Robert Finn

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

Among the key recommendations:

▸ Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight, are additive and together can lower the risk of a first stroke by up to 80%.

▸ Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

▸ Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

▸ The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

▸ The general population should not be screened for carotid artery stenosis.

▸ Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there's no specific recommendation for the use of the factor Xa inhibitor dabigatran, which received FDA approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

“Everything we do is out of date as soon as it's done,” said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. “Our guidelines aren't based on whether a drug has been approved or not. They're based on the science and on the evidence. … It takes some time to produce these things, but if there's a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory.”

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there's no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

“The bottom line is that having this as an option is a very good thing,” Dr. Goldstein said.

“We've had a single drug that's been proved to be efficacious for decades, but it carries its own baggage. We're just going to have to see how this fits into clinical practice.”

The guidelines were released online in Stroke (2010:41 [doi:10.1161/STR.0b013 e3181fcb238]).

Dr. Goldstein acknowledged relationships with Bayer, Pfizer, and Abbott Labs; and other members of the writing committee had a variety of disclosures that are detailed in the publication.

'Everything we do is out of date as soon as it's done. Our guidelines [are] based on the science and on the evidence.'

Source DR. GOLDSTEIN

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

Among the key recommendations:

▸ Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight, are additive and together can lower the risk of a first stroke by up to 80%.

▸ Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

▸ Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

▸ The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

▸ The general population should not be screened for carotid artery stenosis.

▸ Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there's no specific recommendation for the use of the factor Xa inhibitor dabigatran, which received FDA approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

“Everything we do is out of date as soon as it's done,” said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. “Our guidelines aren't based on whether a drug has been approved or not. They're based on the science and on the evidence. … It takes some time to produce these things, but if there's a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory.”

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there's no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

“The bottom line is that having this as an option is a very good thing,” Dr. Goldstein said.

“We've had a single drug that's been proved to be efficacious for decades, but it carries its own baggage. We're just going to have to see how this fits into clinical practice.”

The guidelines were released online in Stroke (2010:41 [doi:10.1161/STR.0b013 e3181fcb238]).

Dr. Goldstein acknowledged relationships with Bayer, Pfizer, and Abbott Labs; and other members of the writing committee had a variety of disclosures that are detailed in the publication.

'Everything we do is out of date as soon as it's done. Our guidelines [are] based on the science and on the evidence.'

Source DR. GOLDSTEIN

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

Among the key recommendations:

▸ Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight, are additive and together can lower the risk of a first stroke by up to 80%.

▸ Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

▸ Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

▸ The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

▸ The general population should not be screened for carotid artery stenosis.

▸ Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there's no specific recommendation for the use of the factor Xa inhibitor dabigatran, which received FDA approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

“Everything we do is out of date as soon as it's done,” said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. “Our guidelines aren't based on whether a drug has been approved or not. They're based on the science and on the evidence. … It takes some time to produce these things, but if there's a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory.”

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there's no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

“The bottom line is that having this as an option is a very good thing,” Dr. Goldstein said.

“We've had a single drug that's been proved to be efficacious for decades, but it carries its own baggage. We're just going to have to see how this fits into clinical practice.”

The guidelines were released online in Stroke (2010:41 [doi:10.1161/STR.0b013 e3181fcb238]).

Dr. Goldstein acknowledged relationships with Bayer, Pfizer, and Abbott Labs; and other members of the writing committee had a variety of disclosures that are detailed in the publication.

'Everything we do is out of date as soon as it's done. Our guidelines [are] based on the science and on the evidence.'

Source DR. GOLDSTEIN

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the factor Xa inhibitor dabigatran, which received FDA approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

The guidelines were released online in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the factor Xa inhibitor dabigatran, which received FDA approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

The guidelines were released online in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the factor Xa inhibitor dabigatran, which received FDA approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

The guidelines were released online in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

The birth rate for U.S. teens aged 15-19 years fell to the lowest level since recording began in 1940, according to new data for 2009 released Dec. 21 by the Centers for Disease Control and Prevention.

The 2009 teen birth rate was 39.1 births per 1,000 teens, down 6% from the 2008 rate of 41.5 births per 1,000, according to the report by the CDC National Center for Health Statistics. The 2009 rate was 37% lower than in 1991, the peak year for teen births.

