Virtual Medical Visits

Virtual Medical Visits

NEW YORK – “Telemedicine has the potential to improve quality of care by allowing clinicians in one ‘control center’ to monitor, consult and even care for and perform procedures on patients in multiple locations,” Doctor and Patient columnist Pauline Chen writes. “A rural primary care practitioner who sees a patient with a rare skin lesion, for example, can get expert consultation from a dermatologist at a center hundreds of miles away.”

The Times continues, “But despite its promise, telemedicine has failed to take hold in the same way that other, newer, technologies have. Not because of technical challenges, expense or insufficient need. On the contrary, the most daunting obstacle to date has been a deeply entrenched resistance on the part of providers”


Virtual Reality Tele-Rehab Improves Hand Function

Virtual Reality Tele-Rehab Improves Hand Function

BLOOMINGTON – Remotely monitored in-home virtual reality videogames improved hand function and forearm bone health in teens with hemiplegic cerebral palsy, helping them perform activities of daily living such as eating, dressing, cooking, and other tasks for which two hands are needed.

“While these initial encouraging results were in teens with limited hand and arm function due to perinatal brain injury, we suspect using these games could similarly benefit individuals with other illness that affect movement, such as multiple sclerosis, stroke, arthritis and even those with orthopedic injuries affecting the arm or hand,” said Meredith R. Golomb, M.D, M.Sc., Indiana University School of Medicine associate professor of neurology. A pediatric neurologist at Riley Hospital for Children, she is the first author of a pilot study which reported on the rehabilitative benefits of these custom videogames.

This project was done in collaboration with the Rutgers University Tele-Rehabilitation Institute, headed by Grigore Burdea, Ph.D., professor of electrical and computer engineering. The study appears in the January 2010 issue of Archives of Physical Medicine and Rehabilitation.

The researchers also reported that improved hand function appears to be reflected in brain activity changes as seen on functional magnetic resonance imaging (fMRI) scans.

The three study participants were asked to exercise the affected hand about 30 minutes a day, five days a week using a specially fitted sensor glove linked to a remotely monitored videogame console installed in their home. Games, such as one making images appear (“sliders”) were custom developed at Rutgers, calibrated to the individual teen’s hand functionality, included a screen avatar of the hand, and focused on improvement of whole hand function.

“Popular off-the-shelf games are targeted to people with normal hand and arm function and coordination. These games don’t work for or benefit those with moderate-severe hemiplegic cerebral palsy and many other disorders that affect movement. They just aren’t made to be used by or improve hands that can’t pinch or grasp” said Dr. Golomb.

In the future, physical therapists could remotely monitor patients’ progress and make adjustments to the intensity of game play to allow progressive work on affected muscles. In addition to meeting an unfulfilled need, this could potentially also save healthcare dollars and time.

Typically, insurance or government program coverage for rehabilitation therapy for cerebral palsy does not cover teens. Long term physical rehabilitation is costly. And even if cost is not an issue, taking an adolescent out of school and transporting him or her to the hospital or rehab center puts stress on both the patient and their parents. These specially developed games motivated rehabilitation exercises in the home at a time convenient for the teens, broadening access to rehabilitation

Yoga Reduces Cytokine Levels Known To Promote Inflammation

Yoga Reduces Cytokine Levels Known To Promote Inflammation

CLEVELAND – Regularly practicing yoga exercises may lower a number of compounds in the blood and reduce the level of inflammation that normally rises because of both normal aging and stress, a new study has shown.

The study, done by Ohio State University researchers and just reported in the journal Psychosomatic Medicine, showed that women who routinely practiced yoga had lower amounts of the cytokine interleukin-6 (IL-6) in their blood.

The women also showed smaller increases in IL-6 after stressful experiences than did women who were the same age and weight but who were not yoga practitioners.

IL-6 is an important part of the body’s inflammatory response and has been implicated in heart disease, stroke, type-2 diabetes, arthritis and a host of other age-related debilitating diseases. Reducing inflammation may provide substantial short- and long-term health benefits, the researchers suggest.

“In addition to having lower levels of inflammation before they were stressed, we also saw lower inflammatory responses to stress among the expert yoga practitioners in the study,” explained Janice Kiecolt-Glaser, professor of psychiatry and psychology and lead author of the study.

“Hopefully, this means that people can eventually learn to respond less strongly to stressors in their everyday lives by using yoga and other stress-reducing modalities.”

For the study, the researchers assembled a group of 50 women, age 41 on average. They were divided into two groups – “novices,” who had either taken yoga classes or who practiced at home with yoga videos for no more than 6 to 12 sessions, and “experts,” who had practiced yoga one of two times weekly for at least two years and at least twice weekly for the last year.

Each of the women was asked to attend three sessions in the university’s Clinical Research Center at two-week intervals. Each session began with participants filling out questionnaires and completing several psychological tests to gauge mood and anxiety levels.

Each woman also was fitted with a catheter in one arm through which blood samples could be taken several times during the research tasks for later evaluation.

Participants then performed several tasks during each visit designed to increase their stress levels including immersing their foot into extremely cold water for a minute, after which they were asked to solve a series of successively more difficult mathematics problems without paper or pencil.

Following these “stressors,” participants would either participate in a yoga session, walk on treadmill set at a slow pace (.5 miles per hour) designed to mirror the metabolic demands of the yoga session or watch neutral, rather boring videos. The treadmill and video tasks were designed as contrast conditions to the yoga session.

Once the blood samples were analyzed after the study, researchers saw that the women labeled as “novices” had levels of the pro-inflammatory cytokine IL-6 that were 41 percent higher than those in the study’s “experts.”

