Jan 18, 2012

Commentary: Parents refuse to vaccinate kids over questionable claims

Thanks to medical and scientific advances, generations of Americans never experienced the horrors of such deadly diseases as polio, whooping cough and measles.

Future generations might not be so lucky.
More and more parents are refusing to immunize their children or are picking and choosing the vaccines they receive. They fear vaccine additives could cause autism and other harmful side effects. They’re also suspicious of the large number of vaccines children now receive.
As the child of a father suffering from post-polio syndrome, I can’t imagine not getting my children vaccinated. In some areas of the world, polio still exists. So does whopping cough. And measles.
We Americans might not see those devastating diseases anymore. But we are not immune.
The growing no-vax trend is fueled in part by California pediatrician Robert W. Sears. Dr. Sears suggests an alternative vaccination schedule that delays shots or spaces them further apart. For the immunization-wary, he suggests getting only certain vaccines.
Most pediatricians disagree with Sears, saying that refusing vaccines endangers all children, even those who have been immunized. Especially at risk are children with compromised immune systems, such as those undergoing chemotherapy. Some doctors have even refused to allow unvaccinated patients in their offices.
Dr. Amy J. Bonneau, a pediatrician with Harrisburg-based Darowish & Associates, said the increase in parents not immunizing their children is “frightening.”
“During the last century, vaccines have actually increased life spans by 30 years. People don’t realize how much of a difference vaccines have made in our lives,” she said.
The no-vax movement is based on hysteria and misinformation, not science, Bonneau said.
“I always ask parents if they have any concerns or questions about the immunizations. More and more often now, they absolutely refuse to even discuss it,” she said.
“I often wonder, ‘Why would you trust someone on the other side of the country who you’ve never met instead of the person sitting across from you who’s showing obvious concern for your child?’ It doesn’t make sense.”
Up to 5 percent of all immunized people never develop immunity to the disease. “Herd immunity” protects those few when everyone is properly vaccinated, Bonneau said.
But you don’t know if you’re one of the 5 percent or not. So if your child was immunized but did not develop immunity, he is at risk of getting the disease from an unimmunized child.
“When certain people don’t get immunized, the benefits of the herd immunity are diminished. If you didn’t develop immunity, you’re out of luck. You’re at great risk of getting exposed,” Bonneau said.
Alternating the vaccination schedule also poses problems, she added.
“It’s difficult to make sure they get all the vaccines they need when they come in at random times,” Bonneau said. “Delaying vaccines makes it more likely a child could get something he could have been vaccinated against.”
In Pennsylvania, unvaccinated children cannot attend school unless they claim a medical or religious exemption. State Health Department figures show the number of children entering public and private kindergartens with those exemptions is increasing:
School year / children
  • 2006-07: 1,700
  • 2007-08: 2,176
  • 2008-09: 2,190
  • 2009-10: 4,701
  • 2010-11: 2,408
“Childhood vaccinations are among the most effective and successful ways to keep Pennsylvania’s children healthy. This is the best way to keep these diseases at low levels in Pennsylvania, especially in places where children come together,” said Holli Senior, Health Department deputy press secretary.
“We encourage every parent in the commonwealth to get his or her child vaccinated.”
I’ve seen firsthand the devastating effects of a disease that immunizations helped to virtually eradicate in this country. I’ve heard my dad describe the isolation of a monthlong quarantine imposed on his entire family, the terror of the iron lung, the painful separation from family and friends as he underwent treatment far from home.
Even though my dad never complains, the disease that robbed him of his mobility as a child is now further destroying his body. It’s heartbreaking.
We have the ability to preserve many diseases as distant memories. Let’s keep them there. By ANNE McGRAW REEVES, The Patriot-News Buscando el bien de nuestros semejantes, encontramos el nuestro.

México a la vanguardia en el Síndrome de Post Polio

Jan 8, 2012

Stroke Robot Therapy

In Depth Doctor's Interview
Dr. Andrew Butler, an Associate Professor of Rehabilitation Medicine at Emory University discusses a clinical trial that is using a new robotic arm in combination with drug therapy to help stroke survivors regain movement in the upper limb
For patients who have strokes what are the challenges that you are trying to address in new ways?
Dr. Butler: Some of the biggest challenges that effect people who have stroke are their movement limitations. There are over seven hundred and fifty thousand people who have strokes every year and a large percentage of them, maybe ten percent of them, have movement limitations. Specifically we’re interested in upper limb movement limitations, the ability to reach and grasp and shake hands and use utensils and things like that. So impairment of the arm and hand is one of the things that’s most affected by stroke and we’re interested in improving.

What is the approach you’re taking and how is it different from the approaches that have been taken in the past?

Dr. Butler:
 There’s a lot of evidence to suggest that repetitive movements, lots of repetitive movements, and strengthening exercises with your hand and forearm will improve paralysis over time. My laboratory is using alternative devices accomplish this goal and one of the devices that we’re using is a robotic arm to help a person perform many repetitive movements. The robotic arm is essentially an exoskeletal, it’s something that fits over top of a person’s arm and helps them  move their wrist up and down. So if a person can’t move their wrist and hand completely the robotic arm will help them. As the stroke survivor improves, the robot  slowly decreases the amount of effort that’s put in by the robot arm and increases the effort that must be put forth by the stroke survivor.   The idea is that over time the stroke survivor will slowly and progressively improve in moving their hand and arm. We’re also trying to decrease the amount of time the stroke survivor is using this robotic arm. There is evidence to support the use of a certain medication that helps the brain re-learn and improves memory. So we’re combining robotic training with a certain pharmacological agent in hopes to improve movement in the upper limb of stroke survivors.

