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ATLANTA (AP) — For the first time, the government is proposing that all baby boomers get tested for hepatitis C.

Anyone born from 1945 to 1965 should get a one-time blood test to see if they have the liver-destroying virus, the Centers for Disease Control and Prevention said in draft recommendations issued Friday.

Baby boomers account for more than 2 million of the 3.2 million Americans infected with the blood-borne virus. It can take decades to cause liver damage, and many people don’t know they’re infected.

CDC officials believe the new measure could lead 800,000 more baby boomers to get treatment and could save more than 120,000 lives.

“The CDC views hepatitis C as an unrecognized health crisis for the country, and we believe the time is now for a bold response,” said Dr. John W. Ward, the CDC’s hepatitis chief.

Several developments drove the CDC’s push for wider testing, he said.

Recent data has shown that from 1999 to 2007, the number of Americans dying from hepatitis C-related diseases nearly doubled. Also, two drugs hit the market last year that promise to cure many more people than was previously possible.

The virus can gradually scar the liver and lead to cirrhosis or liver cancer, and is the leading cause of liver transplant. It can trigger damage in other parts of the body as well. All told, more than 15,000 Americans die each year from hepatitis C-related illnesses, according to the CDC.

The hepatitis C virus is most commonly spread today through sharing needles to inject drugs. Before widespread screening of blood donations began in 1992, it was also spread through blood transfusions.

Health officials believe hundreds of thousands of new hepatitis C infections were occurring each year in the 1970s and 1980s, most of them in the younger adults of the era — the baby boomers. The hepatitis C virus was first identified in 1989.

Today, about 17,000 infections occur annually, according to CDC estimates.

About 3 percent of baby boomers test positive for the virus, the CDC estimates.

Of those, some manage to clear the infection from their bodies without treatment, but still have lingering antibodies that give a positive initial test result. That’s why confirmatory tests are needed.

Still, only a quarter of infected people are that lucky. Most have active and dangerous infections, Ward said.

The agency’s current guidelines recommend testing people known to be at high risk, including current and past injection drug users.

But as many as a quarter of infected baby boomers say they don’t recall engaging in a risky behavior.

It’s possible some people were infected in ways other than injection drug use or long-ago blood transfusions. Some experts say tattoos, piercings, shared razor blades and toothbrushes, manicures and sniffed cocaine may have caused the virus to spread in some cases.

Those kinds of experiences might not raise flags in the minds of many patients or their physicians, experts said.

A recent Harris Interactive survey of 1,000 baby boomers found other forms of ignorance about hepatitis C. Fewer than 20 percent knew they belonged to the generation most likely to be infected, and only a similar percent were aware it can be cured in many patients.

Also, only about 25 percent said they had been tested, according to the survey, done on behalf of the American Gastroenterological Association and Vertex Pharmaceuticals, which makes one of the hepatitis C medications.

Currently, many baby boomers learn of their infection almost by accident, like when they donate blood or get a physical exam for a life insurance policy, said Dr. Ryan Ford, an Emory University physician specializing in hepatitis care.

He and other physicians celebrated the CDC’s announcement.

“It’s a long awaited and very much hoped for development that I believe will save lives,” said Dr. Ira Jacobson, a hepatitis expert at New York Presbyterian/Weill Cornell Medical Center

The new testing recommendation is expected to become final later this year.

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Online:

CDC’s hepatitis page: http://www.cdc.gov/hepatitis/C/index.htm

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LONDON (AP) — In most developed countries, children with autism are usually sent to school where they get special education classes. But in France, they are more often sent to a psychiatrist where they get talk therapy meant for people with psychological or emotional problems.

Things are slowly changing, but not without resistance. Last month, a report by France’s top health authority concluded there was no agreement among scientists about whether psychotherapy works for autism, and it was not included in the list of recommended treatments.

That provoked an outcry from psychiatrists. Groups including Freudian societies, the World Association of Psychoanalysis and France’s Child Institute started a petition calling on the French government to recognize their clinical approach, focused on psychotherapy.

