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more Mednews items


May 12th

Five ways to beat hay fever

One in four of us are affected by this seasonal allergy. We asked experts for their advice

Find the correct treatment

Hay fever is increasingly common and now affects about one in four of the population, says Glenis Scadding, a consultant allergist at the Royal National Throat, Nose and Ear hospital. Citing official advice from the NHS, she says over-the-counter antihistamines are fine for those with mild symptoms, but she warns against sedating antihistamines, which can impair driving and cognitive function. Scadding says the treatment of choice for more severe hay fever is usually an intranasal steroid spray, but she recommends seeking medical advice if symptoms are unclear or potentially complicated by other issues.

Take preemptive measures

Taking hay fever medication early is key to achieving maximum effectiveness when pollen levels peak, says Holly Shaw, a nurse adviser at Allergy UK. People with hay fever are advised to start using nasal sprays two weeks before symptoms usually begin. If you need advice on medication, Shaw advises speaking to a pharmacist. She also stresses the impact pollen can have on those with asthma, 80% of whom will also have hay fever. “Pollen can be an allergic trigger for those with asthma. Managing hay fever symptoms is an important part of keeping asthma under control.”

Check the pollen count

For a daily local pollen forecast in the UK, check the Met Office; from March to September, you can opt in to receive push notifications on its app. It is useful to know that the pollen season falls into three main sections: in the northern hemisphere, tree pollen from late March to mid-May, grass pollen from mid-May to July, and weed pollen from the end of June to September. The NHS recommends wearing wraparound sunglasses when outside, and putting petroleum jelly around the nostrils to trap pollen.

Avoid bringing pollen into the house

Pollen can be carried into your home on clothing or by pets. It is advisable to change your clothes and even have a shower when you come in from outdoors. Allergy UK advises not drying clothes outside and keeping windows closedwhen pollen counts are high, especially in early morning and evenings when levels of pollen in the air are highest. The NHS also recommends not cutting grass, or walking on cut grass, and avoiding keeping fresh flowers in the house.

Try to reduce stress

Studies have shown that stress can exacerbate allergies. Dr Ahmad Sedaghat, an ear, nose and throat specialist at Massachusetts Eye and Ear Infirmary, explains the possible mind-body connection of inflammatory disease. “Stress can make the allergic response worse. We don’t know why exactly, but we think stress hormones can ramp up the already exaggerated immune-system response to allergens.” Meditation, exercise and eating healthily are all recognised ways of trying to reduce stress.

April 16th

Have a tailor-made menopause: How your body type holds the key to beating hot flushes

·       Ayurveda counts Julia Roberts and Jennifer Aniston among celebrity fans

·       The ancient Indian healing system aims to balance mind, body and spirit 

·       Ayurveda expert Jody Vassallo, 52, advised on practicing the system in midlife

·       She revealed each dosha is prone to specific symptoms during menopause

·       VATA are likely to have anxiety, which can be relieved using guided meditation

·       KAPHA usually experience low mood, they must learn to focus on themselves 

·       Although it’s more than 5,000 years old, the traditional practice of Ayurveda is enjoying a resurgence, thanks to a host of A-list fans.

·       Admirers include Gwyneth Paltrow, Julia Roberts and Jennifer Aniston, while celebrity cook Jasmine Hemsley’s latest bestseller, East By West, is based on its principles.

·       Ayurveda is an ancient Indian healing system meaning ‘science of life’. Using food as medicine, it is based on the principle that the five elements — earth, fire, water, air and space — combine within us to form our constitution.

·       Aiming to balance mind, body and spirit, it has found new popularity as a wellness tool. Now, Ayurveda expert Jody Vassallo has shown how it can help negotiate the menopause, too.

·       Vassallo, 52, says that as she neared menopause, her memory was affected: ‘I was blown away by how forgetful I became. Prior to discovering Ayurveda, I was eating a very “heating” diet — lots of Asian foods. I never rested and I was intense. I needed to learn to calm down, slow down, cool down.’

·       In Ayurveda, there are three ‘doshas’, which represent the unique energy patterns within us that govern our physical and mental processes. Pitta is largely composed of fire and water, Vata predominantly air and space, and Kapha mainly water and earth.

·       Each dosha is prone to certain symptoms around the menopause. However, we all have a unique combination of elements and, while one dosha may be dominant, we don’t all fit neatly into a single category.

·       We might be a Kapha, prone to weight gain and low mood, but be Pitta-imbalanced and so suffering hot flushes. Ayurveda treats imbalances with opposites. If there’s overheating in the body, the aim is to cool it down.

·       Here, Jody Vassallo explains how each dosha is often affected by the peri-menopause and menopause and how Ayurvedic lifestyle and diet choices can help...

·       VATA (air, space)

·       BODY TYPE: Naturally thin and wiry. Typical menopause symptoms include anxiety, insecurity, sensitivity, joint pain, forgetfulness, inability to focus and gut issues.

·       Vata people are full of vitality: busy, talkative and on the go. In menopause, they can become depleted and driven by nervous energy. Their constitution is dry, light, cold and brittle, so they may experience issues with arthritis and stiffness.

·       WHAT TO DO: Gentle exercise suits at this time — long, relaxing walks in nature and focused movement, such as Pilates and yin yoga (a gentle form of hatha yoga). Weight-bearing exercise to strengthen is important, too. 

·       WHAT TO EAT: Soft, warm foods, including soups and stews, as well as almond, coconut or soy milk (spiced and hot), or carrot, orange or pineapple juice.

·       This type benefits from having all food cooked, where possible, such as moist, slow-cooked vegetable dishes and roasted veg salads with oily dressings.

·       Bloating can be an issue, so be wary of foods that cause gas.

·       Dairy is good for Vata, as it’s naturally sweet. Warm milk with ghee, cardamom and cinnamon before bed will help with sleep. However, Vata is prone to waking with a busy mind.

·       HOW TO LIVE: Spiralling thoughts may increase Vata’s anxiety, so writing things down is a memory aid and promotes calmness. Rise at the same time every day and don’t skip meals.

·       A creative outlet is beneficial, as is calming music. Silence can exacerbate Vata’s mind chatter. Try guided meditation instead.

·       PITTA (fire, water)

·       BODY TYPE: Medium weight and height and athletic. Prone to hot flushes, insomnia, heartburn, itchy skin and digestive issues. The hottest parts of the day for Pitta are 10am to 2pm and 10pm to 2am.

·       WHAT TO DO: Walking, swimming in fresh water, Pilates and tai chi. Yin yoga is beneficial, as it activates your parasympathetic nervous system — responsible for rest and good digestion repair. It soothes the Pitta and cools the whole body.

·       WHAT TO EAT: Instead of tea or coffee, add fresh mint to boiled water and cool before drinking. Other cooling herbs include coriander and parsley. Cooling fruits and vegetables include avocado and cucumber. Fennel and saffron are effective spices.

·       Avoid heating foods, such as red meat, aged cheeses and red wine. Go easy on grains (though brown basmati rice suits Pitta).

·       Sweet and bitter veg, such as artichoke, asparagus and cooked beetroot, are cooling, as is dairy, except if it’s fermented or soured — fresh cheeses such as cottage cheese or ricotta are preferable to yoghurt. Opt for sweet fruits, such as berries and watermelon. Iced foods can affect digestion.

·       HOW TO LIVE: Pittas are often successful leaders, and it can be fulfilling for them to be part of their community.

·       KAPHA (water, earth)

·       BODY TYPE: Larger build and wide hips and shoulders. Symptoms include weight gain, low mood and fluid retention. Their dominant elements are earth and water: if these are imbalanced, they can become lethargic or suffer respiratory issues.

·       WHAT TO DO: Kapha needs to get the heart rate up and the lungs working to add warmth to the body. So rise early and take a long, brisk walk — hill walking is ideal. For a gym fan, a boxing class or similar would suit.

·       Kapha’s biggest problem is starting, but, once they do, their staying power is impressive. If Kaphas struggle with weight, it is usually because of not moving enough, rather than their diet.

·       WHAT TO EAT: Hot water with lemon and a pinch of cayenne pepper is a good start, as spicy foods are beneficial.

·       Eating a solid meal soon after waking doesn’t necessarily suit Kaphas. They may feel lighter if they eat a larger meal between 10am and 2pm and start the day with a smoothie — blend celery, spinach, coconut water and water, adding pear/apple, dates, avocado, ginger and chia seeds.

·       Kapha types often crave sweet foods (porridge with honey, toast and jam) and white foods such as potatoes and pasta. But none of these suit their constitution, as they don’t have a fast, fiery metabolism. Cold foods such as ice cream and yoghurt don’t suit, either, while sour and salty tastes aggravate.

·       Grains such as brown rice aren’t a good fit. Go for quinoa, buckwheat, corn or millet. Chicken and freshwater fish are a good choice, and pungent and astringent foods will calm — try asparagus, broccoli, Brussels sprouts, cabbage, turmeric, ginger, fenugreek and pepper.

·       HOW TO LIVE: Kapha’s focus is taking care of others. They can become low around menopause, especially if faced with an empty nest. Learning to nurture themselves and taking time to reflect are beneficial, as is stepping out of their comfort zone, rather than standing back, cheering on everyone else.

·       Once they get moving, they’ll be surprised at how fast their body changes.

 

April 15th

Bid farewell to your midlife 'moobs' and paunch with these tips from top trainer

From fasting to weight lifting, celebrity trainer Matt Roberts reveals how to transform your fitness – and your life

Look in the mirror and what do you see? From late 30s onwards it’s not unusual for men to be confronted with a thickening waistline, “moobs” and a paunch.

Battling middle-aged spread and decreasing fitness levels are the main concerns of many of my celebrity and high-flying clients.

Yet my promise to them – and to you – is that it doesn’t have to be that way.

I’ve been working as a personal trainer for 25 years and in that time there has been a dramatic shift in attitudes towards fitness and ageing.

Reaching your mid-40s once meant hanging up your trainers, but today it likely means investing in a new pair and working towards a new fitness goal.

I know from experience that not only is it possible to maintain your fitness level as you get older, but to improve it too.

So what are you waiting for?

How to stay motivated

1.    Who do you want to be? Instead of trying to answer the question “who am I?”, think about “who am I becoming?”. Decide who you need to be and grow into that persona. 
 

2.    Prioritise yourself. Too many people fail to do this. You deserve nothing but the best and have the power to be unstoppable. Make sure you nourish yourself, support yourself with sleep and empower yourself in the process. 
 

