Use Of Low Dose Aspirin To Protect Against Cardiovascular Disease Should Be Abandoned

The latest issue of the Drug and Therapeutics Bulletin (DTB) reports that the use of low-dose aspirin to protect against heart attacks and strokes in individuals yet to develop obvious cardiovascular disease, should be abandoned.

Low-dose aspirin is widely used to prevent further episodes of cardiovascular disease in people who have already had problems such as a heart attack or stroke. This approach is known as secondary prevention. It is well established and of confirmed benefit.

Following an analysis of the available evidence, it is the use of aspirin in primary prevention with which DTB takes issue. This is for individuals without symptoms, who have not yet had, for example, a heart attack or stroke, but who may be at risk.

Across the European Union alone, cardiovascular disease accounted for two million deaths in 2000. “Worldwide, many people take aspirin every day in the belief that doing so helps prevent [cardiovascular disease],” says DTB.

DTB points to various guidelines issued between 2005 and 2008 that recommend aspirin for the primary prevention of cardiovascular disease in various groups of patients. Examples include people aged 50 and older with type 2 diabetes and those with high blood pressure.

However DTB indicates that current evidence does not support the routine use of low-dose aspirin in such groups. This is because of the potential risk of serious gastrointestinal bleeds that accompany its use and the slight impact it has on curbing death rates.

DTB recommends that doctors review all patients currently taking low-dose aspirin for primary prevention, either as prescribed or over-the-counter treatment. It adds that the decision about whether to maintain or discontinue treatment should be made only after fully informing patients of the available evidence.

DTB adds: “Furthermore, in our view, current evidence makes it hard to recommend starting aspirin for primary prevention.”

DTB concludes: “… current evidence for primary prevention suggests the benefits and harms of aspirin in this setting may be more finely balanced than previously thought, even in individuals estimated to be at high risk of experiencing cardiovascular events, including those with diabetes or elevated blood pressure.”

“We believe, therefore, that low dose aspirin prophylaxis should not be routinely used for primary prevention.”

“Aspirin for primary prevention of cardiovascular disease? “
DTB vol 47; No 11, November 2009.

Stephanie Brunner (B.A.)

Obama Administration Calls On Nation To Begin Planning And Preparing For Fall Flu Season & The New H1N1 Virus

The Obama Administration sent a strong message to the nation today that it is time to start planning and preparing for the fall flu season and the ongoing H1N1 flu outbreak and that the federal government is prepared to commit resources, training, and new tools to help state and local governments and America’s families get ready.

White House Homeland Security Advisor John Brennan, Secretary of Health and Human Services Kathleen Sebelius, Secretary of Homeland Security Janet Napolitano, Secretary of Education Arne Duncan joined with delegations from 54 states, tribes and territories today at the H1N1 Influenza Preparedness Summit at the National Institutes of Health in Bethesda, Md., to kick-off the government’s nation-wide fall flu preparedness efforts.

“The President and the administration are actively engaged in mitigating the effects of the H1N1 flu virus and developing a national response framework and action plan that builds on the efforts and lessons learned from this spring’s initial onset to prepare for the possibility of a more serious fall outbreak of the virus,” said White House Homeland Security Advisor Brennan in his address to summit participants.

“Over the course of coming weeks and months, we will move aggressively to prepare the nation for the possibility of a more severe outbreak of the H1N1 virus,” said HHS Secretary Sebelius. “We ask the American people to become actively engaged with their own preparation and prevention. It’s a responsibility we all share.”

“The federal government is working together with its federal, state, local and tribal partners to develop a nation-wide plan to combat the H1N1 flu that incorporates the lessons we learned this spring,” said Homeland Security Secretary Napolitano. “The H1N1 Summit will allow us to continue this aggressive preparation for all possible H1N1 virus outbreak scenarios to ensure that we are doing everything possible to keep our country safe and healthy.”