“The situation in France is sort of like the U.S. in the 1950s,” said Dr. Fred Volkmar, a U.S. expert who directs the Child Study Center at Yale University. “The French have a very idiosyncratic view of autism and, for some reason, they are not convinced by the evidence.”

Behavioral methods, which focus on helping autistic children communicate with others and develop social skills, are the norm in Britain, Canada, Japan, the U.S. and elsewhere in Europe. But they’re seldom used in France.

France has long been criticized for its approach to treating autism. In 2002, the charity Autism Europe lodged a complaint against France with the Council of Europe, charging the country was refusing to educate autistic children, as required under the European Social Charter.

The charge was upheld and the European Committee of Social Rights declared “France has failed to achieve sufficient progress” in educating autistic children. The committee also slammed France for making autistic people “an excluded group” and said there was a chronic shortage of care.

Volkmar said some forms of psychotherapy might be helpful for high-functioning autistic children to handle specific problems like anxiety, but should not be considered a first-line treatment. He said the vast majority of autistic children in the U.S. — more than 95 percent — attend school.

But French children with autism are lagging far behind. According to government data, fewer than 20 percent of autistic children attend school. Mostly they’re either kept at home or go to a day hospital for psychiatric sessions.

Many French experts insist psychotherapy is essential. “I would never say that psychoanalysis is ‘the best’ method, but it is invaluable,” said Marie Dominique Amy, president of CIPPA, a French association of psychotherapists and psychiatrists. She said even in autistic children who don’t speak, the therapy can be done through gestures and interpreting their body language.

Amy said she had nothing against behavioral methods, which could be included in a comprehensive treatment program. But she said it was impossible to accept the assessment from France’s top health authority that there was no consensus for the use of psychotherapy for treating autism.

Amy also said she had seen autistic children improve after being treated with a controversial therapy known as “packing.” That involves wrapping nearly naked children in wet, cold towels in an attempt to “reconnect” them with their bodies. The practice is rare, but is allowed in France as part of research projects. Amy said she had seen autistic children start talking, writing and drawing after the sessions. She said it was essential to get parents’ permission before trying packing.

According to the French Association of Psychiatrists, packing can sometimes produce “spectacular” results. The group said more autistic children in France could benefit from the method if authorities did not so tightly regulate its use.

Others condemn the practice as barbaric. “Not only is there no evidence that packing works, but it’s unthinkable something potentially dangerous and harmful would be performed on vulnerable children,” said Tony Charman, chair of autism at the Institute of Education in London.

Catherine Consel was horrified when she and her husband found out their autistic son Thomas, now 20, had been subjected to regular packing sessions for three years while he was treated in a Bordeaux hospital. “I was shocked,” Consel said. “We trusted the doctors to take care of him.” Consel and her husband found out about the packing sessions by chance years later, after Thomas’ hospital was featured in a television story about the technique.

She and her husband later demanded Thomas’ medical records, where psychiatrists wrote that his autism was the result of his parents’ mental problems. “It was very difficult to read what (Thomas) had been subjected to,” she said of the packing sessions. “They noted it all very precisely, how long it had taken and how he had screamed and cried,” she said.

Consel is convinced Thomas would have fared better had the family stayed in the U.S., where he was born. “There is only one way to do things in France,” she said. “And sometimes the government makes the wrong choice.”

Elsewhere in Europe, packing is unheard of and even psychotherapy is rare.

In Spain, for example, autism treatment guidelines published in 2006 lumped psychotherapy together with alternative therapies like chelation, which involves the injection of chemicals into the body to remove heavy metals. Spanish officials ruled there was no evidence such alternative treatments work.

Joaquin Fuentes, a psychiatrist and scientific adviser for a Spanish autism group, said that where he works in the Basque region, autistic children go to regular schools and none are sent to psychiatric hospitals. “To be exposed to psychoanalytic treatment is a painful and unethical way of treating children with autism,” he said.

Some French parents resort to sending their children abroad to get adequate treatment. When Andy Beverly’s son Guillaume was diagnosed as autistic at age 2, Guillaume began to receive treatment from psychiatrists in Paris.

