By Donna Miles
American Forces Press Service
Jan. 16, 2008 - When Army Sgt. Nicholas Paupore puts a mirror between his legs and looks down, he's whole again. The right leg that was destroyed when an explosively formed penetrator ripped through his Humvee just south of Kirkuk, Iraq, suddenly reappears before his eyes, reflecting the left leg that remains. Paupore, 32, admitted he was skeptical when Navy Cmdr. (Dr.) Jack Tsao suggested using a mirror to help him deal with excruciating pain he continued feeling in his missing right leg.
The phenomenon, called "phantom limb pain," plagues as many as half of all amputees, likely the result of a faulty signal between the brain and the missing appendage, Tsao explained. Neurons in the brain continue sending out signals to a limb that's no longer there. As a result, amputees can feel discomfort or pain and, in some cases, the sense that their missing limb is stuck in an uncomfortable position.
For Paupore, a 101st Airborne Division artilleryman who was serving on a military transition team training Iraqi troops when he was wounded in July 2006, the pain felt like electric shocks or knives stabbing into his missing leg. "It felt like someone ... was putting an electrode on the back of my ankle," he said.
Paupore tried several different painkillers, including morphine, but none gave him relief.
Tsao, associate professor of neurology at the Uniformed Services University of the Health Sciences, in Bethesda, Md., thought he was on to something when he revisited literature he'd first seen while in graduate school. Vilayanur Ramachandran, a neuroscientist at the University of California San Diego, had come up with mirror therapy to treat phantom limb pain in upper extremities.
Ramachandran used mirrors so amputees could "see" and "move" their missing limbs to relieve the discomfort. Funding restrictions and lack of a steady stream of amputees prevented Ramachandran from testing his research through clinical trials.
Tsao, who treats military amputees wounded in Iraq and Afghanistan at Walter Reed Army Medical Center here, had no such restrictions. With huge Defense Department interest in caring for combat-wounded amputees, he had little trouble selling a treatment that involved little more than a $20 mirror.
He set up a clinical trial and recruited 18 combat-wounded amputees suffering from phantom limb pain to participate.
Paupore admitted he wasn't convinced when Tsao first proposed the trial, but said he figured he had nothing to lose. "I was really skeptical," he said. "But I figured, I'm not going anywhere, so I'll try it."
Tsao randomly assigned the participants into three groups. One group received mirror therapy as advocated by Ramachandran. One went through the same therapy, but with the mirror covered by a sheet so it didn't reflect the limb. The third group got no mirror and simply visualized seeing the missing limb in a mirror.
Paupore began the trial in the second group, with a covered mirror. After four weeks, he felt little change. But when Tsao switched him to the group using an uncovered mirror so he was able to "see" his missing leg, Paupore saw immediate improvement.
Sitting on a hospital bed with his legs fully extended, Paupore demonstrated the therapy. He put a standard 6-foot-long mirror lengthwise between his left leg and the residual stump on his right side, with the mirror reflecting the intact leg. He moved the leg, watching the movement in the mirror and imagining that his missing leg was making the movements.
The very first time he tried it, Paupore felt something happening. "The stump started firing off right away," he said. "It got a little uncomfortable."
Participants in the trial used the mirror therapy technique 15 minutes a day, five days a week for four weeks. "Pain levels seemed to come down after the first week and keep diminishing," Tsao said.
Every single person who used the mirror experienced relief, and some reported that their phantom pain disappeared altogether.
Tsao continued administering the therapy for an additional four weeks, up to eight weeks, and saw more success in patients who still felt phantom pain. Many were able to get off their pain medicine altogether or bring their pain levels down to a point where it was manageable with low dosages of drugs, he said.
"The mirror works for most people who have tried it," Tsao said. "It doesn't work fully for everyone. Some people are left with some residual pain, but it is better than when they started. For the most part, if you talk to the amputees here, they have actually been able to get off the medications, some sooner than others."
Those who used the covered mirror or visualization had far less success, Tsao reported. Some said their phantom pain actually worsened until they began therapy with an actual mirror.