“Effectively dealing with a potential H1N1 outbreak requires all of us — parents, educators, health providers, and local, state and federal governments — working together on our emergency management plan,” said Education Secretary Duncan. “Today’s Flu Summit is an important step in that direction. Our primary goals at the Department of Education are the health and well being of students, faculty and staff, and ensuring that, in the event of any school closures, the learning process will continue. ”

Maryland Governor Martin O’Malley moderated a Governors panel with participation via videolink from Governor Jim Douglas of Vermont, Governor Jim Doyle of Wisconsin, Governor Mark Parkinson of Kansas, Governor John Baldacci of Maine and Governor Jodi Rell of Connecticut.

“When responding to a national pandemic or a national recession, the basic principles of smart government remain the same — to increase efficiency, openness, and transparency in everything we do. Today’s summit illustrates our collective commitment to that goal,” said Maryland Governor Martin O’Malley. “The experience in the spring taught us that while earlier pandemic flu planning efforts were effective, there are also areas for improvement. Effective response requires accurate and timely information that is as close to real time as possible. We share the commitment of the Obama Administration to constantly monitor, evaluate and improve these processes as we continue to lead the world in emergency preparedness.”

Throughout the one-day summit, Administration officials laid out specific ways that states and local governments could start their planning and preparation efforts and announced new programs and resources to help state and local governments, the medical community and every day America prepare for H1N1 and the fall flu season.

First, HHS will make available preparedness grants worth a total of $350 million. These grants were funded by Congress in the latest supplemental appropriations bill and they will give state and local public health offices and health care systems valuable resources to step up their preparedness efforts.

Second, the federal government will centralize communications about H1N1 and seasonal flu on the federal government’s new Web site flu. This one-stop comprehensive site brings together flu-related information from across HHS and other federal agencies. The expanded site builds on the pandemic planning information long presented on pandemicflu, and incorporates information about the novel H1N1 flu as well as the seasonal flu.

Finally, HHS is launching a new PSA campaign contest to encourage more Americans to get involved in the nation’s flu preparedness efforts by making a 15-second or 30-second PSA. Officials at the summit stressed the idea of “shared responsibility” when it comes to combating the flu and the goal of the new HHS PSA campaign contest is to tap into the nation’s creativity to help educate Americans about how to plan for and prevent the spread of H1NI influenza. HHS will evaluate submissions and will present the best PSAs back to the public so everyone can vote on their favorite submission. The winning PSA will receive $2,500 in cash and will appear on national television. Contest details as well more information about the larger effort to plan and prepare for the flu season are available at flu.


Ageing Society Must Spur Policy Changes That Support Older People, Says Help The Aged, UK

Responding to the news that the latest population statistics show that the over 60′s now outnumber the under 18′s, Mervyn Kohler, Special Adviser at Help the Aged comments:

“These new figures should be a cause for celebration. Policy makers and others must increasingly adjust their thinking to take stock of these clear changes in population. As Help the Aged has made clear through our own ‘Just Equal Treatment’ campaign, equality for older people matters now more than ever as these demographic changes become clearer to all.

“The key task for policy makers going forward is to ensure that older people can increasingly play an active role in our ageing society. The days of assuming older people are dependents must now come to an end. For example, there will need to be improved engagement with the need to develop housing supply that allows older people a genuine choice about how and where they live. Lifetime homes standards should be embraced as comprehensively as possible to help secure that choice.

“Additionally, the challenges of an ageing society means that the Government must now grasp the nettle of reform to the social care system with real urgency. The costs of allowing the social care system to continue to slowly wither on the vine would be enormous – these new statistics show in the starkest terms that the numbers of people who will require support in older age is set to grow ever larger. That surely means the time has now come to reform the system so that older people themselves are in control of their care packages.

“In employment, these figures clearly show the economic harm that will be caused to UK plc by continuing to exclude older people from the active workforce. Now is surely the time to consign the out-dated requirement for people to retire just because they reach a certain birthday to the dustbin. If an older person wishes to continue working, that should be something the Government and employers warmly welcome, instead of setting arbitrary ages for retirement.

