Category Archives: Research

Report – Scientific Progress – Gulf War Illnesses

The full title of this report is “Scientific Progress Understanding Gulf War Illnesses:  Report and Recommendations“.

Research Advisory Committee on Gulf War Veterans’ Illnesses
September, 2004 

This is an extensive report running 152 pdf pages.   The Executive Summary has these unsettling words:

In the years since the war, thousands of Gulf War veterans have been evaluated and treated by government and private physicians. But the federal research effort has not succeeded in identifying treatments that substantially improve the health of ill veterans.

Further, there are no programs in place to evaluate the effectiveness of treatments currently being used or to identify and develop treatments that may hold promise for these conditions.

(…) Many of the veterans who served in the Gulf War were exposed to a variety of potentially toxic substances during their  deployment.  Among these were several neurotoxins-chemical nerve agents, pills taken to protect veterans from the deadly effects of nerve agents, and multiple types of pesticides-that belong to a single class of compounds that adversely affect the nervous system.

Finding 1  A substantial proportion of Gulf War veterans are ill with multisymptom conditions not explained by wartime stress or psychiatric illness.  (…) 

Finding 2  Treatments that improve the health of veterans with Gulf War illnesses are urgently needed. (…)

Finding 3 A growing body of research indicates that an important component of Gulf War veterans’ illnesses is neurological in character. (…)

Finding 4 Evidence supports a probable link between exposure to neurotoxins and the development of Gulf War veterans’ illnesses. (…)

Finding 5  Other wartime exposures may also have contributed to Gulf War veterans’ illnesses. (…)

Finding 6  The health of Gulf veterans must be carefully monitored to determine if Gulf War service is associated with excess rates of specific diseases, disease-specific deaths, or overall mortality.(…)

Finding 7  Important questions concerning the health of children and other family members of Gulf War veterans remain unanswered. (…)

Finding 8  Progress in understanding Gulf War veterans’ illnesses has been hindered by lack of coordination and availability of data resources maintained by the Department of Defense and the Department of Veterans Affairs.  (…)

Finding 9  Research on Gulf War veterans’ illnesses has important implications for current and future military deployments and for homeland security.  (…)

Finding 10  Further progress in understanding and treating Gulf War veterans’ illnesses requires federal research programs that are properly focused, well-managed, and adequately funded.  (…)

Each of these findings are supported in detail with charts, data and supporting research documents that are organized by topic and by suspected causes.

Here are just a few of the tables and figures:

You can see from this figure that those in the Gulf war report 2 to 7 times as many symptoms as veterans not in the theatre.

Many of the symptoms are common among veterans that did not serve in the Gulf War as shown in the left side of this figure.  However, those veterans that were deployed in the Gulf are about 10 times as likely to report 3 to 6  types of symptoms from Table 1 than those not deployed.

The excess illness column on the far right was used in the study to show that the excess illness was consistent among particular units of deployed veterans vs non-deployed veterans from the same area of the country.  The ratio of deployed ill veterans was 2 to 4 times as high as those not deployed and even though they came from the same area as those that went to the Gulf .   For example those from Kansas that were deployed in the Gulf had 2.5 to 4 times as many multiple symptoms than those from Kansas that were not deployed.

This table is very alarming to me.   It shows that the deployed Gulf War veterans are developing Lou Gehrig’s disease (ALS) at a rate nearly 4 times higher than those veterans not deployed as they age to 55 and older.  ALS is a progressive neurodegenerative disease, with less than 10 percent of patients surviving more than five years after initial diagnosis.

Possible effects of pesticides, PB (Pyridostigmine bromide pills used to pre-treat nerve gas exposure), and other AChEis (acetylcholinesterase inhibitors) chemicals used during the Gulf War.