“In essence, the experts walked into the study with lower levels of inflammation than the novices, and the experts were also better able to limit their stress responses than were the novices,” Kiecolt-Glaser explained.

The researchers did not find the differences they had expected between the novices and experts in their physiological responses to the yoga session.

Co-author Lisa Christian, an assistant professor of psychology, psychiatry and obstetrics and gynecology, suggested one possible reason:

“The yoga poses we used were chosen from those thought to be restorative or relaxing. We had to limit the movements to those novices could perform as well as experts.

“Part of the problem with sorting out exactly what makes yoga effective in reducing stress is that if you try to break it down into its components, like the movements or the breathing, it’s hard to say what particular thing is causing the effect,” said Christian, herself a yoga instructor. “That research simply hasn’t been done yet.”

Ron Glaser, a co-author and a professor of molecular virology, immunology and medical genetics, said that the study has some fairly clear implications for health.

“We know that inflammation plays a major role in many diseases. Yoga appears to be a simple and enjoyable way to add an intervention that might reduce risks for developing heart disease, diabetes and other age-related diseases” he said.

“This is an easy thing people can do to help reduce their risks of illness.”

Bill Malarkey, an professor of internal medicine and co-author on the study, pointed to the inflexibility that routinely comes with aging.

“Muscles shorten and tighten over time, mainly because of inactivity,” he said. “The stretching and exercise that comes with yoga actually increases a person’s flexibility and that, in turn, allows relaxation which can lower stress.”

Malarkey sees the people’s adoption of yoga or other regular exercise as one of the key solutions to our current health care crisis. “People need to be educated about this. They need to be taking responsibility for their health and how they live. Doing yoga and similar activities can make a difference.”

As a clinician, he says, “Much of my time is being spent simply trying to get people to slow down.”

The researchers’ next step is a clinical trial to see if yoga can improve the health and reduce inflammation that has been linked to debilitating fatigue among breast cancer survivors. They’re seeking 200 women to volunteer for the study that’s funded by the National Cancer Institute.

Researchers Heather Preston, Carrie Houts and Charles Emery were also part of the research team which was supported in part by a grant from the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health.

UAB To Study The Effects Of Olive Oil On Breast Cancer

UAB To Study The Effects Of Olive Oil On Breast Cancer

BARCELONA – Ana Ripoll, Rector of Universitat Autonoma de Barcelona (UAB), and Pedro Barato, President of “Organizacion Interprofesional del Aceite de Oliva Espanol” signed a research agreement to carry out an in depth study of how the intake of olive oil can work towards preventing and fighting against breast cancer. The Multidisciplinary Group on Breast Cancer Research (GMECM), directed by Dr Eduard Escrich, lecturer of the Department of Cell Biology, Physiology and Immunology, will be working on this research project during the next five years. GMECM has demonstrated in previous researches that a moderate intake of virgin olive oil slows down the spreading of this cancer.

Researchers at GMECM aim to determine the possible activity of common components of human diets with the objective of formulating scientific opinions on the health of the population or levels of risk, all within the field of breast cancer prevention. Among the results obtained until now researchers highlight the fact that a moderate intake of virgin olive oil can slows down the spreading of this cancer due to the action of mechanisms which counterattack possible harmful effects of fats, while an excessive intake of seed oils can be damaging.

In the study, which will begin this coming year, researchers will continue to study the effects olive oil can have on this type of cancer, with experimental studies and with human cell lines and samples. Among the research studies to be carried out, some of the most prominent focus on the effects fats and oils can have on mammary tumours, and especially those of extra virgin olive oil, and an analysis of the molecular changes found in these tumours in all of the genome and in the specific genes implicated in this pathology.

It is foreseen that the agreement between UAB and the “Organización Interprofesional del Aceite de Oliva Español” will form part of a collaboration framework between the two former entities and the Department of Agriculture, Food and Rural Action, and the Department of Health of the Catalan Government. Under this agreement, GMECM receives the support of another entity of the olive oil sector, and the institutional recognition of its research activities. It has recently received support from entities such as the Ministry for Education and Science, the Catalan Government, the “Patrimonio Comunal Olivarero” Foundation and the Olive Oil Agency belonging to the Spanish Ministry for the Environment and Rural and Marine Regions.

The research tasks of GMECM have earned it numerous recognitions in the past few years, including prizes from the Medical Sciences and Health Academy of Catalonia and the Balearic Islands, the Spanish Society of Senology and Mammary Pathology, and those awarded recently to Dr Escrich: The International Award of “Santiago Dexeus Font” Foundation for his professional trajectory in the field of research in Mastology, the Picudo Award for his research into olive oil and health, and the FECOES National Nutrition Prize for his contributions to the studies into the effects of nutrition on breast cancer. Dr Escrich was also made member of the Mare de Déu de l’Olivera Brotherhood of the Santa Maria del Mar Basilica of Barcelona.

A Discussion on Post Traumatic Stress Disorder

A Discussion on Post Traumatic Stress Disorder

PTSD (Post-Traumatic Stress Disorder) is triggered by a traumatic event – it is a kind of anxiety. The sufferer of PTSD may have experienced or seen an event that caused extreme fear, shock and/or a feeling of helplessness. Most of us experience a brief period of difficulty adjusting and coping with traumatic events. However, we gradually get better with time and healthy coping methods. On the other hand, there are times when symptoms get worse and may last for several months, or years. This study explains how PTSD can surface two years after a traumatic event. Another study found that one in eight Lower Manhattan residents likely had PTSD two to three years after the 9/11 attacks.