3.    Be realistic. A huge goal can seem unattainable so keep focused by challenging yourself with small goals. With a series of small victories, your confidence and motivation can be heightened for months on end.

You are what you eat

Your diet not only influences what you weigh but your overall health and vitality too.

Eating nutritious, hormone-boosting foods will not only ensure you feed your body what it needs but you won’t feel hungry either.

Lose fat, build muscle

This can be achieved by eating a lean balanced diet based on high-quality protein, such as meat and fish, and low-GI carbs.

Your daily diet should include lots of green vegetables, including kale, broccoli and watercress, which are rich in antioxidant vitamins.

As well as this, eat plenty of foods that are rich in vitamin K, a natural testosterone booster such as brussels sprouts, spinach and prunes.

Don’t forget fibre

Fibre is a crucial part of our diet that most people don’t get enough of. It feeds the healthy bacteria in the gut and is key to better digestion. Experts recommend 30g a day but on average men in the UK only have 20g a day. So increase your intake by packing your diet with high-fibre foods, for example nuts, beans, pulses and wholegrains.

Fast forward

Fasting is good for weight loss, boosts hormone production and gives your digestive system a rest. I recommend 16:8 fasting two days a week.

This gentle form of intermittent fasting means you fast for 16 hours and have an eating window of eight hours, during which you consume 700-800 calories.

Most people find it easiest to fast overnight – for example, stopping eating at 4pm and having breakfast at 8am the next morning. A fasting day could include:

Breakfast: Porridge made with 2tbsp oats and a handful of berries.

Lunch: 150g chicken, mixed 
salad made with 80g lettuce, 100g kale or spinach and 100g of two other 
raw vegetables, chopped or grated.

Dinner: 150g white fish, mixed salad, as above.

Make sure you drink two litres of water each day when you’re fasting.

And remember, successful fasting involves planning ahead and not cheating – it does work but only if you give it 100%.

GABA is a neurotransmitter that dampens nerve activity in the brain and promotes deep relaxation.

You can take a supplement but you can also increase levels by eating foods rich in glutamate, which will naturally boost GABA production.

Eggs and poultry, cheese, ripe tomatoes and mushrooms are all good sources. Fermented foods are also good as they contain beneficial bacteria that increase GABA production.

Fast track to fitness

True fitness is the balance of strength, mobility, endurance, stamina and stability.

Forget lengthy cardio sessions and hardcore HIIT workouts – both can take their toll when you’re in your 40s and 50s and even lead to injury.

Instead, follow the advice below, but remember to consult your GP before starting a new exercise or diet plan.

Warm up and stretch

Before you start any workout, make sure you warm up to activate the muscles you’re about to use. After a workout, take the time to stretch properly.

Stretching your muscles when they are warm will not only improve flexibility but enhance your recovery process too. Even on the days you’re not working out, doing some gentle stretches will help with your mobility and posture.

Weight and see

Focus on weight training, which builds muscle, strengthens bones and improves physique by priming the body to produce more testosterone and HGH.

Make sure the weights you are using are heavy enough – too light won’t stimulate HGH production.

When lifting weights, I tell my clients to focus on:

Power: When you lift a weight, there are positive and negative parts of the 
movement. The positive part is what moves the weight when you push, pull or lift it.

The negative is when you return the weight to its start position. For example, in a bench press, the positive part is when you push the bar up and the negative is when you lower the bar back to your chest. Focus on the positive aspect of each lift and think power.

Pace: The speed of each lift is important too. The positive aspect of a lift should take half the time of the negative aspect.

This explosion of power means you will see fast results in terms of muscle, bone and hormone benefits.

Love to lunge

Squats and lunges are great examples of compound moves – exercises that involve large muscle groups working together to create one big movement.

They are a vital part of any exercise routine because they elevate the heart rate, burn calories, improve muscle coordination and increase mobility.

Don’t overtrain

Long sessions of traditional cardio can accelerate ageing. Repeatedly pushing your body to the extreme by training for marathons or other endurance feats can put it under more stress that it can handle.

And this can interfere with the production of testosterone.

All about hormones

As men get older their hormone levels drop, which affects health, wellbeing and fitness.

Men lose testosterone at 1.5-2% a year after the age of 30 and, at the same time, the production of human growth hormone (HGH) – which boosts protein production, helps the body burn fat and regulates blood sugar levels – slows down too.

The good news is that exercise and diet can stem hormonal decline – as long as you follow the right approach.

Supercharge your sleep

Recovery is often overlooked in a fitness regime but it’s hugely important, particularly once you’re over 40. And the best recovery time is when you sleep.

When you consider the fact that sleep is something we spend a third of our life doing, we should be really good at it.

Yet we are getting less sleep than ever. Here are my top tops that’ll help you sleep better.

Drink green tea

Green tea contains an amino acid that increases levels of happy hormones serotonin and dopamine and reduces mental and physical stress.

However, it does contain caffeine so if you are susceptible to its effects, you should avoid it before bedtime.

Detox your bedroom

Make sure your bedroom is conducive to sleep. Banish smartphones and tablets to prevent the blue light they emit keeping you up.

Make sure the room is quiet and dark and the right temperature for sleep – between 16-18C is considered optimum.

 

April 11th 

Sure, you can watch celebrities like Alan Alda and Michael J. Fox talk about life with Parkinson’s disease. You can read medical articles and understand the definition of Parkinson’s, which is a neurodegenerative disorder that targets the neurons in the part of the brain that produce dopamine. This results in motor symptoms like tremor, rigid limbs, balance and gait problems and slowness of movement; and non-motor symptoms like sleep disorders and depression. But there are some things a textbook or doctor can’t tell you — like what it’s really like to live day in and day out with Parkinson’s.

When it comes to those details, only someone else who has Parkinson’s can give you that insider knowledge. If you’re newly diagnosed, they can tell you what to prepare for, and if you’ve been living with Parkinson’s for a while, they can tell you that you’re actually not the only one experiencing that “weird” symptom. So we asked our Mighty Parkinson’s community to share something people don’t tend to understand about Parkinson’s unless they have it themselves. Check out the “secrets” they shared below. Did we miss anything? Be sure to leave a comment and explain what you would add to our list.

1. It can be frustrating not being able to do small things.

The tremors, bradykinesia (slowness of movement) and rigidity caused by Parkinson’s can make doing things requiring fine motor skills difficult. For example, you might have trouble buttoning a shirt or cutting a sandwich.

Ellie Finch Hulme, blogger at PD Mama, explained:

How frustrating it is not being able to do the smallest of things, despite willing your brain to send the right message and have the right limb, for example, receive that message and act upon it. Things as simple as moving fingers to type. Things that we take for granted in our everyday lives.

2. Tremors are not always visible — they can be internal, too.

“People who do not have Parkinson’s do not understand what internal tremors are,” Sharon Krischer, blogger at Twitchy Woman, said.

Most people are aware that external tremors are a hallmark sign of Parkinson’s, but what many people don’t know is that tremors can also be internal. This feels like a shaking sensation inside the body.

3. Women with Parkinson’s disease may present with different symptoms and challenges than men.

For women, hormones can impact Parkinson’s and vice versa — you might notice worsening Parkinson’s symptoms, heavier menstrual flow, more fatigue and less effectiveness of medications while you have your period. Some research has also suggested that during the “preclinical” phase of Parkinson’s, or period of time before a doctor’s diagnosis, women’s non-motor symptoms may be more prominent than their motor symptoms, meaning they may get diagnosed later than men do.

Maria De Leon, blogger at Parkinson’s Diva, shared:

Unless you are a young woman with PD, you don’t realize the impact that having hormone fluctuations play on the symptoms of the disease, while PD itself [can] worsen the menstrual cycle and other hormonal related medical problems like migraines. [Also], how young women with PD take longer to get a diagnosis because of the prevalent non-motor symptoms at presentation compared to their male counterparts.

4. Parkinson’s symptoms are not necessarily the same every single day.

Like most chronic illnesses, Parkinson’s disease does not look exactly the same every day. One day you might feel more fatigue; another day you might realize you’re not moving as slowly as you were the previous week. If you experience these “ups and downs,” you’re definitely not alone!

Blogger Linda Olson explained:

Parkinson’s disease is an erratic partner of mine. Some days I’m stiff and sore and anxious, on those days my mantra is, ‘I can do this.’ Then for no reason at all, it lightens up for a while. I look forward to these ‘gratitude days’ and make sure I share them with those around me.

5. Depression sometimes comes even before other symptoms.

Not everyone with depression will get Parkinson’s and vice versa, but it is common for depression to be among the very first symptoms of the disease to show up.

Sherri Woodbridge, blogger at Parkinson’s Journey, explained how this depression feels:

One of the first symptoms that is often overlooked (while Parkinson’s is frantically trying to make its mark on your life) can be depression. By the time you are actually diagnosed, you may feel like your whole world has caved in and your diagnosis adds a thousand ton weight upon you as you lay smothered in a pit of grief.

6. Parkinson’s drugs can lead to side effects that resemble Parkinson’s.

It sounds unbelievable, but it’s true: drugs designed to treat Parkinson’s can actually cause involuntary movements — a common symptom of Parkinson’s itself. For example, levodopa helps replace dopamine that is lost by Parkinson’s, but a potential side effect is dyskinesia, or involuntary movements.

Hulme noted:

How ironic it is – a condition that can involve shaking, stiffness and slowness of movement, sometimes all in the same day, not to mention the fact that some of the drugs used to stifle inadvertent movement can induce… wait for it… inadvertent movement (dyskinesia)! I mean, come on!

7. Many people with Parkinson’s utilize non-drug treatment options.

There are a number of drugs that can help manage Parkinson’s symptoms. But non-pharmaceutical methods may also be a part of your toolbox. Getting regular movement can help prevent muscle stiffness improve motor symptoms, so exercise like boxing, walking and weightlifting are recommended. Others might take comfort in complementary therapies like acupuncture and hydrotherapy, though there is not as much research behind them.

Karl Robb, blogger at A Soft Voice in a Noisy World, shared what works for him:

Having had Parkinson’s disease for over 30 years, I have identified a variety of triggers like lack of sleep, stress, lack of hydration, poor diet, and feeling rushed can all contribute to my Parkinson’s disease symptoms. Finding complementary therapies and practices such as reiki, Rock Steady Boxing, massage, meditation, and reflexology have all offered me tools to improve my condition.