Evidence in the literature is suggestive, but not conclusive, AChE inhibitors such as organophosphates and carbamates, could be among the potential contributing agents to some of the undiagnosed illnesses seen in Persian Gulf War veterans. -From: A Review of the Scientific Literature As It Pertains to Gulf War Illnesses–Volume 8: Pesticides48

This topic was extensively discussed and seems to be of significant concern to those conducting the study.   AChEis compounds are sometimes used for beneficial medications for Alzheimer’s Disease, but also to make pesticides and saran nerve gas.  

(…) these studies have consistently identified AChEis to be significantly associated with higher rates of symptoms and illnesses in Gulf War veterans. The uniformity of these results contrasts with a lack of consistent findings in multivariable analyses for such wartime experiences as participation in combat, exposure to oil fire smoke, and exposure to depleted uranium. Limitations in epidemiologic studies that rely on selfreported exposures always require a cautious interpretation of findings.

Taken as a whole, however, this accumulated body of research provides compelling evidence of a probable link between neurotoxic exposures in the Gulf War and the development of Gulf War veterans’ illnesses.

Pregnancies, micsarrages, birth defects: 

In 2001, a report from VA’s large National Survey of Gulf War-era Veterans and their Families indicated that Gulf War veterans reported a significantly greater number of post-war pregnancies that ended in miscarriages or children born with birth defects than nondeployed era veterans.

This table is very alarming to me.  It shows that the rate of birth defects for first live births for deployed veterans is two to 3 times as high as for those not deployed.   This applies to children of both male and female veterans.   Something is tragically wrong with this picture.

The above is only a brief overview of this subject.  Depleted Uranium is also a part of this study, but is largely discounted, but not thrown out.   If you are interested in the details, the report is remarkably readable and available at the link above or can be viewed or downloaded here.  This report is more than 3 years old.  It will be interesting to see how many of its recommendations have been followed.

What is so heartbreaking is that the rate of ALS among deployed Gulf War Veterans is higher at all age levels than Gulf War veterans not deployed, 3.5 times as high at ages above 55, birth defect rates are double, Gulf War Veterans are 3 to 4 times as likely to be ill with these symptoms. Yet the funding is dismal, only about $31 million average a year through 2004.

That is about $32.00 per deployed Gulf War veteran a year research funding.    Hmm, 88 cents a day per veteran – about the cost of a single plain doughnut.

Equivalent Funding for Gulf War Illnesses

(photo courtesy of roboppy who posted as creative commons)

(all the others are copied from the cited report)

The veterans deserve significantly more research, deserve the best possible treatment and deserve adequate compensation to offset their illnesses. They are all heroes to me.

Oldtimer

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Traumatic Brain Injury – TBI and Spinal Cord Injury SCI

The VA says this about TBI and SCI: 

Due to the ongoing conflicts in Afghanistan and Iraq, Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) accounts for almost 25% of combat casualties.

Improvised explosive devices, blast (high pressure waves), landmines, and explosive fragments account for the majority of combat injuries in Afghanistan and Iraq. Although Kevlar helmets and advances in body armor have saved the lives of many soldiers, they do not protect against blasts and impacts to the head, face and cervical spinal cord.

Blast injuries often result in multiple traumas, including injuries to internal organs, limb loss, sensory loss, and psychological disorders. The term “polytrauma” has been coined to describe the co-occurring injuries.

The information above and below come from here which are part of an introduction and overview prepared by Joel Kupersmith, MD, Chief Research and Development Officer, VA for the purposes of a proposal solicitation.  I thought the overview might be of interest to those with these injuries and their families.

Traumatic Brain Injury:

Kevlar helmets have done much to protect the head but leave the forehead unprotected. The left and right frontal lobes, located behind the forehead control intellectual abilities such as the ability to plan and organize. This area of the brain also controls personality, behavior, and emotional control.