The CDC’s annual report is based on virtually 100% of vital records collected in the 50 U.S. states, the District of Columbia, and U.S. territories.

Overall fertility also fell in 2009 to 66.7 births per 1,000 women aged 15-44 years, compared with 68.6 per 1,000 women in 2008. The CDC’s preliminary estimate of births in 2009 was 4,131,019, 3% less than 2008. Early data through June 2010 suggest that the decline in fertility has continued, according to the report.

Fertility rates increased in only one age group: women aged 40-44 years. In that group, the 2009 rate was 10.1 births per 1,000 women, up 3% from the 2008 figure and the highest rate since 1967.

[Slight Uptick Seen in Teen Pregnancy Rates]

The rate of preterm births declined for the third straight year, to 12.2% of all births in 2009.

The rate of cesarean deliveries rose to a record high of 32.9% in 2009, up from 32.3% in 2008.

The low birth weight rate remained unchanged at about 8.2% between 2008 and 2009.

The CDC also reported the total fertility rate (TFR) – an estimate of the number of births that a hypothetical group of 1,000 women would have over their lifetimes, based on the age-specific rates of a particular year. The TFR for 2009 was 2,007.5, down 4% from the rate in 2008. This is the largest decline in TFR since 1973. The 2008 and 2009 rates were both below the replacement rate of 2,100 births per 1,000 women. Replacement is the rate at which a given generation can exactly replace itself. The U.S. TFR was below replacement for every year between 1972-2005 and above replacement in 2006 and 2007.

[Some Teens Quit Implanon Despite Advice on Side Effects]

The birth rate for U.S. teens aged 15-19 years fell to the lowest level since recording began in 1940, according to new data for 2009 released Dec. 21 by the Centers for Disease Control and Prevention.

The 2009 teen birth rate was 39.1 births per 1,000 teens, down 6% from the 2008 rate of 41.5 births per 1,000, according to the report by the CDC National Center for Health Statistics. The 2009 rate was 37% lower than in 1991, the peak year for teen births.

The CDC’s annual report is based on virtually 100% of vital records collected in the 50 U.S. states, the District of Columbia, and U.S. territories.

Overall fertility also fell in 2009 to 66.7 births per 1,000 women aged 15-44 years, compared with 68.6 per 1,000 women in 2008. The CDC’s preliminary estimate of births in 2009 was 4,131,019, 3% less than 2008. Early data through June 2010 suggest that the decline in fertility has continued, according to the report.

Fertility rates increased in only one age group: women aged 40-44 years. In that group, the 2009 rate was 10.1 births per 1,000 women, up 3% from the 2008 figure and the highest rate since 1967.

[Slight Uptick Seen in Teen Pregnancy Rates]

The rate of preterm births declined for the third straight year, to 12.2% of all births in 2009.

The rate of cesarean deliveries rose to a record high of 32.9% in 2009, up from 32.3% in 2008.

The low birth weight rate remained unchanged at about 8.2% between 2008 and 2009.

The CDC also reported the total fertility rate (TFR) – an estimate of the number of births that a hypothetical group of 1,000 women would have over their lifetimes, based on the age-specific rates of a particular year. The TFR for 2009 was 2,007.5, down 4% from the rate in 2008. This is the largest decline in TFR since 1973. The 2008 and 2009 rates were both below the replacement rate of 2,100 births per 1,000 women. Replacement is the rate at which a given generation can exactly replace itself. The U.S. TFR was below replacement for every year between 1972-2005 and above replacement in 2006 and 2007.

[Some Teens Quit Implanon Despite Advice on Side Effects]

The birth rate for U.S. teens aged 15-19 years fell to the lowest level since recording began in 1940, according to new data for 2009 released Dec. 21 by the Centers for Disease Control and Prevention.

The 2009 teen birth rate was 39.1 births per 1,000 teens, down 6% from the 2008 rate of 41.5 births per 1,000, according to the report by the CDC National Center for Health Statistics. The 2009 rate was 37% lower than in 1991, the peak year for teen births.

The CDC’s annual report is based on virtually 100% of vital records collected in the 50 U.S. states, the District of Columbia, and U.S. territories.

Overall fertility also fell in 2009 to 66.7 births per 1,000 women aged 15-44 years, compared with 68.6 per 1,000 women in 2008. The CDC’s preliminary estimate of births in 2009 was 4,131,019, 3% less than 2008. Early data through June 2010 suggest that the decline in fertility has continued, according to the report.

