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more Mednews items

Jan 19th

What Is a Fecal Transplant, and Why Would I Want One?

Fecal transplant is used to treat gut infections and is now being studied as a treatment for obesity, urinary tract infections, irritable bowel syndrome and more.

A bottle containing human fecal matter in an OpenBiome laboratory in Medford, Mass. Stool has emerged as a surprisingly effective treatment for hard-to-treat gut infections.CreditSteven Senne/Associated Press

Q. What is a fecal transplant, and why would I want one?

A. Fecal transplant is a medical procedure in which stool from a healthy donor is introduced into the intestine of a patient as a treatment for a disease. The idea is that the stool from the donor contains a healthful mix of gut bacteria that can seed the intestine of the patient, bringing healthful results.

While the procedure may sound highly unappealing, it is not unsanitary. Stool is obtained from a donor or from a stool bank, where it has been screened for pathogens and processed for medical use.

Donor stool may be administered via a plastic tube inserted through the nose into the stomach or small intestine. Alternatively, donor stool may be introduced into the colon via an enema or colonoscopy, or by swallowing a capsule of stool.

Fecal transplant is used as a treatment for a serious infection of the colon with Clostridium difficile, a harmful bacterium that can take hold if antibiotics kill off enough of a person’s “good” gut bacteria. In 2011, C. diff caused some half a million infections, 29,000 deaths and $4.8 billion in health care costs in the United States alone.

A watershed moment in the use of fecal transplant, or what’s known in the medical literature as fecal microbiota transplant, occurred in 1958, when doctors tried the procedure as a last-ditch, heroic measure in four patients with life-threatening C. diff. Remarkably, all four patients survived. The results were described as “immediate and dramatic,” but because of a general revulsion to the thought of ingesting stool, fecal transplant still failed to win mainstream acceptance.

The tipping point occurred in 2013, with the publication of a landmark study showing fecal transplant to be superior to vancomycin, the current gold standard treatment for C. diff. Larger studies soon confirmed and extended these results.

Fecal transplant is now being studied as a treatment for obesity, recurrent urinary tract infectionsulcerative colitisirritable bowel syndrome and a host of other conditions.

The preliminary data are encouraging, but enthusiasm must be tempered. The Food and Drug Administration regards fecal transplant as an “investigational new drug” and has not approved it for general use. Medical insurers typically cover fecal transplant only as a treatment for recurrent, intractable C. diff.

Reported side effects have been mild and include diarrhea, cramps, nausea, constipation and flatulence, though the trials performed to date have not been large enough to detect potentially more serious problems.

Jan 17th

The cause of a dead arm after sleeping

Waking up in the middle of the night to discover one of your arms has lost all feeling is frightening.

At first, the limb is limp and flops around like a useless bag of bone before coming back to life with a flood of "pins and needles" sensations.

When this happened to me as a kid, I panicked, thinking I'd done something horrible to my body, anxious that I'd never be able to move my arm again. But the feeling in my arm always came back.

This phenomenon is really common, James Dyck, a neurology researcher with the Mayo Clinic, told me in 2016. And it's actually a cool example of how the body can protect itself even during the paralysis of sleep.

Dyck explained there's a common misconception that pins and needles and numbness are caused by a lack of blood flow to the nerves. "The more likely thing is nerve compression — nerves are being pushed on and squashed, and that causes these symptoms," he says.

You have several nerves in your arm. Each serves a vital function.

The axillary nerve lifts the arm at the shoulder.

The musculocutaneous nerve bends the elbow.

The radial nerve straightens out the arm and lifts your wrist and fingers.

The ulnar nerve spreads your fingers.

Although Dyck says the exact physiology isn't completely understood, the effect of compressing any of these nerves in sleep — when you sleep on top of your arm or pin it underneath a partner — is like stepping on a garden hose. The information that flows from your extremities back to your brain is temporarily disrupted.

So why does it feel paralysed upon waking?

Dyck suggests two reasons.

1) It is actually, temporarily, paralysed. During REM sleep, the brain sends a signal to cause a body-wide paralysis. The purpose of this is to keep you from acting out dreams (which occur during REM). But if you wake up during one of these phases, you can be conscious before your fully regain control of your limbs. This is called sleep paralysis, and it can be a frightening situation. You're stuck somewhere in between dreaming and wakefulness, and you can't move.

2) The nerve compression has led to a temporary paralysis (perhaps because you got stuck in a compressed position during REM).

Compressing nerves can damage them. The good thing is that the body will naturally wake up as a protection mechanism when a nerve has been compressed too long. After you wake and relieve the pressure, the nerves will quickly come back online, usually first with a pins-and-needles feeling.

"The nerve structures, as they recover, tend to be irritable for a period of time," the University of Rochester Medical Center explains. "That’s because the nerves are firing spontaneously. Most of the time, the feeling of pins and needles is a good sign. It is a temporary phase that means nerves are coming back to life."

Someone who falls asleep on a limb is unlikely to do major damage to the nerves, Dyck says. But there are some cases when compressed nerves can become a greater problem.

One such case is called "Saturday night palsy," when a person falls asleep compressing a nerve while drunk. The alcohol impairs your body's ability to wake you up and protect your nerves.

"If you’re passed out drunk, you won’t move your arm," Dyck says. And when you wake up the next day, you can't extend your wrist and you can’t extend your fingers." That might last longer than a few moments (perhaps even a few days or months) as the nerve has to repair its protective coating.

And then there's hereditary neuropathy with liability to pressure palsies (HNPP), a genetic condition that makes people more susceptible to nerve compression injuries. They might want to be extra careful not to fall asleep on a limb or even cross their leg to avoid nerve compression. (Carpal tunnel may also cause tingling or numbness in limbs at night.)

Again, for most people who wake up to a dead limb, it's just a temporary annoyance. And it "probably takes less time [to recover] than you think it does, because you’re freaking out about it," Dyck says.

Jan 14th

Common cold in children: symptoms, causes and treatment

With more than 100 different viruses that can cause a cold, it's no surprise that pre-school children and babies are more prone to the sniffles. Our resident pharmacist Rita Ghelani offers her expert advice on nursing your little ones back to health:

What is the common cold?

The common cold is a contagious viral infection that affects the soft lining of the nose. There are more than 100 different viruses that can cause a cold. Colds are very common mainly in the winter months when people are indoors and in close contact with each other.

On average pre-school school children contract being three and eight colds per year.

Children and babies are more prone to getting colds than adults. On average pre-school school children contract being three and eight colds per year, and some can get more than this. 

Young children have more colds than older children and adults because they haven’t built up immunity to the many different cold viruses that are in the environment. Once they are exposed to a certain cold virus, they become immune to it – so a child gets fewer colds as they get older.

What are the symptoms of a cold in kids?

Children and babies with a cold can be restless and irritable. The most obvious sign of a cold is a runny or blocked nose, but other symptoms may include a sore throat, a cough and a raised temperature. Sometimes children may experience mild earache, due to the build-up of mucus behind the eardrums.

How do I know if my child has flu or a cold?

The symptoms of flu are similar to a cold but more serious. As well as a runny nose, sore throat and a cough, flu can bring on a fever, headaches, vomiting, diarrhoea, loss of appetite and severe tiredness.

Your child might feel cold and shivery one minute but hot and sticky the next – a high temperature comes on within the first day. The symptoms are flu also have a rapid onset, while the symptoms of a cold start more slowly.

Children with colds usually have energy to play and keep up their daily routines. Children with the flu are usually too poorly and need to remain in bed.

How can I relieve my child's cold?

There is no cure for a common cold. Symptoms of a cold can last up to two weeks in children, especially younger children who can’t blow their noses probably. Antibioticswill not help treat a cold. To help relieve the symptoms of a cold, try some of the following:

✔️ Make sure your child drinks plenty of fluid regularly.

✔️ Keep an eye on their temperature. If your child seems uncomfortable or has a fever, you can give them paracetamol or ibuprofen to relieve pain and lower their temperature.

✔️ For babies and toddlers try keeping the bedroom humid by placing a bowl of warm water under the radiator and raise the baby’s head slightly whilst sleeping by placing a pillow under the mattress of the cot.

✔️ Use saline nasal drops or spray to clear away mucus that may cause congestion in the nose and make breathing through the nose difficult. These are useful for babies having difficulty feeding due to a blocked nose.

✔️ Try using a vapour rubs and inhalant decongestants, which can be applied to a child's clothing, can also be used to provide relief from a stuffy nose.

✔️ For a very congested nose in babies a nasal aspirator can help. This is a device that physical clears mucus from the baby’s nose by a suction method.

✔️ Relief the symptoms of a cough by giving them a simple soothing cough syrup containing glycerol. Ask you pharmacist for advice.

When should we visit the doctor?

Look at your child and use your common sense. Do they seem exhausted or ill? Are they behaving differently? If the answer is yes, call the doctor. Symptoms to look out for that may mean your child has more than just a cold include:

➡️ Symptoms lasting longer than three weeks or suddenly get worse.

➡️ Your child cries and cries and will not be comforted.

➡️ Your child has a temperature over 38ºC (101.3ºF) for more than three days.

➡️ Your child has breathing problems such as wheezing, fast breathing or difficulty breathing.

 

Jan 13th

Constant cravings: is addiction on the rise?

From sex to sugar to social media, people are in the grip of a wider range of compulsive behaviours. But what is driving them – and what can be done?

 The range of things people are getting addicted to has increased, including gambling, shopping and internet addiction. Composite: None/Getty

Addiction was once viewed as an unsavoury fringe disease, tethered to substances with killer withdrawal symptoms, such as alcohol and opium. But now the scope of what humans can be addicted to seems to have snowballed, from sugar to shopping to social media. The UK’s first NHS internet-addiction clinic is opening this year; the World Health Organization (WHO) has included gaming disorder in its official addictions diagnosis guidelines.

The first glimmer of this shift was in 1992, when tabloids reported that Michael Douglas – Hollywood royalty, fresh from starring in the erotic thriller Basic Instinct – was holed up in an Arizonan rehab facility with sex addiction. No matter that, to this day, Douglas stringently denies ever suffering from the condition – the way we perceive addiction had begun to unfurl.

Back then, the broadening of the term was often viewed in medical circles as lazy appropriation; however, neuroscience has now largely accepted that it is the same brain chemical, dopamine, driving these irrepressible cravings. What’s more, our 21st-century world is so heavily baited with cues and stimuli – from stealthy marketing to junk food, not to mention the nagging lure of online life – that it appears to be rigging our dopamine systems to become “hypersensitised”.

 Gaming disorder is now included in the WHO official addictions diagnosis guidelines. Photograph: Carol Yepes/Getty Images

“The range of what people are getting addicted to has increased,” confirms Michael Lynskey, a professor of addiction at King’s College London. “For my parents’ generation, the only options were tobacco and alcohol. Now there are more drugs, including synthetics, along with commercialisation and ways – especially online – of encouraging prolonged use of different things.”

Many of these emerging conditions are seen as behavioural rather than physical, substance-related addictions – but the consequences can be as grave. Gambling is the longest established behavioural addiction, having been medically recognised since 2013. Suicide rates, along with the likelihood of substance addiction, are higher among compulsive gamblers. “I see gambling students who drop out of university because they can’t stop,” says Henrietta Bowden-Jones, the consultant psychiatrist behind the forthcoming NHS internet-addiction clinic. “I see people with shopping compulsions who are in so much debt because they couldn’t stop themselves from buying three dresses in different sizes, that in the end their businesses and families suffer.”

Sometimes, she says, compulsions flit between different vices – for example, a young man seeking refuge from family problems might toggle between gaming and porn. “I saw [a gaming disorder patient] yesterday,” she adds, “who then went on to spending money on objects and clothes. You can somehow shift the behaviour but it’s an illness we don’t yet know enough about.”

It is hard to overlook, however, the fact that many of these thrills are available at the touch of a screen. When the addiction charity Addaction commissioned a YouGov survey in October 2018, it found that parents are twice as worried about their teenage children being addicted to social media as they are about drugs, and a similar ratio when comparing worries about gaming and drugs. Also in October, the EU announced it would fund the European Problematic Use of the Internet Research Network to investigate the public health implications.

Not everyone agrees with defining these new disorders as addictions – after all, you can’t overdose on them. Gambling and gaming are the only ones to have made it on to the WHO list of addictions. However, a paradigm shift in understanding addiction is in motion.

Take sex addiction. Seeking treatment for this controversial condition has, in cases such as that of the golfer Tiger Woods, been criticised as a cynical shortcut to redemption for philanderers. On the other hand, neuroscientists who have been able to study the brains of people with debilitatingly compulsive obsessions with sex witness similar responses to those they have observed in drug addiction cases.

Most of the standard criteria for addiction diagnosis do apply to these disorders, says Lynskey: “Tolerance, neglect of responsibilities, inability to stop, withdrawal.” Withdrawal is the obvious sticking point, although sugar withdrawal symptoms have been induced in lab rats – sweats, shakes, changes in body temperature, anxiety, the whole kaboodle. “If a teenager becomes irritable when a gaming session is cut short, there’s some discussion as to whether that’s a sort of mild withdrawal,” says Lynskey.

Terry Robinson, an esteemed professor of psychology and neuroscience at the University of Michigan – together with his colleague, Kent Berridge – identified dopamine as the neurochemical responsible for craving. He thinks debating the semantics of addiction is unhelpful. “Whether it’s drugs, sex, gambling or whatever, you’re looking at impulse-control disorders where people have difficulty refraining from maladaptive use. There are certainly similarities in terms of the psychological and neurobiological mechanisms involved.”

 The modern environment is stuffed with craving-inducing stimuli. Photograph: Mario Anzuoni/Reuters

Once Robinson and Berridge had identified dopamine as “wanting” and pleasurable brain opiates as “liking” – two distinct phenomena – they discovered that you don’t have to like something in order to want it: a key finding about addiction. In addicts’ brains, the craving is unbearable even when they no longer like the object of their desire. Berridge once told me that the “massive”, “robust” wanting systems in the brain can be turned on with or without pleasure, whereas pleasure “has a much smaller and more fragile brain basis … That’s why life’s intense pleasures are less frequent and less sustained than life’s intense desires”. It also explains, perhaps, why humans are so easily herded into wanting new stuff and instant gratification, even when these things don’t make us happy.

“What’s happening in these addictions,” says Robinson, “is that the dopamine system is becoming hypersensitised, leading to these pathological motivational states.” He has identified three factors that could help explain why “there seems to be a wider variety of problematic things [to get addicted to]”. (He does caution, however, that “getting into social factors is very difficult in terms of proving cause and effect”.)

The first factor is that our modern environment is stuffed with craving-inducing stimuli. “People don’t appreciate the power of cues that have been associated with rewards, be it a drug or sex or food, in generating motivational states.” In fact, addicts can start liking the cues more than the end goal, such as the rigmarole of scoring drugs and so on. “The amount of cues associated with highly palatable foods are everywhere now,” he says. “Drugs, sex and gambling as well, and that has changed quite a bit over the years and could be leading to more problematic use.”

Lynskey agrees, adding “some of the marketing and design of gambling machines is a step ahead of all of us academics in devising ways to attract users and boost dopamine and retain them”. The “like” button, quantifying approval and igniting a compulsion to check social media, is a similar example. Introducing a report into the effects of social media on young people in early 2018, the UK’s children’s commissioner Anne Longfield wrote that “some children are becoming almost addicted to ‘likes’ as a form of social validation”.

 Parents are twice as worried about their teenage children being addicted to social media as they are about drugs. Photograph: golero/Getty Images

Robinson’s second consideration is dosage. Our liking of sweet tastes suited us when we were hunter-gatherers, helping us choose ripe energy sources. Now, we have high-fructose corn syrup, which blows our minds with unnatural levels of glucose. Similarly with drugs, he points out: “Chewing coca leaves in the Andes is not the same as smoking crack cocaine. The pharmacology is different and this can also increase propensity to addiction.”

His final factor is simply access. “Food, sex, gambling and drugs – availability these days is much greater than it was in the past.” (Sex addiction can include consuming porn, sexting, compulsive masturbation, exhibitionism and chemsex.)

All these factors, Robinson continues, “combine in complex ways – and I’m sure we don’t understand them all – to increase the probability of problematic use in a variety of things”. Does this mean that more people are at risk in this era of throbbing dopamine excitation? Major risk factors for addiction, such as deprivation and childhood trauma, are still important predictors for how easily your dopamine system can be hijacked, says Robinson – “but you have laden on top of that ubiquitous cues, more potent formulations and increased availability”.

Another theory about what is driving the diversification of addictive behaviours stems from a series of experiments conducted in Canada in the late 1970s known as Rat Park. The psychologist Bruce Alexander found that lab rats, while isolated in empty cages with the option of drinking either plain or drugged water, easily became addicted to heroin; if you put rats in a vast, toy-filled enclosure with other male and female rats for company, the heroin couldn’t compete. The context was driving addiction, rather than the drug itself. The resulting study made minimal waves when it was published – yet today, Alexander is being flown all over the world to share his take on addiction, which he calls the dislocation theory.

“The modern world breaks down all kinds of community, all kinds of tradition and religions and stuff that has made life integral and full for people in the past,” he says. “You can’t just say: ‘OK, now I’m going to give you back what modernity took away.’ We have to reinvent society, as we perpetually do, with an eye on making sure there are enough connections for human beings with each other in a traditional way, so that people can grow up and be content enough so they don’t need to find substitutes in addiction for life.”

Organisations such as Addaction in the UK, he says, “are finding ways to get [addicts] together into groups and planting these groups in communities and getting the community to support people in these groups, not to give up their addictions but to have a meaningful life”. Steve Moffatt, policy manager at Addaction, says that like all such services, “we’re just starting to try to understand the level of issues that are out there. For this generation coming through, social media is a big thing and online activities generally, but we still don’t know the extent.”

Despite the increase in the range of addictions, says Lynskey, there are still probably fewer addicted people than there were 30 years ago because the level of nicotine dependency – the most deadly one – has dropped from 50% to less than 20% in the UK. However, updates to diagnosis guidelines mean that people who sit lower on the addictive spectrum can now be seen as having problematic dependencies. The influential American Psychiatric Association, he says, “used to distinguish between ‘abuse’ and ‘dependence’, whereas now they are in a single category of drug-use disorders. Perhaps as many as one in four males would meet the criteria for alcohol dependency, and a lower, but still substantial, number of females.” And yet these people are at no risk of seizures or death if they go into withdrawal. “There is a spectrum,” he says, “whether it’s alcohol or drug dependence or shopping addiction and people have become a bit happier with placing the point at which behaviour becomes problematic at a lower level of use.”

Bowden-Jones says the best evidence for treating behavioural addictions is using cognitive behavioural therapy (CBT) to help avoid cues (for example, taking a different route home so you don’t pass the bookmaker), rewarding good behaviour and reaffirming what people have to lose with constant reminders, such as on wristbands.

How dealing with past trauma may be the key to breaking addiction

Assistance can also come in the form of stimulus-control tools. “There are fantastic blocks to put in place that can stop you from watching porn, gambling and indeed anything to do with the behaviour you have an issue with, except for gaming,” says Bowden-Jones. “We need to get to a position where, in the cold reality of your day, you can say: ‘I don’t need to spend more than two hours a day doing this, so I will block myself after two hours [of play].’” This responsibility, she says, lies with the gaming industry.

Mindfulness meditation has also helped to reduce substance abuse. In fact, it was found to be more effective than the Alcoholics Anonymous 12-step programme and CBT in 2014 research led by Sarah Bowden, an assistant professor of clinical psychology at Pacific University in Portland, Oregon; the previous year, Bowden, Berridge and other neuroscientific luminaries met to discuss addiction with the Dalai Lama. After all, Buddhists caught on to this craving problem thousands of years ago, using meditation to overcome the very urges that they identified as the linchpin of human suffering, long before these dopamine-fuelled times.

A modern challenge is the ubiquity, and the necessity: gone are the days when recovering behavioural addicts can be told to avoid the ever-necessary internet, for example. “Younger generations will be socially cut off,” says Bowden-Jones, “and what our patients say is when they feel they’re missing out, it pushes them more toward the virtual life that they already have a problem with rather than engaging properly in their face-to-face lives.” As Moffat says, “that’s where they get their validation”.

Many of us would plot our internet habits on the lower end of this spectrum: slaves to our phones, wasting hours that we will never get back stuck down internet rabbit holes, compulsively checking for likes. “There’s a great distinction,” says Bowden-Jones “between functional use and use that is not necessary. It’s like eating too much cake, which makes you feel bad. People who are on social media too much, it’s not a positive experience, although it may have started off as such.” There goes the dopamine without the pleasure, again.

 

Jan 10th

By mollycoddling our children, we're fuelling mental illness in teenagers

Of course we want to keep children safe. But exposure to normal stresses and strains is vital for their future wellbeing 

Jonathan Haidtand Pamela Paresky

We talk incessantly about how to make children more “resilient”, but whatever we’re doing, it’s not working. Rates of anxiety disorders and depression are rising rapidly among teenagers, and in the US universities can’t hire therapists fast enough to keep up with the demand. What are we doing wrong?

Nassim Taleb invented the word “antifragile” and used it in his book by the same name to describe a small but very important class of systems that gain from shocks, challenges, and disorder. Bones and the banking system are two examples; both get weaker – and more prone to catastrophic failure – if they go for a long time without any stressors and then face a major challenge. The immune system is an even better example: it requires exposure to certain kinds of germs and potential allergens in childhood in order to develop to its full capacity. Parents who treat their children as if they are fragile (for example, by keeping them away from dirt and potential allergens, such as peanuts) are depriving their children’s immature immune systems of the learning experiences those systems need to develop their maximum protective capacity.

Children’s social and emotional abilities are as antifragile as their immune systems. If we overprotect kids and keep them “safe” from unpleasant social situations and negative emotions, we deprive them of the challenges and opportunities for skill-building they need to grow strong. Such children are likely to suffer more when exposed later to other unpleasant but ordinary life events, such as teasing and social exclusion.

Some caveats are needed: kids need friends and a loving and reliable attachment figure. Children raised with high levels of fear in unpredictable or violent environments experience elevated levels of stress hormones for extended periods of time. Such long-term exposure can permanently alter brain development and increase stress reactivity, with lifelong ramifications for mental and physical health.

 ‘Girls use social media more than boys, and they seem to be more sensitive to the focus on physical appearance, chronic social comparison and awareness of being left out.’ Photograph: Getty Images/Hero Images

But brief periods of normal stress are not harmful; they are essential. A 2013 review of stress research titled “Understanding resilience” made the analogy to the immune system explicit: “Stress inoculation is a form of immunity against later stressors, much in the same way that vaccines induce immunity against disease.” What, then, would happen if we suddenly stopped immunising children with this kind of stress?

We recently co-wrote a book, with Greg Lukianoff, titled The Coddling of the American Mind, about the culture that erupted on American university campuses around 2014, and has spread to some campuses in the UK and Canada. In the book we describe how they began using the language of safety and danger to describe ideas and speakers, and to demand policies based on the premise that some students are fragile (or “vulnerable”). Terms such as “safe space, “trigger warning” and “microaggression” entered the language. These, we believe, are requests made by a generation that was deprived of the necessary quantity of social immunisations. Students now react with a kind of emotional allergic response (often referred to as being “triggered”) to things that previous generations would have either brushed off or argued against.

It’s not the kids’ fault. In the UK, as in the US, parents became much more fearful in the 1980s and 1990s as cable TV and later the internet exposed everyone, more and more, to those rare occurrences of brutal crimes and freak accidents that, as we report in our book, now occur less and less. Outdoor play and independent mobility went down; screen time and adult-supervised activities went up.

 ‘Free play, in which kids work out their own rules of engagement and learn to master small dangers (such as having a snowball fight) are crucial for the development of adult social competence.’ Photograph: Ellen Ozier/Reuters

Yet free play in which kids work out their own rules of engagement, take small risks, and learn to master small dangers (such as having a snowball fight) turns out to be crucial for the development of adult social and even physical competence. Depriving them of free play stunts their social-emotional growth. Norwegian play researchers Ellen Sandseter and Leif Kennair wrote about the “anti-phobic effects of thrilling experiences.” They noted that children spontaneously seek to add risk to their play, which then extends their coping abilities, which then empowers them to take on even greater challenges. They warned: “We may observe an increased neuroticism or psychopathology in society if children are hindered from partaking in age adequate risky play.” They wrote those words in 2011. Over the following few years, their prediction came true.

Mental health statistics in the US and UK tell the same awful story: kids born after 1994 – now known as “iGen” or “Gen-Z” – are suffering from much higher rates of anxiety disorders and depression than did the previous generation (millennials), born between 1982 and 1994.

The upward trends for depression among teenage boys and girls are happening in the UK too. Yearly measures of major depression are not available in the UK, but the NHS reports extensive mental health statistics for England from 2004 and 2017 that allow us to make a direct comparison for the same time period. Using a stricter criterion, which finds lower overall rates, the pattern is similar: up slightly for boys, nearly double for girls.

This alarming rise does not just reflect an increase in teenagers’ willingness to talk about mental health; it is showing up in their behaviour too, particularly in the rising rates at which teenage girls are admitted to hospital for deliberately harming themselves, mostly by intentionally cutting themselves. Large studies In the US and UK using data through to 2014 show sharply rising curves in the years after 2009, with increases of more than 60% in both countries. A 2017 Guardian study of more recent NHS data found a 68% rise in hospital admissions for self-harm by English teenage girls, over the previous decade.

Even more tragically, we also see this trend in the rate of teenage suicide, which is rising for both sexes in the US and the UK. The suicide rate is up 34% for teenage boys in the US (in 2016, compared with the average rate from 2006-2010). For girls, it is up an astonishing 82%. In the UK, the corresponding increase for teenage boys through to 2017 is 17%, while the increase for girls is 46%. Nobody knows for certain why recent years have seen so much more of a change for girls than boys, but the leading explanation is the arrival of smartphones and social media. Girls use social media more than boys, and they seem to be more affected by the chronic social comparison, focus on physical appearance, awareness of being left out, and social or relational aggression that social media facilitates.

What can we do to reverse these trends? How can we raise kids strong enough to handle the ordinary and extraordinary challenges of life? There’s a powerful piece of folk wisdom: prepare the child for the road, not the road for the child. As soon as you grasp the concept of antifragility, you understand why that folk saying is true.

 ‘At first, it’s scary for parents to let go.’ Photograph: Nadezhda1906/Getty Images/iStockphoto

Of course, we should work to make life safer by removing physical dangers from the environment, such as drunk drivers and paedophiles. And of course we should teach children to treat each other with kindness and respect. But we also have to let our kids out to roam the road without us. It’s what most of us over the age of 40 did (even in much more crime-prone decades) and it’s what most kids want to do. At first, it’s scary for parents to let go. But when a seven-year-old jumps up and down with excitement and pride after running an errand on her own, it gets easier to let her go and play in a nearby park with her friends – where they all learn to look out for each other and settle their own disputes.

We can’t guarantee that giving primary school children more independence today will bring down the rate of teenage suicide tomorrow. The links between childhood overprotection and teenage mental illness are suggestive but not definitive, and there are other likely causal threads. Yet there are good reasons to suspect that by depriving our innately antifragile kids of the wide range of experiences they need to become strong, we are systematically stunting their growth. We should let go – and let them grow.

• Jonathan Haidt is a social psychologist and professor of ethical leadership at New York University’s Stern School of Business, and the co-author (with Greg Lukianoff) of The Coddling of the American Mind. Pamela Paresky is senior scholar in human development and psychology at the Foundation for Individual Rights in Education. She was the lead researcher on The Coddling of the American Mind.

 

Jan 8th

Autism could be diagnosed with a hearing test at birth

·   The technique by Lake Erie College of Osteopathic Medicine in Pennsylvania measures pressure changes in the middle ear in response to sounds

·       It is non-invasive so can be used on infants without endangering their health

·       Some of the earliest and most consistent signs involve hearing but most tests rely on speech - making them ineffective in the very young 

·       Children with autism could be diagnosed at birth with a simple hearing test, according to new research.

·       It would enable treatments to begin years before symptoms develop - when they are more likely to work.

·       The technique measures pressure changes in the middle ear in response to sounds - assessing sensitivity and response times to a wide range of frequencies.

·       Known as acoustic, or 'stapedial', reflex testing it's non-invasive - so can be used on infants without endangering their health.

·       There is a strong link between auditory dysfunction and autism suggesting newborns with hearing issues could be monitored for the neuro-developmental disorder.

·       Professor of anatomy Randy Kulesza Jr at Lake Erie College of Osteopathic Medicine in Pennsylvania, hopes it will lead to a screening program for all kids.

·       He said: 'Especially early in life the brain is very plastic - meaning the right early interventions can literally train out those deficits.

·       'The person might not be perfectly neuro-typical - but such interventions can improve function.'

·       Children with ASD (autism spectrum disorder) have problems with communicating, social interaction and are prone to repetitive behaviours.

·       But most cases are not confirmed until after the age of four meaning corrective therapies are started later - delaying their potential impact.

·       Some of the earliest and most consistent signs involve hearing but most tests rely on speech - making them ineffective in the very young.

·       The acoustic reflex is an involuntary muscle contraction in the ear when we speak - or hear loud noises.

·       Muscles pull tightly within the 'middle ear' to protect the delicate machinery of the inner ear from being damaged.

·       It's mostly used against deeper, low-frequency sounds - such as a heavy object hitting with the floor.

·       Dr Kulesza said: 'We know the vast majority of people with autism have some type of hearing problem connected to abnormalities in the brain.

·       'That means these issues will be present and detectable at birth.'

·       Uncovering them would also improve outcomes for all children - because the finding would trigger early interventions.

·       The finding published in the Journal of the American Osteopathic Association said was based on a review of brain scan studies and post-mortems of autism patients.

·       It found early detection would benefit all those with deafness - whether they had autism or not.

·       Most autism patients have hearing problems - but not everyone with the latter has the former, said Dr Kulesza.

·       Hearing is also critical to speech-language development which - in turn - also affects social-emotional development.

·       By optimising auditory function the person's quality of life can be profoundly better, he said.

·       Currently all newborns have their ears examined. But this merely assesses whether the child can hear on a pass or fail basis.

·       Prof Kulesza said acoustic reflex testing provides much more information about the types of dysfunction that may be present.

·       He explained: 'Often people with autism suffer from hypersensitivity - meaning even relatively quiet sounds can feel like overwhelming noise.

·       'If parents and physicians understand that from the start they can work to acclimate the child's sensitivity and make his or her experience of the world much less intense and frightening.'

·       Prof Kulesza said autism spectrum disorders - the umbrella term for a range of similar conditions including Asperger syndrome - and auditory dysfunction are clearly linked.

·       But more research is needed to understand how best to employ interventions for those who have the hearing issues.

·       Charities estimate around 700,000 people who are on the autism spectrum in the UK - about one in every 100 people.

·       In the US it's as high as 3.5 million. It's four times more common in boys.

·       There's no 'cure' for but speech and language therapy, occupational therapy and educational support are available to help children and parents.

·       One serious concern Prof Kulesza shares is causing unnecessary stress to parents.

·       He emphasises acoustic reflex testing should not be presented as a diagnostic tool.

Instead parents should understand testing positive for auditory dysfunction allows for tailored early intervention that will maximise their child's potential.

Dr Kulesza said: 'The literature provides an abundance of data supporting both abnormal structure and function in the auditory brainstem in persons with ASD.

'Furthermore, there is evidence from a number of functional studies for irregularities in brainstem processing of sound in ASD.

'Both functional and anatomical investigations indicate auditory issues are present at birth.

'Current screening for ASD typically fails to identify ASD until social or verbal abnormalities are present.

'Auditory function could be used to raise suspicion or identify children at high risk of ASD manifesting later in life.

'The goal of early detection and diagnosis is early intervention to improve the quality of life of persons with ASD.

'Early intervention for children with ASD focusing on eye contact, gesturing and vocalisations can substantially improve the child's language and social interactions.

'There is also evidence auditory integration training normalises brain stem responses in children with ASD and even improves behaviours.

'Additional research in these areas will result in better integration and outcomes for children with ASD.' 

Jan 7th

Heavy snorers have almost doubled in number over the past 20 years, say experts

·       Experts say soaring obesity rates and smartphone use could be behind the rise 

·       Almost four in ten snored at least three nights a week, with men worst offenders 

·       London’s Royal National Throat, Nose & Ear Hospital examined 1,239 adults

·       A peaceful night’s sleep is becoming rarer after scientists discovered that heavy snorers have almost doubled in number over the past 20 years.

·       Experts at London’s Royal National Throat, Nose & Ear Hospital say soaring obesity rates and smartphone use could be behind the rise in rates of severe snoring.

·       They found that seven per cent of the population have sleep apnoea, the most severe form of ‘sleep disordered breathing’, compared to less than four per cent two decades ago. 

·       Researchers examined 1,239 adults and found that almost four in ten people snore at least three nights a week, with men the worst offenders.

·       In findings published in the journal Sleep Medicine, they suggest increases in obesity and the use of smartphones – which can cause daytime drowsiness – may help explain the rise in sleep disorders.

·       ‘Our results suggest that sleep disordered breathing is widely under-diagnosed and, taking into account adverse health effects caused by untreated obstructive sleep apnoea, this indicates an urgent need for policy makers to increase efforts addressing this problem,’ the report’s authors said.

·       Researcher Dr Maurice Ohayon said obesity was the main cause for the increase, but added: ‘Blue light emitted by LEDs in smartphones, computers and street lights are [also] responsible for insufficient sleep, increasing the risk of obesity, sleepiness and cognitive impairment which increase risk of sleep apnoea.’  

Dec 30th 2018

Why sleeping in your contact lenses is dangerous

o you dozed off without removing your contact lenses. Even though we are adequately warned against doing this, it remains one of the most commonly reported behaviors among teenagers and adults who use contacts. 

It looks like a lot of us underestimate how dangerous the habit can be. 

"It's like having a plastic bag over your head when you sleep," said Dr. Rebecca Taylor, M.D., an ophthalmologist in private practice in Nashville, Tennessee. "It's not ideal for oxygen exchange."

The science is pretty simple and has a lot to do with the cornea — this is the outermost, transparent layer of your eye. When you are awake, the cornea receives oxygen via direct contact with the surrounding air. 

So every time you close your eyes during sleep, the oxygen supply is reduced since your eyelid acts as a barrier. But when you fall asleep without removing your contact lenses, these devices can end up being an additional barrier.

Without enough O2, the cornea tends to experience some degree of swelling and may end up with tiny cracks on the surface. This raises the risk of bacteria possibly sneaking through those gaps and leading to an infection. There are many risk factors involved here such as how often you fall asleep with your contacts in, the duration of your sleep, etc.

For example, as contact wearers may know, getting drunk involves a higher risk of passing out with your contacts in. But in addition to that, you are also more prone to an infection thanks to the dehydrating effects of alcohol.

Overnight use of contact lenses, even occasionally, can make you 6.5 times more likely to suffer from keratitis, which is the inflammation of the cornea. In less severe cases, this can usually be healed by not wearing contacts for a while.

"But if an infection develops, it can cause a corneal ulcer. It starts to get eaten away or eroded by microorganisms," NYC-based Andrea Thau, O.D., told SELF. Here, the worst case scenario can mean losing an eye.

If you accidentally fell asleep with your contacts in, you don't have to panic. Just watch out for possible symptoms of an infection. For instance, red eyes, watering, and discharge indicate that you should get them checked out by a doctor.

Of course, another sign is problems with the quality of vision. As Glamour notes, you may be experiencing an infection if looking at an indoor lamp makes you feel like you are directly looking at the sun.

Though there are FDA-approved contact lenses that can be worn for extended periods, experts recommend being on the safe side as much as possible. "Even contact lenses that have extended wear should be removed regularly, at least once a week, to lessen the chances of corneal infection," optometrist Andre Horn cautioned.

Dec 28th 2018

When you live because someone else died

Pippa Kent, 28, was born with Cystic Fibrosis, a degenerative genetic disease affecting the functionality of her lungs and her pancreas. Despite living a relatively normal life for most of her twenties, living in London and working in communications for the government, at 27 the health of her lungs began to rapidly decline and she was left urgently needing a double lung transplant in order to survive. This is her story…

"I didn’t always know I’d need a lung transplant; they aren’t inevitable for everyone with Cystic Fibrosis (CF), and they’re also not viable for everyone, so it wasn’t a given. I was diagnosed when I was about two years old and for most of my childhood and in my early twenties I was pretty healthy.

Because of CF, my lungs would get a build-up of sticky mucus inside them which meant I’d contract more infections than most people which were harder to shift. Over time, my lungs became damaged; they got scarred and became less able to process oxygen. The other side of the disease is a pancreatic deficiency, meaning my pancreas doesn’t produce the enzymes it needs to break down food, so I have to take enzymes every time I eat.

In 2016 I started to notice that I was gradually becoming less able to live a normal life, and made the big decision to go on the list for a transplant. By that point, I wasn’t in dire need of one, but quite often people have to wait a long time for a donor - sometimes around two years - so I had to calculate that into the time.

For some people, the decline from not really needing a transplant to needing one urgently is quite a slow one, but that wasn’t the case for me. In February 2017, three months after going on the list, I got very ill very quickly. I contracted an infection, but because of all the chest infections I’d had over the years, I’d built up a resistance to antibiotics. I was hospitalised and put on oxygen, but when none of the medication worked, doctors weren’t sure whether I would make it. My sister, who was travelling in South America at the time, was asked to come home.

Thankfully, after a few weeks doctors found some antibiotics that did a little bit of good, but I was taken off the transplant list because I wouldn’t have survived the surgery. I spent until early April in hospital, still on oxygen and unable to do very much, just trying to build up some strength to get rid of as much infection as possible. After three months in hospital they put me back on the transplant list and sent me back home with the view that there wasn’t much else they could do except wait for a donor organ.

The transplant list is based on urgency, but there’s also a whole complicated metric including blood type and organ size that decides who’s allocated one. A lot of it comes down to chance, and that made the waiting even more difficult. It was exhausting not knowing, having to play this morbid waiting game. We went through some pretty dark times; we talked about how I might want my funeral, and where I might want to be buried. The reality of it was that if I didn’t get a transplant pretty quickly then I would die. It’s not uncommon for people to die on the list. We tried to be positive, hoping it wouldn’t happen, but they were conversations that were scary to have.

You’re given a special mobile phone when you get put on the list, which only the hospital has the number for. I went back as an active person on the list on the Monday, and I got the call to have my transplant on the Friday. I couldn’t believe it happened so quickly; I felt relieved, terrified, but also quite calm because I didn't know for certain that it would definitely go ahead. Lots of people have false alarms when doctors decide the organ they were going to transplant isn’t actually viable for any number of reasons. They’ll only put in organs that are perfect.

We drove straight to the hospital, arriving at 6pm. By 10pm they had confirmed it was all going ahead, and by 10.30pm I was lying on the operating table. There wasn’t really much time for me to worry.

By 3pm the following day, I came around in intensive care (ICU). I was high as a kite on all my medication, writing demanding notes about things I wanted because I was unable to speak. Within 15 minutes of waking up, they moved me from my bed and into a chair, which was terrifying, but they encourage you to move around and to progress at a fast pace so everything can start working again properly.

Three days after my transplant, I was moved out of intensive care and into the main ward. The next day I was walking around the ward unaided, carrying around my drip as I went. I was on a cycle bike by day 6, and on day 13 I went home. Breathing properly again felt physically very different, it was such a relief.

The main risk of an organ transplant is your body rejecting it. You take anti-rejection medicines which help, but the reality is that at some point your body will go into rejection. Some people have organ rejection within a few weeks of transplant, others have it within a year. Some people have lived post-transplant for 30 or 40 years. I hope I’m still kicking around at 70 or 80, but that depends on science having developed the anti-rejection medicines by then to make them more effective.

After my surgery I felt relieved and excited to get back to my normal life, but I also started struggling with my mental health. Before my transplant I’d always kept my CF very separate, not wanting to identify myself as someone who was unwell, but I had been so ill over the previous few months that it had become all-consuming. It was hard not to let it define me. I started suffering from health anxiety, irrationally panicking that things didn’t feel ‘right’ and convincing myself there was something wrong. But I didn’t want to spend my whole life back at the hospital being checked out, I wanted to get on with things, so I’ve had to learn when it’s right to worry, and when I just need to take a step back and rationalise.

A few months after my transplant, however, I began having problems eating and getting stomach pains. They initially thought I had a stomach ulcer, but after some more tests they actually found out I had cancer. I had developed post-transplant lymphoma in my stomach – there’s a small risk of developing it post-transplant, and an even smaller risk of developing it following a lung transplant specifically – and it had progressed to stage4. When the doctors told me, my mind instantly went to the worst place. I thought that was it; I was only a few months post-transplant, my body was in a weakened state and, having gone through so much already, I thought I would die.

Luckily, the cancer was treatable with a medication called Rituximab which meant I didn’t need to have chemotherapy. I went through four months of treatment which gave me minimal side effects, and I got the all clear shortly after Christmas. I’m just lucky I guess.

While things seem to have stabilised with my health, there are some major changes I’ve had to adapt to as a result of my lung transplant. I have to follow a special diet because I’m immunosuppressed, meaning I can no longer eat rare meat, blue cheese, runny eggs, unwashed fruit and veg, and lots more. As a real foodie – I worked for years in food and drink PR before moving to work for the government – I found it so hard. Food was such a big part of my life that I didn’t want to have to lose that because of these constraints.

But everywhere I looked, I couldn’t seem to find any inspiration or advice on what to cook. I was shocked; it’s not just people who’ve had transplants who have to follow an immunosuppressed diet. People who have Crohn’s disease, rheumatoid arthritis, are undergoing chemotherapy and other things are all advised to follow it too, but there was nothing much out there on it. So I decided to put together a cookbook myself. Using old work contacts, I managed to round up over 90 well-known chefs and restaurants to donate specific, immunosuppressed-diet-friendly recipes following guidance from the dietitian team at my hospital, and I found myself an agent to get it published. But the reality was that for all the big publishers, it wasn’t as commercially viable as most of the other cookbooks they release by famous chefs, and it just wasn’t worth that risk for them.

So instead, we found a smaller publishing house who agreed to publish our cookbook pro bono, giving all the money that they would have charged us to charity - but only if we could fundraise enough to do the printing, design and distribution. Earlier this year, we launched a Kickstarter campaign, where we need to raise £58,00. But after months of campaigning we sadly didn't raise the amount we needed. Now I am exploring other options to create this book which could help thousands of people across the UK and beyond. I want the book to come out as a lasting legacy, and as a major positive out of what has been a very tough year. I want it to be something that could be really useful for people in years to come.

I also think I so desperately want the cookbook project to succeed somehow because I feel a bit of a weight to make the most of my second chance. If I was the one to receive

the lungs, then I should make the most out of them. The waiting list for organs is huge and without more people donating, there will be people who die on the list. I was lucky enough not to be one of those people, and there’s a responsibility that comes with that.

I would love more people to sign up to donate their organs. Some people are strongly against it and I completely understand; I can see that there are reasons why people justify their organs remaining within them after they’ve died, and it’s their personal choice. But the issue is that for the people who would be open to donating their organs, they often don’t get round to putting themselves on the register.

Being a donor, you could save up to nine lives after you’ve died with organs that are otherwise useless. They’re going to be burnt or buried. To me, it means the person goes on living in some way. Wouldn’t it be nice to think that someone else could live because you had died? That nine other people could possibly live because you had died. There’s something magical about that."

An NHS Blood and Transplant spokesman told Cosmopolitan UK: "We’re so grateful for Pippa’s support. More and more families are saving lives through supporting organ donation. We need to stress that the deadly shortage of organ donors remains. Around three people who could benefit from a donated organ still die a day. Please, tell your family you want to donate, and join the NHS Organ Donor Register."

Dec 26th 2018

Statins work best with Mediterranean diet, study finds

Statins work better when they are combined with a Mediterranean diet, a new study finds.

Italian researchers found that, for people who have had a heart attack or stroke, consuming lots of fruit, vegetables, legumes and other traditional Mediterranean ingredients made statins more effective at preventing death from cardiovascular diseases.

Furthermore, they suggested their research should prompt scientists to look at how diet can be used to enhance drugs more generally, to find further examples where they can complement each other.

"We found that statins and Mediterranean Diet together were more effective, as compared to one or the other considered separately, in reducing the risk of cardiovascular mortality. It seems likely that a Mediterranean diet facilitated the beneficial effect of statins," said Marialaura Bonaccio, at the Meditteranean Neurological Insitute in Pozzilli, Italy.

Reduces inflammation

Professor Giovanni de Gaetano, also of the institute, added: "The favourable combination of statins and Mediterranean diet appeared to act by reducing inflammation, a condition that predisposes to a higher risk of illness and mortality, rather than on cholesterol levels."

The Mediterranean diet is also rich in cereals, olive oil, wine, fish, while being low in meat and diary.

The study is published in the International Journal of Cardiology and involved 1,000 patients.

Drug and diet interactions

"Our data suggest that we should focus more on the possible interactions between food and drugs, an aspect largely neglected in research," said another colleague, Giovanni de Gaetano

This research builds on a previous study, also involving Prof Gaetano, which found that heart disease is better treated with a Mediterranean diet than cholesterol-lowering drugs.

The previous study

In that study, the researchers concluded that a diet rich in vegetables, nuts, fish and oils can cut the chances of early death in heart patients by 37 per cent.

It followed 1,200 people who had a history of heart disease and found those who most closely followed a typically Mediterranean diet were less likely to die.

Previously, cholesterol-lowering drugs such as statins were believed to be the most effective method of combating heart disease, the leading cause of death in the UK.

Dec 20th 2018

Don't want your child to have asthma or hayfever? Get a pet! Having a dog or cat in your home 'could reduce a child's risk of having allergies

To protect children from asthma and hayfever, parents may need to fill their house with pets.

Every extra dog or cat in the house reduces a child's chance of getting an allergic disease by a fifth, a study has found.

The danger is lowest for children who grow up with five or more pets, probably because of the bugs the animals carry.

Scientists say a large number of pets may have a 'mini-farm' effect, as children who grow up close to cattle on farms also tend to have a lower risk of allergic conditions. 

The microbes found on animals are believed to trigger an infant's immune system.

Researchers studied more than 1,200 children aged seven to nine, recording how many pets they had in their first year of life and if they had asthma, eczema or hayfever. 

The results show children with no pets had a 49 per cent higher risk of these conditions, suggesting animals in the house could protect them.

The study, led by Dr Bill Hesselmar from the University of Gothenburg, states: 'The prevalence of allergic disease in children aged seven to nine years is reduced in a dose-dependent fashion with the number of household pets living with the child during their first year of life, suggesting a 'mini-farm' effect, whereby cats and dogs protect against allergy development.' 

Cats and dogs carry microbes which may cause the immune system to function properly, so that it does not overreact to triggers like pollen.

Researchers looked at children's medical records or questioned parents on whether they had ever suffered from hayfever, asthma or eczema. 

They also noted how many cats and dogs youngsters had lived with in their first year of life.

The results, published in the journal PLOS One, show each additional pet cut a child's risk of an allergic condition by 20 per cent. 

This was the case for children clinically tested for the diseases and those whose parents reported they had them.

The risk of ever having had an allergy was 49 per cent higher in families with no pets, but plummeted for those with five or more.

The findings back up the 'hygiene hypothesis' that the immune system must be exposed to bugs so it is 'trained' to ignore harmless things like pollen and peanuts and people do not develop allergies.

Dr Hesselmar said: 'Our hypothesis is that the protection is due to exposure to microbes and microbial products, i.e. the hygiene hypothesis, and that more animals will lead to increased exposure.' 

The study concludes: 'Most often research focus on identifying risk factors for allergy development. But in modern society, finding lifestyle factors that could protect from allergy has become equally important.'

Cats have been linked to everything from allergies, bites and even deadly diseases.

Bites from our feline friends make up around 15 per cent of animal bites treated in hospitals and are not usually deep, however, they can cause serious infections.

The bacteria Pasteurella multocida is in the mouths of around 90 per cent of healthy cats. In most cases, infection causes just redness, swelling, pain and difficulty moving the affected area.

Yet, in severe incidences, people can suffer nerve damage and a build up of pus within tissues, known as an abscess.

Cats are also carriers of the bacteria Bartonella henselae, which can cause scratch fever. Symptoms include headache, reduced appetite and exhaustion.

Dr Howard Gittelman, director of Animal Medical of New City, told Healthline: 'Cats contract Bartonella henselae predominantly from the bites of fleas. It causes streaking of the arms and swollen lymph nodes.

'If someone who is immunosuppressed or on chemotherapy gets bitten by a cat that is a carrier of Bartonella, they should be concerned and seek treatment.'

Cats are also the natural hosts for the parasite Toxoplasma gondii, which causes toxoplasmosis. Felines carry millions of the parasite's eggs in their faeces. 

Although toxoplasmosis is usually harmless, if a pregnant woman catches the infection for the first time, she may suffer a miscarriage or stillbirth.

Toxoplasmosis has also been associated with damage to unborn babies' organs, particularly their eyes.

 

Dec 18th 2018

Yes, There Is Such a Thing as Getting Too Much Sleep

Regularly getting a good night's rest is incredibly important. While you’re sleeping, your body is sorting memories, cleaning out your brain, boosting your immune system, and otherwise recovering from the day. But there is such a thing as too much of a good thing: According to Popular Science, it's possible to sleep too much.

It's hard to say exactly how much sleep you should be getting each night, but a new observational study of more than 116,000 people across 21 countries finds that sleeping nine or more hours a night is correlated with a higher mortality risk. The sweet spot for healthy sleep habits, according to this data, seems to be six to eight hours each night. (Even if part of that time comes from daytime naps.)

The new paper published in the European Heart Journal examined data from the Prospective Urban Rural Epidemiology study, followed individuals between the ages of 35 and 70 across the world, some of whom lived in high-income countries like Canada and Sweden; others of whom lived in countries considered middle-income, like Argentina and Turkey; and others who lived in countries considered to be low-income like Bangladesh and Pakistan.

More From Live Smarter

Over the course of an average 7.8 years, study participants answered follow-up questions about what time they went to bed and got up, and whether they napped and for how long. They also answered general healthquestions about things like exercise rates, dietary patterns, and weight. The researchers then collected medical records and death certificates to track whether the subjects had major cardiac events (like heart attacks) or died during the study period.

The researchers found both sleeping too much and sleeping too little to be associated with a higher likelihood of dying before the study was through. Across the world, participants who got less than six hours a day or more than eight hours a day were more likely to experience major cardiac events than participants who slept between six and eight hours a night. When the researchers adjusted the results for age and sex, they still found sleep duration to be a significant predictor of heart issues and all-cause mortality.

While adjusting for factors like physical activity, BMI, and diet did change the results a bit, the basic pattern—a J-shaped curve showing higher risk for short sleepers, low risk for moderate sleepers, and even higher risk for very long sleepers—was the same. While previous research has suggested that naps can be good for your health, this study found that napping was associated with worse outcomes if it put someone over the eight-hours-of-sleep mark in that 24-hour period.

The results may feel like vindication to people who feel terrible whenever they stay in bed too long, but there are some caveats. Sleeping nine hours a day might be a sign that someone has an underlying health condition that in itself poses a higher mortality risk, rather than the cause of the higher mortality risk in itself. The researchers tried to account for this by analyzing the data only for people who were known to have no prevalent diseases and who weren't at risk for conditions like sleep apnea and insomnia, and later by excluding people who had a cardiac event or died during the first two years of the study.

"This suggests that sleep duration per se may be associated with increased risks," they write (emphasis in the original), "but causality cannot be definitively proven from this or other observational studies (and randomized studies of different sleep durations may be difficult to conduct)." So we may never know for sure just how much risk we take upon ourselves when we settle in for a long nap.

Considering that plenty of other research suggests that around seven hours of sleep total is an ideal target, you should probably aim for that number while setting your alarm. And if getting too much shut-eye isn't your problem, check out our tips for getting back to sleep after you've woken up in the middle of the night.

 

Dec 17th 2018

Chronic Fatigue Syndrome may be triggered by hyperactive immune system, study suggests 

Chronic Fatigue Syndrome may be triggered by an out-of-control immune system which overreacts to an illness or emotional stress, a new study suggests.

CFS, also known as myalgic encephalomyelitis (ME), is a long-term illness, characterised by extreme tiredness, but the biology of the disease has remained a mystery.

Now researchers at Kings’ College London have discovered that some patients who were given drugs to ramp up their immune system to fight hepatitis C show similar symptoms to people suffering CFS.

Out of 55 patients studied, 18 developed lasting fatigue, suggesting that their boosted immune system had triggered long term changes in the body.

And crucially, even before treatment, those who went on to develop lasting fatigue already had higher levels of biomarkers associated with inflammation, suggesting their immune system had already been primed to over-respond.

Lead researcher Dr Alice Russell from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s said: “‘For the first time, we have shown that people who are prone to develop a CFS-like illness have an overactive immune system, both before and during a challenge to the immune system.

“Our findings suggest that people who have an exaggerated immune response to a trigger may be more at risk of developing CFS.”

In Britain 250,000 people are affected by CFS, with one in four so severely affected they are rendered housebound or bendbour, with some even needing to be fed via a tube.

Sufferers are often confined to their beds, unable to walk, and need help even to shower - an action that could them lay them low for days, even weeks.

Senior researcher Professor Carmine Pariante added: “A better understanding of the biology underlying the development of CFS is needed to help patients suffering with this debilitating condition.

“Although screening tests are a long way off, our results are the first step in identifying those at risk and catching the illness in its crucial early stages.”

The research was welcomed by charities who called for more research into the link between the immune system and the condition.

Dr Charles Shepherd, the ME Association’s medical advisor, said: “Piecing together the scientific jigsaw, it now seems increasingly likely that we are dealing with a sequence of events in ME/CFS that involve both infection and the immune system response.”

A straightforward viral infection is leading to a immune system reaction that then fails to settle down.

“And the on-going production of inflammation then causes immune system chemicals that affect various parts of the body - muscle and brain function in particular.”

“These findings also reinforce the need to investigate treatments - as are being used very successfully in inflammatory conditions like rheumatoid arthritis - which can dampen down low-level immune system activation.”

The research is published in the journal Psychnoneuroendocrinology.

 

Dec 15th 2018

There's a new reason for the low uptake of vaccinations

Vaccination rates in the UK and Europe continue to fall. In Britain, take-up of the MMR vaccine has fallen for four years in a row. It could even dip below 90% for the first time since the scare in the early 2000s which linked MMR to autism , false though it was, and still is.

However, fraudulent links between the vaccination and autism led to droves of parents preventing their children from being given the vaccine.

The World Health Organization reported 41,000 cases of measles in Europe in the first half of 2018. There was also a further fall in vaccination rates, although that’s probably due to a more complicated set of factors as there’s been a fall in nine other major vaccines too.

According to Lynne Elliot, chief executive of the Vegetarian Society , the use of pork gelatine in vaccines and medicines could be putting people off getting the protection they need.

She said there’s a demand for vegan and vegetarian alternatives to common medicines, so that people didn’t feel conflicted about using them. “It is disappointing that so many medicines and vaccines are still using animal ingredients in their formulation,” said Lynne.

Gelatine is used in many medicines and as a stabiliser in vaccines, ensuring that they remain pure while being transported and stored. However, changing the stabilisers – or any ingredient in a medicinal product – entails going back to square one and that could take years.

In Britain, the most commonly affected vaccines are the nasal flu vaccine, a shingles vaccine and the measles, mumps and rubella (MMR) vaccine. But the latter does have a non-gelatine alternative.

Jewish groups have said that the use of such products doesn’t violate their religious laws, but Public Health England accepted that some Muslim communities wouldn’t consider them halal.

The Muslim Council of Britain said the vaccines would be allowed only if people’s lives were in jeopardy.

Ms Elliot is quick to emphasise that, while the Vegetarian Society was calling for a move away from gelatine, it wasn’t recommending that people shun vaccination.

“Many people will be conflicted about the idea of having to take non-vegetarian medicines, and some will find it upsetting,” she said.

“However, people should not put themselves at risk. They should take the medicines and vaccines they need, even if there are no vegetarian alternatives.

“But vegetarian and vegan versions of all medicines are needed.”

 

Dec 14th 2018

Why Does Scratching Make Itching Worse

It feels like a biological blooper: A persistent itch is made worse by scratching, the one thing that provides instantaneous relief. Evolutionary biologists have proposed that the relationship between scratching and itching developed when disease-carrying parasites and insects bit humans, causing itching skin; scratching brushed the bugs away. Anyone sufferingfrom a mosquito bite can understand that connection.

There’s no simple answer for why skin that has just been scratched becomes even itchier, but researchers have identified some mechanisms behind the irritating phenomenon.

WHY SCRATCHING AN ITCH DOESN'T HELP

Our sensory neurons are constantly bombarded with stimuli, so some sensations take precedence over others. Sensory signals of one type can be overridden by signals of other types if the latter are strong enough. The overridden signals don’t even reach the brain—they’re stopped by specific neurons in the spinal cord. In this way, the pain caused by scratching is often sufficient to drown out the itch—but only temporarily.

Cells in the brain stem produce the neurotransmitter serotonin, which quells pain. But according to Zhou-Feng Chen, Ph.D., director of the Center for the Study of Itch at Washington University School of Medicine in St. Louis, Missouri, serotonin has an additional function. His group has found that as the serotonin spreads through the spinal cord, it can activate neurons that transmit itch signals to the brain, compelling us to scratch even more.

Each time we scratch, we put this cycle in motion. The increasing amount of serotonin may even make us scratch harder, until the urge to scratch becomes detached from any itch trigger on the skin. “It’s to try to suppress the itchy sensation, which occurs in your brain,” Chen tells Mental Floss. By this mechanism, itches can even become chronic.

Serotonin signaling isn’t the only way scratching worsens an itch; harm to the skin caused by scratching is another contributor. “When the skin barrier is irritated or further damaged, it releases certain pro-inflammatory factors that can directly aggravate itch by stimulating the sensory nerve fibers,” Brian Kim, M.D., co-director of the Center for the Study of Itch, tells Mental Floss. Those factors can also activate your immune system, and some types of immune cells around the affected area may produce chemicals that induce itch.

The very idea of scratching can also be a trigger. Chen’s research group reported last year that mice appear susceptible to scratching when they see other mice do the same. “Itching is actually contagious between people, between animals, and in your body itself,” Chen says. “When you scratch one place, you quickly want to scratch another area.” Scratching doesn’t just make itch more intense—it sometimes also causes the sensation to spread.

RELIEF FOR ITCHING

In mild cases, it may be possible to resist scratching through sheer force of will—but that’s not usually a long-term solution.