Concussion or mild TBI is the most common form of combat-related injury. Mild TBI can occur even in those not directly hit by the blast, without obvious external injuries, without loss of consciousness and without visible findings from acute Magnetic Resonance Imaging. Problems with memory, lack of concentration, increased anxiety and irritability are common hallmarks of mild TBI. Although evidence suggests that the majority of OIF/OEF soldiers who suffer mild TBI will recover over time, early diagnoses and treatment are critical so that aberrant behaviors due to TBI are not misinterpreted and soldiers are spared the risk of second impact syndrome. Appropriate recognition of TBI will facilitate quick return to pre-injury activity levels, including return to duty status.

In addition to mild TBI, soldiers close to the blasts are experiencing severe diffuse and contrecoup injuries. Soldiers with a moderate to severe TBI often show the similar symptoms as mild TBI yet also report: worsening headaches; repeated vomiting or nausea; seizures; inability to awaken from sleep; slurred speech; weakness, numbness and loss of coordination. Unlike mild TBI, these problems and others can persist long-term or result in permanent difficulties with memory, reasoning, emotion and expression making it impossible to return to duty, hold steady employment or regain pre-injury quality of life.

Penetrating focal injuries from mortar rounds or other forms of heavy artillery resulting in severe brain injury are not as prevalent. However, focal destruction of brain tissue is the most life-threatening, intractable type of brain injury causing permanent damage to the affected area and the functions it controls.

Spinal Cord Injury:

Current designs in military protective gear and advanced evacuation procedures have resulted in both a decrease in the percentage of spinal cord injured soldiers and an increase in the number of those that ultimately survive. Blast force and shrapnel injuries are most common. For those that survive, the cervical spinal cord, the unprotected and most mobile portion of the spinal cord, is the most common site of injury.

Soldiers with cervical SCI face short- and long-term consequences of losing motor and sensory function below the level of injury, coupled with a loss of autonomic regulation. Every organ system may be affected by cervical spinal cord injury. Alterations in the gastrointestinal, renal, skin and musculoskeletal organs are common, and respiratory problems are the overwhelming cause of morbidity and mortality. In addition, patients may experience chronic pain at or below the level of injury and, less frequently, above it.

Alterations in respiratory mechanics, and the development of alveolar hypoventilation, pneumonia, aspiration of gastric contents, pulmonary embolism, pulmonary edema, and sleep apnea are a few of the common respiratory complications associated with cervical SCI. Ultimately, dysfunction depends on the level and extent of injury. Lesions above C3 paralyze all respiratory muscles. When SCI involves C3 to C5 lesions, profound respiratory muscle dysfunction occurs leaving the patient unable to generate a cough or clear secretions. Because of this, neuroprotective strategies that rescue even one or two segments may be of significant functional benefit to veterans with SCI.

Let’s pray that this proposal results in research that leads to significant help for our injured veterans.    

Oldtimer

VA Research Factsheet on PTSD

The following is a factsheet from the VA’s Research Advances Series titled Posttraumatic Stress Disorder (PTSD),  published in September, 2007:

Soldier from VA BulletinSoldier from VA Bulletin VA’s Office of Research & Development supports a strong program of research directed to understanding, treating, and preventing Posttraumatic Stress Disorder (PTSD), which is an unrelenting biological reaction to the experience of a traumatic event. In the case of veterans, the trauma may occur from combat duty or other experiences where one’s safety or life is threatened. VA researchers have long been leaders in discovering new advances for treating and understanding PTSD.    The photo came with the article in 2007    I found a larger version here They title it “Prayer”.    I don’t know who the original photographer was.

Examples of VA research advances

Drug already used by millions may be effective in the treatment of PTSD – In an exciting new treatment development, VA researchers found that prazosin, an inexpensive generic drug already used by millions of Americans for high blood pressure and prostate problems, improved sleep and reduced trauma nightmares in a small number of veterans with PTSD.  Plans are under way for a large, multi-site trial to confirm the drug’s effectiveness.

Prolonged-exposure therapy effective in treatment of women veterans with PTSD– VA researchers found that prolonged-exposure therapy – in which therapists helped them recall their trauma memories under safe, controlled conditions-was effective in reducing PTSD symptoms in women veterans who have developed PTSD as the result of sexual trauma in the military, and that such reductions remained stable over time. Women who received prolonged-exposure therapy had greater reductions of PTSD symptoms than women who received only emotional support and counseling focused on current problems. This approach may be tested in, and applied to, other PTSD populations.

