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Wednesday, September 21, 2011

Letter to the Editor, USA Today - DoD CDMRP GWI Funding ELIMINATED



Dear Kelly,

Thank you for writing this wonderful 
article, "
Study links Gulf War vets' illnesses to area of service," on this important research study.

Perhaps you might consider a follow-up story about the Senate's inexplicable actions last week to eliminate funding for the DoD program that funded this study (details in the forwarded email, below).

Until recently, VA and DOD wasted over $300 million on so-called GWI research with essentially nothing to show for it -- certainly no treatments or anything else to improve the health and lives of the 200,000+ ill Gulf War veterans.

However, with the relatively new Congressionally Directed Medical Research Program (CDMRP) for Gulf War Illness treatment-focused research, there have been significant and groundbreaking findings like this one, and like the discovery that Coenzyme Q10 is effective in relieving some GWI symptoms.

The follow-up story could focus on these exciting successes, which are now at risk after last week's Senate appropriations committee vote that would entirely eliminate this CDMRP Gulf War Illness program -- the only federal government program or funding that has, to date, provided anything of use to ill Gulf War veterans like me and so many others.

Anthony Hardie
Madison, Wis.
Gulf War veteran, GWI patient



================================


--Forwarded Email--



Dear Friends,

My apologies for being out of touch the last few days, I have been on the road and just now had a chance to go through the Senate Report to the FY12 Defense Appropriations Act.  As you probably already know, on September 15, the Senate Committee on Appropriations approved the FY12 bill by a vote of 30-0.

The Senate included in its version of the bill $1.018 billion for RDT&E in the Defense Health Program.  This is below the level approved by the House in its version of the Defense bill:  $1.187 billion (the table in the Senate report states that the “House allowance” for this line item is $1.217 billion – not sure why there is a discrepancy).  However, it is slightly above the amount that the Senate included in their initial mark last year for the FY11 bill: $1.011 billion.

The bill also includes line items for specific programs in the following amounts: 
Breast Cancer                    $120 million
Peer Review Program    $ 50 million
Ovarian                                $ 10 million
Prostate                               $ 64 million
Psychological/TBI             $ 60 million
Joint Warfighter               $ 50 million

As in previous years, the Senate report includes specific diseases and disorders eligible for funding out of the “Peer Review” program (p. 227).

BOTTOM LINE:  I think given the amount of cuts that the Senate had to absorb, this could have been a lot worse.  If the House and Senate choose to meet half way, it could mean a small reduction below the numbers included by the House for the specific CDMRPs. We should do all we can to preserve the House numbers in conference!

Also, we shouldn’t keep our guard down with respect to possible amendments when this comes to the floor of the Senate.  I have yet to hear of any rumblings from Senator McCain or others, but we need to be prepared in case amendments are offered!

Mark D. Vieth

Mark Vieth
Senior Vice President
Cavarocchi Ruscio Dennis Associates




===============


USA Today article: http://www.usatoday.com/news/military/story/2011-09-19/gulf-war-illness-study/50459462/1