One of the goal is to try and speed up the recovery process. Is your clinical trial trying to make recovery occur in patients that might not have been able to move before? When you start out with the intervention for the patient where are you trying to take them?
Dr. Butler: We’re actually trying to do both, we’re trying to improve the level of movement so many people come to our clinic and they don’t have movement that’s similar to their non affected hand. So we try to improve the function of that hand but we also try to decrease the time it takes to recover. One of the goals of this trial is to decrease the time that they’re in the rehabilitation hospital. In the current medical realm people are in the hospital for a much shorter period of time and receiving therapy for a shorter period of time. By combining  robotic therapy with pharmacologic therapy we hope to improve a person’s overall function as well as decrease the amount of time stroke survivors are in the rehabilitation hospital, with the goal of recovering function to pre-stroke levels.

What kind of a drug is this, what does it target?
Dr. Butler: When learning a new activity whether you’re learning how to play tennis or learning to play the piano one must learn new motor movement and how to move your hands.   But you must also remember those new movements from day to day. So the drug targets the learning and memory system in your brain. After a stroke there are certain parts of the brain that controlled movement and learning and memory are damaged. So the idea is that the combination of the robotic training will help people learn new movements in combination with drug which will restore memory of those new movements.

How unusual is Spencer’s case, is it surprising to see a younger person having stroke or do you see more and more of it?
Dr. Butler: Unfortunately we do see more and more young people having strokes. There are certain reasons that this is occurring in our society but yes, it is quite unusual for a young person to have a stroke. Typically we see people in their forties, fifties and sixties who are having a stroke. So when Spencer’s family contacted us, we were very excited because we thought we could help him in his recovery. Again he’s very motivated he has a past history as an artist and having a specific goal to draw and paint using his hands. We thought that our clinical trial would be a very good match because we offer specific training for the wrist and hand. We want to help Spencer get back to doing what he loves which is drawing, painting and sculpture.

How has rehabilitation and therapy changed for stroke survivors from what it used to be? 
Dr. Butler: Today we focus on the patient’s goals. It’s not exactly what the therapist’s goals are, but the patient’s goals. One of the first questions I asked Spencer and his family is what do you want to do when you finish? He wants to be able to paint and do his sculpture. He had very specific functional goals. So that’s what has changed in Rehabilitation. It’s not about what my goals are as a therapist, but it’s about what the patients and their family’s goals are. That’s really where we’re trying to get, the patient centered goals.

Now there are some pretty hard and standardized measurements that will tell you if he is doing better or not correct?
Dr. Butler: Yes, that’s the unique aspect of this study. We have very specific and quantifiable outcomes that we are measuring. Some are improvements in the hand and arm and those are motor goals and then we have some cognitive and memory goals that we’re measuring. Therapists, occupational therapists and physical therapists do a very good job of evaluating a person’s quality of movement and how that improves over time.  But it is difficult for therapists to quantify every change. The robot measure’s exactly the number of repetitions a person performs, and the amount of difficulty in an exercise. The robot is very quantitative and the nice thing is once Spencer achieves eighty percent of his goals in a given exercise the robot moves Spencer up to the next difficulty level; thereby challenging his brain to improve to reach the next level of difficulty. There are ten difficulty levels and he’s done very well on all of them moving from a very low level, level one and two all the way up to level seven, eight and nine in some exercises.

 This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.

     If you would like more information, please contact:Lance Skelly
Director of Media Relations
Emory Hospitals and Wesley Woods Center
(404) 686-8538

Andrew J. Butler, Ph.D. PT, FAHA
Emory Univeristy
(404) 712-5675

México a la vanguardia en el Síndrome de Post Polio

Jan 4, 2012

What about Post Polio Research?

An Overview of Post-Polio Syndrome Research

Doctors and scientists all over the country are conducting post-polio syndromeresearch. Research studies are designed to answer important questions about post-poliosyndrome and to find out whether new approaches are safe and effective. Post-poliosyndrome research has already led to many advances, and researchers continue to search for more effective methods for dealing with post-polio syndrome.

Current Areas of Focus in Post-Polio Syndrome Research

Current areas of research include:
  • Some post-polio syndrome research scientists are studying the behavior of motor neurons many years after a polio attack.
  • Some researchers are looking at the mechanisms of fatigue and are trying to discover the role played by the brain, spinal cord, peripheral nerves, the neuromuscular junction (the site where a nerve cell meets the muscle cell it helps activate), and the muscles.
  • Some researchers have discovered that fragments of thepoliovirus, or mutated versions of it, are in the spinal fluid of some polio disease survivors. The significance of this finding is not known, and more post-polio syndrome research is being done on this topic.
  • Possible Benefits of Participating in Post-Polio Syndrome Research

    In order for some post-polio syndromeresearch to be conducted, volunteers are needed. Patients who join research studies have the first chance to benefit from treatments that have shown promise in earlier research. People who volunteer will also make an important contribution to medical science by helping doctors learn more about post-polio syndrome. Although post-polio syndrome research trials may pose some risks, researchers take very careful steps to protect their patients.


Post-Polio Syndrome and Exercise

Because post-polio syndrome symptoms (like pain and weakness) can result from the overuse of muscles and joints, there have been mixed views on exercising if you have post-polio syndrome. For people with this condition, exercise is safe and effective when carefully prescribed and monitored by experienced healthcare providers.Read More


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