First ever clinical trial for the treatment of military service-related chronic PTSD– The largest study of its kind, involving 400 veterans from 20 VA medical centers nationwide, is being conducted to determine if risperidone, a medication already shown to be safe and effective in the treatment of PTSD, is also effective in veterans with chronic PTSD who continue to have symptoms despite receiving standard medications used for this disorder.

Facts About PTSD:

PTSD is a psychiatric disorder that can affect people who have experienced life-threatening events, such as combat, a terrorist attack, or a personal assault. Symptoms include flashbacks, nightmares, depression, and social withdrawal, as well as physical health changes. Treatment often includes anti-anxiety drugs or other medication, as well as exposure therapy, a form of cognitive-behavioral therapy in which patients recall their traumas in a safe setting and gradually learn to adjust their emotional response. VA Research has long been leaders in making new advances for treating and understanding PTSD.

http://www.research.va.gov
Research & Development
Veterans Affairs

Oldtimer’s Comment: There are 17 of these factsheets.  Below is a linked list of them.    You may find something of interest in one or more of them.   For example, PTSD is mentioned in several.

Factsheets

  • Alzheimer’s Disease (193 KB, PDF)
  • Depression (192 KB, PDF)
  • Diabetes (168 KB, PDF)
  • Hearing Loss (194 KB, PDF)
  • Heart Disease and Stroke (223 KB, PDF)
  • Hepatitis C (198 KB, PDF)
  • HIV / AIDS (205 KB, PDF)
  • Iraq / Afghanistan (232 KB, )
  • Low Vision (248 KB, PDF)
  • Mental Health (191 KB, PDF)
  • Obesity (214 KB, PDF)
  • Osteoarthritis (175 KB, PDF)
  • Parkinson’s Disease (179 KB, PDF)
  • Personalized Medicine (208 KB, PDF)
  • Post-Traumatic Stress Disorder (PTSD) (189 KB, PDF)
  • Prosthetics / Amputations (209 KB, PDF)
  • Spinal Cord Injury (205 KB, PDF)
  • Substance Abuse (175 KB, PDF)
  • Womens’ Health (201 KB, PDF)
  • Oldtimer

    Program for homeless N.H. vets could close

    Program for homeless N.H. vets not funded
     

    Something is wrong here.  

    Something is very wrong!  

    We seem to be backing up.   The article below is just one of many like it.   Federal funds in support of our homeless are drying up, and even worse, many homeless veterans that have found shelter are themselves cast out onto the streets.  At least Liberty House is determined to keep up the fight for our veterans.   Our government doesn’t seem to really care.   To paraphrase: “We cut the funds, but it is local yokels that decide where the remainder is used.”   

    I’ve seen some of the inside workings of these interagency counsels.  It is kind of like, “they cut our funds for band-aids.  Which wound needs the dressings the most?  Where are the screams coming from?    Do we save that arm or let that leg go?   It is a fact of life that there are no good choices when there isn’t even close to enough money to go around and people are in serious trouble everywhere you look.    So they prioritize, hoping that HUD will not cut funding for the vets.    When an application has 6 choices and HUD chooses to fund the first 5, they are in effect saying, “the homeless veterans on the list are not worth our money”.   Even the VA shortchanges our homeless vets – they allocate only a net of $1.37 a day per homeless veteran.  