“Changes to our population are inevitable over time. An ageing society is a fact of life which should be welcomed and embraced, not treated with concern. These new figures should give everyone pause for thought about our future.”


This is the first year that there are more people in the UK aged 60 and over (13,262,200) than there are under 18 (13,111,000).
Help the Aged is the charity fighting to free disadvantaged older people in the UK and overseas from poverty, isolation, neglect and ageism. It campaigns to raise public awareness of the issues affecting older people and to bring about policy change. The Charity delivers a range of services: information and advice, home support and community living, including international development work. These are supported by its paid-for services and fundraising activities – which aim to increase funding in the future to respond to the growing unmet needs of disadvantaged older people. Help the Aged also funds vital research into the health issues and experiences of older people to improve the quality of later life.

Help the Aged urgently needs donations and support to help it in the increasingly challenging fight to free disadvantaged older people from poverty, isolation and neglect. Visit helptheaged.

Right care, Right deal is the new national campaign launched to build public awareness and support for the need for brave and innovative solutions for the social care system. With the Government indicating that social care is an urgent political priority, and in advance of the expected green paper later in 2008, the campaign combines three of the UK’s largest charities working with and for older people and their families and carers, and will urge the government to renew its vision for the future of social care in England. Visit rightcare The members of Right care, Right deal are Help the Aged, Counsel & Care and Carers UK.

For more information on Help the Aged campaigns, including the ‘Just Equal Treatment’ campaign, please visit helptheaged/campaigns.

Help the Aged

Health Affairs Study Finds Substantial Medical Savings When Patients With Vascular Disease Stick To Their Medications

Improved medication adherence produced up to $7,800 per patient in annual medical savings due to reductions in emergency department visits and inpatient hospital days for patients with one or more of four vascular conditions, according to a new study conducted by researchers at CVS Caremark and published in Health Affairs. The study found that reductions in overall medical costs far outweighed increased prescription drug spending when patients with chronic vascular disease took their medications as directed by their doctors.

The study, “Medication Adherence Leads to Lower Health Care Use and Costs Despite Increased Drug Spending,” analyzed pharmacy and medical claims data for 135,000 patients with congestive heart failure, diabetes, hypertension, and high cholesterol to determine the direct effect of prescription adherence on costs. The researchers found that while adherent patients spend as much as $1,000 more annually on medications, they spend significantly less on their overall health costs.

“Adherence to prescribed medications saves lives and money. Pharmacy benefit managers improve adherence and lower costs for patients and payers,” said Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt.

PCMA represents the nation’s pharmacy benefit managers (PBMs), which improve affordability and quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 200-plus million Americans.

Source: Pharmaceutical Care Management Association

Elderly Patients Who Survive ICU Stay Have High Rate Of Death In Following Years

An analysis of Medicare data indicates that elderly patients who are hospitalized in an intensive care unit (ICU) and survive to be discharged from the hospital have a high rate of death in the following three years, and that, in particular, patients who receive mechanical ventilation have a substantially increased rate of death compared with both hospital and general population controls in the first several months after hospital discharge, according to a study in the March 3 issue of JAMA.

Although there has been a decrease over time in the risk of in-hospital death for patients who receive intensive care in the United States, little is known about subsequent outcomes for those discharged alive. “Patients older than 65 years now make up more than half of all ICU admissions,” the authors write. “Information is needed to understand the patterns of mortality, morbidity, and health care resource use in the months and years that follow critical illness to allow for better targeting of follow-up care.”

Hannah Wunsch, M.D., M.Sc., of Columbia University Medical Center and NewYork-Presbyterian Hospital/Columbia, New York, and colleagues examined the 3-year outcomes and health care resource use of ICU survivors, and identified subgroups of patients and periods in which patients are at highest risk of death, using a 5 percent sample of Medicare beneficiaries older than 65 years. A random half of all patients were selected who received intensive care and survived to hospital discharge in 2003 with 3-year follow-up through 2006. From the other half of the sample, 2 matched control groups were generated: hospitalized patients who survived to discharge (hospital controls) and the general population (general controls), individually matched on age, sex, race, and whether they had surgery (for hospital controls).