Fertility rates increased in only one age group: women aged 40-44 years. In that group, the 2009 rate was 10.1 births per 1,000 women, up 3% from the 2008 figure and the highest rate since 1967.

[Slight Uptick Seen in Teen Pregnancy Rates]

The rate of preterm births declined for the third straight year, to 12.2% of all births in 2009.

The rate of cesarean deliveries rose to a record high of 32.9% in 2009, up from 32.3% in 2008.

The low birth weight rate remained unchanged at about 8.2% between 2008 and 2009.

The CDC also reported the total fertility rate (TFR) – an estimate of the number of births that a hypothetical group of 1,000 women would have over their lifetimes, based on the age-specific rates of a particular year. The TFR for 2009 was 2,007.5, down 4% from the rate in 2008. This is the largest decline in TFR since 1973. The 2008 and 2009 rates were both below the replacement rate of 2,100 births per 1,000 women. Replacement is the rate at which a given generation can exactly replace itself. The U.S. TFR was below replacement for every year between 1972-2005 and above replacement in 2006 and 2007.

[Some Teens Quit Implanon Despite Advice on Side Effects]

In this video, Dr. Rebecca Rogers, president of the American Urogynecologic Society, discusses the four main research challenges faced by urogynecology.

In this video, Dr. Rebecca Rogers, president of the American Urogynecologic Society, discusses the four main research challenges faced by urogynecology.

In this video, Dr. Rebecca Rogers, president of the American Urogynecologic Society, discusses the four main research challenges faced by urogynecology.

Eli Lilly & Co. announced Dec. 13, 2010, the immediate suspension of their phase III trial of tasisulam for unresectable or metastatic melanoma.

The company said in a statement that its action was taken in consultation with an independent data monitoring committee that recommended a "full clinical hold" because of safety concerns. The statement did not specify the nature of those safety concerns.

Lilly is testing tasisulam in other cancers, including soft tissue sarcoma; breast, ovarian, and renal cancers; non-small cell lung cancer; and acute leukemia. The company is continuing those trials without modification because the dosing of tasisulam is different.

Eli Lilly & Co. announced Dec. 13, 2010, the immediate suspension of their phase III trial of tasisulam for unresectable or metastatic melanoma.

The company said in a statement that its action was taken in consultation with an independent data monitoring committee that recommended a "full clinical hold" because of safety concerns. The statement did not specify the nature of those safety concerns.

Lilly is testing tasisulam in other cancers, including soft tissue sarcoma; breast, ovarian, and renal cancers; non-small cell lung cancer; and acute leukemia. The company is continuing those trials without modification because the dosing of tasisulam is different.

Eli Lilly & Co. announced Dec. 13, 2010, the immediate suspension of their phase III trial of tasisulam for unresectable or metastatic melanoma.

The company said in a statement that its action was taken in consultation with an independent data monitoring committee that recommended a "full clinical hold" because of safety concerns. The statement did not specify the nature of those safety concerns.

Lilly is testing tasisulam in other cancers, including soft tissue sarcoma; breast, ovarian, and renal cancers; non-small cell lung cancer; and acute leukemia. The company is continuing those trials without modification because the dosing of tasisulam is different.

Eli Lilly and Company announced Dec. 13, 2010 the immediate suspension of their Phase III trial of tasisulam for unresectable or metastatic melanoma.

The company said in a statement that its action was taken in consultation with an independent data monitoring committee that recommended a "full clinical hold" because of safety concerns. The statement did not specify the nature of those safety concerns.

Lilly is testing tasisulam in other cancers, including soft tissue sarcoma, breast, ovarian, and renal cancers, non-small cell lung cancer, and acute leukemia. The company is continuing those trials without modification because the dosing of tasisulam is different.

Eli Lilly and Company announced Dec. 13, 2010 the immediate suspension of their Phase III trial of tasisulam for unresectable or metastatic melanoma.

The company said in a statement that its action was taken in consultation with an independent data monitoring committee that recommended a "full clinical hold" because of safety concerns. The statement did not specify the nature of those safety concerns.

Lilly is testing tasisulam in other cancers, including soft tissue sarcoma, breast, ovarian, and renal cancers, non-small cell lung cancer, and acute leukemia. The company is continuing those trials without modification because the dosing of tasisulam is different.