The sufferer’s life may be completely disrupted – in such cases the person suffers from PSTD. To prevent PTSD from becoming a long-term illness it is crucial that the sufferer receive treatment as soon as possible.

Military service members returning from Iraq and Afghanistan are likely to experience posttraumatic stress disorder (PTSD) and alcohol use disorders simultaneously, a study found.

According to Medilexicon’s medical dictionary, Post-Traumatic Stress Disorder (PTSD) is “1. Development of characteristic long-term symptoms following a psychologically traumatic event that is generally outside the range of usual human experience; symptoms include persistently re-experiencing the event and attempting to avoid stimuli reminiscent of the trauma, numbed responsiveness to environmental stimuli, a variety of autonomic and cognitive dysfunctions, and dysphoria. 2. A DSM diagnosis that is established when the specified criteria are met.” (DSM = an abbreviation for the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders).
A person can suffer from PTSD after experiencing or witnessing the following events:

  • Military confrontations
  • Natural disasters
  • Serious accidents
  • Terrorist attacks
  • Violent deaths
  • Rape
  • Personal assaults
  • Any situation which triggers fear, shock, horror, and/or helplessness

How common is PTSD?

Any of us can suffer from PTSD, given the right circumstances. It is estimated that approximately 5% of men and 10% of women suffer from PTSD at some point in their lives. PTSD can occur at any age. According to the NHS (National Health Service, UK), about 40% of sufferers developed PTSD after a loved one (or somebody very close) died suddenly. Typically, a person with PTSD relives the horrific event through nightmares and has flashbacks as well; there may be problems with concentration and sleeping, as well as feelings of isolation and detachment from life. Symptoms can reach such a point that the sufferer’s ability to live daily life is seriously undermined.

What are the symptoms of Post-Traumatic Stress Disorder (PTSD)?

The majority of people who are exposed to a traumatic event will experience the symptoms listed below. They will usually taper off and eventually disappear within a few days or weeks. For some people, the symptoms may persist, and even become worse over time:

  • Nightmares
  • Frightening thoughts
  • Sweating and shaking
  • Refusal to discuss the event
  • Avoiding things that remind the person of the event
  • Feeling detached and estranged from others
  • Feeling emotionally and mentally numbed
  • Unable to remember some aspects of the event
  • Reduced interest in life
  • Flight/fight syndrome
  • Difficulties concentrating
  • Insomnia (problems either falling asleep, or waking and then not being able to get back to sleep)
  • Moodiness
  • Irritability
  • Outburst of anger
  • Over-alertness to possible danger
  • Sensations that the event is recurring
  • Feelings of guilt
  • Long-term behavioral traits
  • Over-consumption of alcohol
  • Drug dependency
  • Relationship breakdowns
  • Phobias
  • Anxiety disorders
  • Severe depression
  • Headaches
  • Stomach problems
  • Dizziness
  • Chest pain
  • Body aches and pains
  • Weaker immune system
  • Problems at work
  • A greater perceived disability attributed to chronic pain, this study indicates. However, this study found the opposite – that PTSD patients were less sensitive to pain.

People with PTSD may find that the symptoms come and go, while others will have severe and chronic symptoms (in medicine ‘chronic’ means long-lasting, unremitting). Certain noises, such as a car backfiring can bring symptoms back or quickly increase their severity, as can other reminders, such as a news report, or a smell.

When to see a doctor

People may have symptoms after a traumatic event but not have PTSD – the feelings may include fear and anxiety, as well as a lack of concentration, sadness and changes in sleeping and eating habits. There may even be bouts of crying. This does not necessarily mean that the person has PTSD. However, if these disturbing symptoms persist for more than a month, and if they are severe enough to impede the person’s ability to get back to normal life, he/she should see a health care professional. Prompt treatment with a qualified professional will significantly help prevent the PTSD symptoms from getting worse.

There are times when the PTSD symptoms become so severe than the person considers harming himself/herself. If this happens emergency services should be sought, or help from a family member or a good friend.

What causes Post-Traumatic Stress Disorder (PSTD)?

Experts cannot fully explain why some people develop PTSD while others do not. People of all ages are potential PTSD sufferers. It is especially common among people who have served in combat (often referred to as ‘shell-shock, battle fatigue, or combat stress’). We do know that there are some risk factors (a risk factor may raise the chances of PTSD occurring):