“I always feel bad because a lot of people say to patients, ‘Don’t scratch, don’t scratch,’ but that’s very challenging,” Kim tells Mental Floss. He says he tries to determine the cause of a person’s itchiness first. If it’s caused by an underlying medical problem, such as infestation with lice or liver disease, managing that issue may resolve the itch. Even if the underlying problem can’t be cured, there are medications that can calm itch in certain circumstances, such as antihistamines for allergy-induced itch and topical corticosteroids for itch caused by certain skin conditions, including eczema.

For now, drugs like these may be our best weapons against itching. “I think itch is often viewed as quirky, not serious, or embarrassing,” Kim says, which explains why there’s little research on itch despite its impact on our lives. Unfortunately, that coveted scratch in a bottle remains out of reach.

 

Dec 11th 2018

Why drinking coffee might be fuelling your anxiety

You already know that too much caffeine can bring on the jitters. Sip a second espresso after dinner, and you’re bound to feel a bit on edge. But could that 3 p.m. soy latte actually be messing with your mental health? If you struggle with anxiety, the answer may be yes.

“Overall, caffeine is often bad news for people with anxiety,” says Susan Bowling, PsyD, a psychologist at the Women’s Health Center at the Wooster Branch of Cleveland Clinic. That’s because the powerful stimulant natur

“The natural effects of caffeine stimulate a host of sensations, such as your heart beating faster, your body heating up, your breathing rate increasing—all things that mimic anxiety,” Bowling tells Health. “Psychologically, it’s difficult for your mind to recognize that this is not anxiety because it feels the same.” Restlessness, nervousness, headaches, sweating, insomnia, and ringing in the ears are other common signs of caffeine-triggered anxiety.

According to Bowling, some studies show that consuming more than 200 mg of caffeine (about the amount in just two cups of coffee) can increase the likelihood of anxiety and panic attacks in people sensitive to it. It is so powerful that "caffeine-induced anxiety disorder" is a subclass in the DSM-5 diagnostic manual, she adds.

Yet caffeine, which is the most commonly consumed psychoactive substance in the world, doesn’t affect us all the same way. The reason? “In part, it is the way your body is wired,” says Bowling. “Some people can handle a little caffeine and others are very sensitive to it. It’s based primarily on your genetics." People who are sensitive to the effects of caffeine may simply metabolize it more quickly than others, for example.

If you’re prone to post-coffee anxious feelings, regular caffeine consumption can set you up in a vicious cycle. “[Perhaps] one has an anxiety attack, can't sleep at night due to the caffeine-induced anxiety, feels very low energy in the morning, then drinks coffee to wake up...and then starts the cycle over again,” says Bowling.

Could your morning joe be behind your anxiety? There are ways to tell. Bowling suggests doing a mini-observational study on yourself to find out.

“Keep a journal of the impact of caffeine for a week,” says Bowling. Aside from counting every cappuccino and latte you sip, track of other sneaky sources of caffeine you might consume, such as decaf coffee (yep, even decaf has a little caffeine), cola, chocolate, OTC pain medication, energy drinks, and infused mints or snacks. The next week, eliminate all caffeine while keeping the rest of your diet and activities the same. “For people who have anxiety, they often notice an improvement in their anxiety levels,” she says.

What if you don’t struggle with anxiety—should you still cut back on caffeinated coffee or tea for the sake of your mental health? Not necessary, says Lauren Slayton, RDN, nutritionist and founder of the private practice Foodtrainers in New York City. It’s a question of dosage," explains Slayton. "Coffee absolutely picks you up, and it improves cognition and athletic performance. [But] too much of most things backfires.”

While there’s no one size fits all approach to caffeine consumption, experts suggest sipping coffee in moderation to reap the beverage’s purported health benefits, which include a lower risk of cardiovascular disease and type 2 diabetes. ”We recommend one or two cups of coffee per day max, with no c****y sweeteners of creamers,” says Slayton.

Dec 10 2018

The Best Workouts When You Have Your Period

Oh joy, it's that time of the month again. If you can summon the energy to lace up your sneakers or grab your yoga mat from the closet when every ounce of your being wants to hibernate with Netflix a pint of Ben & Jerry's Brownie Batter ice cream, you've already won half the battle. As much of a struggle as it can be to exercise during your period, experts say the rewards of keeping up with your workout routine include better physical and mental health.

"Movement helps increase oxygen delivery and decrease prostaglandin release, which helps alleviate cramping," says U by Kotex partner Jessica Shepherd, M.D. "Exercise also triggers the release of endorphins, which can alter pain perception, helping women with menstrual pain and cramps."

But before you hit the gym, know that some workouts will probably feel better than others. Knowing which exercises are best during your period can actually help ease PMS and period symptoms like fatigue, headaches, anxiety, cramps, insomnia, and depression while boosting your body's ability to produce hormones that make you feel calm and happy. Try these five workouts and moves to feel like your best self during your most blah days.

1. Keep Blood Flowing With Cardio

Whether you're a fan of running, cycling, boxing, or the elliptical machine, cardiovascular exercises that raise your heart rate can improve blood flow to the uterus and increase energy levels when you're feeling fatigued, Shepherd says. But sometimes that's easier said than done. "Maintaining a high-intensity cardio routine throughout the month can be tricky for women, particularly during the days leading up to your period, when your energy levels really take a nosedive," says certified personal trainer Sia Cooper.

The riskiest thing about choosing a high-impact cardio workout like running during your period is that sometimes our digestive systems… well, you know. If you find yourself too pooped (heh) to run the distance, substitute sweaty treadmill sessions with mindful walks. "Now is also a great time to practice meditation and breathing," Cooper says. "Think about how powerful your body is, observe what's happening around you, and try to relax."

2. Get Down With These Pilates Stretches

When certified group fitness instructor and Blogilates founder Cassey Ho feels PMS and period symptoms taking hold, she hits the mat and turns to simple, effective Pilates stretches. "Anything that opens the hips and inverts the body to help with circulation is super helpful," Ho says. "Like wide straddle, butterfly, puppy pose, and child's pose."

Lucky for Blogilates fans, Ho's YouTube channel video "Stretches You Need After a Stressful Day" features a roundup of her top 10 favorite PMS and period Pilates stretches, which also include neck rolls, seated twists, and the always necessary hamstring stretch.

3. It Might Be Time to Try Something New

Been putting off that intro yoga class? Haven't touched your swim cap since college? Turns out your period might be the right time to get moving in a new way.

According to one study, the focus and mindfulness found in activities like swimming, dance, and yoga can subdue anxiety and release endorphins, which help ease period-related aches and pains. So go ahead and try your first ballet class during your lady-time—trying to remember all the fancy footwork will most likely take your mind off your uterus.

4. Melt Into These Yoga Poses For Pain Relief

No period workout list is complete without yoga. But while a vinyasa flow is great for increased circulation, if you're feeling crampy and sluggish, Cooper stresses the importance of choosing specific restorative moves over more intense poses—although if you really love a good headstand, you can relax about the whole inversions-cause-endometriosis-rumor because it's not a thing.

Cooper recommends reclined bound angle pose to lessen pressure on your pelvic area and relieve cramps, supported pigeon pose to loosen tight hip flexors, corpse pose for complete relaxation, and even a basic child's pose.

Want to make your practice even more comforting? "Try hugging a pillow or placing a yoga bolster between your legs so it can support your body weight," Cooper says. "These poses are often things we find ourselves doing naturally in bed when we wake up reeling from yucky period pains—it's just a more intentional way of giving yourself time for relief."

5. You Don't Need to Stop Strength Training

"Lifting sometimes isn't recommended during the first few days of your period because muscle inflammation can make water retention worse," says Elliott Upton, senior personal training specialist at Ultimate Performance. So if bloating (which most women report feeling on the first day of their period) is your worst nightmare, you might want to skip the weight rack.

But don't stop for long; this Swedish study saw #gains from women strength training in the first two weeks (which includes the crappiest part) of their menstrual cycles. All in all, the physical and mental benefits of strength training are huge, so there are few reasons you should press pause on your routine. The caveat here is to pay close attention to your energy levels—if you're feeling foggy, it's probably not the best time to go for that overhead squat PR.

Bottom Line: Listen to Your Body—EspeciallyDuring Your Period

Even if you feel motivated to continue working out during your period, your body may have a different plan. Self-care involves listening to your body and respecting its wishes to slow down and take breaks when needed—especially during menstruation.

"If you feel pain, slow down and stop," says Diana Ramos, OBGYN, co-chair of The National Preconception Health and Health Care Initiative. "Brisk walking a few minutes a day counts. If there is an exercise you enjoy, try to continue that exercise during your period with realistic expectations. Listen to your body as you go. If you start to feel fatigued, take a step back."

Remember that your fitness goals don't have to be met in a day, so above all, be kind to yourself. Work out to make your body feel its best during your period and save the heavy lifting for the rest of the month.

Dec 9th 2018

What is 'phantom rectum' and why do some people experience the condition

You might not be aware, but thousands of people across the country are currently living with an ileostomy bag as a result of a condition such as bowel cancer or Crohn's disease.

According to the NHS, an ileostomy is a procedure in which the small intestine is diverted through an opening in the tummy.

This opening is called a stoma and a bag is placed over it to collect waste products that would normally pass through the colon and out of the body.

Being told you need to undergo an ileostomy procedure is incredibly daunting as the results are life-changing and bring with them various side effects.

Sam explained that at first it's "all consuming", but it gets easier.

She said: "You have to learn this whole process of how you look after it, how you change it, how you empty it. Now it is totally just part of my daily routine."

Similarly, Hannah revealed that she'd become accustomed to life with an ileostomy bag and often forgets that she even has one.

"I often forget I have one until I go to the toilet," she admitted. "The only time I feel it, is if there is any kind of gas. Then the bag gets a little bit crunch, or if my output is kind of liquidy, then it gets a bit sloshy."

But while they may have adjusted to their new way of living, all three say they have experienced some side effects - including a phenomenon known as phantom rectum syndrome.

So what is phantom rectum?

Phantom rectum is a complication that affects people with ileostomies.

The NHS say the condition is similar to that of phantom limb, where people who have had a limb amputated feel like it's still there.

In this case, those experiencing phantom rectum will feel as if they need to go to the toilet, even though they no longer have a working rectum.

"It's like your brain doesn't know that it's not attached anymore," explains Sam.

Hannah also claims she used to get it all the time following her surgery.

"At the beginning I got it all the time," she said. "I was talking to my nurse about these urges that I need to poo. She said: 'Next time just go sit on the toilet and feel it out.'"

 

Dec 2nd 2018


China’s Infervision is helping 280 hospitals worldwide detect cancers from images

Until recently, humans have relied on the trained eyes of doctors to diagnose diseases from medical images.

Beijing-based Infervision  is among a handful of artificial intelligence startups around the world racing to improve medical imaging analysis through deep learning, the same technology that powers face recognition and autonomous driving.

The startup, which has to date raised $70 million from leading investors like Sequoia Capital China, began by picking out cancerous lung cells, a prevalent cause of death in China. At the Radiological Society of North America’s annual conference in Chicago this week, the three-year-old company announced extending its computer vision prowess to other chest-related conditions like cardiac calcification.

“By adding more scenarios under which our AI works, we are able to offer more help to doctors,” Chen Kuan, founder and chief executive officer of Infervision, told TechCrunch. While a doctor can spot dozens of diseases from one single image scan, AI needs to be taught how to identify multiple target objects in one go.

But Chen says machines already outstrip humans in other aspects. For one, they are much faster readers. It normally takes doctors 15 to 20 minutes to scrutinize one image, whereas Infervision’s AI can process the visuals and put together a report under 30 seconds.

AI also addresses the longstanding issue of misdiagnosis. Chinese clinical newspaper Medical Weekly reported that doctors with less than five years’ experience only got their answers right 44 percent of the time when diagnosing black lung, a disease common among coal miners. And research from Zhejiang University that examined autopsies between 1950 to 2009 found that the total clinical misdiagnosis rate averaged 46 percent.

“Doctors work long hours and are constantly under tremendous stress, which can lead to errors,” suggested Chen.

The founder claimed that his company is able to improve the accuracy rate by 20 percent. AI can also fill in for doctors in remote hinterlands where healthcare provision falls short, which is often the case in China.

Winning the first client

Like any deep learning company, Infervision needs to keep training its algorithms with data from varied sources. As of this week, the startup is working with 280 hospitals — among which 20 are outside of China — and steadily adding a dozen new partners weekly. It also claims that 70 percent of China’s top-tier hospitals use its lung-specific AI tool.

But the firm has had a rough start.

Chen, a native of Shenzhen in south China, founded Infervision after dropping out of his doctoral program at the University of Chicago where he studied under Nobel-winning economist James Heckman. For the first six months of his entrepreneurial journey, Chen knocked on the doors of 40 hospitals across China — to no avail.

“Medical AI was still a novelty then. Hospitals are by nature conservative because they have to protect patients, which make them reluctant to partner with outsiders,” Chen recalled.

Eventually, Sichuan Provincial People’s Hospital gave Infervision a shot. Chen with his two founding members got hold of a small batch of image data, moved into a tiny apartment next to the hospital, and got the company underway.

“We observed how doctors work, explained to them how AI works, listened to their complaints, and iterated our product,” said Chen. Infervision’s product proved adept, and its name soon gathered steam among more healthcare professionals.

“Hospitals are risk-averse, but as soon as one of them likes us, it goes out to spread the word and other hospitals will soon find us. The medical industry is very tight-knit,” the founder said.

It also helps that AI has evolved from a fringe invention to a norm in healthcare over the past few years, and hospitals start actively seeking help from tech startups.

Infervision has stumbled in its foreign markets as well. In the U.S., for example, Infervision is restricted to visiting doctors only upon appointments, which slows product iteration.

Chen also admitted that many western hospitals did not trust that a Chinese startup could provide state-of-the-art technology. But they welcomed Infervision in as soon as they found out what it’s able to achieve, which is in part thanks to its data treasure — up to 26,000 images a day.

“Regardless of their technological capability, Chinese startups are blessed with access to mountains of data that no startups elsewhere in the world could match. That’s an immediate advantage,” said Chen.

There’s no lack of rivalry in China’s massive medical industry. Yitu, a pivotal player that also applies its AI to surveillance and fintech, unveiled a cancer detection tool at the Chicago radiological conference this week.

Infervision, which generates revenues by charging fees for its AI solution as a service, says that down the road, it will prioritize product development for conditions that incur higher social costs, such as cerebrovascular and cardiovascular diseases.

 

Nov 28th 2018

Revealed: Faulty medical implants harm patients around world

Patients around the world are suffering pain and many have died as a result of faulty medical devices that have been allowed on to the market by a system dogged by poor regulation, lax rules on testing and a lack of transparency, an investigation has found.

In the UK alone, regulators received 62,000 “adverse incident” reports linked to medical devices between 2015 and 2018. A third of the incidents had serious repercussions for the patient, and 1,004 resulted in death.

In the US, the Food and Drug Administration (FDA) has collected 5.4m “adverse event” reports over the past decade, some from manufacturers reporting problems in other parts of the world.

These included 1.7m reports of injuries and almost 83,000 deaths. Nearly 500,000 mentioned an explant – surgery to remove a device.

The figures come from research by 252 journalists from 59 media organisations in 36 countries, which has uncovered a litany of problems in the global $400bn (£310bn) industry.

Examples of failure in the market include:

Replacement hips and vaginal mesh products sold to hospitals without any clinical trials.

Patients relying on faulty pacemakers when manufacturers were aware of problems.

Pacemakers, artificial hips, contraceptives and breast implants are among the devices that have caused injuries and resulted in patients having to undergo follow-up operations or in some cases losing their lives.

In some cases, the implants had not been tested in patients before being allowed on to the market.

In the UK alone, regulators received 62,000 “adverse incident” reports linked to medical devices between 2015 and 2018. A third of the incidents had serious repercussions for the patient, and 1,004 resulted in death.

In the US, the Food and Drug Administration (FDA) has collected 5.4m “adverse event” reports over the past decade, some from manufacturers reporting problems in other parts of the world.

These included 1.7m reports of injuries and almost 83,000 deaths. Nearly 500,000 mentioned an explant – surgery to remove a device.

The figures come from research by 252 journalists from 59 media organisations in 36 countries, which has uncovered a litany of problems in the global $400bn (£310bn) industry.

Examples of failure in the market include:

·       Replacement hips and vaginal mesh products sold to hospitals without any clinical trials.

·       Patients relying on faulty pacemakers when manufacturers were aware of problems.

·       Complications with hernia mesh that ruled one of Britain’s top athletes out of competing for years.

·       Regulators approving spinal disc replacements that later disintegrated and migrated in patients.

·       Surgeons admitting they were unable to tell patients about the risks posed by implants because of a lack of central registers.

·       Patients in Australia being given devices that the regulator has approved on the basis they have been approved in Europe.

The findings raise concerns about the level of scrutiny devices undergo before and after they go on the market, and whether regulators detect and act upon findings quickly enough.

Information about problems with devices is, in many countries, kept under wraps, making it difficult for patients to research procedures that have been recommended to them.

Prof Derek Alderson, the president of the Royal College of Surgeons, said there had been enough incidents involving flawed devices to “underline the need for drastic regulatory changes”, including the introduction of mandatory national registries for all implantable devices.

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“In contrast to drugs, many surgical innovations are introduced without clinical trial data or centrally held evidence,” he said. “This is a risk to patient safety and public confidence.”

The Guardian and organisations including the BBC, Le Monde and Süddeutsche Zeitung, coordinated by the International Consortium of Investigative Journalists (ICIJ), have trawled through thousands of documents, many obtained through freedom of information (FoI) requests, to unearth some of the biggest problems.

Alongside interviews with patients and doctors, these have revealed flaws in the way the industry is regulated that are unlikely to be fixed by rules due to come into force in Europe.

Among the concerns raised by the Implant Files project are that manufacturers are in charge of testing their own products after faults have developed – and are allowed to shop around for approval to market their products, without declaring any refusals.

The Guardian has also heard about doctors who have close industry ties or seem eager to be early adopters of the latest devices to enhance their professional standing.

Plans for tougher EU rules have been watered down after industry lobbying, according to a huge trove of documents uncovered by the project.

But data from FoI requests shows there has been a collapse in the proportion of investigations overseen by the MHRA at a time when complaints are soaring.

So far in 2018, one in 100 reports received have prompted it to start a special investigation, compared with one in three in 2008.

Instead, the majority of reports have been passed on to manufacturers and fed into the regulator’s “trending and surveillance” database.

Graeme Tunbridge, the group manager for devices regulatory affairs at the MHRA, said the fall in the number of investigations reflected a change in the way it worked.

“We have been moving towards a more sophisticated and trend-led approach.

“Most problems are systems-level issues, not unique to a single instance, for example where a whole batch is manufactured with a defect. Grouping incidents allows us to see the bigger picture and find the true causes of issues and solve them.”

The MHRA said reports received via its “yellow card” online reporting system did not necessarily mean there was a fault with a device, and that an adverse incident may be the result of a pre-existing medical condition, or the device may not have been used as intended.

Rules making it tougher for devices to get approval are due to be introduced in Europe in 2020.

Tunbridge said the MHRA had been instrumental in agreeing the new legislation, and that it would strengthen the regulatory framework. “Our highest priority is making sure the medical devices available in the UK work and are acceptably safe,” he said.

But critics remain sceptical.

Most devices are cleared through a pathway that allows new products to inherit the approval status of “substantially equivalent” ones that are already on the market, without the need for further trials.

In some cases, after lengthy chains of equivalence-based approvals, new devices scarcely resemble the original version, which may have been withdrawn from use.

British Medical Journal study last year traced the family tree of 61 surgical mesh products to two original devices approved in 1985 and 1996.

Carl Heneghan, a professor of evidence-based medicine at the University of Oxford, said systemic failings in the way medical implants were regulated meant “patients are in one big experiment and they often don’t know it”.

He said the rules due to be introduced in Europe would not fix the structural problems. “You can’t see the evidence that a device is built on – that’s still the same,” he said. “It’s still commercial organisations that control the flow of data.”

Other FoI requests made to the MHRA underline how difficult it is to get information on what is going wrong with devices.

The Guardian requested details of incidents relating to the contraceptive Essure, but was turned down on the basis of commercial confidentiality. Such a response is not unusual, according to a recent paper by scientists.

Nov 26th 2018

20-minute flu test cuts NHS winter chaos and sends patients home early


pioneering test which can determine if a patient has fluwithin 20 minutes can cut bed blocking related to the disease by more than 80 per cent, new trials have found.

Pilot programmes in two NHS hospitals found the technology significantly eased winter chaos by enabling those wrongly suspected of having flu to go home earlier.

Currently, patients usually have to wait several days to find out if they have flu rather than a different condition because samples have to be sent to external laboratories for analysis.

In the meantime they are likely to be placed in isolation, taking up precious space during the busiest time of the year for the health service.

The new test, however, allows medical staff to take a single nasal swab which can be analysed in a machine located in the hospital.

Norfolk and Norwich University Hospitals NHS Foundation Trust began using the cobas Liat system in January this year.

Staff there found that out of 277 tests carried out after four months, 128 (46 per cent) came back positive, leading to more efficient use of side rooms and quicker diagnosis.

The number of blocked beds dropped from an average of 11 pre-test to two post-test, and the mean number of patients with flu in a bay dropped from 12.3 to 2.7 during the period.

Roche Diagnostics, which manufactured the system, said it could save £24 million a year if introduced across the NHS.

The test is also in use at Kingston Hospital NHS Foundation Trust in London, which serves a large elderly population, who are particularly vulnerable to flu.

There, the faster diagnosis meant 33 per cent of patients who tested negative and were otherwise well were discharged on the same day, avoiding unnecessary admissions.

Berenice Constable, head of nursing at the trust, said: "This has had a big impact on improving timely treatment for patients, supporting appropriate isolation procedures and ultimately improving patient experience.

"Operationally it has helped to ensure that beds are not closed unnecessarily and has supported clinical decision making."

Flu affects five to 10 per cent of adults and 20 to 30 per cent of children each year, peaking between January and March.

Last year’s season was the worst for seven years, seeing 15,000 deaths related to the disease.

The average annual number is around 8,000.

The high prevalence put additional pressure on already under strain A&E departments, making last winter one of the most chaotic for patients using the NHS for decades.

Geoff Twist, managing director of Roche Diagnostics, said: "I am delighted that the cobas Liat test has received such good feedback from Kingston and Norfolk, with it leading to clear and significant reductions in the number of unnecessary admissions, blocked beds and bay closures.

"I am particularly happy that this helps us quickly relieve the stress for people of not knowing whether themselves or a loved one has the flu, and swiftly enabling their medical care.”

At Kingston, 1,526 tests were carried out over a 19-week period.

Only 479 came back positive, with 65 per cent of suspected cases discharged or, if admitted, not requiring initial isolation once other risks had been ruled out.

 

Nov 25th2018

Revealed: Faulty medical implants harm patients around world

Patients around the world are suffering pain and many have died as a result of faulty medical devices that have been allowed on to the market by a system dogged by poor regulation, lax rules on testing and a lack of transparency, an investigation has found.

In the UK alone, regulators received 62,000 “adverse incident” reports linked to medical devices between 2015 and 2018. A third of the incidents had serious repercussions for the patient, and 1,004 resulted in death.

In the US, the Food and Drug Administration (FDA) has collected 5.4m “adverse event” reports over the past decade, some from manufacturers reporting problems in other parts of the world.

These included 1.7m reports of injuries and almost 83,000 deaths. Nearly 500,000 mentioned an explant – surgery to remove a device.

The figures come from research by 252 journalists from 59 media organisations in 36 countries, which has uncovered a litany of problems in the global $400bn (£310bn) industry.

Examples of failure in the market include:

Replacement hips and vaginal mesh products sold to hospitals without any clinical trials.

Patients relying on faulty pacemakers when manufacturers were aware of problems.

Pacemakers, artificial hips, contraceptives and breast implants are among the devices that have caused injuries and resulted in patients having to undergo follow-up operations or in some cases losing their lives.

In some cases, the implants had not been tested in patients before being allowed on to the market.

In the UK alone, regulators received 62,000 “adverse incident” reports linked to medical devices between 2015 and 2018. A third of the incidents had serious repercussions for the patient, and 1,004 resulted in death.

In the US, the Food and Drug Administration (FDA) has collected 5.4m “adverse event” reports over the past decade, some from manufacturers reporting problems in other parts of the world.

These included 1.7m reports of injuries and almost 83,000 deaths. Nearly 500,000 mentioned an explant – surgery to remove a device.

The figures come from research by 252 journalists from 59 media organisations in 36 countries, which has uncovered a litany of problems in the global $400bn (£310bn) industry.

Examples of failure in the market include:

·       Replacement hips and vaginal mesh products sold to hospitals without any clinical trials.

·       Patients relying on faulty pacemakers when manufacturers were aware of problems.

·       Complications with hernia mesh that ruled one of Britain’s top athletes out of competing for years.

·       Regulators approving spinal disc replacements that later disintegrated and migrated in patients.

·       Surgeons admitting they were unable to tell patients about the risks posed by implants because of a lack of central registers.

·       Patients in Australia being given devices that the regulator has approved on the basis they have been approved in Europe.

The findings raise concerns about the level of scrutiny devices undergo before and after they go on the market, and whether regulators detect and act upon findings quickly enough.

Information about problems with devices is, in many countries, kept under wraps, making it difficult for patients to research procedures that have been recommended to them.

Prof Derek Alderson, the president of the Royal College of Surgeons, said there had been enough incidents involving flawed devices to “underline the need for drastic regulatory changes”, including the introduction of mandatory national registries for all implantable devices

“In contrast to drugs, many surgical innovations are introduced without clinical trial data or centrally held evidence,” he said. “This is a risk to patient safety and public confidence.”

The Guardian and organisations including the BBC, Le Monde and Süddeutsche Zeitung, coordinated by the International Consortium of Investigative Journalists (ICIJ), have trawled through thousands of documents, many obtained through freedom of information (FoI) requests, to unearth some of the biggest problems.

Alongside interviews with patients and doctors, these have revealed flaws in the way the industry is regulated that are unlikely to be fixed by rules due to come into force in Europe.

Among the concerns raised by the Implant Files project are that manufacturers are in charge of testing their own products after faults have developed – and are allowed to shop around for approval to market their products, without declaring any refusals.

The Guardian has also heard about doctors who have close industry ties or seem eager to be early adopters of the latest devices to enhance their professional standing.

Plans for tougher EU rules have been watered down after industry lobbying, according to a huge trove of documents uncovered by the project.

But data from FoI requests shows there has been a collapse in the proportion of investigations overseen by the MHRA at a time when complaints are soaring.

So far in 2018, one in 100 reports received have prompted it to start a special investigation, compared with one in three in 2008.

Instead, the majority of reports have been passed on to manufacturers and fed into the regulator’s “trending and surveillance” database.

Graeme Tunbridge, the group manager for devices regulatory affairs at the MHRA, said the fall in the number of investigations reflected a change in the way it worked.

“We have been moving towards a more sophisticated and trend-led approach.

“Most problems are systems-level issues, not unique to a single instance, for example where a whole batch is manufactured with a defect. Grouping incidents allows us to see the bigger picture and find the true causes of issues and solve them.”

The MHRA said reports received via its “yellow card” online reporting system did not necessarily mean there was a fault with a device, and that an adverse incident may be the result of a pre-existing medical condition, or the device may not have been used as intended.

Rules making it tougher for devices to get approval are due to be introduced in Europe in 2020.

Tunbridge said the MHRA had been instrumental in agreeing the new legislation, and that it would strengthen the regulatory framework. “Our highest priority is making sure the medical devices available in the UK work and are acceptably safe,” he said.

But critics remain sceptical.

Most devices are cleared through a pathway that allows new products to inherit the approval status of “substantially equivalent” ones that are already on the market, without the need for further trials.

In some cases, after lengthy chains of equivalence-based approvals, new devices scarcely resemble the original version, which may have been withdrawn from use.

British Medical Journal study last year traced the family tree of 61 surgical mesh products to two original devices approved in 1985 and 1996.

Carl Heneghan, a professor of evidence-based medicine at the University of Oxford, said systemic failings in the way medical implants were regulated meant “patients are in one big experiment and they often don’t know it”.

He said the rules due to be introduced in Europe would not fix the structural problems. “You can’t see the evidence that a device is built on – that’s still the same,” he said. “It’s still commercial organisations that control the flow of data.”

Other FoI requests made to the MHRA underline how difficult it is to get information on what is going wrong with devices.

The Guardian requested details of incidents relating to the contraceptive Essure, but was turned down on the basis of commercial confidentiality. Such a response is not unusual, according to a recent paper by scientists.

 

Nov 23rd 2018

How to tell if your child is having suicidal thoughts

"Look out for changes in behaviour and mood, perhaps an increase in them wanting to be on their own."

Self-harm and suicidal thinking are sadly not uncommon among teenagers. One quarter (25.5 per cent) of 11 to 16-year-olds with a mental disorder have self-harmed or attempted suicide at some point, compared with 3 per cent of those not diagnosed with a mental disorder, new data from NHS Digital suggests. Among 17 to 19-year-olds with a mental disorder, nearly half (46.8 per cent) have self-harmed or made a suicide attempt.

For parents it can be hard to know whether your child is struggling. Young people tend to hide their behaviours and thoughts, says Rick Bradley, operations manager for charity Addaction, as they fear being negatively judged or punished, or might be embarrassed or confused about why they are feeling or acting that way.

But there are signs, which parents can be vigilant for, that show something is amiss. “Look out for changes in behaviour and mood, perhaps an increase in them wanting to be on their own,” Bradley advises. “These can of course be typical signs that you are parenting an adolescent but the more time you spend together, the easier it can be to tell if something is wrong.”

Parental intuition can be super important in determining whether something is wrong. But if you’re unable to read your child, there are some physical changes which are worth keeping an eye out for such as marks or scars on their body, or if they change their eating or sleeping patterns or become more withdrawn.

Other signs that something isn’t quite right include if they’re regularly tearful or irritable, they have worries that stop them from carrying out day-to-day tasks, and they no longer enjoy activities they used to enjoy.

If you notice any of the above it’s a good idea to talk to your child about how they’re feeling, says Jo Hardy, head of parent services for the charity YoungMinds. The most important thing you can do is create a comfortable environment where your child has time and space to be with you, and feels they can talk to you about any issues.

Bradley suggests doing more shared activities together, like watching TV or cooking. “Sometimes they will talk, other times they might not, but offering this opportunity is a great start,” he says.

Helpful tips for talking about mental health

:: Consider the language you use when speaking to your child, suggests Laura Peters, head of advice and information at Rethink Mental Illness.

:: Be receptive without being judgmental, she adds. You might not understand why they feel the way that they do, but it’s important to listen.

:: If you choose to make the first move, don’t force the issue.

:: Tell them that you’re worried about them and ask if there’s anything wrong.

:: Constantly remind them that they’re cared for and that you love them. Often young people who are self-harming can feel ashamed, so listen to them and reassure them that you are still proud of them.

If you’re quite sure that something isn’t right and your child is refusing to open up, Hardy advises parents to be bold and take that first step, opening up dialogue. “It can be a hard thing to bring up, but the important thing is to make sure that your child knows that you love them and that you want to help them with whatever they are going through,” she explains.

If your child is self-harming, it doesn’t necessarily mean they are also experiencing suicidal thoughts, but it’s important to get them some mental health support. Hardy adds: “Visit your GP with your child if they are willing to come along, and if not, document the changes you have seen in your child’s mood and discuss that with the GP yourself.”

Useful websites and helplines:

·       Mind, open Monday to Friday, 9am-6pm on 0300 123 3393

·       Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)

·       The Mix is a free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk

·       Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.

 

Nov 21st 2018

Why we shouldn't always ignore the feeling of pins and needles

Pins and needles are a warning to tell us to move our limbs about, because long-term nerve entrapment can cause permanent damage

Everyone has experienced it: that tingling, prickling feeling you get in your limbs when you’ve been sitting or lying in one position for too long. Medical people call it paresthesia, but to the rest of us it’s “pins and needles”. And here’s how it works.

Our bodies contain miles of nerves and blood vessels. Most people know that nerves carry messages as electrical impulses to and from our brain, and blood carries oxygen and nutrients to our organs. What people are less familiar with is the fact that nerves also need blood vessels and blood vessels need nerves.

Nerves are made of living cells and there are special blood vessels called vasa nervorum that deliver oxygen and other nutrients to them. Blood vessels also need nerves to ensure the body is kept at the right temperature and the right amount of blood gets to where it needs to be. Nerves help change the diameter of blood vessels. For example, when we run, nerves widen blood vessels so that more blood can get to the muscles in our arms and legs.

Any compression of nerves or the blood vessels supplying them interferes with the ability of the nerves to transmit impulses back to the spinal cord and brain, so the brain interprets the lack of signals or abnormal signals as pins and needles in the affected area. Long-term compression can progress from pins and needles to more permanent nerve damage or dysfunction.

When pins and needles gets serious

Some forms of pins and needles are caused by occupation or lifestyle, such as carpal tunnel syndrome (CTS). This occurs when the median nerve, which passes through the carpal tunnel (formed by the carpal bones in the hand and a fibrous band of tissue forming a bridge across the bones), becomes compressed by inflamed tendons that also pass through this “tunnel”.

People who use equipment that vibrates, such as pneumatic drills or orbital sanders, are at increased risk of CTS, as are people who play musical instruments or use computer keyboards for long periods of time. These kinds of activities cause stresses and strains through the wrist and carpal tunnel that can pinch the median nerve.

Carpal tunnel syndrome symptoms can be temporarily relieved by shaking the affected hand. But in the longer term it can disappear on its own through ceasing the aggravating activity or by wearing a wrist splint to keep the wrist straight. In some cases, surgery is needed.

Lifestyle induced

While CTS is usually caused by hard work, Saturday night palsy, as the name suggests, usually results from letting your hair down. People get Saturday night palsy when they “fall asleep” with their arm hanging over something, like a chair, bar stool or edge of the bed. Initial pressure causes pins and needles, but this can progress quickly to longer-term damage in the form of palsy.

Saturday night palsy affects the radial nerve in the arm (see diagram above). It is usually damaged at its location next to the biceps muscle and is the most commonly injured nerve in the arm. One study showed more than 70 per cent of reported injuries involved alcohol in some form, and over 75 per cent of people with the condition compressed the nerve for more than two hours, resulting in recovery that took weeks. Evidence shows that this type of alcohol-induced injury is also on the rise.

The same nerve can be injured in another type of palsy. This one is called “honeymoon palsy”. It happens when your partner lays or sleeps on your arm or leg for so long that it causes palsy.

Tight jeans

“Tingling thigh syndrome” and “tight jean syndrome” are terms for a medical condition known as meralgia paresthetica. It is experienced as pins and needles in the outer part of the thigh. These result from compression of a nerve called the “lateral cutaneous nerve of the thigh” – meaning the nerve supplying the skin of the lateral thigh.

There are many causes, most widely seen are those associated with trousers that are too tight around the waist; carrying a wallet, keys or phones in pockets; as well as impact to the thigh during sports, such as the asymmetric bars.

While many of the examples listed above are temporary, there are some instances where pins and needles shouldn’t be ignored. For example, tingling in the lips can indicate a food allergy or a stroke. Tingling in the hands and feet can also indicate mineral or vitamin deficiency. So pins and needles is a way of telling you that something is wrong, although most of the time, the cause is benign.

 

Nov 17th 2018

How to combat Raynaud's syndrome

If your fingers go deathly pale in the cold and lose all sensation, you might suffer from Raynaud's syndrome. Cold weather is unpleasant at the best of times, but freezing temperatures and adverse conditions can make the condition particularly challenging.

We speak to family GP Dr Roger Henderson about how best to manage the condition

What is Raynaud's syndrome?

Raynaud's syndrome (also known as Raynaud's phenomenon) is a disorder that affects your blood circulation and mainly targets your fingers and toes. It comes on when you're cold, anxious or stressed and tends to occur during the winter months. There are two main types of Raynaud's syndrome:

 Vibration white finger (VWF), also known as hand-arm vibration syndrome (HAVS), is a secondary form of Raynaud's syndrome, triggered by continuous use of vibrating hand-

held machinery such as pneumatic drills and power tools, usually in an industrial environment.

⚠️ If you suffer from Raynaud's syndrome, vibrations can trigger a similar Raynaud's attack, for example riding a motorbike or moped in cold conditions.

Raynaud's syndrome symptoms

Raynaud's essentially causes the blood vessels to narrow in response to external triggers including stress and cold temperatures, causing your extremities to go numb and lose colour, as if all of the blood has drained from your digits.

It can impact one or more fingers and tends to be extremely painful. The symptoms can also include numbness, pins and needles, white bloodless fingers or toes and difficulty moving your extremities.

Can anyone get Raynaud's syndrome?

People of all ages can suffer from Raynaud's. 'It may run in families, but the primary form is the most common type, typically starting between the ages of 15 and 25,' says Dr Henderson. 'It is most common in women and people living in cold places or working in cold environments.'

'Secondary Raynaud's tends to start after the age of 35-40, and is most common in people with connective tissue diseases, such as scleroderma, Sjögren's syndrome and lupus,' he adds.

How do I know it's Raynaud's syndrome?

If you suffer from Raynaud's syndrome, you will have a stronger reaction to the cold or stress and your blood vessels will likely narrow much faster and tighter than normal.

'This is called an 'attack' of Raynaud's,' says Dr Henderson. 'During such an attack, the fingers and toes can change colour, going from white to blue to red, and may also feel cold and numb from lack of blood flow. As the attack ends and blood flows back to normal, the affected parts of the body can throb, tingle or be very painful.'

After the cold parts of your body warm up, normal blood flow usually returns in about 15 minutes.

How do I manage Raynaud's syndrome?

The treatment of Raynaud's syndrome aims to reduce the number of attacks occurring, making them less severe, preventing tissue damage and stopping the loss of any tissues of the fingers and toes.

'Primary Raynaud's phenomenon does not lead to tissue damage, so non-drug treatment is used first here,' says Dr Henderson, 'whereas treatment with medication is more common with secondary Raynaud's.'

How to prevent a Raynaud's attack

To minimise the chances of a Raynaud's attack, try the following:

✔️ Maintaining a healthy lifestyle can prevent attacks.

✔️ Keep your hands and feet warm and dry.

✔️ Warm your hands and feet with warm water.

✔️ Avoid air conditioning.

✔️ Wear gloves to touch frozen or cold foods.

✔️ Wear multiple layers of loose clothing and a hat when it's cold.

✔️ Don't smoke - smoking narrows blood vessels even further.

✔️ Exercise regularly to boost blood flow.

✔️ Use chemical warmers, such as small heating pouches that can be placed in pockets, gloves, boots or shoes.

⚠️ For severe cases of Raynaud's syndrome and Vibration white finger, prescribed drugs may be used to reduce the attacks and you may be referred to a specialist for assessment. Ask your GP for advice.

Nov 15th 2018

How to soothe your baby's upset stomach

There's nothing worse than a grissly baby! Our resident pharmacist looks at the 5 most common baby stomach complaints, and how to treat them.

From a soggy nappy to a sore stomach, there are a number of reasons why your babymight be unhappy. Our resident pharmacist Rita Ghelani identifies the most common baby stomach complaints and how to treat them, so you can all get a good night's sleep:

Colic

It is not known what causes colic, but experts believe it may be due to a baby’s immature digestive system. Symptoms of colic include:

·      Looking flushed.

·      Producing more wind.

·      Difficulty sleeping.

·      Drawing in knees, clench fists and arch backs due to the pain of colic.

·      Loud crying which lasts for more than three hours a day for three of more days a week over a period of more than three weeks.

️ Colic treatment

To help ease the symptoms of colic you can try:

➡️ Giving your baby a comforting warm bath.

➡️ Rocking your baby, or take them for a walk or drive.

➡️ Always wind the baby after feeding.

⚠️ For bottle feeding babies make sure that the teat is always full of milk and that the milk is flowing freely to avoid your baby swallowing too much air.

★ Try this: Use colic relief medicines such as Infacol or Dentinox which contain simeticone (also referred to as dimeticone). These products help relieve symptoms of wind, colic and griping pain for both bottle-fed or breast-fed babies.

Although it is difficult to manage an inconsolable crying baby with colic, the good news is that it is completely harmless and usually ends by the time a baby is four to six months old. Speak to your health visitor or doctor if colic persists and your baby is not feeding well. 

Constipation in babies

Babies can become constipated a times, although it’s far less common in breastfed babies. If your baby is passing hard stools less often than normal and seems to be straining or in pain, then it is likely that she/he is constipated. You may also notice that your baby seems unhappy, angry, irritated and lacking in energy.

️ Constipation treatment

Constipation can be caused by several different things including dehydration, minor illnesses such as a cold and changes in diet, including change in formula milk or going on to formula milk after breastfeeding. The symptoms of constipation can be eased by the following:

➡️ Offer your baby cooled, boiled water between milk feeds.

➡️ If your baby is eating some solids, encouraging the baby to eat more fruit may help.

➡️ Massaging the baby’s tummy or moving their legs in a cycling motion will help.

➡️ Make sure that the formula milk feds are made up correctly if your baby is bottle fed. Too much milk powder can make the feed too concentrated.

 Try this: If you are bottle feeding your baby, your doctor or health visitor may suggest changing to a different formula milk if constipation is an ongoing problem. Speak to your pharmacist to get some support, advice and discuss the different options to help relieve constipation.

If hard stools are the main problem causing the constipation your pharmacist may recommend a stool softening laxative called lactulose, which is suitable for children over one month. If constipation persists then you should see your doctor.

Reflux in babies

Babies are prone to reflux, as they have small stomachs and the lower oesophagus valve (which opens to let milk into the stomach and then tightens to prevent it from moving back up) may not be fully developed.

About 50 per cent of babies get reflux up to the age of three months. For most babies the oesophagus valve will strengthen by the time the baby is 10 months old.

All babies posset – bring up a small amount of milk or vomit from time to time. This is normal and usually pass as the baby develops.

If you notice any of the following symptoms or have any other concerns, speak to your doctor:

·      Constant vomiting.

·      Constant or sudden crying.

·      Poor sleep with frequent waking.

·      Your baby arches his/her back during feeding.

·      Wet burps or frequent hiccups.

·      Baby appears to be in pain while feeding.

·      Baby is not gaining weight or showing poor growth.

️ Reflux treatment

To help relieve reflux try the following:

➡️ Wind your baby before, during and after feeding.

➡️ Keep the baby upright for 30 minutes after feeding.

➡️ Avoid putting any pressure on the baby’s stomach after feeding, for example, try to wait for at least 30 minutes before putting the baby into a car seat.

Try this: If the baby is feeding well and seems happy and contented, then there is no need to treat reflux. If reflux is severe, then your doctor may suggest using special thickening agents that are added to formula milk, expressed breast milk or spoon fed. Your doctor may prescribe an infant formulation of Gaviscon that can be mixed with the baby’s milk.

Lactose intolerance

Lactose is a natural sugar found in milk including breast, formula and cow’s milk. It’s an important source of carbohydrate – but for our bodies to use it properly, it has to be broken down by an enzyme called lactase. If there is enough lactase produced, this is referred to as lactose intolerance, because the lactose can’t be digested.

Babies can develop a temporary form of lactose intolerance called secondary lactose intolerance after an illness such as gastroenteritis. Symptoms of this normally disappear after a few weeks, when the lining of the gut heals, and the cells start to product lactase again. Symptoms include:

·      Vomiting

·      Diarrhoea

·      A bloated stomach

·      Stomach pains

·      Wind

Try this: Speak to your doctor if you are worried about the symptoms. Your doctor may recommend a lactose-free milk formula for a few weeks, until the symptoms have cleared. You can also try using Colief colic drops that contain a natural lastase enzyme to break down the lactose in milk. 

Cows’ milk allergy in babies

Allergy to cows’ milk is the most common food allergy in children. Many children grow out of it by the time they go to school. Cows’ milk allergy is an immune reaction to one or more milk proteins in cows’ milk. There are two types of cow’s milk allergies:

·      Immunoglobin E antibody: the first type has an immediate reaction and is caused by the immunoglobin E antibody, the symptoms of allergy come on within minutes of having cow’s milk or within two hours.

·      Non-immunoglobin E: the second type is a delayed response caused by non-immunoglobin E reaction and is the more common one. The symptoms come on slower, after two hours of having cows' milk but it can take up to 72 hours.

Symptoms can vary and begin from when cows’ milk is introduced into the diet and usually include at least two of the following:

·      Vomiting or diarrhoea.

·      Skin problems such as a red itchy rash.

·      Problems with breathing such as wheezing.

·      Breastfeeding is the best way to avoid getting an allergic reaction to cow’s milk.

⚠️ If your baby is allergic to cows' milk, breastfeeding mums should cut out cows’ milk from their diet too.

Try this: After diagnosing a cows' milk allergy for your baby, your doctor may recommend milk formula that are extensively or fully hydrolysed. These milk formulas have the milk protein broken down making it easier to digest and less likely to cause an allergy.

 

Nov 14th 2018

Causes of children's rashes explained - and whether they need to stay off school

Hand, foot and mouth disease, eczema, scarlet fever, slapped cheek syndrome (fifth disease), measles, chickenpox and ringworm symptoms are explained

It’s one of the perils of having kids at school, and rashes are on the rise. But what do the spots and red skin on your child mean – and could it be serious?

Dermatology nurse Karen Pett, from Epaderm, says: “The majority of rashes aren’t dangerous and are often caused by an unexplained viral infection, which will pass without treatment.

“However, if your child has a rash that doesn’t blanch when you hold a glass over it with light pressure, it can be a sign of meningitis.

"And if a rash is accompanied by swelling of the lips and tongue, or difficulty breathing, it could indicate an extreme allergic reaction.

“In both cases you should seek medical treatment immediately.”

Here Karen gives the lowdown on common childhood rashes – spotting the symptoms, treating them and advising whether or not your tots need to take time off school.

HAND, FOOT AND MOUTH DISEASE

The Rash Red spots in the mouth and on the hands and feet that turn into greyish yellow blisters.

It’s caused by a viral infection and your child may also have a sore throat, temperature and painful tummy.

Treatment Give plenty of fluids, children’s paracetamol or ibuprofen and teething gel to soothe mouth blisters. Try not to pop blisters as they could become infected.

See your GP if they do or if temperature rises to 38C or above.

Should they stay off School? Be guided by your child. If they seem unwell, then keep them off until they feel better. Some schools and nurseries have policies asking that you keep your child away until all blisters have dried up.

ECZEMA

The Rash Red, scaly, patches of dry skin, usually on cheeks or in creases of the neck, elbows and knees, but can be anywhere on the body.

Flare-ups can happen in winter because central heating lowers the air humidity which dries out skin. Extreme itchiness can cause your child to scratch the skin so much it weeps and bleeds.

Treatment See your GP if you think your child has eczema for the first time or if the rash becomes infected, yellow and weeping.

Management with frequent application of emollients is key.

Choose one free from sodium lauryl sulfate, perfumes and colouring. Try Epaderm Junior Cream (£7.99, nationwide), developed by dermatologists and recommended by doctors.

Should they stay off School? No, eczema is not contagious.

SCARLET FEVER

The Rash Pink-red rash that feels like sandpaper. Usually starts on the torso and spreads.

Cheeks can be bright red and the tongue red and swollen. Your child may also have swollen neck glands, sore throat and nausea.

Treatment See your GP who will usually prescribe antibiotics for this bacterial infection.

Should they stay off School? Yes, for at least 24 hours after starting antibiotic treatment.

SLAPPED CHEEK SYNDROME (FIFTH DISEASE)

The Rash A bright red rash on the cheeks, sometimes followed by a light pink rash on the body. Usually accompanied by a raised temperature, runny nose and sore throat.

Treatment The virus should clear up without treatment after a few days.

Give plenty of fluids and if they have a temperature or headache, children’s paracetamol or ibuprofen. Use an emollient if the rash is itchy.

Should they stay off School? Only if unwell. They’re no longer contagious when the rash has appeared, but do let the school know.

MEASLES

The Rash Before the rash appears, your child may have cold-like symptoms and sore, red eyes.

White spots may appear in the mouth, followed by a rash of small red-brown flat or raised spots, often starting on the head or neck before spreading to the rest of the body.

Treatment This viral disease is far less common than it was years ago since the introduction of the MMR vaccine. Contact your GP if your child hasn’t been vaccinated and you suspect measles.

Give your child fluids, ibuprofen or paracetamol for aches and pains, and keep their eyes clean by wiping with damp cotton wool.

Measles can cause serious complications so treat it as an emergency if your child develops breathing problems or chest pains.

Should they stay off School? Yes, for at least four days after the rash first appears to avoid spreading the infection.

CHICKENPOX

The Rash Red spots that appear anywhere on the body and fill with fluid to form blisters.

Treatment Ensure your child has plenty of fluids. Try a soothing product such as PoxClin CoolMousse (£10.99 nationwide), to relieve itching.

Should they stay off School? Yes, until all spots and blisters have scabbed over (usually about five days after the spots first appear), as then they will no longer be infectious.

RINGWORM

The Rash Ring-shaped red or silvery rashes that can appear anywhere on the body, caused by a fungal infection.

Treatment See a pharmacist for anti-fungal cream. If the rash is on your child’s scalp they’ll need to see their GP for a specialist fungal treatment.

Should they stay off School? No, it’s fine to go to school once treatment has started, but do let your child’s teacher know. Try to keep the infected areas covered to prevent it spreading.

 

Nov13th 2018

Polycystic ovary syndrome your PCOS questions answered

From symptom checking to fertility, we answer your questions about this common health issue.

Polycystic ovary syndrome (PCOS) is an incredibly common condition among women, but still comes with its fair share of confusion. We speak to the experts about diagnosis, treatment and management. So, if you think you have PCOS, read up, and remember you're not alone.

What is polycystic ovary syndrome?

Up to 10 per cent of women of reproductive age are thought to have PCOS, a condition which affects how a woman's ovaries work.

So what exactly is PCOS? Often the outer surface of the ovary has several small cysts. These cysts can prevent the eggs from fully maturing and being released, so a woman with PCOS may ovulate less frequently and have irregular (or absent) periods. If this happens, she might find it more difficult to get pregnant.

PCOS is also associated with a number of other symptoms including:

✶ Excess body hair

✶ Hair loss from the head

✶ Acne

✶ Difficulty losing weight

✶ Irregular periods

✶ Fertility

What if I only have some of the symptoms?

One of the biggest misconceptions about PCOS is that it's a single entity, rather than a collection of signs and symptoms. In fact, it's a condition that can end up being diagnosed by a range of healthcare professionals: from dermatologists to metabolic physicians. 

Up to 10 per cent of women of reproductive age are thought to have Polycystic ovary syndrome.

'One of the features could be multiple small cysts on your ovaries on a scan. Another feature might be acne or unwanted hair on your face, breast, lips or tummy,' says Dr Amma Kyei-Mensah, a Consultant Obstetrician and Gynaecologist at The Whittington Hospital. 'Alternatively there could be irregularities in your menstrual cycle. You need two out of three of these features to be considered as having polycystic ovarian syndrome.'

There is no typical PCOS patient. If you have many small cysts on your ovaries and irregular periods, even if you have clear skin and no problems with body hair, you could have the syndrome. Likewise, you could have serious acne and absent periods but your ovaries look fine on a scan, and you could still have PCOS

Is there a PCOS and testosterone link?

Some women, particularly those with excess body hair and acne, may find they have raised male hormones (called androgens), usually testosterone. But other women with much higher androgens may have flawless skin and hairless thighs.

It's not just about the amount of androgens, but also about how your body (usually your skin or hair follicles) responds to the hormone that's important. Some women just have more sensitivity to androgens so even normal testosterone levels may be associated with acne and unwanted hair in some cases.

Will I have problems conceiving?

If you don't have any other symptoms of PCOS, you will most likely not struggle to conceive. A lot of women who have an ultrasound scan for reasons unrelated to their fertility (such as abdominal pain) find out they have cysts on their ovaries and worry needlessly.

'A polycystic ovary on scan without any of the other symptoms is a very common finding,' says Dr Kyei-Mensah. 'Women become very upset when they go and look it up online, but they're usually fine.'

Can the contraceptive pill control PCOS?

If you're not looking to get pregnant, birth control pills will likely help a lot of PCOS symptoms – particularly those associated with male hormones like excess body hair and acne. Certain brands of the pill such as Dianette and Yasmin are ideal for these symptoms because they contain an anti-androgen to reduce the effect of male hormones.

If you're not looking to get pregnant, birth control pills will likely help a lot of PCOS symptoms.

But whatever brand you go for, the pill will regulate your periods by giving you a light withdrawal bleed every month when you stop the pill for a week so you'll be able to be sure you're not pregnant. Dr Kyei-Mensah recommends that women with PCOS who aren't having periods and are not on the pill should bleed at least a few times a year, so that the lining of the womb is definitely shed.

'If you have PCOS, your ovaries still make plenty of oestrogen and there's a small risk that you could make a thickened womb lining that could develop abnormal cells,' says Dr Kyei-Mensah. 'That's why we recommend at least 3 – 4 periods a year for women with PCOS who don't normally have periods.'

Will weight loss help PCOS?

Weight loss can make a positive impact and might restore your periods, but only if you're already overweight to begin with. 'Losing weight is one of the main lines of treatment and it can be as efficient as some treatments with hormones,' says Dr Manuel Fernandez, Director of IVI Fertility Sevilla in Spain.

If you're slim, dieting is not a good idea, but eating healthily and taking regular exercise is still important.

I have PCOS - can I get pregnant?

If you're hoping to get pregnant and think you have PCOS, seek fertility help before the normal one year recommendation, says Dr Fernandez. If you've been trying for six months with no joy, it's worth chatting to a fertility specialist.

If you're hoping to get pregnant and think you have PCOS, seek fertility help.

Dr Geetha Venkat, director of Harley Street Fertility Clinic says around 60 per cent of her patients have PCOS. And before IVF is considered, a medicine called clomifene is used to help a woman's eggs grow to maturation and be released in ovulation.

'Clomiphene is the basic underpinning of traditional fertility help, but some women won't respond. For these patients, we have to make the eggs grow directly by giving them hormones like FSH,' says Dr Venkat. 'Of course, if this doesn't work after trying for a few months, the woman might need to try IVF.'

What's the link between PCOS and diabetes?

In recent years, PCOS has been linked to the way women's bodies use insulin – the hormone that turns excess sugar in your blood to fat. Overweight women with PCOS are far more likely to develop type 2 diabetes than the average woman, but even if you're slim with PCOS, your risk is increased. So it's important to eat a diet that's low in sugar and exercise regularly, even if you're slim.

The diabetes drug metformin may be prescribed to women to reduce their insulin resistance, improve the regularity of their periods and may even reduce testosterone-associated symptoms like excess body hair and acne.

Does PCOS impact bone density?

Another common misconception is that women with PCOS aren't producing enough of the female hormone oestrogen, but this is rarely the case. In fact they often produce higher amounts. Oestrogen is needed to build a strong skeleton. Despite not having periods, women with PCOS still make plenty of oestrogen so they are not at risk of thin, brittle bones.

 

Nov 8th 2018

Heavy menstruation is a common complaint that affects one in three women as they approach the menopause

More than one in five British women suffer heavy periods, rising to one in three when approaching the menopause.

Heavy periods can have a big impact on your life, keeping you from normal activities and even work.

Yet a survey by the ‘Wear White Again’ campaign reveals 62% of women don’t realise it’s treatable and almost half haven’t spoken to a GP.

The study found that many accept it as “just part of being a woman.”

But experts stress that help is out there, and a trip to the doctor is often a good idea.

Here's everything you need to know, what treatments are available, and self-help tips you can try at home.

1. What are heavy periods?

Menorrhagia is the medical term for heavy menstruation, says Mr Paul Bulmer, consultant gynaecologist at St George’s Hospital, London.

The womb grows a lining every month in readiness for pregnancy.

If there is no pregnancy, this lining is shed. “A heavy period is blood loss of more than 80ml (around four tablespoons) but this is difficult to measure,” says Mr Bulmer.

“We ask the patient how long bleeding lasts (over seven days is excessive), what sanitary products are used and how often they need to change them.”

Some women have to double up on protection and many complain of clotting and “flooding” with blood soaking through clothing or bedding.

Other symptoms include pain, feeling tired or weak, depressed or moody.

“Heavy periods can have a big impact on quality of life,” adds Mr Bulmer. “If heavy flow keeps you from normal activities, or even stops you from working, seek help.”

2. What causes heavy periods?

In the majority of cases the cause is due to a hormone imbalance.

In some, however, there may be an abnormality that affects the womb cavity.

This may be due to polyps or fibroids – non-cancerous growths that develop in or around the womb, or an inflammation due to endometriosis.

This occurs when small pieces of the womb lining end up outside the womb.

Adenomyosis describes womb tissue lining becoming embedded in the womb wall. Other less common causes include polycystic ovary syndrome (PCOS), pelvic inflammatory disease (PID), an infection of the womb, fallopian tubes or ovaries, an underactive thyroid (hypothyroidism), blood-clotting disorders, and, rarely, cancer of the womb.

3. How can heavy periods be treated?

Don’t suffer in silence.

“See your GP who will take a medical history", says Mr Bulmer.

“There is a questionnaire and diary at Wear White Again that can be filled out to help your doctor’s diagnosis.”

Your GP will also ask about bleeding in between periods and peeing more often, and may feel the tummy for any lumps, explains Mr Bulmer.

“These are ‘red-flag’ symptoms that will need investigation, such as a trans-vaginal ultrasound to rule out fibroids or polyps.”

Updated (National Institute for Health and Care Excellence) guidelines recommend women with heavy periods have a hysteroscopy – a telescopic investigation of the womb via the vagina.

Treatment depends on the patient’s fertility plans too, says Mr Bulmer.

Tranexamic acid is a first-line drug that works by slowing bleeding and is to be taken three times a day during periods.

“It reduces bleeding by 50% but is only successful in half of cases,” he says. “Try for one or two cycles.”

Alternatively, mefenamic acid is a non-steroidal, anti-inflammatory drug that reduces blood loss by around 20% while also alleviating pain.

For those who need contraception, the Mirena intrauterine system has an “anti-growth” effect on the womb lining.

For the first few months there may be bleeding between periods but this usually settles.

Periods get lighter until they usually stop completely within six months. It lasts for five years but is instantly reversible.

Other hormonal options include the combined pill, which works by preventing ovaries releasing an egg each month, the progestogen-only pill, a 12-weekly progestogen injection, and a contraceptive implant that lasts three years. These lighten periods but may cause side effects like water retention and mood swings.

If these don’t work or the GP suspects a physical problem with the womb, the patient will be referred to a gynaecologist, says Mr Bulmer. Hospital treatments include...