8. Reaching out to friends for help doesn’t make you a “burden.”

When you’re first diagnosed, you might feel embarrassed or guilty about asking for help, worrying that you’re burdening others. But the more you become accustomed to Parkinson’s and realize how helpful it is when friends lend a hand (or ear, or any type of support that lightens your load). There’s no need to feel guilty for asking loved ones to support you, and any true friend will be glad to do it.

“Parkinson’s disease is a neurodegenerative disease that is slowly stealing many of my motor and cognitive skills. Friendship has become more precious as I learn to ask for and accept help more often,” Olson said. “And… surprisingly, my friends are grateful when I ask for and accept their help.”

9. Parkinson’s may be invisible, but that doesn’t mean it’s not there.

Like many chronic illnesses, Parkinson’s may not always cause “obvious” symptoms. However, just because there are times when other people can’t “see” your symptoms, that doesn’t mean you’re not still feeling painful, uncomfortable symptoms, mental health challenges like anxiety and depression, or dealing with the stress of communicating with insurance companies or getting accommodations from work. “Invisible” doesn’t mean “easy!”

“Parkinson’s is an invisible disease and the majority of people don’t get that. It’s a disease that may not look like much of anything to some people, but if you’ve got it, you had better believe it’s something indeed,” Woodbridge said.

10. Friends who also have Parkinson’s can bring so much joy to your life.

One of the things you likely heard when you were first diagnosed was, “Join a support group!” If the suggestion didn’t thrill you when you first heard it, you’re probably not alone. But people who have literally felt what you feel can offer a kind of support and understanding that no one else can. And nowadays you don’t have to go to support groups in person — you can join groups on social media or post Thoughts and Questions on The Mighty to meet and chat with other people with Parkinson’s.

“I cherish my friends with Parkinson’s disease. We understand each other in ways that our family and friends do not,” Krischer said.

11. Parkinson’s affects younger people, too.

It’s true that the average age of diagnosis is 60. However, young onset Parkinson’s disease occurs in people younger than 50, and affects 2 to 10 percent of the one million people with Parkinson’s disease in the U.S.

As Nikki Louiselle, blogger at Just Shake It Off, explained:

Unless you live with Parkinson’s disease you most likely see it as an ‘old person’s’ disease. I did, until I heard those devastating words. Until I received my diagnosis 17 months ago, I thought it was something old people had. I’m 46.

12. Parkinson’s might teach you things you never knew about yourself.

There’s no doubt that the physical and emotional challenges of Parkinson’s can change your life in pretty difficult ways. But some people with Parkinson’s find that it helps them discover who their true friends are, focus on the “little things” that make them happy, and learn to appreciate a slower pace of life.

“My Parkinson’s disease may have reduced my speed for moving and my reaction time, but in doing so, it has allowed me to appreciate the world at a pace that I would have never experienced. I am grateful for so much!” Robb said.

Whether you are seeking a diagnosis, just received your diagnosis, or have been living with Parkinson’s for a while, hearing what others have gone through can hopefully bring you reassurance that you’re not alone. Parkinson’s may feel like it’s turned your life (and body) upside down, but there are people out there who are ready to support you. Check out more stories for more insight into the Parkinson’s experience:

March 27th

The dangers of unvaccinated children

On Tuesday, a New York county announced that it had banned unvaccinated children from all public spaces following the largest measles outbreak in the county in decades.

According to the Centres for Disease Control and Prevention (CDC), more than 180 cases of measles have recently been confirmed in New York City.

Officials in Rockland County have emphasised the importance of having children vaccinated, saying that they will "not sit idly by while children in our community are at risk".

So how do vaccines work and what are the dangers of unvaccinated children? Here's everything you need to know:

How do vaccines work?

The aim of vaccines is to help the body produce antibodies that can fight off disease, the NHS explains.

When a person comes into contact with a disease, if they've been vaccinated against it, their immune system should be able to recognise it and produce the antibodies it needs to cause it to dissipate quickly.

Some vaccines are more effective than others.

For example, the MMR vaccine, which protects against measles, mumps and rubella, provides patients with 90 per cent protection against the diseases after one dose.

However, the typhoid vaccine, which individuals get when travelling to countries with high risk of typhoid and hepatitis A, provides around 70 per cent protection for about three years.

What diseases have been eliminated due to use of vaccines?

Several diseases have been eliminated thanks to vaccines, with some gradually on their way to becoming completely eradicated.

In the 20th century, an estimated 300 million people died from smallpox.

In 1980, it was declared that smallpox had been completely wiped out, with the last known case occurring in Somalia in 1977.

Other conditions on their way to becoming eliminated due to the prevalence of vaccines include polio, whooping cough and meningitis C.

What are the dangers of unvaccinated children?

The first main danger of a child not being vaccinated is that they'll be at higher risk of being diagnosed with a harmful disease.

As their body may be unable to produce the antibodies necessary to fight the disease, this could put their life at risk, states Vaxopedia, an online resource created by paediatrician Dr Vincent Iannelli.

However, it's not just their own health that's a cause of concern, but also the wellbeing of others.

If an unvaccinated child catches an illness, they could be at risk of spreading it to someone else who hasn't been vaccinated.

This may include individuals who can't be vaccinated due to health issues, or those too young for the injections.

There is also still a small possibility that those who have been vaccinated can still catch a disease when exposed to it.

Approximately one in seven children around the world do not receive vaccinations that could prove life-saving, charity Save the Children states.

Vaccination currently prevents between two and three million deaths on an annual basis, the World Health Organisation (WHO) outlines. However, a further 1.5 million deaths could be prevented if vaccination was improved on a global scale, the organisation adds.

Why do some adults choose not to vaccinate their children?

Vaccine hesitancy, as described by WHO, is the "reluctance or refusal to vaccinate despite the availability of vaccines".

The organisation explains that the reasons why people choose not to vaccinate are "complex", pinpointing the two main reasons as "complacency" and "lack of confidence".

In January, a report released by the Royal Society for Public Health (RSPH) warned that social media is acting as a "breeding ground" for false and harmful information about the safety of vaccines.

The charity stated that groups looking to spread "misleading and dangerous information" about vaccines tend to be more prominent on social media platforms such as Facebook than in other forms of media.

WHO recently described the anti-vaccine movement as one of the worst threats facing humanity in 2019.

The warning came following a 30 per cent increase in the number of cases of measles worldwide, including in several countries where the disease had almost been completely eradicated.

 

March 25th

FDA to assess long-term effects of breast implants

The FDA is holding a meeting over the next two days to discuss the long-term risks of breast implants. There are two types of FDA-approved implants, and about a decade ago, the agency first identified a possible association between the use of implants and a particular type of lymphoma. Women have also reported other side effects, such as fatigue and joint pain after getting implants. The FDA says it will consider post-approval studies as well as issues associated with the use of surgical mesh in breast procedures. The agency will hear from researchers, plastic surgeons, and implant makers, as well as from women who say their implants caused health problems.

March 22nd


Down SyWhat is Down Syndrome?

In every cell in the human body there is a nucleus, where genetic material is stored in genes. Genes carry the codes responsible for all of our inherited traits and are grouped along rod-like structures called chromosomes. Typically, the nucleus of each cell contains 23 pairs of chromosomes, half of which are inherited from each parent. Down syndrome occurs when an individual has a full or partial extra copy of chromosome 21.

This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome. A few of the common physical traits of Down syndrome are low muscle tone, small stature, an upward slant to the eyes, and a single deep crease across the center of the palm – although each person with Down syndrome is a unique individual and may possess these characteristics to different degrees, or not at all.

How Common is Down Syndrome?

According to the Centers for Disease Control and Prevention, approximately one in every 700 babies in the United States is born with Down syndrome, making Down syndrome the most common chromosomal condition. About 6,000 babies with Down syndrome are born in the United States each year.

When Was Down Syndrome Discovered?

For centuries, people with Down syndrome have been alluded to in art, literature and science. It wasn’t until the late nineteenth century, however, that John Langdon Down, an English physician, published an accurate description of a person with Down syndrome. It was this scholarly work, published in 1866, that earned Down the recognition as the “father” of the syndrome. Although other people had previously recognized the characteristics of the syndrome, it was Down who described the condition as a distinct and separate entity.

In recent history, advances in medicine and science have enabled researchers to investigate the characteristics of people with Down syndrome. In 1959, the French physician Jérôme Lejeune identified Down syndrome as a chromosomal condition. Instead of the usual 46 chromosomes present in each cell, Lejeune observed 47 in the cells of individuals with Down syndrome. It was later determined that an extra partial or whole copy of chromosome 21 results in the characteristics associated with Down syndrome. In the year 2000, an international team of scientists successfully identified and catalogued each of the approximately 329 genes on chromosome 21. This accomplishment opened the door to great advances in Down syndrome research.

Are There Different Types of Down Syndrome?

TRISOMY 21 (NONDISJUNCTION)

Down syndrome is usually caused by an error in cell division called “nondisjunction.” Nondisjunction results in an embryo with three copies of chromosome 21 instead of the usual two. Prior to or at conception, a pair of 21st chromosomes in either the sperm or the egg fails to separate. As the embryo develops, the extra chromosome is replicated in every cell of the body. This type of Down syndrome, which accounts for 95% of cases, is called trisomy 21.

MOSAICISM

Mosaicism (or mosaic Down syndrome) is diagnosed when there is a mixture of two types of cells, some containing the usual 46 chromosomes and some containing 47. Those cells with 47 chromosomes contain an extra chromosome 21.

Mosaicism is the least common form of Down syndrome and accounts for only about 1% of all cases of Down syndrome. Research has indicated that individuals with mosaic Down syndrome may have fewer characteristics of Down syndrome than those with other types of Down syndrome. However, broad generalizations are not possible due to the wide range of abilities people with Down syndrome possess.

TRANSLOCATION

In translocation, which accounts for about 4% of cases of Down syndrome, the total number of chromosomes in the cells remains 46; however, an additional full or partial copy of chromosome 21 attaches to another chromosome, usually chromosome 14. The presence of the extra full or partial chromosome 21 causes the characteristics of Down syndrome.

What Causes Down Syndrome?

Regardless of the type of Down syndrome a person may have, all people with Down syndrome have an extra, critical portion of chromosome 21 present in all or some of their cells. This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome.

The cause of the extra full or partial chromosome is still unknown. Maternal age is the only factor that has been linked to an increased chance of having a baby with Down syndrome resulting from nondisjunction or mosaicism. However, due to higher birth rates in younger women, 80% of children with Down syndrome are born to women under 35 years of age.