In the data analyzed for the study, 35,308 ICU patients survived to hospital discharge. The ICU survivors had a higher 3-year mortality (39.5 percent) than hospital controls (34.5 percent) and general controls (14.9 percent). The ICU survivors who did not receive mechanical ventilation had minimal increased risk compared with hospital controls (3-year mortality, 38.3 percent vs. 34.6 percent).

“However, mortality for those who received mechanical ventilation was substantially higher than for the corresponding hospital controls (3-year mortality: 57.6 percent vs. 32.8 percent, respectively). This difference was primarily due to mortality during the first 2 quarters following hospital discharge (6-month mortality: 30.1 percent for ICU survivors vs. 9.6 percent for hospital controls),” the authors write.

Discharge to a skilled care facility for ICU survivors (33.0 percent) and hospital controls (26.4 percent) also was associated with high 6-month mortality (24.1 percent for ICU survivors and hospital controls discharged to a skilled care facility vs. 7.5 percent for ICU survivors and hospital controls discharged home).

“The magnitude of the postdischarge use of skilled care facilities for both ICU survivors and hospital controls and the high long-term mortality for all of these patients call into question whether discharge to skilled care facilities is merely a marker for higher severity of illness with appropriate delivery of care. These patients could have been discharged prematurely from acute care hospitals, and needed a higher level of care than they received. It also is possible that these patients could have had better outcomes if discharged home, but were not able to be sent there due to lack of sufficient support from family or friends to act as caregivers. These findings highlight the need for a much more detailed understanding of the long-term care needs of these patients,” the authors conclude.

JAMA. 2010;303[9]:849-856.

Journal of the American Medical Association

Stem Cell Versatility Could Help Tissue Regeneration

Scientists have reprogrammed stem cells from a key organ in the immune system in a development that could have implications for tissue regeneration.

Their research shows that it is possible to convert one stem type to another without the need for genetic modification.

Researchers, who used rat models, grew stem cells from the thymus – an organ important for our immune systems – in the laboratory using conditions for growing hair follicle skin stem cells.

The team was from the Ecole Polytechnique FГ©dГ©rale de Lausanne in Switzerland and the University of Edinburgh’s Medical Research Council Centre for Regenerative Medicine.

When the cells were transplanted into developing skin, they were able to maintain skin and hair for more than a year.

The transplanted follicles outperformed naturally-produced hair follicle stem cells, which are only able to heal and repair skin for three weeks.

Once they were transplanted, the genetic markers of the cells changed to be more similar to those of hair follicle stem cells.

The research, published in the journal Nature, shows that triggers from the surrounding environment – in this case from the skin – can reprogramme stem cells to become tissues they are not normally able to generate.

Professor Yann Barrandon, Joint Chair of Stem Cell Dynamics at the Ecole Polytechnique FГ©dГ©rale de Lausanne, UniversitГ© de Lausanne and Centre Hospitalier Universitaire Vaudois, who led the study, said: “These cells change because of the environment they come into contact with, the skin. In theory this operation could be recreated with other organs as well.”

When an animal develops, embryos form three cellular or germ layers – ectoderm, endoderm and mesoderm – which then go on to form the body’s organs and tissues.

Ectoderm becomes skin and nerves, endoderm becomes the gut and organs such as the liver, pancreas and thymus, and mesoderm becomes muscle, bones and blood.

Until now it was believed that germ layer boundaries could not be crossed – that cells originating in one germ layer could not develop into cells associated with one of the others.

This latest research shows that thymus cells, originating from the endoderm, can turn in to skin stem cells, which originate from the ectoderm origin. This suggests germ layer boundaries are less absolute than previously thought.

Dr Clare Blackburn, of the University of Edinburgh’s Medical Research Council Centre for Regenerative Medicine, said:В  “It’s not just that a latent capacity is triggered or uncovered when these stem cells come in to contact with skin. They really change track – expressing different genes and becoming more potent. It will be interesting to see whether microenvironments other than skin have a similar effect.”