·       Hysteroscopic morcellation: A hysteroscope is inserted into the womb through the cervix and an instrument called a morcellator is used to cut or “shave” away small abnormalities, such as polyps.

·       Endometrial ablation: This destroys the womb lining with either laser, heat or ultrasound energy. It can be performed as a day case and usually takes just 15 minutes. Most women have no periods afterwards.

·       Uterine artery embolisation: This treats fibroids and involves inserting a small tube into the groin to block the blood vessels supplying blood to the fibroid.

·       Myomectomy: A procedure to remove fibroids.

·       Hysterectomy: A 100% effective procedure to remove the womb. It can be done vaginally, by keyhole surgery or by a surgical cut, which requires a hospital stay.

4. Self-help tip for heavy periods

“Magnesium is excellent for heavy periods,” says Alison Cullen, nutritionist and menopause expert at A. Vogel supplements.

“It acts as a gentle muscle relaxant so it can help take the edge off very strong contractions of the uterus which can give rise to very heavy periods.

“Try incorporating plenty of magnesium-rich foods into your diet. These include dark leafy veg, nuts, seeds, beans and wholegrains.”

 

Nov 7th 2018

Man Dies 8 Years After Swallowing a Live Slug That Left Him Paralyzed

In 2010, a teenage rugby player in Australia named Sam Ballard accepted an unusual dare at a party: swallow a live garden slug. The experience left him paralyzed and with significant brain damage, and on Friday (Nov. 2), Ballard died in a Sydney hospital at the age of 28.

The strange and sad case occurred because, along with the slug, Ballard had swallowed a parasite called Angiostrongylus cantonensis, commonly known as rat lungworm, which the slug likely picked up from rat droppings, according to the U.K.'s EveningStandard.

Rat lungworm infection can lead to bacterial meningitis, which may include symptoms such as headaches, nausea, vomiting, and "abnormal sensations" in the arms and legs, according to the Centers for Disease Control and Prevention (CDC). Typically, rat lungworm infections get better without treatment. But in some cases, serious complications can occur and cause severe disruption of the nervous system or even death, the CDC says. [8 Awful Parasite Infections That Will Make Your Skin Crawl]

In the days after swallowing the slug, Ballard developed pains in his legs and was hospitalized after spells of persistent dizziness and vomiting. Doctors diagnosed him with a rat lungworm infection, and he fell into a coma that lasted 420 days, Live Science previously reported.

After Ballard emerged from the coma, he was paralyzed from the neck down, had difficulty communicating and required 'round-the-clock care, according to the Independent.

Ballard's story made headlines earlier this year after medical funding used for his care and provided by the Australian government's National Disability Insurance Scheme was reduced by half; the government eventually reversed the decision following extensive media coverage and an appeal by Ballard's family, News.com reported.

People can avoid exposure to the rat lungworm parasite by avoiding eating raw or undercooked slugs and snails, frogs, land crabs, and freshwater shrimp, according to the CDC. Vegetables that may have come in contact with slugs or snails should be washed before being eaten raw, and people preparing raw slugs or snails should thoroughly clean their hands and utensils afterward, the CDC says.

 

Nov 6th 2018

Collagen: What you need to know

In recent years, there has been a lot of buzz in the beauty industry surrounding collagen.

But what exactly is collagen? In humans and animals, collagen is an abundant protein and is mostly found in fibrous tissues such as skin, tendons and ligaments.

"Collagen is the building blocks of skin. Think of it as scaffolding," Andrew Petrou, Bioglan skincare expert, told us. "It is an essential component not only of skin, but of our whole bodies. There are various types of collagen, but Type 1 is most common in the skin."

Collagen provides strength, flexibility, protection and firmness in the skin, and accordingly, medical collagen - which is derived from young beef cattle - is often used in cosmetic surgery in order to heal burn patients and for a wide variety of other dental, orthopaedic, and surgical purposes.

A number of creams, lotions, serums and masks designed for everyday skincare use claim to be infused with collagen too, though Andrew is sceptical that the protein alone can really have an impact on the complexion when included in such formulas.

"The collagen molecule is huge, so it is unlikely to penetrate skin layers when used in creams," he explained. "However, peptide technology (along with amino acids) can have a signalling effect for skin to maintain and repair existing sources."

In humans, collagen stores decline steadily from the age of 25. But thankfully, there are some ways to boost the protein in the body.

Bioglan scientists have developed a range of Beauty Collagen edible products, including tablets, gummies and powders, which are formulated with readily absorbed hydrolysed Marine Collagen, derived from fish, as well as biotin and selenium.

There are various supplements available in health food shops, while drinkable collagen brands such as Skinade, Beauty & Go, and Pure Gold Collagen are cropping up too.

 

Nov 4th 2018

'Fluorescent marker' could help surgeons remove deadly brain tumours

luorescent marker could be used to boost survival from one of the deadliest form of brain tumours.

Scientists found that using a chemical to highlight cancerous cells meant that they were able to identify the most aggressive types of disease, and to ensure that healthy brain tissue was not harmed.

The study, presented at the National Cancer Research Conference in Glasgow, involved 99 patients suffering from suspected glioma.

The disease, which killed former Labour cabinet minister Dame Tessa Jowell, is the most common form of brain cancer, with more than 2,200 cases diagnosed each year in England.

Treatment usually involves surgery to remove as much of the cancer as possible, but it can be difficult for surgeons to identify all of the cancer cells while avoiding healthy brain tissue.

Research on 99 patients found that the markers were able to detect the fastest growing tumours, and to improve the accuracy of subsequent surgery.

Scientists used a compound called 5-aminolevulinic acid or 5-ALA, which glows pink when a light is shone on it. Previous research shows that, when consumed, 5-ALA accumulates in fast growing cancer cells and this means it can act as a fluorescent marker of high-grade cells.

The study involved patients with suspected high-grade gliomas treated at the Royal Liverpool Hospital, Kings College Hospital in London and Addenbrooke’s Hospital in Cambridge.

Before surgery to remove their brain tumours, each patient was given a drink containing 5-ALA, and assessed for signs of fluorescence.

Surgeons then used operating microscopes to look for fluorescent tissue while removing tumours.

It was found in 85 cases, of which 81 were confirmed to be suffering from high-grade disease.

In the 14 cases where fluoresence was not seen, seven tumours were subsequently found, but all were low-grade disease, which grows far more slowly.

Scientists said the findings could extend survival for some of the deadliest forms of brain cancer, which often means patients only live months after diagnosis.

Lead researcher Colin Watts, Professor of Neurosurgery and chair of the Birmingham brain cancer programme at the University of Birmingham, said: “Neurosurgeons need to be able to distinguish tumour tissue from other brain tissue, especially when the tumour contains fast-growing, high-grade cancer cells. This is the first prospective trial to show the benefits of using 5-ALA to improve the accuracy of diagnosing high-grade glioma during surgery. These results show that the marker is very good at indicating the presence and location of high-grade cancer cells.”

“The advantage of this technique is that it may highlight more quickly high-grade disease within a tumour during neurosurgery. What this means is that more of the tumour can be removed more safely and with fewer complications, and that’s better for the patient.”

Professor Anthony Chalmers, chairman of NCRI’s Clinical and Translational Radiotherapy Research Working Group said there was a “desperate” need for better treatments for brain tumours, and said he hoped the technique could extend lives.

“The benefit of using a fluorescent marker is that it helps neurosurgeons see more accurately where the high-grade cancer is within the brain, in real time. In treating cancer, we are trying to improve survival by tailoring treatments to each individual patient. This technique provides on-the-spot information to help surgeons tailor the operation according to the location, size and grade of the tumour. We know that patients who have near total removal of their tumour have better outcomes, so we are optimistic that, in the long term, these new data will help to increase survival times for glioma patients,” he said.

 

Nov 3rd 2018

What do your FEET say about your health? Doctor reveals all, from them being cold to thick nails and even pungent smells

·       Dr Dawn Harper discuses warning signs in the shape, look and smell of feet 

·       Common symptoms yellow nails can get as serious as skin cancer, she says

·       90% of women suffer from some form of foot problem during their lives

·       They may not be our prettiest assets, but we rely on them every day.

·       Around 90 per cent of women suffer from some form of foot problem during their lives, according to a survey.

·       Dr Dawn Harper, an ambassador for Sole Bliss. says our feet can reveal a lot about our health, and the signs not to ignore. 

·       Shape 

·       'When you stand on a flat floor in bare feet, there should be an arch on the inside of the foot. If the whole foot is splayed on the floor, you may have what is called fallen arches', says Dawn.

·       This can be caused by a multitude of things other than a birth defect, such as broken or dislocated bones, rheumatoid arthritis or nerve problems. 

·       The risk can be increase by obesity, diabetes, pregnancy and ageing.   

·       Symptoms can worsen, with many people experiencing pain in the arches, swelling, or even back and leg pain.  

·       'Insoles in your shoes may improve your posture and feel more comfortable.

·       'Your big toe should be straight and in alignment with the rest of your foot. If it is bent away towards the other toes leaving a boney prominence at the base of the big toe, you may have a bunion (also called hallux valgus).

·       'It is estimated that at least 14 million people in the UK have bunions and I am sad to say I am one of them. 

·       'Once formed, they can only be cured with surgery and that is a bigger undertaking than most people realise. 

·       'Splints available from your pharmacist will bring the toe back in to alignment whilst they are worn and gel pads over the boney prominence will alleviate the pressure. 

·       'I am often asked whether heels are to blame. In fact the greatest risk factor is your family history', says Dr Harper.

·        The exact cause of bunions is unknown but it is likely that factors include inherited foot type, injuries, and deformities present at birth. 

·       Experts disagree on whether footwear such as high heels contributes to bunion development.

·       It is thought that wearing heels push your weight forward and forces your toes into the front of the shoes.

·       'Very pointy ill-fitting shoes will make the problem worse', says Dr Harper.

·       'Broad fitting shoes are great for some people. I love wearing heels and was thrilled when I discovered Sole Bliss (www.solebliss.com) as the shoes are fitted with special padding meaning I can wear my heels and still be comfortable.'

·       Colour and temperature

·        

·       Cold feet can signal bad circulation, and should be checked out, according to Dr Harper

·       'Your feet should be the same colour as the rest of you. We all get blue feet occasionally but feet that are always dusky blue could be a sign of poor circulation. It can be more difficult to see on darker skins. 

·       'Try pressing your fingers in to the pulp of your toes. The skin should blanch and return to a normal colour as soon as you release the pressure. If this takes some time it is called poor capillary return and could be a sign of circulatory problems.

·       'Similarly permanently cold feet may reflect a circulatory problems and should be checked out', says Dr Harper.

·       'In extreme cases, poor circulation could lead to gangrene so it's a symptom not to be ignored. 

·       'It could also mean problems with circulation elsewhere in the body so your doctor will want to know and will check your blood pressure and test your cholesterol and glucose levels.’ 

·        

·       Cramps

·        

·       When your body gets low in fluids and electrolytes, your muscles become more vulnerable to spasms and cramps

·       Normal foot cramps will go away with stretching or massaging the feet.

·       However if you suffer more than occasionally, poor blood flow could be the cause. 

·       When your body gets low in fluids and electrolytes, your muscles become more vulnerable to spasms and cramps, so it's also important to stay hydrated.

·       Chronic or recurring cramps in the foot may include leg cramping. Night-time calf cramping affects approximately 1 in 3 adults.

·       This could signal more serious problems, including nerve compression. 

·       Too little of minerals such as potassium, calcium or magnesium in your diet could contribute to muscle cramps. Magnesium plays a role in neuromuscular transmission and muscle contraction.

·        

·       Nails

·       Yellow nails can be caused by the overuse of nail polish. However it's important to keep an eye on it, because 'thick discoloured nails could be a sign of a fungal infection', says Dr Harper.

·       'Your GP will probably want to send some nail clippings to the lab for analysis to confirm this before prescribing antifungal paint or tablets.'

·       Toenail fungus affects adults and the chances of getting it increase as you age.   

·       The nails may become brittle (crumbly), thicker and change shape and sometimes they hurt too. The affected part of the nail may detach from the nail bed. 

·       In the vast majority of people, the fungus develops at the front or side edge of the nail. This most commonly happens in people with a severely weakened immune system – following a serious illness, for example.

·       'If you notice what looks like a bruise under the nail but don’t remember injuring it, it is important to get this checked out as sometimes a skin cancer can develop under the nail and this needs urgent assessment and treatment', says Dr Harper.

·       An estimated 1.4 per cent of all diagnosed melanoma (skin cancer) cases in the UK are those that affect the nail, according to the Journal of Foot and Ankle Research. 

·        

·       Dry or cracked skin

·      

·       Constant dry skin, despite moisturising, could be a sign of hyperkeratosis, which the elderly are more at risk of

·       If feet remain dry or cracked despite constant moisturising it may be worth giving this problem some attention.

·       One explanation may be hyperkeratosis (thick skin). This is when the skin becomes too thick and won't change with cream.  

·       It's part of the skin's normal protection against rubbing, pressure and other forms of irritation. Examples of hyperkaeratosis include corns, calluses and warts.

·       Activities that put repeated pressure on the foot, such as running or walking barefoot, can cause calluses to form.

·       Elderly people are at a higher risk, with reduced fatty tissue in their skin.

·       Other causes for feet that continue to be dry and cracked despite treatments may be Athlete's Foot, dermatitis, psoriasis, eczema or keratoderma - a marked thickening of the skin.         

·       Odour

·       'Smelly feet can be a sign of infection, the most common being athletes foot, which is caused by a fungus', says Dr Harper.

·       Symptoms of athletes foot include skin that is itching, stinging, blistering, cracking, or dry between your toes and on the soles of your feet.  

·       You can catch the fungus through direct contact with an infected person, or by touching surfaces contaminated with the fungus.

·       Fungi love warm sweaty environments', says Dr Harper. The fungus thrives in places such as swimming pool areas.

·       'If you are a sufferer, get into the habit of drying between each toe after showering and spend as much time bare foot as you can to allow the foot to dry out. 

·       'Change your socks every day and try to wear natural fibres rather than manmade. 

·       'Trainers in particular retain a lot of moisture so if you can, invest in a second pair and when you are not wearing them stuff your trainers with paper and leave in a warm dry place – an airing cupboard is perfect. 

·       'Your pharmacist will also be able to advise on creams and powders to treat the fungus.'

·       Athlete’s foot can be hard to cure if you have diabetes or a weakened immune system. 

 

Nov 1st 2018

Yes, you should have a flu jab

With thousands dying each year from the virus, getting vaccinated should be a no-brainer. So why is take-up still so low?

Renate Rothwell had not planned to have a flu jab. “I am 71, so I’m invited to have it at my GP surgery, but I ignored the invitation,” she says. “My feeling was that I didn’t need it. But then I went to see the doctor about something else, and he said I should have the jab.”

She did – and regretted it. “I was unwell for four days. It more or less wiped out the week. I’ve never had flu so I can’t compare it with having the illness itself, but I can’t remember ever being that ill. I felt nauseous, I felt weak, I couldn’t eat anything.”

She says that if she had known then what she knows now, she would have been firmer about not needing the jab: “I’m very healthy, I eat well, I go to the gym. I think they need to be more honest about the side-effects. If I’d known I could get that ill, I wouldn’t have had that jab.”

Yet while many people feel they are invincible, up to 17,000 people in the EU die annually from flu, which might be why healthcare workers have a high level of takeup. Last winter, 68.7% of frontline NHS staff received the vaccination, with some health trusts having vaccinated more than 90% of their staff.

This is partly because if they get flu they can pass it on to more vulnerable patients, but also, says Professor Anita Simonds, a consultant in respiratory medicine at the Royal Brompton hospital, because they have seen the worst that flu can do. “Every year, I see people who end up in the intensive care unit because of it. And people die: it’s one of the biggest causes of death.”

But some people still have questions. Will the vaccine work? Last year’s was not as effective as in previous years, so how do we know 2018’s will be any good? There is also the question Rothwell is asking: are you actually inviting an illness that, while it may not be as bad as flu itself, certainly isn’t much fun?

With the vaccination now widely available in chemists and even supermarkets for as little as £7, and with more people than ever offered it free on the NHS (to qualify you must be over 65 or between two and 10, or be pregnant, have a health condition such as asthma or diabetes, or be a carer), the direction of travel would seem to be towards increased takeup. However, research out this week from the European Commission has found more scepticism about the flu vaccine, especially from younger adults. While more than 85% of Britons still believe the vaccine is safe, less than 60% of French, Latvian and Austrian people do.

Public Health England is so busy that no one is available to talk about the flu jab, but it does supply some reassuring responses to my emailed questions. Yes, the flu vaccination for this year is “significantly improved”. No, you can’t get flu from the flu jab. Yes, people are warned about side-effects before they have the jab. And, yes: “Vaccine safety is of paramount importance and under constant review.”

There is a feeling that it is tired of dealing with these questions – yet the message does not seem to be getting through to the sceptics.

The response from the Medicines and Healthcare Products Regulatory Authority (MHRA) provides more detail on side-effects for the injected vaccine: “These typically include a mild fever, aching muscles, tiredness, injection-site reactions (such as a sore arm, swelling and redness) and headaches. These are usually mild and transient.” The nasal spray vaccine, which is the one given to children, “may commonly cause a runny or blocked nose, headache, tiredness and some loss of appetite”. It says that about one in 10 people having the jab can expect some kind of reaction.

So, is there anyone who shouldn’t have the vaccine? According to the MHRA, the only people who should not have it are those who have had a serious allergic reaction to a previous dose, and the nasal vaccine should not be given to anyone with severe asthma or a suppressed immune system.

Asked whether we should be concerned about becoming ill from the vaccine, it cites the public health argument: “Millions of people receive a flu vaccine across the UK every year, with tens of millions more globally. Every year, we hear anecdotes of the ‘vaccine being worse than flu’, and we also receive isolated reports of serious illnesses following vaccination. Such reports are always taken seriously and safety is kept under continual review. But, especially during winter, naturally occurring infections and illnesses can coincide with vaccination, and are a more likely explanation in these cases.”

So, what about Rothwell’s experience? Dr Jeremy Rossman, senior lecturer in virology at the University of Kent, says that, in view of the timing of her illness: “There’s a possibility of coincidence, but I think she probably did have a response to the vaccine.”

But what is important, he says, is a balance of risks. Vaccines are not risk-free. “There are low risks, but there are not no risks. People say they didn’t ‘need’ to get the vaccine, and then it made them feel bad. But what’s less easy to see is that you didn’t get the flu and you could have felt much worse, and it could have been a much more serious illness. Flu has far more serious risks than the vaccine.”

When it comes to public health, then, the flu vaccine, especially for those most at risk, is a no-brainer. At an individual level, however, you simply don’t know whether or not you would have got the disease – and you might get side-effects, although they probably will not be as bad as Rothwell’s. It is easy to be swayed by fears, says Rossman, when social media is swirling with stories of adverse reactions – and, of course, no one ever posts on Twitter to say they had their flu jab last week and it was a complete non-event.

In a straw poll of my household, the young, fit people (especially the males) don’t think they need to be vaccinated. But you don’t only try to escape flu for yourself, points out Simonds: there are also the people around you, who might catch it from you, or who would have to look after you if you were ill. And for freelance workers, a growing group, there is the risk of lost earnings.

Having spent the past few days reading up on the flu jab, I’m off to have mine.

 

Oct 31st 2018

WHY EVERYONE AROUND THE WORLD IS HAVING THE SAME NIGHTMARE

By Corinne Purtill

October 31, 2018

The first time Tim Brown saw the Hat Man, he was 14 years old and curled up in his bed in Nashville, Tennessee. He was dozing, with the only light in the room coming from the flicker of late-night television. As he drifted off to sleep, a sound from the television shook him back awake.And that’s when he saw him. The dark figure of a man, as featureless as the shadows where he stood. He was tall. He wore a broad-brimmed hat and a trench coat. He didn’t say a word. He didn’t need to. The fear sucked the breath from Brown’s chest, rendering him mute and immobile. The man lingered just outside the frame of Brown’s bedroom door, flickering in the shadows between the hallway and his grandmother’s room. Finally, as if breaking a spell cast over him, Brown threw himself from his bed screaming and ran into the hallway for a fight.But the man was gone.Still haunted by the vision more than a decade later, in 2008, Brown posted his story on a blog he called The Hat Man Project and encouraged others to share as well. (Quartz’s attempts to reach Brown for comment were unsuccessful.) He also scoured the internet, and found more posts on forums and blogs describing similar encounters.The global anthology of Hat Man stories has only grown since. The shape of the frightening figure occasionally varies, but the way he makes his victims feel never does: utterly paralyzed with terror, and breathless, as if fear had frozen them from the inside out.The Hat Man has been the subject of documentaries and seems to have inspired one of the more chilling ghosts in the Netflix horror show The Haunting of Hill House. Otherwise sober-minded people report having woken from their dreams to see the figure. Some dismiss him as a bad dream or a neurological quirk; others feel in his presence something much more sinister and otherworldly.But if the Hat Man is just a nightmare, how did the whole world start having the same bad dream at once?Shared nightmaresShelley Adler, a medical anthropologist at the University of California, San Francisco, had a similar question. Adler became interested in the cultural origins of nightmares after reading about the deaths of several ethnic Hmong refugees who emigrated to the US from Laos.In four years spanning the late 1970s and early 1980s, 18 seemingly healthy Hmong men living in the US perished suddenly in their sleep. Almost 100 more deaths followed in the next decade before tapering off.Doctors ascribed the deaths to a condition with the alarming name of “sudden unexpected/unexplained nocturnal death syndrome,” or SUNDS. In the years since, researchers have theorized that many SUNDS deaths are caused by Brugada syndrome, a genetic condition more common in people of Southeast Asian descent that causes irregular heartbeats and increases the risk of sudden death.But in the Philippines, Thailand, Laos, and other places where such deaths were slightly more common, SUNDS had a different name that often translated as some variation of “nightmare” or “nightmare death syndrome.”The name suggested that it was the dream itself that killed people, a sort of real-life version of Nightmare on Elm Street, the horror flick in which people murdered in their dreams by the blade-fingered Freddy Krueger died in real life, too.In an effort to understand Hmong interpretations of these deaths, Adler interviewed Hmong refugees living in Stockton, California. When asked about common nightmares, men and women described a figure called dab tsog (pronounced “da cho”), an evil spirit that visited sleepers at night, pressed upon their chests, and attempted to smother them as they slept. Almost all of the interviewees were familiar with dab tsog; 58% reported having been visited by the nightmare themselves.But the Hmong were hardly the first or the only people to have an oral record of such suffocating night-time visitors, as Adler describes in her book, Sleep Paralysis: Night-mares, Nocebos, and the Mind-body Connection.For about as long as written records have existed, people have described a frightening night-time vision that paralyzes them with fear and seems to suck the breath right out of them, often by pressing directly upon their chest. Tales of such evil spirits come from ancient Assyria and Greece. Among the Canadian Inuit, the word uqumangirniq described this awake-but-paralyzed feeling; in Japan, kanashibari. Folklore from Newfoundland describes an old hag who sits upon sufferers’ chests as they sleep.“The entity has stalked human beings throughout history, not merely within a particular society or during a specific time,” Adler wrote. The appearance of the figures that people saw in these frightening episodes, if they saw anything at all, varied across culture. But the fear was always the same.Sleep scienceUntil relatively recently, people who experienced these night frights had little choice but to ascribe them to culturally available explanations: demons, ghosts, spirits, indigestion, madness. But by the late 20th century, science offered a new explanation, one rooted in biology: sleep paralysis.People who wake in the night and feel paralyzed with terror aren’t crazy or imagining things. During the rapid eye movement (REM) stage of sleep, the muscles relax to the point where they become immobilized, probably to keep us from violently acting out our dreams when we sleep. This is also the stage of the most intense dreams. People who experience sleep paralysis have essentially woken up before they’ve stopped dreaming.It’s an incredibly common sleep problem. An estimated 8% of people experience it regularly, and some estimates have placed the number of people who have at least one experience of it in their lifetimes as high as 40%.Many who experience sleep paralysis also experience hypnagogic hallucinations: vivid images perceived in the transition from wakefulness to sleep, or the other way around. Spiders or insects crawling up the walls is a particularly common such vision, according to Alon Avidan, a professor of neurology at the University of California Los Angeles and director of the UCLA Sleep Disorders Center. So are human-shaped figures. These episodes are often accompanied by a profound sense of fear and anxiety, and a sense that something is trying to harm the sleeper.“What they’re seeing is very real to them, and they’re reacting to the image in a way that seems to be very similar across individuals, across cultures, and across geographies,” Avidan said.Stress, caffeine, and sleep deprivation can all make these episodes more frequent and intense, he said. Reports of such episodes from patients at the UCLA clinic—many of whom are university students—tend to spike during finals and midterms.The stuff that dreams are made ofSleep science can’t yet explain why the brain serves up the specific images it does in dreams, Avidan said—nor why multiple people across cultures might experience the same dream (or nightmare).We’re also not always conscious of the ways in which images in popular culture influence dreams and memories. Memory is a fluid and easily manipulated thing, and it’s not uncommon for people to have memories that feel entirely real, without being aware of the role that outside factors may have played in their creation.The fluidity of memory can lead to new cultural myths. In 1961, a US couple named Betty and Barney Hill arrived home from a road trip tired, disheveled, and unable to account for the previous few hours. Two years later, under hypnosis in a psychiatrist’s office, the couple reported that they’d been abducted by aliens during the journey—something never before reported, though it had recently been a plotline on the popular sci-fi television show The Outer Limits. Barney Hill described a bug-eyed creature that closely resembled the alien on that show.Media reports then publicized the Hills’ version. In the two years after NBC aired a 1975 TV movie about the couple’s experience, reports of alien abductions—a thing never recorded in human history before Betty and Barney Hill—rose 2,500%.At the time of their infamous drive, the Hills were stressed and sleep-deprived, both of which can contribute to false memory formation. By all contemporary accounts, they were upright citizens who truly believed that this abduction happened to them. They probably weren’t aware that the portrayal of extraterrestrials in popular culture might have influenced their own memories.When faced with the unknown, humans tend to reach for the closest culturally available explanation. If you can’t account for time and have long been interested in contact with aliens, as Betty Hill was, then an alien abduction might seem like a possible answer. If you wake up afraid and breathless at night, and you live in a society where more than half of the people you know have reported having an evil spirit sit upon their chests as they sleep, an evil spirit is a logical explanation for your own experience. The more people report such experiences, the easier they are to accept.In contemporary US society, Adler wrote, the primary disseminator of these experiences is the internet. “People who have night-mares outside of a cultural framework of understanding draw upon a contemporary narrative in interpreting their experiences—such as one derived from medicine or psychiatry (for example, heart disease or mental illness), religion (demons), or the paranormal (including alien abductions),” she wrote.Christopher French, a psychology professor at Goldsmiths, University of London, thinks something very similar is happening with sleep paralysis and the Hat Man. In sleep paralysis, “you’re in this weird kind of hybrid state, a mix of normal waking consciousness and dream consciousness. You know you can’t move. You can see that you’re in your bedroom. So it feels very, very real,” French said.“When I sat and thought about [the Hat Man], the thing that came to my mind was Freddy Krueger,” he continued. “This notion that you can be attacked when you’re asleep, that’s when you’re vulnerable. And of course, Krueger wears a hat.”The horror film Nightmare on Elm Street came out in 1984. In it, a terrifying man in a broad-brimmed hat attacks victims in their beds. Freddy Krueger’s distinctive silhouette become an iconic symbol of fear for a generation. It’s possible that Krueger has infiltrated some of our nightmares—and that by sharing our stories on the internet, we are creating the stuff of others’ nightmares too.

Oct 29th 2018

How to cure 'short-term' insomnia

Sometimes, life is hard and it makes falling asleep even harder. It might seem like there aren't enough sleep meditations, CBD tinctures, or weighted blankets to calm your mind and lull you to sleep each night, because you're that stressed. But does being unable to sleep mean you have insomnia, or could this just be a phase?

Technically, there is such a thing as short-term or "acute" insomnia, and it's defined as a brief period of difficulty sleeping, according to the National Sleep Foundation. Short-term insomnia can last for a matter of days or weeks, but usually is no longer than 30 days. Although it's short-lived, it can be pretty miserable.

Short-term insomnia can usually be traced to a stressful life event — whether that's receiving bad news about your job, learning that a family member is sick, coping with the aftermath of a natural disaster, or grieving the loss of a loved one. This stress can make it harder to fall or stay asleep, which leads to poorer sleep quality. As a result, you may feel tired and groggy during the day, or have difficulty focusing when you are awake, according to the National Institute of Health (NIH). And in some cases, insomnia can also lead to anxiety and depression — so it's a vicious cycle.

The good news is that short-term insomnia usually goes away without treatment, according to the National Sleep Foundation. Once whatever event or situation is keeping you awake at night passes or resolves, and you're feeling less anxious and stressed, it can make it easier to fall asleep each night. In the meantime if you find yourself tossing and turning, you might find that making simple lifestyle changes (like putting down your phone before bed) or getting a grip on your sleep hygiene (by setting consistent bedtimes) helps, too, according to the NIH.

One strategy that we know works wonderfully for treating acute and chronic insomnia is cognitive behavioral therapy (CBT), which is a type of psychotherapy. During CBT for insomnia, a therapist would help you re-frame the thoughts and worries you have that keep you awake — including the ones you have about your ability to fall asleep, according to the Mayo Clinic. It sounds so simple, but it works: a 2015 study found that just one session of CBT is sufficient for treating acute insomnia.

So, if you are in a rough patch of sleep and are getting more and more discouraged by your ability to snooze, perhaps it's important to remember that this — and all the stressful events keeping you up at night — too shall pass.

Oct 28th 2018

A man who received a stem cell transplant for multiple sclerosis can walk and dance again after suffering from the disease for a decade

A man from Gloucester, England, can walk and dance for the first time in 10 years after receiving a revolutionary stem cell transplant for his multiple sclerosis, CBS News reported on Wednesday.

Roy Palmer, a 49-year-old man who used a wheelchair, opted to undergo the treatment known as hematopoietic stem cell transplantation after watching a BBC program that showed the results of the treatment.

Palmer reportedly regained feeling in his legs two days after the procedure.

Hematopoietic stem cell transplantation, which uses stem cells to "reboot" the immune system, is still considered to be risky by the National Multiple Sclerosis Society. The treatment, which is reportedly still in its experimental stages and has not been approved by the Food and Drug Administration, may result in long-term side effects such as infections and infertility.

Multiple sclerosis is a disorder in which the bodily systems that are supposed to keep people healthy mistakenly attack the protective covering of nerves. This results in damage to the communication between the spinal cord and brain, according to Healthline.com. In severe cases like Palmer's, the disease can result in paralysis, vision loss, and lessened brain functions.

"They take the stem cells out of your body," Palmer said to the BBC. "They give you chemotherapy to kill the rest of your immune system."

There are about 2.3 million people living with multiple sclerosis around the world, Healthline reported. Researchers have yet to identify the cause of the disease.

 

Oct 27th 2018

Stay positive

One in 15 people in the UK suffers from Seasonal Affective Disorder (SAD), which is a form of depression that is most apparent in the winter. Although ongoing or severe symptoms of depression should always be discussed with your GP, maintaining a sunny outlook can go a long way in the darker months.

'Symptoms of SAD often begin when the clocks go back so take steps to mitigate against the changes, such as getting outdoors for some natural sunlight or buying a light therapy lamp,' says psychologist Dr Becky Spelman.

She also suggests giving your body a boost by adding supplements such as Berocca to your morning routine. 'This helps to help maintain your energy levels when they are most likely to be at their lowest,' adds Dr Spelman.

Oct 26th 2018

Induced Labour: 6 Things Expectant Mothers Need To Know About It

Almost one in three pregnant women in England now undergo induced labour, up from one in five a decade ago, according to new data released by NHS Digital. 

A total of 31.6 per cent of pregnant women had their labour induced in 2017/18, compared to 29.4 per cent in 2016/17. So what’s behind the rise and what do women need to know before choosing this option?

1. Induced Labour Is Offered For A Variety Of Reasons. 

Induced labour is offered to women who have passed their due date if they don’t go into labour naturally (or “spontaneously”, as it’s sometimes known) by the time they are 42 weeks pregnant. 

The increase in induced labours is thought to be linked to the rising average age of mothers, plus the increase in obesity and other underlying health conditions among pregnant women. Older mothers (aged 40+) are offered induced labour at 40 weeks, as are other women considered at risk of complications. 

“The average age of women giving birth is rising all the time,” Pat O’Brien, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecologists, told the BBC.

“They are also more likely to have pre-existing problems, such as type 2 diabetes and high blood pressure, which create complications. And with the rise in obesity, more women are likely to have bigger babies which leads to more inductions.”

2. There Are Different Methods Of Inducing Labour.

The first option for induction of labour is a “membrane sweep”, which is generally considered less invasive than other forms of labour. 

“Sweeping the membranes... involves a midwife inserting her finger into the cervix during an internal examination, and moving it in a circular action to separate the membranes of the amniotic sac from the cervix,” NCT explains.

“This helps to release natural prostaglandins which can initiate labour within a few days.”

If the sweep does not induce labour, a woman will be offered a pharmacological induction using synthetic hormones. In the first instance, these are given via a slow-release gel or tablet inserted into the vagina, but if this doesn’t induce labour a woman may receive an alternative dose or hormones via a drip. 

Once drugs have enabled the opening of the cervix, a doctor will ask if they can break the waters surrounding the baby. Other drugs can be used to stimulate contractions if needed.

3. Labour Can Happen At Different Speeds After Induction.

While some women may go into labour soon after, or hours after, a membrane sweep, for others it may take a couple of days. Occasionally, where induction does not kick-start labour, women may be offered a caesarean instead. 

4. It Can Reduce The Risk Of Still Birth (But The Figures Are Small).

There’s a higher risk of stillbirth or problems for the baby if a woman goes over 42 weeks pregnant and data shows instances of stillbirth are reduced if a woman has an induced labour after reaching 41 weeks, compared to when she decides to continue the pregnancy naturally.

However, the numbers for still birth occurrence are still very low for both.

The risk of a baby dying is between one and two in every 1,000 births (or 0.16 pre cent) if a woman continues with natural labour after 41 weeks, according to the NHS. In contrast, the risk of the baby dying is less than one in every 1,000 births (or 0.07 per cent) with an induced labour. 

Research has suggested inducing labour may be particularly effective in reducing stillbirth and neonatal deaths for women over the age of 35, for whom there is slightly higher risk than for the general population. 

A study of nearly 80,000 UK women, published in the journal PLOS Medicine, showed that inducing these women one to two weeks earlier (at 40 weeks) was linked to the risk of baby death falling from 26 per 10,000 pregnancies to eight per 10,000 pregnancies.

5. Induced Labour Can Be More Painful Than Spontaneous Labour.

NICE guidelines stipulate that women being offered induction of labour should be informed that induced labour is likely to be more painful than spontaneous labour.

Jessica Prime, who was induced two weeks past her due date, blogged about her experience of this on HuffPost UK, to counteract the “woeful lack of education for women around the realities of birth”.

“I was induced two weeks past my due date, and we would later find out that I was hypersensitive to the hormones used,” she explained. “This meant labour was very intense, with few breaks between contractions. I was in almost constant agony for hours. By the time it came to push, I was exhausted.”

6. You Always Have Choice.

Although it’s common for doctors to recommend induced labour if you’ve passed your due date, it’s entirely your choice whether to have your labour induced or not, and most women will go into labour without inducing by the time they are 42 weeks pregnant. 

Abi Wood, head of campaigns and communications at NCT, previously told HuffPost UK: “NICE guidance makes it clear that women’s decisions about whether or not to have an induction should be respected, and that the timing should take into account their preferences and circumstances.”

 

Oct 25th 2018

6 Easy Ways To Get Healthier That Have Nothing To Do With Exercise

Exercise is important, but there are other habits that you also need to practice if you want to have a healthier life.

When it comes to getting healthy, it’s not all about working up a sweat. In fact, there are tons of practical and beneficial habits you can work into your day-to-day that have nothing to do with hitting the gym or making rounds on the ClassPass circuit.

Some of these lifestyle adjustments involve eating more mindfully, which includes techniques like slowing down as you eat and paying attention to signals that let you know when you’re full. But getting enough sleep, reducing stress and cutting back on alcohol are all important too.

“Our environment, our habits and our mindset are almost just as important as what it is we are putting in our mouths. And we have to realize that,” said Lisa Young, a registered dietitian and adjunct professor of nutrition at New York University.

Here are some of our favorite tips for boosting your health that have nothing to do with burning calories, but are almost guaranteed to leave you feeling better:

1. Slow down at meal time.

These days, everything we do ― eating included ― tends to happen at hyper speed. And it’s simply not good for your health. Nutritionists advise slowing down and chewing each bite of food somewhere between 20 and 30 times, which makes it easier to digest and absorb. In fact, the more you break down the food in your mouth, the more you’re going to absorb in the intestine, said Kelly Johnston, a registered dietitian and health coach at Parsley Health.

For the sake of digestion, try setting aside a bit more time so you can eat your meals in a less hasty way, even if it’s not 20 to 30 chews per bite of food.

“I always say the first line of digestion is your mouth, and chewing is such an important part of that,” Johnston said. “The less work you do in your mouth, the more work you have to do in your stomach and intestine, which can cause bloating downstream, constipation and just more work for the intestine.”

Eating at a slower pace also gives you more time to register fullness, which can lower your chances of overeating.

“Challenge yourself to take at least 15 to 20 minutes to finish a meal, because that is how long it takes for your gut to tell your brain it’s full,” said Tracy Lockwood Beckerman, a registered dietitian in New York City.

2. Limit your distractions while eating.

Despite the fact thatmore than half of Americans eat lunch at their desks each day, nutritionists say this isn’t the best choice for your health. For one, the body has trouble prioritizing digestion when you’re stressed.  

“The uptick of the stress hormone cortisol may cause nutrients to become poorly digested and disrupt the normal digestion process,” Beckerman said.

We get it though: Sometimes you have no option other than to work through lunch. In these situations, Young suggested planning exactly what you’re going to eat. This can help you avoid overeating, which seems to happen way too easily when you’re focused on your screen rather than the food you’re putting in your mouth.

“The problem when you eat mindlessly is that you don’t even realize that you’ve eaten,” Young said.

3. Eat whole rather than processed foods.

Ultra-processed foods are often high in sodium and added sugars and come with long lists of ingredients, many of which do little in terms of benefiting your overall health. Making a real effort to swap processed for whole foods is a great way to get healthier. Consider focusing on foods that exist in nature like vegetables, fruits, nuts, seeds, healthy fats and high-quality proteins like beans, fish and meat.

“Processed foods have fillers, stabilizers and thickeners that can disrupt your body’s ability to soak in essential vitamins and nutrients from real foods,” Beckerman said. “You’ll be able to deliver and maximize the purest forms of nutrients to your body when you can eat whole foods.”

4. Get enough sleep.

When you’re trying to squeeze in time for everything possible in life ― work, social commitments, family, exercise, cooking healthy meals and more ― maintaining a healthy sleep schedule is often pushed aside. But getting enough sleep probably deserves a higher spot on your list of priorities. After all, this is the time of day where your body relaxes and repairs.

The exact amount of sleep varies from person to person, but somewhere around seven to eight hours a night is a good target, Johnston said. You surely know this from experience, but when you don’t get enough sleep, your body struggles the next day.

“Research shows that if you don’t get enough sleep, you automatically usually have an elevated blood sugar the following day because you haven’t metabolized well,” Johnston said.

Meanwhile, sleep deprivation disrupts the balance of the body’s hunger and satiety hormones, which can lead you toward that bottomless-pit feeling where you eat and eat but don’t feel full, Beckerman explained. Not getting enough sleep also leads to low levels ofleptin, a hormone that helps regulate the body’s energy balance by inhibiting hunger. The result? Increased cravings of sugary and sweet foods, Beckerman said.

5. Find a way to let go of stress.

Some stress is good for you, especially the type that appears when you’re excited. Butchronic stress, the kind that feels inescapable, can have a ton of negative effects on the body, from depression and anxiety to gastrointestinal problems and cardiovascular disease. For the sake of your health, it’s important to find a stress-relieving habit you can turn to regularly to balance the daily demands that drain you.

For some, this release can have to do with exercise, like going for a walk or going to a yoga class. For others, it might mean journaling, meditating or talking to a close friend. Really, the method is up to you as long as you take some time to yourself to let some of the stress fade away.

“Just recharging your battery is so important,” Johnston said.

6. Cut back on alcohol.

Besides contributing to those dreaded hangovers, drinking more than the recommended amount (up to one drink a day for women and two for men) can increase your risk ofcancer and high blood pressure, as well as contribute to poor sleep, overeating, impaired cognitive function evenafter the alcohol leaves your system andearlier signs of aging, like wrinkles and broken blood vessels.

Many types of alcohol are also super sugary, which can lead to weight gain and problems with blood sugar levels. Additionally, alcohol and sugar can both negatively impact “the health of our gut and our microbiome,” Johnston said.

Alcohol also impairs the efficacy of the hormone leptin, which as mentioned earlier, plays a role in keeping you full.  

“This imbalance influences our powerful brains towards convincing us that we want more carbohydrate heavy and greasy meals,” Beckerman said. So, while there’s usually nothing wrong with a drink here and there, it’s best to keep it to a minimum.

 

Oct23rd 2018

Why we need to talk about mental health in the workplace

For many people experiencing mental health difficulties, fear of the stigma associated with conditions can affect how they relate to others. This fear is not just limited to social interactions, it can affect all aspects of life, including the workplace.

At work, the potential reactions of both colleagues and employers may make those struggling with a mental health condition feel unable to be open about their experiences. This is not a small problem, it is claimed that 95 per cent of employees calling in sick with stress give a different reason for needing time off.

There have been some moves to tackle the problem in the UK, however. Mental health discrimination initiative Time to Change has formulated an employer pledge, through which companies can demonstrate their “commitment to change how we think and act about mental health in the workplace, and make sure that employees who are facing these problems feel supported”.

At the time of writing, 865 organisations have made the pledge. It’s encouraging to see so many companies taking the issue seriously – but this pledge does not go far enough. In seeking to challenge the stigma in the workplace, it is easy to think that creating an atmosphere which encourages openly talking about mental health will help to address the issue. It means employees would be free to talk about their experiences without fear of being judged. For those who had felt that they had to keep their experiences secret this might seem like a new and valuable freedom. But things might not be so simple.

Being yourself

In the 1970s, the French philosopher Michel Foucault wrote, “one has to have an inverted image of power to believe that all those voices … repeating the formidable injunction to tell what one is and what one does … are speaking to us of freedom”. Foucault was writing about the Christian confessional rather than about chatting to office colleagues at the coffee machine, yet his point is still relevant.

Foucault points out that we may often think that the ability to express who we are is a way of expressing our freedom from power. However, for him, it is important to recognise that describing yourself as a person who thinks or feels certain things means that you become identified as a certain kind of person. This actually means being subject to a certain kind of power. In other words, when a person talks about their mental health in the workplace there is a danger that they can become tied – and possibly reduced – to it.

If an employee approaches a line manager or member of the HR team and explains that they have recently been experiencing low moods, there are two ways of seeing this. One is that the person is having a difficult time, but that this is understandable given recent events – maybe they’ve broken up with their partner or a loved one has died.

Another way is to think that the person is naturally inclined to feel this way. This could involve beliefs about their genetic history, or the idea that they have a depressive personality. The difference between these two versions of events is between understanding the story as an experience the person has, and something the person is.

You are not your mental health

It may not be obvious why this distinction matters, or why it might be a problem. After all, in both cases the person is seeking help and can expect support from their organisation. The problem with understanding mental health as part of who we are is that it puts us in danger of ignoring the way in which our environment has a large effect on our mental health.

Suppose that an employee tells their line manager they are feeling stressed in work and finding it difficult to cope. One way to respond is based upon the belief that this person is someone who naturally gets stressed. In this case we might offer them support, possibly access to an employee assistance programme. The other way would be to look at other factors, for example the person’s workload. Maybe unreasonable demands are being made and they are being asked to do too much. Perhaps what they are expected to do would make anyone stressed.

While the aim of destigmatising mental health in the workplace is admirable, we must consider what this entails. We need to understand the important role that our day-to-day experiences – including experiences of work – have in shaping our mental health. Unless we appreciate the effect of these experiences we will simply be finding ways for people to cope rather than helping them in a meaningful way.

Oct 22nd 2018

Wean babies 'sooner to prevent allergy epidemic'

We could be creating a food allergy epidemic because we are not weaning babies on to allergens sooner, according to a leading paediatric allergy specialist.

Public Health England's advice urges the introduction of peanuts and other allergens from around six months but Gideon Lack, professor of paediatric allergy at King's College London, says that could be two months too late.

"Food allergy is a growing issue, it has become a big issue, I would say to use the word 'epidemic' would not be inappropriate."

Each year, 64,000 new cases emerge of children with food allergies.

From peanuts to cheese, the issue is growing. Two per cent of babies born in the UK will have a serious peanut allergy by the age of three, and nearly one in 10 will be vulnerable to an anaphylactic food allergy.

Professor Lack is advocating for a strategy he believes reduces these figures. In a 2015 study, he urged health policies to consider weaning babies on to allergen foods from four months.

"Six months is certainly too late for egg allergy - the majority of which develops between four and six months of age," he said.

"If we are to prevent an egg allergy and a substantial proportion of peanut allergy, we need to intervene earlier."

New national health guidelines in North America advocate peanut be considered as early as four months in high risk children with severe eczema. Australia and some European countries have also adopted the strategy.

Callum Newman, seven, suffers from 28 food allergies - eight of them anaphylactic.

His mother Nathalie said she is so vigilant over which foods are safe for her son that her investigative skills would put the FBI to shame.

She said: "All labels need to be checked, in case manufacturing methods change.

"And when eating out, making sure the right questions are asked to ensure food is safe and cross contamination isn't a problem."

The recent case of Natasha Ednan-Laperouse, 15, who died from an allergic reaction after eating a Pret a Manger sandwich on a flight, highlighted the terrible consequences of eating the wrong thing.

Some food allergies are there to stay for life and any of them can cause life-threatening reactions, or even very unfortunately in some cases fatalities due to anaphylaxis," said Prof Lack.

"This is a very big burden of disease and a serious burden on the population."

Oct 19th 2018

'Mad cow disease' at Aberdeenshire farm after BSE confirmed

A case of BSE - so-called mad cow disease - has been confirmed at a farm in Aberdeenshire.

BBC Scotland understands the "isolated" case involves a beef herd in the Huntly area.

Rural Economy Secretary Fergus Ewing said a movement ban was now in place on the unnamed farm.

Investigations are under way to identify the origin of the disease - the first in Scotland in a decade - which was found after an animal died.

§  What you need to know about BSE

The case involving a five-year-old animal was identified before entering the human food chain.

Four others from the herd were being destroyed as a precaution.

There are understood to have been 16 cases in the UK since 2011, with the last in 2015 when farming officials confirmed a case of BSE in Carmarthenshire, Wales.

That was discovered following routine tests carried out when a farm animal dies.

The monitoring of BSE has been an important function since the crisis of 1986 when 180,000 cattle were infected and 4.4 million slaughtered in order to eradicate the disease in the UK.

Bovine spongiform encephalopathy (BSE) is a brain disorder in cattle that can be transmitted to humans who eat infected meat.

Mad cow disease - as it is more commonly known, because of the animals' erratic behaviour and movements - destroys their brains by eating away the nerve tissue.

§  The first recorded case in the UK was in 1986.

§  About 180,000 cattle were infected and 4.4 million slaughtered in order to eradicate the disease.

There was nationwide alarm following the confirmation of the first deaths caused by transmission of BSE to humans in 1996. At the time there were fears that hundreds of thousands of people might die as a result of eating infected beef.

As it turned out 178 people have died of the human form of mad cow disease, known as Variant Creutzfeldt-Jacob disease (CJD). It is believed that these individuals were genetically more sensitive to succumbing to the disease than the wider population.

Since then, cattle are closely monitored for signs of the disease and it seems that, in this instance, the surveillance system has worked well.

The cause is not known at this stage. But if it is an isolated case there is very little if any risk to human health.

According to Prof Matthew Baylis, Chair of Veterinary Epidemiology at the University of Liverpool, "BSE in cattle in the UK is largely over but there is still the odd detected case - one in 2014, two in 2015 and now one in 2018. It is too early to say if this case is significant".

On the Aberdeenshire case, Scotland's Chief Veterinary Officer Sheila Voas said: "I would urge any farmer who has concerns to seek veterinary advice."

She added: "While it is too early to tell where the disease came from in this case, its detection is proof that our surveillance system is doing its job.

"We are working closely with the Animal and Plant Health Agency to answer this question."

Andrew McCornick, president of NFU Scotland, said: "It is disappointing to learn of this BSE case within the Aberdeenshire area."

He added: "Whilst we lose our negligible risk status, it is not unexpected to see a new case and demonstrates the efficacy of the surveillance measures in place. This simply brings us back in line with the rest of Great Britain, reverting back to where we were 18 months ago.

"When Scotland applied for BSE negligible risk status it was with the full knowledge that there was every possibility of a sporadic case of BSE emerging as has been the case in France and Ireland."

Ian McWatt, director of operations in Food Standards Scotland, said that there were strict rules in place to protect consumers from the risk of BSE, including controls on animal feed.

What has changed since the BSE crisis?By Kevin Keane, BBC Scotland environment and rural affairs correspondent

Although the BSE case in Scotland is significant, the industry is genuinely not concerned about any immediate impact. Movement restrictions only apply to the farm identified.

Unlike in the 1980s and 90s, the disease is more clearly understood. There have long been cases of BSE and there will continue to be so. But the practice of feeding infected meat and bonemeal back to the cattle was what led to the rapid acceleration in numbers which became the crisis.

Some of the most recent cases are a legacy of that - the offspring of older cattle. But the Aberdeenshire case is in a five-year-old animal and so it is likely that it was just predisposed to the condition.

A lot has changed since the BSE crisis. Brain and spinal cord no longer enter the food chain and there's a more rigorous process for monitoring. So the risk to human health is virtually nil. And it is not a condition that can be passed from animal to animal, other than through birth.

The biggest concern is in international confidence. BSE has long been a barrier to exporting beef as other countries did not want anything to do with nations where there had been cases.

It has been a decade since the last case in Scotland. A country is classed as 'negligible risk' 11 years after the birth of the last known case and that status was achieved in 2016. This latest case takes them back a step but only to the same level as the rest of the UK.

But with Brexit on the horizon - and wider trade deals being a big part of that - there are fears that this will be a barrier to entering new markets.

 

Oct 18th 2018

Health Secretary urges businesses to use standing desks

Employers should give workers standing desks and get staff on their feet for meetings, the health secretary has said.

Matt Hancock called on businesses to help employees to build activity into their days, in a bid to counter deadly sedentary lifestyles.

The health secretary said he uses a standing desk - finding it boosted his increased his activity levels, and boosted productivity.

Research has found that sitting for eight hours a day could increase the risk of premature death by up to 60 per cent.

Mr Hancock urged companies to offer stand-sit desks, and to avoid too many seated meetings, to ensure workers spend more of the day on the move.

Speaking after a two-and-a-half hour cabinet meeting to discuss Brexit negotiations, the minister said such measures had multiple benefits - not only to health.

“Workplaces can make a difference; encouraging breaks, offering standing desks, having standing meetings - which in my experience tend to finish quicker too,” he told a global conference on physical activity.

“I know from personal experience that having a standing desk can help you get some exercise and improve your productivity at work,” he later added.

Standing desks have been found to burn around 50 calories extra an hour.

This means three hours standing daily could result burn around 30,000 extra calories - typically, resulting in around 8lbs weightloss.

Research has found that sitting for eight hours a day could increase the risk of premature death by up to 60 per cent.

The Health Secretary also urged GPs, schools and parents to do more to encourage physical activity, describing it as a “miracle cure” which cuts the risk of a host of illnesses.

“Doctors should not be afraid to tell patients that they need to be more active,” he told the London summit. “Our message should be that movement is medicine.”

Under NHS targets, some hospital trusts are able to receive extra funding by introducing measures to boost staff fitness.

One trust was last year found to have introduced targets which meant they could receive extra funds if staff stand up - for at least two minutes - in any meetings lasting at least one hour.

Oct 16th 2018

Medicinal cannabis should be available for all NHS patients, campaigners say

Medical cannabis should be made available for all NHS patients, campaigners have said, amid expectations it will only be prescribed to help treat three conditions.

The Telegraph understands formal NHS England guidelines, due to be released before November 1, will advise specialist doctors on prescribing cannabis for epilepsy, chronic pain and nausea caused by chemotherapy.

Although new legislation technically allows cannabis to be taken for any condition, doctors are expected to strictly follow the guidelines, meaning they are unlikely to prescribe it for conditions other than those listed.

Campaigners have urged for the drug to be accessed by all patients and pointed to the thousands of people taking cannabis oil illegally for a variety of other conditions.

Patients using the oil for cancer symptoms, Parkinson’s disease, and PTSD must wait until full prescription guidelines are published in October 2019 to see if GPs will prescribe for their conditions.

The full guidelines are expected to give the UK some of the most liberal medicinal cannabis laws in the world.

In the meantime, users could be prosecuted for using cannabis oil or growing their own plants for medicinal use, campaigners said.

Jon Liebling, Political Director of the United Patient Alliance, said: “We do believe that everybody should have access. 

"When you're talking about cannabis as a medicine, you really do have to compare the risks associated with cannabis that we're aware of versus the risks of those drugs that patients are already taking.”

Q&A | CBD and cannabis oilWhat is CBD oil?

Cannabidiol, or CBD, is one of more than 80 cannabinoids, natural compounds found in the marijuana plant. It is extracted from the plant via steam distillation and usually bottled with a dropper. Unlike THC, Tetrahydrocannabinol – the most abundant cannabinoid, CBD does not have an intoxicating effect.

What does it do?

Most studies of CBD’s effects are preclinical, but is been shown useful in treating social anxiety and lessening episodes of schizophrenia. The most complete research on the benefits of CBD is on treatment of childhood epilepsy and a plant-based medicine, Epidiolex is scheduled for FDA approval in the US.

Another cannabis-based drug, Sativex, is already approved to relive the pain of muscle spasms in people suffering from multiple sclerosis. Clinical trials are also underway to test this category of drugs for cancer pain, glaucoma and appetite loss in people with HIV or AIDS.

Is it legal?

A low-concentration CBD oil is available in UK pharmacies as a health supplement. Campaigners have called for a high-concentration oil to also be made legal here. In December 2016, the government’s Medicines and Healthcare Products Regulatory Agency ruled that “products containing CBD used for medical purposes are a medicine”.

Read more from the NHS on Cannabis: the facts

Patrick O’Hara, 63, who imports cannabis oil for his daughter Caroline, who has a brain tumour, said that a doctor told him discreetly where to buy the drug online but could not formally recommend its use.

He imports the oil from Canada at a cost of around £1,000 per month, and has written to the Home Secretary asking for cannabis to be available to cancer patients on the NHS.

He said: "There’s a groundswell of opinion among the medical staff, that this is something people should consider doing.”

A spokesman for the Department of Health said that the new law will not limit the types of treatment for which cannabis can be prescribed.

 

Oct 14th 2018

Plantar Fasciitis: Causes, Symptoms & Treatment

If the first few steps you take in the morning are painful, you might be experiencing plantar fasciitis. It's one of the most common causes of foot pain, with 2 million to 3 million patients seeking medical treatment each year, said Dr. Michael Greaser, an orthopedic surgeon and assistant professor at McGovern Medical School at The University of Texas Health Science Center at Houston. Many of the patients typically seek treatment after having months or years of heel pain. There are most likely many others who have plantar fasciitis that never seek treatment.

The stabbing pain that is felt is caused by inflammation of a band of tissue known as the plantar fascia that connects the heel bone to the toes. The pain is normally localized near the heel but can be felt anywhere along the plantar fascia ligament, according to Dr. Dominic Catanese, professor and chief of podiatric surgery at Montefiore Medical Center at Albert Einstein College of Medicine in New York.

The pain tends to beworse first thing in the morning and after long periods of sitting or standing. When there is no weight put on the foot, the ligament shortens and tightens, Catanese said. Then when the patient stands, the sudden stretching of the plantar fascia with the added weight may result in pain. Usually the pain subsides after a few minutes of walking and stretching.

Causes and diagnosis

There are many reasons why one might develop plantar fasciitis, according to the American Orthopedic Foot & Ankle Society. Some of these factors include being overweight, being on your feet for extended periods and wearing shoes with inadequate support. In addition, impact exercises such as running, tight calf muscles that limit ankle mobility, flat feet or high arches, excessive pronation (when the foot rolls severely inward when walking) or wearing high heels on a regular basis can be aggravating factors.

Heel spurs are commonly thought to cause plantar fasciitis, but the opposite is more likely to be true, Greaser said. A heel spur is the bony outgrowth on the edge of the heel that's often the result plantar fasciitis, but it's rarely the cause of heel pain.

Treatment options

To diagnose plantar fasciitis, a doctor will question the patient about their pain and examine the foot, including looking for areas of tenderness, the height of the arch and ankle mobility, according to the American Academy of Orthopedic Surgeons (AAOS).

Imaging tests such as X-rays or MRIs may also be used to rule out other potential causes of foot pain, such as fractures or arthritis.

According to Catanese, there are three main ways to treat plantar fasciitis: stretching the plantar fascia and the muscle group in the back of the leg, using good quality and supportive shoes or orthotics, and reducing inflammation. More than 90 percent of people with plantar fasciitis experience a significant reduction in pain after less than a year of treatment.

Stretching is the single most important thing to do to eliminate and prevent pain, Catanese told Live Science. According to AAOS, two of the most important stretches are for the calves (place one leg in front of the other with the front leg bent, both heels on the ground, and lean into the wall) and the plantar fascia (from a seated positing, cross the foot with plantar fasciitis over the knee of your opposite leg and carefully stretch the toes towards your body). Doctors recommend taking a break from high-impact exercises like running and switching to low-impact exercises like swimming or yoga.

Over-the-counter anti-inflammatory medications such as ibuprofen or a steroid injection are other ways to reduce the inflammation and associated pain. Ice and massage are also used to reduce inflammation.

Another option is to use splints at night to stretch the plantar fascia while sleeping. Physical therapy and extracorporeal shock wave therapy, which sends high-energy pulses to stimulate the plantar fascia, may also promote healing.

If none of those options improve plantar fasciitis, more invasive options are available. Common surgical options include removing scar tissue around the plantar fascia, partially removing the plantar fascia from the heel, or surgically lengthening the calf muscles.