USA TODAY: Study links Gulf War illnesses to location



By Kelly Kennedy - USA TODAY
Posted : Monday Sep 19, 2011 7:20:53 EDT
WASHINGTON — New research to be released Monday shows that veterans with Gulf War illness faced different toxins depending on where they were served: anti-nerve-agent pills and Scud missiles for forward-deployed troops and pesticides for support personnel in the rear.
There’s also no correlation between anthrax shots, depleted uranium and psychological issues and Gulf War illness, said the study by the Midwest Research Institute to appear in the Environmental Health Perspectives journal. That supports earlier research on those topics.
“Already, the evidence was mounting for these two exposures,” said Lea Steele, lead author and director of Baylor University’s Research Initiative on Complex Illness. “When you pull all the research together, you start to see patterns that are very consistent.”
About one-fourth of the 700,000 veterans who served in the 1991 Persian Gulf War developed symptoms that include chronic headaches, widespread pain, memory and concentration problems, persistent fatigue, gastrointestinal problems, skin abnormalities and mood disturbances.”
Steele and her co-authors surveyed 144 veterans with Gulf War illness and 160 Gulf War veterans with no symptoms. But rather than ask them if they were exposed to depleted uranium or anthrax shots, which many troops did not know, they asked about their experiences: Did you receive an injection in the buttocks in theater? Did you have contact with destroyed enemy vehicles? Were you directly involved in ground combat?
Nerve agents, anti-nerve agents and insecticides come from the same chemical family and, therefore, affect the body in similar ways, Steele said. That’s why people may have the same symptoms for different exposures, Steele said. But she said the research also does not discount other possible toxins, such as oil fires or fine particulate matter from dust storms.
“We could have solved this a long time ago if there were a smoking gun for a single issue,” she said.
They found Gulf War illness was most prevalent in the veterans who served in Iraq or Kuwait — or the combat zones — who took pyridostigmine bromide pills, which were small doses of nerve agent meant to help troops build up a resistance in case of a chemical attack. However, those troops did not report using pesticides on their clothing or skin. These service members also reported being within one mile of an exploding Scud missile.
In support areas, such as on a ship or in Saudi Arabia, Gulf War illness was most prevalent in personnel who used pesticides on their uniforms or skin, the researchers found.
Army veterans have suffered from Gulf War illness at higher rates than those from other services, Steele said. However, troops from other services who said they also took the nerve agent bills also report Gulf War illness at similar rates to soldiers, she said.
Insecticides used in rear areas are only considered potential causes. Only Army support troops used a 70 percent DEET insecticide and lindane powder, which is no longer used in the Army. Insecticides now contain only 30 percent DEET. DEET contains the same chemical that causes problems in nerve agents, but the Environmental Protection Agency has determined it’s safe as long as it’s used as directed by civilian manufacturers.
Soldiers also used the insecticide permethrin on their clothing. It’s designed to last through six months’ worth of washings, but the researchers found that improperly trained soldiers applied the solution once a week or even, in some cases, daily.
Steele said there are more published studies due by the end of the year that investigate potential causes and treatment. One treatment includes the successful use of fibromyalgia medication.
“I’d say there’s hope on the horizon,” Steele said.



Causes Of Gulf War Illness Are Complex And Vary By Deployment Area, According To Baylor University Study


Causes Of Gulf War Illness Are Complex And Vary By Deployment Area, According To Baylor University Study

Sept. 19, 2011
Follow us on Twitter:@BaylorUMediaCom

Gulf War Illness (GWI)--the chronic health condition that affects about one in four military veterans of the 1991 Gulf War--appears to be the result of several factors, which differed in importance depending upon the locations where veterans served during the war, according to a Baylor University study.

Published online today in the journal Environmental Health Perspectives the study investigated links between GWI and veterans' locations during the war. GWI was most prevalent in veterans who served in forward areas of Iraq and Kuwait, where it was most strongly associated with use of a medication given to 1991 Gulf War troops to protect them from effects of nerve agents. For personnel who remained in support locations, GWI was significantly associated only with pesticide use during the war.

"Understanding the causes of GWI has presented a complex puzzle in the 20 years since the Gulf War," said Lea Steele, Ph.D., Baylor University epidemiologist and lead author of the study. "Many of the nearly 700,000 U.S. veterans who served in that war encountered different levels and combinations of potentially hazardous substances. Our study determined that wartime exposures and rates of GWI were not the same for all veterans in all areas. In earlier studies, the causes of GWI often seemed indecipherable, when such differences were not taken into account."

The study found that GWI prevalence was nearly six times higher in veterans who served in Iraq or Kuwait, where all ground battles took place during the 1991 conflict, compared to veterans who remained on board ship during the war. For troops in the high-risk areas, GWI prevalence was 3.5 times greater in the subgroup that used pyridostigmine bromide pills, or PB, compared to those who did not use PB, which was issued by the military as a protective measure in the event of a nerve gas attack. GWI was also increased for forward-deployed personnel who reported being near exploded SCUD missiles or smoke from the Kuwaiti oil fires, and pesticide use.

In contrast, for veterans who remained in support areas, GWI was significantly increased only in the relatively small subgroup that wore pesticide-treated uniforms and also used skin pesticides. The study found no significant link between GWI and warzone experiences associated with a high degree of psychological stress, such as serving in combat and seeing others who were killed or badly injured.

The study evaluated symptoms, health conditions and deployment experiences reported by 304 veterans who served in the 1991 Gulf War, also known as Operation Desert Storm. That conflict concluded in February, 1991, after a six-week air campaign and four-day ground war.

Although the war was brief, concerns have been raised about a variety of chemical exposures associated with Gulf War deployment. The Baylor study found that a large proportion of veterans who were in Iraq and Kuwait used PB pills and were exposed to the smoke from over 600 burning oil well fires, which darkened Kuwaiti skies for much of 1991. Investigations sponsored by the U.S. Department of Defense also indicate that approximately 100,000 U.S. troops were potentially exposed to low levels of chemical nerve agents released during weapons demolition operations in Iraq after the 1991 cease fire, and that thousands of troops were likely overexposed to different types of pesticides, which were commonly misused and overused during the 1991 Gulf War.

