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The Power of a Second Look

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Evidence-Based Medicine and Conflicting Opinions on Stroke Treatment

At MCN we emphasize evidence-based medicine, and our doctors support each of their claim decisions with referenced sources and years of training and practice. But in the world of science and medicine, interpreting findings isn’t without disagreement and it sometimes takes years to find medical solutions to disease and injury.

This article from The New York Times demonstrates this conflict as doctors around the world debate whether tissue plasminogen activator (T.P.A.) can prevent brain injury after a stroke or if it does more damage than good.

Dr. Christopher Lewandowski, the principal contributor to TPA research and findings, proved that this clot-buster drug could open up the blocked vessel in the brain during a stroke and prevent/minimize permanent disability in the future. The first clinical trial to test this drug took place 22 years ago, and Dr. Lewandowski is still trying to explain the data to doubtful doctors around the world who refuse to use it.

According to this article, 700,000 people have blood clot related strokes a year, and 30% of the patients who qualify for TPA never receive it. Doctors in favor of administering TPA say that without it as part of a treatment plan, “many patients end up permanently disabled.”

On the flip side, doubters question the validity of the first experiments saying that they were flawed because TPA was used on the least severe type of stroke. Those receiving the remedy, therefore, were less badly effected from the start, and professionals are unsure if the recovery can be credited to TPA or natural causes. Eleven other experiments have shown no benefit to TPA, but those studies were conducted on severe stroke patients and those outside the recommended window of time for TPA to be administered.

As the medical field progresses, cures and conflicting opinions will continue to exist. That’s why we believe in the power of a second look.

Full Face Transplant a “Success”

 

A man referred to only as Rafael was the recipient of the first full face transplant. The operation, which was done in March, was performed by 30 Spanish doctors in Barcelona. Mr. Rafael underwent the transplant after nine previous operations failed to help his neurofibromatosis, a genetic disorder that caused benign tumors to grow on his face.

Study: Brain Exercises Don’t Improve Cognition

A recent article in Time concludes “getting a good night’s sleep, excercise, and eating right” are more likely to “maximize a brain’s potential” than a computer game. The interesting thing about this is that neuroscientists can’t agree. Some believe these games can alter the dopamine receptors, which would theoretically aid in learning and cognitive functions, while others believe the phrase “practice makes perfect” better describes the improvement, and  does not carry over to cognitive functions.

Silk Brain Implant Could Aid Spinal Injuries, Epilepsy

Reuters posted a very compelling article about a silk chip that adheres to the brain that has the potential to help people with epilepsy or spinal cord injuries. The water-soluble silk dissolves onto the brain leaving only the electrodes behind. Going forward, this technology could have the potential to help other disorders like Parkinson’s Disease and Multiple Sclerosis.

Welcome to MCNtalk – a discussion group for you

MCNtalk, which has existed for many years as an email broadcast, is being converted into a blog. Advantages include the ability for prior articles to be stored, indexed and accessed by readers, as well as a robust ability to include many features and full user control of how or if they receive notifications of new postings or comments.

In addition, this blog will be readily available on the web for subscribers and non-subscribers alike.

It is a work in progress and we hope to add many enhancements over time.

The address is http://www.mcntalk.com

Your comments and ideas are welcome as well as requests to add a particular site or blog to the featured list. We also welcome links to articles of interest, or even your own idea pieces.

Our goal is to present articles of interest and potential relevance to those who deal with medical issues in claims management, disability, injury and related legal and administrative issues, as well as those who have a general interest in health-care issues. I am linking to blogs that focus on health care politics but we will do our best to steer clear of partisan and acutely political matters. We recognize that our readership is diverse and that there is no shortage of good sources for thoughtful comments, reflections and positions on current political issues.

This does not mean that the occasional article will not be controversial, and we welcome divergent comments. Inclusion of a particular article does not necessarily imply agreement with the stated position by MCN or it’s staff.

The original MCNTalk email list will be used for periodic reminders about the blog and recent articles. But we encourage direct subscription via the button on the upper left, which will provide immediate notice of new postings. You may change your subscription preferences or unsubscribe at any time.

We welcome comments but they should be signed, courteous and relevant to the posting. We will tread gently into the world of comments and initially screen them before posting, perhaps opening them up to non-screened postings for repeat commentators or all.

If you have ideas or thoughts about making MCNTalk more effective and relevant – send them to us at MCNTalk@mcn.com.

Thank you.

Brian L. Grant, MD
Chairman and Medical Director