Don't ignore it

If plantar fasciitis remains untreated, chronic heel pain can develop with irreversible consequences, including scarring and thickening of the plantar fascia at its origin in the heel, Greaser said. The ligament could also become partially or completely ruptured if a person with plantar fasciitis continues their high-impact activities.

Some cases of chronic heel pain have also been found to develop into distal tarsal tunnel syndrome, similar to carpal tunnel syndrome in the wrists, where the nerves running along the bottom of the foot can become entrapped. According to Johns Hopkins Medicine, symptoms can include shooting pain, a tingling or burning sensation, or numbness.

The feet are relatively small body parts that experience significant pressure and stress on a daily basis for most people, according to the Institute for Preventive Foot Health. For that reason, it's important to make sure your feet stay healthy and be aware of the symptoms of foot conditions such as plantar fasciitis.

 

Oct 12th 2018

More Cases of Rare 'Polio-Like' Illness Pop Up Around the US

More and more cases of a rare polio-like illness are being reported across the country, according to news reports.

In recent weeks, six cases of the illness, known as acute flaccid myelitis(AFM), have been diagnosed in children in Minnesota — a state the typically sees less than one case of AFM per year, according to the Minnesota Department of Health. On Tuesday (Oct. 9), a hospital in Pittsburgh said it is currently treating three children with suspected AFM, according to local news outlet KDKA. And yesterday (Oct. 10), the Illinois Department of Public Health said it had received recent reports of nine children diagnosed with the condition.

Also this week, the Colorado Department of Public Health and Environment announced that 14 cases of AFM have occurred in the state this year.

AFM is a condition that affects the nervous system and causes muscle weakness, according to the Center for Disease Control and Prevention (CDC). In particular, the condition can cause weakness in the arms and legs along with loss of muscle tone and problems with reflexes. Other symptoms include facial drooping, difficulty moving the eyes, difficulty swallowing and slurred speech, the CDC says. Most cases are in children.

The condition is not new, but officials started to see a rise in cases in 2014. Since then, more than 350 cases of the illness have been reported in the U.S. over a four-year period. So far this year, there have been 38 cases in 16 states, the CDC says.

The cause of AFM, and the reason for the rise in cases starting in 2014, is not known. However, the 2014 cases coincided with a national outbreak of a respiratory illness caused by a virus called enterovirus D68. It's possible that AFM has a variety of causes, including viruses (such as poliovirus and enteroviruses), environmental toxins and genetic disorders, the CDC says.

The condition is still very rare, occurring in fewer than one in a million people in the U.S. each year, the CDC says.

 

Oct 11th 2018

·       Irregular heartbeat may increase a person’s risk of developing dementia Those with atrial fibrillation experience a faster decline in memory skills

·       Having an out of sync heart may cause blood to pool in the vital organ

·       This may then lead to clots that could travel to the brain, leading to stroke  

·       An irregular heartbeat may increase a person's risk of developing dementia, warns new research.

·       The study shows that people with a particular kind of irregular heartbeat called atrial fibrillation may experience a faster decline in thinking and memory skills, and have a greater risk of dementia than those without the condition.

·       With atrial fibrillation, a form of arrhythmia, the heart's normal rhythm is out of sync.

·       As a result, blood may pool in the heart, possibly forming clots that may go to the brain, causing a stroke.

·       The good news from the study is that people with atrial fibrillation who were taking anticoagulants, or blood thinners, to keep their blood from clotting were actually less likely to develop dementia than those who did not take blood thinners.

·       Study author Dr Chengxuan Qiu, of the Karolinska Institute and Stockholm University in Sweden, said: 'Compromised blood flow caused by atrial fibrillation may affect the brain in a number of ways.

·       'We know as people age, the chance of developing atrial fibrillation increases, as does the chance of developing dementia.

·       'Our research showed a clear link between the two and found that taking blood thinners may actually decrease the risk of dementia.'

·       For the study, researchers looked at figures from 2,685 participants with an average age of 73 who were followed as part of a larger study.

·       The participants were examined and interviewed at the start of the study, and then once after six years for those younger than 78 and once every three years for those 78 and older.

·       All the participants were free of dementia at the start of the study, but 243 people (nine per cent) had atrial fibrillation.

·       Through face-to-face interviews and medical examinations, the researchers gathered lifestyle and medical data at the start of the study and during each follow-up visit.

·       All were screened for atrial fibrillation, for overall thinking and memory skills, as well as dementia.

·       Over the course of the study, an additional 279 people (11 per cent) developed atrial fibrillation and 399 (15 per cent) developed dementia.

·       Researchers found that those who had atrial fibrillation had a faster rate of decline in thinking and memory skills than those without the condition and were 40 per cent more likely to develop dementia.

·       Of the 2,163 people who didn't have irregular heartbeat, 278 people developed dementia (10 per cent). Of the 522 people with irregular heartbeat, 121 developed dementia (23 per cent).

·       Researchers also found that people who took blood thinners for atrial fibrillation had a 60 per cent decreased risk of dementia.

·       Of the 342 people who did not take blood thinners for the condition, 76 people developed dementia (22 per cent). Of the 128 people taking blood thinners, 14 developed dementia (11 per cent).

·       There was no decreased risk among people who took an antiplatelet treatment like aspirin.

·       Dr Qiu added: 'Assuming that there was a cause-and-effect relationship between using blood thinners and the reduced risk of dementia, we estimated that about 54 per cent of the dementia cases would have been hypothetically prevented if all of the people with atrial fibrillation had been taking blood thinners.

·       'Additional efforts should be made to increase the use of blood thinners among older people with atrial fibrillation.'

·       The findings were published online by the journal Neurology.

Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate.

A normal heart rate should be regular and between 60 and 100 beats a minute when you're resting.

You can measure your heart rate by feeling the pulse in your neck or wrist.

In atrial fibrillation, the heart rate is irregular and can sometimes be very fast. In some cases, it can be considerably higher than 100 beats a minute.

This can cause problems including dizziness, shortness of breath and tiredness.

Atrial fibrillation is the most common heart rhythm disturbance, affecting around 1 million people in the UK.

It can affect adults of any age, but it's more common in older people. It affects about 7 in 100 people aged over 65.

You may be aware of noticeable heart palpitations, where your heart feels like it's pounding, fluttering or beating irregularly, often for a few seconds or, in some cases, a few minutes.

You should make an appointment to see your GP if:

·       you notice a sudden change in your heartbeat

·       your heart rate is consistently lower than 60 or above 100 (particularly if you're experiencing other symptoms of atrial fibrillation, such as dizziness and shortness of breath)

·       See your GP as soon as possible if you have chest pain.

 

Oct 10th 2018

How phantom smells can ruin lives

Have you ever smelled odours other people can’t smell? If you have, you may have experienced phantosmia – the medical name for a smell hallucination.

Phantosmia odours are often foul; some people smell faeces or sewage, others describe smelling smoke or chemicals. These episodes can be sparked by a loud noise or change in the flow of air entering your nostrils.

Spookily, some people seem to have a premonition that they are going to happen. The first time they occur, the phantom smell can linger for a few minutes, and the episodes may repeat daily, weekly or monthly for up to a year.

Since our sense of smell dominates the flavour of food in our mouth, any food consumed during a phantosmic episode will be tainted with the properties of the phantom odour. It is easy to see how these symptoms can severely affect a person’s quality of life. In extreme cases, it can even induce suicidal thoughts.

People with phantosmia often also report a closely related condition known as “parosmia”. This is where an actual smell is perceived as something quite different, such as the smell of a rose being perceived as cinnamon, although it is more often perceived as something unpleasant.

Both phantosmia and parosmia are known as “qualitative olfactory disorders” in that it is the perceived quality of the odour that has changed. In contrast, quantitative disorders are where the strength of the odour has changed and include conditions such as anosmia (loss of sense of smell) and hyperosmia (enhanced sense of smell to an abnormal level). Quantitative conditions can be measured using an objective standardised test.

It is rare for someone to experience phantosmia without some other existing quantitative condition, such as anosmia. And, interestingly, phantosmias often occur in the nostril with the least sense of smell.

Usually, the first experience of phantosmia happens between 15 and 30 years of age with females more likely to be affected. It has been found in a number of different patient populations, including those with depression, migraine, epilepsy and schizophrenia.

Rates for phantosmia vary widely – from 0.8 to 25 per cent – being much higher for those people with existing olfactory conditions.

We don’t know what causes phantosmia, but it is thought to originate either from the central brain areas, including those that control emotion, or the peripheral areas more related to smell function, such as those areas involved in detecting odours.

Some people find that administering saline drops to the nose can alleviate phantosmia, as can drugs used to treat existing neurological conditions, such as antidepressants and anti-epileptic medication. In extreme situations, and only after extensive medical consultation, some patients have the offending olfactory bulb (we have one for each nostril – see illustration above) removed by surgery, but this is a very risky procedure and would lead to permanent loss of smell for that nostril. Fortunately, though, phantosmia usually resolves on its own without the need for treatment.

If you start to smell odours that others can’t, you might wish to consult your GP, if only to rule out serious underlying disorders that may be causing the phantom smell. But just remember that in the vast majority of cases, phantosmia is a harmless condition rather than a sign of a serious underlying condition.

Oct 9th 2018

Unlocking the World of Sound for Deaf Children

‘My mother practically cried when I heard a cricket chirping in the house,’ says a woman who got a cochlear implant at age 11.

Jane R. Madell, a pediatric audiology consultant and speech-language pathologist in Brooklyn, N.Y., wants every parent with a child who is born hearing-impaired to know that it is now possible for nearly all children with severe hearing loss to learn to listen and speak as if their hearing were completely normal.

“Children identified with hearing loss at birth and fitted with technology in the first weeks of life blend in so well with everyone else that people don’t realize there are so many deaf children,” she told me.

With the appropriate hearing device and auditory training for children and their caregivers during the preschool years, even those born deaf “will have the ability to learn with their peers when they start school,” Dr. Madell said. “Eighty-five percent of such children are successfully mainstreamed. Parents need to know that listening and spoken language is a possibility for their children.”

Determined to get this message out to all who learn their children lack normal hearing, Dr. Madell and Irene Taylor Brodsky produced a documentary, “The Listening Project,” to demonstrate the enormous help available through modern hearing assists and auditory training.

Among the “stars” in the film, all of whom grew up deaf or severely hearing-impaired, are Dr. Elizabeth Bonagura, an obstetrician-gynecologist and surgeon; Jake Spinowitz, a musician; Joanna Lippert, a medical social worker, and Amy Pollick, a psychologist. All started out with hearing aids that helped them learn to speak and understand spoken language.

But now all have cochlear implants that, as Ms. Lippert put it, “really revolutionized my world” when, at age 11, she became the first preteen to get a cochlear implant at New York University Medical Center.

“Suddenly when I was playing soccer, I could hear what my teammates were saying,” Ms. Lippert, now 33, recalled. “My mother practically cried when I heard a cricket chirping in the house. I couldn’t talk on the phone before. Now in my job at the Veteran’s Affairs Hospital in Manhattan, I’m on the phone all day long. The implant has been a wonderful gift.”

Ms. Pollick, 43 and deaf since birth, lives in Washington, D.C., with her husband and two young children, all with normal hearing. Her deaf parents, determined that she learn to speak, got her a hearing aid at 6 months along with years of auditory therapy. A graduate of New York’s prestigious Stuyvesant High School and Wesleyan University, Ms. Pollick was in graduate school researching primate vocalizations when she got a cochlear implant.

She told me, “The earlier you get the implant, the more successful it is because the more auditory input the brain gets at an early age, the better the auditory skills you will develop.”

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Dr. Bonagura, 34, who lives in Alameda, Calif., didn’t get a cochlear implant until she was 22. She said it made medical school a lot easier and enabled her to work in obstetrics, a field that involves emergencies, loud operating rooms and the use of face masks that make lip reading impossible.

“No other field of medicine compares to the joy of delivering babies,” she said.

Mr. Spinowitz, a 27-year-old guitarist living in San Francisco, was born with profound hearing loss and used hearing aids until age 15 when suddenly they no longer worked because there was nothing to amplify — he had lost all residual hearing.

Once he got his implant, he said, “I began listening to music — all kinds of music — trying to make up for lost time.” He played in bands throughout high school and college and now works at YouTube helping music labels get their work represented.

“The implant made it easier to communicate in all kinds of situations. It made college and my job possible,” Mr. Spinowitz said. His message to the parents of children with profound hearing loss: “Sound makes the world a better place, so if you can have it, go for it.”

cochlear implant bypasses the nonfunctioning hair cells of the auditory system and transmits sound directly to the auditory nerve so that the brain can process it. Implants can be inserted in babies before they can walk. According to the National Institute on Deafness and Other Communication Disorders, children with profound hearing loss who receive implants before 18 months of age “develop language skills at a rate comparable to children with normal hearing.”

As Dr. Bonagura says in the documentary, “The ability now to put implants in babies is incredible. They grow up with sound; they grow up hearing everything. Sound is a gift — laughter, voices, nature. How can you take that away from anyone?”

Still, many deaf people resist the current technology and insist that children with profound hearing loss should learn only sign language. They reject the idea that deafness needs to be corrected.

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But, as Dr. Madell points out, only 0.1 percent of the population knows sign language, and 95 percent of deaf children are born to hearing parents, who then have to spend a long time learning to sign, during a period when children are normally learning to speak.

“Deafness today is not what it was 20 years ago,” she said. “Technology is so much better that virtually every child with hearing loss will be able to hear with the right devices — hearing aids and cochlear implants.”

Every baby born in the United States is supposed to be screened at birth for hearing loss. One baby in 1,000 of those screened will turn out to have moderate, severe or profound hearing loss that, if not promptly and properly treated, can delay their ability to learn to speak and understand speech.

Today’s auditory technology makes it possible for these babies to be fitted with a device that enables them to hear and, with auditory training, develop language skills as good as those of their normal-hearing peers.

Without newborn screening, critical months for learning spoken language can be lost. Children with serious hearing loss who are not screened at birth or soon thereafter often do not get their hearing checked until many months later when parents realize that they don’t respond appropriately to sounds and speech, or even later when they don’t start to speak at the usual milestones.

The American Academy of Pediatrics has established what are known as 1-3-6 guidelines that state that every baby should be screened for hearing by 1 month of age, a diagnosis of hearing loss made by 3 months and entry into early intervention services by 6 months. Yet currently only 67 percent of babies with profound hearing loss receive appropriate intervention by 6 months of age.

Jane Brody is the Personal Health columnist, a position she has held since 1976. She has written more than a dozen books including the best sellers “Jane Brody’s Nutrition Book” and “Jane Brody’s Good Food Book.” 

 

Oct 8th 2018

Second Pret allergy death named as 'wonderful' 42-year-old mother of five

A mother of five young daughters has been named as the victim of a second allergy death related to Pret A Manger food. 

Celia Marsh, from Melksham in Wiltshire, died on December 27, 2017 after eating a 'super-veg rainbow flatbread', which was meant to be dairy-free, according to reports. 

Ms Marsh, who has four daughters from a previous marriage and an 8-year-old daughter with her widow, Andy Marsh, was described as an "amazing" and "caring" woman.

Julie Dowie, Mr Marsh's former partner, also described Ms Marsh as "a wonderful stepmother to my three sons who shall dearly miss you." 

Ms Marsh was laid to rest at a funeral in west Wiltshire on January 18.

The latest death emerged as Pret was facing national scrutiny over the death of Natasha Ednan-Laperouse.

Natasha Ednan-Laperouse died on a flight after eating a Pret sandwich CREDIT:  PA

The 15-year-old collapsed on board a flight in 2016 after eating a Pret baguette which contained sesame, to which she was severely allergic.

Pret announced last Wednesday that it will include full ingredient labelling on all of its products and the Government is considering a law change after the death of Natasha, from Fulham, south-west London.

She collapsed on board a flight in July 2016 after eating an artichoke, olive and tapenade baguette she had bought in Heathrow Airport. Natasha's parents, Nadim and Tanya Ednan-Laperouse, have since campaigned for allergy awareness and a change into food labelling laws.

In a statement, provided via lawyers Leigh Day after the second death, Nadim and Tanya said: "Nadim and Tanya Ednan-Laperouse said: “We were incredibly saddened to learn of someone else losing their life from allergens in their food. Our hearts go out to the bereaved family.

“As we said at the end of Natasha’s inquest, we hope that this will be a watershed moment for allergy awareness in this country. 

“We also hope that we can start to understand why an increasing number of people are at risk of potentially fatal reactions from allergens."

Commenting on the death of Ms Marsh, Dave Whitbonbe, an administrative assistant at Avon Coroner’s Court, said: “She died in the Royal United Hospital in Bath shortly after eating this food from a large restaurant chain.”

He also confirmed that Ms Marsh suffered from a dairy allergy.

 

Oct 4th 2018

Night terrors: what do anxiety dreams mean?

These are anxious times – but how does this affect our sleep, and what can we learn from the exam crises and missed trains that haunt the small hours

Antonio Zadra, a psychologist, is sharing a memory of a horrific experience at sea. He had almost made it to shore, but knew he was about to die. In fact, these were his final 20 seconds of life. Just then, his eight-year-old son appeared at the water’s edge. He looked at Zadra, and Zadra heard the words: “Dad, no!” Two years later, remembering the fear and horror of the moment makes him well up. “I was thinking: ‘I am about to die and I am going to die in front of my eight-year-old son.” He recalls the vivid depth in his son’s eyes, the completeness with which he was able to look into them. And then, of course, he woke up and everything was OK, but not OK. The first thing he did in the morning was hug his son.

Zadra says this is his worst anxiety dream; one that still has the power to take his breath away. And, having read more than 10,000 dream reports for his work at the Center for Advanced Research in Sleep Medicine at the University of Montreal, he knows that his dream contains one of the most common motifs of anxiety dreams: that of our own imminent death (others include chase and pursuit, and loss of control). But this knowledge did nothing to ameliorate the shock and anguish of the moment. Technically, the only thing that stops this dream from being classified as a nightmare is the fact that it didn’t wake him up.

It is not surprising that anxiety seeps into our sleep. We live in anxious times. According to the World Health Organization (WHO), depression and anxiety disorders cost the global economy $1tn a year, with a 50% increase in the number of people with depression or anxiety between 1990 and 2013. In the US, general anxiety disorder affects 6.8 million adults and sales of books on anxiety are up 25% year on year at Barnes & Noble. In the UK, the Office for National Statistics’ national wellbeing survey last month showed that 17.8% of the population reported “some evidence indicating depression or anxiety”. So does the rise in our awareness and reporting of anxiety make us more likely to have anxious dreams? And do anxiety dreams – even the worst ones such as Zadra’s – bring any lasting benefit?

In fact, most dreams contain elements of anxiety. About one-third of all dream reports in Calvin Hall and Robert Van de Castle’s seminal 1966 work, The Content Analysis of Dreams, contain “misfortunes” of some kind. According to G William Domhoff, a sociologist and psychologist who worked with Hall, and who later analysed the dream reports, 80% of men’s dreams and 77% of women’s dreams feature at least one of the “negative elements” of sadness, anger, confusion and apprehension. “On the other hand, only 53% of dreams for men and women have at least one of several positive elements, such as friendly interactions, good fortune, success and happiness,” he adds.

In other words, says Isabelle Arnulf, a neuroscientist and president of the French Society for Sleep Research and Sleep Medicine, “it is normal to have anxious dreams”. But lots of her patients talk about anxiety dreams, worried that “they are abnormal”. No wonder the word people most commonly usein their sleep is: “No!”

“We have always had a proportion of people who contact us saying their dreams bother them,” says Nicky Lidbetter, the chief executive of the charity Anxiety UK, whose own anxiety dreams tend to centre on being stuck in traffic (she is agoraphobic). But she and her colleagues have not noticed an increase in the number of people reporting them. While research has shownthat people who have experienced trauma go on to experience trauma-related anxiety dreams, those who suffer general anxiety in their waking hours are not necessarily more likely to have anxious dreams. “It’s not just being more anxious that makes you likely to have anxious dreams,” Zadra says. “It’s being more anxious and finding yourself in a stressful situation.”

The correlation between waking anxiety and anxiety dreams is complex. Mark Blagrove, a professor of psychology at Swansea University and head of its sleep lab, has measured “nightmare distress”. He says that anxiety not only causes dreams to be “more negative, but you then get a worse reaction to the negative dreams because you are anxious”. In another anxiety double-bind, daytime stress can lead to sleep deprivation and more regular night-waking, which can in turn lead to an increase in the number of dreams we recall.

But do anxiety dreams have a function? Arnulf, who experiences them before important meetings, thinks that they do. In 2014, she led a study of students taking the Sorbonne medicine exam. It is extremely competitive – fewer than 10% of those tested are admitted. She and her team asked examinees to complete a survey about how they slept the night before the exam.

Between them, the students had experienced almost every imaginable examination-related dream. Some couldn’t find the examination hall; others were late. Many dreamed that they ticked the wrong box in answer to the first question, thereby rendering every subsequent answer wrong. One dreamed that their walls and curtains were covered in chemical formulae and another raised their hand for paper and was given sliced bread. All kinds of transport disasters surfaced: trains didn’t turn up, operators went on strike.

This last, Arnulf says, is such a common daytime worry that many students book a hotel room near the Sorbonne to circumvent waking-world transport problems. “But even those students,” she says, “would dream that they woke to go to the bathroom only to find a queue of people … and then they were late for the exam.”

Arnulf’s favourite anxiety dream of those she studied was from a female student who dreamed she was revising, but could no longer remember an important detail about the spinal cord. She awoke in the middle of the night, went to her desk and opened her textbook at the appropriate page. Realising that she didn’t know the detail in question, she started to revise.

One suspects Arnulf likes this one because it is the most narrative illustration of the correlation her research unearthed: that the students who had the most anxiety dreams the night preceding the exam scored the highest marks. “Whatever happened in their brain during the night before, it gave a cognitive gain compared with the other students,” she says. Her team of statisticians equated the gain to half a point, which, given that the average score for the test was seven, is sizable. (This statistic has inspired a number of enterprising students to ask Arnulf which dreams are the most beneficial.)

Arnulf’s findings tally with something called the “threat simulation theory” of dreaming, which holds that people rehearse frightening situations in their dreams and that the rehearsal equips them to face those situations in waking life. If you dream of facing a lion and in the morning happen to meet one, the theory is that you will be better prepared for the encounter. A more evolved version of this is “social threat simulation theory”, which centres on the idea that dreams prepare us for social stress.

These theories are appealing because they help to make sense of the way we might (if only we could be sure) make sense of things in our sleep. But why, then, is the most common anxiety dream that the Anxiety UK helpline receives related to exam crises when most callers are long past the throes of exams? Why am I, for that matter, still dreaming that I am failing to memorise quotations from Henry James 22 years after I committed them to what has turned out to be my short-term memory?

Exactly, says David Bell, a psychoanalyst at the Institute of Psychoanalysis. He says that dreams following severe trauma are often recurrent and undisguised, which suggests that “if [anxiety dreams] are an attempt to prepare us, it is remarkable how consistently this attempt fails”. He adds that Freud believed there may be a kind of default, which means “you end up repeating again and again, without growth or management, the same traumatic event”.

In this scenario, the repeated nightmare is almost a glitch in the dreamer’s system. Of course, it is not only traumatic dreams that are repeated. I often dream that I have just moved into a new home needing a lot of refurbishment only to find a hidden extra room and then lose it, spending the rest of my dream trying to find it again. But what might this mean, I wonder? Bell can’t say because he doesn’t know me, but, as a starting point, he suggests that this kind of dream makes him ask: “Does the person feel that they have done some damage somewhere and they need to repair it – the total refurbishment?” (I have always assumed the dream literally expressed the fact that I would like a room of my own, along Virginia Woolf’s lines.) In other words, dreams communicate our unconscious preoccupation. Recurrent exam nightmares, for instance, may represent the fear of being exposed or humiliated for some guilty, dark thought.

Then again, it is possible, as Blagrove from the Swansea sleep lab, says, that there is no adaptive function to this or any dream: “We simply dream of these things happening because they’re on our mind during the day, so they stay on our mind when we sleep … It doesn’t do anything for us. It’s just that the brain doesn’t completely shut down.” He veers between believing that anxiety dreams have a function and no function at all.

Zadra, on the other hand, believes that some bad dreams do have a lasting impact. He points out that, except in the case of people with post-traumatic stress disorder, only between 1% and 2% of all dreams recalled include exact replays of things we have seen. Instead, dreams often have bizarre or unusual structures or conflate seemingly disparate experiences and characters. Zadra is convinced that “whatever functions dreams have, they get executed when the dream is taking place … and probably more at cortical levels, outside our immediate awareness, where our brains try to relate current concerns with established networks of past experiences to see what associated memories are relevant to recent events”.

Our ability to recall our dreams “has no bearing” on their function, he says. If remembering our dreams were important, he argues, we would remember more of them. After all, most of us have one and a half to two hours REM sleep a night – the phase in which dreams mostly occur – yet “we remember a very small fraction of our dreams”. Regarding his near-drowning experience, he says he has “little to no idea what the ‘purpose’ of that dream was in terms of underlying neuronal activity – but I can certainly tell you the clear message that it left me. Do not take your most cherished things in life for granted and do take the time to savour and love all that is important to you.” This particular dream, he says, “pushed me into taking a step back”.

He also believes that “sleep is very important to consolidating memories and even learning new skills”, whether emotional, cognitive or even physical. A study of German athletes, for instance, found that nearly 10% of them felt that they could use their lucid dreams (when the dreamer is aware that they are dreaming) to practise aspects of their performance. Sleep can also hone emotional gains. One friend, who saw a psychoanalytical psychotherapist after making the difficult decision to have an abortion, describes how each week after her session, she would dream “by numbers”. She was in the bathroom, someone was on the floor and she was killing them. “It was like a parody of a dream,” she says. She felt she was dreaming to order for her therapist, who told her this was “a rite of passage”. After a while, these dreams gave way to others and provided a gateway to a deeper discussion.

After all, even Blagrove, who is not convinced of the function of dreams, believes in their usefulness. “We are producing a whole complicated film while we sleep,” he says. He likes the film analogy because of the way that dreams invite retelling and discussion, and because the prevalence of metaphor in dreams – people falling down holes or endlessly running, or in the case of another friend, caring for an ever-diminishing baby – spurs a search for meaning.

At the Swansea sleep lab, Blagrove and his students recently asked participants in their research to keep a diary and evaluate the emotional intensity of their experiences. They then woke them up in the sleep lab and asked them to describe their dreams. The researchers printed the dreams on one side of A3, the dreamer’s diary on the other and studied the way that waking-life events were incorporated into dreams. They found that “the more intense the emotion, the more likely it was to appear in a dream”, Blagrove says. He recently dreamed that he was tweeting in upper case, even though he knows this is considered discourteous. He was able to map his dream to a family trip to the theatre when he became stressed about returning late from the interval.

If none of this makes you feel any better about anxious dreams, and you are disinclined to explore their meaning alone or with professional help, you could investigate image rehearsal therapy, which trains dreamers to rescript their dreams to render them undisturbing. Most psychoanalysts would see this as a contamination of good material, but Arnulf, a neurologist, thinks the meaning of dreams is irrelevant. The key, she says, is that “you must get to the end of the dream”. Waking up “interrupts a good process”. So try to sleep better generally and your dreams should become more bearable and, who knows, maybe even useful.

 

Oct 3rd 2018

This is how long sex is normally supposed to last

Measuring the average time is not a straightforward matter.Universal Pictures

·       Discovering the "normal" time that sex is supposed to last is difficult because it's not something people tend to monitor, and those who take notice might oversell their time. ·       A study timed 500 couples to determine what was normal, but they found that the average time ranged from 33 seconds to 44 minutes. ·       The average time sex normally lasts comes out to 5.4 minutes.

·       If you're a non-scientist, you might have once asked yourself, propped against the bedhead after disappointingly quick intercourse, how long does sex "normally" last?

·       A scientist, though, would phrase the same question in an almost comically obscure way: What is the mean intravaginal ejaculation latency time?

·       I know there's a lot more to sex than putting the penis into the vagina and ejaculating, but the rest is not always easy to define. (Kissing? Rubbing? Grinding?) To keep things simple and specific, we'll just focus on the time to ejaculation.

·       Measuring an average time to ejaculation is not a straightforward matter. What about just asking people how long they take, you say? Well, there are two main problems with this. One is that people are likely to be biased upwards in their time estimates, because it's socially desirable to say you go long into the night.

·       The other problem is that people don't necessarily know how long they go for. Sex isn't something people normally do while monitoring the bedside clock, and unassisted time estimation may be difficult during a transportative session of lovemaking.

·       What does the research say?

·       The best study we have estimating the average time to ejaculation in the general population involved 500 couples from around the world timing themselves having sex over a four-week period — using a stopwatch.

·       That is as practically awkward as it sounds: Participants pressed "start" at penile penetration and "stop" at ejaculation. You may note this could affect the mood somewhat, and might perhaps not exactly reflect the natural flow of things. But — science is rarely perfect, and this is the best we've got.

·       So what did the researchers find? The most striking result is that there was a huge amount of variation. The average time for each couple (that is, averaged across all the times they had sex) ranged from 33 seconds to 44 minutes. That's an 80-fold difference.

·       So it's clear there's no one "normal" amount of time to have sex. The average (median, technically) across all couples, though, was 5.4 minutes. This means that if you line up the 500 couples from shortest sex to longest sex, the middle couple goes for an average of 5.4 minutes each time they do it.

·       There were some interesting secondary results, too. For example, condom use didn't seem to affect the time, and neither did men's being circumcised or not, which challenges some conventional wisdom regarding penile sensitivity and its relationship to staying power in the sack.

·       It didn't much matter which country the couples came from either — unless they came from Turkey, in which case their sex tended to be significantly shorter (3.7 minutes) than couples from other countries (Netherlands, Spain, the United Kingdom, and the United States). Another surprising finding was that the older the couple, the shorter the sex, contrary to the prevailing wisdom (probably peddled by older men).

·       Why do we have sex for so long?

·       As an evolutionary researcher, all this talk of how long sex lasts make me wonder: Why does it last any time at all? All sex really needs to achieve, it seems, is to put sperm into the vagina. Why all the thrusting and bumping? Instead of sliding the penis in and out many hundreds of times per sexual session, why not just put it in once, ejaculate, and then go have a lemonade and get on with the rest of the day?

·       Before you say, Because it's fun to go in and out!, remember evolution doesn't care about fun per se— it generally only "designs" things to be enjoyable if they helped our ancestors pass on their genes to future generations. For example, even though we like eating food, we don't chew each mouthful of it for five minutes just to make the enjoyment last longer. That would be inefficient, and so we've evolved to find it gross.

·       Why we last so long is a pretty complicated question with no clear answer, but a clue may be in the way the penis is shaped. In 2003,researchers showed - using artificial vaginas, artificial penises, and artificial sperm (corn syrup) - that the ridge around the head of the penis actually scoops out pre-existing syrup from the vagina.

·       What this suggests is that men's repeated thrusting might function to displace other men's semen before ejaculating, ensuring their own swimmers have a better chance of reaching the egg first. Incidentally, this could explain why it becomes painful for a man to continue thrusting after ejaculating since that would risk scooping out his own semen as well.

·       So what to do with this information? My advice would be to try not to think about it in the throes of passion.

 

Sept 30th 2018

Do cold and flu home remedies really work

When we feel the sniffles coming on, it's common to reach for a herbal remedy before heading to the chemist. But do they really work?

In a bid to tackle the growing problem of antibiotic resistance, new guidance from Public Health England (PHE) and The National Institute for Health and Care Excellence (NICE) is urging doctors to recommend honey and over-the-counter remedies as the 'first point of call' for coughs rather than antibiotics.

But just how effective is honey, lemon, zinc or chicken soup in beating the dreaded cold and flu? We ask the experts:

1. Echinacea

➡️ Can echinacea reduce the severity of a cold?

A 2014 Cochrane review looked at the evidence for the effectiveness of echinacea in preventing and treating the common cold, reviewing 24 controlled clinical trials. It concluded that echinacea does NOT reduce the length of colds significantly, but may offer weak benefits.

⚠️ The most important recommendation for consumers and clinicians is a caution that echinacea products differ greatly, and the majority of these products have not been tested in clinical trials.

The verdict: 'As there is no real risk in taking echinacea (other than side effects reported from continuous, preventative use), I would hesitate to say "do not take", when some people may find this useful,' says Dietitian and BDA spokesperson Aisling Pigott. 'Professionally, I would not advocate the use of echinacea as there is insufficient evidence. However, I wouldn't tell somebody to stop if they found it beneficial.'

2. Honey

➡️ Will honey soothe a sore throat?

A drink of honey mixed with lemon and hot water is a common go-to when it comes to soothing sore throats and a runny nose. PHE recommends patients should try using honey or cough medicines containing pelargonium, guaifenesin or dextromethorphan, which have some evidence of benefit for symptom relief.

The verdict: 'Although there is insufficient evidence to support its effectiveness, who are we to argue with someone who finds something useful for them?' says Pigott. 'I would always remind people that honey is high in sugar and calories, so as a regular addition to the diet it may not be beneficial. Also, honey should never be given to children under one, due to the risk for botulism.'

3. Zinc lozenges

➡️ Does zinc reduce the severity of colds and flu?

'There is some evidence that zinc reduces the duration of cold symptoms such as nasal congestion, sneezing, coughing and a sore, scratchy and hoarse throat,' says Dietitian Lauren McGuckin. 'Zinc is an important nutrient for regulating immunity.'

The verdict: 'Zinc lozenges are likely to contain sugar, and therefore can be detrimental to teeth as well as contributing unnecessary calories,' says McGuckin. 'However, zinc supplementation may be beneficial to individuals who aren't meeting dietary intakes.'

Zinc-rich foods include seafood, lamb, beef, wholegrains, pumpkin seeds and baked beans.

4. Chicken soup </h2>

➡️ Can chicken soup cure the common cold?

'There is little evidence to suggest that chicken soup reduces the symptoms of a cold,' says Pigott. 'However, we know that protein and energy requirements increase during illness, while appetite and gastric functioning reduce. Therefore, based on that evidence, warming and nutritious food (eg chicken soup) may help restore energy during times of illness.'

Chicken soup with plenty of vegetables contains lots of healthy nutrients, increases hydration and tastes delicious!

The verdict: 'It is not a cure!' warns McGuckin. 'However, as a warming, hearty, protein and nutrient rich comfort food, chicken soup is an ideal meal for someone who is feeling under the weather.'

5. Garlic

➡️ Will garlic shorten the duration of cold and flu?

A trial suggested that garlic may prevent occurrences of the common cold, but more studies are required to validate this finding.

The verdict: 'Garlic contains a compound called allicin, which has been shown to be beneficial for the immune system,' says McGuckin. 'However, the way in which garlic is processed can affect the potency of allicin. Chopped/diced/sliced raw garlic appears to have the greatest benefit.'

'I'd recommend garlic as a wholefood,' adds McGuckin. 'Garlic is not only good for you, it's also a fantastic flavour addition to many dishes. Supplements on the other hand aren't regulated, therefore you can't be certain of the allicin content.'

6. Vitamin C

➡️ Can foods high in vitamin C treat the common cold?

Vitamin C is key to the immune system functioning, and there is evidence to suggest it may reduce the length of colds - but not prevent them.

The verdict: 'The sharpness of citrus can be helpful with relief from catarrh and congestion and taken with warm water and other ingredients such as honey can be very soothing - a key part of recovery,' says Dietitian and BDA spokesperson Amanda Squire.

Foods rich in vitamin C include citrus fruits, red pepper, blackcurrants, kale, broccoli and strawberries.

'Cold symptom relief and illness recovery is generally about allowing your body to recover and fight the infection,' concludes Squire. 'An overall well-balanced and varied diet gives our bodies the best chance of maintaining a strong immune system.'

 

Sept 27th 2018

Eight everyday habits affecting your eye health

They're the things we see with, but how much thought do we give to the health of our eyes?

Now, contact lens wearers are being warned to look after their eye health following an outbreak of a rare infection that can cause blindness.

Scientists at University College London and Moorfields Eye Hospital warned, last week, that paying attention to hygiene is essential for eye health, especially for Britain's 4 million contact lens wearers.

The researchers warned there had been a threefold increase in the number of cases of a rare eye infection that can cause blindness since 2011.

The condition, acanthamoeba keratitis is more likely to affect contact lens wearers as the disease is linked to lenses coming into contact with contaminated water, but anyone can be affected, say the researchers.

The number of cases seen at Moorfields has risen from 15 to 23 in a year in the last decade to 36 to 65 a year.

The acanthamoeba micoorganism is found in the UK's domestic water supply in higher rates than other countries.

Researchers found that the risk is three times higher for contact lens wearers who don't wash and dry their hands before handling lenses and for those who use ineffective contact lens solution.

Showering while wearing lenses is also a risk factor, says the research which was published in the British Journal Of Opthalmology last week.

Professor John Dart, from the UCL Institute of Opthalmology and Moorfields Eye Hospital, who led the study said: 'People who wear resuable contact lenses need to make sure they thoroughly wash and dry their hands before handling their lenses.'

This new research underlines the fact that our eye health is not down to luck, there's in fact plenty we can do protect our vision and keep our eyes healthy.

We've spoken to Vision Direct optometrist Brendan O'Brien to find out which daily habits can damage your eyes and what we should do to keep them healthy.

1. Your daily swim 

Swimming is hugely beneficial for your cardiovascular system but if you're not wearing goggles, your eyes might be suffering, especially if you're a contact lens wearer and you open your eyes underwater, explains O'Brien.

'The water in pools, rivers and the sea, or even the shower can leave your eyes vulnerable to bacterial infection,' warns O' Brien.

‘The microorganism acanthamoeba lives in water and can cause serious damage if it gets into your eye'.

'Wearing contact lenses makes us more vulnerable because the bacteria attaches to the lens and can cause the surface of your eye to become inflamed and eventually infected,' says O'Brien.

Contact lenses will also naturally absorb any water around them, which could change their shape dramatically. This will make them uncomfortable to wear, often causing your vision to become distorted and blurry.

If you really must wear your lenses in the pool stick to daily disposables along with waterproof swimming goggles, or better still invest in a pair of prescription goggles which will help you see clearly without water coming in direct contact with your eyes.

2. Your out of date mascara 

You know how your mascara gets all clumpy after three or four months, but you don't want to buy a new one because that stuff is pricey?

Well, it's time to cull your make-up bag of all out of date eye make-up, especially mascara, yes even your favourite Chanel one you bought in 2016.

Mascara can harbour bacteria which can cause infections leading to redness, light sensitivity and irritation and, in rare cases, even blindness. Liquid liner and mascara have a shelf life of around three months once opened.

Unopened, well-formulated cosmetics can remain stable for a couple of years.

What's more, eye make-up applied inside the eyeline, such as eyeliner, can increase the risk of eye infection, according to research from the University of Waterloo published in the peer-reviewed journal of the Contact Lens Association of Ophthalmologists, Eye and Contact lens.

The research by the scientist Dr Alison Ng found that contact lens wearers were more vulnerable to infection from eye make-up. Dr Ng recommends preventing bacterial transfer by sharpening eye pencils thoroughly before each use.

Similarly, false eyelashes could put your eyes at risk. According to experts, false eyelashes are a hygiene risk because they tend to trap dirt and bacteria, while poor quality, unhygienic lashes increase the risk, so it's important to find a reputable beautician.

3. Skipping your annual eye test 

One in six Brits aren't bothering to get our eyes tested, leaving us vulnerable to health problems.

'An eye test can turn up health problems like diabetes, glaucoma and high blood pressure, all of which can lead to serious eye problems and even blindness if left unchecked,' says O'Brien.

Even arthritis which causes joint inflammation can be spotted with an eye test, because the inflammation also turns up in the eye and will eventually attack the eye too if left untreated.

'Most optometrists recommended taking an eye test every two years, unless you have eye issues or are over 70, in which case, a test every 12 months is best to catch any health problems early,' says O'Brien.

'Children up to the age of 16 should be tested annually too, according to the College of Optometrists, as children's vision can change very rapidly at this stage of their lives.'

4. Staring at your smartphone 

Staring at your smartphone or computer screen or TV for hours on end is not good for your eye health, says research by the University of Toledo, published in Scientific Reports.

That's because these screens emit blue light which is absorbed by vital cells in the eye's retina triggering toxic chemicals, which can eventually kill the photoreceptors we need for vision. And the older you get the more vulnerable you are.

The study's lead researcher Dr Ajith Karunarathne, an assistant professor in the UT department of chemistry and biochemistry says we shouldn't be checking phones and tablets in the dark, because this can dilate the pupils making them more vulnerable to damage.

Dr Karunarathne explains wearing glasses with an anti-glare coating that filters blue light, or adding a blue light filter screen to your phone or computer.

Examples of blue light filters for digital devices to look for include: Eyesafe (Health-E), iLLumiShield, RetinaShield (Tech Armor), Retina Armor (Tektide), Frabicon and Cyxus.

5. That casual smoking habit 

We hardly need to say it: smoking is BAD, but few of us realise it damages our eyes. 'Smoking increases risk of cataracts and age related macular degeneration (AMD), which is a common condition that affects the middle part of your vision. In fact, AMD is Britain's leading cause of sight loss.

'AMD occurs when the small central portion of the retina, known as the macula, deteriorates and is the major cause of blindness in the over fifties, ' says O' Brien.

Risk of AMD doubles with smoking over fifty, says one British study published in The British Journal of Ophthalmology. So that's another reason to sign up for Stoptober.

6. Forgetting to wear sunglasses 

You might you think your sunnies are no longer needed now that the dark nights are closing in. Not so says O'Brien. UV is still an issue on overcast winter days.

'Although the UV count is typically higher on sunnier days, it is important to bear in mind that up to 80% of UV radiation can penetrate cloud, meaning that forgetting to wear sunglasses on an overcast day can still damage your eyes,' says O'Brien.

'That means it's just as good an idea to pop on a pair of shades on a sunny December morning as it is on a hot July afternoon.'

But don't think just because your glasses are dark tinted they offer ultra violet protection. 'The tint of a sunglasses lens has no effect on UV protection,' says O'Brien.

'While wearing darker lenses means that less light will enter your eye and will help you see better, the same amount of UV is blocked as if you were wearing shades with a lighter tint.'

And unless your sunglasses are offering good UV coverage, the tint means they will dilate your pupils and allow more UV light in than normal, so it's potentially worse than going without sunglasses if your glasses aren't up to scratch.

The message? Don't fall for those designer look-alikes, unless you can verify their UV credentials. 'Look for a CE mark (a European standard of UV protection),' says O'Brien.

'This means they allow a maximum of 5% of UV rays to penetrate.'

Not all cheap sunglasses are bad news however. Tests reveal that some £3 Primark pairs do the job as well as £300 designer glasses.

Look for styles that fit close to your face and don't let light in at the side and if you're a contacts wearer opt for brands like Acuvue with UV filters included or remember to wear sunglasses with your contact lenses.

Warning: Your eyes are even more susceptible to burning than your skin. As it's harder to tell when your eyes are getting burnt than it is when your skin starts turning red, it's easy to end up doing lasting damage to your eyes without knowing.

Frequent exposure to UV can lead to the development of eye conditions such as cataracts and AMD which can impair sight and even cause partial or total blindness.

Indeed, One systematic review published in 2014 of scientific research on the subject found that sunlight exposure to eyes was a key risk factor in the development of AMD.

7. Your fan

Leaving a fan running all night can increase irritation and dry eyes for contact lens wearers. Why? Because fans blow allergens like dust or pollen towards your eyes as you sleep, so that when you insert your lenses in the morning these deposits cause irritation and discomfort.

The fix? Thoroughly dust bedroom surfaces, including the fan blades and keep a bottle of contact lens solution handy to cleanse your lenses to remove any impurities.

Consider setting a timer on your fan, so it switches off shortly after you doze off and wear a sleep mask, so your eyes are protected.

8. Over-using eye drops 

While it's tempting to reach for the eye drops rather than put up with looking like a pink-eyed bunny, you can have too much of a good thing, say experts, as plenty of eye drops can lead to a rebound effect.

Rebound redness results because the blood vessels in the eye dilate as the effects of the medication in the drops wears off, creating a vicious circle. What should we do instead? 'Try to pinpoint the cause and deal with it, ' says O'Brien.

If, for example, your eyes are dry due to cold winter weather and central heating, invest in a humidifier and try not to sit too close to a radiator.

Rehydrate by drinking lots of water and eat plenty of foods rich in A, C and E vitamins and omega-3 fats, like salmon. And when the wind starts whistling, don your sunglasses to protect your eyes from the biting cold.

How often you can use eyedrops safely will depend on the type, says O' Brien.

'There are two types: eye drops with preservatives and preservative-free eye drops. Eye drops that contain preservatives have a longer shelf life. The preservatives are chemicals that prevent bacteria from growing. This allows you to use one bottle of eye drops for a length of time.

'However, the preservatives in OTC eye drops cause eye irritation to become worse. Eye specialists typically recommend that you use this type of eye drop no more than four times a day.' Preservative-free eye drops are best for those with sensitive eyes.

Sept 26th 2018

Your body odour changes when you're around poorly people

If you’ve noticed your body odour (BO) changing recently, it might be a sign that you’re about to get sick.

A new study has revealed that your BO changes when you’re around poorly people.

Researchers from the Monell Centre suggest that this change in odour may be a tactic to prevent the spread of the illness.

Dr Stephanie Gervasi, who led the study, said: “Exposure to the odours of sick individuals may trigger protective or preparative responses in their social partners to minimise the risk of impending infection.”

In the study, the researchers injected mice with lipopolysaccharide (LPS) - a non-infectious bacterial toxin that causes symptoms associated with sickness.

The LPS-injected ‘sick’ animals were then housed in the same cages as healthy animals.

Results revealed that the healthy mice picked up the same smell as the sick mice.

This suggests that body odours of healthy animals can change in the presence of odour-based sickness signals.

Dr Gary Beauchamp, another author of the study, said: “This work shows not only that odors signal disease but that they can have strong effects on individuals that detect them.

“This is a remarkable transfer of information via olfaction that specifically alters physiology and could play a role in disease transfer among individuals in many species."

Sept 25th 2018

At Least 68 People Are Nearly Blind After A Botched Drug Was Injected Into Their Eyeballs

Their tragedies expose a shadowy US industry that sells drugs with little government oversight

The syringe sliding into Curtis Cosby’s eyeball was supposed to make life easier.

It was Valentine’s Day 2017 in Dallas, Texas. Like millions of Americans around retirement age, Cosby was getting cataract surgery to replace the cloudy lens in his right eye. After the quick procedure, the doctor injected a medication that was supposed to speed up healing and spare him the inconvenience of buying eye drops later. That sounded good to him. He’d been a truck driver since he was a teen and just wanted to get back on the road as soon as possible.

One afternoon two weeks later, Cosby was driving a 10-wheeler back from Oklahoma when something blew through the open window and into his left eye. He rubbed it. Only when that eye was covered did he realize that he could not see out of the one that had just been operated on.

Frightened, Cosby pulled over. He called his surgeon, Kate Lee — something had gone wrong, he told her — and she invited him to come in the next day. At the appointment, he recalled, she looked him in the eye and apologized.

“What do you mean, ‘I’m sorry’?” he remembers responding. Lee explained that there had been problems with the injected drug, and that other patients had come in with the same symptoms. A retina specialist next door gave Cosby aspirin in the hope that it might increase blood flow to the back of his eye. It didn’t.

“I still can’t get over that this is really the way it’s going to be.”

Cosby was far too nervous to go back for the same surgery on his rapidly deteriorating left eye, as he had originally intended. So now, more than 18 months later, he’s close to blind. In broad daylight, he can see the outline of a house, but not what it’s made of. Night is pitch-black. Driving is out of the question. He failed his commercial driver’s license test, entering retirement a decade earlier than expected and forcing his wife, a teacher, to keep working for years longer than planned so they can pay off their mortgage.

“I just— I still can’t get over that this is really the way it’s going to be,” Cosby, 58, told BuzzFeed News.

He’s one of at least 68 cataract patients in the Dallas area who say they were partially blinded or worse within days or weeks of being injected with a knockoff version of a drug called TriMoxi. Some cannot perceive depth or colors. Others see glare, halos, flashing lights, or darkness. Many are constantly disoriented, plagued with headaches and nausea, unable to drive or work.

Now, they’ve lawyered up against the pharmacy that mixed the drug, the company that allegedly designed the shoddy recipe, and the clinics that injected it. Two of the patients filed lawsuits last week, and several dozen others, including Cosby, are lined up to join them.

The defendants are pointing fingers at one another. The company accused of coming up with the drug’s recipe, the Professional Compounding Centers of America (PCCA), denies it did so, and says that the trouble was caused in part by the pharmacy that mixed it, Guardian Pharmacy Services. Guardian, meanwhile, says there’s no link between its products and the patients’ vision problems, which were known complications of the surgery. And the clinics that performed the surgery — which typically has a low rate of complications — say the drug was certainly to blame.

The lawsuits spotlight the shadowy, booming industry of “compounding pharmacies,” companies that make drugs for people who need customized products that aren’t sold by pharmaceutical companies — such as a pill in liquid form. Federal law dictates what types of ingredients can be used in compounded drugs, but nobody is required to test whether the end product is safe and effective. Consequently, companies like PCCA and Guardian are free to formulate or sell untested drugs with little government oversight.

In 2013, after mistakes at one such facility in Massachusetts led to 64 deaths, Congress passed a law intended to increase the FDA’s authority. The industry balked, arguing that states were already providing adequate oversight. Critics, meanwhile, faulted the law for being too weak, saying that its loopholes allow the bulk of the industry to continue business as usual.

Some of the companies named in the Dallas lawsuits have checkered pasts, a BuzzFeed News review of FDA documents, court filings, and state pharmacy board and business records shows. In 2010, for example, PCCA was sued for allegedly formulating yet another drug that blinded a patient. (The case was settled without an admission of guilt.) And two Guardian executives previously helped run illegally operating internet pharmacies, roles that led to the suspension of their licenses — and for one of them, a felony conviction.

“It’s hard for me to remember a case in which there has been such disregard for patient safety regarding the preparation of a compounded drug,” Larry Sasich, a pharmacist in Ontario, Canada, who tracks the compounding industry and is not involved in the lawsuits, told BuzzFeed News.

With so few consequences for wrongdoing, he added, similar tragedies could easily strike customers of the thousands of other compounding pharmacies in the US. By one estimate, more than 110 deaths have been linked to compounding over the last two decades. The Dallas patients are likely the biggest group of people to claim harm from compounding errors since the Massachusetts tragedy.

“These things don’t have to happen,” Sasich said. “There is no legitimate reason they should happen.”

Sarah Lim for BuzzFeed News

Curtis Cosby with his dog Sweet in Royse City, Texas.

The art of mixing ingredients into remedies, or compounding, dates back to ancient Egypt and Rome. In the US, compounding pharmacists made most medications until the 1960s, when big pharmaceutical companies started mass-producing drugs and overtaking corner drugstores.

Compounding never disappeared, though, because it fills legitimate needs. Sometimes a patient is allergic to an ingredient, or wants a medication to have a different flavor, or needs a different dose.

The industry began to grow again in the 1980s, spurred in part by PCCA. Formed in 1981, the trade organization aimed to revitalize the practice by supplying chemicals to its member pharmacies, sharing its recipes (or “formulas”) with them, and later promotingcompounding in pharmacy schools.

Although compounders aren’t allowed to copy any medication (whether patented or generic) that is readily available, they can make substitutes for drugs that are off the market or in short supply. Unlike Big Pharma, these businesses don’t need to get their drugs approved by the FDA, and they generally don’t make proprietary products. Their business is more like a grocery store, dependent on local demand. But compounding can still be lucrative because the ingredients tend to be cheap and companies don’t have to pay for rigorous safety testing.

It’s hard to assess the scope of the industry, but trade groups estimate that today about 7,500 independent pharmacies specialize in compounding in the US, and at least 1% of all prescription drugs nationwide — roughly 40 million prescriptions a year — are compounded. One market research firm estimates that by 2022, the global compounding industry will bring in $12 billion.

Among some observers, this growth has raised red flags. In 1996, then–FDA commissioner David Kessler warned Congress that compounders were likely to spawn a “shadow industry of unapproved generic drugs” that “could result in serious adverse effects, including death.”

Sixteen years later, a deadly fungus contaminated drugs made by the New England Compounding Center in Massachusetts. As a congressional investigation would later reveal, things went wrong partly because of confusion over which regulatory body was responsible for keeping the company in check. The state pharmacy board had investigated the compounder a dozen times, and the FDA had inspected three times, before the contaminated drugs sickened nearly 800 customers across 20 states and killed more than 60 of them. The pharmacy’s owner has since been convicted of more than 50 counts of mail fraud and racketeering.

After a massive public outcry, Congress passed the 2013 Drug Quality and Security Act, which gave the FDA primary oversight over large compounders — like the New England Compounding Center — that sell drugs in bulk to doctors and hospitals, as opposed to tailoring them to specific patients’ prescriptions. But businesses must volunteer to be part of this group, with its tougher manufacturing standards and regular FDA inspections. Unsurprisingly, only about 70 operations have done so.

What’s more, the law says that the FDA is not primarily responsible for smaller compounders that tailor drugs for individual patients — a category that includes most of the industry. These companies are primarily regulated instead by state pharmacy boards, whose rules and enforcement vary widely from state to state; many do not even track how many pharmacies compound drugs that need to be kept sterile. The FDA can still step in when problems happen. Industry groups say that’s plenty of oversight.

“The state boards of pharmacy across all 50 states, they do a very good job [as a] watchdog on the industry,” Gary McCrory, interim executive vice president of the International Academy of Compounding Pharmacists, told BuzzFeed News. “State boards of pharmacy are on the ground every day, inspecting pharmacies and making sure that pharmacies are meeting” basic manufacturing standards.

But the situation in Dallas shows how state and federal laws can still contradict each other. In the new lawsuits, two clinics are accused of buying the eye injections in batches from Guardian without providing prescriptions, in violation of federal law. Under Texas law, though, pharmacies are allowed to compound a “reasonable quantity” of a medication without prescriptions. (Informally, Texas’s pharmacy board does advisepharmacies to follow the national law.) In any case, Guardian is not one of the 70 or so compounders that have volunteered to be on the FDA’s watch list, so its oversight primarily falls to the Texas pharmacy board.

Guardian has technically existed for more than two decades, but has kept a low profile. It was first registered as a business in Texas in 1997 under the official name of JMA Partners, according to state records. Its current address is an office park in West Dallas, where 11 to 50 employees work, according to a LinkedIn company page that lists the same address. (It is not related to another pharmacy with the same name, which is headquartered in Atlanta but has a branch in the Dallas area.)

The Texas-based Guardian’s Facebook page has been dormant for a year, but before that, it advertised compounded treatments for hormone replacement therapy, men’s health, weight loss, and chronic pain. The page also links to a website that sells the active ingredient in Viagra ($99 for 90 tablets).

Guardian’s legal troubles began on Sept. 12, 2016, when a pair of FDA inspectors dropped in on the Dallas facility. A few months earlier, a customer had complained to the agency about an “adverse event” (unspecified in inspection documents) linked to an antibiotic. Guardian had also received a half-dozen complaints from customers about broken and leaky equipment transporting its medications, one employee told the agency.

Based on the inspectors’ nine-page list of concerns, the FDA believed that Guardian was violating the law. As the agency later summed it up to Guardian: “[T]he investigators noted serious deficiencies in your practices for producing sterile drug products, which put patients at risk.” Those included failing to make sure the sterilization process worked and failing to properly disinfect the rooms where those sensitive drugs were being made. Guardian also didn’t have some required patient prescriptions on file, the inspectors noticed, and it was using grape seed oil, a barred ingredient.

During that monthlong inspection, Guardian voluntarily recalled 180 syringes filled with an anesthetic due to reported contamination problems. Still, even as founder and president Jack Randall Munn pledged to make improvements, he argued that Guardian was being wrongly held to federal manufacturing standards when it only needed to comply with less stringent rules in Texas.

“For the past years, GPS has been providing the highest quality compounded medications to its patients for a multitude of conditions to fulfill their otherwise unmet medical needs,” he wrote to the FDA on Nov. 7, 2016. (The agency declined to comment on Guardian.)

As it tangled with the feds, Guardian stayed open for business. And as fall turned to winter, dozens of people in the Dallas area scheduled cataract surgeries to clear up their vision.

More than 3 million people in the US and some 20 million globally get cataract surgeryevery year. After the outpatient procedure, patients are typically prescribed antibiotic eye drops to curb inflammation and infection. But most use the drops incorrectly.

The Dallas patients are suing over a medication that was sold to them as an alternative to those drops. Although their knockoff TriMoxi was mixed by Guardian, the drug was originally developed by yet another compounder marred in legal controversy. TriMoxi’s history shows not only the big business of cataract surgeries, but the fiercely competitive side of the compounding industry.

In 2014, San Diego–based Imprimis Pharmaceuticals debuted its “Go Dropless” campaign for a line of compounded injections for use after eye surgery, including TriMoxi, a combination of a steroid (triamcinolone) and an antibiotic (moxifloxacin hydrochloride). The company also funded studies claiming medical and financialbenefits of the drugs. One injection of TriMoxi, for instance, costs health care providers around $22, whereas drops can cost patients as much as $650 per eye. By July 2017, Imprimis had sold 500,000 units of its injections, including TriMoxi, according to regulatory filings. It reported selling about $19 million worth of ophthalmology drugs in 2017.

But some of Imprimis’s advertising has gone too far for regulators. In December 2017, an FDA warning letter accused the company of making false and misleading claims, such as failing to mention the side effects and risks of its “dropless” therapies, on its website, a brochure, and investor documents. (Imprimis has since said that it didn’t believe its language was misleading, but that it addressed the FDA’s concerns.)

Those problems, though, are separate from the ones raised by the Dallas lawsuits, which do not name Imprimis as a defendant nor question the safety of its original TriMoxi formula. Imprimis says the drug made by Guardian was a knockoff formulation that shouldn’t even be called “TriMoxi,” although the lawsuits do refer to it as such.

One of the first clinics to advertise post–cataract surgery injections as an alternative to eye drops was the Key-Whitman Eye Center, the biggest eye-care practice in North Texas. Its 140-person staff is led by president and chief surgeon Jeffrey Whitman, named one of Dallas’s top doctors for 13 years straight by D Magazine. His operation has grown from one office to six, including, as of 2016, a two-story, 35,000-square-foot facility.

“Don’t have to worry about using drops four times, three times a day, twice a day,” Whitman said in a November 2015 ad. “We instill the medication at the end of the surgery. They don’t have to worry about a thing.