"Our study results strongly suggest that GWI is the residual effect of exposures encountered by military personnel who served in the 1991 Gulf War," said Steele, research professor of biomedical studies in the Institute of Biomedical Studies at Baylor. "Although the specific biological mechanisms are not well understood, we know that a number of the 1991 Gulf War exposures of concern--PB pills, many of the pesticides, and low-level nerve agents--affect the same nerve signaling chemical, acetylcholine, which is involved in diverse processes necessary for normal brain and neurological function."

Gulf War Illness is the term commonly used for the complex of symptoms that affect Gulf War veterans at excess rates and are not explained by established diagnoses or routine laboratory tests. Symptoms of GWI typically include some combination of chronic headache, widespread pain, memory and concentration difficulties, unexplained fatigue, and digestive and other abnormalities. Studies indicate that GWI affects at least 25 percent of veterans who served in the 1991 Gulf War, and that few have recovered over time.

"Twenty years after Desert Storm, it is essential to understand why veterans became ill," Steele said, "to better address the biological mechanisms that underlie veterans' symptoms and to prevent this problem from happening in the future."

Study co-authors include Antonio Sastre, Ph.D., and Mary R. Cook, Ph.D., formerly of Midwest Research Institute in Kansas City, MO, and Mary M. Gerkovich, Ph.D., of the Department of Biomedical and Health Informatics, at the University of Missouri-Kansas City School of Medicine.

This study is funded by the U.S. Department of Defense, Congressionally Directed Medical Research Program (http://cdmrp.army.mil).  Editor's Note: The U.S. Senate recommended last week to eliminate funding for the CDMRP program for Gulf War Illness research.

About Baylor University

Baylor University is a private Christian university and a nationally ranked research institution. The university provides a vibrant campus community for approximately 15,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating university in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 11 nationally recognized academic divisions.




Epoch Times: Dr. Lea Steele Study Says Gulf War Illness is Result of Multiple Causes


ORIGINAL EPOCH TIMES ARTICLE: http://www.theepochtimes.com/n2/united-states/study-says-gulf-war-illness-is-result-of-multiple-causes-61790.html


Dr. Lea Steele Study Says Gulf War Illness is Result of Multiple Causes

By Paul Darin
Epoch Times Staff
Created: Sep 19, 2011Last Updated: Sep 20, 2011

 
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Related articles: United States > National News
U.S. Marines walk towards their barracks upon landing at Saudi Dhahran air base in August 1990. There is a chronic health condition known as the Gulf War Illness (GWI) which affects approximately one-quarter of military veterans who fought in the War.
U.S. Marines walk towards their barracks upon landing at Saudi Dhahran air base in August 1990. There is a chronic health condition known as the Gulf War Illness (GWI) which affects approximately one-quarter of military veterans who fought in the War. (Gerard Fouet/AFP/Getty Images)
In the 1990s, long after Vietnam veterans returned home with serious medical problems they attributed to Agent Orange; Americans thought we were past this kind of chemical exposure for troops. That was until Persian Gulf War veterans started to experience their own disastrous medical affects. A universitystudy found new information about chemical exposure in the first Gulf War.

Known as the Gulf War Illness (GWI), this chronic health condition affects approximately one-quarter of military veterans who fought in the Gulf War. For years GWI stumped doctors and medical scientists. Neither a specific cause nor proper diagnosis could be given for many veterans. Now GWI appears to be the result of several factors.

The term “Gulf War Illness” was given to soldiers who suffered a complex range ofsymptoms that could not be explained through common laboratory tests. Soldiers who have GWI may show any combination of: chronic headaches, widespread pain, memory and/or concentration difficulties, unexplained fatigue, digestive, and other abnormalities. Few GWI patients have recovered since 1991.

The Baylor University study was funded by the Department of Defense and co-authored by Antonio Sastre, Ph.D.; Mary R. Cook, Ph.D., formerly of Midwest Research Institute in Kansas City, Mo.; and Mary M. Gerkovich, Ph.D., of the Department of Biomedical and Health Informatics, at the University of Missouri-Kansas City School of Medicine. The study focused on 304 veterans suffering from GWI and was published Sept. 19 inEnvironmental Health Perspectives, a medical journal.