This research was supported by EU Sixth Framework project EuroStemCell and continued under the FP7 projects EuroSyStem and OptiStem.

Source: University of Edinburgh

Diabetes Researchers Pioneer Islet Cell Xenotransplantation In Primate Studies

A team of researchers from the University of Alberta, the Yerkes National Primate Research Center of Emory University and the Emory Transplant Center has successfully transplanted insulin-producing neonatal porcine islet cells into monkeys, a procedure the researchers say represents a promising intermediate solution to the critical supply problem in clinical islet cell transplantation.

“Our work at the U of A and Emory, along with recent work at the University of Minnesota, is very exciting and shows that xenotransplantation in humans may soon be possible, thus solving the islet supply problem,” says one of the study authors Ray Rajotte, a professor of Surgery at the University of Alberta.

The paper appeared in an advanced on-line publication of Nature Medicine, February 26, entitled “Long-term survival of neonatal porcine islets in non-human primates by targeting co-stimulation pathways.” The work follows on the heels of similar work published last week by University of Minnesota researchers; those researchers used islets isolated from adult pig pancreases.

Neonatal islets were produced in Edmonton using a procedure Drs. Greg Korbutt and Rajotte developed in 1995. The pig islets were sent to the Yerkes Research Center for transplantation into diabetic rhesus macaques using an anti-rejection protocol developed by Drs. Christian Larsen and Kenneth Cardona of the Yerkes Research Center and the Emory Transplant Center. The isolation method developed by the U of A researchers is simple and reproducible with the neonatal pig islets having some growth potential post-transplant, considered a major advantage over adult pig islets.

The diabetic animals were treated with a CD28/CD154 co-stimulation blockade-based immunosuppressive regimen, and achieved sustained insulin independence (median survival >140 days with one animal now at 300 days) without evidence of porcine endogenous retrovirus (PERV) dissemination. “This represents a major step forward and proves neonatal porcine islets can correct diabetes long-term in primates,” said Drs. Korbutt and Rajotte.

“To meet the needs of the millions suffering from type 1 diabetes, we must find new donor sources to allow large-scale application of islet cell transplantation in humans,” said Dr. Larsen. “While there is much work to be done these studies suggest that the rejection response to porcine islets can be surmounted.”

“The next step is to prove that these neonatal porcine islet cells could become a source for human transplantation,” said Dr. Rajotte. “It’s hoped that within the next three to five years, we will be transplanting patients with pig islets once we prove that it is safe.”

Using a relatively simple and reproducible method of obtaining large numbers of islets from neonatal pig pancreata developed at the U of A, the researchers then transplanted islets comprised of endocrine and endocrine precursor cells into the monkeys. In vivo, these cells have been shown to proliferate, differentiate and reverse hyperglycemia in immunodeficient diabetic mice and allogeneic out-bred pigs.

However, humans and Old World primates have naturally occurring antibodies that are directed against antigens that can cause hyperacute or acute humoral rejection. To combat that, the researchers administered an anti-IL-2 receptor and anti-CD154 (H106) antibody, while maintaining immunosuppression using sirolimus and belatacept (a second-generation high affinity derivative of CTLA4-Ig)9-11 on diabetic rhesus macaques transplanted with neonatal porcine islets.

Other researchers involved in the work include: Zvonimir Milas1, James Lyon2, Jose Cano1, Wanhong Jiang1, Hameeda Bello-Laborn1, Brad Hacquoil2, Elizabeth Strobert3, Shivaprakash Gangappa1, Collin Weber1, and Thomas Pearson1. (1. Emory Transplant Center, Department of Surgery, Emory University School of Medicine, Atlanta; 2. Surgical-Medical Research Institute, University of Alberta, Edmonton,; 3. Yerkes National Primate Research Center, Emory University, Atlanta.)