Key-Whitman bills about $40 million for all of its procedures every year, thanks in part to aggressive marketing and TV commercials. How much it was making off the post-surgery injections is unknown. TriMoxi is not covered by insurance; one patient’s receipt, seen by BuzzFeed News, shows that the clinic charged them $250 out of pocket to receive TriMoxi after cataract surgery.

The clinic initially sourced its TriMoxi injections from Imprimis, according to one of the Dallas lawsuits. But for reasons still unclear, for a three-week period at the beginning of 2017, it ordered the drugs from Guardian instead. Those drugs were used in cataract surgeries between Jan. 30 and Feb. 21, and then the clinic went back to Imprimis.

It’s disputed how Guardian created the formula for its version of TriMoxi and whether it had help from PCCA. Regardless, the results were botched. According to a medical expert’s report filed in court, as well as an FDA investigation, the injections contained too much of a chemical compound known as a poloxamer: Imprimis’s original formula contained less than 3% of it, whereas Guardian’s batches tested as high as 12%. In the course of preparation, the too-high dose of poloxamer apparently disintegrated into a toxic mix. In the case of one patient described in his doctor’s report, that toxicity appeared to irreversibly damage his retina — the thin layer of tissue on the back wall of the eye that contains the cells crucial for vision. (The medical expert, one of TriMoxi’s original inventors, maintained that the original formula was safe.)

“What they did was completely criminal, and I think that I was used as a guinea pig.”

The FDA knows of at least 43 people harmed by Guardian’s version of TriMoxi. Attorneys say they know of at least 68, the vast majority of whom — including Cosby — had their surgeries done at the Key-Whitman clinic. A dozen others went to a smaller facility in Dallas, the Park Central Surgical Center, which was using injections from Guardian for surgeries around November 2016, according to Andrew Sommerman, an attorney for the plaintiffs.

One patient is suing Guardian in a lawsuit now pending before an appeals court in Texas, after a trial court refused to dismiss the lawsuit. (His attorney did not return a request for comment.) The rest plan to join the complaints filed last week, according to their attorneys.

Guardian’s Munn told BuzzFeed News that “no connection has been established between any Guardian product and the unfortunate adverse event alleged” in Texas. He also said the company “is committed to the quality and safety of all of its compounded products and has a rigorous quality assurance program in place.”

The surgeons disagree. A spokesperson for Park Central Surgical Center said, “We were devastated to learn that some of our patients may have been harmed by a product prepared by Guardian.” The center has stopped using the product and the pharmacy, and notified patients and the FDA, the spokesperson said.

Last spring, when his patients were reporting vision loss, Whitman blamed Guardian in an interview with the Dallas Morning News. Although he felt “a little bit hopeless,” he said he was “more angry at the compounding pharmacy for making something that injured our patients.” The clinic has also said that the problems were not caused by “any surgical technique.” Key-Whitman declined to comment for this story, and surgeons Whitman and Lee did not respond to requests for comment.

Whitman’s patients included Van Vandiver, a retiree in the town of Lindale, Texas, who had the surgeon remove a cataract in his left eye in February 2017. Two weeks later, Vandiver began having headaches and blurred vision. He told Whitman about them, but “they were dismissed as issues that would eventually clear up,” according to court filings.

So Vandiver returned to have the surgery on the other eye. By the end of March, he could not see the big “E” on an eye chart. Everyday activities — driving, mountain biking, woodworking — are no longer possible for him, according to court filings.

Sue Pope, 72, was enjoying a retirement filled with cruises to destinations like Alaska and the Panama Canal. In hopes of seeing them more clearly, she went to Key-Whitman last January to have the cataract removed from her right eye.

When her eye patch came off a few days later, “I saw these blades that looked like ceiling fans going around and around and around,” recalled Pope, who lives outside Dallas in Wylie. They never went away. She trips over curbs and stairs because she has lost her depth perception. She can’t drive on freeways anymore, and never drives at night. At best, she figures her right eye is capable of seeing 10% of what it once could.

“What they did was completely criminal,” she told BuzzFeed News, “and I think that I was used as a guinea pig.”

Cecelia Griffin, 58, of Edgewood, Texas, was nervous about cataract surgery. But as a grocery store merchandiser, she was constantly bending over to shelve snacks, and was frustrated that her glasses would slip off. Plus, she’d seen so many commercials for the procedure on TV, full of people marveling over their newly clear vision. She figured it was worth having it done, starting with her right eye.

But by the time of her follow-up appointment two weeks later, the sight out of that eye was filled with black dots, and she was unable to focus on anything that wasn’t close by. Now, she comes home from work exhausted from straining her good eye, which, she fears, could someday go bad too.

“I went in to have a procedure done to help my vision so I wouldn’t have this problem,” she said. “And I trusted somebody and my fears came true.”

Cecelia Griffin in Edgewood, Texas.

During a congressional hearing in January, FDA Commissioner Scott Gottlieb acknowledged that, despite increased federal oversight of compounders, patients are still getting hurt from a variety of drugs.

Since the Drug Quality and Security Act was passed in November 2013, Gottlieb said, the FDA has overseen more than 150 recalls of compounded drugs and sent more than 180 warning letters. The agency has noted problematic conditions in the “vast majority” of nearly 500 inspected facilities. This month, the FDA said that it and the Department of Justice planned to step up enforcement “against compounders that threaten public health.”

Year after year, people report getting sick or worse from compounded drugs. In 2013, 15 patients developed blood infections after receiving infusions of a compounded medication contaminated with bacteria, leading Specialty Compounding to issue a recallin Texas. (Although Speciality was not found guilty of any wrongdoing, it entered a settlement that restricted it from making certain drugs. It is now closed, according to an attorney.)

In 2015, a 22-year-old woman in Texas died after using a pain cream that contained a muscle relaxant and the powerful anesthetic ketamine. The compounded creams turned out to be part of a $17 million health insurance fraud scheme involving two pharmacies, Diamond Pharmacy and Save Rite, whose leader was convicted and sentenced to 14 years in prison.

In 2016, three babies at an Indiana hospital received compounded painkillers that were almost 25 times as potent as they should have been. One had to be airlifted out to another hospital for treatment. Afterward, two executives from Pharmakon Pharmaceuticals were indicted on 10 federal charges related to selling those and other drugs. (One has pleaded guilty, and the other not guilty.)

“A few people die here, a few people die there, and nobody knows it’s happening across the country.”

Since 2001, at least 1,416 injuries, including 115 deaths, have been linked to compounding errors or potential errors, according to the Pew Charitable Trusts, which says those figures are almost certainly incomplete.

“It’s always been a problem with pharmacy compounding: A few people die here, a few people die there, and nobody knows it’s happening across the country,” said Sasich, the Ontario pharmacist.

Some of that bad behavior is conducted by pharmacists who were punished for violations in the past — then moved on to the next gig. For example, two of the executives at Guardian, which is now accused of blinding people, have previously helped run illegal drug-dealing operations.

Guardian’s head pharmacist, Waldrick Lynn Lemons, used to work at Friendly Pharmacy, a now-defunct internet business formed in Garland, Texas, in 1999. According to court documents, Lemons illegally filled online orders for prescriptions, signed by a doctor who never met or spoke with customers.

In a northern Texas district court, Lemons argued that he wasn’t part of the pharmacy’s inner circle, didn’t share its profits, and was merely “a conscientious, yet unwitting, pharmacist working in a ‘climate of activity that reeks of something foul,’” according to records. But during his tenure at Friendly, from April to September 2000, the pharmacy filled more than 1,000 prescriptions a month for prescription drugs, including many doses of the painkiller known as Vicodin. An employee also testified that Lemons expressed concern about the pharmacy’s legality, and Lemons lied to an inspector about who the pharmacy’s customers were, according to court records.

In 2003, Lemons was convicted of conspiracy to distribute a controlled substance, a felony offense. The court put him on probation for five years and house arrest for 180 days. On top of that, in 2006, the Texas pharmacy board suspended his license for five years and ordered him to pay a $1,200 probation fee, according to disciplinary records. (Lemons did not respond to a request for comment sent to Guardian.)

During the same period, Munn, Guardian’s current president, was the head pharmacist and president of a Dallas-based online pharmacy that sold millions of Vicodin pills and other prescription drugs without valid prescriptions. Those sales made Madison Pain Clinic a $24 million enterprise, according to federal prosecutors. (The owner of Madison, David Allen Vogel, was convicted of money laundering and illegal distribution of controlled substances, ordered to repay the government, and sentenced to prison for 20 years.)

Madison’s customers filled out an online form with their symptoms and ordered prescriptions without ever getting examined by a doctor, and Munn approved many of them, according to Texas pharmacy board disciplinary records. In 2007, he allegedly processed nearly 2,300 invalid prescriptions for patients around the country. Munn neither admitted nor denied the allegations before the board in 2009, but his license was suspended for five years and he was ordered to pay $1,200 in probation fees.

Munn’s suspension wasn’t up until the end of 2014, but his other company, the pharmacy that started in 1997, apparently continued to operate during that time. The business has had a few different names over the years, including Melrose Pharmacy Services, state records show. It became Guardian Pharmacy Services in 2011, but two years later, the state of Texas ordered it to cease operations for tax-related reasons.

By 2016, Munn was filing paperwork to reinstate the business. And within a few months, he was facing a new set of problems with the law.

First there was the FDA inspection, prompting the syringe recall. Less than a year later, in July 2017, the agency alerted doctors of the shoddy TriMoxi injections prepared by Guardian.

Four months after that, the FDA rattled off a host of apparent violations in a warning letter to Guardian. Yet another inspection in April of this year yielded a new set of alleged violations related to contamination. And in July, the FDA published its tests of Guardian’s botched TriMoxi, which found the unusually high amount of poloxamer.

Guardian denies allegations that it was negligent in compounding the medications. In response to the April inspection, Munn once again promised to make improvements and argued that Guardian was being held to unfair manufacturing standards, according to a letter that has not been made public but was obtained through a records request.

Even after all that, now two years after the FDA’s first inspection, Guardian has a clean disciplinary record with the Texas pharmacy board, according to the board’s website as of early September. As of this summer, Munn and Lemons have also not been disciplined by the state for anything they’ve done at Guardian.

Allison Benz, the pharmacy board’s executive director, declined to comment on whether Guardian was under investigation. She said that when pharmacists with disciplinary records apply to start new pharmacies, the board weighs several criteria in deciding whether to approve them, including the severity of their past actions and the time that’s lapsed since.

To this day, Guardian appears to be operating as usual. Its answering machine prompts refill-seeking customers to leave a message with their prescription number. Their order, a woman’s voice promises, will be processed the next business day.

Guardian isn’t the only company accused of botching the cataract patients’ eye injections. The Professional Compounding Centers of America — the “mothership” of compounding, as one pharmacist puts it — may also be to blame.

PCCA, headquartered in Houston, is not a compounder itself, but it’s the largest distributor in North America of formulas and ingredients to compounding pharmacies that pay membership fees. The Texas lawsuits accuse PCCA of supplying Guardian with a defective formula that it failed to properly research, test, and inspect, as well as warn about its risks.

In a March 10, 2017, email to a Key-Whitman employee, made public in court filings, Guardian’s president, Munn, wrote that the TriMoxi formula it used “initially came from the PCCA consultant that works on and prepares requested formulas for members (like Guardian).” He added that although Guardian didn’t have paperwork “on the ‘original’ Imprimis formula,” the PCCA consultant had previously worked with Imprimis. The relationship between those two companies goes back several years: PCCA invested $4 million in Imprimis in 2012, according to financial filings.

PCCA told BuzzFeed News it has had no involvement with Imprimis’s operations nor the development of TriMoxi. It also said that Munn’s email was inaccurate. The company has never employed a consultant who worked on Imprimis’s TriMoxi formula, a spokesperson said, and its pharmacy consultants do not prepare formulas.

What’s more, PCCA denies all of the lawsuits’ allegations. “Any statement that PCCA ‘supplied’ Guardian Pharmacy Services with a ‘defective TriMoxi formula’ is completely false,” a spokesperson said in a statement to BuzzFeed News. TriMoxi is not, and has never been, in PCCA’s database of formulas, the spokesperson said.

But PCCA has been linked to at least one similar case in the past. During a cataract surgery in 2009, a Florida woman was injected with a compounded medication that, she alleged in a lawsuit, blinded her left eye. The compounder, AnazaoHealth Corporation, in turn blamed PCCA for providing it with a “negligently written” formula. Anazao alleged that it had followed the recipe exactly, but that PCCA later corrected it without telling Anazao about the change. The case was eventually settled for an undisclosed amount, and PCCA denied any responsibility for the alleged injuries.

PCCA has also clashed with federal regulators. A 2001 FDA warning letter, for example, said that PCCA had failed to make sure that penicillin shipments weren’t being contaminated by other antibiotics. (PCCA said there was no contamination found and the issues raised in the letter were resolved.)

In 2006, US marshals and the FDA raided PCCA and seized more than 300 bottles of four medications meant to be sold to compounding pharmacies. Those allegedly “misbranded” meds included domperidone, a drug not approved for use in the US. (PCCA says that the FDA’s warnings about domperidone were not clear or legally binding, and that it did not violate federal or state law. Under a 2009 settlement in which PCCA did not admit to wrongdoing, it agreed to destroy the seized drugs because they were old, not because they were illegal, according to PCCA.)

But from 2012 to 2015, as the California pharmacy board later found, PCCA was still selling hundreds of orders of domperidone to at least 113 pharmacies. In February of this year, its license in California was put on probation for a year, and it was fined $5,500, under a settlement agreement, again not admitting to any wrongdoing.

More troubling conditions turned up in a 2017 FDA inspection of PCCA, including failures in its drug quality-control process and failures to properly clean the equipment used to repackage medications. PCCA says it immediately corrected the problems.

Experts who track the compounding pharmacy world don’t agree on the best way to regulate it.

Some say the 2013 Drug Quality and Security Act is making the industry better, albeit gradually. Research by the Pew Charitable Trusts, for example, shows that most states have toughened requirements for pharmacies compounding drugs that need to be kept sterile. Those include strengthened manufacturing standards and prohibitions from making drugs without prescriptions.

Elizabeth Jungman, Pew’s director of public health programs and a former US Senate staffer who worked on the 2013 law, noted that the FDA is still drafting guidelines for how to comply with the law.

“The idea that it didn’t immediately, the day the law passed, transform everything, is not at all surprising,” she said.

“You’ve actually done very little to prevent this from happening again.”

But others say that industry lobbying watered down the bill so much that it’s basically useless.

“You’ve actually done very little to prevent this from happening again,” said Kevin Outterson, a health law professor at Boston University, who was part of a commission that proposed responses to the Massachusetts disaster. “I hope I’m wrong — I hope nothing like this ever happens again — but there’s very little in the DQSA that was really going to make you feel good that [that] tragedy wasn’t going to be repeated.”

Andrew Sommerman, one of the attorneys for the Dallas patients, says that his clients, who will likely never regain their full sight, are each seeking at least $1 million for their injuries. “It is a poor substitute, but it is the only one the law allows,” he said.

He says that the case should serve as a wake-up call to compounders like Guardian. “We hope that our victory in this case will send a message to the compounding industry, one that says you cannot skirt the rules of the FDA, or safe and effective rules associated with drugs and pharmacies, by creating drugs in a roundabout way,” he said.

Cosby, the former trucker, has a simple wish for all the businesses involved. “I wish all of them would have to shut down,” he said.

No matter what happens to Guardian, PCCA, or the eye surgeons, Cosby doesn’t expect he’ll ever again get behind the wheel of a truck. He used to coach youth football and basketball, and umpire baseball games. He used to hunt and play golf. Nowadays, he can barely make out Food Network shows on the newly purchased, nearly 7-foot TV screen in his house, where the lights remain on around the clock.

Sometimes, he said, he sees commercials for Key-Whitman.

People in the commercials say, “Come see us — we’ll change your life,” Cosby said. “I’ve never seen a truer commercial in my life.”

 

Sept 24th 2018

Experts reveal why new mothers should not be scared to breastfeed

Why new mothers should NOT be scared to breastfeed: Expert reveals 7 reasons many think they can't feed babies the 'natural way' and what to do instead

·       Professor Amy Brown, a researcher and infant feeding expert, shares her tips

·       A survey found just half of UK women are still breastfeeding after six weeks

·       Common fears include breastfeeding pain and not producing enough milk

 

Breastfeeding is good for both mothers and babies, but not everyone will find it comes naturally.

Nursing hit headlines last week when ultra-marathon runner Sophie Power, 36, stopped halfway through a 106-mile race to breastfeed her baby.

The photo went viral and, although some questioned her choice to do the run while nursing a baby, many were supportive of her juggling motherhood with fitness.

An infant feeding survey conducted by the NHS found that 80 per cent of women who stop breastfeeding in the first 6 weeks are not ready to do so – and most stop for reasons that, with the right support and information, could have been prevented. 

It also found that in the UK, just half of women are breastfeeding by six weeks compared to 90 per cent in Scandinavia. 

There are common misconceptions and fears new mothers may have about breastfeeding and, in this piece for Healthista, researcher and infant feeding expert Professor Amy Brown, of Swansea University, debunks seven common fears about nursing.

1. It will hurt

It’s common to worry that breastfeeding will hurt, but with the right advice and support, it shouldn’t. 

The sensation can sometimes take a little getting used to, but any pain that lasts more than a brief few seconds, is excruciating rather than uncomfortable, or damages your nipple, needs sorting out. 

But the good news is that there are plenty of trained professionals out there who can help you.

The key to comfortable feeding is getting your latch right. 

Lots of people imagine a baby just sucking on the nipple like a straw but when a baby latches on correctly they take a big mouthful of your nipple and surrounding darker skin (your areola) and draw your nipple right back into their mouth.

It can be tricky to get this right at first, but it’s really important to persevere as if the latch is not right your baby can damage your nipple and may not get enough milk.

A few tiny adjustments in angle or how you are holding your baby could save your nipples. Ask your midwife to check your latch as many times as you like.

If your baby is still struggling and doesn’t seem to be able to get a deep mouthful of breast, talk to your health professional about getting them assessed for tongue tie. 

Some baby’s tongues are tethered too tightly in their mouths meaning they struggle to latch. Infections such as thrush or mastitis can cause pain too. 

If you notice any itching or pain in your nipples, or deep in your breasts, or hot, red areas then contact your health professional as soon as possible. 

All of these things are fixable and do not have to mean the end of breastfeeding. 

2. ‘I won’t be able to make enough milk’

You might have heard stories that lots of women don’t make enough milk. 

However, with the right knowledge and support most women should make enough milk for their baby. The secret is to feed your baby responsively. 

This means feeding them whenever they want to be fed, throughout the day and night. Babies often feed at least every 2 – 3 hours, often more.

Sometimes they have short feeds, and sometimes longer – just like as adults we don’t eat and drink in a set pattern.

Your body matches your milk supply to how much milk you or your baby remove. When you feed your baby, your body replaces that milk. 

If you feed frequently, you make more milk but if you try to feed less often or give a bottle your body thinks less milk is needed, so makes less. 

Your baby is the best judge of whether they are hungry, not the clock. Ignore anyone who suggests your baby feeds too much or should feed in a routine.  

You can check whether your baby is getting enough milk by thinking about what goes in and what comes out.

Is your baby feeding at least eight to 12 times in 24 hours? Can you hear them swallowing?

If they’re over a week old do they have at least six wet and two dirty nappies a day? (babies older than six weeks might have dirty nappies less frequently). 

Do they look alert and hydrated? For more signs check out the Baby Friendly website.

Some health conditions such as diabetes or thyroid disorders mean you might not make enough milk. 

Sometimes women do not have enough glandular tissue in their breasts (known as hypoplasia) so might make less milk. 

If you have this you probably noticed your breasts did not change much in pregnancy, may be long and thin, and widely spaced. 

However, not making a full milk supply does not need to mean the end of breastfeeding – you can still breastfeed alongside formula if necessary. 

Talk to your health professional about the best ways of making as much milk as possible.

Breastfeeding is good for both mothers and babies, but not everyone will find it comes naturally.

Nursing hit headlines last week when ultra-marathon runner Sophie Power, 36, stopped halfway through a 106-mile race to breastfeed her baby.

The photo went viral and, although some questioned her choice to do the run while nursing a baby, many were supportive of her juggling motherhood with fitness.

Sept 22nd 2018

Lemon water can actually improve your health — here's the best time to drink it

    The lemon wedge you use to flavor your water might actually be good for your health Lemons are a good source of vitamin C and they contain compounds that may protect your cells and improve metabolic health. Staying hydrated maintains your ability to produce energy and allows you to exercise efficiently.

What do you drink first thing in the morning? If it doesn't involve water and a lemon you might be missing out on some pretty fantastic benefits for your health.

"Drinking water with lemon anytime of the day can help you get and keep better health," registered dietitian Ashley Koff, RD, told INSIDER.

Water is helpful because it brings nutrients into the cells and it also helps remove waste products from the body.

Koff explained that adding lemon (juice) will make the water more "alkaline-forming." This can be helpful for the digestive tract because it creates a nicer home for good bacteria.

"The lemon triggers the release of sodium bicarb (alkaline part) into the small intestine, and this can help relieve indigestion," said Koff.

Stephanie Ferrari, MS, RDN, told INSIDER there's no reason not to drink lemon water. "It helps keep you hydrated and thus improves muscle function and digestion. It may also aid in weight loss."

She explained that the bitter flavor of the lemon is thought to increase bile production and flow.

What's so special about lemons?

Well, not only do they taste good with pretty much everything, lemons are also a great source of vitamin C, polyphenols, antioxidants, and vitamin C.

Plus, the powerful antioxidants found in vitamin c help fight the damage caused by free radicals.

Drinking lemon water first thing in the morning gives your body the antioxidants it needs to rejuvenate your skin and keep it looking fresh.

Why should you drink lemon water in the morning?

If lemon water is good for you anytime of the day, what makes the morning so important?

"The benefits of drinking lemon water in the morning may be more related to drinking water than the lemon itself," registered dietitian and weight loss expert Paul Salter told INSIDER.

He explained that drinking a large glass of water can help re-hydrate you after an extended period without fluid consumption. Plus, it also has a positive impact on appetite suppression.

Ferrari explained that when you wake up in the morning your body is in a state of dehydration. Since you've gone roughly eight hours overnight without eating or drinking, your gastrointestinal tract is like a clean slate.

"By starting the day with a full glass of lemon water, you are jump-starting your day with a good source of vitamin C form the lemon and all the benefits of naturally hydrating with water," said Ferrari.

And as an added bonus, if you replace less healthy beverages (like sugar-sweetened coffee drinks) with lemon water, you're cutting calories and adding nutrients. Now that's a win-win.

 

Sept 20th 2018

The surprising things that could be causing your headaches

Painful headaches can strike unexpectedly and leave you feeling tired, washed out or worse, nauseous and bed-ridden.

Research has shown the ailment is so common that up to a third of the world's population suffer from this affliction daily basis.

And while some causes are obvious there are also a few lesser-known reasons for what causes headaches and migraines. 

From air conditioning to poor posture and even ill-fitting bras, here FEMAIL takes a look at some of the more unusual headache triggers.

Many homes and offices come fitted with air conditioning as a way to control the elements.

But for those who suffer headaches, this could potentially be a cause.

This is because air conditioning removes all moisture from the air which can lead to dehydration.

On top of this, air conditioning units can circulate dust and mould and if you are prone to allergies this can leave you with swollen and painfully blocked sinus passages.

'Then, there’s the fact that when it gets too cold, the blood vessels in your brain can contract, resulting in headaches,' Sporteluxe reports.

Certain foods

If you get headaches after you've eaten, these may be caused by consuming certain foods.

Alcohol, chocolate, and caffeine have been identified as common migraine triggers, however, other foods, particularly those that are aged, pickled, marinated or smoked have also been found the cause of some headaches.

The reason for this is these foods contain a naturally occurring compound called Tyromine.

Tyromine is also found in larger amounts in over-ripe bananas, avocados and chocolate.

Poor posture

Slumping and slouching isn't just bad for your posture, it's also a cause of tension headaches. 

Tension headaches are generally characterised by a constant ache and feeling of pressure round the head.

They are usually caused by either muscle contractions or chronic tension in the head and neck region.

A change in the weather

While you wouldn't expect it, a change in the weather can be enough of a trigger to set off a headache in some.

This is because pressure changes that affect the weather are thought to cause imbalances in brain chemicals, including serotonin, which can prompt a migraine, the Mayo Clinic's website states.

'Weather-related triggers also may worsen a headache caused by other triggers.'

Wearing an ill-fitting bra

If you're wearing the wrong size bra for your shape, this could be a contributing factor as to why you may be suffering headaches. 

Paula Svoboda, a Sydney-based bra fitting specialist said previously that wearing the incorrect size, along with the weight of the breast can cause stress on the shoulder, which then leads up the neck.

'Headaches can be triggered by bras which are either too tight or too loose, but more often they are caused by looser fits,' she said.

Her claim is supported by Triumph's 2008 research, which found 70 per cent of women surveyed wore bras that were too small, while 10 per cent wore excessively large designs.

Sex headaches

For some, a passionate night between the sheets can result in painful headaches.

According to the sex researcher, Dr Margaret Redelman 'sex headaches' - which affect men more - come in two forms.

The first, called pre-orgasmic headache, is triggered by a build-up of pressure that increases as sexual excitement does.

And the other, dubbed orgasmic headache, have an 'explosive, throbbing quality and appear just before or at the moment of orgasm'.

This thunder-clapping pain has been described as feeling 'as if you’ve been hit over the head with a cricket bat'.

 

Sept 19th 2018

Woman's Liver Problems Tied to Her Turmeric Supplement

Turmeric supplements are popular these days, but for one woman in Arizona, taking a turmeric supplement may have triggered an uncommon liver problem, according to a new report of the case.

What's more, the link between the woman's liver problem and her turmeric supplement use wasn't identified by her doctors — but rather by the woman herself, after she consulted the internet.

Until the woman brought it up, her doctors weren't aware that she was taking a turmeric supplement, and the case underscores the need for doctors and patients to communicate about the supplements that patients are taking, the report's authors said. [27 Oddest Medical Cases]

The report, by researchers at the University of Arizona, was published Sept. 10 in the journal BMJ Case Reports.

Turmeric as a supplement

Turmeric is perhaps best-known as a spice in curry powder, but some studies suggest that it has anti-inflammatory properties. Early research suggests that turmeric may help with certain conditions, such as osteoarthritis and rheumatoid arthritis, but more research is needed on its benefits, according to the National Institutes of Health (NIH).

In the new case, the 71-year-old woman started taking turmeric supplements after she read a news article about a study in animals that suggested turmeric may help prevent stroke. She was also taking 20 other medicines and supplements. Her health care providers knew about most of these medicines and supplements, but not the turmeric.

About eight months after she started the turmeric supplements, a blood test showed elevated levels of liver enzymes — a sign of liver problems, the report said.

Further tests revealed the woman had a condition called autoimmune hepatitis, in which the body's immune system attacks the liver, causing inflammation and liver damage, according to the NIH.

After her diagnosis, the woman was monitored closely without receiving specific treatment. But three months later, she told her doctor she had stopped taking turmeric, after she read on the internet about a possible link to liver problems.

This was the first time the woman had told her doctors about the turmeric supplement. And her suspicion about its tie to her liver problems may have been right — after she stopped taking the turmeric supplement, her doctors noticed a rapid decrease in her levels of liver enzymes, the report said.

It's known that in about 10 to 15 percent of people with autoimmune hepatitis, the condition is triggered by drugs or supplements, the report said. In these cases, the condition is called drug-induced autoimmune hepatitis. It's unclear how drugs or supplements trigger drug-induced autoimmune hepatitis, but it's thought that in some cases, the breakdown of drugs may lead to the formation of molecules that trigger an immune reaction, according to the NIH.

When the authors of the new report reviewed 35 previous studies of turmeric supplements in people, they found that about 5 percent of participants in those studies experienced liver problems tied to the supplements. It may be that some patients, such as older adults or those who consume alcohol, are more prone to these problems tied to supplements.

Still, the authors said that it's unclear whether turmeric compounds were indeed responsible for the liver problems in the woman's case. A sample of the product was not available to test, but it could be that contaminants in the product, rather than the turmeric itself, triggered the condition, the report said. Or, it may be that the combination of turmeric and other medicines and supplements that the woman was taking led  to the condition.

Still, the new case "highlights the importance of discussing DS [dietary supplement] use," particularly among older patients, who may be taking multiple drugs and are also at greater risk of liver problems, the report said.

The NIH recommends that patients tell their health care providers, including their doctors, pharmacists and dietitians, about which dietary supplements they are taking so that they can discuss what's best for the patients' overall health.

 

Sept 18th 2018

Having fish eat dead skin off your feet may be a trendy (and ticklish) way to exfoliate, but so-called "fish pedicures" could pose health risks. Indeed, one woman in New York developed an odd toenail problem after having a "fish pedicure," according to a new report of the case.

The woman, in her 20s, went to the doctor after noticing that her toenails looked abnormal — a problem she'd had for about six months, the report said.

She wasn't in pain, but there appeared to be breaks in her toenails, so that the bottom part of her nails separated from the top part

After having a "fish pedicure," a woman in New York developed a toenail condition called onychomadesis. The condition can cause deep grooves that run horizontally across the nails, or large gaps where there is no nail.

Credit: Reproduced with permission from JAMA Dermatology. 2018. doi:10.1001/jamadermatol.2018.1827. Copyright© 2018 American Medical Association. All rights reserved.

The patient didn't have any typical risk factors for toenail problems — such as an injury to the nails, or a family history of nail disorders — but she did report that she had a fish pedicure a few months before her nail problems started. [27 Oddest Medical Cases]

The patient was diagnosed with onychomadesis, a condition in which the nail separates from the "nail matrix," or the tissue under the nail that produces cells that allow the nail to grow. The condition occurs when something causes the nails to stop growing for a while, according to the American Academy of Dermatology (AAD). As a result, people may see deep grooves that run horizontally across their nails — known as Beau lines — or they may see larger gaps where there is no nail, the AAD said.

Ultimately, the condition usually causes the nail to fall off, according to the new report, published today (July 3) in the journal JAMA Dermatology. However, people with onychomadesis usually experience spontaneous regrowth of their nail within 12 weeks, according to a 2017 report in the journal Cutis.

A number of things may cause onychomadesis, including infections, autoimmune disorders, certain medications or hereditary conditions. But this is the first case of onychomadesis tied to a fish pedicure, the new report said.

During a fish pedicure, people immerse their feet in a tub of water that contains small, freshwater fish called Garra rufa, which are native to the Middle East, according to the Centers for Disease Control and Prevention. These fish typically eat plankton, but if plankton aren't available, they will eat dead human skin.

The popularity of fish pedicures peaked about 10 years ago, but they are still trendy today, the report said. But, there are several risks linked to fish pedicures — for example, when the fish are present, the tubs cannot be properly cleaned between one customer's use and another's. In addition, the fish themselves cannot be sanitized between each customer's pedicure session, the CDC says. So, there's concern that the pedicures might spread infections.

Indeed, in 2012, researchers in the United Kingdom intercepted shipments of Garra rufa fish bound for U.K. spas and tested them for bacteria. They found that the fish carried a number of potentially harmful bacteria, including Vibrio vulnificus, which can cause skin infections, and Streptococcus agalactiae, which can cause skin and soft-tissue infections, according to the 2012 study, published in the CDC journal Emerging Infectious Diseases. In addition, in 2014, researchers from Italy reported the case of a person who took a fish pedicure and then developed a foot infection caused by the Staphylococcus aureus bacterium.

In the new case, it's not exactly clear how fish pedicures might cause onychomadesis, but it's likely that trauma from the fish biting multiple nails caused the nails to stop growing, the report said.

"This case highlights the importance of skin and nail problems associated with fish pedicures and the need for dermatologists to educate our patients about these adverse effects," the report concludes.

 

Sept 11th 2018

Back to school kids can be helped to ease their anxiety with these tips

Some children worry more than others – and it can be heartbreaking and frustrating for parents and grandparents (

Tears, tantrums and tummy aches come with the territory with a new school year. But they could be a sign your child has crippling anxiety.

Some children worry more than others – and it can be heartbreaking and frustrating for parents and grandparents.

Here, psychologist Dr Nigel Blagg, author of the School Phobia And Its Treatment guide, offers this lesson.

FIND THE CAUSE

Anxiety about going back to school is often caused by additive stress – when worries build up over time.

These concerns can be caused by relationships with other pupils, reading out loud or being asked questions in class.

Difficulties with a teacher or an aspect of your child’s school work could also be a factor, as could travelling on a school bus or worries about doing PE.

Starting secondary school is a trigger. You have lots of different teachers, different expectations and you find yourself with a whole new group of children. You have to get used to a bigger environment and some don’t find it easy to adapt to that change.

Or it could be separation anxiety – fears about leaving mum or dad. The start of a new school term is always difficult because youngsters have been spending so much time with parents over the holidays.

BE CALM BUT FIRM

You have to be encouraging but firm with your child.

If anxiety means they do not go to school atall, then all sorts of problems can build up quickly.

They do not get into the routine, fall behind with work and worry about what teachers and other pupils will say.

With separation anxiety, the dynamic that usually occurs is your child is anxious and as a parent, you are over-attentive to that. This then makes your child more anxious.

You have to stay relaxed and not give them the impression you are worried.

REASSURE THEM

Reassure your child using positive, optimistic phrases.

Promote the positives of a new school year – it will be exciting to start a new school or class, have a new teacher and make new friends.

You can also help them realise it is not unusual to worry.

Use examples from your own life experience to explain that many fears are greater than they seem and will be dealt with faster by facing them.

STICK TO A ROUTINE

It is important to get your child into the school routine as quickly as possible.

Try to stick to the normal routine at your school – taking your child to school every day instead of sending them on the bus, for example, can create a dependency difficult to break.

SPEAK TO SCHOOL

If your child is really presenting with a lot of anxiety and worries, have a word with the school. They are usually sensitive about children with anxiety problems and can do a lot to help.

Speak to the year tutor if it is a secondary school or the head if it is a primary. Sometimes it is enough to tell the child you have talked with a tutor who will make sure they do not feel awkward.

RAPID IMPROVEMENT

Although your child might be anxious to the point of feeling sick, trembling or having severe tantrums, you can find their anxiety disappears quickly once they get in a routine.

Separation anxiety most often occurs in younger children. Usually they have one teacher to get to know, who is attentive.

Once your child forms a relationship with them, all is well.

GET EXTRA HELP

If the problem cannot be resolved with support from the school, request urgent help from an educational psychologist via the school or your local authority.

If it remains unresolved, speak to your GP and request an urgent referral to child and adolescent mental health service.

 

Sept 10th 2018

Heartburn: This is what causes acid reflux and how you can treat it

You've probably experienced heartburn before, but some people may not know what causes the uncomfortable burning feeling in their chest.

It's felt directly behind the breastbone, and can also rise to the throat and result in an acidic or bitter taste in the mouth.

The pain is often worse after eating, when lying down, or in the evening, and although the discomfort is typically not a cause for worry, it can be irritating if it occurs frequently.

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Fortunately, occasional heartburn is easy to remedy with over-the-counter medicines or lifestyle changes.

What is heartburn?

The burning in your chest is the result of acid reflux, a phenomenon where stomach contents are forced back up into the oesophaguses, the pipe where food travels to the stomach, according to the Mayo Clinic.

The issue frequently occurs when the lower oesophageal sphincter weakens or relaxes abnormally.

The contents of the stomach are extremely acidic, which is what causes the burning sensation.

The feeling can also be felt in the back of the throat.

Frequent acid reflux that occurs more than twice a week is called gastro-oesophageal reflux disease (GORD), which may have more severe consequences than occasional heartburn, according to the NHS.

What causes heartburn?

There is not just one thing that causes heartburn - as different foods, beverages and lifestyle choices can trigger it.

According to the NHS, food and drinks such as coffee, alcohol, chocolate, and fatty or spicy foods can all lead to heartburn.

There are also certain factors that contribute to the possibility of heartburn, such as smoking, stress and anxiety, being overweight, or pregnancy, according to the NHS.

According to Livescience, heartburn occurs more frequently in the elderly, however, anyone can get heartburn.

If you are experiencing frequent heartburn more than twice a week, you should visit the doctor, as it can be a sign of a more serious medical condition.

How do you cure heartburn?

Fortunately, occasional heartburn is quick and easy to fix.

For those suffering with heartburn, antacids, which can be found at the pharmacy, are helpful.

Antacids neutralise stomach acid and provide relief.

H-2-receptor antagonists (H2RAs), which reduce stomach acid, may also be used to treat heartburn, according to the Mayo Clinic. These typically provide longer-lasting relief, however, they make take longer to work.

Another over-the-counter option are proton pump inhibitors, which are also used to reduce stomach acid.

Additionally, changing your lifestyle can also be beneficial in preventing heartburn.

To reduce the risk of acid reflux, you can limit trigger foods, eat smaller meals, and refrain from eating three to four hours before laying down.

Other changes, such as avoiding tight-fitting clothing and sleeping with your head elevated may also ease heartburn.

If you do suffer from occasional heartburn, try changing your lifestyle in addition to using medicines known to help with the symptoms.

If symptoms persist or worsen, you should seek medical attention.

 

Sept 9th 2018

More antibiotics could be key to battling antibiotic resistance

Antibiotic resistance could be tackled by giving people a combination of drugs which no longer work on their own, a new study suggests.

Scientists have discovered thousands of drug cocktails which can fight bacteria even though bacteria may have grown resistant to them individually

Previously it was thought that the downside of combining antibiotics outweigh the benefit because of dangerous interactions.

But the University of California discovered around 8,000 combinations of four and five pills that are effective, a breakthrough which researchers say could be a major step forward in protecting public health.

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"I was blown away by how many effective combinations there are as we increased the number of drugs," said Van Savage, the study's other senior author and a UCLA professor of ecology and evolutionary biology and of biomathematics.

"People may think they know how drug combinations will interact, but they really don't."

Health experts have warned that within 20 years even routine operations such as hip replacements and organ transplants could be deadly because of the risk of infection.

In Britain, at least 12,000 people die from antibiotic-resistant bugs each year, experts estimate - more than die of breast cancer.

For the new research, scientists looked at eight common antibiotics and analysed how every possible four and five drug combination, including with varying dosages, worked against e-coli.

The combinations worked together because individual medications have different mechanisms for targeting E. coli.

"A whole can be much more, or much less, than the sum of its parts, as we often see with a baseball or basketball team,” said Dr Pamela Yeh, one of the study's senior authors and a UCLA assistant professor of ecology and evolutionary biology.

"There is a tradition of using just one drug, maybe two. We're offering an alternative that looks very promising. We shouldn't limit ourselves to just single drugs or two-drug combinations in our medical toolbox.

“We expect several of these combinations, or more, will work much better than existing antibiotics."

The research was published in the journal Systems Biology and Applications. 

Sept 7th 2018

The hidden health benefits of bee stings

A doctor in Gaza is experimenting with bee stings to treat a wide range of ailments.

Many people fear bees because they don't want to get stung, but, despite the discomfort felt, bee stings can actually promote health.

When a bee stinger is activated, it releases more than just venom. An estimated 18 to 20 naturally occuring antibiotics and antivirals can be found in the ensuing concoction, along with anti-inflammatory and pain reduction substances. Bee stings can also trigger reactions in the human body that generate healing properties that would otherwise remain dormant. 

Consuming honey is believed to promote general wellbeing and is thought to be effective against "insomnia, anorexia, stomach and intestinal ulcers, constipation, osteoporosis, and laryngitis." 

There's been a recent surge in interest around the medicinal purposes of bees, also known as Apitherapy, but humans have sought these therapeutic benefits for millennia. 

Thousands of years ago the Egyptians used bee products to address arthritis. More recently, doctors in the US have turned to bees to treat multiple sclerosis and immune system disorders that attack skin or nerves. 

In Gaza, as the video above shows, an alternative medicine professional and a team of researchers are cultivating bees to treat health issues ranging from "hair loss to cerebral palsy to cancer." 

A lot of research has to be done to determine just how effective apitherapy is, but there's little reason to discount the possibility of widespread health benefits. After all, the majority of medicine used today is derived from naturally occuring substances or is modelled on the properties and behaviors of what can be found in nature. Since bees interact with wildlife, it makes sense that they would develop methods for combatting pathogens, while also picking up beneficial substances.

Of course, not everyone can get stung by a bee. Some people will have harsh allergic reactions. 

But at a time when fears of antibiotic resistant super bugs are on the rise, this hidden trove of medicine could help doctors discover new treatments.

Bees already provide humans with copious benefits, mostly by pollinating 30% of the world's crops and 90% of the world's flowers. So protecting them and restoring their ecosystems needs no further justification. 

But if it turns out that bees can also treat a range of health problems, then their survival becomes even more important. 

 

Sept 6th 2018

Statins 'have no benefit' for thousands of healthy older people taking them

Statins have no benefit for thousands of healthy older people taking them to prevent heart disease or stroke, according to research.

Many over-75s take the pills to protect against the risk of illness.

Yet the study suggests they only benefit those in this age group already with heart disease or type 2 diabetes.

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Around six million UK adults take them. Experts say a further six million high-risk patients should too.

Statins cost 3p a day and lower bad cholesterol.

But the findings said there was “no evidence” that taking them for primary prevention in healthy over-75s prevents cardiovascular disease, the leading cause of death for this age group, or early death.

The five-year population study looked at 47,000 people in Spain. Diabetics aged 75 to 84 had a 24% lower risk of CVD with statins and a 16% lower risk of dying. The protective effect appeared to end by 90.

Dr Rafel Ramos, of Barcelona’s Jordi Gol Institute for Primary Care Research, said the study had “a large sample size, reflecting real-life clinical conditions”.

But Prof Colin Baigent, of the University of Oxford, said the use of routine health records was “a very unreliable way to determine effects of statins on the risk of heart attacks.

“Clinical trials have shown clearly that statins prevent heart attacks and stroke in over-75s, and benefits are similar irrespective of whether a person’s had a previous [one].”

Studies have shown patients on statins after a heart attack or stroke are 25% less likely to have another one or die early.

 

Sep 2nd 2018

Scientists uncover two 'dreaming genes' that regulate how much you dream at night

Two "dreaming genes" that regulate how much we dream have been identified by scientists. 

The discovery sheds light on the mystery of REM (Rapid Eye Movement) sleep - the phase of sleep during which most dreaming takes place.

Both humans and animals dream, but scientists are still trying to understand what, if any, function dreaming has.

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One school of thought says dreams are simply a by-product of brain activity during sleep.

Another suggests they might have a necessary function, such as helping the brain archive important memories or rehearse challenging scenarios.

During REM sleep, which occurs at intervals during the night, the brain is as active as it is when awake.

Now a team of Japanese scientists has located two genes that appear to switch the REM dreaming state on.

In mice, REM sleep was reduced to almost undetectable levels when both genes were deactivated.

The genes code for two "receptor" proteins, Chrm1 and Chrm3, that produce a biological response when exposed to the neurotransmitter acetylcholine.

Neurotransmitters are chemicals that allow nerve signals to pass between neurons.

When both genes were "knocked out", the mice almost completely stopped experiencing

REM sleep, but appeared unharmed by the experience.

Lead researcher Dr Hiroki Ueda, from the University of Tokyo , said: "The discovery that Chrm1 and Chrm3 play a key role in REM sleep opens the way to studying its underlying cellular and molecular mechanisms and will eventually allow us to define the state of REM sleep, which has been paradoxical and mysterious since its original report.”

Writing in the journal Cell Reports, the scientists said the research would help to show whether REM sleep and dreaming plays a role in learning and memory.

Sept 1st 2018

Is garlic the answer to beating antibiotic resistance?

Scientists hope they have solved the growing threat of human resistance to antibiotics by reproducing a compound found in garlic.

The compound ajoene has been created in a laboratory for the first time, raising hopes it could now be manufactured at low cost and on a large scale.

Antibiotic resistance has been labelled one of the most urgent threats to public health by medical professionals.

They fear a rise in drug-resistant super bugs could become a reality, caused by an overuse of antibiotics.

Antibiotic resistance occurs when bacteria develop the ability to defeat the drugs designed to kill them.

But the new findings could help combat the threat after ajoene, a colourless liquid which interferes with the chemical communication signals between bacteria, was synthetically created for the first time.

The results of the Cardiff University-led research have been published in leading chemistry journal Angewandte Chemie.

Lead author of the study Professor Thomas Wirth, from Cardiff University’s School of Chemistry, said: “Using easily available starting materials we’ve successfully created an efficient, robust and reliable way of producing ajoene in large volumes.

“The remarkable antibacterial properties of this compound have shown great promise and we hope that this new breakthrough will accelerate efforts to produce ajoene in large volumes and better test its effectiveness as a therapeutic drug.”

Aug 30th 2018

Plastic surgery abroad: what you need to know about 'medical tourism'

Know the facts before you go under the knife 

Jetting off abroad for plastic surgery sells the promise of a transformed new you for a fraction of the average UK price.

By travelling abroad, people can save 40 to 80 per cent on plastic surgery, depending on the procedure and the country, according to the International Society of Aesthetic Plastic Surgery (ISAPS).

But whilst choosing to have a procedure abroad might be an attractive option for many, it's often not as smooth sailing as it sounds and can even prove fatal. Tragic Brit Leah Cambridge, 29, died this week after suffering complications from a bum lift surgery in Turkey.

Bum lifts are becoming increasingly popular as women try to achieve the hourglass figure made famous by Kim Kardashian and Nicki Minajbut experts have warned the procedure can carry serious complications.

Of course, cosmetic surgery both in the UK and abroad have their risks, but it is more difficult to fix complications abroad should they arise.

Here's what you need to know if you're considering cosmetic surgery out of the UK...

Is it safer to have plastic surgery in the UK or abroad?

No surgery is risk-free, however, if you choose to get your surgery done in the UK, then the surgeon will be able to discuss long term aftercare and be on-hand if something goes wrong.

Some overseas clinics may not provide aftercare or follow up treatments.

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPAS) encourages patients to make sure they have frequent contact with their surgeon.

They said: "At BAPRAS we believe that patients should be able to see the plastic surgeon who actually carried out the operations if there are any concerns."

What are the risks involved in getting plastic surgery abroad?

As well as various complications that can occur during surgery, there are also risks to consider when travelling back home after having a procedure.

Flying back soon afterwards can leave you vulnerable to deep vein thrombosis (when a blood clot forms in a vein, partially or completely blocking blood flow) and a pulmonary embolism (when a blood vessel supplying the lung becomes blocked by a clot).

BAPRAS advises waiting five to seven days to fly home after procedures such as breast surgery and liposuction, and seven to ten days after facial cosmetic surgery procedures or tummy tucks.

There is also travel insurance to consider. It's rare that a policy will cover you in the event of something going wrong during a planned surgery, so check that you have full insurance cover before you travel.

What is medical tourism?

'Medical tourism' is the term used to describe those travelling to another country to obtain medical treatment.

Medical tourism, which covers all types of procedures including elective plastic surgery, is growing worldwide at an estimated rate of 15 to 25 per cent, according to research firm Patients Beyond Borders.

More specifically, the past few years have seen a rise in cosmetic surgery tourism, which is often sold as a package deal promising surgery and a holiday.

Generally speaking, it's best to approach these kinds of holiday deals with caution.

Firstly, there's the fact that vacation time and surgery just don't go together. You'll need sufficient time to recover after the procedure, which means avoiding lying in the sun, doing anything energetic or drinking alcohol - which are often the highly anticipated parts of the holiday experience.

The NHS advises avoiding 'meet-and-greet evenings' with salespeople, and instead, meeting with the surgeon who will operate on you.

Also never pay to go a hospital you've never seen with a surgeon you've never met without any real understanding of what the surgeon can provide.

Where are the most popular destinations for cosmetic surgery?

Cosmetic surgery tourism is rife, and there are a variety of places patients are currently flocking to for their procedures.

In Europe, popular destinations include Poland, Spain, Czech Republic, Slovakia and Turkey.

Elsewhere, cosmetic surgery is big in Brazil, Thailand, the US and Japan.

How can I minimise the risks?

First, find out as much as possible about the procedure itself.

Then, you need to thoroughly do your research into clinics in your chosen country to find out if they're regulated and have surgeons that are fully trained and can speak English.

Check online reviews and social media to gather independent feedback on the services provided by a specific surgeon or clinic.

Finally, consider the worst case scenario. You need to have a plan in place in case something goes wrong, including insurance arrangements.

BAPRAS advises waiting five to seven days to fly home after procedures such as breast surgery and liposuction, and seven to ten days after facial cosmetic surgery procedures or tummy tucks.

There is also travel insurance to consider. It's rare that a policy will cover you in the event of something going wrong during a planned surgery, so check that you have full insurance cover before you travel.

What is medical tourism?

'Medical tourism' is the term used to describe those travelling to another country to obtain medical treatment.

Medical tourism, which covers all types of procedures including elective plastic surgery, is growing worldwide at an estimated rate of 15 to 25 per cent, according to research firm Patients Beyond Borders.

More specifically, the past few years have seen a rise in cosmetic surgery tourism, which is often sold as a package deal promising surgery and a holiday.

Generally speaking, it's best to approach these kinds of holiday deals with caution.

Firstly, there's the fact that vacation time and surgery just don't go together. You'll need sufficient time to recover after the procedure, which means avoiding lying in the sun, doing anything energetic or drinking alcohol - which are often the highly anticipated parts of the holiday experience.

The NHS advises avoiding 'meet-and-greet evenings' with salespeople, and instead, meeting with the surgeon who will operate on you.

Also never pay to go a hospital you've never seen with a surgeon you've never met without any real understanding of what the surgeon can provide.

Where are the most popular destinations for cosmetic surgery?

Cosmetic surgery tourism is rife, and there are a variety of places patients are currently flocking to for their procedures.

In Europe, popular destinations include Poland, Spain, Czech Republic, Slovakia and Turkey.

Elsewhere, cosmetic surgery is big in Brazil, Thailand, the US and Japan.

How can I minimise the risks?

First, find out as much as possible about the procedure itself.

Then, you need to thoroughly do your research into clinics in your chosen country to find out if they're regulated and have surgeons that are fully trained and can speak English.

Check online reviews and social media to gather independent feedback on the services provided by a specific surgeon or clinic.

Finally, consider the worst case scenario. You need to have a plan in place in case something goes wrong, including insurance arrangements.

 

Aug 29th 2018

Three bars of chocolate a month 'can reduce chances of heart failure'

A little bit of what you fancy could be good for the heart, as well as the soul, a study suggests.

Research on more than half a million adults found that those who ate chocolate in moderation had a lower risk of heart failure than those who avoided such treats.

Scientists found those eating up to three bars monthly had a 13 per cent lower risk of heart failure compared to those who ate none. 

Researchers say natural compounds in cocoa called flavonoids boost blood vessel health and help reduce inflammation. 

But they warned against having too much chocolate, with those indulging daily seeing their risk of heart failure increase by 17 per cent.

The condition affects more than 900,000 adults in the UK, causing breathlessness, chronic coughing, fatigue, and often premature death.

Lead researcher Dr Chayakrit Krittanawong, from the Icahn School of Medicine at Mount Sinai in New York, said: "I believe that chocolate is an important dietary source of flavonoids which are associated with reducing inflammation and increasing good cholesterol. 

“Most importantly, flavonoids can increase nitric oxide [a gas which expands blood vessels, helping circulation].

“However, chocolate may have high levels of saturated fats. I would say moderate dark chocolate consumption is good for health."

The study, presented at the European Society of Cardiology conference in Munich, looked at five studies involving more than 575,000 individuals.

Previous research from Harvard University found eating two to six 30g portions each week cut the risk of atrial fibrillation - one of the biggest causes of strokes - by 23 per cent.

Researchers behind the new study said further trials were needed. 

Victoria Taylor, senior dietitian at the British Heart Foundation, said cocoa had been linked to a variety of health benefits.

She said: “This large-scale analysis suggests that enjoying a moderate amount of chocolate might protect you against heart failure, but too much can be detrimental. 

“If you have a sweet tooth, make it an occasional small treat and go for dark chocolate with the highest cocoa content.”

Aug 28th 2018

12 Health Conditions That Can Affect Your Breasts

Women’s breasts are complex structures, changing naturally with age and hormone fluctuations from menstruation, breastfeeding, and menopause. Even different medications can affect how your breasts feel.

Some breast changes, though, are diagnosable conditions. Of course, you know to discuss changes that could be signs of cancer with your doctor, but there are others that aren’t cancerous now, but may put you at a higher risk for the disease later.

That said, most breast changes are nothing quite that serious. “In 80% of women who come in with a lump, it will be benign,” says Monique Swain, MD, an obstetrician and gynecologist in the breast division of Henry Ford Health System in Detroit.

Most breast conditions–whether they involve lumps or not–can be effectively treated.

Here’s a guide to the different conditions that can affect your breasts.

Fibrosis

Fibrosis, sometimes known as having fibrocystic breasts, is one of the most common breast conditions a woman can have, even more common if you’re still in your childbearing years. It means you have extra tissue in your breasts that would normally be found in scars or ligaments, making your breasts feel ropy or lumpy. The extra breast tissue can also feel rubbery or firm. Some women describe the feeling “as a bag of marbles–very, very lumpy,” says Dr. Swain.

Fibrosis doesn’t raise your risk for breast cancer and, in most cases, doesn’t even need to be treated unless the symptoms are bothersome. Some women report that cutting back on caffeine improves fibrosis symptoms like pain. Over-the-counter pain relievers may also help.

Cysts

Unlike fibrosis, which stays relatively stable, breast cysts can move around your breasts and tend to wax and wane with your menstrual cycle. These fluid-filled lumps may get bigger and more painful just before your period.

“Cysts are nodules. You can feel them when they’re large enough,” says Lauren S. Cassell, MD, chief of breast surgery at Lenox Hill Hospital in New York City. “You can [also] see them on a sonogram. They look like little Swiss cheese holes.”

Cysts don’t need to be treated unless they’re uncomfortable, in which case the fluid can be drained with a hollow needle. Cysts generally don’t raise the risk of breast cancer unless they’re “complex cysts,” meaning they have both a fluid and a solid component. These need to be biopsied to make sure there’s no cancer.

Adenosis

This is a benign breast condition that happens when the lobules (the milk-producing glands inside your breast) get enlarged and proliferate. Adenosis is usually found by accident, when doctors do a biopsy of cysts or fibrosis.

“You can’t tell by feeling,” says Dr. Cassell. “The only way is to see something on a mammogram or sonogram.” It can be difficult to tell adenosis and breast cancer apart on these imaging tests, however, so adenosis usually requires a biopsy to rule out cancer. If no malignancy shows up on the biopsy, adenosis doesn’t need to be treated, Dr. Cassell adds.

Some lobules also contain scar-like tissue. This condition, called sclerosing adenosis, can be painful.

Fibroadenomas

Fibroadenomas are made up of glandular and stromal (connective) tissue, and they can be felt. They’re usually round, firm or rubbery, and can be moved around–but they’re typically not painful.

Experts don’t know what causes fibroadenomas, but estrogen may be involved. “They become enlarged when a woman is on birth control pills, menstruating, and pregnant,” says Dr. Swain. Fibroadenomas also tend to go away after menopause.

Some fibroadenomas can increase your risk of breast cancer and need to be monitored and sometimes removed.

Mastitis

Breastfeeding mothers, in particular, are susceptible to mastitis, an inflammation in the breast usually caused by an infection. The infection may be caused by a clogged milk duct or small lacerations in the breast that bacteria can enter.

In addition to swelling, your breasts may hurt, appear red, and feel warm to the touch if you have mastitis. Some women also have flu-like symptoms like fever and a headache.

Mastitis itself doesn’t increase your risk of breast cancer, but it can be confused with inflammatory breast cancer (IBC), a rare and aggressive form of the disease. If antibiotics don’t succeed in resolving mastitis, you may need a skin biopsy to make sure you don’t have a malignancy.

Hyperplasia

Hyperplasia is an overgrowth of extra cells in the ducts and/or milk glands in your breast. It can be called ductal hyperplasia or lobular hyperplasia depending not so much on where the cells are growing but on what they look like under the microscope. Hyperplasia isn’t cancer per se, but certain types can raise your risk for cancer.

If you have cells that look relatively normal (called “usual hyperplasia”), your risk for breast cancer is not elevated. “Atypical hyperplasia” is when the cells look abnormal under a microscope. This can raise your risk as much as fivefold.

If you have hyperplasia (usually seen on a mammogram and diagnosed with a biopsy), talk to your doctor about how to manage any increased risk of breast cancer.

Breast cancer

There are many different types of breast cancer–not to mention individual preferences for screening and treatment. “Breast cancer is not one disease. Each patient’s history is their history, and their disease is not what their friend has,” says Dr. Cassell.

At its core, breast cancer is an abnormal change to breast tissue that keeps reproducing. Some women may notice a lump while others may notice changes in the skin of their breast or their nipple.

Fortunately, an array of different treatments has emerged to treat breast cancer. “Treatment is very much tailored [to the individual],” says Dr. Cassell.

To help determine treatment, doctors look at factors including the size of the tumor, whether the cancer has spread to the lymph nodes, whether the tumor has estrogen and progesterone receptors, and if it expresses the protein HER2/neu, which can be elevated in some cancer patients.

Eczema

Eczema is technically a skin condition, not a breast condition, but it can certainly affect breasts. Symptoms include dry, red, scaly skin and itchiness. The condition is chronic, meaning it never goes away. Instead, symptoms tend to reappear.

When it comes to eczema on your breasts, the most important thing is to make sure it is not a rare form of breast cancer known as Paget’s disease. This type of breast cancer and eczema “can look very similar–even to the experienced eye–and sometimes it requires biopsy of the skin and underlying tissue to determine,” says Dr. Cassell.

If it is eczema, treatment is the same as it would be on any other part of your body: smart skincare and sometimes medicated creams or ointments.

Psoriasis

Like eczema, psoriasis is a dermatological condition that can affect any area of skin, including your breasts. Psoriasis is an autoimmune disease–when your immune system flips and starts attacking healthy cells–so it can sometimes lead to wider damage throughout your body, including heart disease and psoriatic arthritis, if it’s not controlled.

In psoriasis, the misfiring immune system causes skin cells to die at an accelerated rate. Because of that, cells accumulate on your skin, creating silvery scales and red patches that itch and may hurt. It’s chronic and often requires prescription medication

chickenpox

If you had chickenpox when you were young and think you are safe from any related problems, you could be wrong: Shingles can be a later-in-life consequence of having had the childhood disease.

Shingles occurs when the varicella zoster virus, the virus that causes chickenpox, re-erupts in your body, causing a rash with blisters on one side of your body, sometimes including your breast. Other than a visible rash, the most common complaint is severe pain.