Our study results strongly suggest that GWI is the residualeffect of exposures encountered by military personnel who served in the 1991 Gulf War.
—Lea Steele, Ph.D., epidemiologist at Baylor University
According to the study, the locations where the vets served seem to be a major contributing factor. It appears that soldiers who fought in forward ground areas of Iraq and Kuwait suffered higher rates of GWI than those who did not.

These soldiers on the front lines of Iraq and Kuwait were given a medication called pyridostigmine bromide (PB) in 1991 to protect them from the affects of nerve gas that could have been used by Saddam Hussein’s forces. Soldiers who took the PBmedication were 3.5 times more likely to show signs of GWI than those who did not.

Additionally, personnel who served in support locations away from the nerve gas medication but who still show symptoms of GWI may have been exposed to pesticides misused during the Gulf War.

Soldiers who were near SCUD missiles when they exploded or near smoke from the Kuwaiti oil fires set by Iraqi forces as they were forced out of Kuwait also show higher levels of GWI than those who were not present.

GWI may be the result of several chemical agents, according to the study. Many veterans took the PBmedication and were exposed to smoke from the oil fields, which darkened skies and polluted the earth. The U.S. Department of Defense also concluded that about 100,000 troops were exposed to low levels of nerve gas used by Hussein’s Iraqi forces.

Related Articles
“Our study results strongly suggest that GWI is the residual effect of exposures encountered by military personnel who served in the 1991 Gulf War,” said Lea Steele, Ph.D., Baylor University epidemiologist and lead author of the study, in a press release. “Although the specific biological mechanisms are not well understood, we know that a number of the 1991 Gulf War exposures of concern; PB pills, many of the pesticides, and low-level nerve agents affect the same nerve signaling chemical, acetylcholine, which is involved in diverse processes necessary for normal brain and neurological function.” Steele is research professor of Biomedical Studies in the Institute of Biomedical Studies at Baylor.

Friday, September 16, 2011

Dallas Observer: Gulf War Syndrome Is Brain Damage Caused By Nerve Gas, Not Psychological Issues, UT Southwestern Study Suggests

ORIGINAL DALLAS OBSERVER ARTICLE: http://blogs.dallasobserver.com/unfairpark/2011/09/gulf_war_syndrome_is_brain_dam.php
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Nature + Science

Gulf War Syndrome Is Brain Damage Caused By Nerve Gas, Not Psychological Issues, UT Southwestern Study "Proves"

Comments (18)

Gulf-War-syndrome.jpg
​There's no denying it now: Gulf War Syndrome, characterized by memory loss, lack of concentration, neuropathic pain and depression, is a physiological illness, not a psychological one.
A UT Southwestern study, published in the journal Radiology, used a specialized MRI that specifically measures blood flow in the brain and detected marked abnormalities in the brains of those with Gulf War Syndrome. Not only have those abnormalities persisted for 20 years, but in some cases they've worsened.

The findings mark a significant advancement in our understanding of the syndrome, which was for years written off by the Defense Department and the Department of Veterans Affairs as a form of combat stress rather than an objectively diagnosable injury. Dr. Robert Haley, chief epidemiologist at UT Southwestern, and a cadre of clinicians and researchers, have struggled with the government for some 18 years for research funding and to have the syndrome recognized as a legitimate war injury caused by chronic exposure to minimal amounts of sarin gas.

"This was really one of the first techniques to show an objective picture of whether there's really brain damage or not," Haley tells Unfair Park.

In this study, Haley used a neurotransmitter called acetylcholine, which mimics nerve gas and acts to slow the heart rate and blood flow to the brain, making you groggy. For those with receptors damaged by nerve gas, they don't become groggy at all. In fact, sometimes it has the opposite effect. By administering the neurotransmitter and projecting radio waves into the carotid artery, Haley used a kind of MRI to measure blood flow in response. Veterans afflicted with Gulf War Syndrome didn't respond normally by showing decreases in blood flow to the brain you'd expect.

It's no surprise, then, that many of them report sleep difficulties as well. Approximately 20 percent of the population has a weak form of a gene that protects nerve receptors from sarin gas, Haley says. As a result of this study, it's likely no coincidence that at least 25 percent of veterans who were deployed in Iraq are thought to have the syndrome, according to a 2008 VA report.

Because of Haley's work, we now know brain damage is involved. But which specific brain cells, and what's wrong with them? Until we understand the underlying pathology, Haley says, we can't treat them. "We're shooting in the dark," he said, referring to potential treatments. "So far, nobody's guessed right.