“They said his autism was a psychosis and that Guillaume needed to figure out himself how to get over it,” Beverly said. After years of sporadic schooling in France, Beverly sent Guillaume to a school in Belgium that focuses on techniques to help him interact with others and do simple things like putting on his coat. He is convinced that Guillaume, now 15, would be more advanced if he’d gotten better treatment as a child.

“I started out having a lot of trust in the French doctors, but it was only later that I realized we were in the wrong country,” Beverly said. “The situation may finally be getting better, but for a lot of families with autistic children, that’s not enough.”

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Online:

www.autismeurope.org

Associated Press

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SAN FRANCISCO (AP) — Armando Rodriguez was warned several times to continue taking his tuberculosis medicine.

At one point, authorities said, he told his case officer he stopped the treatment out of concern for his liver while binging on alcohol and methamphetamine.

So on Tuesday, authorities took the unusual step of arresting Rodriguez and charging him with refusing to comply with a tuberculosis order to be at home at certain times and make appointments to take his medication.

It’s a move that divides public health officials.

“I think it’s an error to confine someone in the criminal justice system for a public health crime,” said Lawrence Gostin, a Georgetown University public health law professor who drafted a model law adopted by several states struggling with the issue. “The whole intention is to protect the public’s health. It’s not to lay blame on someone.”

Health officials say Rodriguez, 34, of Stockton has active pulmonary tuberculosis, which can include coughing up blood or phlegm and can spread through the air.

Rodriguez has been noncompliant with his treatment and could become contagious as a result, Ginger Wick, nursing director for San Joaquin County, said in a letter requesting a warrant for Rodriguez’s arrest.

After failing one time to give himself the drugs, Rodriguez told a nurse he had gone on an alcohol binge and taken methamphetamine and didn’t want to hurt his liver, Wick said in her letter.

Rodriguez was arrested Tuesday and is expected to be arraigned Thursday on two misdemeanor counts.

He will likely be appointed a public defender.

Tuberculosis is a bacterial infection that usually attacks the lungs. Many people have a latent form, and the active form usually only affects adults whose immune systems are compromised, which can happen from drug use.

Public health experts are divided on the issue of mandatory treatment and criminal charges for patients who don’t comply with treatment orders.

Many of those who do support criminal prosecution in the rarest of cases when public health is in jeopardy oppose the jailing of patients.

Implementing mandatory treatment should be a last resort, and prosecuting someone for disobeying a public health order is unhelpful and sends the wrong message if protecting public health is the intent, Georgetown’s Gostin said.

Instead, the afflicted should be given assistance such as transportation to and from treatments rather than punishment as an incentive to take their medicine, he said.

The Centers for Disease Control and Prevention said laws to control the spread of tuberculosis have been in use for more than a century, though regulations differ in each state.

As many as 12,000 new cases of tuberculosis are reported in the country each year, the CDC reported. California recorded 2,317 new cases in 2011, a low since records have been kept.

Nonetheless, officials throughout the nation continue to struggle to stop the spread of tuberculosis, with several drug-resistant strains emerging in recent years.

Federal and state officials don’t keep records of the number of people prosecuted for refusing to take their medicines. But some say it’s exceedingly rare to file criminal charges in such cases.

San Joaquin County has had more than 30 tuberculosis prosecutions since 1984, prosecutor Stephen Taylor said, noting the county is more aggressive than other jurisdictions in prosecuting patients to get them to take their medication.

“The criminal cases we’re dealing with generally involve drug users who are harder to treat and manage because the TB medicines conflict with street drugs,” he said. “We have to throw these people in jail and treat them as in-patients. They don’t cooperate as out-patients.”

Karen Furst, San Joaquin County public health officer, said the county arranges transportation and other services to help patients stick to their drug regimen and turns to the legal system only as a last resort.

“I have to make sure that if I’m aware that somebody is in a position that could possibly be spreading a disease to another person, that I take steps that are necessary to prevent that from happening,” she said.

Rodriguez was discharged in March from San Joaquin General Hospital with four medications for active tuberculosis and agreed to take the drugs under observation by a county health official on weekdays and on his own on weekends, authorities said.

He allegedly refused to take the drugs on another day and then was not at home on three occasions and missed an appointment.