Newer vaccines can help prevent shingles, though they don’t eliminate the risk. If you do get shingles, you generally have to wait out the outbreak, although pain medications can help you get through it.

Rashes

In addition to eczema, psoriasis, and breast conditions like mastitis, IBC, and Paget’s disease, you could also have rashes on the skin of your breasts from other causes. That includes yeast infections, hives, and scabies (caused by mites), as well as intertrigo, a rash that can appear anywhere skin folds. Folds of skin cause friction and trap moisture, leading to red, raw, or cracked skin and a hospitable environment for yeast, fungus, or bacteria.

Most rashes can be handled with simple skincare steps you can take at home: Don’t scratch, don’t use products with fragrances, and stop using any new products you think might have caused or contributed to the rash. Keep the area dry as much as you can.

If the rash doesn’t go away, gets worse, or comes with fever or severe pain, contact your doctor. It’s probably not breast cancer, but you definitely want to make sure.

Acne

Yes, you can get pimples on your breasts. “Most people get acne on the face, however acne can affect other parts of the body, such as the breast and chest,” says dermatologist Michele S. Green, MD, also with Lenox Hill Hospital.

Chest or breast acne can be caused or aggravated by stress, hormones, diet, and certain topical medications, Dr. Green says. Birth control pills may help if hormones are a culprit. Wearing breathable fabrics when you work out, taking a shower afterwards, and using oil-free sunscreen on your chest can also minimize outbreaks.

Follow the same skincare habits you would for acne on your face, Dr. Green adds. “Cleanse your skin using a non-comedogenic cleanser containing glycolic acid or salicylic acid,” she says. “After cleansing, towel dry with a clean towel and apply moisturizer containing salicylic acid, benzoyl peroxide, or glycolic acid. If your skin becomes too dry, alternate between a non-comedogenic moisturizer.

Tea tree oil and topical zinc have antibacterial properties that may help reduce acne on your breasts or chest, as well.

 

Aug 23rd 2018

How to get rid of your runny nose fast

Dry up your drippy nostrils with these simple remedies for your runny nose

A nasty cold isn’t the only thing that causes drippy nostrils. Pretty much anythingthat irritates the sinus cavity or the nerves of your nose — infection, allergies, and even the food you eat — can make your nose super runny.

“In normal situations, the sinonasal mucosa (the lining of your nasal and sinus cavities) can produce up to a quart of mucus per day,” says Ahmad R. Sedaghat, MD, PhD, an otolaryngologist at Massachusetts Eye and Ear Infirmary in Boston. “This mucus normally flows to the back of the nose, down the throat and then is swallowed.”

In short, you don’t notice it. But sometimes, you become a mucus-producing machine. And if you do, it’s important to figure out what’s causing the leak, because different causes have different treatments. While there are surgeries for vasomotor rhinitis (chronic runny nose), there are steps you can take to reduce the flow on your own in most cases. Here, seven common reasons your nose won’t stop running — and how to turn the faucet off.

1. The common cold

When a virus like the common cold enters your nose, it attaches to cell molecules and spurs a release of chemicals called cytokines, which cause inflammation, explains Erich Voigt, MD, an otolaryngologist at NYU Langone Health.

“The human body utilises the process of inflammation to fight off the virus, however, the effects of the inflammation include a runny nose.” With a cold, mucus is usually clear and watery, Dr. Voigt notes. Other symptoms include sneezing, coughing, a sore throat, watery eyes, and mild body aches.

Runny nose remedy: Unfortunately there’s no cure for the common cold, so your best bet is rest, hydration, and over-the-counter cold medicines with an antihistamine — a medication that works to stop a chemical called histamine that can cause a runny nose — and a decongestant, says Dr. Voigt. Sudafed fits the bill.

If you have a fever, can’t-get-out-of-bed tiredness, a cough, congestion, or a thicker, yellow/green discharge running from your nose, your “cold” might actually be a sinus infection, which can crop up when bacteria cause irritation, infection, and discharge, says Anthony G. Del Signore, MD, an otolaryngologist at Mount Sinai Beth Israel in New York. With a sinus infection, you could also notice post-nasal drip, when mucus drains to the back of your throat.

Runny nose remedy: Since sinus infections can be bacterial, you might need an antibiotic. OTC decongestants can also help, and many docs also recommend salt water rinses, which can clear the nasal cavity, says Dr. Sedaghat.

To make a saline mixture, mix ½ teaspoon non-iodised salt and ½ teaspoon baking soda into 150g of distilled or sterile water, says Dr. Sedaghat. This concentration matches the concentration of salt in the body, he notes. There are also also many pre-made saline packets you can pick up at your local pharmacy or Amazon.

To do a rinse, fill a neti pot, lean over the sink, put the tip of the nozzle into your nostril and gently squeeze, going back and forth until the mixture is used up. “The saline may come out the same nostril, it may come out of the other nostril, or it may come out of the mouth,” says Dr. Sedaghat. Do this once or twice a day.

3. Allergies

Your nose can also become runny if it’s exposed to an irritant. “Typically, an acute exposure to an allergen will make the nose itchy, swollen inside, will trigger a lot of sneezing, and clear watery mucous production,” says Dr. Voigt. Allergies cause the chemical histamine to be released, which directly causes said symptoms.

Runny nose remedy: Antihistamines (like Zyrtec or Claritin) are your friend here, as they work to stop the histamine response in the first place. Nasal steroid sprays (like Flonase or Nasacort) can also help decrease inflammation in the nasal cavity and, thus, liquid production, says Dr. Voigt.

If your allergies are caused by pollen, try to avoid it by checking pollen counts. But don’t overlook indoor allergies: Vacuuming your carpet frequently (carpets can fill with dust mites and mould), and using dust mite covers on your bed can help keep symptoms at bay, says Purvi Parikh, MD, an allergist and immunologist at the Allergy & Asthma Network. Keeping your pet out of your bedroom can also limit exposure to allergens.

If you’ve been leaking for more than a week and notice your goop is starting to get thicker or looks yellow or green, make an appointment. Allergies can sometimes morph into sinus infections, Dr. Voigt notes.

Sometimes, your nose runs because of nerve stimulation. “Certain types of nerves in the sinonasal cavities can stimulate the production of more mucus,” says Dr. Sedaghat. And some of those nerves can be activated by spicy foods, he notes.

Capsaicin, in particular — the chemical in hot peppers — causes rhinorrhea (an excess of fluid in your nasal cavity) and sweating. “It’s likely a response to try to get the irritant out of the body,” says Dr. Voigt.

Runny nose remedy: A prescription spray called Atrovent can work to ‘turn off’ the nerves that fire up from spicy foods as well as strong odors, reducing excessive mucus production, says Dr. Sedaghat. But if spicy foods really bother your nose, it’s best to just skip them.

5. Crying heavily

Ever notice that you’re a slobbery mess after a breakdown? “Crying will cause a runny nose because tears drain into the nose through tear ducts,” says Dr. Voigt. 

Stop a runny nose: It’s pretty normal to become a running faucet after you cry. “Sniffing and blowing the nose will clear out the tears and excess mucus, so keep some tissues around,” Dr. Voigt adds.

6. Nasal polyps

Nasal polyps are soft yellow growths that can grow in your nose and sinuses. They have a jelly-like consistency, are made up of inflammatory cells, and can lead to a chronic runny nose, explains Dr. Voigt. If you have them, you might notice a decreased sense of smell, facial pressure, or even difficulty breathing sometimes (if the polyps grow). Doctors aren’t quite sure what causes them, but they appear to be associated with allergies and infections.

Runny nose remedy: See your doctor. Small, benign polyps can sometimes be treated with medications, such as steroids. But if they continue to grow or obstruct your breathing or sense of smell, there are surgeries that can be done to remove the polyps.

“Exercise temporarily increases mucus in your nose and lungs as there is increased inflammation and blood flow to these areas,” says Dr. Parikh. Exercise in lower temps and you’ll get a double whammy: Cold, dry air is particularly irritating to the sinuses and lungs, which prefer warm, moist air, research shows.

Runny nose remedy: Drippy nostrils from a chilly outdoor run usually resolves on their own. Exercising with a scarf or neck guard over your nose can help warm up the air before you breathe it in, too, says Dr. Parikh. If you’re really stuffed up — from a run or just from time spent outside — inhaling the steam during a hot shower can help open your nasal passages, he says.

 

Aug 21st 2018

You and your husband are compatible in so many ways—your love for ceviche, hiking and Black Mirror knows no bounds. But while you’re ready to zonk out at ten, he can stay up until 3 a.m. and still wake up early, feeling refreshed. What gives? We checked in with Dr. Martha Cortes, a New York City-based dentist who sub-specializes in the treatment of sleep breathing disorders, for four of the main biological differences in the way guys and gals sleep. 

1. Women Need More Sleep
Great news: Women are, in general, more adept at multitasking than men are. But all that brain power means that typically, women “need more sleep, because they need the brain to recover from all the work of multitasking,” Dr. Cortes explains. How much more? The National Sleep Foundation says it’s about a 20-minute difference. Worth the daytime productivity, if you ask us.

2. Women Are More Likely to Go to Sleep Earlier
And, in turn, women tend to wake up earlier, too. This is caused by differences in circadian rhythm, which, according to the National Sleep Foundation, is “basically a 24-hour internal clock that is running in the background of your brain and cycles between sleepiness and alertness at regular intervals.” Per Dr. Cortes, women have circadian cycles that are, on average, six minutes shorter. Because of this six-minute difference, women typically go to bed and wake up earlier.

3. Insomnia Is More Common in Women
Sleep apnea, on the other hand, is more common in men. “About 4 percent of men have sleep apnea, compared to about 2 percent in women,” says Dr. Cortes. Women are more likely to experience insomnia than their male counterparts.

4. Women Sleep Deeper Than Men
While women do require more sleep, that sleep is typically more productive than the z’s men are getting. According to a study at the Penn State College of Medicine, “Women without sleep complaints sleep objectively better across age than men, and the sleep of young women is more resistant to external stressors.” Go, girls.

 

Aug 19th 2018

Pain-relieving drug 'reduces need for epidural during labour'

A pain-relieving drug could help halve the number of women needing epidurals during labour, a study has said.

Scientists say remifentanil, which is rarely offered during labour, is more effective at relieving pain than the more commonly-used pethidine, which is given to more than 250,000 women each year.

A study involving 400 women found that half as many of those who were given remifentanil needed a subsequent epidural, compared to those who were given pethidine.

Epidurals, which are given as injections around the spinal chord, provide effective pain relief by blocking sensation, but can often lead to a forceps or vacuum delivery and more problems for mothers later down the track.

Lead author Dr Matthew Wilson, from the University of Sheffield, said the study’s findings “challenge the routine use of pethidine for pain relief during labour”.

He added: “Previous studies have shown that at least one in three women given pethidine to manage pain during labour require a subsequent epidural as the drug is not always effective.

“It also has unwanted side effects such as sedation and nausea for the mother, and it may pass into the baby’s bloodstream through the placenta.

“Remifentanil reduced the need for an epidural by half and there were no lasting problems for the mothers and babies in our trial, although the effect of remifentanil on maternal oxygen levels needs to be clarified in further studies.”

Half of those involved in the trial, which was conducted across 14 maternity units, were given remifentanil during labour, which women could administer themselves by pressing a hand-held device when they felt pain.

The rest were given pethidine, which was given as an injection up to every four hours.

Some 19% of those in the remifentanil group went on to have an epidural, compared to 41% in the pethidine group.

Women given remifentanil rated their pain as less severe, and were also less likely to need forceps and vacuum during labour than women given pethidine (15% vs 26%).

However, experts have cautioned that further studies will be needed before any changes in clinical practice.

Aug 17th 2018

Hope for a new autism treatment as defunct gene is discovered

Scientists have discovered a defunct gene that affects most autism patients.

Known as CPEB4, the gene controls the expression of around 200 other genes that have previously been associated with the condition, a Spanish study found.

The researchers believe CPEB4 may be affected by 'environmental factors' that alter a person's brain development and increase their risk of the spectrum disorder.

Previous findings suggest children may be at a greater risk of autism if their mothers were exposed to certain chemicals or battled an infection during pregnancy. Certain epilepsy drugs and a lack of oxygen at birth are also linked to the condition.

The scientists hope their discovery will help in the development of new autism treatments and methods of diagnosis.

More than 695,000 people in the UK are thought to be on the autistic spectrum. The disorder affects around one in 59 children in the US. 

Protein changes genes linked to autism 

Lead author José Lucas, from the Spanish National Research Council, Madrid, said: 'Upon studying the changes in protein expression in a mouse model with altered CPEB4 activity, we were surprised to observe that the changes included most of the genes that predispose individuals to autism spectrum disorder.'

Co-author Alberto Parras added: 'Since CPEB4 is known to regulate numerous genes during embryonic development, this protein emerges as a possible link between environmental factors that alter brain development and the genes that predispose to autism.'

They concluded: 'Understanding the biological bases of autism may facilitate the design of future experimental treatments and diagnosis tools for this condition. 

'Although further research is required, CPEB4 emerges as a potential new therapeutic target.' 

New cancer drugs could halt autism symptoms and prevent their onset

This comes after research released last June suggested drugs under development for cancer could halt autism symptoms by blocking a protein linked to both conditions.

Unnamed medications that stop the protein ERK2 reaching the brain reverse autism-like symptoms in mice, a study found.

When given to pregnant rodents, the drugs not only ease the mothers' symptoms, such as hyperactivity, but also prevent their offspring from being born with the disorder, the research adds.

Lead author Professor Riccardo Brambilla, from Cardiff University, said: 'It could be possible, in principle, to permanently reverse the disorder by treating a child as early as possible after birth'.

 

Aug 15th 2018

They Thought Hemophilia Was a ‘Lifelong Thing.’ They May Be Wrong.

Experimental gene therapies have yielded promising results in early trials. But the drugs have left some patients wary, worried that success will not last.

Scientists are edging closer to defeating a longtime enemy of human health: hemophilia, the inability to form blood clots.

After trying for decades to develop a gene therapy to treat this disease, researchers are starting to succeed. In recent experiments, brief intravenous infusions of powerful new treatments have rid patients — for now, at least — of a condition that has shadowed them all their lives.

There have been setbacks — years of failed clinical trials and dashed hopes. Just last week, a biotech company reported that gene therapy mostly stopped working in two of 12 patients in one trial.

But the general trajectory has been forward, and new treatments are expected by many experts to be approved in a few years.

No one is saying yet that hemophilia will be cured. Currently the gene therapy — which uses a virus to deliver a new gene to cells — can only be used once. If it stops working, the patients lose the benefits.

For now, “we are anticipating that this is a once-in-a-lifetime treatment,” said Dr. Steven Pipe, director of the hemophilia and coagulation disorders program at the University of Michigan and a lead investigator of a clinical trial conducted by the biotech company BioMarin.

The successful treatments are so recent it is hard to say how long they will last. But for the few patients who have been through the clinical trials successfully, life after treatment is so different that it’s something of a shock.

There are 20,000 hemophilia patients in the United States who lack one of two proteins needed for blood to clot. It’s a genetic condition, and the gene for blood clotting sits on the X chromosome. Virtually all people with hemophilia are men.

Those most severely affected must inject themselves every couple of days with the missing proteins, clotting factor VIII or factor IX. The shots keep hemophiliacs alive, but levels of clotting proteins drop between injections.

Even with regular injections, people with hemophilia risk uncontrolled bleeding into a muscle or joint, or even the brain. They must be extremely careful. Once bleeding begins, a joint may bulge as the joint space fills with blood. When the bleeding stops, the joint may be damaged.

Even a routine flight is risky, said Mark Skinner, a 57-year-old attorney in Washington with hemophilia who is a past president of the World Federation of Hemophilia.

“Carrying luggage around, you can twist the wrong way and immediately trigger a bleed,” he said. “Or you can get hit with a cart going down the aisle.”

People with hemophilia often are taught as children to avoid most sports and to find professions that will not require much physical activity. Many move to cities to gain easier access to treatment.

They may change jobs to get insurance needed to cover medical bills for hospitalizations and surgeries that can reach $1 million a year, plus an average of $250,000 to $300,000 a year for the clotting proteins. (The shots alone can cost as much as $1 million per year.)

Despite their vigilance, most with severe disease eventually develop permanent joint damage from bleeds, often leading to surgery for ankle fusion or hip or knee replacements at an early age. Most live with chronic pain from past bleeds.

For older patients, there is an additional complication. The clotting proteins used in the 1980s were contaminated with H.I.V. and hepatitis C. Nearly everyone with hemophilia got infected.

Now, though, researchers see the start of a new era.

“It’s a really optimistic time,” said Dr. Lindsey A. George, a hematologist at the Children’s Hospital of Philadelphia and a principal investigator for Spark Therapeutics, one of several companies developing gene therapies for hemophilia.

Imperfect successes

The goal of gene therapy is to reduce or eliminate patients’ need for injections with clotting factor and to reduce the number of bleeds. The gene to be inserted depends on whether the patient has hemophilia A, caused by a mutation in the gene for factor VIII, or hemophilia B, caused by a mutation in the gene for clotting factor IX.

Although the symptoms are the same with both forms of the disease, hemophilia A is by far the most common.

A handful of biotech companies are now rushing to get their gene therapies to market. Spark, with gene therapy for hemophilia B, and BioMarin, another biotech company, with a similar treatment for hemophilia A, are starting large, final-phase clinical trials. (Pfizer is taking over the development of the Spark drug.)

Results from the two companies’ preliminary trials were not perfect.

Patients in Biomarin’s hemophilia A trial got, on average, normal or above normal levels of factor VIII in their blood, but in the second year, those levels dropped to a median of 46 percent. It’s not clear why.

Patients in Spark’s hemophilia B trial only reached on average 35 percent of normal blood levels of factor IX. But those levels have remained steady for the two years they have been followed.

The good news is that those levels are sufficient for blood to clot, because normal levels are more than people need. After dreaming of a cure for decades, some treated patients are trying to adjust to newfound freedom.

John Brissette, 39, a computer user interface designer in Hanover, Mass., said hemophilia A always dominated his life.

He spent childhood yearning to be active like other kids. But bleeds into his joints put him on crutches for days at a time or forced him to keep his arm in a sling.

He would be out of school for a week, then back, then out again with yet another bleed. He was embarrassed by nosebleeds that would not stop.

As an adult, he had to have his damaged ankle bones fused. His elbow, after numerous bleeds over the years, gives him chronic pain.

Foreseeing more pain and injuries in the years to come, Mr. Brissette began seeking out gene therapy clinical trials. Eventually, he enrolled in a Spark trial. (The company has an experimental hemophilia A drug, too.)

He received a single infusion on April 19. His blood levels of factor VIII rose from zero to as high as 30 percent of normal and so far have stayed there.

“I have not had a single bruise. I have not had a single bleed,” Mr. Brissette said.

He has not given himself a shot of clotting factor since the procedure.

But he is still struggling to let go of a lifetime of wariness. As he tries to do work around the house or run around with his children, he is unable to shake the dread that he will bleed.

“I’ve become a very cautious person,” Mr. Brissette said.

A lucky mutation

At first, hemophilia seemed ideal for gene therapy.

Normal blood levels of clotting proteins range widely, from 50 percent to 150 percent of average. A gene therapy for the disease would not have to provide much to be effective for patients.

And researchers knew just which genes to insert into patients’ liver cells. The genes for hemophilia A and B were isolated in the early 1980s.

But the research proved difficult, and the first positive result was reported just a decade ago by scientists at University College London. They treated ten patients with hemophilia B and managed to increase their blood levels of factor IX to between 2 percent to 6 percent of normal.

In those patients, clotting proteins have persisted at those levels ever since.

Then scientists stumbled upon an unexpected bonanza. They found a man in Padua, Italy, who had a genetic mutation that made cells churn out as much as 12 times the usual amounts of factor IX.

Investigators realized that they could put the mutated gene into a virus and use it to insert the mutated gene into the cells of patients with hemophilia B.

The advantage was that they would not have to use so much virus — and the lower the dose, the less likely the immune system would attack.

“We dropped the dose four-fold,” said Dr. Kathy High, a hematologist who is president of Spark.

“Our first patient was a 23-year-old nurse. His level of factor IX rose to around 30 percent and has remained there for two years,” she said. The nurse has not needed to inject factor IX and has had no bleeds, she added.

But hemophilia A has been more daunting.

The viruses used to carry modified genes into patient cells are called adeno-associated viruses. They cannot carry a large gene, and the gene for factor VIII, needed to treat hemophilia A, is enormous.

After 15 years of effort, investigators finally discovered they could reduce the gene to a manageable size by slicing out portions that turned out not to be needed.

No longer are scientists and patients dazzled by a treatment that raises blood clotting factor levels merely to 6 percent of average. “My thinking has evolved,” said Mr. Skinner of the World Hemophilia Foundation.

The results that companies are reporting now “really seemed unimaginable” just a few years ago, he added.

‘On high alert’

Bill Konduros, 59, owner of a machine shop who lives in Mississauga, Ontario, and his brother, Jay Konduros, 54, a baker in Cambridge, Ontario, had assumed that constant vigilance and increasing disability was their lot in life.

Hemophilia would be “a lifelong thing,” said Jay Konduros. Then the brothers joined Spark’s gene therapy trial for hemophilia B.

The actual infusion of the experimental drug was anticlimactic, Jay Konduros recalled. He walked into a hospital in Philadelphia, sat in a chair and had an intravenous drip for half an hour. That was it.

Now levels of factor IX in Jay Konduros’s blood are around 50 percent. Bill, who also joined the trial, has levels closer to 75 percent. Neither has required any factor IX since their gene therapy.

Both struggle to accept the fact that, for the moment, their lives are very different.

“When I hit myself or strain a muscle or twist, I immediately revert to thinking like a hemophiliac,” Bill Konduros said. “You go on high alert. Is the ache spreading? Is it throbbing?”

One day in May, Jay fell, landing on his forearms. Both wrists hit hard on concrete, and he struck the left side of his thigh, already damaged from previous bleeds.

He took a few deep breaths and told himself, “You will be O.K., you will be O.K.”

He worried, anticipating disaster. That night he stretched. He examined himself. Nothing seemed damaged. He woke up in wee hours of the morning and nervously examined himself again.

He was fine. He waited three days to call his brother and tell him: He was now a normal person who had a minor fall.

“You hear a lot of things described as miracles or miraculous,” Bill said. “I guess I would say this truly is.”

 

Aug 12th 2018

5 yeast infection symptoms in women that should never be ignored

If you notice these warning signs, it's time to see your doctor.

Getting your first period is a right of passage for women, and guess what? So is your first yeast infection. The issue, which doctors also call candidal vulvovaginitis or vaginal thrush, is incredibly common, affecting three out of four women in their lifetimes. Some even experience it four or more times in a year. (Though we really, really hope that doesn't happen to you.)

The health condition is so, err, popular because every woman naturally has yeast (aka candida) brewing in their vaginas. But sometimes an overgrowth can occur, and that's when problems pop up.

one thing that can throw off the environment of your vagina can cause yeast infections, whether it's medication, excess moisture, condoms, IUDs, or even tampons,' says Angelique Mason, a family nurse practitioner at Hahnemann University Hospital in Philadelphia.

Other common causes: douching, using vaginal products that have fragrance chemicals, hanging out in wet or sweaty clothing and swimsuits, and wearing underwear that's too tight.

But how do you know if what you're seeing – or feeling – is actually a yeast infection? These surefire signs signal that it's time to schedule a visit with your doctor. That way you'll know if an over-the-counter treatment will actually work, or if you need to grab a prescription for something stronger. Either way, you'll be on your way to a healthy, back-in-balance vagina.

1. Your vaginal discharge looks like cottage cheese

It's one of the more gag-worthy comparisons out there, but anyone who's experienced this yeast infection symptom firsthand knows it's accurate. 'Generally, women will come in and complain of an odourless discharge – something that’s thick, whitish, and looks like cottage cheese,' Mason says. Normal discharge is typically somewhere between clear and milky white, so you'll notice a distinct difference.

2. You feel sore for no reason

It wouldn't be all that surprising to feel general vaginal pain or soreness after an enthusiastic romp in the sack. But if that didn't actually happen – and there are no other obvious reasons behind your pain – then that could be a sign of a yeast infection, reports the Centers for Disease Control and Prevention.

3. Peeing is super painfull

One day you're peeing without a care in the world and the next it becomes one of those moments that you dread (and may even try to avoid). Mason says painful urination is one of the most telltale yeast infection symptoms in women. When you're experiencing it, you'll most likely notice other symptoms, including redness and swelling in the vulva, reports the Cleveland Clinic.

4. You're itching like crazy

One of the most common symptoms is intense itchiness in both the vaginal opening and the vulva, so feeling like you constantly have to scratch is a solid indicator that something isn't right, Mason says. It doesn't help that fungus thrives in warm, moist environments (like your vagina), so it's important that you start treating a yeast infection right away before your symptoms get worse.

5. There's a burning sensation during sex

If things are tingling downstairs in a not-so-pleasant fashion, the Mayo Clinicsays this is a common symptom of an active yeast infection. But here's a doozy: if you have one, it's possible to spread it to your partner. It’s not overly common, but since men also have candida on their skin, having unprotected sex can cause an overgrowth that results in an infection called balanitis, or inflammation of the head of the penis.

Because of that, Mason says they could experience an itching or burning sensation, redness, and small white spots on the skin. If that happens, he'll need to see the doc too so he can be treated with over-the-counter anti-fungal medications.

 

Aug 11th 2018

Why You Should Never Ignore Sweet-Smelling Urine (or These Other Body Odors)

Humans, at their most basic, are smelly beings. So many things about us have a scent, be it our sweat, hair, mouth, or freaking feet. And even if it smells bad, that doesn't necessarily trigger cause for concern. (After all, my husband's feet smell to high heaven after a hot workout, but that's normal.)

What's not normal is when the scents you're accustomed to start to change. Like, when you usually can't smell your pee, yet all of a sudden sweet-smelling urine starts showing up. Or when your poop smells worse than usual. These are potential signs of something being off with your health, in which case you may need to call a doctor. So if you notice any of these body smells, don't ignore them — start dialing.

1. You can actually smell your pee.

Normally urine is scent-less, or if it has a scent, it's usually a very subtle, ammonia-like smell, says Scott Sullivan, M.D., a professor of OBGYN at the Medical University of South Carolina. So if you get a big whiff of sweet-smelling urine without even trying — and it's accompanied by pain when you pee — schedule a gyno visit. You could have a urinary tract infection (UTI), which means you'll need to cycle through a dose of antibiotics.

If there isn't any pain, your diet may be to blame, Sullivan says. "Urine smell is extremely variable and could change a number of times over the course of a week; that's perfectly normal," he says. Strong-scented foods, like asparagus or garlic, could have an impact, as could dehydration.

2. Your sweat smells all sorts of nasty.

Let's be frank: Sweat is not a sweet-smelling scent, um, ever. But there are certain areas of your body — like your pubic hair and underarms — that naturally give off a stronger scent than your hair, chest, and back. So if you smell yourself in those "stronger" areas, don't freak out right away — as long as things smell the way they normally do, you're probably fine.

But if you notice a stronger foul smell coming from those more subtle regions, pay attention. Sullivan says a rancid scent could mean your body is struggling with digestion issues. "It's rare, but it happens," he says. It may just be a matter of changing up your diet and adding in more high-fiber foods, but your doctor can advise you on the best course of action.

3. Your morning breath sends your partner running.

It's not the sexiest thing in the world, but if you have bad morning breath you may be snoring or sleeping with your mouth open. Those who do tend to have dry mouth, which typically lowers the flow of saliva in your mouth. Saliva is responsible for cleaning out food particles and protecting the teeth and gums from bacterial infection, says Alice Boghosian, spokesperson for the American Dental Association. If that's the case, your dentist can prescribe an artificial saliva mouthwash to help fix the problem.

If dry mouth isn't the problem, have your dentist do a thorough checkup to rule out any dental health issues, like gum disease, which Boghosian says can be caused by plaque. Then head to your doctor, as bad breath could be a symptom of various medical conditions such as sinus or lung infections, bronchitis, gastric reflux, a tonsil infection, and even some liver or kidney diseases.

4. Or it smells like a bowl of fruit.

Just because it's a more pleasant scent than say, garbage, doesn't mean you're out of the woods. In fact, if your breath smells like you just noshed on the entire grapefruit section of the grocery store, then head to your doctor immediately — it could mean you have diabetes, says Boghosian.

According to the American Heart Association, getting too many calories from protein, which is usually the case for those eating low-carb, can result in not enough insulin in the body, and that forces us to start burning energy from our fat stores. When we burn energy from fat, it releases chemicals called ketones. (An energy source many are now turning to on the keto diet.) "One of the signs that ketones levels are too high is a fruity smell to the breath, and if that happens it can be very serious and dangerous to one's health," says Boghosian. The scent could also be evident in the vaginal area, Sullivan says, so if your partner notices it while he's pleasuring you (Sullivan notes about 50% of his patients' partners notice problems first), that could be another warning sign.

5. Your vaginal discharge smells like fish.

Having discharge is normal. But having it come out clumpy or smelling like the raw fish market is not good, and it could be a sign of a yeast infection, sexually transmitted infection (STI), or chlamydia. As soon as you notice these symptoms, get to your gyno. Regardless of your diagnosis, it's likely you'll need a course of treatment.

6. Your vagina smells sour.

"Most women have a very subtle, sort of acidic or vinegar-y odor, and it's usually one you wouldn't notice from a distance; you'd have to be very close up," Sullivan says. But if you notice your scent has become strong — and it's likely a fishy, sour, or even musty smell — that's a telltale sign of bacterial vaginosis (BV), an inflammation caused by the overgrowth of bacteria (usually gardnerella) normally found in the vagina. "It can happen to anybody, and we don't understand all the ways it can happen — it could be anything from having sexual relations with a new partner to not getting enough sleep or exercise — but this foreign bacteria helps bad bacteria, like chlamydia, do its dirty work," he says. Treatment typically involves an antibiotic, either through a topical gel or oral medication, and can be cleared up within a week in most cases.

7. Or it kind of smells like something died down there.

It doesn't paint a pretty picture, but it can happen, and it may mean that a foreign object (like a tampon, female condom or diaphragm) has been left in your vagina, Sullivan says. "That foreign object will start to attract bad bacteria, and that buildup is where the smell comes from," he explains. Usually there won't be a major problem — having your gyno take out the object should clear the odor in a few days — but in rare, extreme cases, it could lead to a bacterial infection and toxic shock syndrome (a severe disease caused by staph bacteria). If you notice the smell and are experiencing a high fever, contact your doctor immediately.

 

Aug 9th 2018

Children should be banned from heading in football, says brain injury expert

Children should no longer be allowed to head footballs and it should be restricted within the professional game, according to a leading brain injury expert.

Dr Bennet Omalu, who discovered the brain disease chronic traumatic encephalopathy (CTE), has described heading in football as "dangerous" and said it is "time for us to change our ways".

Speaking to Phil William's on BBC Radio 5 Live, the eminent forensic pathologist and neuropatholoist said: "It does not make sense to control an object travelling at a high velocity with your head.

"I believe, eventually, at the professional level we need to restrict heading of the ball.

"It is dangerous."

Ban on heading

The doctor, who was portrayed by actor Will Smith in the 2015 film Concussion, first discovered chronic traumatic encephalopathy after studying the brain of NFL player Mike Webster.

Since then it has been found in the brains of a number of deceased NFL players.

Now Dr Omalu has set his sights on English football warning heading could result in similar brain damage NFL players displayed.

He told BBC Radio 5 Live:"The human brain floats like a balloon inside your skull so when you head the ball you suffer brain damage.

"You damage your brain when you head the ball.

"Playing soccer would increase your risk of suffering brain damage when you are much older and developing dementia and CTE."

He wants a more contactless form of football for kids under 12 to 14 and a ban on heading until the age of 18.

Dr Bennet Omalu said:"You damage your brain when you head the ball.

"Playing soccer would increase your risk of suffering brain damage when you are much older and developing dementia and CTE."

The US physician said: "Kids under the age of 12 to 14 should play a less contact form of soccer which we should develop for them.

"Kids between 12 and 18 can play but should not head the ball.

Aug 7th 2018

16 natural remedies for headache and migraine pain

Plagued by headaches or migraines but reluctant to take medication? Try these natural remedies out for size.

When a headache strikes it can be painful and debilitating, but it’s also a fairly good indicator that your body is out of balance. While over-the-counter medication is usually very effective for pain management, the good news is there are a number of healthy at-home remedies you can use to combat headaches and provide natural and cost-effective pain relief.

Headaches are not typically related to more serious conditions, but could be a red flag that you’re overtired, hungry, thirsty, tense, hormonal or suffering from low blood sugar. While over-the-counter pain relief should do the trick, the following natural remedies should give you a head start:

Peppermint oil

Research carried out by the National Center for Complementary and Integrative Health, suggests that peppermint oil can relieve tension headaches. Peppermint helps to control blood flow and open up the sinuses, improving oxygen flow. Plus, its active ingredient menthol may also lessen the intensity of acute migraines. Add a few drops in your bath, mix it with your massage oil or sip peppermint tea to ease the pain.

Book a massage

If you’re struggling with tension headaches or migraines, a full-body massage can help. Stress is a known headache trigger, so a good rub down will provide much needed relief and loosen you up in the process. Research shows regular massage can also help to prevent headaches from occurring, so book yourself in for a rub.

Keep a diary

If you're prone to migraines, you may have noticed that certain stimuli can bring on an attack. Keep a diary noting the pain patterns and your daily activities, so you can spot trigger factors. It's also worth showing the results to your doctor so they can decide what type of treatment is most appropriate for you.

Meal plan

Fluctuations in blood sugar can lead to migraines, so try to avoid skipping meals and ensure you always have snacks at hand. Include lean protein in your meal plans to help keep glucose levels steady. Avoid any food or drink in your diet that have been identified as possible triggers associated with migraine headaches.

Meditate

American researchers recently found that people who incorporated meditation and controlled breathing into their daily routine have better regulation of the stress hormone cortisol. Stress can lead to headaches, so reducing cortisol could also help to ease headaches and other chronic pain. Not sure where to start? Download the meditation app Headspace.com.

Sidestep caffeine

If you’re a coffee drinker, you set yourself up for withdrawal headaches, which can stimulate your brain's migraine centre and develop into migraines. Limit your daily intake to 1-2 cups a day, substitute for herbal teas and steer clear of caffeine altogether if you feel a migraine coming on.

Try acupuncture

A treatment derived from ancient Chinese medicine, acupuncture involves inserting very fine needles into pressure points on your body for therapeutic purposes. The British Medical Association endorsed the treatment for migraines, as acupuncture effectively provides pain relief, reduces inflammation and boosts levels of the feel-good hormone serotonin.

Rest is best

Resting or sitting in a darkened room can help relieve symptoms, especially if you are struggling with migraines, but it can help if you’re suffering from headaches. For best results, switch off all electrical appliances, close your eyes and focus on relieving tension in your neck, back and shoulders.

Hit the road

Once a headache hits you may be in too much pain to consider heading to the gym, but some sufferers have found that if you time it right, going for a jog can successfully sidestep a migraine. According to The Migraine Trust, 30 minutes of gentle exercise three times a week should help to manage migraine symptoms, but stick to moderate exercise so you don’t risk triggering an attack onset.

Yoga

An ancient spiritual discipline that promotes holistic living through a combination of postures and breathing techniques, yoga has been found to ease headache and migraine pain. Breathing deeply releases tension, while opening the neck, shoulders, and spine helps blood flow to your head more freely. Try these ultimate yoga poses for relaxation.

Drink up

Dehydration is a common headache trigger, and simply ensuring you drink enough water can stop a headache and migraine in its tracks. This Joseph Joseph Dot Hydration Tracking Water Bottle displays a dot every time you refill, helping you hit your daily hydration target and keep head pain at bay.

Hormonal balance

If you notice your migraines are more prevalent around the time you menstruate, top up on foods that are high in phytoestrogens to balance your hormones, such as lentils, flaxseed, sesame seeds and soybeans.

Ginger

Known for its antioxidant and anti-inflammatory properties, humans have been harvesting the powers of this zesty root for centuries. Ginger has also been known to reduce the nausea that comes with migraine attacks. Chew on a fresh clump or drink ginger tea.

Lavender oil

Famous for its relaxation benefits, lavender oil also has proven migraine-busting properties. A recent study found that 92 out of 129 migraine sufferers who inhaled lavender during a migraine attack responded positively to the essential oil. Rub it on your temples and wrists, add a few drops to your bath or try a diffuser to fragrance your whole house.

Feverfew

Feverfew is a perennial flowering herb belonging to the daisy family and has been used to ward off migraines for centuries. Research has shown that the fabled flower reduces the frequency of migraine headaches and headache symptoms, including pain, nausea, sensitivity to light and noise. Take it in capsule form for best results.

Ice ice baby

2013 a trial found that holding an ice pack at the base of the neck helped to drastically reduce the pain and severity of migraines. If an ice cold neck doesn’t appeal, try a cold compress.

 

Aug 6th 2018

Migraine Awareness Week: ultimate guide to the condition that causes immense pain

Migraine affects one in seven people – that’s over eight million people in the UK alone – making it more prevalent than diabetes, epilepsy and asthma combined. 

The World Health Organisation recognises it as one of the most disabling lifetime conditions, yet awareness and understanding is low.

To mark Migraine Awareness Week, check out our ultimate guide...

“Migraines often have other symptoms in addition to head pain,” says Dr Clare Morrison, GP at online doctor and pharmacy, MedExpress ( www.medexpress.co.uk ).

“These include nausea, pain behind an eye or ear and extra sensitivity to light or sound.”

Around 20-25% of people experience a migraine with aura (visual or sensory disturbances).

Causes

Experts now believe there is a genetic link that could make people more sensitive to migraine attacks, says Dr Riccardo Di Cuffa, Director and GP at Your Doctor www.your-doctor.co.uk . There are many triggers which contribute to a migraine.

“Migraine and stress are strongly connected,” he adds. “Anxiety, excitement and any form of tension can lead to a migraine attack.”

Other possible causes are too much caffeine, dehydration, skipping meals or eating high sugary foods.

Treatment

Aspirin or non-steroidal anti-inflammatories (such as ibuprofen) can relieve some of the pain.

For regular migraines that don’t respond to regular painkillers, your doctor may prescribe a triptan, which narrows the blood vessels in the head and also blocks the transmission of pain.

But it’s important to act fast, warns Dr Morrison. “The first 20 minutes are critical in order to prevent a migraine from spreading throughout the entire nervous system.

1. Keep a diary to identify triggers, says Dr John Janssen, consultant neurologist at Re:Cognition Health www.recognitionhealth.com . Record factors including the duration, medications that have and have not worked, severity of headache, menstrual cycle (if applicable), the location and type of pain, symptoms (vomiting, noise / light sensitivity) and the ability to perform tasks e.g. not being able to walk, work, restricted vision etc.

2. Review key lifestyle factors that may also be playing a part in the onset of a migraine including diet, alcohol, caffeine, dehydration and exercise. “Whilst there are no foods that have been scientifically proven to help cure or prevent migraines, it is advised to avoid the ‘C’ foods: coffee, carbonated drinks, Chianti (alcohol in general), citrus, cheese and chocolate,” explains Dr Janssen. The key thing is to stay hydrated.

3. Review your painkillers: Taking a lot of painkillers can paradoxically end up making the situation worse by causing medication overuse headache so consult your GP. They can check for abnormality of the nervous system, neck tension, blood pressure and eye examination to make sure there is no evidence of raised intracranial pressure. They will be able to review your diary and help with working out a pattern.

4. Eat at regular hours: “Women in particular going through the phases of the menstrual cycle or changes in their lives (pregnancy or menopause), seem to experience a higher recurrence of headaches and migraines. To balance your hormones eat at regular hours, include lots of protein and whole grains, and limit your sugar intake to prevent sugar highs and lows,” suggests Dr Marilyn Glenville, Nutritionist and women’s health expert ( www.marilynglenville.com ).

Aug 6th 2018

The surprising symptoms of sunstroke you may not have known

Sunstroke isn't really anything to do with sunburn at all.

In case you've been on lockdown for the past month, stuck inside with your blackout blinds padlocked to the windowsill, you'll be aware that the UK is experiencing something of a heatwave.

Temperatures have reached the mid-thirties and, quite frankly, we don't know how to cope. If you're not holed up inside a delightfully air-conditioned office () nine-to-five, it's more important than ever to make sure you're being safe in the sun, or else you could end up with sunstroke.

Sunstroke, contrary to popular belief, is not simply hyperbole for a bit of bad sunburn. In fact, it's got very little to do with sun burn at all, as Dr Emma Wedgeworth, Consultant Dermatologist and British Skin Foundationspokesperson told Cosmopolitan.com/uk.

'The medical definition of sunstroke (also known as heat stroke) is a core body temperature of over 40 degrees Celsius,' Dr Wedgeworth explained. 'The reaction is more to the heat than to the sun itself. Whilst the skin on the outside shows signs of sunburn, inside your body, organs can be damaged as well.'

The doctor went on to describe how sunstroke can affect various different internal organ systems 'such as the brain, caused by prolonged exposure to high temperatures often in combination with dehydration'.

Symptoms

It's because of this that some of the lesser known symptoms of sunstroke can occur. Sunstroke can be incredibly serious and can lead to:

·      Changes in behaviour

·      Confusion seizures

·      Unconsciousness

'Paradoxically, despite the high temperatures, people suffering from sunstroke may not actually sweat,' Dr Wedgeworth noted.

Other, more commonly known symptoms of sunstroke – or heat stroke, as it's also referred to – include:

·      A throbbing headache

·      Red sore skin

·      Nausea and vomiting

·      Dizziness

·      Muscle weakness

Milder effects from overexposure to heat can include 'heat-related fainting, heat exhaustion and heat cramps', said the expert.

The reason sunstroke can affect your organ systems is because 'your body’s cells require a very specific temperature range to ensure that all the machinery works properly'.

'If the body is subjected to either temperatures that are too hot or too cold, it can damage the way organs, such as your brain, work,' explained Dr Wedgeworth, adding: 'People at the extremes of age and those with chronic health problems are most at risk.'

What to do if you've got sunstroke

'True sun stroke is a medical emergency, so you need to seek medical attention as soon as possible,' said the doctor. 'Whilst doing that, move to a cool shady area, remove unnecessary clothing. Use fans or sponges with cool water to encourage temperature reduction and stop any exercise immediately.'

 

Aug 5th 2018

Ever wake up to a numb, dead arm? Here’s what’s happening.

Waking up in the middle of the night to discover one of your arms has lost all feeling is frightening.

At first, the limb is limp and flops around like a useless bag of bone before coming back to life with a flood of "pins and needles" sensations.

When this happened to me as a kid, I panicked, thinking I'd done something horrible to my body, anxious that I'd never be able to move my arm again. But the feeling in my arm always came back.

This phenomenon is really common, says James Dyck, a neurology researcher with the Mayo Clinic. And it's actually a cool example of how the body can protect itself even during the paralysis of sleep.

Dyck explained there's a common misconception that pins and needles and numbness are caused by a lack of blood flow to the nerves. "The more likely thing is nerve compression — nerves are being pushed on and squashed, and that causes these symptoms," he says.

You have several nerves in your arm. Each serves a vital function.

The axillary nerve lifts the arm at the shoulder.</div>

The musculocutaneous nerve bends the elbow.

The radial nerve straightens out the arm and lifts your wrist and fingers.

The ulnar nerve spreads your fingers.

Although Dyck says the exact physiology isn't completely understood, the effect of compressing any of these nerves in sleep — when you sleep on top of your arm or pin it underneath a partner — is like stepping on a garden hose. The information that flows from your extremities back to your brain is temporarily disrupted.

So why does it feel paralyzed upon waking?

Dyck suggests two reasons.

1) It is actually, temporarily, paralyzed. During REM sleep, the brain sends a signal to cause a body-wide paralysis. The purpose of this is to keep you from acting out dreams (which occur during REM). But if you wake up during one of these phases, you can be conscious before your fully regain control of your limbs. This is called sleep paralysis, and it can be a frightening situation. You're stuck somewhere in between dreaming and wakefulness, and you can't move.

2) The nerve compression has led to a temporary paralysis (perhaps because you got stuck in a compressed position during REM).

Compressing nerves can damage them. The good thing is that the body will naturally

wake up as a protection mechanism when a nerve has been compressed too long. After you wake and relieve the pressure, the nerves will quickly come back online, usually first with a pins-and-needles feeling.

“The nerve structures, as they recover, tend to be irritable for a period of time," the University of Rochester Medical Center explains. "That’s because the nerves are firing spontaneously. Most of the time, the feeling of pins and needles is a good sign. It is a temporary phase that means nerves are coming back to life."

Someone who falls asleep on a limb is unlikely to do major damage to the nerves, Dyck says. But there are some cases when compressed nerves can become a greater problem.

One such case is called "Saturday night palsy," when a person falls asleep compressing a nerve while drunk. The alcohol impairs your body's ability to wake you up and protect your nerves.

"If you’re passed out drunk, you won’t move your arm," Dyck says. And when you wake up the next day, you can't extend your wrist and you can’t extend your fingers." That might last longer than a few moments (perhaps even a few days or months) as the nerve has to repair its protective coating.

And then there's hereditary neuropathy with liability to pressure palsies (HNPP), a genetic condition that makes people more susceptible to nerve compression injuries. They might want to be extra careful not to fall asleep on a limb or even cross their leg to avoid nerve compression. (Carpal tunnel may also cause tingling or numbness in limbs at night.)

Again, for most people who wake up to a dead limb, it's just a temporary annoyance. And it "probably takes less time [to recover] than you think it does, because you’re freaking out about it," Dyck says.

Aug 3rd 2018

Fat flu sufferers likely to be 'contagious for longer than slimmer peers'

Flu sufferers could be contagious for longer if they are fat, research suggests.

The study by the University of Michigan found that obese adults tended to harbour the virus for longer, giving them more time to spread it.

Researchers said those with excess weight should be targeted for flu jabs.

It is already know that obesity increased the risk of suffering complications from flu, and is linked to higher severity of disease.

But the research is the first to suggest that fatter people are also contagious for longer.

Assistant Professor of Epidemiology Dr Aubree Gordon of the University of Michigan School of Public Health said: "This is the first real evidence that obesity might impact more than just disease severity. It might directly impact transmission as well."

The study analysed 1,800 adults and children in 320 households in Managua, Nicaragua, to investigate the effect of obesity on the duration of viral shedding over three influenza seasons from 2015 to 2017.

Nose and throat swabs determined the duration they shed the virus.

It found obese adults with flu symptoms shed influenza A virus for 42 per cent longer than adults with flu who were not obese.

And infected obese adults with mild or no symptoms shed the virus 104 per cent longer than non-obese adults with flu.

The study was published in The Journal of Infectious Diseases.

Prof Gordon said further research was underway to establish if the flu virus shed for longer periods by obese individuals continued to be infectious, spreading the illness to others.

It is suggested being overweight alters the body's immune response and lead to chronic inflammation, which increases with age, as well as making breathing harder.

These factors may help explain how obesity could affect influenza risk, severity, and transmission potential, the study authors said.

 

Aug 1st 2018

How Parents and Doctors Can Support Transgender Children

Every kid is different and thus has different needs. Some kids want to run around outside all day; others want to sit indoors with a book. Some have an easy time making lots of friends; others struggle. Some kids are entirely comfortable with the gender they were assigned at birth, and others don't conform quite so neatly to expectations.

Parenting any kid is a challenge. But one challenge parents of gender-non-conforming kids — that is, those whose gender expression is different from conventional expectations of masculinity and femininity — face is that it can be hard to get good information about the sort of support their kids need. (Not all gender-non-conforming people identify as transgender — a term that describes people whose gender identity or gender expression differs from what's typically associated with the sex they were assigned at birth — and vice versa, according to GLAAD.) A Google search on care for gender-non-conforming or transgender kids turns up a lot of misinformation, including about what good support for trans kids really looks like.

Live Science spoke with pediatricians who responsibly affirm and support gender-non-conforming and trans kids about the facts and myths of medical care for these young individuals. They answered questions about what parents can do to support their gender-non-conforming children and how they can ensure their children receive the best possible care. [25 Scientific Tips for Raising Happy (& Healthy) Kids]

The first step is always a conversation, led by the patient.

Dr. Daniel Summers, a Boston-area general-practice pediatrician, said he makes an effort to understand his young patients' gender expression on their terms — particularly when they tell him that they're not comfortable with the gender they were assigned at birth or that they belong to a different gender.

"I find out: 'Well, what does that mean to you?'" he said. "'Does that mean that this is how you've been able to live? Is this how you're wanting to live? Is this something you've been able to tell other people about?'"

Summers and two other pediatricians told Live Science that their goal is never to encourage patients to express a particular identity. Rather, he tries to create a space where they're comfortable frankly discussing their own feelings on the matter.

Dr. Andrew Cronyn, a pediatrician in Tucson, Arizona, who has seen more than 70 gender-non-conforming patients as a routine part of his general practice, said some kids state a clear gender preference from a very young age.

"For some of these kids," he said, "it means that when they were 3 years old, they started asking their parents questions like, 'When am I going to grow a penis? Why do I have to wear these boy clothes all the time? Why can't I wear a dress? I'm not a boy. I'm a girl.'"

Other kids' gender expressions are more ambiguous, he said.

Dr. Olivia Danforth — who sees young patients in Corvallis, Oregon, and helps run a clinic for trans adults — said that, in those cases, her role is to provide parents and kids with information, reassure them that their situation is normal and let them know about resources they can access if the kids' gender identities become a source of distress.

Cronyn said he often connects parents with local support groups and summer camps for families with gender-non-conforming kids.

The goal there, he said, is "giving people a chance to meet these other families. And sometimes, they will go … then talk to their kid, and they'll realize that this isn't really the route they're on — it's a little boy who wants to wear nail polish, but he's not transgender," Cronyn said. "And he's perfectly happy with his body and his gender right now."

But sometimes, he said, a child will express that they do want to transition — meaning to affirm publicly the gender they know themselves to belong to. The best thing parents and healthcare providers can do for those kids, he said, is to follow their lead.

Kids, not doctors, lead the way when they transition.

The first step in transitioning, Cronyn said, isn't medical. It's social.

That's especially true in kids who haven't yet entered puberty and whose bodies don't yet bear many obvious markers of sex, he said. Kids will let their friends at school, teachers and wider families know about their genders. That can often involve taking a new name, and it almost always involves letting people know the correct pronouns to use with them.

Often, kids who transition will also make changes to the way they dress to clearly mark their genders — though Danforth said it's important to understand that (just like their cisgender, or non-transgender, peers) not all trans kids will want to dress in ways stereotypical of their genders. [Why Is Pink Associated with Girls and Blue with Boys?]

Cronyn said he often sees a difference between how trans boys and trans girls handle transitions.

"Some of the boys will immediately socially transition," he said. "They will cut their hair short, wear boy clothes. They might wear binders; they might wear a packer."

Girls can be a little more cautious, he said. "A lot of times, they realize the safety issues related to someone seen as masculine presenting as a woman," Cronyn said.

Trans girls in his practice often take the process of coming out more slowly, he said, but they tend to be just as consistent in their intent to transition as trans boys are. The most important thing parents, family and friends can do when a child socially transitions, Danforth said, is to respect and affirm the gender that the child expresses.

Prepubescent kids don't take hormones, and minors never get genital surgery.

A lot of scaremongering about health care for trans kids falsely suggests that doctors push kids into making permanent changes to their bodies. Every pediatrician who spoke with Live Science for this story emphasized that this isn't true and that they don't know of any doctors who would do that.

Kids who haven't yet reached the stage of puberty in which physical changes begin don't receive medication of any kind, Cronyn said. For kids who want them, those treatments don't begin until puberty begins in earnest. And the first stage of treatment isn't hormones. Instead, doctors prescribe kids puberty blockers, which can safely put those changes on "pause." That's the standard of care endorsed by both the Pediatric Endocrine Society (PES) and the World Professional Association for Transgender Health (WPATH). (A representative for the American Academy of Pediatrics told Live Science that it has an official policy statement on the subject in the works, which it will publish later this year.)

There is some limited evidence that puberty blockers can impact height and bone density, but Cronyn said those risks are low enough that he's never encountered issues in his practice. More recent research has cast doubt on the idea of bone density issues.

In his clinic, Cronyn said, no child ever receives any medication related to transitioning unless they've been demonstrably "insistent, consistent and persistent" about their gender for at least six months. (Again, this in keeping with PES and WPATH guidelines.)

At the same time, Danforth said, parents should be aware that there are some doctors who take that idea too far.

"The big caution I think — that may be hard for parents who are nervous to resist — is to pay attention to what kind of terms and conditions a provider wants to attach to care," she said. "There has been a historical tradition of making patients jump through hoops and sort of perform in these arbitrary ways."

For example, she said, trans girls might be expected to always wear a dress and paint their fingernails to "prove" their genders, even though there are plenty of cisgender girls who don't do either of those things. Acting overtly, stereotypically masculine or feminine, she said, isn't a condition a responsible doctor sets before pausing puberty.

Why pause puberty? There's a real risk, Danforth said, that kids might hurt themselves or even attempt suicide if their bodies start to develop in ways that trigger debilitating dysphoria (a sense of conflict between one's gender identity and physical or social presentation).

There's evidence for the idea that supporting trans kids in their transitions can protect their mental health. A 2015 study published in The Journal of Adolescent Health showed that trans kids in general are at much higher risk of suicide, but a 2016 study in the journal Pediatrics showed that teenagers who are supported in their transition seem to be no more depressed and only slightly more anxious than their cisgender peers.

Adolescent mental health isn't the only reason for puberty blockers though, Cronyn said. Even trans kids who don't go through self-harm during unchecked puberty are at risk of developing unwanted physical traits that are difficult or impossible to reverse. Puberty blockers, he said, are a safe and effective way to ward off life-altering physical problems without starting kids on hormones before they're ready — or before most doctors are comfortable prescribing them. The point, Danforth said, is to protect kids from having to go through a puberty that isn't right for them.

"If you never fully develop breasts, you're never going to have to have chest reconstruction," Cronyn said. "If you never develop an Adam's apple, you're never going to have to have your Adam's apple shaved."

In addition, kids, with medical guidance, can decide to stop taking these puberty blockers so that puberty will begin on its own.

A lot of discussion of transitioning focuses not on puberty blockers or hormones, but on the idea of surgery. However, Cronyn, Danforth and Summers said, the notion of trans kids getting surgery is largely a myth.

Clinics simply don't offer "bottom" surgery of any kind — meaning surgery to change a person's genitals — to children under the age of 18. And while the World Professional Association for Transgender Health (WPATH) guidelines do allow "top" surgery — surgery to remove breasts and reconstruct the chest — for certain adolescent boys "after ample time of living in the desired gender role and after one year of testosterone treatment," that course of treatment isn't common.

Hormones don't start until much later in the transition process.

The point of trans kids receiving hormones is to enable their bodies to develop in line with their genders, Cronyn said. And kids never receive them unless they've reached puberty and have expressed consistently and persistently that they want to receive them.

Once kids do begin to take hormones, Cronyn said, they'll go through puberties that are, in most respects, indistinguishable from those of their cisgender peers. Boys' voices deepen more than girls'; they develop Adam's apples and facial hair; and they develop testosterone-driven facial structures. Girls develop breasts; their voices don't deepen as much as boys'; and they develop estrogen-driven facial structures.

Typically, Cronyn said, trans girls remain on puberty blockers for as long as their bodies still produce high levels of testosterone, while trans boys can stop taking them as soon as they begin taking hormones, because "testosterone is a bulldozer."

Hormones do change the kinds of medical risks these kids face, he said — trans boys on hormones are at increased risk of baldness, for example, and trans girls on hormones are at increased risk of blood clots — but those risks aren't that different from their cisgender peers'.

The most significant difference between puberty on hormones and most non-drug-induced puberties, Cronyn said, is fertility. Hormones can make it difficult for trans people to have biological children. Some patients and their families elect to store eggs and sperm before hormones begin, he said, though that can be an expensive and sometimes difficult process.

"The thing that we also have to look at, though, is the risk of not treating [gender-non-conforming kids]," he said.

Kids who have treatment withheld, or who are pushed to suppress their genders, are at significant risk of self-harm and other mental-health issues.

"Doing nothing is not a benign action," Danforth said. "It's not neutral, because [the kids] aren't getting a choice in what's happening to their bodies."

Forcing a trans kid to go through puberty without blockers or hormones, perhaps with the idea that they can transition as adults, does a lot of harm and no good, she said.

"We know for a fact that whether these kids are accepted or rejected, it's never going to affect whether they are trans or not, or whether they are the gender that they are or not," Danforth said. "But it is a life-or-death thing. There are potentially lives being lost in failing to be supportive and compassionate about this stuff."

The most significant debate among responsible doctors, Danforth and Cronyn said, isn't about providing hormones to kids but about when to start. Current standards, based on the age of consent in the Netherlands, instruct doctors to wait until a kid turns 16 to start them on hormones.

Cronyn and Danforth argued that, in some cases, the long wait can be irresponsible, putting the child in the position of remaining prepubescent until their sophomore year of high school. Some doctors, they said, are starting to seriously consider offering hormones earlier to kids who want them

 

July 26th 2018

Feeling lightheaded when standing up could be a warning sign of dementia, study says

·       Orthostatic hypotension occurs when your blood pressure suddenly drops when changing from a sitting position to a standing position

·       People with this condition in middle-age were 1.5 times more likely to develop dementia 

·       They also had twice as great a risk of developing an ischemic stroke, which occurs when an artery to the brain is blocked due to a blood clot

·       Feeling lightheaded when you stand up could be a warning sign of dementia, a new study has found.

·       Researchers say that those who feel faint upon standing could be experiencing  orthostatic hypotension, which is a sudden decrease in blood pressure.

·       Their findings showed that people with this condition in middle-age were about 1.5 times more likely to develop dementia and twice as likely to suffer a stroke.

·       The team, from Johns Hopkins University in Maryland, says the findings show a new marker that medical professionals can spot early on to prevent, or delay, the onset of age-related diseases.

·       When you stand up after sitting or lying down, the body works to send blood and oxygen towards the brain.

·       If this does not occur, your blood pressure can fall significantly, creating what is known as orthostatic hypotension.

·       Symptoms of the condition include lightheadedness, blurred vision, nausea, fatigue and fainting. 

·       There are many potential causes, some of which include aging, anemia, dehydration, and certain medications such as beta blockers.

·       Treatment for orthostatic hypotension depends on the underlying cause. If it is due to dehydration, doctors will suggest an increase in fluid intake.

·       If the medication is the cause, then your doctor might change the type of prescriptio or the dosage.