  • Traumatic events that commonly trigger PTSD in men – these include combat exposure, rape, childhood neglect and physical abuse.
  • Traumatic events that commonly trigger PTSD in women – these include rape, sexual molestation, physical attack, being threatened with a weapon, childhood physical abuse.
  • Other traumatic events that trigger PTSD – these include fire, natural disasters, muggings, robbery, assault, civil conflict, automobile accident, airplane crash, torture, kidnapping, terrorist attack, and being attacked by an animal.
  • Life threatening medical diagnosis or a major medical event – this study found that breast cancer patients who have a prior history of mood and anxiety disorders are at a much higher risk of experiencing post-traumatic stress disorder following their diagnosis. Another study revealed that the prevalence of posttraumatic stress disorder symptoms and PTSD in patients following ICU hospitalization is about 20%. Support from hospital staff and family is an important factor in preventing post-traumatic stress disorder after a major intensive-care intervention, according to researchers from the Charite Hospital in Berlin, Germany.
  • Family history of mental health problems – people who have a close relative with mental health problems, or those who experience child abuse are at higher risk of developing PTSD if they experience traumatic events.
  • Gender – a woman is four times more likely to develop PTSD than a man. Psychiatrists say this is probably because women run a higher risk of experiencing interpersonal violence, such as sexual violence. In times of war the risk may be higher for men, as a percentage of the total population. A study found that although males experience more traumatic events on average than do females, females are more likely to meet diagnostic criteria for PTSD.
  • Genetics – scientists are beginning to suggest that certain genetic factors may raise a person’s risk of developing PTSD. Researchers at UCLA Department of Psychiatry and Biobehavioral Sciences found a genetic connection between PTSD, depression and anxiety.
  • Physical factors – we know that the hippocampus – a part of the brain linked to emotions and memory – appears different in MRI scans in people with PTSD. These alterations are probably linked to flashbacks and memory problems.
  • Poor physical or mental health – military personnel with diminished mental or physical health before combat exposure are more vulnerable to developing PTSD after deployment, according to US researchers.
  • Watching tragedies on TV – a study indicates that watching tragedies, such as 9/11 on TV, can cause PTSD in some people, even though they were not physically there.
  • Childbirth – This study reveals that childbirth triggers many more cases of PTSD than people realize.
  • Abnormal hormone response to stress – according studies, levels of hormones are abnormal among people with PTSD when they respond to stress. When we are in extreme danger our bodies produce natural opiates which trigger a reaction in the body when we are put under extreme stress or into a fight or flight situation. These opiates deaden the senses and dull pain. People with PTSD appear to produce high levels of these chemicals when there is no danger present. This may be why they feel detached and emotionless.
  • Panic attacks and later PTSD susceptibility not linked – an interesting study found that if a person experiences a panic attack during a traumatic event that they will be no more likely to suffer from PTSD in the future.

How is Post-Traumatic Stress Disorder (PSTD) diagnosed?

Most GPs (general practitioners, primary care physicians) in North America, Europe, and many other parts of the world are able to diagnose PTSD after discussing all the symptoms with the patient. The doctor will need to know how the patient feels, his/her overall health, and how they are sleeping. There are especially-designed questionnaires which help a doctor diagnose PTSD. The diagnosis is made based on signs and symptoms and a psychological evaluation. Often, GPs may refer the patient to a psychologist for further evaluation.

The patient will also be asked to explain his/her symptoms in detail, including how severe they are, when they occur, and how long they last. The patient will probably be asked to describe the event that led to the symptoms. Doctors may also carry out a physical exam to check for any other physical problems.

A person with PTSD must meet the criteria spelled out in the DSM (Diagnostic and Statistical Manual of Mental Disorder) published by the APA (American Psychiatric Association). The manual is used by psychologists, psychiatrists, and other mental health professionals to diagnose mental conditions by insurance companies to determine reimbursement for treatment (in the USA).

Scientists at the University of Alberta in Edmonton, Canada are getting closer to being able to use brain scans to help diagnose PTSD.

The criteria for post-traumatic stress disorder to be diagnosed include:

  • The patient experienced or witnessed an event involving either death or serious injury, or the threat of death or serious injury.
  • The patient responded to the event with intense fear, shock, horror and a sense of helplessness.
  • The patient relieves the experiences of the event, this may include having distressing memories or images, disturbing dreams, flashbacks, and even perhaps some physical reactions.
  • The patient deliberately avoids situations or triggers that may remind him/her of the traumatic event.
  • The patient may feel a sense of emotional numbness.
  • The patient feels he/she is constantly in a state of alert for signs of danger. This may bring with it sleeping problems and difficulties with mental concentration.
  • The patient’s symptoms have continued for more than one month.
  • The symptoms may interfere with the patient’s ability to carry out his/her normal daily tasks, or cause significant distress.

What is the treatment for Post-Traumatic Stress Disorder (PTSD)?

In the UK the GP will most likely refer the patient to a mental health professional, this could be a counselor, a community psychiatric nurse, a psychologist or a psychiatrist. A good health care professional will explain to the patient exactly how he/she plans to go ahead with treatment. PTSD is a medically recognized anxiety disorder – in order to achieve the most effective treatment results it is important that the patient and his/her loved ones acknowledge this fact.

PTSD is generally treated with psychotherapy, medication or both. Below are examples of possible treatments:

  • Playing some computer games – playing ‘Tetris’ after traumatic events could reduce the flashbacks experienced in PTSD, preliminary research by Oxford University psychologists suggests.
  • CBT (Cognitive-behavioral therapy) – this involves teaching learning skills that help the patient change his/her negative thought processes. It also includes mental imagery of the traumatic event to help work through the trauma, in order to gain control of the fear and distress.
  • EMDR (Eye movement desensitization and reprocessing) – the patient recalls the event while making several sets of side-to-side eye movements. This has been shown to lower distress levels for people with PTSD, allowing the patient to have more positive emotions, behaviors and thoughts.
  • Exposure therapy – this involves making the patient safely confront the very thing that upsets and disturbs him/her, so that he/she can learn to cope with it effectively. This type of therapy has become controversial, with some well respected experts indicating that it may, in fact, do more harm than good. However, this interesting article indicates that most therapies have unclear outcomes, except for “exposure therapy”, which appears to be effective.
  • Medications:
    • SSRIs (selective serotonin reuptake inhibitors) – these are the most commonly prescribed medications for PTSD; paroxetine is an example of such a drug. They also help treat depression, anxiety and sleep problems – symptoms often linked to PTSD. Patients under 18 should not take SSRIs, with the exception of fluoxetine under specialist advice.
    • Benzodiazepines – these are effective for treating irritability, insomnia and anxiety. They should be used with caution because people with PTSD may become dependent. They are, nevertheless, very effective in treating PTSD symptoms, especially feelings of anxiety.
    • Ecstasy – MDMA – the pharmaceutical version of Ecstasy – may help suffers of post-traumatic stress learn to deal with their memories more effectively by encouraging a feeling of safety, according to an article published by SAGE.
    • Cortisone hormone therapy – a study by Ben-Gurion University of the Negev (BGU) researchers found that a high dose of cortisone could help reduce the risk of PTSD.
  • NICE (National Institute for Health and Clinical Excellence) , a UK organization that approves drugs and treatments for the National Health Service (free universal healthcare), has the following guidelines for PTSD treatment:
    • If symptoms are mild and have been present for less than four weeks – watchful waiting.
    • All patients should be offered trauma-focused CBT or EMDR on an individual outpatient basis.
    • Young people, including children, should be offered trauma-focused CBT adapted for their circumstances and age.
    • Medication should not be routinely used as first line treatment in preference to trauma-focused psychological treatment. Medication should be considered as first line of treatment only for adults who refuse to take part in psychological treatment.
    • Debriefing sessions should not be routine practice (single sessions focusing on the traumatic event). All disaster plans need to have a planned psychological response to a disaster, with health care workers having clear responsibilities agreed beforehand.


