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Bob,

 Enclosed are posts comprising a current PIENO thread about dura products.   Can you shed some light on whether there's any likelihood this material was used in the DBS procedures  (or, for that matter, the various  -otomies ) our members have had  over the last several years?  

I understand you can't be aware of the extremes of surgeons, patients and situations that might drive a decision to use a particular product.  I am interested in knowing whether there is any reasonable possibility that a routine procedure for a PWP might involve use of a dura product.       

Thanks,

Bob  Bowling

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Janet,

Hmmmmm.  

You suspect dura matter might have been used in closing up some DBS incisions?  I presume you wouldn't have gone to the trouble if it wasn't  a matter of potential interest to some of us.  Any thoughts on how we can figure out if we've been "patched" without making a production of it?  (I suppose a case of CJD would be a clue.)  I scanned my hospital and doctor bills and learned nothing.  I'll try the surgeon next.  

The dates in your article indicate warnings were issued to the medical community in roughly 1988 about the dangers inherent in dura products.   Filings with the FDA indicate dura was still being used in the US  as recently as August,  2001.  That's the date of a request to the FDA to ban their use.  It would seem likely that, even if the FDA moved with uncharacteristic speed, use of dura continues today.  By copy of this letter, I'll ask Bob Fink if he can shed some light on the matter.  

Bob Bowling

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Brain patch suspected of spreading CJD

Last Updated Tue, 26 Mar 2002 23:57:03 - TORONTO - The use of human tissue
during surgery is putting Canadians at risk of contracting brain-wasting
Creutzfeldt-Jakob disease, researchers say.

What has them concerned is a patch of tissue called dura matter, taken from
human cadavers and used to seal incisions during brain surgery.

"We estimate that probably somewhere between two and 400 grafts per year
are used in Canada," says Richard Moulton of the Canadian Neurosurgical
Society.

Moulton says his group believes the tissue patch should be banned to reduce
the risk of accidental transmission of CJD.

Human dura matter is believed to have caused more than 114 cases of CJD
worldwide, including four in Canada.

At age three, Dominique Roy-Regimbald underwent surgery in Montreal to
remove a brain tumor. To repair the brain membrane, doctors used a Lyodura
patch made in Germany.

Dominique's family believes the patch carried the infectious agent that
caused him to develop CJD. He died of the disease in 1999, at age 14.
Health Canada had warned hospitals of the risk one year before Dominique's
surgery.

"There are people in Canada who have received it after the warning," says
Dr. Neil Cashman, a CJD researcher at the University of Toronto.

Written by CBC News Online staff
http://cbc.ca/stories/2002/03/26/cjd_tissue020326

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