The research was supported by the Alberta Diabetes Foundation, Canadian Institutes of Health Research, Edmonton Civic Employees Charitable Assistance Fund, Canadian Diabetes Association, and University of Alberta Hospital Foundation MacLachlan Fund. Dr. Korbutt received a Career Development Award from the Juvenile Diabetes Research Foundation and a Senior Scholarship from the Alberta Heritage Foundation for Medical Research. The work at Emory was supported by National Institute of Health, the Juvenile Diabetes Research Foundation Center, Yerkes Research Center Base Grant P51-RR000165-45, the McKelvey Lung Transplant Center, and the Carlos and Marguerite Mason Trust.

The Islet Transplant Group at the University of Alberta is involved in all aspects of islet transplantation, from trying to develop an unlimited source of islets (this study) to developing transplant protocols that don’t need anti-rejection drugs or drugs that only need to be given for a short period of time (tolerance induction).

Michael Robb
University of Alberta

Gates Foundation Grant Supports Novel Device To Detect Malaria

Ionita Ghiran, MD, an investigator in the Division of Allergy and Inflammation at Beth Israel Deaconess Medical Center (BIDMC) and Assistant Professor of Medicine at Harvard Medical School, has been awarded a $100,000 Grand Challenges Exploration Grant from the Bill & Melinda Gates Foundation.

The Gates Foundation’s Grand Challenges Exploration (GCE) program funds scientists and researchers worldwide in the pursuit of novel ideas that can break the mold in solving persistent global health challenges. Ghiran’s project uses the principles of magnetic levitation and cell phone technology to create an inexpensive, portable device to quickly and accurately diagnose malaria outside of the laboratory setting. The GCE received more than 2,500 grant submissions from 100 countries; Ghiran’s work is one of 88 projects to receive funding.

“GCE winners are expanding the pipeline of ideas for serious global health and development challenges where creative thinking is most urgently needed,” said Chris Wilson, director of Global Health Discovery at the Bill & Melinda Gates Foundation. “These grants are meant to spur on new discoveries that could ultimately help save millions of lives.”

Malaria causes nearly 1 million deaths per year throughout developing countries (85 percent of which are children under the age of 5) and parasites are becoming increasingly resistant to anti-malarial drugs, in part due to overdiagnosis.

“The lack of suitable methods of malaria diagnosis makes presumptive treatment often the only available option for local health service providers,” notes Ghiran. To address this challenge, Ghiran, in collaboration with Pierre Striehl, PhD, from the Harvard School of Dental Medicine, developed an antibody-free diagnostic screening device which separates malaria-infected red blood cells from uninfected red blood cells by way of magnetic levitation.

“Our screening device is light-weight, disposable and inexpensive to manufacture,” he notes. The prototype system requires less than a drop of finger-prick blood and a small volume of red-blood-cell friendly buffer containing paramagnetic ions. Diagnostic results can be obtained within a few minutes solely by using a set of permanent magnets immobilized in a plastic structure surrounding a glass or plastic capillary containing the blood. Results are visualized, recorded and stored using a standard camera phone. No additional imaging equipment, or staining reagents are required.

“This method helps fill the need for malarial diagnostic technologies capable of promptly and reliably ascertaining true malarial infections in the field,” says Ghiran. “We hope that this will help prevent the overdiagnosis of malaria and subsequent drug resistance.”

Bonnie Prescott
Beth Israel Deaconess Medical Center

AUA 2006 – Stone Disease: SWL & Invasive Therapy Including Ureteroscopy (II) – Podium Session

UroToday – Antony Devasia and his coworkers from Vellore, India, studied the effects of tamsulosin after ESWL for renal and ureteral stones. In this randomized, placebo controlled and double-blind study, daily administration of 0.4 mg of tamsulosin resulted in a higher stone clearance rate, lower requirement of analgesia and reduced need of secondary intervention, as compared to placebo. Although tamsulosin has been found to facilitate spontaneous passage of distal ureteral stones in prior studies, the current study seems to be the first evidence for a similarly beneficial effect after ESWL.