·       Another treatment comes in the form of compression stocking, which stops the buildup of fluid in the legs when a person lies down or sits.  

·       'Orthostatic hypotension has been linked to heart disease, fainting and falls,' said study author Dr Andreea Rawlings, a biostatistician at Johns Hopkins University.

·       'So we wanted to conduct a large study to determine if this form of low blood pressure was also linked to problems in the brain, specifically dementia.'

·       For the study, researchers followed more than 11,700 participants over the course of 25 years.

·       The participants, who were 54 years old on average, did not have a history of stroke or heart disease at the study's start.

·       At the beginning of the study, the team asked the participants to lie down for 20 minutes and then quickly stand.

·       Blood pressure was measured once while resting and five times while standing. They found that about five percent of the group began the study with orthostatic hypotension.

·       Participants were monitored for stroke and dementia either through the visits every five years or from their medical records. 

·       Over the course of the study, about nine percent of the participants developed dementia and a little more than seven percent suffered an ischemic stroke, which occurs when an artery to the brain is blocked due to a blood clot. 

·       The findings showed that the participants with orthostatic hypotension at the study's start, even with treatment, were 54 percent more likely to develop dementia than those who did not have the condition.

·       Nine percent of those without orthostatic hypotension developed dementia in comparison with 12.5 percent of the people with the condition.   

·       Additionally, people with orthostatic hypotension had twice the risk of suffering from an ischemic stroke.

·       Around 15 percent of people with the condition had this type of stroke while about seven percent of people without it had an ischemic stroke.   

·       'Measuring orthostatic hypotension in middle-age may be a new way to identify people who need to be carefully monitored for dementia or stroke,' Dr Rawlings said. 

·       'More studies are needed to clarify what may be causing these links as well as to investigate possible prevention strategies.' 

 

July 21st 2018

More Pregnant Women Are Having Heart Attacks. But Why?

Women who are pregnant may not spend much time worrying about their own hearts, but a new study suggests that the risk of having a heart attack during pregnancy or within six months of giving birth is on the rise in the U.S.

Researchers found that, from 2002 to 2014, the risk of a pregnant woman having a heart attack increased by 25 percent, with rates rising from 7.1 women per 100,000 women hospitalized during pregnancy in 2002 to 9.5 women per 100,000 in 2014. (Women who had heart attacks within six weeks of giving birth are included in these statistics.)

Although the overall risk of a pregnant woman having a heart attack is low, the findings show that even young women are susceptible to heart disease, said lead author Dr. Nathaniel Smilowitz, an interventional cardiologist at NYU Langone Health in New York City. (Heart disease increases a person's risk of having a heart attack; heart attacks occur when blood flow to part of the heart muscle is reduced because of a blood vessel blockage.) [Blossoming Body: 8 Odd Changes That Happen During Pregnancy]

Indeed, there are many changes taking place in a woman's body during pregnancy that may make her more vulnerable to heart disease, Smilowitz told Live Science. For example, the amount of blood in the bodyincreases, and substantial hormonal changes can put more stress on blood vessels. In addition, pregnancy can be a stressful time for women both emotionally and physically, and this stress can bring about heart complications. (Smilowitz added that risk may remain elevated postpartum because it takes some time for a woman's body to return to its pre-pregnancy state.)

Heart attack risks

In the study, published today (July 18) in the journal Mayo Clinic Proceedings, the researchers looked at health insurance claims from a large national database of U.S. hospitals collected between 2002 and 2014. In particular, they analyzed claims from women ages 18 and older who were hospitalized during pregnancy, delivery or in the six weeks after giving birth.

Of the more than 55 million pregnancy-related hospitalizations during this period, the study found that nearly 4,500 women had heart attacks during pregnancy, childbirth or in the six weeks after delivery. Around 200 women died after having a heart attack, according to the findings.

It was surprising to find that the death rate among these women was almost 5 percent, which is a high mortality rate in what is considered a low-risk population for heart disease, Smilowitz said.

The analysis also showed that pregnant women who were older were more likely to have a heart attack. For example, pregnant women between ages 35 and 39 were almost six times more likely to have a heart attack than pregnant women in their 20s. Similarly, pregnant women between 40 and 44 were about 10 times more likely to have a heart attack during the study period than younger women, according to the findings.

The risk of heart attack was also higher among pregnant women who had diabeteshigh blood pressure or elevated lipid levels, as well as among those who were smokers, which are all known risk factors for heart disease.

It's worth noting that the study found increasing rates of heart disease in pregnant women during a decade when there have been advances in cardiovascular risk reduction and improved treatments, Smilowitz said. One possible explanation for the upward trend is that women are having children later in life, he said. Another possibility is that rates of obesity and diabetes — both risk factors for heart disease — are increasing in women of childbearing age, he said. [Are You Pregnant? 10 Early Signs of Pregnancy]

Greater awareness of heart-disease risk factors is needed to improve outcomes in pregnant women who develop heart disease, Smilowitz said. 

One of the limitations of the study is that the data did not indicate which trimester of pregnancy the heart attacks occurred.

 

July 20th 2018

How to decode your stomach pain, according to a doctor

Research from Mintel reveals that a whopping 86 per cent of all British adults have suffered some form of gastrointestinal problem or ailment in the last year. There are many different conditions and aliments that can cause abdominal pain so it can be difficult to know what is wrong.

Family GP Dr Roger Henderson helps decipher seven types of tummy pain, their symptoms and as well as advice on how to ease any troubles.

1. Irritable bowel syndrome (IBS)

Symptoms: Irritable Bowel Syndrome (IBS) affects around 1 in 5 of the population at some point in their lives, according to NHS, and is defined by the presence of a group of symptoms which are present over a period of time. Symptoms can include abdominal pain and discomfort, diarrhoea, constipation as well as bloating of the abdomen. 

Causes: The cramping pain and discomfort of IBS is caused by muscle spasms in the bowel. Experts don't know exactly why the condition develops, although they do agree that there are some things that can trigger symptoms and make them worse. Triggers for IBS vary between individuals but stress, dietary factors and some medicines are the common triggers, often in combination.

Family GP Dr Roger Henderson says: 

"IBS is a painful long-term condition which can have a big impact on day-to-day life. It's important to understand your triggers and how to deal with a flare-up so you can manage symptoms effectively." 

2. Trapped wind

Symptoms: The typical symptoms of trapped wind in the bowels include stomach cramps, burping, bloating, flatulence, nausea, vomiting and pain when bending over, lying down or with physical exercise. 

Causes: It is normal to have gas in your intestine and we all produce several litres of gas a day through the normal processes of digestion. Some of this is reabsorbed into the bloodstream and eventually breathed out, with the remainder being expelled as wind.

One possible cause of excess gas may be swallowing too much air when eating, drinking or talking. Certain foods and fizzy drinks can also contribute to this. Smoking can also make you swallow more air and some people also swallow air as a nervous reaction.

Excess gas can also be caused by bacteria in the colon producing too much gas when they break down food. Foods containing complex carbohydrates, for example vegetables such as beans, cabbages and Brussels sprouts, are difficult for the human body to digest and are broken down by gas-producing bacteria instead. Foods that contain sorbitol, an artificial sweetener, can lead to similar problems.

Family GP Dr Roger Henderson says:

3. ConstipationCut down on foods known to cause wind and bloating such as beans, onions, broccoli, cabbage, sprouts and cauliflower but make sure you still eat five portions of fruit and vegetables a day

Try avoiding high fat foods and eggs as these can produce bad smelling gas as well as refined and sugary foods, especially those containing the artificial sweetener sorbitol

Symptoms: The symptoms of constipation are infrequent bowel movements, hard, dry stools, difficulty or pain when defecating and swelling of the abdomen. 

Causes: The cause of constipation can be down to diet. Not eating enough fibre such as fruit and vegetables and not drinking enough water can contribute to the condition. With a change in lifestyle, often comes a change in eating habits, which may be causing problems. Certain medications can have side effects which include constipation and it can also be a result of anxiety or depression.

Family GP Dr Roger Henderson says:

"Try to eat foods high in fibre, including raw fruits and vegetables, pulses and whole grains. If you're experiencing symptoms of constipation, eating oranges at least once a day may be helpful as the citric acid they contain is a natural laxative. Drink at least eight glasses of water or juice a day and exercise regularly. Whenever possible go to the lavatory as soon as the urge strikes, or take a laxative if necessary." 

4. Crohn's disease

Symptoms: Crohn's disease is a condition that causes the lining of the digestive system to become inflamed. The symptoms include unintended weight loss, blood and mucus in stools, abdominal pain, diarrhoea and extreme fatigue. If there is a problem within the immune system, this could cause the body to attack healthy bacteria in the gut. An infection may trigger a similar response from the immune system. 

Causes: Genetics and the environment (Crohn's is more common in westernised countries such as the UK) have also been linked to the disease.

Family GP Dr Roger Henderson says: 

"The treatment for Crohn's comes in the form of medication which aims to reduce the inflammation and treat the symptoms. Many people with Crohn's find that dairy can make symptoms worse so avoiding this may reduce them. Aloe Vera has anti-inflammatory properties and some find this can help ease the symptoms when taken on a regular basis. Stress may exacerbate symptoms too so limiting stress and adopting relaxation techniques may also help." 

5. Coeliac disease

Symptoms: The symptoms of coeliac can present as mild or severe and most often include diarrhoea, making it very difficult to separate from other tummy issues. 

Causes: Coeliac disease is a well-defined, serious illness where the body's immunesystem attacks itself when gluten is eaten. This causes damage to the lining of the gut and means that the body cannot properly absorb nutrients from food. Coeliac disease is not a food allergy or intolerance, it is an autoimmune disease.

Family GP Dr Roger Henderson says: 

"The most common symptom of coeliac disease is diarrhoea, caused by the body not being able to fully absorb nutrients known as malabsorption. This can result in stools containing high levels of fat, make them foul smelling, greasy and frothy. Unfortunately there is no cure for coeliac disease yet, but switching to a gluten-free diet will reduce the severity of symptoms and prevent serious complications in the future." 

6. Gastroenteritis

Symptoms: The main symptoms of gastroenteritis are sudden, watery diarrhoea, feeling sick, vomiting, and a mild fever. Some people also have other symptoms such as a loss of appetite, an upset stomach, aching limbs and headaches. Symptoms typically appear up to a day after becoming infected and can last a few days but can sometimes last longer. 

Causes: The most common cause is a viral infection such as with the norovirus and adenovirus. Food poisoning can also cause it, such as food infected with Campylobacter, Salmonella and E. Coli. Meat, poultry, dairy products, eggs, shellfish and parboiled rice are the most commonly affected.

Family GP Dr Roger Henderson says:

"Gastroenteritis vomiting bug can be a very unpleasant illness but try to avoid seeing your GP as it's extremely contagious. Wash your hands and the surfaces you come into contact with regularly as it's likely to spread to those around you. If you are concernedor need advice call NHS 111 or your GP surgery. Otherwise with plenty of fluids and rest it should clear up on its own within a week."

7. Stomach ulcer

Symptoms: A stomach ulcer is very different from a stomach ache so the two should not be confused. Symptoms of a stomach ulcer can vary greatly from person to person. Many people never realise that they have an ulcer, others feel pain or a burning sensation in their upper abdomen. The symptoms are often described as indigestion, heartburn, hunger pangs or dyspepsia. Some sufferers find that eating actually helps settle their discomfort for a while, others find it makes them worse. Citrus drinks and fruit and spicy or smoked foods can all make the pain worse. 

An ulcer is potentially dangerous so it's important to look out for the warning signs. These include difficulty swallowing or regurgitation, persistent nausea and vomiting, vomiting blood or vomit with the appearance of 'coffee grounds', black or tar-like stools, unintended weight loss, anaemia (paleness and fatigue) and sudden, severe and incapacitating abdominal pains. If any of these occur, seek medical advice.

Causes: Until the 1980s it was often thought that stress and spicy food directly caused ulcers but it is now known that almost all patients with ulcers have a bacterial infection of the stomach called Helicobacter pylori. Other causes include non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen, smoking and heavy alcohol intake.

Family GP Dr Roger Henderson says:

"Stop smoking, take paracetamol instead of aspirin, avoid taking non-steroidal tablets (NSAIDs) for arthritis or pain control whenever possible, reduce your alcohol intake and try to keep stress levels to a minimum." 

July 18th 2018

Omega-3 supplements 'do not cut risk of early death and do little to protect heart'

Fish oil and omega-3 supplements offer little or no protection to the heart and may even lower levels of healthy cholesterol, a myth-busting major study has found.

The review looking at trial data from more than 100,000 people around the world also failed to show any evidence that the popular supplements reduce the risk of dying.

Millions of people take omega-3 in the belief that it helps prevent heart disease and early death. The fatty acids, mostly found in oily fish such as salmon and tuna, are known to benefit health when consumed in small amounts in food.

But controversy surrounds the burgeoning industry and hype surrounding omega-3 supplements, which are claimed to prevent a host of ills ranging from dementia and depression to heart disease and rheumatoid arthritis.

The new research looked specifically at evidence of their impact on rates of heart disease, stroke and death.

Scientists from the Cochrane organisation, a global network of experts dedicated to informing health policy, pooled findings from 79 randomised trials involving 112,059 participants.

The studies, conducted in North America, Europe, Australia and Asia, investigated the effect on the heart and arteries of taking omega-3 and fish oil supplements.

Combining results from many trials, known as "meta-analysis," can highlight trends that may previously have been hidden.

In this case the scientists found "high certainty evidence" that long-chain omega-3 fats had "no meaningful effect" on death risk. They also had "little or no" impact on the risk of heart attacks, strokes or heart irregularities.

However there was some evidence that the supplements reduced levels of high-density lipoprotein (HDL) - the "good" form of cholesterol known to protect arteries from damage.

Lead researcher Dr Lee Hooper, from the University of East Anglia, said: "We can be confident in the findings of this review which go against the popular belief that long-chain omega-3 supplements protect the heart.

"This large systematic review included information from many thousands of people over long periods. Despite all this information, we don't see protective effects.

"The review provides good evidence that taking long-chain omega 3 supplements does not benefit heart health or reduce our risk of stroke or death from any cause.

"The most trustworthy studies consistently showed little or no effect of long-chain omega-3 fats on cardiovascular health.

“On the other hand, while oily fish is a healthy food, it is unclear from the small number of trials whether eating more oily fish is protective of our hearts."

The findings are published in The Cochrane Library, the collection of databases maintained by the Cochrane organisation.

Dr Hooper said there was "moderate" evidence that one type of short-chain omega-3 fat found in plant oils and nuts, alphalinolenic acid (ALA), may provide a small degree of heart protection.

However he added: "The effect is very small - 143 people would need to increase their ALA intake to prevent one person developing arrhythmia (irregular heart beat).

“One thousand people would need to increase their ALA intake to prevent one person dying of coronary heart disease or experiencing a cardiovascular event."

Commenting on the results, cardiologist Professor Tim Chico, from the University of Sheffield, said: "This analysis of many studies shows clearly that omega-3 supplements do not reduce heart disease.

“Such supplements come with a significant cost, so my advice to anyone buying them in the hope that they reduce the risk of heart disease, I'd advise them to spend their money on vegetables instead."

Nutrition expert Dr Ian Johnson, from the Quadram Institute Bioscience, said: "The results show little or no evidence for important beneficial effects. Given the strong evidence from previous epidemiological studies this conclusion is somewhat surprising, but it needs to be taken seriously.

"Either the protective effects of oily fish consumption that are observed in populations are due to mechanisms that cannot be reproduced by relatively short-term interventions with purified omega-3 supplements, or perhaps they are caused by other unidentified environmental factors somehow linked to oily fish consumption."

July 16th 2018

How to spot age-related macular degeneration

Fifteen years ago, Lorna Blakeney thought she had a lump of mucus in her eye. “I was sitting reading a book after lunch and suddenly realised there was something in my left eye. I tried to blink and rub it away. I thought a night’s sleep would help. But in the morning, it was still there. I didn’t do anything about it for two weeks, which was stupid of me, especially as my daughter is an optometrist.”

Lorna’s daughter sent her mum straight to an ophthalmologist. “But it was too late. I was diagnosed with wet age-related macular degeneration (AMD); there was no treatment in those days and I was told there was an 82% chance that my other eye would go, too.”

Lorna’s daughter, Dr Sue Blakeney, is a clinical adviser at the College of Optometrists. She says that what happened to her mum is not uncommon. “Macular degeneration causes damage to the part of the retina responsible for central vision. It affects one eye first, so you often don’t notice it unless you close one eye at a time; you can be almost blind in one eye and not be aware of it.” Lorna is even more pithy: “You have two eyes – make sure you compare them. One is often stronger than the other, but if things change, get help.”

Ophthalmologist Pearse Keane of Moorfields eye hospital in London says that AMD is the most common cause of irreversible sight loss in the UK and Europe. “Every day in the UK alone, nearly 200 people develop the severe, blinding forms of AMD. There are two main forms of AMD – a ‘dry’ type and the ‘wet’ one. Wet AMD has nothing to do with watery eyes but is so-called because abnormal blood vessels grow under the centre of the retina (the nerve tissue that lines the back of the eye). These blood vessels leak fluid and bleed easily, and this can cause severe visual loss because it is such a sensitive area.”

Keane says that, until about 10 years ago, there was no effective treatment for the wet form of AMD, but now it can be treated with regular injections of drugs such as Eylea or Lucentis into the eye. They block the growth of new blood vessels and reduce the leakage of fluid from existing vessels. This improves sight substantially in about a third of patients and prevents further worsening of vision in about 95% of cases. However, the effects of the drugs last only one to two months, so people need frequent injections over long periods of time.

Andrew Lotery, a professor of ophthalmology at the University of Southampton, says everyone over 50 should at least be aware that if they have a loss of vision in one eye that is not corrected when they put on their glasses, then it could be rapidly developing wet AMD.

“You should be seen in hospital within a week because scarring develops if wet AMD is left untreated.” Optometrists and ophthalmic practitioners (doctors trained to examine eyes) can look for early signs of macular degeneration and will refer on urgently if they are concerned. In the past, diagnosis relied on a slit-lamp examination – a contact lens put on the eye and observed through a microscope looking for thickening of the retina – and a fluorescein angiogram (FA), which involves an injection into a vein in the arm to highlight blood vessels in the eye. But “FA makes lots of people sick and occasionally causes severe allergic reactions,” says Lotery.

Happily, there is an alternative now. “The initial diagnosis of wet AMD, and the need for follow-up treatments, is determined with a form of retinal imaging called optical coherence tomography (OCT),” says Keane. OCT is a relatively new form of medical imaging, having been around since 1991. It is analogous to ultrasound except that it measures the reflection of light waves, rather than sound. Most people with known retinal disease have an OCT scan at every hospital eye clinic appointment and get offered more injections into the eye if there are signs of “fluid”.

Lotery says the price of OCT machines are coming down all the time although they still cost around £50,000 each. There are also now handheld OCTs, which some believe will make detecting eye disease as “easy as scanning a barcode”, but Lotery urges caution: “Don’t rush out to buy one. You still need a trained health professional to interpret the results – it’s easy to misinterpret them.”

Machines are also being trained in diagnostic techniques. Google’s DeepMind has used data from thousands of OCT scans to develop an algorithm that can diagnose wet AMD at least as quickly and effectively as eye specialists can. A partnership with Moorfields and the NHS will shortly publish more detailed results.

AMD develops as the eye ages – and Blakeney says other risk factors include a family history of AMD, smoking, excessive exposure to UV light and, possibly, to screens. Maintaining a normal weight may be protective and there is probably a role for foods that contain dietary pigments, such as blueberries and peppers. “There is no good evidence that the general population should take supplements, but if you already have AMD in one eye, it may be advisable.”

 

Dry AMD is less severe than wet, progresses over years rather than months and causes more gradual loss of central vision. “Unfortunately, there is no effective treatment for dry AMD, although there are many clinical trials under way,” says Keane.

The exciting developments in diagnosis and treatment of wet AMD have come too late for Lorna Blakeney. She is one of the 360,000 people in the UK who are registered as blind or visually impaired. Six years after her initial diagnosis, Lorna noticed that the venetian blinds in her bathroom window looked wiggly in her remaining sighted eye. “This time, I had injections of the drug Lucentis into my eye. I thought it would be a magic bullet; it is for many, but it wasn’t for me. Gradually, I lost the sight in the eye and I’m now registered as severely sight impaired, with only a bit of peripheral vision left.”

“There is life after AMD. I manage pretty well, with every gadget known to man.” She uses software on her phone and a tablet with “speaking” icons, has voice recognition software to dictate emails, a talking watch, clock, kitchen scales, measuring jug and microwave. One gadget rests on the edge of a mug and beeps twice; once for the water and once for the milk, to make a perfect cup of tea without spillages. Another clips on to her glasses and scans and speaks the writing on food labels in the supermarket. Lorna says all these aids are enormously helpful, but they don’t come cheap and most are not subsidised.

“If I go out on my own, I have a symbol cane to let other people know that I can’t see them although I have enough peripheral vision that I can move around without bumping into things. Not being able to read is biggest nuisance. One very posh British restaurant we went to had the French ‘mesdames’ and ‘messieurs’ in pale grey letters on a pale-green sign. I didn’t stand a chance.”

July 14th 2018

Mums-to-be are swearing by this tip to cope with the heat during pregnancy

We're not used to this weather in rainy Manchester and the heat is certainly proving a challenge to those pregnant ladies out there.

After asking mums and mums-to-be to share their tips for keeping cool we've been inundated with suggestions.

From wearing wet socks to dipping your feet (or even your whole body) in a paddling pool, you've been giving women some great ideas to cool down as the temperatures soar.

But this one tip has proved more popular than most - and all it involves is some ice and a fan.

Whether you did it in a pregnancy years ago, or are expecting your first child, many of you have been telling us the benefits of putting ice - either cubes or a bottle - in front of a fan to fill the room with cool air. Oh and eating some ice cubes while you're at it.

One of the hundreds of women who commented on the post on the M.E.N's Facebook page was mum Sarah Ogden, sharing her experience of being pregnant - and VERY hot - when carrying her son.

She said: "I had my son in September 2006, that August was so warm. The best thing I did was freeze a bottle of water - just a two-litre empty pop bottle - then put it in front of a fan.

"It was nice freezing cold air being blown right at me, it was amazing."

Mum Gayle Waddell did the same. She said: "My eldest was a July baby so I can completely empathise.

"My biggest tip is sleeping (or working!) with a fan with a bowl of ice in front of it to keep cool. I just constantly ate ice cubes."

Janine Davies said she had 'scorching summer weather' in all four of her pregnancies. She too turned to ice.

She said: "I was heavily pregnant all through summer. The only thing that kept me cool was sucking ice cubes and constantly putting my wrist under cold water.

"It really helped, as did thin cotton clothing and sitting in the shade."

Other tips include constantly having wet hair, suggested by mum Helena Thomas, whose children were born in the summers of 2007 and 2013, and sleeping with a wet towel over you and the fan on, from Sam Louise.

Some of you pregnant ladies are playing it safe and staying out of the sun altogether, including Nicole Affleck, who said: "35+1 and the swelling of the hands and feet have got me today. I'm not going out at all, day in for me."

So if you know a mum-to-be who's suffering, send this their way. And if you have a tip to share then let us know in the comments

July 12th 2018

Here's how much sleep you have lost since heatwave started

This summer's heatwave has collectively cost Britons more than 471 million hours of sleep.

And according to a study, 42% of us have also slept with bedroom windows wide open during the last two weeks.

The study was carried out by a British mattress brand, in a bid to discover more about the UK’s sleeping habits during this unusual stretch of warm temperatures.

The poll found that most people have switched their duvet for something lighter for a more comfortable night’s rest and one in five have slept apart from their partner at least once to try and stay cool.

www.Ergoflex.co.uk asked a total of 2,133 about their sleep patterns since the June 25 when the heatwave really began.

The overwhelming majority, 88%, of the people taking part in the survey said that they had lost sleep due to the heatwave.

And when asked to estimate how much they had lost since the start of June, the average answer was revealed to be 45 minutes per night, per person; 10 hours and 30 minutes in total.

More than two fifths of the respondents taking part in the poll confessed that they had slept with their bedroom windows wide open for the majority of nights over the past two weeks, posing a risk to home security.

Steve Willis from www.Ergoflex.co.uk said: “As much as we all love the fact that we’re actually getting a proper summer for a change, there’s no hiding the fact that this country just isn’t cut out for lasting hot weather and it’s clear that our sleep suffers badly as a result.

“Not getting a good night’s sleep affects everything from your mood to your productivity, and even your appetite, so losing sleep over a sustained period like during the heatwave can be very problematic in our day-to-day lives.

"Switching to a lighter duvet, preparing the bedroom in advance by drawing curtains early, circulating air with a fan, and investing in a mattress that promotes airflow are good starting points for a more comfortable night during warm weather.

"By actively dealing with warmer nights we can get the sleep we need to actually enjoy these sunny days while they’re here, rather than suffering from sleep deprivation.”

July 11th 2018

Multivitamins and mineral supplements won't save you from heart disease deaths, finds study

Multivitamin and mineral supplements have no benefit in preventing heart attacks, strokes or cardiovascular disease, an analysis of more than 2 million participants has found.

A multibillion dollar industry, they often marketed with a wide array of health promoting claims.

But researchers from the University of Alabama who followed more than 2 million people from 18 trials of nutritional supplements, saw no evidence they could lower heart disease deaths.

Instead, they suggested much more effective steps people can take to improve their health without extra cost are discounted.

“It has been exceptionally difficult to convince people, including nutritional researchers, to acknowledge that multivitamin and mineral supplements don’t prevent cardiovascular diseases,” said the study’s lead Dr Joonseok Kim, an assistant professor of cardiology in the Department of Medicine.

“I hope our study findings help decrease the hype around multivitamin and mineral supplements and encourage people to use proven methods to reduce their risk of cardiovascular diseases – such as eating more fruits and vegetables, exercising and avoiding tobacco.”

The nutritional supplement industry will be worth more than £200bn globally by 2024, Dr Kim writes in the study published in the American Heart Association (AMA) journal,

But these products in countries like the UK and US do not require approval on safety or effectiveness grounds.

While manufacturers are barred from making specific claims about their products ability to prevent, cure or treat diseases, this does not extend to more general health claims.

Dr Kim added that examples of these types of supplements causing direct harm were “rare” but that people could be neglecting lifestyle or medical interventions of proven benefit if they thought vitamins were an easier option.

“Eat a healthy diet for a healthy heart and a long, healthy life,” said Dr Eduardo Sanchez, the AMA’s chief medical officer for, who was not a part of this study. “There’s just no substitute for a balanced, nutritious diet with more fruits and vegetables that limits excess calories, saturated fat, trans fat, sodium, sugar and dietary cholesterol.”

 

July 10th 2018

What is sepsis? Symptoms, tests and treatment - knowing these signs could save a life

As more cases of sepsis are being reported, here's what it is and how you can stay safe - know the symptoms as Corrie sheds light on the condition with Jack Webster storyline

Most people think flu-like symptoms are a sign they're coming down with a cold, but they can actually be far more serious.

Recognising sepsis blood poisoning in time for treatment could save someone's life, according to NHS Choices.

Without being treated quickly, sepsis can lead to multiple organ failure - and even death.

There have been multiple cases in the news of people who thought they had a common cold, or they were misdiagnosed actually having sepsis, a rare but serious complication arising from infection.

Jack Webster (Kyran Bowes) in Coronation Street was also struck down by Sepsis in the latest storyline shedding light on the condition.

While the boy has been fighting for his life, as dad, Kevin, looked on distraught fans were left wondering what Sepsis was.

So what is sepsis and how do you recognise it? Here's everything you need to know

Sepsis is a common and potentially life-threatening condition triggered by an infection.

The infection may have started anywhere in a sufferer’s body, and may be only in one part of the body or it may be widespread.

Sepsis can occur following chest or water infections, problems in the abdomen like burst ulcers, or simple skin injuries like cuts and bites.

If not treated quickly, sepsis can eventually lead to multiple organ failure and death.

Early symptoms of sepsis usually develop quickly and can include:

High temperature or fever,

·       Chills and shivering,

·       A sped-up heartbeat

·       Fast breathing

In some cases, symptoms of more severe sepsis or septic shock - when blood pressure drops to a dangerously low level - develop soon after.

These can include:

·       Feeling dizzy or faint,

·       Confusion or disorientation,

·       Nausea and vomiting,

·       Diarrhoea and cold,

·       Clammy and pale or mottled skin

·       See your GP immediately if you have recently had an infection or injury and you have possible early signs of sepsis.

·       Severe sepsis and septic shock are medical emergencies. If you think that you or someone in your care has one of these conditions, call 999 and ask for an ambulance.

Go straight to A&E or call 999 if your child has any of these symptoms:

·       looks mottled, bluish or pale

·       is very lethargic or difficult to wake

·       feels abnormally cold to touch

·       is breathing very fast

·       has a rash that does not fade when you press it

·       has a fit or convulsion

Temperature

·       temperature over 38C in babies under three months

·       temperature over 39C in babies aged three to six months

·       any high temperature in a child who cannot be encouraged to show interest in anything

·       low temperature (below 36C – check three times in a 10-minute period)

Breathing

·       finding it much harder to breathe than normal – looks like hard work

·       making "grunting" noises with every breath

·       can't say more than a few words at once (for older children who normally talk)

·       breathing that obviously "pauses"

Toilet/nappies

·       not had a wee or wet nappy for 12 hours

Eating and drinking

·       new baby under one month old with no interest in feeding

·       not drinking for more than eight hours (when awake)

·       bile-stained (green), bloody or black vomit/sick

READ MORE

·       When do babies sleep through the night? Expert reveals surprising answer to the question every parent asks

Activity and body

·       soft spot on a baby's head is bulging

·       eyes look "sunken"

·       child cannot be encouraged to show interest in anything

·       baby is floppy

·       weak, "whining" or continuous crying in a younger child

·       older child who's confused

·       not responding or very irritable

·       stiff neck, especially when trying to look up and down

In older children and adults

Early symptoms of sepsis may include:

·       a high temperature (fever) or low body temperature

·       chills and shivering

·       a fast heartbeat

·       fast breathing

Symptoms of more serious sepsis can develop soon after.

·       feeling dizzy or faint

·       a change in mental state – such as confusion or disorientation

·       diarrhoea

·       nausea and vomiting

·       slurred speech

·       severe muscle pain

·       severe breathlessness

·       less urine production than normal – for example, not urinating for a day

·       cold, clammy and pale or mottled skin

·       loss of consciousness

·       Each year in the UK, there are 123,000 cases of sepsis a year in England. Around 37,000 people will die as a result of the condition.

·       Anyone can develop sepsis after an injury or minor infection, although some people are more vulnerable.

·       People most at risk of sepsis include those with a medical condition or receiving medical treatment that weakens their immune system, those who are already in hospital with a serious illness, those who are very young or very old or those who have just had surgery or who have wounds or injuries as a result of an accident.

If sepsis is detected early and has not yet affected vital organs, it may be possible to treat the infection at home with antibiotics. Most people who have sepsis detected at this stage will make a full recovery.

Some people with severe sepsis and most people with septic shock require admission to an intensive care unit (ICU), where the body’s organs can be supported while the infection is treated.

As a result of problems with vital organs, people with severe sepsis are likely to be very ill and the condition can be fatal.

However, if identified and treated quickly, sepsis is treatable and in most cases leads to full recovery with no lasting problems.

You may need to give a blood test. Other tests used include:

·       urine or stool samples

·       a wound culture – where a small sample of tissue, skin or fluid is taken from the affected area for testing

·       respiratory secretion testing – taking a sample of saliva, phlegm or mucus

·       blood pressure tests

·       imaging studies - like an X-ray

 

July 7th 2018

Flawed herpes testing leads to many false positives — and needless suffering

Herpes is a lifelong infection, but Lauren had it only for six tumultuous months. Or rather, she believed she did, after a request for sexually transmitted disease testing returned a positive result. But after weeks of Googling, chatting with members of online herpes forums, and reading scientific papers, she asked for a different test, which eventually confirmed her suspicion — her herpes diagnosis was wrong.

In the six months that passed between the tests, the mistake led her to keep a romance at bay and left her anxiously patrolling her health.“Every tingle I would get in my leg or any kind of itch down there would just set me off,” sending her into a new flurry of research, she said. “And that was just to try to calm my own anxiety, but it would only really make it worse.”

Genital herpes, predominantly caused by herpes simplex virus type 2, is a sexually transmitted disease that’s very common — 1 in 6 people aged 14 to 49 in the United States have HSV-2, and this number goes up with age. Most of these people, however, don’t have obvious symptoms and wouldn’t know they were carriers without blood tests.

But blood tests can be highly unreliable. The kind of test used to diagnose Lauren, an IgM test, has long been rejected by the Centers for Disease Control and Prevention but is still used by some clinicians. Meanwhile, the CDC and the US Preventive Services Task Force concur that the most widely available herpes test, called HerpeSelect, should not be used to screen asymptomatic people because of its high risk of false positives: Up to 1 in 2 positive tests could be false, according to the USPSTF’s most recent guidelines.

That high failure rate isn’t, however, always communicated to patients. Online forums abound with stories like Lauren’s, of people who request herpes tests alongside those of other STDs and are shellshocked by the results. Some doctors discourage the testing or simply don’t include it in a standard STD panel without having the conversation. But no data exists on herpes screening rates, according to Kimberly Workowski, lead author of the CDC’s STD treatment guidelines — so it’s difficult to say how many people could be living with the misdiagnosis.

Testing pitfalls

Next to the meandering waterways connecting Puget Sound to Seattle’s Lake Washington is the only laboratory in the world that offers to the public the Western blot, the gold standard test for herpes. The University of Washington Clinical Virology Laboratory provides the test to patients across the country, a practice it began over a decade ago when it realized the more common tests were prone to false positives.

The problem, said Christine Johnston, a physician and researcher at the lab, is “low-positive” results of antibodies to HSV-2. The cutoff for a positive result on the HerpeSelect test, manufactured by Quest Diagnostics, is 1.1. A 2005 studypublished in the journal BioMed Central Infectious Disease found that index values above 3.5 yielded over 90 percent accuracy — but scores between 1.1 and 3.5 had around a 50 percent chance of being wrong.

What’s more, scores falling just above the 1.1 cutoff had an almost 90 percent chance of being wrong.

When tests fall between 1.1 and 3.5, more testing is necessary, said Johnston. This recommendation is also noted in the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines. But some patients will never be referred for a second test.

“I think most clinicians are unaware and perhaps labs don’t have this available and/or it is not straightforward to order,” Johnston said of second-step tests.

But while her facility’s Western blot is considered highly accurate, it is expensive and cumbersome to perform. Each test costs over $200 and the University of Washington is the only lab that provides it.

Other confirmatory tests also exist, for instance Biokit’s HSV-2 Rapid Test and Quest’s own HSV-2 IgG Inhibition assay. The latter, which adds only $4 to the price of the HerpeSelect test, performed well in a study conducted over a decade ago. Rick Pesano, the medical director for infectious disease at Quest, believes that with more awareness, the test could stand in for the Western blot. But the test was not mentioned in the USPSTF guidelines because it still has not been evaluated in asymptomatic individuals, according to Cindy Feltner, associate director of the RTI-UNC Evidence-based Practice Center, who helped prepare the science review for USPSTF.

“We need better diagnostic testing. That is where we are stuck at this point,” said Johnston. “We don’t have a good test that’s inexpensive, high throughput, and reliable.”

Finding out the hard way

No good data exist on how often patients with questionable positive results are actually re-tested. Until the 2015 update, CDC herpes testing guidelines had no mention of confirmatory testing for low-positive results, said Johnston. So patients often discovered the option not through their doctors, but through searching the web and reading online herpes forums.

That was the experience of Bryan, a 40-year-old man who lives in Indiana, who wrongly believed he had herpes for about two months in 2011. The misunderstanding actually put him at higher risk, he said: During those months he considered joining the hundreds of thousands of Americans on dating sites for herpes-positive people. Exclusively dating people with herpes would have increased his likelihood of contracting the virus.

The experience of YT, a 33-year-old mom who has suffered from frequent herpes symptoms over the last year, shows another side of the testing breakdown. She believes she was given HSV by a partner who didn’t realize herpes wasn’t included in his previous STD tests, she told STAT. Having herpes has caused her significant emotional trauma, and has driven her to permanently swear off dating. Had her partner known his true status, she wonders if her story would have been different.

These kinds of stories come out in anguished postings on internet forums and in dozens of confused calls to the UW lab each week, where research coordinator Matt Seymour says some desperate patients call over and over again, unable to get the answers they need from their doctors.

“People call and say, ‘I just don’t know what’s going on,’” he said. “We’ve almost become de facto counselors.”

In the absence of answers

Herpes tests aren’t the only ones with a risk of false positive results. False positives can occur for any test that diagnoses viral infection based on antibodies, i.e., your body’s immune reaction, rather than direct detection of the virus. For similar diagnostics like HIV and hepatitis C testing, protocols automatically call for a second test that directly detects the virus whenever an antibody test comes back positive, said Paul Swenson, laboratory director in the department of public health of King County, Washington. Herpes, however, is a particularly challenging infection to directly test for, because the virus spends most of its time hiding in nerves. Swab tests can sometimes detect the virus during outbreaks, but this isn’t an option for people without symptoms. Thus even the Western blot relies on antibodies, and may give indeterminate results to a small number of people.

But two steps of antibody testing are still more reliable than one step; today’s diagnostics for Lyme disease and syphilis are a two-step antibody testing approach, said Dr. Edward Hook, a medical epidemiologist specializing in STI screening and prevention at the University of Alabama, Birmingham, who questioned why such a standardized two-step approach hasn’t taken firm hold for herpes.

“Some research has shown that two-step testing … might improve the specificity — that is avoid false positive results for the blood test — which would be a great thing because these diagnoses create great anxiety and concern for people,” he said. In a commentary accompanying the USPSTF guidelines, Hook expressed disappointment that herpes testing had barely improved over the past decade.

“There is no perfect test but there are ways to reduce the inaccuracies and reduce the number of equivocal results and those are actively used in other diseases,” he said in an interview with STAT. “But they haven’t been used very aggressively for the purpose of herpes.”

In the absence of sure-fire test advances, education and a lessening stigma surrounding herpes might help, not only by reducing test-related confusion, but potentially by bringing discussion of the virus out into the mainstream, said Hook.

“There’s no major herpes advocacy group,” he said. “People call attention to diseases that they suffer from, but people with herpes don’t feel they can call attention to it. And that creates a lot of suffering.”

 

July 5th 2018

Staff praised for 'brilliance' as NHS turns 70

There are events taking place across the country, with NHS boss Simon Stevens giving "heartfelt" thanks to healthcare staff.

09:36, UK,
Chief executive Simon Stevens says the service's success is due to the "brilliance" of its 1.5 million doctors, nurses, ambulance staff, therapists, porters, caterers and others who, along with volunteers, make up the biggest care team in the world.

In a message recorded in an ambulance control room, Mr Stevens said: "It's a time of celebration, looking back over seven decades when we're all living a lot longer and healthier, more than 10 years extra.

"So, although this is our birthday, today our ambulance crews, here in the ambulance control room where I'm standing, our community nurses, our midwives welcoming new babies into the world, people who are going to be visiting their GP today...

"Staff are going to be doing what they do day in day out.

"And it's frankly because of the staff of the health service that the nation has just re-committed to the idea of a health service, there when you need us based on how sick you are - not whether you can afford us, a principle that has stood the test of time.

"On that basis, we should use this moment to say a heartfelt thank you to the million-and-a-half staff of the National Health Service for everything you do for all of us and for our families, day in, day out."

The day will see celebrations around the country, including thousands of Big 7Tea events to thank staff and raise awareness of NHS charities.

July 4th 2018

A Beautiful Mind: Brain Injury Turns Man Into Math Genius 

In 2002, two men savagely attacked Jason Padgett outside a karaoke bar, leaving him with a severe concussion and post-traumatic stress disorder. But the incident also turned Padgett into a mathematical genius who sees the world through the lens of geometry.

Padgett, a furniture salesman from Tacoma, Washington, who had very little interest in academics, developed the ability to visualize complex mathematical objects and physics concepts intuitively. The injury, while devastating, seems to have unlocked part of his brain that makes everything in his world appear to have a mathematical structure.

"I see shapes and angles everywhere in real life" — from the geometry of a rainbow, to the fractals in water spiraling down a drain, Padgett told Live Science. "It's just really beautiful." [Album: The World's Most Beautiful Equations]

Padgett, who just published a memoir with Maureen Seaberg called "Struck by Genius" (Houghton Mifflin Harcourt, 2014), is one of a rare set of individuals with acquired savant syndrome, in which a normal person develops prodigious abilities after a severe injury or disease. Other people have developed remarkable musical or artistic abilities, but few people have acquired mathematical faculties like Padgett's.

Now, researchers have figured out which parts of the man's brain were rejiggered to allow for such savant skills, and the findings suggest such skills may lie dormant in all human brains.

'Struck by genius'

Before the injury, Padgett was a self-described jock and partyer. He hadn't progressed beyond than pre-algebra in his math studies. "I cheated on everything, and I never cracked a book," he said.

But all that would change the night of his attack. Padgett recalls being knocked out for a split second and seeing a bright flash of light. Two guys started beating him, kicking him in the head as he tried to fight back. Later that night, doctors diagnosed Padgett with a severe concussion and a bleeding kidney, and sent him home with pain medications, he said.

Soon after the attack, Padgett suffered from PTSD and debilitating social anxiety. But at the same time, he noticed that everything looked different. He describes his vision as "discrete picture frames with a line connecting them, but still at real speed." If you think of vision as the brain taking pictures all the time and smoothing them into a video, it's as though Padgett sees the frames without the smoothing. In addition, "everything has a pixilated look," he said.

"I see this image in my mind's eye, now in 3-D, every time imagine how my hand moves through space-time."

With Padgett's new vision came an astounding mathematical drawing ability. He started sketching circles made of overlapping triangles, which helped him understand the concept of pi, the ratio of a circle's circumference to its diameter. There's no such thing as a perfect circle, he said, which he knows because he can always see the edges of a polygon that approximates the circle. [Gallery: See Padgett's Amazing Mathematical Drawings]

Padgett dislikes the concept of infinity, because he sees every shape as a finite construction of smaller and smaller units that approach what physicists refer to as the Planck length, thought to be the shortest measurable length.

After his injury, Padgett was drawing complex geometric shapes, but he didn't have the formal training to understand the equations they represented. One day, a physicist spotted him making these drawings in a mall, and urged him to pursue mathematical training. Now Padgett is a sophomore in college and an aspiring number theorist.

Padgett's remarkable abilities garnered the interest of neuroscientists who wanted to understand how he developed them.

Beautiful mind

Berit Brogaard, a philosophy professor now at the University of Miami, in Coral Gables, Florida, and her colleagues scanned Padgett's brain with functional magnetic resonance imaging (fMRI) to understand how he acquired his savant skills and the synesthesia that allows him to perceive mathematical formulas as geometric figures. (Synesthesia is a phenomenon in which one sense bleeds into another.) [Top 10 Mysteries of the Mind]

"Acquired savant syndrome is very rare," Brogaard said, adding that only 15 to 25 cases have ever been described in medical studies.

Functional magnetic resonance imaging measures changes in blood flow and oxygen use throughout the brain. During scans of Padgett, the researchers showed the man real and nonsense mathematical formulas meant to conjure images in his mind.

The resulting scans showed significant activity in the left hemisphere of Padgett's brain, where mathematical skills have been shown to reside. His brain lit up most strongly in the left parietal cortex, an area behind the crown of the head that is known to integrate information from different senses. There was also some activation in parts of his temporal lobe (involved in visual memory, sensory processing and emotion) and frontal lobe (involved in executive function, planning and attention).

But the fMRI only showed what areas were active in Padgett's brain. In order to show these particular areas were causing the man's synesthesia, Brogaard's team used transcranial magnetic stimulation (TMS), which involves zapping the brain with a magnetic pulse that activates or inhibits a specific region. When they zapped the parts of Padgett's parietal cortex that had shown the greatest activity in the fMRI scans, it made his synesthesia fade or disappear, according to a study published in August 2013 in the journal Neurocase.

Brogaard showed, in another study, that when neurons die, they release brain-signaling chemicals that can increase brain activity in surrounding areas. The increased activity usually fades over time, but sometimes it results in structural changes that can cause brain-activity modifications to persist, Brogaard told Live Science.

Scientists don't know whether the changes in Padgett's brain are permanent, but if he had structural changes, it's more likely his abilities are here to stay, Brogaard said.

The savant in everyone

So do abilities like Padgett's lie dormant in everyone, waiting to be uncovered? Or was there something unique about Padgett's brain to begin with?

Most likely, there is something dormant in everyone that Padgett tapped into, Brogaard said. "It would be quite a coincidence if he were to have that particular special brain and then have an injury," she said. "And he's not the only [acquired savant]."

In addition to head injuries, mental disease has also been known to reveal latent abilities. And Brogaard and others have done studies that suggest zapping the brains of normal people using TMS can temporarily bring out unusual mathematical and artistic skills.

It's always possible that having savant skills may come with trade-offs. In Padgett's case, he developed fairly severe post-traumatic stress disorder and obsessive-compulsive disorder, and he still finds it difficult to appear in public.

Yet Padgett wouldn't change his new abilities if he could. "It's so good, I can't even describe it," he said.

 

July 3rd 2018

FDA eyes safety standards at cosmetic companies

There isn’t much public information on how the cosmetic industry makes sure its products are safe — but the FDA is looking to change that. The agency is proposing a new study of safety practices and manufacturing standards in the U.S. cosmetic industry. Here's what you need to know: 

§ The U.S. cosmetic industry has been widely unregulated for close to a century. The Food, Drug, and Cosmetic Act of 1938 essentially lets companies that produce makeup, hair products, and perfumes self-police their standards.

§ There's growing concern about bad reactions to products, along with questions about the possible long-term health risks of some chemicals used in cosmetics.

§ Lawmakers are also eyeing the issue. Sens. Dianne Feinstein (D-Calif.) and Susan Collins (R-Maine) introduced a bill earlier this year that would establish an independent review process for all ingredients used in personal care products in the U.S. The bill has been introduced in past legislative sessions, and it’s not clear yet whether it’ll gain the momentum this time around to pass.

Complications are common in patients with catheters

A new study finds that more than half of hospitalized patients who get a urinary catheter might experience a complication of some kind. Researchers combed through more than 2,000 charts and interviewed patients two weeks and a month after their catheters were removed. Roughly 10 percent of patients experienced an infection, and infections were more common among women. More than half of patients reported another kind of issue, such as pain after the catheter was taken out. One big takeaway, according to the authors: While hospitals and public health experts have made it a priority to prevent infections linked to catheters, there are other complications that also warrant their attention. ​

New details out on contaminated kratom investigation

The FDA has released new details into its monthslong investigation into kratom products contaminated with salmonella. The outbreak spurred a slew of recalls, including the FDA's first mandatory recall. By the end of May, there were 199 cases of salmonella infection in 41 states linked to kratom. Health officials collected kratom samples from sick patients to identify the types of salmonella involved, then compared those test results to CDC's database of salmonella strains. That turned up even more people who had consumed contaminated kratom. The FDA has wrapped up its investigation, but says anyone who consumes kratom still might be at risk of salmonella. 

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Inside STAT: Researchers hunt for new ways to prevent sepsis deaths

 

RONNIE ROBERTS LOST HIS FIANCEE, DORICE BROUGHTON, TO SEPSIS IN 2015. (ARAM BOGHOSIAN FOR STAT)

Ronnie Roberts believes that if he had known the signs of sepsis and pushed for his fiancee to be treated properly, she would still be alive. Sepsis — the body’s overwhelming response to a blood infection — kills more than 250,000 people each year in the U.S. But many doctors, nurses, and family members don’t recognize sepsis until it’s too late. Researchers across the country are pursuing different ideas to reduce deaths due to sepsis, including a new blood test that aims to quickly identify the bug triggering a patient’s infection, so that doctors can provide more targeted antibiotics. STAT contributor Karen Weintraub has the story here. ​

Texas officials investigate illnesses blamed on parasite 

Texas health officials are investigating 56 illnesses linked to the parasite Cyclospora that have cropped up since early May. The microscopic parasite — which can be found in tainted food or water — causes gastrointestinal issues that can last anywhere from a few days to a few months. The state health department says it's searching for a common source and is urging doctors to test patients for the parasite when appropriate. And since past illnesses have been linked to certain contaminated produce, health officials recommend thoroughly washing all fruits and veggies. 

Here's your annual reminder to stay healthy on July 4

It’s almost the holiday — and that means it’s time for your once-a-year reminder to stay safe while cooking out and celebrating with flammable objects. Fireworks injuries spike every year around the Fourth of July. The most common type of injury: thermal burns. For more on fireworks injuries, read this. And if you’re grilling meat tomorrow, watch this video on how to the reduce the risk that your barbecue is harboring any potentially harmful compounds produced when meat is hit with high temperatures from an open flame. Or, skip meat altogether and feast on fruits and vegetables — just don’t leave your potato salad in the sun too long. ​

What is kratom?

Kratom is a tropical tree (Mitragyna speciosa) native to Southeast Asia, with leaves that contain compounds that can have psychotropic (mind-altering) effects.

Kratom is not currently an illegal substance and has been easy to order on the internet. It is sometimes sold as a green powder in packets labeled "not for human consumption." It is also sometimes sold as an extract or gum.

Kratom sometimes goes by the following names:

·       Biak ·       Ketum ·       Kakuam ·       Ithang ·       Thom

How do people use kratom?

Most people take kratom as a pill, capsule, or extract. Some people chew kratom leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food.

How does kratom affect the brain?

Kratom can cause effects similar to both opioids and stimulants. Two compounds in kratom leaves, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure, and decreased pain, especially when users consume large amounts of the plant. Mitragynine also interacts with other receptor systems in the brain to produce stimulant effects. When kratom is taken in small amounts, users report increased energy, sociability, and alertness instead of sedation. However, kratom can also cause uncomfortable and sometimes dangerous side effects.

What are the health effects of kratom?

Reported health effects of kratom use include:

·       nausea ·       itching ·       sweating ·       dry mouth ·       constipation ·       increased urination ·       loss of appetite ·       seizures ·       hallucinations

Symptoms of psychosis have been reported in some users.

Can a person overdose on kratom?

Kratom by itself is not associated with fatal overdose, but some forms of the drug packaged as dietary supplements or dietary ingredients can be laced with other compounds that have caused deaths.

Is kratom addictive?

Like other drugs with opioid-like effects, kratom might cause dependence, which means users will feel physical withdrawal symptoms when they stop taking the drug. Some users have reported becoming addicted to kratom. Withdrawal symptoms include:

·       muscle aches ·       insomnia ·       irritability ·       hostility ·       aggression ·       emotional changes ·       runny nose ·       jerky movements

How is kratom addiction treated?

There are no specific medical treatments for kratom addiction. Some people seeking treatment have found behavioral therapy to be helpful. Scientists need more research to determine how effective this treatment option is.

Does kratom have value as a medicine?

In recent years, some people have used kratom as an herbal alternative to medical treatment in attempts to control withdrawal symptoms and cravings caused by addiction to opioids or to other addictive substances such as alcohol. There is no scientific evidence that kratom is effective or safe for this purpose.

Points to Remember

·       Kratom is a tropical tree native to Southeast Asia, with leaves that can have psychoactive effects. ·       Kratom is not currently illegal and has been easy to order on the internet. ·       Most people take kratom as a pill or capsule. Some people chew kratom leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food. Two compounds in kratom leaves, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure, and decreased pain. ·       Mitragynine can also interact with other receptor systems in the brain to produce stimulant effects. ·       Reported health effects of kratom use include nausea, sweating, seizures, and psychotic symptoms. ·       Commercial forms of kratom are sometimes laced with other compounds that have caused deaths. ·       Some users have reported becoming addicted to kratom. ·       Behavioral therapies and medications have not specifically been tested for treatment of kratom addiction.

 

June 29th 2018

Bad breath means millions dread talking to their colleagues

Almost one in five ‘can’t bear’ to talk to a colleague because of their bad oral odour.

Millions of workers admit they dread talking to a colleague – because of their bad breath, a study has found.

Researchers who polled 2,000 adults found 63 per cent have had to turn away from someone mid-conversation because they couldn’t stand the smell of their breath.

And almost one in five ‘can’t bear’ to talk to a colleague because of their bad oral odour.

But it’s not just work where we are at the mercy of other people’s bad breath with more than one in three even pulling back from a kiss with a date after being overwhelmed by the smell.

It also emerged almost half of Brits worry they suffer from bad breath themselves, with more than a third even having it highlighted by others.

The stats emerged in a study by UltraDex One Go, single-use liquid mouthwash sachets that freshen breath instantly when you are on the go.

Leading London dentist Dr Mervyn Druian said: “Bad breath can be extremely off-putting.

“Bad breath can be due to many factors but living a fast-paced, ‘on the go’ lifestyle often means eating on the hoof and drinking caffeine to stay awake.

“This all impacts on our breath, but there are things people can do to battle smelly breath instantly to banish odour and inhibit the harmful bacteria which can cause bad breath."

The study also found the average Brit will have to endure someone else’s bad breath at least 104 times a year – twice every week.

The most shameful bad breath odours are from cigarette breath, ‘morning mouth’, poor oral hygiene and perhaps unsurprisingly, lingering garlic breath.

A fishy tuna sandwich, spicy curry or cheesy breath also feature among the most hated bad odours.

Researchers also found those surveyed are most likely to worry their breath smells straight after drinking coffee or eating lunch.

One in twenty worry about having bad breath on the commute into work, while fifteen per cent start to worry after a long journey or flight.

And more than three quarters of adults admit having bad breath has ‘knocked their confidence’.

Regular teeth brushing is considered the best way to combat bad breath, but more than 90 per cent reckon the fresh feeling from brushing wears off within just five hours.

And although around 30 per cent carry mints or chewing gum as ‘emergency’ breath fresheners, using a mouthwash was considered a better way of achieving fresh, clean breath.

Researchers found it could be bad news if you suffer from bad breath though as just 15 per cent of people would tell their friend if they had the problem.

And more than one in three have offered someone gum or mints as a subtle way of trying to improve the smell of their breath.

London dentist Dr Mervyn Druian added: “Products like the handy UltraDex One Go Mouthwash that work instantly to eliminate bad breath for at least 12 hours will become indispensable.

“This, combined with a good oral hygiene routine, means there really is no need for people to have to suffer from bad breath or for that matter to have to endure it.”

Top 10 ways to combat bad breath:

1. Brushing teeth regularly

2. Using a mouthwash

3. Chewing gum

4. Flossing

5. Mints

6. Drinking water to moisten your mouth

7. Scraping your tongue

8. Avoiding foods with lingering odours

9. Eating something else to cover up the smell

10. Avoiding alcohol

 

June 28th 2018

What is Pots

When Tori Foles, wife of Philadelphia Eagles quarterback Nick Foles, started having symptoms of dizziness, nausea and fatigue, one doctor told her she might have anxiety or depression. Another doctor thought she might have a viral infection. But it turned out that she had a mysterious condition that affects blood flow, called "postural orthostatic tachycardia syndrome," or POTS.

"They told me I had a virus," Tori Foles told CNN. "But I had never heard of [a viral illness] where you are dizzy all the time. There were a lot of times I couldn't get out of bed," said Foles, who recently spoke at a meeting of Dysautonomia International, a nonprofit organization that focuses on POTS research and education. [10 Celebrities with Chronic Illnesses]

POTS is a disorder of the autonomic nervous system, the part of the nervous system that controls involuntary functions, such as heart rate, blood pressure and digestion.

The main feature of POTS is so-called orthostatic intolerance, or symptoms that occur when a person moves from lying down to standing up, according to the National Institutes of Health's Genetic and Rare Diseases Information Center (GARD). In people with POTS, too little blood returns to their heart when they move from lying down to standing up, GARD says. In addition, their heart rate increases by more than 30 beats per minute within 10 minutes of standing, according to Dysautonomia International.

These circulatory problems lead to symptoms that can include lightheadedness, dizziness or fainting; heart palpitations; headaches; blurred vision; gastrointestinal symptoms, including nausea, bloating, constipation and diarrhea; shortness of breath; and tiredness.

An estimated 1 million to 3 million Americans have POTS, which most frequently affects women under age 35, according to GARD. But the condition can be difficult to diagnose; one study found that POTS patients see about seven doctors over four years, on average, before receiving a POTS diagnoses, CNN reported.

Many POTS patients are initially misdiagnosed with a mental health condition prior to their POTS diagnosis. One study in the United Kingdomfound that nearly 50 percent of POTS patients had previously been told they had a psychiatric disorder that was responsible for their symptoms. This may be partly because many people with POTS are young and healthy before their symptoms appear and because 80 percent of people with POTS are women, who are generally more likely to develop depression, according to CNN.

Indeed, Foles, who was diagnosed in 2013 at age 23, wrote on her blogthat she was frustrated when several doctors initially suspected her symptoms were due to anxiety or depression.

"I will never forget when [one doctor] looked at me in his office and said, 'You are young and healthy. You are in perfect condition. Have you looked into depression or anxiety?' I was so confused and so frustrated," Foles wrote. "There is nothing worse then [sic] someone telling you that you are perfectly healthy when you feel like your body is breaking down. Doctors need to be more educated on this illness and they need to look for it when a patient comes in complaining of these symptoms."

The cause of POTS is not known, but a person's symptoms may be triggered by certain events, such as a pregnancy, major surgery, trauma or viral illness, according to GARD.

There's no single treatment for POTS, but some people see improvement in their symptoms with lifestyle changes aimed at increasing blood pressure and blood volume. These lifestyle changes include adding extra salt to the diet, drinking more fluids and avoiding things that may make symptoms worse (such as alcohol and caffeine), GARD said. Certain medications may be prescribed, such as fludrocortisone (a steroid) or midodrine (a medication aimed at treating low blood pressure).

June 27th 2018

Third of workers fear being stigmatised in the workplace for health problems

A third of workers have lied about their reason for calling in sick, over fears of stigma in the workplace, a study has found.

Instead of telling the truth about health problems which mean they need the time off, employees would rather pretend they have a different complaint to their boss or work colleagues.

And long-term health conditions are deemed the ‘least valid’ reasons for not attending work, despite their often-devastating symptoms.

Only fifteen per cent of people said that Crohn’s Disease and Ulcerative Colitis – the two most common forms of Inflammatory Bowel Disease – were acceptable reasons to call in sick.

Other often invisible long-term conditions, such as depression, anxiety and fatigue scored even lower.

But vomiting, flu and food poisoning were considered the most ‘legitimate’ reasons for taking a sick day.

