the muscles of upper and lower limbs on the left, and massively hypertrophied gastrocnemius, soleus and tensor fascia late on the right. The calf circumference on the right exceeded that on the left by 10 cm (figure1). The right shoulder girdle, triceps, thenar eminence and small muscles of the hand were wasted and there was winging of both scapulae. The right quadriceps was also wasted. The wasted muscles were also weak but the hypertrophied right ankle plantar flexors had normal power. The tendon reflexes were absent in the lower limbs and present in the upper limbs, although the right triceps was reduced. The remainder of the examination was normal.

Figure 1

The patient's legs, showing massive enlargement of the right calf and wasting on the left

Questions

1
What is that nature of the acute illness in infancy?
2
What is the nature of the subsequent deterioration?
3
What investigations should be performed?
4
What is the differential diagnosis of the cause of the progressive calf hypertrophy?

Answers

QUESTION 1

An acute paralytic illness which follows symptoms of a viral infection with or without signs of meningitis is typical of poliomyelitis. Usually caused by one of the three polio viruses, it may also occur following vaccination and following infections with other enteroviruses.1 Other disorders which would cause a similar syndrome but with upper motor neurone signs would include acute vascular lesions, meningoencephalitis and acute disseminated encephalomyelitis.

QUESTION 2

A progressive functional deterioration many years after paralytic poliomyelitis is well known, although its pathogenesis is not fully understood.2 It is a diagnosis of exclusion; a careful search for alternative causes, for example, orthopaedic deformities such as osteoarthritis or worsening scoliosis, superimposed neurological disorders such as entrapment neuropathies or coincidental muscle disease or neuropathy, and general medical causes such as respiratory complications and endocrinopathies.3

QUESTION 3

Investigations revealed normal blood count and erythrocyte sedimentation rate and normal biochemistry apart from a raised creatine kinase at 330 IU/l (normal range 60–120 IU/l), which is commonly seen in cases of ongoing denervation. Electromyography showed evidence of denervation in the right APB and FDI with polyphasic motor units and complex repetitive discharges, no spontaneous activity in the left calf and large polyphasic units in the right calf consistent with chronic partial denervation. Motor and sensory conduction velocities were normal. A lumbar myelogram was normal. Magnetic resonance imaging (MRI) scan of the calves is shown in figure2.

Figure 2

Axial T1 weighted MRI scan (TR 588 ms, TE 15 ms) of the calves, showing gross muscle atrophy and replacement by adipose tissue on the left, and hypertrophy of the muscles on the right, with only minor adipose tissue deposition

QUESTION 4

The differential diagnosis of the progressive calf hypertrophy is given in the box.

Causes of calf muscle hypertrophy

Chronic partial denervation

  • radiculopathy

  • peripheral neuropathy

  • hereditary motor and sensory neuropathy

  • spinal muscular atrophy

  • following paralytic poliomyelitis

    Neuromyotonia and myokymia

  • Isaac's syndrome

  • generalised myokymia

  • neurotonia

  • continuous muscle fibre activity due to: chronic inflammatory demyelinating polyradiculopathy, Guillain Barre syndrome, myasthenia gravis, thymoma, thyrotoxicosis, thyroiditis

    Muscular dystrophies

    Myositis

    Infiltration

  • tumours

  • amyloidosis

  • cysticercosis

    Link here