Each charge against Rodriguez carries a maximum penalty of a year behind bars. In her letter, Wick said Rodriguez would need nine months of treatment.

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Associated Press writer Paul Elias in San Francisco contributed to this report.

Associated Press

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WASHINGTON (AP) — The Obama administration is asking a presidential commission to help decide an ethical quandary: Should the anthrax vaccine and other treatments being stockpiled in case of a bioterror attack be tested in children?

“We can’t just assume that what we have for adults works for children,” Health and Human Services Secretary Kathleen Sebelius told the panel Thursday.

Controversy over whether to open pediatric studies of the anthrax vaccine led Sebelius to ask the Presidential Commission for the Study of Bioethical Issues to tackle the question. The commission began its deliberations Thursday; recommendations are expected by year’s end.

Sebelius made clear that the question is far broader than anthrax.

“There are serious ethical issues around the development of medical countermeasures for children” in general, she said.

Developing protections for youngsters is critically important, but in a way that puts “our children’s safety as our highest priority,” Sebelius said.

A decade after the anthrax attacks in the United States, the government has a multibillion-dollar stockpile of tools to fight back against some of the threats that worry defense experts. Notably missing is information on how to treat children in various emergencies — whether the same drugs their parents will get will work or be safe for them, and even what dose youngsters should receive.

Thus the debate on whether to conduct studies now, before millions of children might need to try an untested product in an emergency. Even if those studies were offered, there’s no way to know how many parents would agree to enroll their children.

Testing medications in children always requires extra safeguards. It’s fairly straightforward to test a potential treatment for cancer or some other childhood disease. But if a child won’t receive a direct medical benefit, federal regulations say studies are allowed only if testing adults can’t provide the answers and if the risks to participating children are minimal.

Anyone exposed during an anthrax attack would require 60 days of powerful antibiotics, or antibiotics until a vaccine could kick in. Last fall, the National Biodefense Safety Board, which advises the government, recommended child testing of the anthrax vaccine, but only if outside ethical experts agreed such studies could be done appropriately.

The shots have been widely used in adults, including U.S. troops, and are considered safe for them, said the board chairman, Dr. John Parker, a retired Army major general who has been vaccinated.

Side effects include shot-site soreness and redness, muscle aches, fatigue and headache. Rare but serious allergic reactions have been reported.

The bioethics commission wrestled with how to define “minimal risk” when there is no imminent emergency, and the chairwoman, Dr. Amy Gutmann, wondered whether people urging such testing would enroll their own children.

Parker responded that he’s discussed that with first-responders and some in the military. “There are groups out there that would want their families protected as much as they are protected as they do their job, in fear of bringing something home,” he said.

Other doctors told the panel that 60 days of antibiotics can cause bad side effects for children, including diarrhea, other infections and dangerous allergic reactions. Plus there’s concern that many people wouldn’t take the full course, Parker said.

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Online:

Presidential Commission for the Study of Bioethical Issues: http://www.bioethics.gov

National Biodefense Safety Board: http://tinyurl.com/7c79bbd

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WASHINGTON (AP) — Researchers say the U.S. approved more new medicines in less time than Europe and Canada in the last decade, challenging long-standing criticisms that the Food and Drug Administration lags behind its peers in clearing important new drugs.

Between 2001 and 2010, the FDA’s typical review of a new drug was about 15 percent faster than those by the European Medicines Agency and Health Canada, its counterparts abroad, according to a study published Wednesday by the New England Journal of Medicine. The analysis by researchers at Yale and the Mayo Clinic is the first to compare the FDA’s recent drug review performance to similar agencies around the world.

Criticism that the FDA is too slow on drug approvals is a perennial theme for the pharmaceutical industry, which spends more than $50 billion annually to develop new drugs. The complaint has resurfaced in the past year as the industry renegotiates the fees it must pay the FDA to review new drug applications — a program which is reauthorized by Congress every five years.

The study authors address this issue directly, defending the agency’s performance.

“Our findings contradict recent criticisms of the speed of review by the FDA and lead to questions about whether the speed of the review process is justified as an emphasis … particularly since the FDA continues to outpace its European and Canadian peers,” the authors state.