Eli Lilly and Company announced Dec. 13, 2010 the immediate suspension of their Phase III trial of tasisulam for unresectable or metastatic melanoma.

The company said in a statement that its action was taken in consultation with an independent data monitoring committee that recommended a "full clinical hold" because of safety concerns. The statement did not specify the nature of those safety concerns.

Lilly is testing tasisulam in other cancers, including soft tissue sarcoma, breast, ovarian, and renal cancers, non-small cell lung cancer, and acute leukemia. The company is continuing those trials without modification because the dosing of tasisulam is different.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

The new guidelines were released online Dec. 2 in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the oral direct thrombin* inhibitor dabigatran, which received Food and Drug Administration approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

* CORRECTION,  12/3/2010: The original version of this article misstated the action of dabigatran. It is an oral direct thrombin inhibitor. This version has been updated.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

The new guidelines were released online Dec. 2 in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the oral direct thrombin* inhibitor dabigatran, which received Food and Drug Administration approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

* CORRECTION,  12/3/2010: The original version of this article misstated the action of dabigatran. It is an oral direct thrombin inhibitor. This version has been updated.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

The new guidelines were released online Dec. 2 in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the oral direct thrombin* inhibitor dabigatran, which received Food and Drug Administration approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

* CORRECTION,  12/3/2010: The original version of this article misstated the action of dabigatran. It is an oral direct thrombin inhibitor. This version has been updated.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

The new guidelines were released online Dec. 2 in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the oral direct thrombin* inhibitor dabigatran, which received Food and Drug Administration approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

* CORRECTION,  12/3/2010: The original version of this article misstated the action of dabigatran. It is an oral direct thrombin inhibitor. This version has been updated.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

The new guidelines were released online Dec. 2 in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the oral direct thrombin* inhibitor dabigatran, which received Food and Drug Administration approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

* CORRECTION,  12/3/2010: The original version of this article misstated the action of dabigatran. It is an oral direct thrombin inhibitor. This version has been updated.

The American Heart Association and the American Stroke Association have together issued new guidelines on how to prevent strokes. The new guidelines constitute a thorough reevaluation of the scientific literature on stroke prevention, and contain many differences from the previous set of guidelines, which were published in 2006.

The new guidelines were released online Dec. 2 in Stroke (2010:41 [doi:10.1161/STR.0b013e3181fcb238]).

Among the key recommendations:

• Healthy lifestyle choices, such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly, and maintaining normal body weight are additive and together can lower the risk of a first stroke by up to 80%.

• Emergency physicians should attempt to identify patients at high risk of stroke, and they should consider making referrals, conducting screenings, or beginning preventive therapy.

• Genetic screening for stroke risk is not recommended for the general population, but it may be appropriate in some circumstances, depending on family history and other factors.

• The usefulness of carotid artery stenting or carotid endarterectomy for patients with asymptomatic carotid artery stenosis remains uncertain. The advantages of revascularization over medical therapy alone are not well established.

• The general population should not be screened for carotid artery stenosis.

• Low-dose aspirin does not prevent a first stroke in low-risk patients or those with diabetes or asymptomatic peripheral artery disease. Aspirin may be appropriate for patients whose risk of stroke is high enough to outweigh the risk of bleeding with aspirin.

While the recommendations discuss the use of warfarin and antithrombin prophylaxis in atrial fibrillation, there’s no specific recommendation for the use of the oral direct thrombin* inhibitor dabigatran, which received Food and Drug Administration approval on Oct. 19, after the guidelines had been finalized, raising the question of whether the new guidelines are already out of date.

"Everything we do is out of date as soon as it’s done," said Dr. Larry B. Goldstein, who chaired the statement writing committee, in an interview. "Our guidelines aren’t based on whether a drug has been approved or not. They’re based on the science and on the evidence. ... It takes some time to produce these things, but if there’s a new study or studies that become available after a guideline has been published that affects our recommendations, then we publish an intermediate practice advisory."

While he regards dabigatran as very promising, Dr. Goldstein, director of the Duke Stroke Center in Durham, N.C., noted that many questions still remain. For example, it is unknown how often patients on dabigatran should have their liver function tested. If a patient has a bleeding complication while on the drug, there’s no way currently to reverse that. There are suggestions that dabigatran might increase the risk of myocardial infarction and may interact with other drugs, such as verapamil.

