Amantadine Accelerates Brain Recovery
After a severe trau-
MossRehab Resource Net
matic brain injury (TBI),
some patients suffer from
The Center for Outcome
disorders of consciousness
Measurement in Brain Injury
(DOC), including coma,
the vegetative state, and
Brain Injury Association of
the minimally conscious
state. Until recently, there
have been no treatments
proven to speed up or im-prove recovery. As a re-
Brain Injury Association of Pennsylvania
sult, rehabilitation has fo-
cused on improving bodily
Brain Injury Resource Line
health and preventing
complications, while wait-ing for natural recovery to occur.
Brain Injury Association of
Dr. Sooja Cho & Dr. John Whyte
Physicians may attempt unproven treat-
ments in the hopes of enhancing recovery – e.g., psychostimulants, hyperbaric
oxygen, and sensory stimulation. For the first time, however, a drug called aman-
tadine has been shown to accelerate recovery from post-traumatic DOC. An inter-
national study led by Joseph Giacino, PhD, currently at Spaulding Rehabilitation
Brain Injury Association of
Hospital and Harvard Medical School, and John Whyte, MD, PhD, at Moss Reha-
bilitation Research Institute, was funded by the National Institute on Disability and
Rehabilitation Research to address this topic.
The study involved 184 patients at 10 clinical sites in the United States and
Europe. Dr. Sooja Cho led the study at MossRehab. Study participants had a DOC as a result of TBI and were enrolled between 1 and 4 months post-injury. About
Pennsylvania Department of
half the participants were treated with amantadine and half with an inert placebo
Health Brain Injury Helpline
over a 4-week period. Treatment was then stopped and patients were assessed for 2
As reported in the New England Journal of Medicine on March 1, 2012,
with extensive follow-up in the media, the group receiving amantadine made faster
progress during the 4 weeks of treatment. When the drug was stopped and partici-pants were followed for 2 more weeks, the placebo group began to "catch up" to the amantadine group. Side effects did not differ between groups.
(Cont'd on page 3)
Meet Seamus – Our Newest Therapist
Meet Seamus (pronounced "Shay-mus"),
one of the newest team members on the MossRe-hab Drucker Brain Injury Center's inpatient unit, and already one of the most popular! Seamus, an ultra-mellow 2-1/2-year-old Lab-golden retriever mix, came to Moss as part of the canine assisted therapy program started through the hard work and dedication of Carolyn Tassini, Drucker's Physical Therapy Team Leader. As a "cadet" in the Canine Companions for Independence pro-gram he went through more than 6 months of ad-vanced training on service skills, from which only 40% graduate. Seamus then trained with his
handler, Carolyn, for 2 weeks before starting daily, full-time work on the inpatient unit.
Seamus accompanies Caro-
lyn to therapy sessions and follows various combinations of service commands to work with patients. For example, by following the "tug" command, he can deliver balance challenges to patients who are kneel-ing, sitting, or standing on foam. Pa-tients who help groom Seamus, dress him in his special vest, or attach one of his three different collars get "painless" lessons in sequencing, persistence, and fine motor skills. Seamus also walks with patients, both indoors and out. Whatever the task, Seamus' friendly and respon-
sive presence helps patients to focus attention and improve their interaction with the environment.
When not working, Seamus is a run-
ning partner for Carolyn. He also likes to wrestle with a ball, eat carrots, play with his squeaky toys, and hop in the lake with his brother, Finn, a Portugese water dog.
Welcome, Seamus! You're "top dog"
at Moss, and (last time we checked) the only employee who's never complained about a long day at work.
Activities to Support Brain Injury Awareness
Walk, Run, Roll Events
Brain Safety Fairs
Two local Walk, Run, Roll
This year, the Brain Injury
The Brain Injury Asso-
events are held annually in the
Association of Pennsylvania is
ciation of Pennsylvania's an-
greater Philadelphia area to pro-
having Brain Safety Fairs at the
nual conference is coming up!
mote awareness about brain injury
Franklin Institute Science Mu-
It will be held on Monday,
and raise funds.
seum, both on Community Nights
June 25 – Tuesday, June 26,
2nd Annual Walk, Roll,
when admission to the museum is
in Lancaster at the Lancaster
Run for Brain Injury, a partnership
free of charge. They're scheduled
(PA) Marriott. The program is
between the Brain Injury Associa-
for Wednesday May 23rd
intended for survivors, caregiv-
tion of Pennsylvania and Camp
Wednesday June 20th
from 5:00 –
ers and professionals.