There is no definitive scientific research that indicates that Down syndrome is caused by environmental factors or the parents’ activities before or during pregnancy.

The additional partial or full copy of the 21st chromosome which causes Down syndrome can originate from either the father or the mother. Approximately 5% of the cases have been traced to the father.

Does Down Syndrome Run in Families?

All 3 types of Down syndrome are genetic conditions (relating to the genes), but only 1% of all cases of Down syndrome have a hereditary component (passed from parent to child through the genes). Heredity is not a factor in trisomy 21 (nondisjunction) and mosaicism. However, in one-third of cases of Down syndrome resulting from translocation there is a hereditary component – accounting for about 1% of all cases of Down syndrome.

The age of the mother does not seem to be linked to the risk of translocation. Most cases are sporadic – chance – events. However, in about one-third of cases, one parent is a carrier of a translocated chromosome.

What Is the Likelihood of Having a Second Child with Down Syndrome?

Once a woman has given birth to a baby with trisomy 21 (nondisjunction) or translocation, it is estimated that her chances of having another baby with trisomy 21 is 1 in 100 up until age 40.

The risk of recurrence of translocation is about 3% if the father is the carrier and 10-15% if the mother is the carrier. Genetic counseling can determine the origin of translocation.

How Is Down Syndrome Diagnosed?

PRENATALLY

There are two categories of tests for Down syndrome that can be performed before a baby is born: screening tests and diagnostic tests. Prenatal screens estimate the chance of the fetus having Down syndrome. These tests do not tell you for sure whether your fetus has Down syndrome; they only provide a probability. Diagnostic tests, on the other hand, can provide a definitive diagnosis with almost 100% accuracy.

There is an extensive menu of prenatal screening tests now available for pregnant women. Most screening tests involve a blood test and an ultrasound (sonogram). The blood tests (or serum screening tests) measure quantities of various substances in the blood of the mother. Together with a woman’s age, these are used to estimate her chance of having a child with Down syndrome. These blood tests are often performed in conjunction with a detailed sonogram to check for “markers” (characteristics that some researchers feel may have a significant association with Down syndrome). New advanced prenatal screens are now able to detect chromosomal material from the fetus that is circulating in the maternal blood. These tests are not invasive (like the diagnostic tests below), but they provide a high accuracy rate. Still, all of these screens will not definitively diagnose Down syndrome. Prenatal screening and diagnostic tests are now routinely offered to women of all ages.

The diagnostic procedures available for prenatal diagnosis of Down syndrome are chorionic villus sampling (CVS) and amniocentesis. These procedures, which carry up to a 1% risk of causing a spontaneous termination (miscarriage), are nearly 100% accurate in diagnosing Down syndrome. Amniocentesis is usually performed in the second trimester between 15 and 20 weeks of gestation, CVS in the first trimester between 9 and 14 weeks.

Use this language when referring to Down syndrome and people who have Down syndrome:
  • People with Down syndrome should always be referred to as people first.
  • Instead of “a Down syndrome child,” it should be “a child with Down syndrome.” Also avoid “Down’s child” and describing the condition as “Down’s,” as in, “He has Down’s.”
  • Down syndrome is a condition or a syndrome, not a disease.
  • People “have” Down syndrome, they do not “suffer from” it and are not “afflicted by” it.
  • “Typically developing” or “typical” is preferred over “normal.”
  • “Intellectual disability” or “cognitive disability” has replaced “mental retardation” as the appropriate term.
  • NDSS strongly condemns the use of the word “retarded” in any derogatory context. Using this word is hurtful and suggests that people with disabilities are not competent.
Down vs. Down’s
  • NDSS uses the preferred spelling, Down syndrome, rather than Down’s syndrome.
  • Down syndrome is named for the English physician John Langdon Down, who characterized the condition, but did not have it. An “apostrophe s” connotes ownership or possession.
  • While Down syndrome is listed in many dictionaries with both popular spellings (with or without an apostrophe s), the preferred usage in the United States is Down syndrome. The AP Stylebook recommends using “Down syndrome,” as well.
Q&A for Kids

Question: What is Down syndrome?

Question: How do people get Down syndrome?

Question: Do kids with Down syndrome like the same things as other kids?

Question: Why is it called Down syndrome?

Question: Can kids with Down Syndrome go to school?

Question: Are people with Down syndrome always happy?

 

March 21st

Common midlife health signs you shouldn't ignore, from memory loss to appetite changes

We all know things start to change as you grow older. 

Reaching your forties and fifties might come with greater confidence and a higher libido, but other age-related changes are less appealing. 

But, sometimes what’s thought to be a sign of ageing might actually indicate an underlying health condition.

Certain symptoms, such as sudden memory changes or problems emptying your bladder, should almost always be investigated rather than dismissed, stresses GP and aesthetic doctor Dr Jane Leonard.

While there’s usually no cause for alarm – and likely nothing at all wrong – it’s always best to be vigilant. 

READ MORE: The two ages we’re most happy at

“Whether your symptoms are in isolation or linked to anything else, it is not your job to put it down to ageing,” Dr Leonard tells Yahoo UK. “It is important to investigate thoroughly before making that conclusion for yourself.”

So, what are some of the health ailments that could hint at a more serious condition?

1. Needing to wee during the night

For some, one or more toilet trips during the night is completely normal. But if you’re not usually prone to waking needing to pee, something could be going on. 

“Sometimes the detruser muscle (so the muscle in your bladder wall) can become more sensitive and the capacity to hold urine can be less so you may find yourself getting up at night to pass urine,” explains Dr Leonard.

However, it can also point to a urine infection or, in men, prostate issues. The latter is very common in men over the age of 50, and 

If you are going to the toilet more often or feeling more urgency to go than usual , experiencing pain passing urine, or passing blood in your urine, you should see a doctor. 

An inability to complete empty your bladder should also be cause for concern, Dr Leonard adds.

Log on to Prostate Cancer UK to find out more information about prostate issues and treatment. 

2. Memory changes

Healthy brain ageing, which involves the inability to remember details like where objects are located, begins in your 40s, according to one study.

But, as much as we joke about having “senior moments” in middle age, it is important to differentiate between normal brain ageing and what’s known as “acute confusion”.

The latter, where you experience a very sudden change in your memory, should be discussed with your doctor. 

“If it is a more chronic issue of losing memory, or you are becoming forgetful, simple blood tests can be done to investigate causes. You may also be referred to the memory clinic, which can be helpful,” advises Dr Leonard.

Head to the Dementia UK website for further information about memory problems and testing. 

READ MORE: The age women start turning into their mothers

3. Appetite changes

Your appetite and food tastes may change as you age, with one study finding our sense of smell dwindles as we get older, leaving us less able to enjoy the flavours of what we eat.

However, if you experience a loss of appetite which leads to unintentional weight loss, it should be looked into. This can hint at anything from gastrointestinal problems to anxiety and depression.

4. Sleep

We’ve all heard the myth that you need less sleep as you get older, but Dr Leonard says this is not necessarily true of everyone: “Some people sleep less, other people need more sleep depending on their personal situations.”

However, if you are plagued by chronic insomnia, this should be a cause for concern, she adds.

“Mental health problems such as depression and anxiety often manifest as changes in sleep. See your doctor for further investigation.”

If you are experiencing mental health issues, you can get access to advice and someone to talk to on the Mind website.

5. Weight changes

Weight can fluctuate with age, with one survey finding men are most susceptible to gaining weight at the age of 44, while women experience this somewhat earlier at 38.

The danger of obesity in middle and old age is well documented, increasing risk of diseases like diabetes and heart disease, according to a body of research.

However, if you lose a significant amount without changing your diet, this could also be an indication of a more serious problem, including certain cancers. A recent studyidentified unexplained weight loss as one of the most important indicators of cancer.

“Anyone who is losing weight unintentionally is concerning and something to take into consideration and be checked,” says Dr Leonard.

Adults in the England ages 40-74 are eligible for a health check-up. Designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia, the check helps finds ways to lower this risk. 

 

March 20th

9 Health Benefits of Aloe Vera Juice

What is Aloe Vera Juice?

The aloe vera plant is a succulent plant species from the genus Aloe. It grows abundantly in tropical climates and has been used for centuries as a medicinal plant.

Aloe vera juice is a gooey, thick liquid made from the flesh of the aloe vera plant leaf. It's commonly known to treat sunburns. But drinking this healthy elixir in juice form provides you with a number of other health benefits.

Aloe vera juice is made by crushing or grinding the entire leaf of the aloe vera plant, followed by various steps to purify and filter the liquid. With a mild, tolerable flavor, the juice mixes easily into smoothies and shakes. This makes aloe vera juice a practical whole food supplement.

What Are the Health Benefits of Drinking Aloe Vera Juice?

Here are nine reasons to drink pure, uncolored, low anthraquinone aloe vera juice.

1. Alkalinity

A body with an acidic pH is a breeding ground for disease. It's an atmosphere where illness thrives. Help keep your body balanced by eating and drinking alkaline foods and beverages such as aloe vera juice.

Other smart alkaline food choices include:

·       leafy greens

·       root vegetables

·       legumes

·       nuts and seeds

·       fruits

2. Hydration

The aloe plant is very water-dense, so it's an ideal way to prevent or treat dehydration. Staying hydrated helps your body detox by providing a way for you to purge and flush out impurities. The juice also packs a hefty punch of nutrients that optimize your body's organ output.

This is crucial, because your kidneys and liver are largely responsible for the task of detoxifying your blood and producing urine. For this reason, you need to keep them healthy.

Recovery from heavy exercise also requires rehydration through the intake of extra fluids. Your body requires more fluids in order to flush and rid itself of the lactic acid buildup from exercising. Try aloe vera juice instead of coconut water after your next hard workout.

3. Liver function

When it comes to detoxing, healthy liver function is key.

Aloe vera juice is an excellent way to keep your liver healthy. That's because the liver functions best when the body is adequately nourished and hydrated. Aloe vera juice is ideal for the liver because it's hydrating and rich in phytonutrients.

4. For constipation

Drinking aloe vera juice helps increase the water content in your intestines. Research has shown a relationship between increasing the intestinal water content and the stimulation of peristalsis, which helps you pass stool normally.

If you're constipated or have problems with frequent constipation, try incorporating aloe vera juice into your daily routine. Aloe also helps normalize the healthy bacteria in your gut, keeping your healthy intestinal flora balanced.