"The bottom line is that having this as an option is a very good thing," Dr. Goldstein said. "We’ve had a single drug that’s been proved to be efficacious for decades, but it carries its own baggage. We’re just going to have to see how this fits into clinical practice."

Dr. Goldstein acknowledged relationships with Bayer Corp., Pfizer Inc., and Abbott Labs, and other members of the writing committee had a variety of disclosures that are detailed in the publication.

* CORRECTION,  12/3/2010: The original version of this article misstated the action of dabigatran. It is an oral direct thrombin inhibitor. This version has been updated.

A survey of more than 700 medical students found that 14% were moderately or severely depressed. Those depressed students were significantly more likely than students who were not depressed to express concern about stigmas associated with depression, according to the survey.

For example, 53% of the students with moderate to severe depression agreed with the statement, “Telling a counselor I am depressed would be risky,” compared with 17% of students with no or minimal depression.

The results come from a survey of all 769 students enrolled at the medical school of the University of Michigan, Ann Arbor, in September-November 2009. Of the students surveyed, 505 (66%) responded, reported Dr. Thomas L. Schwenk and his colleagues at the university (JAMA 2010;304:1181–90).

First- and second-year students were no more likely than third- or fourth-year students to report moderate to severe depression (13% vs. 15%). But significantly more women than men scored in the moderate to severe range (18% vs. 9%).

Third- and fourth-year students with moderate to severe depression were more likely to report suicidal ideation than were first- and second-year students (7.9% vs. 1.4%).

Significant differences were found between students with moderate to severe depression and those with no or minimal depression on several other stigma-related statements. For example, 62% of the students with moderate to severe depression, compared with 34% of those with no or minimal depression, agreed with the statement, “If I were depressed and asked for help, I would be admitting that my coping skills are inadequate.”

Depressed students also expressed significantly more concern about being less competitive in their residency applications.

On the other hand, 86% of students with moderate to severe depression disagreed with the statement, “Medical students with depression are dangerous to their patients,” compared with 74% of students with no or minimal depression who disagreed with that statement. The difference was statistically significant.

“These results suggest that new approaches may be needed to reduce the stigma of depression and to enhance its prevention, detection, and treatment,” the investigators wrote.

The study was funded by the department of family medicine at the University of Michigan. The authors reported no financial disclosures.

A survey of more than 700 medical students found that 14% were moderately or severely depressed. Those depressed students were significantly more likely than students who were not depressed to express concern about stigmas associated with depression, according to the survey.

For example, 53% of the students with moderate to severe depression agreed with the statement, “Telling a counselor I am depressed would be risky,” compared with 17% of students with no or minimal depression.

The results come from a survey of all 769 students enrolled at the medical school of the University of Michigan, Ann Arbor, in September-November 2009. Of the students surveyed, 505 (66%) responded, reported Dr. Thomas L. Schwenk and his colleagues at the university (JAMA 2010;304:1181–90).

First- and second-year students were no more likely than third- or fourth-year students to report moderate to severe depression (13% vs. 15%). But significantly more women than men scored in the moderate to severe range (18% vs. 9%).

Third- and fourth-year students with moderate to severe depression were more likely to report suicidal ideation than were first- and second-year students (7.9% vs. 1.4%).

Significant differences were found between students with moderate to severe depression and those with no or minimal depression on several other stigma-related statements. For example, 62% of the students with moderate to severe depression, compared with 34% of those with no or minimal depression, agreed with the statement, “If I were depressed and asked for help, I would be admitting that my coping skills are inadequate.”

Depressed students also expressed significantly more concern about being less competitive in their residency applications.

On the other hand, 86% of students with moderate to severe depression disagreed with the statement, “Medical students with depression are dangerous to their patients,” compared with 74% of students with no or minimal depression who disagreed with that statement. The difference was statistically significant.

“These results suggest that new approaches may be needed to reduce the stigma of depression and to enhance its prevention, detection, and treatment,” the investigators wrote.

The study was funded by the department of family medicine at the University of Michigan. The authors reported no financial disclosures.