"But the research is really going to come to a head in the next six to 12 months."

Tuesday, September 13, 2011

Haley's MRI Digs Deeper into Brain Dysfunction in Gulf War Veterans

SOURCE:  Health Imaging, http://www.healthimaging.com/index.php?option=com_articles&article=29479



Radiology: Advanced MRI unlocks mystery of Gulf War syndromes

ASL perfusion imaging slab position. The oblique coronal ASL imaging sections were positioned to cover the head of the hippocampus, with the inferior edge of the imaging slab parallel to the longitudinal anteroposterior axis of the hippocampus and tangent to the gyrus of the temporal lobe, by using T1-weighted high-spatialresolution anatomic images for accurate reference. Source: Radiology.
After nearly two decades of trial and error, researchers leveraged arterial spin labeling (ASL) perfusion MRI and physostigmine challenge to demonstrate persistent and worsening chronic hippocampal dysfunction in the brains of veterans with Gulf War syndromes, according to a study published online Sept. 13 in Radiology

“We’re dealing with a very complicated disease. All of the simplistic studies failed,” Robert W. Haley, MD, chief of epidemiology in the departments of internal medicine and clinical sciences at the University of Texas Southwestern Medical Center in Dallas, told Health Imaging in an interview.

The researchers determined that abnormal cerebral blood flow continued or worsened over the 11-year span since initial diagnosis with SPECT. “We also [found ASL MRI with physostigmine challenge] better diagnoses and distinguishes between the three main types of Gulf War illness,” Haley said, describing the find as “a home run.”

Gulf War illness is a poorly understood chronic condition associated with exposure to neurotoxic chemicals and nerve gas. It affects an estimated 25 percent of the 700,000 military personnel deployed to the 1991 Persian Gulf War, according to the U.S. Department of Veterans Affairs’ scientific advisory committee.

The three main syndromes associated with Gulf War illness produce a variety of symptoms. Syndrome 1 is associated with memory problems, syndrome 3 with chronic pain and syndrome 2, the most severe, with severe confusion, balance disturbances and a host of neurological symptoms.

In 1998, Haley’s research team used SPECT to demonstrate abnormal blood flow in the hippocampi of veterans with Gulf War syndrome, illustrating that the condition is not psychological.

Since the initial study, the research team has investigated other methods to measure the disease. “We finally hit on something that looks like it’s important,” Haley said.

In the current study, the researchers used ASL MRI to assess hippocampal regional cerebral blood flow in 13 control participants and 35 patients with Gulf War syndromes 1, 2 and 3.

Each patient received intravenous infusions of saline in an initial session, and physostigmine in a second session 48 hours later. Physostigmine is a short-acting cholinesterase inhibitor, used to test the functional integrity of the cholinergic system, a neurotransmitter system involved in the regulation of memory and learning.

“ASL scanning after giving this medication is particularly well suited to diagnosing Gulf War illness, because it picks up brain abnormalities too subtle for regular MRI to detect,” co-author Richard W. Briggs, PhD, professor of radiology at UT Southwestern, said in a statement. “This allows us to make the diagnosis in a single two-hour session without the need for exposure to ionizing radiation.”

ASL, said Haley, offers multiple advantages over SPECT. “We need to milk every bit of power out of imaging studies because the differences between veterans with Gulf War syndrome and healthy veterans are subtle. ASL MRI provides higher resolution images and more precision than SPECT.”

The findings replicated the results of the initial SPECT study of largely the same group of veterans. The results showed that abnormal hippocampal blood flow persisted and may have progressed 11 years after initial testing and nearly 20 years after the Gulf War, suggesting chronic alteration of hippocampal blood flow.

Physostigmine significantly decreased regional cerebral blood flow (rCBF) in control participants and veterans with syndrome 1, but significantly increased rCBF in the right hippocampus of veterans with syndrome 2 in the original study. The abnormal increase in rCBF was now found to have progressed to the left hippocampus with syndrome 2 and to both hippocampi of the veterans with syndrome 3.

“This suggests a progressive illness,” said Haley.

“Having an objective diagnostic test allows researchers to identify ill veterans for future clinical trials to test possible treatments,” Haley said. “It is also critical for ongoing genomic studies to see why some people are affected by chemical exposures, and why others are not.”

The researchers have replicated the ASL studies in a national sample of Gulf War veterans and are beginning to analyze the data to determine if the results are generalizable outside of the initial battalion studied in the 1998 and recent ASL study, Haley said.