5. For clear skin

Hydrating aloe vera juice may help reduce the frequency and appearance of acne. It may also help reduce skin conditions like psoriasis and dermatitis.

Aloe vera is a rich source of antioxidants and vitamins that may help protect your skin.

The important compounds in aloe vera have also been shown to neutralize the effects of ultraviolet (UV) radiation, repair your skin from existing UV damage, and help prevent fine lines and wrinkles.

6. Nutritious boost

Aloe vera juice is jam-packed with nutrients. Drinking it is an excellent way to make sure you don't become deficient. It contains important vitamins and minerals like vitamins B, C, E, and folic acid.

It also contains small amounts of:

·       calcium

·       copper

·       chromium

·       sodium

·       selenium

·       magnesium

·       potassium

·       manganese

·       zinc

Aloe vera is one of the only plant sources of vitamin B-12, too. This is excellent news for vegetarians and vegans.

Keeping your food and drink intake nutrient-rich is key in combating most preventable diseases.

7. Heartburn relief

Drinking aloe vera juice may give you relief when heartburn attacks. The compounds present in aloe vera juice help control secretion of acid in your stomach. The effects have even been shown to combat gastric ulcers and keep them from getting larger.

8. Digestive benefits

Aloe vera contains several enzymes known to help in the breakdown of sugars and fats and to keep your digestion running smoothly.

If your digestive system isn't operating optimally, you won't absorb all of the nutrients from the food you're eating. You have to keep your internal engine healthy in order to reap the benefits from your diet.

Aloe vera may help decrease irritation in the stomach and intestines. The juice may also help people with irritable bowel syndrome (IBS) and other inflammatory disorders of the intestines.

One 2013 study of 33 IBS patients found that aloe vera juice helped reduce the pain and discomfort of IBS. The study was not placebo-controlled, so more research is needed.

Aloe vera was also beneficial to people suffering from ulcerative colitis in an earlier double-blind, placebo-controlled study.

9. Beauty hacks

Keeping aloe vera juice on hand can also be good for a number of beauty and health needs.

Try using it for the following:

·       makeup primer (apply before foundation)

·       makeup remover

·       sunburn soother

·       lightweight moisturizer

·       treatment for irritated scalp (mix in a few drops of peppermint oil)

What are the Side Effects of Drinking Aloe Vera Juice?

Decolorized (purified, low anthraquinone) whole leaf aloe vera is considered safe. A 2013 studyin mice fed various concentrations of purified aloe vera for three months showed no adverse effects at all from the juice.

Colored vs. decolorized aloe juice

On the other hand, nondecolorized, unpurified aloe vera juice can have unpleasant side effects, including diarrhea and cramping.

Diarrhea can lead to severe pain, dehydration, and electrolyte imbalances.

Researchers have concluded that the side effects caused by unpurified aloe vera juice are a result of the presence of anthraquinone, which is considered a laxative.

Though anthraquinone is an organic compound naturally found in the leaf of the aloe vera plant, it's considered toxic and should be avoided.

One 2013 study found that aloe vera whole-leaf extract increased the risk of colon adenomas (benign) and carcinomas (cancer) in rats. However, another study on rats that same year noted that purified and decolorized juice is a safer option when compared to colored aloe vera.

When shopping, look for the following statements on the label:

·       purified

·       decolorized

·       organic

·       safety tested

Drug Interactions With Aloe Vera Juice

Aloe juice has been shown to interact with certain medications. If you are taking any drug that is considered a substrate of Cytochrome P450 3A4 and CYP2D6, do not drink aloe vera juice. Aloe vera juice may increase the risk of side effects of these drugs.

Aloe may also add to the effects of sevoflurane, causing excessive bleeding during surgery. If you are taking sevoflurane, check with your doctor before drinking aloe juice.

How Much Sugar is in Aloe Vera Juice?

Unlike most juices, a 4-ounce serving of aloe vera juice contains no sugar and only a few calories. If you're watching your sugar intake, aloe vera juice is a healthy choice.

Where to Find Aloe Vera Juice

Aloe vera juice can be purchased online or in most health food markets. When shopping for aloe vera juice, it's important to consider the quality of the product.

Look for organic, pure, and 100 percent aloe juice. It's important to drink pure aloe vera juice rather than a blend that has fillers. Read the label carefully.

Next Steps

For a health boost, drink up to 8 ounces of aloe vera juice per day. You can pour it over ice, mix it in with your smoothie or favorite juice, or just drink it from the bottle.

 

March 16th

What the New Egg Study Means for the Beloved Breakfast Food

Eggs are back in the news, with a new study concluding that regular consumption of the beloved breakfast food may increase the risk of heart disease after all.

The large, long-running study — published today (March 15) in the journal JAMA — found that eating three to four eggs per week was linked to a 6 percent increase in a person's risk of developing heart disease and an 8 percent increase in their risk of dying from any cause during the study period, compared with not eating eggs.

The culprit, the researchers wrote, appears to be cholesterol; the study also found that eating 300 mg of cholesterol per day was tied to a 17 percent increase in the risk of developing heart disease and an 18 percent increase in the risk of dying during the study period, compared with consuming no cholesterol.

The new findings contradict the latest dietary guidelines for Americans, released in 2015; in them, the U.S. Department of Health and Human Services and the U.S. Department of Agriculture (USDA) said that Americans no longer had to worry about keeping their cholesterol intake within a certain limit.

The authors of the new study, from Northwestern University Feinberg School of Medicine, conclude that Americans should limit their cholesterol and egg consumption, and that current dietary guidelines for cholesterol may need to be reevaluated.

So what does this mean for the beloved breakfast food? Indeed, at 186 milligrams of cholesterol per egg yolk, eggs are one of the highest cholesterol foods typically consumed by Americans. [7 Tips for Moving Toward a More Plant-Based Diet]

To find out where Americans should stand on "eggs for breakfast," Live Science reached out to several experts who weren't involved with the new research.

The trouble with cholesterol

"There's always been a [suggestion in the data] that eggs can raise cholesterol and create cardiovascular harm," said Dr. Andrew Freeman, director of the Cardiovascular Prevention and Wellness program at National Jewish Health hospital in Denver. "The evidence is pretty clear that animal products, and high-cholesterol products, should be limited" in the diet, Freeman told Live Science.

Although some previous studies have failed to find a link between eggs, along with other forms of cholesterol consumption, and heart disease risk, the new study was able to thoroughly adjust for other foods in a person's diet in order to focus on the effect of eggs and cholesterol.

"This study does a good job of parsing the data and identifying dietary cholesterol as an individual and independent component of diet" that's linked with heart disease and mortality, said Dana Hunnes, a senior dietitian at the Ronald Reagan UCLA Medical Center in Los Angeles.

The apparent back-and-forth on egg recommendations has meant that "this had become a confusing topic to discuss with patients," said Dr. Seth Martin, a cardiologist and associate professor of medicine at Johns Hopkins University School of Medicine. "It is nice to get clearer data on this controversial topic to better inform future guidelines and our patients," Martin said of the new study.

Some of the confusion around cholesterol in the diet stems from two seemingly contradictory statements that appear in the 2015 dietary guidelines. On the one hand, the guidelines say that "cholesterol is not a nutrient of concern for overconsumption;" but on the other hand, the guidelines say that "individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern." [9 Disgusting Things That the FDA Allows in Your Food]

Freeman cited concerns about the influence of the agricultural and food industry over the guidelines as a reason for this contradiction, and the general downplaying of the link between dietary cholesterol and heart disease.

Hunnes agreed. "The USDA oversees both agriculture — including [the] egg industry — and dietary guidelines. They are not free from industry bias," she said.

Moderation is still important

Still, the findings don't mean that you have to shun eggs all together. As with any food, "everything in moderation" remains good advice, said Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City.

Limiting cholesterol may be particularly important for people already at risk for heart disease.

"Given the volume of heart disease and death from chronic diseases … in our country, I think that consuming fewer eggs on a weekly basis would behoove most people, and especially those with other [health conditions] and/or chronic diseases to start out with," Hunnes said in an email.

The authors pointed out that most of the cholesterol found in eggs is in the egg yolk, so egg whites are still on the table.

It's important to note that the study found only an association, and it cannot prove that eggs or cholesterol directly cause heart disease. In addition, the study assessed people's diets at a single point in time, not accounting for changes in a person's diet that may have occurred during the study period.

 

March 15th

THE 200-YEAR HISTORY OF THE ANTI-VAXXER MOVEMENT: FROM 'COWPOX FACE' TO AUTISM CLAIMS

THE ANTI-VAXXER MOVEMENT IS NOTHING NEW—IN FACT, IT’S AS OLD AS VACCINES THEMSELVES.

nti-vaxxers are in the news regularly—the World Health Organization even named vaccine hesitancy one of the ten biggest threats to global health in 2019.

But the anti-vax movement is nothing new—in fact, it’s as old as vaccines themselves.

1796: The smallpox vaccine is introduced

In the late 1790s, smallpox outbreaks devastated Europe, killing approximately 400,000 people a year and leaving many more blind or disfigured. Chinese medicine had recognized centuries earlier that survivors of smallpox subsequently became immune to the disease—in fact, as far back as the 9th century, healers inoculated patients by scratching smallpox scabs and blowing the powdered material up healthy patients noses.

Variolation, rubbing powdered smallpox scabs onto small scratches in the skin, was introduced in the West in the 18th century. It still involved exposing a healthy person to smallpox (and possibly other illnesses, like syphilis) but it had a much lower mortality rate than contracting smallpox naturally. That didn't stop vaccine denialists: When Cotton Mather promoted variolation in the Massachusetts colony, they threw bricks through his window and called him a child-killer.

It was Scottish doctor Edward Jenner who popularized the idea of infecting patients with the similar, but much milder cowpox virus to immunize them against smallpox. Jenner published his findings in 1796 and, by 1800, more than 100,000 people had  been vaccinated against smallpox in Europe. That same year, Harvard medical professor Benjamin Waterhouse performed the first vaccinations in the United States—on his children and servants.

Thus the modern-day vaccination was born—and so, too, was the anti-vax movement: One of the earliest bits of anti-vaxxer propaganda also appeared around 1800—a French cartoon of two men weilding a giant syringe and pulling a monster behind them, as a group of children run in terror. In 1802, the English engraving The Cow-Pock-or-the Wonderful Effects of the New Inoculationshowed newly vaccinated people sprouting cow heads from fresh injection sites, a reference to the pus taken from cowpox-ridden bovines that was used in smallpox vaccines at the time.  