    Find the rest of this story here

    Program for homeless N.H. vets could close 

    By PHILIP ELLIOTT, The Associated Press
    Published: Wednesday, Mar. 14, 2007

    CONCORD – A temporary home for homeless veterans in Manchester will lose its entire federal budget next year, officials said Tuesday. Liberty House received $150,000 over the past three years from the U.S. Department of Housing and Urban Development, founder Don Duhamel said. But the money wasn’t included in the proposed federal budget. “We’re fighting for our life,” Duhamel said. “We’re going to have to go out and beg and whatever and find other sources.”Liberty House was at the bottom of Manchester’s six-item, $881,000 HUD application. The agency funded the first five requests and awarded them $723,000. It also set aside $82,000 for emergency shelters. “We don’t pick and choose the projects to receive funding in any local community,” HUD spokesman Brian Sullivan said. Those are chosen by local interagency committees, he said. Liberty House didn’t make the cut. “There’s only so much money that HUD gives,” said Paul Crawford, chair of Manchester’s board that reviews potential federal homeless programs. “We’ve been waiting for six months to hear. It wasn’t until the federal budget for the last year was done that we could find out.” Mary Sliney helped coordinate the city’s applications. She said outside experts in homelessness reviewed the proposals and ranked them.Liberty House has 10 beds for homeless vets and recently started letting another two sleep on couches, Duhamel said.

    “I’ll be damned if we’re going to close our door,” he said. “We’re taking them off the street and sending them back out there as taxpayers. We want to get them a job, an apartment, have them walk out of here as taxpayers and living a clean life.”

    Duhamel pointed to the growing number of Iraq war vets as a reason to keep funding his program.

    “They are giving us a hard time and this is when they need us the most. With this kind of war and all these brain injuries, they’re going to be hurting for the next 20 years,” he said.

    Sliney agreed that veterans from Iraq and Afghanistan need attention. 

    “This is a critical time as we’re looking at the folks who are the new veterans from our current wars,” Sliney said. “This is something we need to pay attention to.”

    Oldtimer’s comment:

    Wave more than just flags ’cause…

     Heros are out there too.

    For all homeless Veteran Posts

    Homeless Youth – Some Random Facts That May Scare You

    Some random facts that may scare you:

    Estimates are that one in seven youths will leave home by the age of 18 (National Runaway Switchboard, 2001).

     “Every year, assault, illness, and suicide claim the lives of approximately 5,000 runaway and homeless youth” (The National Runaway Switchboard, 2001, p. 2). 

     Young people on the streets find it very difficult to meet their basic needs, so they may also resort to survival sex to provide for themselves. 

     According to the Office of Juvenile Justice and Delinquency Prevention, more than half of all runaways are girls (Hammer, et al., 2002). Makes you want to cry

    The National Network for Youth (2003) reports that most homeless youth living on the streets are boys. Boys are more likely to be kicked out and girls more likely to run away, possibly because boys are more likely to engage in deviant behaviors that cause parents to kick them out and girls are more likely to experience sexual abuse that prompts them to run away.

    The same abuse continues on the streets as girls are more likely to be raped and boys are more likely to be physically assaulted (Cauce, et al., 2000; MacLean, Embry,& Cauce, 1999).

    Ensign and Bell (2004) found the average length of homelessness differed significantly according to whether the youth lived in a shelter or on the streets. For those living in shelters, the average length of homelessness was four months (range one to nine months), but the average length for those on the streets was three years (range one month to eight years).

    One in eight youth under 18 will leave home and become a street person in need of services (Raleigh-DuRoff, 2004), and 40 percent do not return home

    Do you have children or grandchildren or neighbors with children at risk?   Do something about it before it is too late.  Get help now.

    I hope the picture above makes you want to cry.  

    Oldtimer’s comment:  Click for All the Homeless Youth articles

    Research – Unaccompanied and Homeless Youth Review of Literature (1995-2005)

    Research – Unaccompanied and Homeless Youth Review of Literature (1995-2005)

    National Center for Homeless EducationThis review is based on literature published between 1995 and 2005 on issues concerning unaccompanied youth experiencing homelessness. It provides an overview of the challenges these young people face and includes research about why they leave their homes, how they live after leaving, and what interventions are being used to assist them.   NCHE stands for National Center for Homeless Education.

    pdf icon This is a 30 page pdf that you can read or download here