More than a year after completing his mirror therapy, Paupore said he still experiences occasional phantom pain, but "only once in a great while." The pain is far less severe than before the mirror therapy, and Paupore is off painkillers altogether.
"It tricks your brain into thinking your leg is still there, so it's not misfiring," he said. "I don't know how it works, but it works."
Paupore said he encourages other amputees suffering from phantom pain to give mirror therapy a try. "I've always recommended it to them," he said. "At least give it a try. Some people may get mild help out of it; some may get extraordinary help out of it."
Tsao is quick to say mirror therapy doesn't work for everybody. "It's not a cure-all for all kinds of phantom pain, but it's definitely a way to improve therapy," he said.
Even patients whose pain remains after the therapy reported less severe symptoms. "A lot of them are very surprised that they are actually able to get movement and then the pain seems to be going away."
Tsao published the results of the clinical trials this past fall in the New England Journal of Medicine. Based on the promise it's shown, he said, he hopes to get approval for two more studies.
One will test mirror therapy for treating phantom pain in missing arms; Tsao said he hopes to conduct that trial both at Walter Reed at the Center for the Intrepid military rehabilitation facility, at Brooke Army Medical Center in San Antonio. The second trial, called functional magnetic resonance imaging, will attempt to figure out precisely why mirror therapy works.
Overall, Tsao called the Defense Department's advances in treating amputees "nothing short of phenomenal" and said he's proud to be playing a part.
"I think the most gratifying part of this is that we are actually able to help in the rehabilitation process for the amputees here," he said. "I go home everyday knowing people are going to be getting better. It makes me feel great."
Showing posts with label university. Show all posts
Showing posts with label university. Show all posts
Thursday, January 17, 2008
Thursday, January 10, 2008
ChemBio Weapons and WMD Terrorism News- January 9, 2008
New York Presses To Deploy More Bioweapons Sensors
“[New York] City officials last month quietly activated some of the nation's newest generation of early warning sensors to detect a biological attack, turning on a limited number of filing-cabinet-size air filters in sensitive, high-volume areas of Manhattan. But city officials say their effort to expand the program has run into surprising resistance from the White House, which is not widely deploying the machines. Five years ago, officials here note, the Bush administration was prodding local authorities to move faster to detect the use of biological weapons and pouring billions into biosecurity-related initiatives. New York's leaders now say the administration's enthusiasm and sense of urgency has flagged in its final year in office.” (Washington Post, 09Jan08; Spencer S. Hsu) http://www.washingtonpost.com/wp-dyn/content/article/2008/01/08/AR2008010803892.html?hpid=topnews
Will ‘NIMBY’ Syndrome Kill N.C. [North Carolina]’s Chances for Bioterror Lab?
“Tuesday’s news that the Granville County [North Carolina] Board of Commissioners has pulled support for building a bioterrorism lab near Butner is bad news for the project. The NIMBY syndrome – as in ‘not in my back yard’ – will chill local and state efforts to win the $450 million project and the hundreds of scientific research jobs that go with it.