Another English doctor, Benjamin Moseley, emerged as a prominent early anti-vaxxer: Moseley still endorsed variolation and this new treatment threatened his livelihood. In an 1806 essay, he claimed mixing cow matter into humans was a violation of natural law. He described fictional post-vaccination ailments like “cowpox face” and speculated that British women “might wander in the fields to receive the embraces of the bull.”

Other early anti-vaxxers argued that vaccinations perverted God’s will: In the 1850s, John Gibbs preached that there were a fixed number of diseases and if smallpox was eliminated, other illnesses like measles would occur more frequently. Gibbs also taught that, though often fatal, smallpox should be encouraged because it '"relieves the system of humours that ought to be carried out of it, and is a healthy process."

1853: The smallpox vaccine becomes compulsory in England

The Vaccination Act of 1853 made smallpox vaccinations mandatory for all infants under three months, levying fines and prison terms against parents who refused. It spurred anti-vax sentiment throughout the country: Violent riots broke out in Ipswich, Henley and Mitford. In London, the Anti-Vaccination League was formed.

After a 1867 law expanded mandatory vaccination to all children under 14, there was even more dissent—John Gibbs, long with his brothers Richard and George, founded the Anti-Compulsory Vaccination League that same year. A journal, the Vaccination Inquirer, was started in 1879 by the London Society for the Abolition of Compulsory Vaccination.

This time, the anti-vaxxers got their way: An 1898 act in Parliament removed cumulative penalties and introduced a “conscious clause” that allowed parents to opt out of vaccinating their children.

1870s: The American anti-vax movement gains momentum

British reformer William Tebb began spreading anti-vax propaganda to Americans in the 1870s, including the (fictitious) statistics that 25,000 British children were “slaughtered” each year because of vaccines and that 80 percent of smallpox deaths were among people who had been vaccinated. Tebb’s arguments encouraged anti-vaxxers in the U.S.: The Anti-Vaccination League of America held its first meeting in New York in 1882.

The American anti-vaxx movement was also galvanized by the proliferation of patent medicines and homeopathic “cures” in the mid-to-late 19th century. Laws were extremely lax: Anyone could call themselves a physician and make claim that lifestyle, diet and medicinal herbs were enough to ward off even the most serious diseases. Evidence-based, state-sponsored vaccinations programs directly threatened these snake-oil salesmen—and they fought hard against them.

Other anti-vaxxers had a more libertarian bent, viewing compulsory vaccinations as an intrusion on personal liberty. The 19th century was also an era of tremendouz urbanization in America and vaccinations became a flashpoint for fears about the dissolution of a more autonomous agrarian society.

1885: Up to 100,000 anti-vax demonstrators march in England

Throughout the 19th century, working class British parents continued to complain that mandatory vaccinations violated their right to make choices for their own family: In 1869, the Leicester Anti-vaccination League was formed. It proved so successful in sowing skepticism that the number of unvaccinated children in the city grew from seven in 1874 to almost 2,000 a decade later. In 1881, the MP for Leicester, P. A. Taylor, wrote an open letter titled Current fallacies about vaccination, and 200,000 copies were circulated.

Anti-vax books and journals advised parents on how to get around compulsory vaccinations. In 1885, nearly 100,000 demonstrators flooded Leicester to protest compulsory vaccination laws. They carried children’s coffins and beheaded an effigy of Edward Jenner.  

Anti-vax sentiment spread to former colonies, too: In 1885, a mob of more than a thousand people in Montreal gathered outside a provincial health board office—smashing windows, breaking doors and reportedly even firing guns—to protest mandatory vaccinations in Canada.

1905: Mandatory vaccinations ruled legal in the U.S.

By the early 20th century, around half of all states had vaccine requirements. But lack of enforcement meant that many unvaccinated children slipped under the radar. Minnesota legislators bowed to anti-vax pressure and passed a law banning compulsory vaccination for schoolchildren in 1903. That measure would be blamed for a smallpox epidemic in 1924 that saw 28,000 people infected. (Anti-vaxxers also succeeded in repealing compulsory vaccination laws in California, Illinois, Indiana, West Virginia and Wisconsin.)

After Swedish immigrant Henning Jacobson was arrested for defying Massachusetts’ mandatory vaccination laws, his case went before the Supreme Court. In a landmark 1905 ruling, the justices ruled against Jacobson—a Lutheran pastor—by holding up proof that vaccinations provided herd immunization and that states had the right to impose mandatory vaccinations for the greater good of the community. The ruling was balanced by outlawing forcible vaccinations, though, and resistance continued: In 1928, a group of visiting health officers were driven out of Georgetown, Delaware, by an armed mob of anti-vaxxers.

One of the most prominent leaders of the early 20th century anti-vaxxer movement was Lora Little, a mother who blamed the death of her only son on the smallpox vaccine. Hospital records indicate Kenneth Little died of diptheria more than six months after receiving his vaccination, but Little insisted “the artificial pollution of [his] blood,” had fatally weakened her son’s system.

Little claimed the American medical establishment was a tool of the U.S. government and that compulsory vaccinations set a dangerous precedent for the state to control people’s bodies. In 1898, she founded The Liberator, a monthly magazine that praised healthy diets an active lifestyles and condemned vaccines. Her 1906 book, Crimes of the Cowpox Ring: Some Moving Pictures Thrown on the Dead Wall of Official Silence , painted vaccine manufacturers as powerful and greedy and cataloged the stories of hundreds of American children she believed to be vaccine-injured. In 1916, while speaking with servicemen in North Dakota, Little told them to resist the vaccinations they were required to receive and was arrested for inciting mutiny under the Espionage Act.  

1970s: U.K. whooping cough epidemic 

Efforts during WWII led to the creation new vaccines, but anti-vax sentiment still flared up throughout the 20th century: In the 1970s, the diphtheria, tetanus and pertussis (DTP) vaccine was blamed for neurological conditions in some British children, even though numerous studies indicated ”no close association with their brain disease was possible.”

DTP vaccine adherence in the U.K. fell from 81 percent in 1974 to 31 percent in 1980, resulting in major pertussis (whooping cough) epidemics in 1977-79 and 1981-83. In 2012 the UK experienced another major pertussis outbreak, with more than 9,300 cases in England alone—more than ten times the average in recent years

1998: Lancet study links vaccines to autism

In 1998, British gastroenterologist Andrew Wakefield published a report liking the combination measles, mumps and rubella (MMR) vaccine—routine since the early 1970s—to autism and bowel disease in infants. But subsequent researchers were unable to reproduce Wakefield’s results and, in 2004, and investigation by the Sunday Times revealed he had fabricated his research.

The Lancet withdrew his report and Wakefield was barred from practicing medicine in the U.K., but he moved to America and doubled down on his anti-vax claims: He directed the anti-vaxxer propaganda film Vaxxed: From Cover-Up to Catastrophe in 2016, the same year he attended Donald Trump’s inauguration ball.

As recently as March 2019, a study of 600,000 Danish children determined there was no connection between the MMR jab and autism. But Wakefield’s research continues to fuel skepticism: A 2018 survey by Zogby Analytics revealed that nearly 20 percent of Americans believe vaccines are unsafe.

 

March 14th

Kidney disease Facts and myths

Ever think about your kidneys? Unless there's something directly wrong with them, we don't usually give them much thought. But kidneys are incredibly important – they filter our blood to make urine and remove waste from our bodies. But they don't always function correctly. Approximately 3 million people in the UK have kidney disease – that's a lot of people.

However, there are many misconceptions surrounding symptoms, treatments and who is at risk and general awareness of the disease is poor. As a result of this lack of understanding, many people with kidney disease are in the dark when it comes to what to expect, with up to a third (1 million) going completely undiagnosed.

Dr Charlie Tomson, consultant nephrologist at Newcastle Hospitals and Kidney Research UK Trustee, filters the facts from the fiction, so you can focus on getting the best from your kidney health:

Myth: you will know if you have kidney disease

Think you'll know when something is amiss? Think again. 'Kidney disease, in some cases, is a silent killer,' explains Dr Tomson. 'This is because symptoms often don't materialise until the disease is in its more severe stages. The human body is usually able to cope with a significant reduction in kidney function, and therefore, problems aren't always spotted early on.'

Dr Tomson outlines the key warning signs to be aware of that can characterise kidney disease:

·      Swollen ankles/ feet / hands

·      Shortness of breath

·      Blood in your urine

·      Fatigue

·      An increased need to go to the toilet

·      Back pain in the renal area

⚠️ If you are concerned about any of these symptoms seek medical advice as soon as possible.

 

Fact: there are multiple causes of kidney disease

Kidney disease has multiple causes, and often a combination of factors can lead to an individual developing it. 'In some cases, long-term conditions which put a strain on the kidneys, such as poorly controlled blood pressure and diabetes, are the root cause,' says Dr Tomson.

'Other potential factors which can trigger kidney disease include large kidney stones, glomerulonephritis (kidney inflammation), and injury to the kidneys.'

Fact: kidney disease varies in severity

There are in fact five stages of kidney disease, which are determined by how quickly the kidneys clean the blood. 'In stages 1 and 2, when kidney disease is caught early patients can go into remission after taking medication and amending their lifestyle choices,' says Dr Tomson. 'However, if a patient reaches stage 5 kidney disease, it usually means that they will need a transplant.'

Many people with kidney disease are able to live a normal life if they manage the condition.

'Due to this, it's really important to screen 'at-risk' people because treatment can delay the progression of kidney disease and even, in some instances, reverse its onset,' he adds.

'Many people with kidney disease are able to live a normal life, and just need to ensure they are managing their condition through regular check-ups, prescribed medication, a healthy diet and exercise.'

 

Myth: if you have kidney disease you will need dialysis

Kidney disease can vary greatly in levels of severity. 'Not everyone who is diagnosed will reach the stage in which they experience kidney failure and need dialysis,' explains Dr Tomson. 'Usually, our kidneys filter the blood, removing harmful waste products and excess fluid, and turning these into urine.'

'However, if you experience kidney failure, your kidneys might not be able to do this effectively, and therefore, dialysis can assist with this process,' he adds. 'Thankfully, only a small proportion of those with kidney disease will reach this stage.'

 

Fact: kidney disease can be linked to diet

What you eat plays a vital role in kidney health. 'Eating a healthy and balanced diet is important for all of us. However, when it comes to kidney disease, a good diet can have a huge impact on the disease and prevent complications,' explains Dr Tomson.