The median time for drug reviews by the FDA was 322 days, or about 10 and a half months. That was 45 to 70 days ahead of Europe and Canada, which typically completed their drug reviews after 12 and 13 months, respectively. Over the same 10-year time frame, the FDA reviewed 225 drug applications, 40 more than Europe and nearly 125 more than Canada.

The researchers also found that most new drugs are approved in the U.S. before the two other regions. Among drugs approved in both the U.S. and Europe, 64 percent were first approved by the FDA. For drugs approved in both the U.S. and Canada, 86 percent were first approved by the FDA.

“This allows us to focus on the important question of whether there are real barriers to drug innovation in the U.S.,” said Kathleen Stratton of the Pew Charitable Trusts, which provided funding for the research. “But it’s clear from this study that the speed at which the FDA reviews drug applications is not one of them.”

Pew has lobbied for increased FDA funding to assure the safety of food, drugs and other regulated products.

The study authors acknowledge some limitations with the data. For example, they did not account for drugs which are ultimately rejected. FDA and other agencies don’t release review times for drugs that are never approved. However, since the FDA approves 80 percent of all the applications it receives, the authors say it’s unlikely the missing data would have changed their findings. The study was also limited to novel drugs, which means copycat drugs and reformulations of older products were excluded.

The Pharmaceutical Research and Manufacturers of America did not comment directly on the findings. However, the group said in a statement it appreciates “the importance of balancing timely access to new medicines with the need for thorough review of safety and efficacy data.”

While the study appears designed to influence drug user fee legislation, it may come too late in the process to have much impact. The FDA and the drug industry reached a tentative agreement last fall, with the agency pledging to work toward faster, more predictable reviews in return for a 6 percent increase in company fees. Congress is now drafting the agreement into law, including provisions added by lawmakers who want to accelerate FDA drug approvals even further.

The latest draft of the user fee bill on Capitol Hill would task the FDA with speeding up the approval of breakthrough drugs by relaxing certain requirements, including allowing drugmakers to conduct smaller, shorter clinical studies. The approach has been embraced by top FDA officials, who have spent the last year highlighting their efforts to accelerate development of novel medical products. Innovation has been a key talking point for the Obama administration since early 2011, when the president outlined a strategy to boost economic growth by encouraging innovation by companies and federal agencies.

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WASHINGTON (AP) — Doctors increasingly are ditching the prescription pad: More than a third of the nation’s prescriptions now are electronic, according to the latest count.

The government has been pushing doctors to e-prescribe, in part because it can be safer for patients. This year, holdouts will start to see cuts in their Medicare payments.

Thursday’s report from Surescripts, the largest network for paperless prescribing, shows more doctors are signing up fast.

At the end of 2011, 36 percent of all prescriptions were electronic — the doctor wrote it by computer and sent it directly to the pharmacy with the push of a button, the report found. That’s up from 22 percent of prescriptions that were paperless a year earlier.

For patients, the convenience is obvious — shorter drugstore waits. Pharmacists like not having to squint at the doctors’ messy handwriting. And computerized ordering systems allow doctors to easily check that a new drug won’t interact badly with one the patient’s already taking.

New research by Surescripts and some pharmacies and pharmacy benefit managers uncovered another benefit: More patients pick up a new prescription when it’s filed electronically.

Doctors know that too often, patients never fill some of their prescriptions. Maybe they lose the slip of paper, or forget to drop it off, or decide they can’t afford it.

The new research examined 40 million prescriptions, a mix of paper, phoned, faxed or electronic ones — and found a 10 percent increase in patients who fill a prescription when it’s e-prescribed.

The main reasons: Drugstores receive every paperless prescription, and they can call patients to come in and pick up their waiting medicine, said Surescripts’ researcher Seth Joseph. Also, e-prescribing programs automatically show the doctor which brands are covered by the patient’s insurance with the lowest out-of-pocket cost.

For several years, the government has run incentive programs to encourage doctors to adopt e-prescribing and other computerized health records, offering payments to help defray the costs of adopting the systems. Now Medicare is beginning to cut some reimbursements to certain doctors who don’t e-prescribe at least a little bit.