However, […] federal officials are at fault for not helping to allay people’s concerns about the project. ‘Homeland Security is not talking to people, not answering their questions,’ local resident John Monroe [said]. Have concerns about the project? Go to our Web site, said Homeland Security. Poor communication about what exactly the project is – and how dangerous it could be – could very well throw North Carolina’s extensive recruitment efforts into turmoil.” (WRAL LocalTechWire.com, 09Jan08, Rick
Smith)
http://www.localtechwire.com/business/local_tech_wire/opinion/blogpost/2275140/
Lab electrician contends firing was retaliatory
“A former electrician at Rocky Mountain Laboratories in Hamilton [Montana] is alleging that he was fired last spring after lodging complaints about safety breaches at the research facility, which is building a lab to study dangerous diseases such as Ebola. The matter goes before a federal administrative judge in Missoula today for a two-day hearing to determine if managers fired the man as punishment for being a whistle-blower. Rick Hurley, a licensed master electrician who has worked for the federal government for more than 20 years, filed a whistle-blower complaint in March 2006. The National Institutes of Health, which ultimately oversees the lab, issued a statement Monday saying officials investigated all of Hurley's complaints regarding electrical safety at the lab and found them baseless. […] At issue in today's hearing is not whether Hurley's allegations are true, but if the lab was right to fire him and whether managers did so in retaliation for his allegations. The hearing is a result of Hurley's appealing his April 2007 termination.” (Billings Gazette, 07Jan08, Jennifer McKee) http://www.billingsgazette.net/articles/2008/01/08/news/state/24-electrician.txt
The growing number of immunocompromised
“It's estimated that about 10 million people in the United States (3.6 percent of the population) are immunocompromised. But that's likely an underestimate because it only includes those with HIV/AIDS (diagnosed and undiagnosed), organ transplant recipients, and cancer patients; there's a sizable population that takes immunosuppressive drugs for other disorders such as rheumatoid arthritis and inflammatory bowel disease. This is a concern because while modern medicine allows many immunocompromised individuals to live longer, they're at an increased risk for acquiring and spreading infections to others. […] Agents of bioterrorism such as smallpox also pose a great risk to the immunocompromised, who are ineligible for the smallpox vaccine because it contains an active (although weakened) virus that could cause a deadly adverse reaction.”
(Bulletin of the Atomic Scientists, 07Jan08, Laura H. Kahn) http://www.thebulletin.org/columns/laura-kahn/20080107.html
Oregon commission reopens public testimony on Umatilla waste
“In response to a lawsuit, the Oregon Environmental Quality Commission voted Tuesday to reopen public comment on the disposal of secondary waste from the destruction of aging chemical weapons stored at the Umatilla Chemical Depot near Hermiston. The waste includes plastic protective suits used by workers and contaminated carbon filters from the incinerators used to destroy the stockpile of Cold War chemical weapons at the Army depot in Eastern Oregon. The Government Accountability Project, based in Washington, D.C., won a ruling in April in Multnomah County Circuit Court in Portland ordering the state to review the ‘best available technology’ for disposing of secondary waste.” (OregonLive.com, 08Jan08, AP) http://www.oregonlive.com/newsflash/index.ssf?/base/news-22/1199832242189460.xml&storylist=orlocal
Army Corps hopes to resume chemical munitions dig
“The U.S. Army Corps of Engineers is awaiting a safety board's approval to resume digging for buried chemical munitions near American University [Washington, D.C.]. Army Corps officials say they stopped digging in early December after the discovery of a shell that was configured to explode. Project manager Dan Noble says it's only the second explosively configured munition found in 15 years of digging for World War I munitions buried in the area. In a meeting with nearby residents late Tuesday, officials said the shell did not have a fuse attached, making the chance of an explosion highly unlikely. The Army operated a chemical warfare station at the university to develop and test weapons during the war. Munitions were buried behind the campus when the Army left decades ago.” (Examiner.com, 09Jan08)
http://www.examiner.com/a-1146999~Army_Corps_hopes_to_resume_chemical_munitions_dig.html
Feds, farm groups working to improve security of high-risk farm chemicals
“The Department of Homeland Security (DHS) is working to make the screening process regarding chemical security regulations more appropriate for farmers. The department recently announced a delay that exempts farmers and other agricultural facilities from having to complete the vulnerability screening, which has caused some confusion about who should complete the screening and who is exempt. The screening will help DHS determine if it needs to follow up with individuals to do further vulnerability assessments, according to a university report. ‘The system that is in place for chemical manufacturing, refining and distribution plants is not ideal for farm operations,’ says Purdue University Extension Disaster Education Network communication specialist and field staff liaison Steve Cain. ‘The U.S. Department of Agriculture, the Extension Disaster Education Network (EDEN) and farm organizations will work with the department to help develop a system more appropriate for agriculture.’” (Agriculture Online, 09Jan08) http://www.agriculture.com/ag/story.jhtml?storyid=/templatedata/ag/story/data/1199892909300.xml