Staying at a healthy weight and eating a diet low in salt and fat can help control your blood pressure.

'Staying at a healthy weight and eating a diet low in salt and fat can help control your blood pressure, one of the main causes of kidney disease,' he adds.

'When kidney disease reaches its later stages, patients are likely to work closely with a dietitian to help manage their symptoms

Myth: only the elderly get kidney disease

You should take good care of your health at any age. 'Kidney disease is commonly associated with getting older, however, it's important to note that anyone at any age can get kidney disease,' says Dr Tomson. ;Therefore, everyone should be aware of the signs and symptoms, eat a healthy diet and exercise regularly.'

Myth: you can cure kidney disease

Once kidney disease has reached a chronic stage, unfortunately there is no cure. 'The aim of treatment is to help manage the disease by controlling symptoms, reducing complications and slowing progression,' explains Dr Tomson.

it's essential to exercise regularly, eat a healthy diet, reduce salt intake and keep blood sugar low.

'Although most people who have kidney disease will need to take medicine to manage it, it's essential that these people also exercise regularly, eat a healthy diet, reduce their salt intake and keep their blood sugar low.

When kidney disease becomes chronic, dialysis or a kidney transplant can be the only options.'

 

March 13th 

Parents reminded to avoid honey in babies

Parents are being reminded not to feed honey to babies after three cases of botulism in the past year.

Children under the age of one year are unable to fight off the botulism bacteria which can cause serious illness and lead to paralysis, The Food Standards Agency warned.

Some parents may be tempted to use honey as a sweetener, it said.

There have been only 11 confirmed cases of infant botulism in the past 30 years.

A statement from the FSA said the illness was "rare but serious".

Although it might be tempting to give honey to your baby to ease coughs, infant botulism is a very serious illness and it simply isn't worth the riskSam Montel, Nutritionist, FSA

The three cases that have occurred in the past year have all had possible links to honey.

The most recent case involved a 15-week-old baby.

Toxin

Botulism is caused by a germ which normally lives in a dormant form in soil and dust and occasionally gets into honey.

In a baby's undeveloped intestine it can grow and produce a toxin or poison, leading to infant botulism.

For this reason, parents have long been advised not to give honey to babies under one year.

Although infant botulism is incredibly rare, it is a serious illness that causes muscle weakness and breathing problems, often resulting in hospital treatment.

Sam Montel, nutritionist at the Food Standards Agency, added: "For around the first six months babies only need breast milk or infant formula and although it might be tempting to give honey to your baby to ease coughs, infant botulism is a very serious illness and it simply isn't worth the risk.

"Once introduced to solid foods, it's always best to avoid sweetening your baby's food or giving them sugary snacks and drinks, this will help stop them developing a sweet tooth and tooth decay."

March 11th

High cholesterol: symptoms, treatment and prevention

Concerned about your cholesterol level? We look at the causes and treatments for this growing problem.

Concerned about your cholesterol levels? While cholesterol plays a vital role in your body, too much bad cholesterol can increase your risk of heart and circulatory diseases.

We speak to Dr Riccardo Di Cuffa, GP and founder of Your Doctor, about the causes and consequences of high cholesterol, as well as treatments and preventative measures:

What is cholesterol?

Cholesterol is a fatty substance made in the body by the liver, but it is also found in some foods, including eggs, cheese, shellfish and fatty meats. It is carried in the blood attached to proteins, called lipoproteins.

Cholesterol plays a vital role, but too much bad cholesterol can increase your risk of heart disease.

There are two main forms of cholesterol – low density lipoprotein (LDL) and high density lipoprotein (HDL). Too much LDL (‘bad’) cholesterol is unhealthy, while HDL (‘good’) cholesterol is actually protective.

Good cholesterol plays a vital role in every cell of your body, whereas too much bad cholesterol in the blood can increase your risk of getting heart and circulatory diseases. 

What are the causes of high cholesterol?

Unhealthy blood cholesterol can be genetic, meaning you can inherit it. However, it can be caused by poor diet and lifestyle choices, including eating foods high in trans fats, smoking and not exercising.

Your age, ethnicity, medical history and even sex can also influence how likely you are to have high cholesterol.

What are the symptoms of high cholesterol?

You can have high cholesterol without any symptoms at all. However, associated symptoms include:

·      Chest pain

·      Angina

·      Heart attack

·      Stroke

·      Pain while walking - caused by blocked arteries that are unable to send blood to the legs.

What counts as high cholesterol?

The amount of cholesterol in your blood – both HDL and LDL – can be measured with a blood test.

Generally, total cholesterol levels should be 5mmol/L or less for healthy adults, or 4mmol/L or less for those at high risk.

LDL levels should be 3mmol/L or less for healthy adults, or 2mmol/L or less for those at high risk. Too low a level of healthy cholesterol (HDL) can also increase your risk of heart disease.

Getting your cholesterol level checked

Your GP may recommend that you have your blood cholesterol levels tested if you have been diagnosed with a heart condition or have had a stroke, have a family history of early cardiovascular disease or a cholesterol-related condition, are overweight, have high blood pressure, or have diabetes.

You should have a full blood test every five years from when you are 20 years old and then at least every one or two years after 45 years, depending on your risk factors. If you are already known to have high cholesterol, you should be re-tested annually if you are making lifestyle changes to reduce your cholesterol.

Treatments for high cholesterol

If you have been diagnosed with high cholesterol, you will usually be advised to make changes to your diet and increase your level of exercise.

If after a few months, your cholesterol level hasn't dropped or it is severely high at your initial blood test, you may be advised to take cholesterol-lowering medication, such as statins.

There are plenty of things you can do to help lower your cholesterol or to help prevent high cholesterol developing, including changing your diet, cutting down on alcohol, stopping smoking and doing regular exercise.

The best way to manage your cholesterol is through your diet, and making positive lifestyle changes will help, too. Here are the best ways to lower your cholesterol:

✔️ Follow a healthy diet

Eat healthy proteins for breakfast and the right fats (such as monounsaturated and polyunsaturated fats), found in foods such as salmon, avocado, nuts, seeds and olive oil.

✔️ Skip the sugar

Reduce the amount of sugar in your diet, and limit your intake of foods full of saturated fats and trans fats.

✔️ Sidestep processed meats

Swap processed meats for omega-3-rich fish, such as salmon, sardines, herring, mackerel and trout at least twice a week. Oily fish contains huge amounts of omega-3fats, helping to reduce inflammation, which helps to protect against chronic diseases such as heart disease and arthritis.

✔️ Eat plenty of fruit and veg

Eat around 7-10 portions of fruit and vegetables every day. This will mean your body is absorbing the amount of vitamins and minerals needed to help your body fight against the absorption of bad cholesterol. Antioxidant-rich blueberries are thought to help lower LD cholesterol, for example.

✔️ Don't forget fibre

Eat more soluble fibre, to reduce the absorption of cholesterol into your bloodstream. You can get fibre from foods such as wholemeal bread, bran, oats, potato skins, fruit and vegetables. It’s recommended that you eat at least 30g a day.

✔️ Manage your weight

If you’re overweight, take steps to lose weight to reduce your risk of developing heart disease. Losing excess weight is beneficial for all sorts of reasons, from improving your cholesterol profile to preventing type 2 diabetes, high blood pressure, heart attacks, strokes and cancer.

✔️ Take regular exercise

Exercise can increase your HDL (good protective cholesterol) by four to five per cent, as well as helping you lose weight if you need to.

✔️ Manage stress in your life

Stress can cause an increase in bad cholesterol indirectly, as you are more likely to eat unhealthily and have a higher body weight if you suffer from excessive stress over a long period of time. Try not to overwork or overload yourself, in order to protect yourself from developing heart disease.

 

March 10th

Can You Learn Anything While You Sleep

There are only 24 hours in a day, and usually about a third of that is spent sleeping. So, the overambitious have always wondered: Is it possible to make use of this time and learn a new skill or even a language? In other words, is sleep learning possible?

The answer is yes and no, depending on what we mean by "learning."

Absorbing complex information or picking up a new skill from scratch by, say, listening to an audio recording during sleep is almost certainly impossible. But research shows that the sleeping brain is far from idle and that some forms of learning can happen. However, whether that's worth losing sleep over has yet to be determined. [Why Can't We Remember Our Dreams?]

Sleep learning: From sham to science

The concept of sleep learning, or hypnopedia, has a long history. The first study to demonstrate a memory and learning benefit from sleep was published in 1914 by German psychologist Rosa Heine. She found that learning new material in the evening before sleep results in better recall compared to learning during the day.

Thanks to many studies done since then, we now know that sleep is crucial for forming long-term memories of what we have encountered during the day. The sleeping brain replays the day's experiences and stabilizes them by moving them from the hippocampus, where they are first formed, to regions across the brain. Given that so much is happening to memories during sleep, it's natural to ask if the memories can be altered, enhanced or even formed anew.

One popular approach to sleep learning was Psycho-phone, a popular device in the 1930s. It played out motivational messages to sleepers, such as "I radiate love," supposedly helping the people absorb the ideas in their subconscious and wake up with radiant confidence.

At first, it seemed that research backed up the idea behind devices like Psycho-phone. Some early studies found that people learned the material they encountered during sleep. But those findings were debunked in the 1950s, when scientists began to use EEG to monitor sleep brain waves. Researchers found that if any learning had happened, it was only because the stimuli had woken the participants. These poor studies launched sleep learning into the trash can of pseudoscience.

But in recent years, studies have found that the brain may not be a total blob during sleep. These findings suggest that it is possible for the sleeping brain to absorb information and even form new memories. The catch, however, is that the memories are implicit, or unconscious. Put another way, this form of learning is extremely basic, much simpler than what your brain has to accomplish if you want to learn German or quantum mechanics.

Still, these findings have elevated sleep learning from the category of pipe dreams and put it back on scientists' radar.

"For decades the scientific literature was saying sleep learning was impossible. So, even seeing the most basic form of learning is interesting for a scientist," said Thomas Andrillon, a neuroscientist at Monash University in Melbourne, Australia. "But people are not really interested in this basic form of learning."

For scientists, the recent discoveries have raised hopes about possible applications, Andrillon told Live Science. For example, the implicit nature of sleep learning makes the phenomenon useful for people who want to shed a bad habit, like smoking, or form new good ones. [Why Is It So Hard to Quit Smoking?]