Surescripts’ report counted 390,000 doctors who were e-prescribing at least some of the time in 2011, and its records show an additional 10,000 had begun by the end of February. That translates into just over half of office-based physicians, a big jump since 2008, when only about 12 percent of doctors were e-prescribing.

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CHICAGO (AP) — An antibiotic widely used for bronchitis and other common infections seems to increase chances for sudden deadly heart problems, a rare but surprising risk found in a 14-year study.

Zithromax, or azithromycin, is more expensive than other antibiotics, but it’s popular because it often can be taken for fewer days. But the results suggest doctors should prescribe other options for people already prone to heart problems, the researchers and other experts said.

Vanderbilt University researchers analyzed health records and data on millions of prescriptions for several antibiotics given to about 540,000 Tennessee Medicaid patients from 1992 to 2006. There were 29 heart-related deaths among those who took Zithromax during five days of treatment. Their risk of death while taking the drug was more than double that of patients on another antibiotic, amoxicillin, or those who took none.

To compare risks, the researchers calculated that the number of deaths per 1 million courses of antibiotics would be about 85 among Zithromax patients versus 32 among amoxicillin patients and 30 among those on no antibiotics. The highest risks were in Zithromax patients with existing heart problems.

Patients in each group started out with comparable risks for heart trouble, the researchers said.

The results suggest there would be 47 extra heart-related deaths per 1 million courses of treatment with Zithromax, compared with amoxicillin. A usual treatment course for Zithromax is about five days, versus about 10 days for amoxicillin and other antibiotics. Zithromax is at least twice as expensive as generic amoxicillin; online prescription drug sellers charge a few dollars per pill for Zithromax.

“People need to recognize that the overall risk is low,” said Dr. Harlan Krumholz, a Yale University health outcomes specialist who was not involved in the study. More research is needed to confirm the findings, but still, he said patients with heart disease “should probably be steered away” from Zithromax for now.

The study appears in Thursday’s New England Journal of Medicine. The National Heart, Lung and Blood Institute helped pay for the research.

Zithromax, marketed by Pfizer Inc., has been available in the United States for two decades. It’s often used to treat bronchitis, sinus infections and pneumonia. Wayne Ray, a Vanderbilt professor of medicine, decided to study the drug’s risks because of evidence linking it with potential heart rhythm problems. Also, antibiotics in the same class as Zithromax have been linked with sudden cardiac death.

Zithromax is among top-selling antibiotics. U.S. sales last year totaled $464 million, according to IMS Health, a health care information and services company.

Pfizer issued a statement saying it would thoroughly review the study. “Patient safety is of the utmost importance to Pfizer and we continuously monitor the safety and efficacy of our products to ensure that the benefits and risks are accurately described,” the company said.

Patients studied were age 50 on average and not hospitalized. Most had common ailments, including sinus infections and bronchitis. Those on Zithromax were about as healthy as those on other antibiotics, making it unlikely that an underlying condition might explain the increased death risk.

Medicaid patients generally have more disability and lower incomes than other patients, so whether the same results would be found in the general population is uncertain, Ray said.

Dr. Bruce Psaty, a professor of medicine at the University of Washington, said doctors and patients need to know about the potential risks. He said the results also raise concerns about long-term use of Zithromax, which other research suggests could benefit people with severe lung disease. Additional research is needed to determine if that kind of use could be dangerous, he said.

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AP Medical Writer Lindsey tanner can be reached at http://www.twitter.com/LindseyTanner

Associated Press

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WASHINGTON (AP) — A small study raises more concern about the long-term consequences of brain injuries suffered by thousands of soldiers — suggesting they may be at risk of developing the same degenerative brain disease as some retired football players.

Autopsies of four young veterans found the earliest signs of chronic traumatic encephalopathy, or CTE, in their brain tissue, Boston researchers reported Wednesday.

They compared the brain tissue of some of the youngest athletes ever found with signs of early CTE, in their teens and 20s, and concluded the abnormalities were nearly identical.

“It’s very distinctive,” said Dr. Lee Goldstein of Boston University, who led the study with Dr. Ann McKee of the VA New England Healthcare System. “You don’t see this in normal individuals.”