The stats emerged in an independent OnePoll study of 1,000 employed adults, commissioned by national charity Crohn’s & Colitis UK.

It also found more than half of respondents who suffer a long-term health condition feel they have to downplay their condition at work.

Juliet Chambers, Communications Manager at Crohn's & Colitis UK says: “Living with any long-term condition is hard.

“Crohn’s and Colitis are a growing but hidden health crisis in UK workplaces – and people need better support and understanding to manage these conditions.

“Right now, too many people feel forced to downplay the severity of their illness at work because of stigma.

“What’s worse, the stress and anxiety experienced by employees calling in sick will only increase the already devastating symptoms of their disease.

“We need to break down this taboo in the workplace and help employers and colleagues understand the true impact of these hidden diseases.”

The research found 51 per cent of respondents feel their workplace does not provide a supportive environment for those dealing with long-term conditions.

Just under one in five workers feel ‘frustrated’ towards colleagues who are frequently off sick, and six per cent feel ‘angry’ towards these colleagues.

Sarah Brown, 34, works in a media agency in London and has Ulcerative Colitis.

She says: “Before I call in sick to work I get extremely anxious that my colleagues will judge me for taking more time off work.

“For this reason, I often downplay my Colitis as a stomach bug as I don’t want others to think my long-term condition will have an impact on how well I can do my job.”

Yvonne Tyree, 54, found the worry so bad that she is now self-employed: “Whilst in employment I often asked my GP to put something other than Crohn’s Disease on my sick note for fear of judgement that I was unable to do my job.”

Crohn’s & Colitis UK is the national charity leading the battle against Crohn’s Disease and Ulcerative Colitis and fighting to achieve a better quality of life for the 300,000 people in the UK with these and other forms of Inflammatory Bowel Disease.

Their annual WALK IT events raise funds and vital awareness of Crohn’s and Colitis.

For more information and support please visit Crohn’s & Colitis UK - crohnsandcolitis.org.uk or phone their information line 0300 222 5700.

June 26th 2018

One in three women is experiencing severe reproductive health issues, including infertility or menopause

One in three women is experiencing severe reproductive health issues, including infertility, period pains or the menopause.

A government survey of 7,300 women has lifted the lid on the prevalence and impact of these problems for the first time. 

Many of those affected said they were reluctant to speak to their doctor or boss about their complaint for fear of being judged.

The survey of women over 16 found that 81 per cent had experienced a reproductive health issue in the past 12 months.

These ranged from struggling to conceive, heavy or irregular periods, debilitating menopausal symptoms or lack of sexual enjoyment.

A total of 31 per cent of these women said their problems were severe and often had a debilitating impact on day-to-day life

One woman spoke of how the menopause had left her feeling ‘worthless’ while another described it as a ‘frightful experience’.

Yet just 46 per cent of all women who had experienced any kind of reproductive health issue in the past year had sought medical advice. 

Public Health England (PHE) – which carried out the survey – said there was still a ‘stigma’ and ‘embarrassment’ surrounding these problems. 

Dr Sue Mann, a consultant in reproductive health from PHE said: ‘Women’s reproductive health concerns can fundamentally influence physical and mental well-being throughout their whole life course.

‘Our research has highlighted that while individual reproductive health issues and concerns change throughout a woman’s life, the feelings of stigmatisation and embarrassment were almost universal.’

The survey involved 7,367 women and is the first of its kind to cover all types of reproductive issues. 

It found that 42 per cent reported a lack of sexual enjoyment over the past 12 months.

Another 48 per cent said they had struggled with ‘menstrual issues’, including heavy or irregular periods. 

A further 25 per cent had experienced menopausal symptoms and 18 per cent had incontinence, most commonly following childbirth.

PHE, alongside the Department of Health and NHS England, have promised to prioritise reproductive health issues and ensure women seek help.

One woman went to her GP with severe menopausal symptoms including anxiety and depression only to be told it was normal.

Another younger patient who was struggling to conceive was advised by her GP that she should have started trying aged 22.

Dr Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare, said: ‘It is alarming and deeply concerning that almost a third of all women surveyed experiences serious reproductive health issues with many reluctant to seek help. 

'Contraception, abortion, menstrual health, menopause and other issues have for too long being de-prioritised in the health system.’

Professor Helen Stokes-Lampard, chairman of the Royal College of GPs, said: ‘Even though in the modern day we don’t expect there to be social stigmas around women’s health matters, unfortunately stigma does still exist and it is concerning that many women do not seek help for conditions which can often be very serious.’

June 24th 2018

Easy sleep hacks for your best night's shut eye

Do you lie in bed unable to sleep? Are you exhausted and unable to concentrate all day? Everyone knows such nights. But what can you do if it happens often? How much sleep do we need?

Most people do best on seven hours a night. But the quality of sleep is more important than the quantity.

When it gets dark, our body releases the sleep hormone melatonin to initiate sleep. Supported by the growth hormone BDNF (brain-derived neurotrophic factor) and other hormones, our brain recovers mainly during the first four hours of the night. It stores memories and the body rids itself of accumulated toxins. Melatonin frees the cells from aggressive oxygen radicals. Preventing our bodies from going into this deep-sleep phase can cause serious damage.

In the second part of the sleep — the dream phase — our brain processes the day. Interconnections form between nerve cells and the brain regenerates.

So what can you do to get a good night’s sleep? It is important to develop a regular sleep pattern. Go to bed and get up at the same time. If you can’t get enough sleep during the week, recover at the weekend. Take a 20-minute power nap during the day if you work at night. 

An optimal room temperature is 17– 22°C. Drink alcohol moderately as it inhibits the release of the BDNF hormone. You won’t recover.

Do not eat too much protein before going to bed or drink coffee too late, and do not work late on your computer or watch TV for too long — light inhibits the release of melatonin. Most importantly: go to bed with happy thoughts.

June 20th 2018

This Is the Single Best Cure for Insomnia

FALL ASLEEP FASTER AND STAY ASLEEP LONGER WITH THIS SIMPLE TIP.

We’ve all been there: after a long day of work, we get in bed exhausted. However, despite our desire to fall asleep, we simply can’t. Insomnia has its claws in us. We stare at the ceiling. Suddenly, it’s time to get up for the day. Between demands at work and home, it’s hard to get enough sleep. Even worse, the stress that comes along with thinking about all the things we have to do in a day can make things even worse. According to the CDC, 35 percent of adults in the United States are skimping on sleep tonight.

Worse yet, Gallup research reveals that our time spent sleeping has been steadily declining for 70 years. While just three percent of adults reported sleeping less than five hours a night in 1942, that number had shot up to 14 percent by 2013. So, what’s an exhausted individual to do?

If you want to beat those insomniac tendencies and enjoy the best sleep of your life—and assuming you’re doing all of the most common tactics that aren’t working—try sitting down to journal for five minutes before bed. Better yet, write down all the things you have to accomplish in the next few days.

While it may sound counterintuitive, research shows that creating a to-do list can make it much easier to get some shut-eye. In fact, according to a study published in the Journal of Experimental Psychology: General, study subjects who wrote out the things they had to do in the following days in specific detail actually fell asleep significantly faster than those who wrote out the things they’d accomplished the day prior. And once you’re well-rested, start incorporating the 29 Best Body Clock Hacks to Maximize Your Day into your routine and every day will be off to a brighter start.

 

June 19th 2018

Joanna Lumley Is Speaking Out to End This Seriously Neglected Disease

It's the leading infectious cause of blindness in the world — but you likely haven't heard of it.

Actress and human rights activist Joanna Lumley is raising her voice to put an end to a hidden and neglected disease that, although many of us have never heard of it, is actually the leading infectious cause of blindness in the world. 

It’s called trachoma, and it puts more than 190 million people at risk of blindness in 41 countries, according to the World Health Organisation . It’s responsible for the blindness or visual impairment of around 1.9 million people worldwide. 

But, vitally, it’s completely preventable and countries around the world are successfully eliminating it. What we need now is for the whole world to put some muscle behind stamping it out for good.

Take action: No Woman Should Suffer From Diseases We Know How to Treat or Prevent

And that’s where Joanna Lumley comes in — using her public profile to raise awareness of this debilitating disease.

When Lumley first saw an advert about trachoma in a newspaper 20 years ago, she wrote in an article for the Telegraph , “it stopped me in my tracks.” 

“I remember being shocked at how cheap it can be to stop trachoma in its early stages and that the condition is completely preventable altogether,” wrote Lumley, an ambassador for Sightsavers , an NGO that works against avoidable blindness. 

“The infection is spread by flies and, I think perhaps most tragically, by human touch, meaning that mothers wiping the faces of their children might accidentally pass the infection to them and vice versa,” she added. 

Read more: These 7 Countries Eliminated a Neglected Tropical Disease in 

— and More Will Follow in 2018These diseases are deadly and debilitating. But they are also entirely preventable.

Right now, 1.5 billion of the world’s poorest and most marginalised people are facing the devastating threat of a group of diseases that you’ve probably never heard of.

They’re known as neglected tropical diseases (NTDs) — and they’re a group of chronic infections found in tropical and sub-tropical areas. 

They can be fatal, or they can cause serious and debilitating illness and, crucially, they’re diseases of poverty. Affected adults can’t go to work, affected children can’t go to school, and these diseases only serve to continue the cycle of poverty. 

Take action: No One Should Suffer From Diseases We Know How to Treat or Prevent

What’s more, because affected people are often unable to participate fully in community life, these diseases are often surrounded by social stigma. 

But, vitally, these diseases are entirely preventable and the drugs required to do this are freely donated by pharmaceutical companies. They are easy to administer and are safe — we already know how to stop them.

In 2017, seven countries around the world successfully eliminated an NTD — an incredible step on the path to worldwide elimination. 

Each of the seven countries eliminated either trachoma or lymphatic filariasis — otherwise known as elephantiasis.

Read more: The Most Dangerous Diseases You've Never Heard Of

Lymphatic filariasis (LF) is a parasitic infection transmitted to people by infected mosquitoes. It targets the body’s lymphatic system, and can cause severe disfigurement, pain, and disability. Sufferers often lose their livelihoods, and experience knock-on psychological effects such as depression or anxiety. 

As of October, according to the World Health Organization (WHO), LF threatens 856 million people in 52 countries worldwide.

Trachoma, meanwhile, is an eye disease caused by bacterial infection. And it’s the leading infectious cause of blindness worldwide. 

Infection can be spread through contact with discharge from the eyes and nose of an infected person — particularly young children — or through flies which have been in contact with the eyes or nose of an infected person. 

Read more: This 2-Month-Old Girl Is Living Proof That We're Winning the Fight Against Polio

Repeated infection can cause the inside of the eyelid to become so scarred it turns inwards, forcing the eyelashes to rub against the eyeball, scarring the eyeball and potentially causing blindness. 

As of July 2017, according to WHO , trachoma was a public health problem in 41 countries, and is responsible for the blindness or visual impairment of about 1.9 million people.

But these seven countries have successfully proven that these horrific diseases can be beaten, with the right political and financial will. 

1. Cambodia

In September, Cambodia successfully eliminated trachoma — which has been a recognised problem in the country since the 1990s. 

In 2000, a series of trachoma rapid assessments were carried out in Cambodia, followed by a rollout of control activities across the country — including provision of surgery, treatment of communities, and health education. Improvements in living standards, water supply, sanitation, and hygiene also contributed to the landmark achievement. 

Read more: Global Citizen Live Is Coming to London — and You Can Be There. Here's How

2. Laos

In September, Laos also successfully eliminated trachoma — which has haunted the country since the 1970s, and was particularly common among young children. 

“By eliminating this disease, our children can now grow up safe from this painful and potentially blinding infection,” said Dr Bounkong Syhavong, Lao People’s Democratic Republic’s Minister of Health.

As with Cambodia, the measures included screening and treatment services across the country, as well as improvements in living standards and hygiene. 

3. Thailand

In September, Thailand officially eliminated lymphatic filariasis — which had once been so serious in the country it was endemic in 11 provinces. 

The final push against the disease came in 2001, with the launch of the National Programme for Elimination of Lymphatic Filariasis. The programme championed surveying cases, and providing timely preventative chemotherapy to at-risk populations. 

Citizens in affected provinces were also vital in the effort, taking annual doses of medication even if they showed no symptoms of disease.

Read more: Why Global Citizen Live in London Is a Big Deal for Gender Equality, Health, Nutrition, Education, and More

4. Tonga

In July, Tonga also bid farewell to lymphatic filariasis after decades of dedicated efforts to stop transmission of the disease. 

LF has a long history in Tonga — even Captain Cook noticed common swelling among people in Tonga in the 1770s — and in the 1950s the prevalence rate was close to 50%. 

Mass drug administration helped bring that down significantly — but only a series of further efforts, including strong financial support, and the commitment of affected communities, in recent years helped achieve the elimination target. 

5. Mexico

In April, Mexico became the first country in the Americas to officially eliminate trachoma, and the third in the world — after Oman and Morocco — in what WHO described as an “historic moment.” 

In Mexico, the disease was endemic in 246 communities in five municipalities in the state of Chiapas, affecting over 140,000 people. But a series of interventions launched in 2004 helped put an end to it — including surgery for advanced cases, antibiotics, facial cleanliness, and environmental improvement to reduce transmission. 

Read more: WTF Is Polio? 17 Facts About the Disease That We're This Close to Eradicating

6. Togo

The first country in sub-Saharan Africa to eliminate lymphatic filariasis was Togo, in April. 

For the past 15 years, Togo has carried out a sustained campaign in all districts and areas affected. Then, in 2010, it moved in a 5-year surveillance phase until elimination was officially validated by WHO in 2015. 

7. The Marshall Islands

In March, the Marshall Islands was the first country of the year to successfully eliminate an NTD — ridding itself of lymphatic filariasis.

It was described as “an enormously important achievement” for the health of its citizens, by WHO . 

These inspirational steps were sparked by the World Health Assembly (WHA) launching targeted global focus against these diseases. 

In 1997, the WHA called for the elimination of lymphatic filariasis as a public health problem; and in 1998, it passed a resolution targeting trachoma for elimination as a public health problem.

And the very good news is that even more countries are set to follow in 2018. Already this year, both in March, Egypt has eliminated lymphatic filariasis, and Kenya has eliminated Guinea-worm disease — which is caused by a parasitic worm and can lead to severe pain as the worm travels through the person’s body. When it emerges (normally through the feet) it causes blisters, ulcers, and fever, nausea, and vomiting. 

Read more: How We Can Be the Generation to End Extreme Poverty

But, as proved in 2017, when the world comes together to fight these issues in a united, targeted way, we can beat them. 

So watch this space. 

Global Citizen campaigns to achieve the UN’s Global Goals, which include action on global health and well-being. You can join us by taking actionhere to call on world leaders to work together to bring an end to the 10 NTDs. And, by taking action, you can earn free tickets to Global Citizen Live when it comes to London on April 17 , to see Emeli Sandé, Professor Green, Naughty Boy, Gabrielle Aplin, and more, live. 

 

late June 16th 2018

Home Office U-turn as medicinal cannabis oil returned to epileptic boy

The Home Office has released the medicinal cannabis oil it confiscated from Billy Caldwell’s family, who used it to treat his severe epilepsy. 

The government backdown came shortly after the 12-year-old’s mother, Charlotte, said she was confident the Home Office would grant a special licence so her son could be treated with the anti-epileptic cannabis medicine.

Sajid Javid said on Saturday he had used an exceptional power as home secretary to urgently issue a licence for Billy to be treated with cannabis oil.

“This is a very complex situation, but our immediate priority is making sure Billy receives the most effective treatment possible in a safe way,” he said.

“We have been in close contact with Billy’s medical team overnight and my decision is based on the advice of senior clinicians who have made clear this is a medical emergency.

“The policing minister met with the family on Monday and since then has been working to reach an urgent solution.”

The Home Office had been under intense pressure to allow Billy to be prescribed the medicine that had kept his seizures at bay for around 300 days before his doctor was forced to stop the prescriptions.

Billy had two seizures on Friday night after opiate-based medicines failed to control his condition, and was taken to Chelsea and Westminster hospital by ambulance.

Before the confiscated oil was returned,

his mother said: “The Home Office and myself and our team have been working extremely hard together throughout the night to make this happen, which is truly amazing.

“But there can only be one conclusion here: that my little boy, my beautiful sweet little boy, who has a life-threatening form of epilepsy, and one seizure can kill him, he needs his medicine back today.

“There’s a lot of bureaucracy around it and we’re working towards obviously getting his medicine and just it’s one step at a time. But we’re confident that the Home Office is working with us and that we’re going to get this done.”

The decision to allow Billy to be prescribed the treatment, is the first time that cannabis oil containing THC, the psychoactive component, has been prescribed in the UK since it was made illegal in 1971.

We need to change the law. Treating #CannabisMedicine oils for epilepsy like recreational street cannabis is criminalising patients and fuelling a dangerous black market. #MedicalCannabis@VoltefaceHub@BBCNews@SkyNewshttps://t.co/EMRaopHKdD

— George Freeman MP (@GeorgeFreemanMP) June 16, 2018

The six-month cache of anti-epileptic medicine taken from, and now returned to, the family was understood to have been held at the Home Office.

A doctor in Northern Ireland had prescribed cannabis oil for Billy last year, when it became clear it was the only effective treatment. It was the first time a child had been issued the substance on the NHS.

However, the Home Office ordered him to stop prescribing the medicine as it was “unlawful to possess Schedule 1 drugs”.

This prompted the Caldwells to go to Canada to obtain the medicine.

When they returned with six months’ worth of anti-epileptic cannabis oil, it was confiscated and they were told by a minister that it would not be returned.

The Home Office then recommended three neurologists who could help manage Billy’s transition off cannabis oil, but none subsequently saw him. Caldwell said one of the experts told her they did not have the time, another was on holiday, and the third did not return her calls.

June 16th 2018

Epileptic boy 'in life-threatening state' after cannabis oil seized

Billy Caldwell, the 12-year-old boy who had his anti-epileptic medicine confiscated by the Home Office this week, has been admitted to hospital, with his mother saying his condition is life-threatening.

“Billy has had back-to-back seizures today,” his mother, Charlotte Caldwell, said on Friday. “On his medication, which included the vital but banned THC component, he was seizure-free for more than 300 days.”

On Friday afternoon, Billy was taken to Chelsea and Westminster hospital in west London in an ambulance after experiencing seizures.

Caldwell said doctors in Canada and Northern Ireland familiar with the case had described her son’s situation as life-threatening. She said the Home Office would be held accountable if her son died.

Billy had been placed on CBD oil, along with opiate-based medication, after he was forced to stop taking cannabis oil, but he failed to respond positively to the treatment and his health deteriorated as his seizures gradually resumed.

Speaking from hospital on Friday evening, Caldwell told Sky News: “[Billy’s] out of the seizure but I cannot administer any more rescue medicine for him at home. He’s been admitted and they’re keeping him in hospital simply because Billy’s seizures are life-threatening ... one seizure can kill him.

“I’m just absolutely devastated that we’re back now where we were nearly two years ago before medicinal cannabis ... I would appeal to the Home Office if they have any compassion. Please bring the medicine to Billy because this is the only way we’re going to stop his seizures.”

Earlier on Friday, Caldwell criticised the government for effectively forcing them to leave the UK.

“No mother should be made to flee the country to keep their child alive,” said Caldwell. She and Billy have spent about four of the past 12 years abroad because cannabis oil is illegal in the UK.

On Monday they had six months’ worth of anti-epileptic medicine confiscated by customs agents when they arrived at Heathrow from Toronto. Caldwell was invited to meet the Home Office minister Nick Hurd, who told her that it would not be returned, despite her pleas.

“It has to be the most frightening situation that a mother could ever be put in,” Caldwell told the Guardian, describing how she and Billy had been forced to leave their home, friends and family in order to access the potentially life-saving medicine.

“He’s undergone countless administrations of anti-epileptic pharmaceutical drugs which have never worked and have upset his entire system,” Caldwell said. “The side-effects left him so depleted that he couldn’t even lift his head or pick up a toy.”

The anti-epilepsy drugs prescribed by the NHS often cause uncontrollable tremors, hair loss, swollen gums and rashes, among other adverse effects. Feeling that she had no choice but to seek treatment for her child abroad, Caldwell found a doctor in the US in September 2007 who “saved Billy’s life” by weaning him off anti-epileptic pharmaceutical drugs, which she says were aggravating his seizures.

The doctor also placed him on a ketogenic diet – a high-fat, low-carbohydrate food plan – that helped his seizures to rapidly subside.

Eight years later, in June 2016, the seizures returned. They travelled to California again in September that year, until their money ran out eight months later and they came back to their home in Northern Ireland.

In March 2017 they walked 150 miles in eight days, from their home to the hospital, to demonstrate the incredible improvement in Billy’s condition after the cannabis treatment.

A doctor in Northern Ireland prescribed him the oil, since it was clear it was the only effective treatment. This was the first time a child had ever been issued the substance on the NHS.

In October 2016, the Medicines and Healthcare Products Regulatory Agency issued an opinion that products containing cannabidiol (CBD) used for medical purposes are medicine. However, medicines containing THC, the psychoactive constituent of cannabis that gets users high, remain illegal in its raw form.

The government’s current position is that THC has no recognised medicinal or legitimate uses beyond potential research.

Although some children with epilepsy respond positively to CBD, the conditions of others, such as Billy, respond only to THC-derived products. And there is growing evidence of the benefits of prescribing medicinal cannabis.

After about 300 days without a seizure, the Home Office recently ordered the doctor to stop prescribing the oil, prompting Caldwell to seek treatment in Canada, which is preparing to legalise cannabis.

The case has shone a light on a drug policy that critics see as outdated and has provoked widespread demands for urgent reform, as well as calls for an exception to be made for Billy until legislation can be considered.

Caldwell said she doubted whether she or Hurd would be arrested if the minister decided to “do the right thing” and allow Billy to have his anti-epileptic medication. 

“Surely common sense should prevail,” she said, pointing to the public support for the legalisation of medical cannabis, and the fact that police in some parts of the country had deprioritised cannabis offences.

“To me, this is not an illegal or controlled substance, this is my little boy’s medicine. Even if you drank six months’ worth of this medicine, you wouldn’t get high because the THC content is so low.”

There are around 63,400 children with epilepsy in the UK and a third of those do not respond to the medication prescribed by the NHS. Some 1,150 people died of epilepsy-related causes in 2009.

Billy, who also has severe autism, cannot talk and requires 24/7 care, enjoys riding his pony Paddy, often goes swimming and attends a special needs school.

Asked how Billy had handled a week of intense media attention, Caldwell said he had been “a wee bit out of sorts” and that “he knows that something is going on”.

On Tuesday morning, however, he had his first seizure in almost a year.

On the same day, a group of pro-reform Tory MPs said that medicinal cannabis could be on sale within a year. But this could be too late for Billy. “The fear that Billy will die without his medication has been my overriding emotion this week,” says Caldwell. “I think that fear is keeping me going.”

June 15th 2018

Spilt milk: are the breastfeeding wars finally over?

‘Absolutely, breastfeeding is best for babies and for mothers,” says Gill Walton, chief executive of the Royal College of Midwives. We were talking yesterday, just after news broke of a major development in the territory of infant feeding. “But anybody supporting women needs to give them support to bottle feed safely, if that’s what they decide to do.”

This support for mothers who bottle feed has been hailed as the end of a battle that has raged for at least a decade, the Treaty of Versailles in a postpartum wrangle in which the breastfeeding side was considered so righteous that it didn’t even have to acknowledge the other one.

Walton’s position sounds so straightforward, so obvious: why would you ever not want to support bottle or mixed feeding women, given that they represent over 60% of the population? Yet the orthodoxy that breast is best had become so established that the answer to those women for whom breast was, in fact, worst, was always: you need more support.

It would take a woman with first-hand experience of painful or ungenerative milk production to really give voice to how undermining and unjust this “support” mantra was, but I’ve heard it done – so have you, probably – and they use some pretty fruity language. It really isn’t the case that all women can breastfeed perfectly well, if only they have enough health visitors. Clare Byam-Cook, a nurse and midwife turned guru, is the Madonna of old-school breastfeeding experts, and she always had this as a backstop: if it’s really not working, stop doing it.

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But since the start of this century, pragmatists have been increasingly drowned out in favour of a 00s absolutism that affected all kinds of areas of parenting (principally, motherhood): a mother who would accept second-best was barely even a mother. Breastfeeding was the frontier issue in a burgeoning culture where intense risk aversion was a sign of perfect parenting. It covered alcohol in pregnancy, soft cheese, stress; at one point, the Royal College of Obstetricians and Gynaecologists put out advice to pregnant women not to sit on new furniture. Breastfeeding was its purest iteration, partly because everyone could see it and judge it; partly because it was a chance to legitimately instruct women to subsume themselves utterly to their child’s welfare; and partly because the science was apparently so settled. Breastfed babies were less likely to get gastroenteritis, less likely to get ear infections and eczema, less likely to become obese, both mothers and babies were less likely to get cancer, and they would have a higher IQ (typically, the uptick was six points, with some wild studies claiming far more). Advice from the Department of Health, spinning out from that of the World Health Organization (WHO), was to breastfeed exclusively for the first six months, or, to put that in baby language for the new mum: “Don’t rush to mush”.

The problem, in the first instance, was that, for all the certainty with which it was discussed, the science was never actually that settled. A lot of the WHO evidence was taken from studies of women where a clean water supply wasn’t assured, or they couldn’t necessarily afford adequate formula. Bottle feeding was always, therefore, going to be difficult, if not impossible. Comically, one of the reasons that was given in favour of breastfeeding was that it prevented the return of menstruation, and therefore acted as a contraceptive This is comical, a) because it’s not very reliable and you actually can get pregnant while you’re breastfeeding, and b) because a woman in Keswick does not need to breastfeed in order to prevent a pregnancy. It’s like telling a population in South Korea to clean a wound with ash to ward off infection: ash might be better than no ash, but not if you’ve got Germolene.

The gastric effect was pretty well established (although the much-quoted interventionist study in Dundee was extremely small), and its mechanism known and understood – it hinges on a specific agent found only in human milk, secretory immunoglobulin, or SIgA. Critically, though, as the American academic Joan B Wolf, author of Is Breast Best?, summarised: “The majority of studies have demonstrated that there’s a relationship between breastfeeding and better health. But whether this relationship is causal has never been established.” No study has ever been able to disaggregate the act of breastfeeding from the decision to breastfeed – which is to say, the milk itself from thekind of mother who chooses to feed her child breastmilk. So it would be unwise to discount the possibility that what we were seeing was not the magic properties of “liquid gold” (as my midwife used to call it) but the health benefits of being born into one social environment over another.

The fury, if you ever pointed this out, was truly bizarre, and it is for this reason, I think, that the RCM and many other bodies have until now steered carefully along a course almost entirely dominated by the breastfeeding enthusiasts (or lactivists, if you prefer). Writing anything about evidence bases, much like writing anything about economics, always invites a fair amount of sneering (“Why, oh why, does this journalist think she could ever understand this material which only I understand”) but this is, funnily enough, the only time I have ever been physically threatened: I covered some of that evidential insufficiency – which is explicitly accepted by the American Academy of Paediatrics – and shortly afterwards chaired an event for the RCM. The then chief executive, who was actually brilliant, although we disagreed about breastfeeding, warned me that some people were intending to protest, and maybe throw things. What kind of things? Oh, nothing serious. Maybe an egg. On the one hand, I was actually breastfeeding at the time, so was always covered in stuff. But on the other, I had just had a baby. I really didn’t want anyone throwing eggs at me.

Spleen tends to attach to cases that are not as strong as they claim. The underlying issue was class-based: breastfeeding, the middle-class choice, gave middle-class parenting a superior status that would otherwise have been difficult to assert. In fact, during this period, the non-middle-class parent was under constant and strange attack: when the coalition government came in, the First Three Years became a key policy area, with improbable and unpleasant assertions about what non-U parents were like. They fed their babies formula, then they left them all day strapped into a buggy, pointed at awall; they didn’t give them the right vocabulary because they weren’t interested in talking to them. Bottles became a key signifier of parental neglect, and I always wondered why the women who couldn’t breastfeed didn’t kick up more of a fuss about this, since the alternative was to bottle feed your baby with a sense of shame. But parenting is a great leveller, and some people don’t want to be level.

The Centre for Parenting Culture Studies, at Kent University, did fascinating work on this and many of those other trigger issues, culminating in Charlotte Faircloth’s PhD thesis, Full-term breastfeeding: Nature, morality and feminism in London and Paris: “Everything had become very heated, moralised. How you feed your kids is no longer a personal decision. There’s this idea that you can breastfeed your way out of poverty. It all got a bit out of hand.”

There were dissenting voices, interestingly from French rather than Anglo-Saxon feminism: Élisabeth Badinter caused an incredibly strange controversy in the early 2010s, when she said: “If, 24 hours a day, the women is reduced to her role as a nursing animal, the father is completely put aside.” This was a red rag to the feminism that says women should be making their own decisions when they become mothers, and shouldn’t be worrying about what their partners think: but in fact, a women’s rights framing – in which the woman is “liberated” from her sexual identity, in order to be ruthlessly policed in her maternal one – isn’t very feminist either. At its simplest, Badinter’s message was: “There are women for whom breastfeeding is a true pleasure. It’s very good for them and very good for the baby. But to breastfeed a baby if the mother herself doesn’t like it? It’s a catastrophe. The decision to breastfeed is an intimate and private decision. No one should be able to interfere.”

And that is where the RCM has also landed. “It’s part of a wider campaign we’ve got about trusting women,” Walton explains. “There has been an increase in mental health problems following childbirth, and while we can’t ascribe that to the previous breastfeeding advice, we do know that there are lots of women feeling guilty, made to feel guilty by their friends and their families. We’re saying, once they’ve made their choice, trust them. Actually, what you need to get right is to feed your baby and love it.”

This has been a culture war, and quite an exhausting one, where nothing meant exactly what it said: the pro-breastfeeding line originated with second-wave feminism, asserting a woman’s choice to feed with her baby as she saw fit, without medical or corporate interference. That liberation became an oppression; if it’s the only thing you’re allowed to choose, that’s not a choice. It fed into a set of ideas that located the source of childhood disadvantage not in hardship but in their parents’ sub-optimal behaviour, so that poverty would indicate, literally, that if you weren’t a bad person then probably your mother was. And this political notion was mediated not just through women’s bodies but through our actual t*ts. It was faintly chilling for all women, mothers or not. It would be wonderful if the RCM’s humane, good sense intervention marked the end of it.

June 14th 2018

Too much or too little sleep can damage your health, study finds

When a person is suffering from sleep deprivation, indulging in a lengthy lie in at the weekend may seem like a logical course of action to catch up on some zzzs.

However, doing so could prove extremely detrimental for your health.

A recent study published in the journal BMC Public Health has found that having both too much or too little sleep could lead to a variety of health conditions, such as high blood pressure or elevated cholesterol levels.

The team who conducted the research, from the Seoul National University College of Medicine, analysed the data of 133,608 Korean men and women aged between 40 and 69 years old.

The information was originally gathered as part of a HEXA (The Health Examinees) study, which collected the data over the course of nine years from 2004.

The 44,930 men and 88,678 women were placed into four sleep categories: less than six hours sleep, between six and eight hours sleep, between eight and ten hours sleep and more than ten hours sleep.

The results of the study stated that the men who slept for less than six hours a night were more likely to develop metabolic syndrome than those who managed to hit the hay for eight hours.

Metabolic syndrome refers to a number of conditions, including increased blood sugar levels, high cholesterol levels, high blood pressure and additional fat around the waist area.

Furthermore, both the men and women who regularly had less than six hours sleep also had a greater chance of having a larger waist circumference.

While some may assume that the participants who slept for more than 10 hours sleep a night were better off, the research proved the contrary.

Both men and women in that particular category also had a greater likelihood of developing metabolic syndrome, while the women were more likely to have excess fat around the waist.

“This is the largest study examining a dose-response association between sleep duration and metabolic syndrome and its components separately for men and women,” said Claire E. Kim, lead author of the study.

“We observed a potential gender difference between sleep duration and metabolic syndrome, with an association between metabolic syndrome and long sleep in women and metabolic syndrome and short sleep in men.”

The authors of the study have noted that their research is solely observational and therefore cannot draw definite conclusions about cause and effect.

June 11th 2018

Your tea towels can cause food poisoning, study suggests

Repeated use of tea towels in the kitchen could be putting families at risk of food poisoning, according to new research.

Bacterial build-up was measured on 100 towels over the course of a month during an experiment by scientists at the University of Mauritius.

Researchers found bacteria growth on 49 towels, with more than a third testing positive for coliforms, the group of species of which E. coli is a member.

The study found E. coli was more likely to develop on towels that had been left to sit damp, while coliforms and S. aureus bacteria were detected at significantly higher rates in households with non-vegetarian diets.

It also found tea towels in the homes of larger families and those of a lower socio-economic background had higher rates of bacteria growth.

“Our study demonstrates that the family composition and hygienic practices in the kitchen affected the microbial load of kitchen towels,” said Dr Susheela Biranjia-Hurdoyal, of the University of Mauritius. "We also found that diet, type of use and moist kitchen towels could be very important in promoting the growth of potential pathogens responsible for food poisoning.”

Researchers said the presence of E. coli on several towels in the study is likely to have come from faecal contamination, suggesting unhygienic practices in the kitchen are widespread.

In total, 37 per cent of towels used in the experiment grew coliforms, 37 per cent tested positive for Enterococcus bacteria and 14 per cent developed Staphylococcus aureus.

Scientists concluded using disposable, single-use paper towels for kitchen tasks was a more hygienic option.

“The data indicated that unhygienic practices while handling non-vegetarian food could be common in the kitchen,” Dr Biranjia-Hurdoyal added.

“Humid towels and multipurpose usage of kitchen towels should be discouraged. Bigger families with children and elderly members should be especially vigilant to hygiene in the kitchen.”

Coliform bacteria can cause a wide range of conditions in humans, from stomach cramps, fever and vomiting to more serious conditions such as pneumonia and respiratory illnesses.

Staphylococcus aureus can lead to life-threatening conditions such as meningitis, bacteremia and toxic shock syndrome.

June 6th 2018

Green tea may help reduce the risk of heart attacks

A substance found in green tea could help scientists find new ways to reduce the risk of heart attacks, research suggests, although experts say that doesn’t mean you should rush to put the kettle on.

The study found that a molecule in green tea, known as EGCG, can bind to a protein that is found in plaques linked to coronary artery disease and, under certain circumstances, make it more soluble.

While experts say the latest discovery could open up new possibilities for developing molecules to tackle deposits within blood vessels which contribute to coronary artery disease, they say it is far from clear that drinking green tea will help with the condition.

“If you drink normal quantities of green tea it will probably be unlikely to have an effect,” said Prof David Middleton, a co-author of the study from the University of Lancaster. “What we are saying is that we need to look at this molecule more carefully and figure out ways we can either adapt it to make it more [available to the body when taken] or ways of delivering it to the plaques.”

EGCG has previously been shown to affect the architecture of proteins that make up the plaques linked to Alzheimers disease.

Writing in the Journal of Biological Chemistry, researchers at the University of Leeds and Lancaster University describe how they sought to explore the effect of green tea on apoA-I: a protein that is a key component of so-called “good cholesterol” HDL, but which also has a dark side.

“A certain amount of the protein exists by itself and this seems to be the case particularly as we get older,” said Middleton, adding that in certain circumstances the protein can misfold and form fine fibres which build up in plaques within arteries. Middleton adds that it is thought the addition of the fibres makes the plaques more likely to break up into chunks, thereby increasing the risk of heart attacks and stroke

The team began by brewing up green tea using a microwave – a point that might raise the eyebrows of tea connoisseurs – and after careful analysis found EGCG from the tea bound to fine fibres of the protein.

Moreover, the EGCG appeared to break down the fine fibres of the protein into smaller, circular forms which were soluble, provided the fibres originally formed in the presence of a substance similar to that found between cells in the body.

The study was met with caution by experts who noted that having a balanced diet, not smoking and other aspects of lifestyle are key ways that individuals can lower their risk of coronary artery disease.

“[This latest] research is very early on,” said Prof Naveed Sattar of the University of Glasgow. “We’ve been here before with novel agents in foods and drinks which may lessen some health risks but, to date, few things have led to any real advances. So, my advice would be not to rush to [drink] green tea for now.”

Dr James Brown, a senior lecturer in biology and biomedical science at Aston University was also cautious, pointing out that “it is not the same as drinking green tea and seeing that have an effect in the body.”

He added that the body breaks down the components of green tea, and it is not clear how much EGCG would end up in the blood. “They haven’t taken a mouse or a human that has evidence of these [plaques], given them green tea or EGCG and then seen a reduction in those.”

 

May 30th 2018

Scientists create the first 3D-printed human corneas

Newcastle University researchers have devised a groundbreaking experimental technique that could help millions on the corneal transplant waiting list. By using a simple 3D bio-printer, Professor of Tissue Engineering Che Connon and his team of scientists were able to combine healthy corneal stem cells with collagen and alginate (a type of sugar sometimes used in tissue regeneration) to create 'bio-ink' -- a printable solution that enabled them to reproduce the shape of a human cornea in just 10 minutes.

The cornea has a significant role in helping us focus and barricading our eyes against dirt and bacteria. However, since it's located on the outermost layer of the eye, it's also pretty vulnerable to injury. Worldwide, approximately 10 million people risk corneal blindness due to infectious disorders like trachoma, but there's a dearth of readily available transplants. Because Connon's 3D-printed corneas utilize stem cells, corneal replicas could potentially provide a limitless supply of much-needed transplants.

"Our unique gel - a combination of alginate and collagen - keeps the stem cells alive whilst producing a material which is stiff enough to hold its shape but soft enough to be squeezed out the nozzle of a 3D printer," Connon said.

Before printing the corneal replicas, researchers scanned patients' eyes to ascertain the necessary dimensions and coordinates. While it's likely patients will have to wait "several years" before these 3D-printed corneas are available in an official capacity, they still represent incredible hope for those with more severe corneal-related impairments. 

May 28th 2018

Plaque

Nano fighters

Careening through the bloodstream, a single nanoparticle is dwarfed by red blood cells whizzing by that are 100 times larger. But when specially designed nanoparticles bump into an atherosclerotic plaque — a fatty clog narrowing a blood vessel — the tiny particles can play an outsized role. They can cling to the plaque and begin to break it down, clearing the path for those big blood cells to flow more easily and calming the angry inflammation in the vicinity.

By finding and busting apart plaques in the arteries, nanoparticles may offer a new, non-surgical way to reduce a patient’s risk for heart attack and stroke.

Nanoparticles measure less than 100 nanometers across — a thousandth the thickness of a dollar bill. Despite being tiny, they can be engineered to haul a mix of molecules — such as tags that make them stick to a plaque, drugs that block inflammation or dyes that let scientists track their movements. Over the last two decades, scientists have exploited these strategies to fight cancer, designing nanoparticles that deliver drugs (SN Online: 1/3/14) or dyes for imaging deep into the core of a tumor. The U.S. Food and Drug Administration has approved a few dozen cancer-focused nanomedicines.

May 21st 2018

People with large waistlines have lower levels of vitamin D, study finds

Obese people who carry excess fat around their midriffs have lower vitamin D levels, new research suggests.

Liver fat is also associated with reduced levels of the sunshine supplement in overweight men, but not women, the study found.

It is unclear if a lack of vitamin D contributes to abdominal-fat storage or if obesity reduces the vitamin's levels.

Previous research suggests the supplement lowers people's risk of developing conditions such as arthritis, asthma and type 1 diabetes due to its anti-inflammatory and immune-strengthening effects.

Around 26 per cent of adults in the UK are obese, which puts them at risk of heart disease, stroke and premature death.

'Individuals with larger waistlines are at risk of deficiency'

Lead author Dr Rachida Rafiq, from the VU University, Amsterdam, said: 'The strong relationship between increasing amounts of abdominal fat and lower levels of vitamin D suggests that individuals with larger waistlines are at a greater risk of developing deficiency, and should consider having their vitamin D levels checked. 

'Due to the observational nature of this study, we cannot draw a conclusion on the direction or cause of the association between obesity and vitamin D levels. 

'However, this strong association may point to a possible role for vitamin D in abdominal fat storage and function.' 

The researchers plan to investigate the role of vitamin D in obesity. 

How the research was carried out 

The researchers analysed abdominal and overall body fat in people aged 45-to-65 who took part in a previous obesity study.

The participants' vitamin D levels were also assessed. 

Findings from the study were presented at the European Society of Endocrinology annual conference in Barcelona.

Vitamin D is an 'inexpensive solution' to heart drugs 

This comes after research released last January suggested vitamin D is an 'inexpensive solution' to drugs.

Scientists discovered the sunshine supplement repairs and prevents damage to the heart caused by diabetes and high blood pressure.

Vitamin D stimulates the production of nitric acid, which is involved in regulating blood flow and preventing the formation of blood clots, according to the first study of its kind.

It also reduces 'internal stress' in the cardiovascular system, which could avoid heart-related incidents, the research adds.

Study author Dr Tadeusz Malinski, from Ohio University, said: 'There are not many, if any, known systems which can be used to restore cardiovascular cells which are already damaged, and vitamin D can do it.

'This is a very inexpensive solution to repair the cardiovascular system. We don't have to develop a new drug. We already have it.' 

May 16th 2018

UK scientists believe they may have found a way to combat the common cold.

Rather than attacking the virus itself, which comes in hundreds of versions, the treatment targets the human host.

It blocks a key protein in the body’s cells that cold viruses normally hijack to self-replicate and spread.

This should stop any cold virus in its tracks if given early enough, lab studies suggest. Safety trials in people could start within two years.

The Imperial College London researchers are working on making a form of the drug that can be inhaled, to reduce the chance of side-effects.

In the lab, it worked within minutes of being applied to human lung cells, targeting a human protein called NMT, Nature Chemistry journal reports.

All strains of cold virus need this human protein to make new copies of themselves.

Researcher Prof Ed Tate said: “The idea is that we could give it to someone when they first become infected and it would stop the virus being able to replicate and spread.

“Even if the cold has taken hold, it still might help lessen the symptoms.

“This could be really helpful for people with health conditions like asthma, who can get quite ill when they catch a cold.”

He said targeting the host rather than the infection was “a bit radical” but made sense because the viral target was such a tricky one.

Cold viruses are not only plentiful and diverse, they also evolve rapidly, meaning they can quickly develop resistance to drugs.

The test drug completely blocked several strains of cold virus without appearing to harm the human cells in the lab. Further studies are needed to make sure it is not toxic in the body though.

Dr Peter Barlow of the British Society for Immunology said: “While this study was conducted entirely in vitro – using cells to model Rhinovirus infection in the laboratory – it shows great promise in terms of eventually developing a drug treatment to combat the effects of this virus in patients.”

Fighting a cold

Colds spread very easily from person to person. And the viruses that cause the infections can live on hands and surfaces for 24 hours.

Painkillers and cold remedies might help ease the symptoms. But currently there is nothing that will halt the infection.

You can catch a cold by:

  • inhaling tiny droplets of fluid that contain the cold virus – these are launched into the air when an infected person coughs or sneezes
  • touching an object or surface contaminated by infected droplets and then touching your mouth, nose or eyes
  • touching the skin of someone who has the infected droplets on their skin and then touching your mouth, nose or eyes

Symptoms – a runny or blocked nose, sneezing and sore throat – usually come on quickly and peak after a couple of days. Most people will feel better after a week or so. But a mild cough can persist for a few weeks.

 

May 15th 2018

Ginger reduces serious vomiting in gastroenteritis and 'could save lives', finds clinical trial

Ginger could help save lives after scientists found it works as a powerful treatment against vomiting bugs that are a cause of dehydration and death in the developing world.

The findings of a clinical trial into the root and store cupboard stalwart’s antiemetic effects in children with serious gastroenteritis found ginger could lower both the severity and frequency of vomiting.

The researchers found that children between one and 10 years old with serious gastroenteritis cut their number of vomiting episodes by 20 per cent, when compared with a placebo supplement.

Among those in school, they found the number of children having sick days off was 28 per cent lower in the group receiving ginger.

Dr Roberto Berni Canani, associate professor of paediatrics from the University of Napoli, Italy who led the research said the findings could “potentially save lives” across

the globe, as well as lower the pressure on health systems.

Gastroenteritis is an inflammation of the stomach and intestines caused by highly infectious bacteria, including salmonella and rotavirus in food and water; viruses, such as the norovirus vomiting bug; or parasite species.

Vomiting and diarrhoea make it impossible for patients to absorb or keep down food, drink or oral medication to treat their infection.

This can be serious in already vulnerable patients, such as young children or frail older people.

Globally, acute gastroenteritis kills 1.34 million children each year, which equates to approximately 15 per cent of all childhood deaths.

“Acute gastroenteritis is still one of the biggest causes of death in children living in developing countries,” Dr Berni Canani told The Independent, and dehydration is its “most frequent and dangerous complication”.

While dehydration can be managed with rehydration drinks, vomiting limits the use of this strategy. “Ginger could be very helpful in this,” Dr Berni Canani added.

“We anticipate that the results will have a great impact on future clinical practice and the advice given to parents in the treatment of acute gastroenteritis and could potentially save lives across Europe and the globe.”

In Europe, mortality rates are low, but it causes 87,000 hospital admissions a year and 700,000 outpatient visits – norovirus in the UK also adds to the NHS bed shortages because affected wards have to be closed for cleaning.

Ginger is known to have anti-inflammatory properties and it may be this that is producing the antiemetic effect.

Dr Berni Canani said his team’s next steps would be to look at whether ginger can be effective in children without acute gastroenteritis, where home remedies treatment could also lower the need for a GP visit.

The findings are being presented at the annual meeting of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and have yet to be published in a peer-reviewed journal.

The clinical trial included 140 children from Naples and was run “double blind”, with neither patients nor doctors aware of whether the children were receiving ginger or a placebo.

They were given the ginger extract in drops, though there was no taste difference, but Dr Berni Canani told The Independent: “Fresh root or dried ginger could contain the same active ingredients [and] can be used to flavour foods and drinks.”

Previous studies in pregnant women with morning sickness or patients undergoing chemotherapy have also found evidence of ginger’s ability to reduce vomiting.

 

May 14th 2018

Pediatricians are concerned about climate change, and here's why

Doctors have long raised alarm about the potential health risks of climate change, but it turns out that children are particularly vulnerable.

Children are estimated to bear 88% of the burden of disease related to climate change, according to a paper published Tuesday in the journal Pediatrics.

The new paper highlights some studies on the implications of climate change for children's health and then calls for the world to better prepare for these health risks, not just in the future but in the present.

"We already have seen the impacts," said Dr. Kevin Chan, chairman of pediatrics at Memorial University and head of child health at Eastern Health in Canada, who co-authored the paper.

Chan pointed to Hurricanes KatrinaHarvey and Irma as examples of climate change-related weather events that have affected children's health, along with extreme heat waves and emerging infectious pathogens such as the Zika virus.

'We grossly underestimated' Zika, expert says 01:10

During pregnancy, Zika infection can cause a serious birth defect called microcephaly, a condition in which a baby's head is smaller than expected and the brain has not developed properly. There is no treatment for microcephaly that can return a child's head to a healthy size or shape.

Alerts of an outbreak of Zika, spread mostly by mosquitoes, emerged in 2015 and continued through 2016. Some studies suggest that increased climate instability has contributed to the emergence and spread of mosquito-borne infections like Zika.

"Absolutely, that was one that disproportionately affected children," Chan said of Zika.

"The basic message is that climate change is occurring, and I think it disproportionately affects the most vulnerable populations, and that includes children," he said.

 

Tick- and mosquito-borne diseases more than triple, since 2004, in the US

In the new paper, Chan and co-author Dr. Rebecca Pass Philipsborn, a member of the pediatrics faculty at the Emory University School of Medicine, cited a separate study that found that deaths due to diarrhea, malaria and nutritional deficiencies among children younger than 5 accounted for 38%, 65% and 48% of all global deaths, respectively, in 2015.

That study was published in The Lancet in 2016. The new study reports that those causes of death can be climate-sensitive.

For instance, certain changes in climate can make it more suitable for the transmission of malaria, a mosquito-borne disease caused by a parasite transmitted through the bite of infected mosquitoes.

 

Is there a link between climate change and diabetes?

Similarly, climbing temperatures have been tied to an increased incidence of waterborne bacterial infections that cause diarrhea. When compared with a future without climate change, an estimated 48,000 additional deaths due to diarrheal illness are projected among children younger than 15 by 2030, according to the World Health Organization.

As for nutritional deficiencies, about 95,000 additional deaths due to childhood undernutrition are projected for 2030, according to the WHO. Extremely high seasonal temperatures and extreme weather events could damage crops, impacting the food supply and thus childhood nutrition.

In their paper, Chan and Philipsborn also referenced studies on children's vulnerability to extreme heat, droughts and air pollution.

A separate report, published last year by the Medical Society Consortium on Climate and Health, mapped how those climate change-related events and others threaten the health of people across the United States -- and those threats can vary by region.

Dr. Mona Sarfaty, executive director of the Medical Society Consortium on Climate and Healthand director of the program on climate and health at George Mason University's Center for Climate Change Communication, said the the sources for the new Pediatrics paper are credible and well-known to experts on climate change and health.

"The danger to children is real and is already witnessed by physicians in the US," said Sarfaty, who was not involved in the paper.

"Children suffer more heat impacts because they spend more time outside. They are more vulnerable to the heat-related increases in air pollution that come from fossil fuel exhaust, because their lungs are still developing. Outdoor play also makes them more prey to insect vectors carrying dangerous infections," she said. "The doctors in our societies are seeing these problems today, and they will undoubtedly get worse if we don't decisively address climate change."

Though the new paper highlights the current body of research on climate change and children's health, Chan said that more research could help physicians better understand and prepare for the health impacts of climate change.

"Specifically, what we wanted to highlight was, there's very little research and evidence around children," Chan said.

"A lot of the research is very, very broad and tends to look more at adult populations. I don't think they factor in the specific impacts on children themselves, and I think more research is needed in that arena," he said. "We really need more efforts into addressing climate change to protect our children."

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In 2015, the American Academy of Pediatrics published an updated policy statement on global climate change and children's health, calling for health facilities to reduce their carbon and environmental footprints and for politicians to promote energy efficiency, among other recommendations.

"Climate change is a rising public health threat to all children in this country and around the world," former academy President Dr. Sandra G. Hassink said in a news release at the time.

"Pediatricians have a unique and powerful voice in this conversation due to their knowledge of child health and disease and their role in ensuring the health of current and future children," she said.

May 13th 2018

Menstrual migraines: Everything you need to know

It had been happening every two weeks, like clockwork, for five months.

The worst attacks involved sharp, blinding pain that seared up the back of my head, along with nausea, fatigue, and light sensitivity. It would go on for hours; sometimes the only solution was sleep.

Migraines and other migraine-related symptoms plagued me daily. The more mild episodes were less painful, but still frustratingly stubborn: migraines arriving in the form of aching sinus headaches not cured by any over-the-counter (OTC) pain reliever or decongestant.

Then, for two weeks, I would have virtually no symptoms - until it started all over again.

After several months, I finally opened up my calendar, determined to figure out what was triggering them. As I scrutinised the dates of my migraine episodes, I started to connect the dots. Why did I have symptoms every day for those particular weeks in December, and then not again until January? And why did that pattern repeat itself every month?

That’s when it clicked: My period was the trigger.

My husband and I practice fertility awareness for our family planning needs, so I know the ins and outs of my cycle like the back of my hand. Whenever my period started, so did the migraines; whenever I ovulated, they disappeared. I talked to my doctor, who agreed that my migraines weren’t random - they were menstrual.

What are menstrual migraines?

Migraines triggered by hormone fluctuations in a woman’s monthly cycle are considered menstrually-related migraines (MRM), which the National Institutes of Health classifies as any migraine episode that occurs up to two days before the onset of a period and three days after, for at least two out of three periods.

“Some studies have identified that about 70 percent of women with migraine have MRM, while others have shown more conservative numbers of 40 to 50 percent,” says Jelena Pavlovic, attending neurologist and assistant professor at New York’s Montefiore Health System. “But menstrual migraine is often underreported and underdiagnosed because, in many women, the attacks often start prior to the onset of bleeding and/or do not last the whole menstrual period.”

Why does menstruation have the power to trigger migraines in so many women? Blame oestrogen.

“Menstrual migraine is commonly thought to be ‘triggered’ by the late-luteal phase [or premenstrual] drop in oestrogen,” says Pavlovic. 

"Identifying my migraines as menstrually-related was the most valuable thing I’ve done"

Since my migraines start with menstruation but continue for nearly two weeks, there are likely other common triggers causing me to experience migraines during a time when I’m particularly susceptible to them (oestrogen levels surge around ovulation, which likely explains why I find relief at that point in my cycle).

But menstruation remains my initial trigger - which means it has also been the key to figuring out how best to treat my migraines. 

Slideshow: 10 things that mess with your period (Health.com)

Menstrual migraine treatments

There are no specific treatment options identified solely for MRM, but a combination of traditional migraine treatments, alternative therapies, and hormone-related strategies can be effective. 

OTC or prescribed NSAIDs, like ibuprofen and naproxen, can be a first line of defence in treating migraines, though they may not quite do the trick. A 2013 review of clinical trials showed that the effectiveness of naproxen often depends on the severity of the migraines and whether it’s being used in conjunction with other medications.

Triptans are a type of drug that work to reduce the swelling of blood vessels in the head, are one of the more popular prescription medication options for migraines.

“A long-acting triptan may be used preventively, beginning about a day before the expected onset of symptoms and continuing for the usual length of symptoms,” says Pavlovic. “For this method to work it is important that a patient have a regular menstrual cycle and keep a good headache diary, so she can calculate when her migraines are likely to start and can make a plan to avoid other triggers.”  

For women who don’t find much relief with non-hormone treatments, transdermal estradiol (like in an 0estrogen patch) can help. Since MRM is linked to low levels of oestrogen, raising those levels around the time that patients normally experience migraines is a potential solution.

Video: Bizarre things that happen to your body on your period (Wochit News)

“[Transdermal estradiol] can be applied for a week, starting about five to seven days premenstrually and continuing through the second day of bleeding,” says Pavlovic. Again, this method is preventative, so it helps to be able to track and predict your menstruation. 

It's no coincidence that some OTC painkillers for migraines include a combination of aspirin, acetaminophen and caffeine - according to the Cleveland Clinic, the stimulant is sometimes used as a treatment for migraines, though it can also contribute to migraines and cause rebound headaches.

Holly Lucille, a private-practice naturopathic physician and educator, says caffeine works on multiple levels to assist with migraines: “It’s often considered a taxi that moves pain-relief ingredients quickly through the bloodstream, but it’s actually a pain-reliever in its own right.”

However, a 2016 study in The Journal of Headache and Pain suggests that the discontinuation of caffeine intake gives migraine sufferers better results. Pavlovic agrees. "In those who have frequent headaches, daily caffeine intake can worsen them and lead to more headaches,” she says. “They are advised to limit, if not completely cut out, caffeine from their diet." 

 

 

Magnesium is pretty widely accepted as a potential remedy.“Magnesium may be in short supply in those who suffer from migraines, acting as a co-conspirator with hormone fluctuations in causing the condition,” says Lucille.

"Magnesium has been used primarily as a preventive agent for menstrual migraine," adds Pavlovic. The American Migraine Foundation also acknowledges that magnesium is a reliable preventative strategy with an “excellent safety profile.” (Just remember to consult a doctor before taking any dietary supplements.)

'I'm still figuring out what works for my migraines'

It’s been more than a year of trial and error so far.

I know that a large glass of water followed by a cup of caffeinated coffee first thing in the morning does wonders to stave off many of my symptoms. If a migraine develops anyway, I take a triptan; if I wake up with one already in progress, a painkiller containing caffeine is the fastest and most reliable option.

I’ve also started taking a daily dose of chelated magnesium, though I’ve struggled to find an effective amount that doesn’t upset my stomach.

But ultimately, identifying my migraines as menstrually-related was the most valuable thing I’ve done. I’m not at the mercy of my migraines as much as I was before: I know what’s causing them, when they’ll start, and (thankfully) when they’ll end.

For a condition where prevention remains one of the most useful treatment strategies, that knowledge is power.

 

May 11th 2018

Thymus: Facts, Function & Diseases

By Alina Bradford, Live Science Contributor

Though the thymus is a little-known organ in the body, it does some very important things. It is part of the lymphatic system, along with the tonsils, adenoids and spleen, and it's also part of the endocrine system. 

Function

The thymus produces progenitor cells, which mature into T-cells (thymus-derived cells). The body uses T-cells help destroy infected or cancerous cells. T-cells created by the thymus also help other organs in the immune system grow properly. 

These cells are so vital, they are often donated to those in need. "It (the thymus) is the primary donor of cells for the lymphatic system, much as bone marrow is the cell donor for the cardiovascular system," according to a paper, "The Thymus: A Forgotten, But Very Important Organ," published by the U.S. National Library of Medicine (NLM).

Size & shape

The thymus is located just below the breast bone. It is relatively large in infants and grows until puberty. In adulthood, it starts to slowly shrink and become replaced by fat, according to the National Institute of Neurological Disorders and Stroke. It can weigh only 5 grams in elderly adults.

As it grows smaller, it seems the organ becomes less important. "Removal of the organ in the adult has little effect, but when the thymus is removed in the newborn, T-cells in the blood and lymphoid tissue are depleted, and failure of the immune system causes a gradual, fatal wasting disease," according to Encyclopedia Britannica.

The thymus gets its name from its silhouette. It is shaped much like a thyme leaf, a common cooking herb. It has two separate lobes divided by a central medulla and a peripheral cortex and is formed with lymphocytes and reticular cells. The reticular cells form a mesh that is filled with lymphocytes.

Diseases & conditions

The most common thymus diseases are myasthenia gravis (MG), pure red cell aplasia (PRCA) and hypogammaglobulinemia, according to the NLM. 

Myasthenia gravis occurs when the thymus is abnormally large and produces antibodies that block or destroy the muscles' receptor sites. This causes the muscles to become weak and easily tired. 

Medications may be prescribed that help the communication between nerves and muscles, such as pyridostigmine (Mestinon). Corticosteroids like prednisone or immunosuppressants, such as azathioprine (Imuran), mycophenolate mofetil (CellCept), cyclosporine (Sandimmune, Neoral), methotrexate (Trexall) or tacrolimus (Prograf), may be used to inhibit the immune system. Your doctor may also prescribe other medications that alter your immune system, according to the Mayo Clinic.

Pure red cell aplasia is thought to be caused commonly by the patient's own immune cells attacking blood-forming stem cells. This can happen when the thymus has a tumor, according to&