Cranium, was held on April 14th at
The theme for his year's
Tyler State Park in Newtown, PA.
Come and learn about how
conference is Improving Qual-
The 4th Annual Walk, Run, Roll for
the brain works, how to keep it
ity of Life: Practical Ap-
Thought: Race for Recovery will
safe, and get fitted with a free bi-
proaches and Cutting Edge
be held on May 26th
cycle helmet! For more informa-
Goshen Park in West Chester, PA.
tion about Brain Safety Fairs being
To learn more about
To learn more about these
held throughout Pennsylvania, go
the conference, go to
and other events across Pennsyl-
vania, go to www.biapa.org.
Amantadine Speeds Recovery (con't)
March 21st was Blue Jean Day
From Page 1:
Blue Jean Day is an annual
What we know from this study is that amatadine
effort of the Drucker Brain Injury
can speed up recovery for patients with traumatic DOC,
Center (DBIC) to raise awareness
and that it does so without any obvious side effects.
about brain injury in the local commu-
What we can't tell from this study is whether aman-
nity, and to raise funds. Blue Jean Day
tadine improves an individual's long-term outcome, or
works through several entities within
simply achieves that outcome more rapidly. Future re-
the Albert Einstein Medical Center, with DBIC at the lead, to sell Blue
search can help clarify this question. In the meantime,
Jean Day Buttons to local schools and
amantadine may be a drug of choice since it seems fair
businesses. Wearers of the buttons can dress in
to say that both family members and health profession-
jeans on Blue Jean Day.
als would favor faster recovery, even if the long-term
This year, over 1,400 buttons were sold
result is the same.
and more than $2,600 will support the MossRehab DBIC Clubhouse Programs.
at Elkins Park Hospital
SUPPORT GROUP INFO:
Traumatic Brain Injury Model Systems
PENNSYLVANIA EMPOWERMENT GROUP
The Elkins Park Empowerment Group meets on
the second Monday of each month from 6-7:30 at
60 Township Line Road, Elkins Park, PA 19027.
Summer Gathering on June 11th, 6-8pm.
Please bring a side dish or dessert to share.
For more information, contact Debbi Eisen at
as of October, 2007
215-663-6857 OR Katie Soreth-Harman at 215-663-6757.
TBI Model Systems National Database NIDRR 5/2001
The Moss TBI Model System
NEW JERSEY SUPPORT GROUP
The National Institute on Disability and Rehabili-
The New Jersey Support Group meets on the
tation Research has designated MossRehab as a
of each month from 5:30-6:30
Model System of Care for traumatic brain injury
at 135 S. Broad Street, Woodbury NJ 08096.
The TBI Model System program seeks to improve
For more information, contact Dayna Scott at
lives by creating and disseminating new knowl-
856-853-9900 ext. 102.
edge about the course, treatment and outcomes of
Effectiveness of policy Chapter 7 – The effectiveness of alcohol policy Alcohol policies can be grouped within five headings: (i) policies that reduce drinking and driving; (ii) policies that support education, communication, training and public awareness; (iii) policies that regulate the alcohol market; (iv) policies that support the reduction of harm in drinking and surrounding environments; and (v) policies that support interventions for individuals. Since the 1970s, considerable progress has been made in the scientific understanding of the relationship between alcohol policies, alcohol consumption and alcohol-related harm. The drinking-driving policies that are highly effective include unrestricted (random) breath testing, lowered blood alcohol concentration (BAC) levels, administrative license suspension, and lower BAC levels for young drivers. The limited evidence does not find an impact from designated driver and safe drive programmes. Alcohol locks can be effective as a preventive measure, but as a measure with drink driving offenders only work as long as they are fitted to a vehicle. The World Health Organization has modelled the impact and cost of unrestricted breath testing compared with no testing; applying this to the Union finds an estimated 111,000 years of disability and premature death avoided at an estimated cost of €233 million each year. The impact of policies that support education, communication, training and public awareness is low. Although the reach of school-based educational programs can be high because of the availability of captive audiences in schools, the population impact of these programs is small due to their current limited or lack of effectiveness. Recommendations exist as to how the effectiveness of school-based programmes might be improved. On the other hand, mass media programmes have a particular role to play in reinforcing community awareness of the problems created by alcohol use and to prepare the ground for specific interventions. There is very strong evidence for the effectiveness of policies that regulate the alcohol market in reducing the harm done by alcohol, including taxation and managing the physical availability of alcohol (limiting hours and days of sale and raising the minimum drinking age). Alcohol taxes are particularly important in targeting young people and the harms done by alcohol. If alcohol taxes were used to raise the price of alcohol in the EU15 by 10%, over 9,000 deaths would be prevented during the following year and an approximate estimate suggests that €13bn of additional excise duty revenues would also be gained. The evidence shows that if opening hours for the sale of alcohol are extended more violent harm results. The World Health Organization has modelled the impact of alcohol being less available from retail outlets by a 24 hour period each week; applying this to the Union finds an estimated 123,000 years of disability and premature death avoided at an estimated implementation cost of €98 million each year. Restricting the volume and content of commercial communications of alcohol products is likely to reduce harm. Advertisements have a particular impact in promoting a more positive attitude to drinking amongst young people, and, even in advertisements that do not portray drinking of alcohol, young people perceive the characters as heavy drinkers. Self-regulation of commercial communications by the beverage alcohol industry does not have a good track record for being effective. The World Health Organization has modelled the impact of an advertising ban; applying this to the Union, finds an estimated 202,000 years of disability and premature death avoided, at an estimated implementation cost of €95 million each year.