A survey of more than 700 medical students found that 14% were moderately or severely depressed. Those depressed students were significantly more likely than students who were not depressed to express concern about stigmas associated with depression, according to the survey.

For example, 53% of the students with moderate to severe depression agreed with the statement, “Telling a counselor I am depressed would be risky,” compared with 17% of students with no or minimal depression.

The results come from a survey of all 769 students enrolled at the medical school of the University of Michigan, Ann Arbor, in September-November 2009. Of the students surveyed, 505 (66%) responded, reported Dr. Thomas L. Schwenk and his colleagues at the university (JAMA 2010;304:1181–90).

First- and second-year students were no more likely than third- or fourth-year students to report moderate to severe depression (13% vs. 15%). But significantly more women than men scored in the moderate to severe range (18% vs. 9%).

Third- and fourth-year students with moderate to severe depression were more likely to report suicidal ideation than were first- and second-year students (7.9% vs. 1.4%).

Significant differences were found between students with moderate to severe depression and those with no or minimal depression on several other stigma-related statements. For example, 62% of the students with moderate to severe depression, compared with 34% of those with no or minimal depression, agreed with the statement, “If I were depressed and asked for help, I would be admitting that my coping skills are inadequate.”

Depressed students also expressed significantly more concern about being less competitive in their residency applications.

On the other hand, 86% of students with moderate to severe depression disagreed with the statement, “Medical students with depression are dangerous to their patients,” compared with 74% of students with no or minimal depression who disagreed with that statement. The difference was statistically significant.

“These results suggest that new approaches may be needed to reduce the stigma of depression and to enhance its prevention, detection, and treatment,” the investigators wrote.

The study was funded by the department of family medicine at the University of Michigan. The authors reported no financial disclosures.

An extremely simple device that tests an athlete's reaction time is showing promise in diagnosing concussions, according to a study announced in advance of its scheduled presentation at the meeting in Toronto.

Seven of eight Division I athletes who had suffered a concussion showed significantly slowed reaction times with the device, Dr. James T. Eckner said in an interview. “It's actually very similar to an experiment that's done commonly in physics classrooms in high schools,” said Dr. Eckner, of the department of physical medicine and rehabilitation at the University of Michigan, Ann Arbor, In that experiment, reaction times are judged by the speed with which people can catch a ruler dropped between their fingers.

The device “is a fancier ruler, essentially,” Dr. Eckner said. “It's basically a dowel rod that we've coated in friction tape, and we've marked it in centimeter increments. And then at the base of it there's a little rubber disc, which is actually a hockey puck that it's embedded in.”

The device is so simple that it has the potential of being used on the sidelines of a football game. The person being tested sits with his or her forearm resting on a table. The person administering the test holds the device so that the subject's hand is encircling, but not touching, the hockey puck. At a random moment the investigator drops the device, and the subject catches it as soon as he or she can.

“We measure then how many centimeters it fell before they caught it, and then we use a simple physics equation for a body falling under the influence of gravity to convert that into how many milliseconds it fell for,” Dr. Eckner said.

For the experiment, Dr. Eckner and his colleagues recruited 209 members of Division I football, wrestling, and soccer teams. Before the start of the season the investigators measured each athlete's normal baseline reaction time. During the course of the season, eight of the athletes suffered concussions diagnosed by a physician. The investigators tested those eight athletes within 72 hours of their injury. Seven of the eight athletes showed significant slowing of reaction. Their average reaction time increased from 193 milliseconds at the start of the season to 222 milliseconds after their injuries, a statistically significant difference.

Dr. Eckner said that in practice, a 10%–15% increase in the length of reaction time would likely be statistically significant and perhaps clinically significant as well.

“I think that our results are still a little bit preliminary,” Dr. Eckner said. “They're all very encouraging, but the study we've got so far is fairly small.”

The Foundation for Physical Medicine and Rehabilitation and the University of Michigan supported the study.

Dr. James T. Eckner (standing) says the device is so simple that it could be used on the sidelines of a football game.

Source Courtesy Dr. James T. Eckner

An extremely simple device that tests an athlete's reaction time is showing promise in diagnosing concussions, according to a study announced in advance of its scheduled presentation at the meeting in Toronto.