  • Brain may be physically affected – this study found that children with post-traumatic stress disorder and high levels of the stress hormone cortisol were likely to experience a decrease in the size of the hippocampus – a brain structure important in memory processing and emotion.
  • Higher mortality among some heart patients – in patients who receive implantable cardiac defibrillators after a sudden heart event, there is a higher likelihood of death within five years if they experience symptoms of post-traumatic stress disorder, this study found.
  • Higher risk of long-term health problems – a study found that veterans suffering from PTSD are as likely to have long-term health problems as people with chronic disease risk factors such as an elevated white blood cell counts and biological signs and symptoms.
  • Heart disease risk – older men with PSTD have a higher risk of developing heart disease, according to a study carried out by researchers at the Harvard School of Public Health.


Tests Reveal Why Light Can Worsen Migraines

Tests Reveal Why Light Can Worsen Migraines

LONDON – The researchers studied two groups of blind people who suffered migraine headaches.

They found light triggered a reaction in a group of brain neurons that remained active for some time.

Migraines are one-sided throbbing headaches that cause nausea and affect up to six million people in the UK.

The researchers, writing in the journal Nature Neuroscience, said they noted that even blind people who had migraines experienced sensitivity to light or photophobia.

The observation led them to the idea that the signals transmitted from the retina via the optic nerve were somehow triggering worsening of the pain.

Sleep-wake cycles

They looked at 20 blind people who fell into two groups – the first were totally blind due to eye diseases such as retinal cancer and glaucoma.

They were unable to see images or to sense light and therefore could not maintain normal sleep-wake cycles.

Patients in the second group were legally blind due to retinal degenerative diseases, such as retinitis pigmentosa.

Although they were unable to perceive images, they could detect the presence of light and maintain normal sleep-wake cycles.

The patients in the second group described intensified pain when they were exposed to light, in particular to blue or grey wavelengths.

Rami Burstein, professor of anaesthesia and critical care medicine at the Beth Israel Deaconess Medical Centre in Boston, US, led the study.

Professor Burstein said: “While the patients in the first group did not experience any worsening of their headaches from light exposure, the patients in the second group clearly described intensified pain when they were exposed to light.

“This suggested to us that the mechanism of photophobia must involve the optic nerve, because in totally blind individuals, the optic nerve does not carry light signals to the brain.

“We also suspected that a group of recently discovered retinal cells containing melanopsin photoreceptors (which help control biological functions including sleep and wakefulness) is critically involved in this process, because these are the only functioning light receptors left among patients who are legally blind.”

Lee Tomkins, director of Migraine Action, said: “We have known from previous research that this sensitivity can be triggered by the blue light waves in the light spectrum, but avoiding grey light is a new aspect, and we are now wondering if this research might help us to further understand why so many people with migraines are sensitive to low energy light sources as well.”

Electrical signals

Migraine pain is believed to develop when the meninges, the membranes that surround the brain and central nervous system, become irritated.

This stimulates pain receptors and triggers a series of events that lead to the prolonged activation of groups of sensory neurons.

The researchers also examined what happened when they injected dyes into the eyes of rats.

They traced the path of the melanopsin retinal cells through the optic nerve to the brain where they found a group of neurons that become electrically active during a migraine.

“When small electrodes were inserted into these ‘migraine neurons’, we discovered that light was triggering a flow of electrical signals that was converging on these very cells,” said Professor Burstein.

Even when the light was removed these neurons remained activated.

“This helps explain why patients say that their headache intensifies within seconds after exposure to light, and improves 20 to 30 minutes after being in the dark.”

Dr Sue Lipscombe, a GP from Brighton with a special interest in headaches, said: “It suggests that an external source is contributing to the migraine condition and it is not just a contained brain disorder that just takes its cycle but that there are outside modifying factors.”


Gene Map of Anti-Malaria Plant Could Boost Supply

Gene Map of Anti-Malaria Plant Could Boost Supply


Researchers have mapped the genes of Artemisia annua to allow selection of high-yield varieties.


The study, published in the journal Science, aims to make growing the plant more profitable for farmers.


“It’s a major milestone for the development of this crop,” Professor Ian Graham from the University of York in the UK told BBC News.