Flexible ureteroscopy with holmium: YAG laser intracorporeal lithotripsy is currently the most versatile endoscopic treatment modality for stones, irrespective of location and composition. During stone fragmentation, there is some risk of damage to ancillary equipment if the laser is accidentally aimed at it. Patrick Honeck from Peter Alken’s group in Mannheim, Germany, presented the results of an in vitro study to evaluate the effect of laser energy on guide wires and stone baskets. A 0.035 in Bentson guide wire, a 0.025 in Terumo glidewire, a 3 French Dormia basket and a 2.2 French tipless nitinol basket were tested with different laser fiber diameters (230 microns) and power settings (800-2000 mJ). While the holmium laser was able to transect all of these devices, the time required for disruption was fairly long for all (15-103 seconds), except for the nitinol basket (1-4 seconds). Thus, while the risk of breaking a guide wire seems to be relatively low during holmium laser lithotripsy; accidental disruption of nitinol baskets appears much more likely. Design of baskets specifically for laser lithotripsy of entrapped stones is still awaiting improvement.

By Alfred Krebs, MD

UroToday – the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:

Copyright © 2006 – UroToday

PBA Tour Fraught With Injuries

Professional football has recently come under scrutiny for the lingering effects of injuries caused by years of high-impact collisions, but doctors are quick to point out that football is not the only sport where athletes are suffering intense physical pain. One of the most physically demanding sports, according to medical experts, is professional bowling.

“Bowling is a repetitive motion sport,” says Dr. Steven Siwek, Medical Director of The Pain Center of Arizona, “and one out of every two athletes that comes to my office will come there for a repetitive motion injury.”

Dr. Siwek points out that professional bowlers have numerous physical disadvantages going against them.

“Simple actions repeated consistently over a long period of time can cause great stress on muscles and joints, and bowlers on the PBA tour are asked to throw 16-pound bowling balls down a lane with the exact same motion for 10 frames a game, often well over 50 games per week. When you consider the stress caused by overuse, then combine it with the intensity of facing elite competition, injuries are inevitable for these athletes.”

For over 50 years, the Professional Bowlers Association has provided entertainment for bowling fans worldwide. The PBA tour allows the best bowlers in the world to compete at the highest levels and yet, despite a tradition steeped in history, professional bowling remains an underground sport struggling for attention and respect.

Perhaps better known for its somewhat unfortunate portrayal in the media through movies like The Big Lebowski, Kingpin, and even Bowling for Columbine, bowling allows a comfortable existence for only its very best competitors. The life of a professional bowler can be a difficult one. Life on the road can take a toll on both the body and the social life of even the very elite of the PBA tour.

Chad Harris, CEO of Hotseat Media, and cofounder of “The Pain Channel,” recently took a camera crew to the 2011 World Series of Bowling.

“We were amazed by the consistency of injuries throughout the bowling world. We were there to cover the pain aspects of competing on the PBA tour, and we were hopeful to find one or two good stories, but literally every bowler we talked to had an unbelievable story about persevering through painful injuries. We actually had to make two episodes because there were just too many injuries to cover.”

The Pain Channel recently released their second episode on injuries in bowling, a feature on Michael Haugen Jr. Haugen Jr. won the 2008 Tournament of Champions, a PBA major title, then injured his finger just weeks later at a charity event. Thought to be a front runner for PBA Player of the Year, his season was cut short. He lost his next season to a knee injury. Now, he is fighting to regain his top form.

“I’m rolling the dice,” Haugen Jr. says of competing with his knee injury, “but that’s my living. That’s what I do. You look at Favre, he played 297 consecutive games, and it didn’t matter what was wrong with that guy, he got up and he played. I’m kind of the same way. If I can walk and I can throw it, I’m going to throw it.”

“The Pain Channel” is a web series devoted to informing the public about proper pain management and care. The episode chronicling Haugen Jr.’s story is currently being viewed at as The Heart of a Champion.


The Pain Center of Arizona