Seven of eight Division I athletes who had suffered a concussion showed significantly slowed reaction times with the device, Dr. James T. Eckner said in an interview. “It's actually very similar to an experiment that's done commonly in physics classrooms in high schools,” said Dr. Eckner, of the department of physical medicine and rehabilitation at the University of Michigan, Ann Arbor, In that experiment, reaction times are judged by the speed with which people can catch a ruler dropped between their fingers.

The device “is a fancier ruler, essentially,” Dr. Eckner said. “It's basically a dowel rod that we've coated in friction tape, and we've marked it in centimeter increments. And then at the base of it there's a little rubber disc, which is actually a hockey puck that it's embedded in.”

The device is so simple that it has the potential of being used on the sidelines of a football game. The person being tested sits with his or her forearm resting on a table. The person administering the test holds the device so that the subject's hand is encircling, but not touching, the hockey puck. At a random moment the investigator drops the device, and the subject catches it as soon as he or she can.

“We measure then how many centimeters it fell before they caught it, and then we use a simple physics equation for a body falling under the influence of gravity to convert that into how many milliseconds it fell for,” Dr. Eckner said.

For the experiment, Dr. Eckner and his colleagues recruited 209 members of Division I football, wrestling, and soccer teams. Before the start of the season the investigators measured each athlete's normal baseline reaction time. During the course of the season, eight of the athletes suffered concussions diagnosed by a physician. The investigators tested those eight athletes within 72 hours of their injury. Seven of the eight athletes showed significant slowing of reaction. Their average reaction time increased from 193 milliseconds at the start of the season to 222 milliseconds after their injuries, a statistically significant difference.

Dr. Eckner said that in practice, a 10%–15% increase in the length of reaction time would likely be statistically significant and perhaps clinically significant as well.

“I think that our results are still a little bit preliminary,” Dr. Eckner said. “They're all very encouraging, but the study we've got so far is fairly small.”

The Foundation for Physical Medicine and Rehabilitation and the University of Michigan supported the study.

Dr. James T. Eckner (standing) says the device is so simple that it could be used on the sidelines of a football game.

Source Courtesy Dr. James T. Eckner

An extremely simple device that tests an athlete's reaction time is showing promise in diagnosing concussions, according to a study announced in advance of its scheduled presentation at the meeting in Toronto.

Seven of eight Division I athletes who had suffered a concussion showed significantly slowed reaction times with the device, Dr. James T. Eckner said in an interview. “It's actually very similar to an experiment that's done commonly in physics classrooms in high schools,” said Dr. Eckner, of the department of physical medicine and rehabilitation at the University of Michigan, Ann Arbor, In that experiment, reaction times are judged by the speed with which people can catch a ruler dropped between their fingers.

The device “is a fancier ruler, essentially,” Dr. Eckner said. “It's basically a dowel rod that we've coated in friction tape, and we've marked it in centimeter increments. And then at the base of it there's a little rubber disc, which is actually a hockey puck that it's embedded in.”

The device is so simple that it has the potential of being used on the sidelines of a football game. The person being tested sits with his or her forearm resting on a table. The person administering the test holds the device so that the subject's hand is encircling, but not touching, the hockey puck. At a random moment the investigator drops the device, and the subject catches it as soon as he or she can.

“We measure then how many centimeters it fell before they caught it, and then we use a simple physics equation for a body falling under the influence of gravity to convert that into how many milliseconds it fell for,” Dr. Eckner said.

For the experiment, Dr. Eckner and his colleagues recruited 209 members of Division I football, wrestling, and soccer teams. Before the start of the season the investigators measured each athlete's normal baseline reaction time. During the course of the season, eight of the athletes suffered concussions diagnosed by a physician. The investigators tested those eight athletes within 72 hours of their injury. Seven of the eight athletes showed significant slowing of reaction. Their average reaction time increased from 193 milliseconds at the start of the season to 222 milliseconds after their injuries, a statistically significant difference.

Dr. Eckner said that in practice, a 10%–15% increase in the length of reaction time would likely be statistically significant and perhaps clinically significant as well.

“I think that our results are still a little bit preliminary,” Dr. Eckner said. “They're all very encouraging, but the study we've got so far is fairly small.”

The Foundation for Physical Medicine and Rehabilitation and the University of Michigan supported the study.

Dr. James T. Eckner (standing) says the device is so simple that it could be used on the sidelines of a football game.

Source Courtesy Dr. James T. Eckner