Short supply


The research has been welcomed by Dr Chris Drakeley, director of the Malaria Centre at the London School of Hygiene and Tropical Medicine. “Anything that enables an increased yield of product from something like Artemisia annua is a major step.


“This is the first line anti-malarial in nearly all endemic countries at the moment and supplies can be limited.”


Artemisinin combination therapies, or ATCs, are used widely to treat malaria and are seen as the best solution to the parasite’s increasing resistance to anti-malarial drugs.


Professor Graham, who led the study, hopes that new higher yielding and more robust varieties could increase global supply of the malaria treatment within three years.


“Our aim is to have hybrid seeds that can be released to farmers in the developing world by 2011 or 2012. With a year lag for planting, this would have an impact on supply in 2012 or 2013.”


“We have to wait six to eight months from putting the seed in the ground to harvesting the crop and seeing how it has performed.”


Dr Drakeley hopes the new varieties will become available quickly.


“This will allow an increase in the basic compound that forms ATC therapies. If they can get these seeds out in the timeframe they’re talking about it’ll be a major advance,” he said.


Eye Test that Spots Alzheimer’s 20 Years Before Symptoms

Eye Test that Spots Alzheimer’s 20 Years Before Symptoms

LONDON – A test that can detect Alzheimer’s up to 20 years before any symptoms show is being developed by British scientists.

The simple and inexpensive eye test could be part of routine examinations by high street opticians in as little as three years, allowing those in middle age to be screened.

Dementia experts said it had the power to revolutionise the treatment of Alzheimer’s by making it possible for drugs to be given in the earliest stages.

The technique, being pioneered at University College London, could also speed up the development of medication capable of stopping the disease in its tracks, preventing people from ever showing symptoms.

Rebecca Wood, of the Alzheimer’s Trust, said: ‘These findings have the potential to transform the way we diagnose Alzheimer’s, greatly enhancing efforts to develop new treatments.’

Alzheimer’s and other forms of dementia blight the lives of 700,000 Britons and their families, and the number of cases is expected to double within a generation.

There is no cure and existing drugs do not work for everyone.

Current diagnosis is based on memory tests, and expensive brain scans are also sometimes used.

However decisive proof of the disease usually comes from examination of the patient’s brain after death.

Diagnosis: Eye drops would be used in the test to highlight diseased cells at the back of the eye

The eye test would provide a quick, easy, cheap and highly-accurate diagnosis.

It exploits the fact that the light-sensitive cells in the retina at the back of the eye are a direct extension of the brain.

Using eye drops which highlight diseased cells, the UCL researchers showed for the first time in a living eye that the amount of damage to cells in the retina directly corresponds with brain cell death.

They have also pinpointed the pattern of retinal cell death characteristic of Alzheimer’s. So far their diagnosis has been right every time.

With research showing that cells start to die ten to 20 years before the symptoms of Alzheimer’s become evident, it could allow people to be screened in middle age for signs of the disease.

However, some may not want to know their fate so far in advance. There is also the fear that insurance companies could increase premiums for those who test positive while still young.

The experiments, reported in the journal Cell Death & Disease, have been on animals but the team are poised to start the first human trials.

Researcher Professor Francesca Cordeiro said: ‘The equipment used for this research is essentially the same as is used in clinics and hospitals worldwide.

‘It is also inexpensive and non-invasive, which makes us fairly confident that we can progress quickly to its use in patients.

‘It is entirely possible that in the future a visit to a high street optician to check on your eyesight will also be a check on the state of your brain.’

The technique could also improve the diagnosis of other conditions, including glaucoma and Parkinson’s disease.

In the short term, an early diagnosis would give patients and their families much more time to prepare for the future.

In the longer term, it would allow new drugs that stop the disease in their tracks to reach their full potential.

Professor Cordeiro said: ‘If you give the treatment early enough, you can stop the disease progressing, full stop.’

Dr Susanne Sorensen, of the Alzheimer’s Society, cautioned that the test was still experimental but added: ‘This research is very exciting. If we can delay the onset of dementia by five years, we can halve the number of people who will die from the disease.’




Contact: James McMann – 702 516-4047


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Hand Size–Not Sex–Determines Sense of Touch

OTTOWA – Sometimes a difference between the sexes is not based on sex at all. Women have a finer sense of touch than men do, but a new study shows that this is simply because their fingertips tend to be smaller.

Neuroscientist Daniel Goldreich of McMaster University in Hamilton, Canada, and his colleagues first became curious about the sex difference while studying differences between blind and sighted people. They found that blind people are better than those with normal vision at distinguishing fine textures but that, within each group, women are better than men.

The researchers thought that the discrepancy might be the result of brain differences between men and women, but they first wanted to see if something simpler could explain it. So they tested 50 women and 50 men on a simple task: Each person touched a small, grooved surface and tried to identify the orientation of the grooves. As the grooves got closer together, it became more difficult to determine their direction.

As expected, women performed better at this task than men did, but when the scientists looked at the results by finger size, they found that the sex difference disappeared: On average, men and women with the same size fingertips perform at the same level, the team reports in the 16 December issue of The Journal of Neuroscience. (Finger size does not explain all individual variability, however; there are differences between people with the same size fingers, perhaps as a result of differences in the mechanical properties of skin or in how each person’s brain processes the information.)

The researchers also came up with a potential explanation for the size effect. Cells in the finger called Merkel cells appear to transmit this type of touch information to the brain. Goldreich and his co-workers measured the number of Merkel cells in their subjects’ fingertips and found that everyone had about the same number, regardless of finger size. They suspect that this explains the effect: Merkel cells are spaced more densely in smaller hands, giving those hands the ability to distinguish finer textures.