Poison sent to councillor 'strong enough to kill'
“The poison in a vodka bottle sent to a Blackburn [U.K.] councillor as part of a campaign for Scottish independence was strong enough to kill him, a court heard. Wayne Cook, 45, is on trial at the court charged with two counts of using noxious substances or things to cause harm and intimidate, under anti-terrorism legislation. The unemployed father-of-three is accused of sending a miniature bottle of vodka filled with caustic soda to Darwen councillor John Wright in April 2007 while another parcel with the same contents was posted to a Scottish journalist, Myra Philp. […] It is alleged that the parcels were sent as part of a campaign by the Scottish National Liberation Army (SNLA) to force the British Government out of Scotland. Cook denies the charges.” (Blackburn Citizen, 09Jan08, Telegraph Newsdesk) http://www.blackburncitizen.co.uk/news/newsheadlines/display.var.1953786.0.poison_sent_to_councillor_strong_enought_to_kill.php
Congress Calls for Outside Look at Radiation Detectors
“The omnibus spending bill passed late last year by Congress has placed additional hurdles in front of the Homeland Security Department’s drive to roll out next-generation radiation detectors at U.S. ports, including demanding an outside scientific evaluation of the technology. The new requirements are just the latest development in a more than yearlong battle between the Government Accountability Office, lawmakers and DHS officials over the efficacy of the new technology and the way in which the department has tested it. The new detectors, called Advanced Spectroscopic Portal monitors (or ASPs), are designed to not only detect radiation but to identify the nature of its source, eliminating the need for time-consuming secondary inspections to determine whether the material is innocuous or dangerous. A number of mundane items regularly shipped into the United States, including ceramic tiles and bananas, contain radioactive isotopes that can set off the radiation detectors.” (Global Security Newswire, 09Jan08, Jon Fox)
http://www.nti.org/d_newswire/issues/2008_1_9.html#65053A68
Press candidates on threat of nuclear terrorism, two say
“Voters should press the presidential candidates to say what they would do, if elected, to prevent terrorists from carrying out a nuclear attack in the U.S., an expert on nuclear terrorism and the daughter of a victim of the Sept. 11 attacks said Tuesday. Michael Hurley, a counter terrorism advisor to the Nuclear Threat Initiative and a senior staff member to the
911 Commission, and Carie Lemack, founder of Families of September 11, commended efforts since the 2001 attacks to avoid a promised al-Qaida-led nuclear attack on the nation, but they said more can be done.” (Arkansas News Bureau, 09Jan08, Rob Moritz) http://www.arkansasnews.com/archive/2008/01/09/News/344767.html
CNS ChemBio-WMD Terrorism News is prepared by the Chemical and Biological Weapons Nonproliferation Program of the James Martin Center for Nonproliferation Studies at the Monterey Institute of International Studies in order to bring timely and focused information to researchers and policymakers interested in the fields of chemical, biological, and radiological weapons nonproliferation and WMD terrorism.
For more information and resources on CBW and WMD terrorism, visit the web page of the Center for Nonproliferation Studies, at http://cns.miis.edu/research/cbw/index.htm
“[New York] City officials last month quietly activated some of the nation's newest generation of early warning sensors to detect a biological attack, turning on a limited number of filing-cabinet-size air filters in sensitive, high-volume areas of Manhattan. But city officials say their effort to expand the program has run into surprising resistance from the White House, which is not widely deploying the machines. Five years ago, officials here note, the Bush administration was prodding local authorities to move faster to detect the use of biological weapons and pouring billions into biosecurity-related initiatives. New York's leaders now say the administration's enthusiasm and sense of urgency has flagged in its final year in office.” (Washington Post, 09Jan08; Spencer S. Hsu) http://www.washingtonpost.com/wp-dyn/content/article/2008/01/08/AR2008010803892.html?hpid=topnews
Will ‘NIMBY’ Syndrome Kill N.C. [North Carolina]’s Chances for Bioterror Lab?
“Tuesday’s news that the Granville County [North Carolina] Board of Commissioners has pulled support for building a bioterrorism lab near Butner is bad news for the project. The NIMBY syndrome – as in ‘not in my back yard’ – will chill local and state efforts to win the $450 million project and the hundreds of scientific research jobs that go with it.