Advocate Spot-on Solution Animal Health DivisionBayer House, Straw berry Hill,New buryBerkshire RG14 1JA Incorporating the data sheets for the follow ing products:Advocate 40 mg + 4 mg spot-on solution for smal cats and ferretsAdvocate 80 mg + 8 mg spot-on solution for large catsAdvocate 40 mg + 10 mg spot-on solution for smal dogsAdvocate 100 mg + 25 mg spot-on solution for medium dogsAdvocate 250 mg + 62.5 mg spot-on solution for large dogsAdvocate 400 mg + 100 mg spot-on solution for extra-large dogsPresentationAdvocate spot-on solution for cats and ferrets is a clear yel ow to brow nish solution containing 100 mg/ml imidacloprid and 10mg/ml moxidectin w ith benzyl alcohol and Butylhydroxytoluene 1 mg/ml (E 321 as an antioxidant). Each pipette of the smal catand ferret presentations contains 0.4 ml (40 mg imidacloprid, 4 mg moxidectin), the large cat presentation contains 0.8 ml (80 mgimidacloprid, 8 mg moxidectin). Advocate spot-on solution for dogs is a clear yel ow to brow nish solution containing 100 mg/ml imidacloprid and 25 mg/mlmoxidectin w ith benzyl alcohol and Butylhydroxytoluene 1 mg/ml (E321 as an antioxidant). Each pipette of the dog presentationscontains either 0.4 ml (40 mg imidacloprid, 10 mg moxidectin), 1.0 ml (100 mg imidacloprid, 25 mg moxidectin), 2.5 ml (250 mgimidacloprid, 62.5 mg moxidectin) or 4.0 ml (400 mg imidacloprid, 100 mg moxidectin).UsesFor use in cats, ferrets and dogs suffering from, or at risk from, mixed parasitic infections: For cats: For the treatment and prevention of flea infestation (Ctenocephalides felis), treatment of ear mite infestation(Otodectes cynotis), prevention of heartw orm disease (L3 and L4 larvae of Dirofilaria immitis) and treatment of infections w ithgastrointestinal nematodes (L4 larvae, immature adults and adults of Toxocara cati and Ancylostoma tubaeforme). The productcan be used as part of a treatment strategy for flea al ergy dermatitis (FAD).For ferrets: For the treatment and prevention of flea infestation (Ctenocephalides felis) and the prevention of heartw ormdisease (L3 and L4 larvae of Dirofilaria immitis).For dogs: For the treatment and prevention of flea infestation (Ctenocephalides felis), treatment of biting lice (Trichodectescanis), treatment of ear mite infestation (Otodectes cynotis), sarcoptic mange (caused by Sarcoptes scabiei var. canis),demodicosis (caused by Demodex canis), prevention of heartw orm disease (L3 and L4 larvae of Dirofilaria immitis) andangiostrongylosis (L4 larvae and immature adults of Angiostrongylus vasorum), treatment of Angiostrongylus vasorum andCrenosoma vulpis and treatment of infections w ith gastrointestinal nematodes (L4 larvae, immature adults and adults ofToxocara canis, Ancylostoma caninum and Uncinaria stenocephala, adults of Toxascaris leonina and Trichuris vulpis). Theproduct can be used as part of a treatment strategy for flea al ergy dermatitis (FAD).Dosage and administration