The paper is “very solid and convincing” regarding the effect of fingertip size on this specific task, says neuroscientist François Tremblay of the University of Ottawa in Canada. However, other types of tactile tasks may not work the same way, he adds. For example, passively pressing the skin against a textured object–as the study participants did–involves different neuronal pathways than actively moving the fingers around an object and may be controlled differently.

Controlling Your Breathing Helps Sea Sickness

PITTSBURGH – If you get seasick easily, you may prepare for boat rides with pressure-point bracelets, ginger, or a prescription skin patch. Now there’s one more remedy: timing your breathing to counteract the nauseating motion. The technique presumably works because it helps control gravity sensors in the abdomen–a lesser-known input to our fine-tuned balance system.

The brain is traditionally thought to sense body position in three ways. The inner ears sense motions of the head; the eyes see where the head is; and tiny sensory organs in muscles and tendons sense where the rest of the body is. More recently, researchers have realized that sensors in many other parts of the body also play a role: in the abdomen, the lower organs, and even blood vessels. As long as all of these sensors send matching signals to the brain, we feel oriented. But if one or two don’t match up, the brain gets confused and we become nauseated.

Scientists knew the most sickening motions closely match the rate of natural breathing; they also knew that people naturally tend to breathe in time with a motion. In fact, Navy seamen in World War II discovered that they could use certain breathing tricks to combat motion sickness. But no one had ever tested whether breathing out of time with a motion could prevent nausea.

Researchers from Imperial College London enlisted 26 volunteers to sit in a tilting, rocking flight simulator and coordinate their breathing in various ways with the motion. The tests lasted up to 30 minutes, or until subjects felt moderately sick. The natural tendency was for volunteers to inhale on every backward tilt, in rhythm with the rocking. But if the subjects exhaled on every backward tilt, they didn’t get sick as quickly. They felt even better if they breathed slightly faster or slower than the cyclic heaving of the chair; using that technique, the time until onset of nausea was 50% longer than during normal breathing.

So why do these tactics work? Abdominal sensors are known to send motion signals to the brain more slowly than those in the inner ear because they’re farther away from the brain and because abdominal organs have more mass, which means they resist movement a tiny bit longer. The time lag between the two types of sensors creates a mismatch that builds up in the brain and makes us gradually sicker, the researchers say. But if the diaphragm opposes gravity-induced stomach motions with controlled breaths, there is less sensory conflict and less nausea. “This technique is very good for mild everyday challenges,” says medical research scientist Michael Gresty, a member of the study team. “It’s completely safe, and it’s not a drug.” The results appear in the December issue of Autonomic Neuroscience.

“It’s a carefully designed study that shows there’s some modest effect of controlled respiration on motion sickness,” says neuroscientist Carey Balaban of the otolaryngology department at the University of Pittsburgh in Pennsylvania. But, he says, more controlled experiments are needed to confirm the proposed mechanism.

Dimensions of the Most Attractive Face

TORONTO – Scientists believe they have worked out the dimensions of the most attractive female face.

They say the key to the ideal arrangement of female facial features is the measurements between the eyes, mouth and ears.

Applying their results, the Canadian pop singer Shania Twain was rated as having the perfect visage.

The study, led by the University of Toronto, appears in the journal Vision Research.

The researchers asked students to rate the attractiveness of colour photographs of the same woman’s face, laid out side by side.

Using photoshop, the researchers altered the vertical distance between the eyes and mouth, and the horizontal distance between the eyes in each image.

The features themselves never changed, just the distance between them, and the woman’s face was only compared to her own.

Following a series of experiments, the researchers came up with the most attractive length and width ratios between features.

On length, the distance between a woman’s eyes and mouth should be just over a third or 36%, of the overall length of her face, from hairline to chin.

For width, they calculated that the space between a woman’s pupils should be just under half, or 46%, of the width of her face from ear to ear.

Fortunately, the researchers calculated that these ratios correspond to an average face.

The researchers said women who did not fit the “perfect dimensions” had no need to resort to extreme measures, such as plastic surgery.

They said hairstyles could be used in effect to create an optical illusion.

Lead researcher Professor Kang Lee said the face of actress and renowned beauty Angelina Jolie did not fit the golden ratio either for length or width.

British actress Elizabeth Hurley scored on the golden ratio for length, and just missed out the width measurement.

Both were eclipsed by Shania Twain, 44, whose hits include Man! I Feel Like a Woman!

The results suggest her face has a perfect set of geometric measurements.

However, the study looked only at white women, and the researchers admit their findings could not be applied to other groups.

Professor David Perrett, of the perception lab at St Andrew’s University, said the physical dimensions of a face provided a lot of clues about the health and fertility of the owner.

He said men tended to be attracted to female faces that were young and feminine – probably because they suggested heightened fertility.

But he said the distance between features was probably less important than the appearance of the features themselves.

For instance, a man was likely to be attracted by big eyes, rather than by the fact that they were a certain distance apart.

Alzheimers Risk Linked to Level of Appetite Hormone

WASHINGTON – High levels of a hormone that controls appetite appear to be linked to a reduced risk of developing Alzheimer’s disease, US research suggests.

The 12-year-study of 200 volunteers found those with the lowest levels of leptin were more likely to develop the disease than those with the highest.

The JAMA study builds on work that links low leptin levels to the brain plaques found in Alzheimer’s patients.

The hope is leptin could eventually be used as both a marker and a treatment.

The hormone leptin is produced by fat cells and tells the brain that the body is full and so reduces appetite. It has long been touted as a potential weapon in treating obesity.