However, […] federal officials are at fault for not helping to allay people’s concerns about the project. ‘Homeland Security is not talking to people, not answering their questions,’ local resident John Monroe [said]. Have concerns about the project? Go to our Web site, said Homeland Security. Poor communication about what exactly the project is – and how dangerous it could be – could very well throw North Carolina’s extensive recruitment efforts into turmoil.” (WRAL LocalTechWire.com, 09Jan08, Rick
Smith)
http://www.localtechwire.com/business/local_tech_wire/opinion/blogpost/2275140/
Lab electrician contends firing was retaliatory
“A former electrician at Rocky Mountain Laboratories in Hamilton [Montana] is alleging that he was fired last spring after lodging complaints about safety breaches at the research facility, which is building a lab to study dangerous diseases such as Ebola. The matter goes before a federal administrative judge in Missoula today for a two-day hearing to determine if managers fired the man as punishment for being a whistle-blower. Rick Hurley, a licensed master electrician who has worked for the federal government for more than 20 years, filed a whistle-blower complaint in March 2006. The National Institutes of Health, which ultimately oversees the lab, issued a statement Monday saying officials investigated all of Hurley's complaints regarding electrical safety at the lab and found them baseless. […] At issue in today's hearing is not whether Hurley's allegations are true, but if the lab was right to fire him and whether managers did so in retaliation for his allegations. The hearing is a result of Hurley's appealing his April 2007 termination.” (Billings Gazette, 07Jan08, Jennifer McKee) http://www.billingsgazette.net/articles/2008/01/08/news/state/24-electrician.txt
The growing number of immunocompromised
“It's estimated that about 10 million people in the United States (3.6 percent of the population) are immunocompromised. But that's likely an underestimate because it only includes those with HIV/AIDS (diagnosed and undiagnosed), organ transplant recipients, and cancer patients; there's a sizable population that takes immunosuppressive drugs for other disorders such as rheumatoid arthritis and inflammatory bowel disease. This is a concern because while modern medicine allows many immunocompromised individuals to live longer, they're at an increased risk for acquiring and spreading infections to others. […] Agents of bioterrorism such as smallpox also pose a great risk to the immunocompromised, who are ineligible for the smallpox vaccine because it contains an active (although weakened) virus that could cause a deadly adverse reaction.”
(Bulletin of the Atomic Scientists, 07Jan08, Laura H. Kahn) http://www.thebulletin.org/columns/laura-kahn/20080107.html
Oregon commission reopens public testimony on Umatilla waste
“In response to a lawsuit, the Oregon Environmental Quality Commission voted Tuesday to reopen public comment on the disposal of secondary waste from the destruction of aging chemical weapons stored at the Umatilla Chemical Depot near Hermiston. The waste includes plastic protective suits used by workers and contaminated carbon filters from the incinerators used to destroy the stockpile of Cold War chemical weapons at the Army depot in Eastern Oregon. The Government Accountability Project, based in Washington, D.C., won a ruling in April in Multnomah County Circuit Court in Portland ordering the state to review the ‘best available technology’ for disposing of secondary waste.” (OregonLive.com, 08Jan08, AP) http://www.oregonlive.com/newsflash/index.ssf?/base/news-22/1199832242189460.xml&storylist=orlocal
Army Corps hopes to resume chemical munitions dig
“The U.S. Army Corps of Engineers is awaiting a safety board's approval to resume digging for buried chemical munitions near American University [Washington, D.C.]. Army Corps officials say they stopped digging in early December after the discovery of a shell that was configured to explode. Project manager Dan Noble says it's only the second explosively configured munition found in 15 years of digging for World War I munitions buried in the area. In a meeting with nearby residents late Tuesday, officials said the shell did not have a fuse attached, making the chance of an explosion highly unlikely. The Army operated a chemical warfare station at the university to develop and test weapons during the war. Munitions were buried behind the campus when the Army left decades ago.” (Examiner.com, 09Jan08)
http://www.examiner.com/a-1146999~Army_Corps_hopes_to_resume_chemical_munitions_dig.html