The research suggests that the cause of the injury, whether a blast or repeated blows, doesn’t matter — it can trigger the same disease-causing process, said McKee, who has long studied the athlete connection.

Further experiments with mice showed that a single blast, equivalent to a roadside bomb, was enough to start the damage — offering a model to help scientists better understand these wounds and perhaps how to treat them, the team reported in the journal Science Translational Medicine.

CTE is a progressive disease linked to multiple concussions. It has made headlines in recent years with the deaths of some former professional athletes, and lawsuits filed against the National Football League by others worried about the still unclear toll of a sport that can bring repeated blows to the head. Symptoms include memory problems, behavior changes including aggression, and eventually dementia. For now, only an autopsy confirms a diagnosis.

Traumatic brain injury, or TBI, is a signature injury of the wars in Iraq and Afghanistan, most of them closed-head injuries caused by being near an explosion. While many recover fine, others have some lasting cognitive or psychiatric symptoms — and traditional medical exams can’t see the damage, making it incredibly difficult to diagnose what’s wrong. Additionally, scientists have long warned that many of those veterans may be at risk of long-term problems such as Alzheimer’s-like dementia.

Wednesday’s study, while very small, sheds important light on how damaging those TBIs can be even if the person walks away from the blast.

The four young veterans, ages 22 to 45, lived for a year or longer after their military TBIs, but complained of problems with memory, irritability, sleep and other issues before dying of suicide or other causes. Goldstein and McKee found their brains contained broken axons, the nerve fibers that act as the brain’s telephone system.

More surprising: Abnormal tangles of a brain protein named tau are a hallmark of early CTE, and researchers found that tau buildup in the brains of the veterans’ and the young athletes, three of them who played high school or college football and the fourth a professional wrestler. They didn’t see it in the brains of four other young men who hadn’t experienced concussions before death.

Three of the veterans had been exposed to blasts, while one had a different kind of concussion while deployed — and all had had at least one pre-military concussion, from football, wrecks or fights.

While that begs the question of whether the blast was to blame, Goldstein said the mouse study shows a single explosion could trigger that kind of damage. Wind from a simulated blast whipped the animals’ heads like a bobble-head doll, severely shaking the brain, he explained. They experienced broken axons and blood vessels, inflammation and problems with learning and memory — and two weeks later, were forming abnormal tau.

When the animals’ heads were immobilized, they escaped that damage, Goldstein said.

He said helmets may be crucial in protecting the skulls of soldiers and athletes, but they cannot protect the brain from that kind of rattling injury and might even worsen it by increasing the load on the neck.

Specialists not connected to Wednesday’s study caution that far more research is needed on the possible link between this brain degeneration and TBIs, especially in veterans.

Still, “they are very important findings,” said TBI researcher Dr. Amy Wagner of the University of Pittsburgh School of Medicine.

For abnormalities to begin so soon after injury triggers questions about how resilient different people are, she said: Who’s more likely to recover? How many blows are too many? What other factors could make this slow-moving disease eventually worsen?

A key next step will be for brain banks, which store donated brain tissue for research, to look more closely for CTE so scientists can learn how often it occurs and in whom, said neuroscientist Dr. Sam Gandy of New York’s Mount Sinai School of Medicine. He predicts that people who carry genes linked to Alzheimer’s disease would be more prone to lasting damage from TBI. In an editorial in the same journal on Wednesday, he suggested studying if gene testing of would-be high school athletes or military recruits might one day help persuade the most vulnerable to avoid those occupations.

McKee said her lab so far has found evidence of CTE in more than 65 athletes and veterans, ranging from the early abnormalities to profound degeneration. She now is researching how to diagnose CTE before death, perhaps with brain scans or by measuring tau in spinal fluid.

“This work raises a number of questions for researchers to explore in further studies. In particular, the animal model developed by the researchers will enable a better understanding of the brain pathology involved in blast injuries and ideally lead to new therapies to help service members and veterans with TBIs,” Dr. Joel Kupersmith, research chief at the Department of Veterans Affairs, said in a statement.

Associated Press