But there is growing evidence that the hormone also benefits brain function.

Research on mice – conducted to establish why obese patients with diabetes often have long-term memory problems – found those who received doses of leptin were far more adept at negotiating their way through a maze.

The latest research, carried out at Boston University Medical Center, involved regular brain scans on 198 older volunteers over a 12-year period.

A quarter of those with the lowest levels of leptin went on to develop Alzheimer’s disease, compared with 6% of those with the highest levels.

“If our findings our confirmed by others, leptin levels in older adults may serve as one of several possible biomarkers for healthy brain ageing and, more importantly, may open new pathways for possible preventive and therapeutic intervention.”

Rebecca Wood, chief executive of the Alzheimer’s Research Trust, said: “Previous studies have shown that obesity in mid-life is associated with an increased risk of dementia, but this new research suggests that leptin might have a role to play.

“There is evidence that leptin has functions in the brain – further studies in this area could lead to the possibility that this hormone plays a role in new treatments for Alzheimer’s.”

Susanne Sorensen, head of research at the Alzheimer’s Society, described the research as “important”.

She said: “Further investigation is now needed to understand this relationship.

“This could move us closer to understanding the causes of the disease and provide vital information for drug development.”

There are currently 700,000 people in the UK living with dementia.

Whisky Hangover Worse Than Vodka, Study suggests


BOSTON – Drinking whisky will result in a worse hangover than vodka, according to research by US scientists.

The reason might lie in the number of molecules called “congeners” which it contains compared to vodka, the Brown University team said.

But the study also suggested that sticking to vodka all night rather than whisky would not improve your performance at work the next day.

The study is published in Alcoholism: Clinical and Experimental Research.

Drinking too much of any alcoholic drink can have a number of undesireable short and long-term effects

The 95 volunteers for the research, all healthy alcohol users, had one night of “acclimatisation” before drinking either whisky or vodka the following night.

They were given enough alcohol to put them a third over the legal driving limit for the UK.

On the third night they were given a “placebo” drink containing no alcohol.

On each occasion, they were then asked how they felt the following day, and were tested on how well they could concentrate on tasks.

The volunteers who drank whisky reported far more hangover symptoms such as headache nausea, thirst and fatigue compared with those who drank vodka.

However, the overall performance at the concentration task was roughly the same between the two groups.

Professor Damaris Rohsenow, who led the research at Brown University in Rhode Island, said: “While people felt worse, they didn’t perform worse after bourbon (a type of whisky made in the US) than after vodka.”

He said that the study also showed that workers in “safety-sensitive” roles could be impaired by drinking – long after the alcohol itself had disappeared from the bloodstream.

Chemical trace

The study, which also monitored sleeping patterns in the volunteers, found that disrupted sleep was no worse in either group.

The reason why whisky might cause more unpleasant hangovers might lie in the number of molecules called “congeners” which it contains compared to vodka, said Professor Rohsenow.

These include small amounts of chemicals such as acetone, acetaldehyde and tannins.

Chris Sorek, the chief executive of charity Drinkaware, said that social drinkers should be aware that no alcoholic drink removed the risk of a hangover.

He said: “Christmas is a time to socialise and celebrate, but many people will be drinking excessively – drinking too much of any alcoholic drink can have a number of undesirable short and long-term effects.”

While exceeding recommended daily limits might mean hangovers the following day, he said, in the long term, regular heavy drinking could increase the risk of cancer or liver disease.

Fake Blood-Clotting Products to Heal Wounded Soldiers

BEVERLY HILLS – Scientists say they have made a synthetic blood-clotting agent that could help wounded troops and patients.

In the lab, the fake platelets cut bleeding in half compared with having no treatment.

They could offer doctors a limitless supply with a longer shelf life than fresh donor platelets, the journal Science Translational Medicine reports.

The Case Western Reserve University team in the US hopes the product could become available in coming years.

The stuff the fake platelets are made from is already used in treatments approved by the US regulators, which the scientists say should help speed things along.

James Bertram and Professor Erin Lavik developed the platelets using biodegradable polymers and designed them to home in and link up with a patient’s own platelets at the site of injury.

This could be a complement to current therapies. Natural blood platelets are good at helping wounds to clot but can be overwhelmed by large injuries.

Using donor platelets from other people can boost clotting but carries risks of complications, including rejection. They also have a shelf life of only five days.

The researchers’ aim is to develop a treatment that medics can keep in their packs to treat wounded soldiers in the field.

“The military has been phenomenal at developing technology to halt bleeding from external or compressible injuries.

“But so many injuries are from blast traumas where the damage is on the inside. And it can be hard to stop bleeds like this in the field.”

She said the fake platelets could offer a viable solution and an immediate treatment before transfer to a field hospital.

The synthetic platelets work alongside the body’s own platelets to quickly stem the bleeding.

In rats, injections of the therapy prior to injury halved bleeding time. When given 20 seconds after the injury, bleeding time was cut by a quarter.

To avoid the fake platelets clumping together and creating an artificial clot, each synthetic platelet is built with a surrounding water shield.

This also means that any surplus platelets not needed for the clotting should be flushed out of the body with no ill effects.

Trauma specialist Colonel Tim Hodgetts, from the Royal Centre for Defence Medicine, said the military currently relies on blood stocks shipped from the National Blood Service by the RAF.

“This can be phenomenally challenging, particularly because the fresh platelets have a five-day shelf life.

“Within the military we would always consider innovations in medical practice.

“But it would only be attractive if it had proven benefit and safety in humans.”