Feds, farm groups working to improve security of high-risk farm chemicals
“The Department of Homeland Security (DHS) is working to make the screening process regarding chemical security regulations more appropriate for farmers. The department recently announced a delay that exempts farmers and other agricultural facilities from having to complete the vulnerability screening, which has caused some confusion about who should complete the screening and who is exempt. The screening will help DHS determine if it needs to follow up with individuals to do further vulnerability assessments, according to a university report. ‘The system that is in place for chemical manufacturing, refining and distribution plants is not ideal for farm operations,’ says Purdue University Extension Disaster Education Network communication specialist and field staff liaison Steve Cain. ‘The U.S. Department of Agriculture, the Extension Disaster Education Network (EDEN) and farm organizations will work with the department to help develop a system more appropriate for agriculture.’” (Agriculture Online, 09Jan08) http://www.agriculture.com/ag/story.jhtml?storyid=/templatedata/ag/story/data/1199892909300.xml
Poison sent to councillor 'strong enough to kill'
“The poison in a vodka bottle sent to a Blackburn [U.K.] councillor as part of a campaign for Scottish independence was strong enough to kill him, a court heard. Wayne Cook, 45, is on trial at the court charged with two counts of using noxious substances or things to cause harm and intimidate, under anti-terrorism legislation. The unemployed father-of-three is accused of sending a miniature bottle of vodka filled with caustic soda to Darwen councillor John Wright in April 2007 while another parcel with the same contents was posted to a Scottish journalist, Myra Philp. […] It is alleged that the parcels were sent as part of a campaign by the Scottish National Liberation Army (SNLA) to force the British Government out of Scotland. Cook denies the charges.” (Blackburn Citizen, 09Jan08, Telegraph Newsdesk) http://www.blackburncitizen.co.uk/news/newsheadlines/display.var.1953786.0.poison_sent_to_councillor_strong_enought_to_kill.php
Congress Calls for Outside Look at Radiation Detectors
“The omnibus spending bill passed late last year by Congress has placed additional hurdles in front of the Homeland Security Department’s drive to roll out next-generation radiation detectors at U.S. ports, including demanding an outside scientific evaluation of the technology. The new requirements are just the latest development in a more than yearlong battle between the Government Accountability Office, lawmakers and DHS officials over the efficacy of the new technology and the way in which the department has tested it. The new detectors, called Advanced Spectroscopic Portal monitors (or ASPs), are designed to not only detect radiation but to identify the nature of its source, eliminating the need for time-consuming secondary inspections to determine whether the material is innocuous or dangerous. A number of mundane items regularly shipped into the United States, including ceramic tiles and bananas, contain radioactive isotopes that can set off the radiation detectors.” (Global Security Newswire, 09Jan08, Jon Fox)
http://www.nti.org/d_newswire/issues/2008_1_9.html#65053A68
Press candidates on threat of nuclear terrorism, two say
“Voters should press the presidential candidates to say what they would do, if elected, to prevent terrorists from carrying out a nuclear attack in the U.S., an expert on nuclear terrorism and the daughter of a victim of the Sept. 11 attacks said Tuesday. Michael Hurley, a counter terrorism advisor to the Nuclear Threat Initiative and a senior staff member to the
911 Commission, and Carie Lemack, founder of Families of September 11, commended efforts since the 2001 attacks to avoid a promised al-Qaida-led nuclear attack on the nation, but they said more can be done.” (Arkansas News Bureau, 09Jan08, Rob Moritz) http://www.arkansasnews.com/archive/2008/01/09/News/344767.html
CNS ChemBio-WMD Terrorism News is prepared by the Chemical and Biological Weapons Nonproliferation Program of the James Martin Center for Nonproliferation Studies at the Monterey Institute of International Studies in order to bring timely and focused information to researchers and policymakers interested in the fields of chemical, biological, and radiological weapons nonproliferation and WMD terrorism.
For more information and resources on CBW and WMD terrorism, visit the web page of the Center for Nonproliferation Studies, at http://cns.miis.edu/research/cbw/index.htm
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