Rotten eggs and smoking: Making associations

Multiple studies have found that a basic form of learning, called conditioning, can happen during sleep. In a 2012 study published in the journal Nature Neuroscience, for example, Israeli researchers found that people can learn to associate sounds with odors during sleep. The scientists played a tone to sleeping study participants while unleashing a nasty spoiled-fish smell. Once awake, upon hearing the tone, the people held their breath in anticipation of a bad smell.

"This was a clear finding showing humans can form new memories during sleep," said Andrillion, who was not involved in that study.

Although the memory was implicit, it could affect the people’s behavior, researchers found in a 2014 study published in the Journal of Neuroscience. In that research, smokers used fewer cigarettes after spending a night being exposed to the smell of cigarettes paired with rotten eggs or spoiled fish.

"Guga" means elephant: Learning languages during sleep?

Andrillon and his colleagues have found that learning in sleep can go beyond simple conditioning. In their 2017 study published in the journal Nature Communications, subjects were able to pick out complex sound patterns that they had heard during sleep.

Learning abilities in sleep may extend to the learning of words. In a study published in the journal Current Biology in January, researchers played pairs of made-up words and their supposed meanings, like that "guga" means elephant, to sleeping participants. After this, when awake, the people performed better than chance when they had to pick the right translation of made-up words in a multichoice test.

What all these studies have in common is that they show an implicit form of memory. "It's not some knowledge they'll be able to use spontaneously, because they don't know this knowledge is even there," Andrillion said. "The question is, 'Where do we go from there?'"

Learning a new language involves many different layers: recognizing the sounds, learning the vocabulary and mastering the grammar. So far, research suggests it may be possible to get familiarized with the tone and accent of a language or even the meaning of words while sleeping, but to a weaker level than what we already do all the time during the day without noticing. [Why Don't We Remember Being Babies?]

And then you have to consider the cost, Andrillion said. Stimulating the sleeping brain with new information likely disrupts the functions of sleep, negatively affecting the pruning and strengthening of what we have learned over the previous day, he said.

While losing quality sleep to potentially learn a few words is not a smart trade-off, researchers continue to study sleep learning because the compromise may be worth it in special cases. For example, sleep learning could be useful when people need to change a habit or alter stubborn disturbing memories in cases of phobias and post-traumatic stress disorder.

And some forms of implicit learning that may help in those situation may occur more strongly during sleep. The conditioning that happened in the smoking and rotten egg study, for example, doesn't work well when done during wakefulness. If you smoke every day near a garbage bin, you know the two are unrelated, so you don't link them. We are not easily tricked when awake.

"But the sleeping brain is not so smart, and we can manipulate it for our own good," Andrillion said. "It sounds a lot like the 'Eternal Sunshine' [movie], and this is still ongoing work, but the possibility is there."

Until then, remember that a good night's sleep is already sleep learning at its best.

March 7th

4 Women Share The Reality of Living with Endometriosis Symptoms

March 2019 is Endometriosis Awareness Month – a chance to increase the conversation around this common but painful and often debilitating condition. Affecting an estimated 10% of women, it's the result of the tissue that lines your uterus growing elsewhere – typically in your pelvic region, think places such as your ovaries or fallopian tubes.

At WH, we're focusing in on opening up the conversation around the condition. Here, four women dealing with the condition fill us in on their coping strategies.

Despite affecting around 1.5 million women in the UK, endometriosis remains an untalked about women’s health issue. Which means? 1.5 million women are suffering the debilitating endometriosis symptoms, often in silence.

Ever since Lena Dunham opened up about her endometriosis, people have started acknowledging about the condition and making moves to find cures. A study published in Reprod Health in May stressed just the importance of filling the gaps in Western medicine for adequate treatment of endometriosis. Shortly after, in July in the USA, the FDA approved the first ever treatment for endometriosis symptoms, a drug called elagolix.

Yet in the UK there is no such drug, and even the NHS website admits 'there's no cure and it can be difficult to treat'. As a result, millions of women across the rest of the world are still struggling daily with the pain and suffering that endometriosis can bring.

'Delayed diagnosis is a significant problem for many women with endometriosis leading them to years of unnecessary distress and suffering,' says Professor Mark Baker, Director of the Centre for Guidelines at NICE. 'The condition is difficult to diagnose as symptoms vary and are often unspecific. However, once it has been diagnosed, there are effective treatments available that can ease women’s symptoms. This guideline will help healthcare professionals detect endometriosis early, to close the symptom to diagnosis gap and to ensure more timely treatment.'

Common endometriosis symptoms

As endometriosis is a condition where cells, like the ones in the lining of the womb, are found elsewhere in the body symptoms vary from woman to woman. Most commonly they include:

·         Pelvic and lower back pain

·         Bloating

·         Diarrhoea

·         Painful bowel movements

·         Urinary urgency issues (read: peed my pants all the time)

·         Fatigue

·         Painful sex

But the tides are turning on suffering in silence thanks to an increasing number of you speaking up and sharing your experiences of endometriosis symptoms.

Here, four women do just that – talking about their own endometriosis symptoms, plus the endometriosis treatments, endometriosis diet recipes and endometriosis strategies they’ve tried and tested to help manage them, and to stop them from controlling their lives.

The reason they’ve come forward? Like many of you, they’re fed up with living in the shadows. They want to make sure women with endometriosis symptoms know that there are people out there who understand what they’re going through – and who care. No one should have to cope with endometriosis symptoms on their own, after all.

Hoe 4 women deal with endometriosis symptomsHOW TO DEAL WITH ENDOMETRIOSIS SYMPTOMS AS: A NETWORKER

Jaimee McCormack, 28, Cardiff

Endometriosis symptoms hero: Holistic therapies

'Since being diagnosed with endometriosis, I’ve come across so many other women with the condition, who have given me inspiration and support. I wish I’d met them sooner because for 14 years, I felt isolated and alone with my endometriosis symptoms.

For me, endometriosis goes straight for my bowels and stomach – I suffer from sickness and diarrhoea on a regular basis, and struggle to keep weight on. It feels like I’m being stabbed with hot knives and, when I ovulate, and am on my period, I’ll be bent double with cramping and also struggle for breath.

For years, I just accepted that this was how my life would be. I lost friends, boyfriends and jobs because I was often in so much discomfort all I could do was lie in a hot bath. People don’t know what endometriosis is – my current partner thought it was a Harry Potter spell – and because no one talks about it, it’s hard for non-sufferers to understand what it’s really like to experience endometriosis symptoms.

It’s also frequently misdiagnosed for other conditions. I was told I had IBS, for example, or a bad case of food poisoning, or that I’d drunk too much on a night out. When I left home after school, I was even told my symptoms were simply a case of being homesick. It’s hard not to feel like a scrap of paper, when you’re being passed from doctor to doctor.

But when I was 23, I started to end up in hospital with my endometriosis symptoms a little too often for my liking. I decided to try acupuncture and it was my therapist, who suggested I be tested for endometriosis. It was two years before the condition was finally confirmed. After years of being told my symptoms weren’t real, it came as a huge relief.

Since then, I’ve taken everything from hormone tablets to morphine. At one point, I was on 28 tablets a day. Who wants to live like that long-term? That’s why, in the past year, I’ve started to cut back on the medication and replace it with therapies such as acupuncture, reiki and havening, a form of hypnotherapy. I’ve also cut out dairy, meat and sugar, although that’s a challenge – because I love chocolate.

I believe it’s time people treated women’s health issues with more respect, which is why I spray painted a wall outside my house with the phrase #endometriosisexists. I wanted to raise awareness of the condition and let other women know that they are not alone. Pictures of my EndoWall quickly went viral and from knowing just a handful of other women with endometriosis, I’m now in touch with more than 300. I’ve started to host regular EndoMeets to bring women with the condition together and to give them a safe space to share their experiences, and I’m planning another EndoWall, too.

Endometriosis robbed me of my life for too many years but, by speaking out about the condition, I hope I can stop it from doing the same to other women like me.'

Jaimee’s next EndoMeet will be taking place on 10 March at Cathays Sports and Social Club, Cardiff. Doors open from 4pm.

HOW TO DEAL WITH ENDOMETRIOSIS SYMPTOMS AS: AN ENTREPRENEUR

Bridie Appleby-Gennill, 32, Dorchester

Endometriosis symptoms hero: Plant-based eating and stress reduction

'The first time I had a period, aged 10, I thought I was going to die. It was like a scene from a horror film; I’ve never seen so much blood. My periods didn’t get much better after that. But I was told to suck it up – women have periods. Period. The bleeding would be so heavy I would soak through an extra-large sanitary towel in half an hour.

Which gets pretty expensive when goes on for three weeks, and is accompanied by anaemia, bad bowel pains and stomach cramps. It made school life tough – the other kids didn’t understand why I couldn’t join in with sport; the teachers thought I was acting up by continually asking to use the toilet. It was easier to be homeschooled by my mum.

I started taking the Pill, running packs together, to ease my symptoms when I was 14 – sometimes it stopped my period; other times it didn’t. What was certain, though, was the excruciating pain; that never went away. It wasn’t until I was 17 that I was diagnosed with endometriosis.

Although it was a relief to finally know what was wrong, the treatments that followed were far from good – an induced medical menopause, hormone injections, laser surgery to remove the endometriosis, which was in my pelvic area and around my bladder and bowels. I didn’t know who I was anymore. I felt stripped of everything that made me, me: my femininity, my sexuality, my strength.

RELATED STORY

5 Signs you Might have Endometriosis

 

So I decided to quit it all. I’d done a lot of reading into plant-based living and the benefits it can have for endometriosis symptoms. Overnight I gave up processed foods, meat and coffee, and switched to wholegrains, vegetables and chamomile tea. It was hard but it worked – over the next few years, the inflammation went down and everything got better.

There have been flare-ups since then – a couple of years ago I was diagnosed with adenomyosis, which is when you have endometriosis in your womb; and I also passed out at work and was taken to hospital in an ambulance – but since I took control of the condition, as opposed to let it control me, I feel like I’ve regained my identity.

Now, when I feel that burning heat coming – the sign of a flare-up – I retreat to a soothing bath. I’ll put lavender and bay leaves in it, plus Epsom salts to ease the cramping. I light a candle and then lie there, watching films back to back. People know when I’m at my worst now, because I go off the radar for a few days.

Stress is a big trigger for my endometriosis symptoms so I’m working hard to cut it out. I find the deep breathing of kundalini yoga helps and last year I left a demanding job. It was scary but it’s given me the space to set up my own business – which I can fit in around my flare-ups. I now sell vegan, organic, aromatherapy candles and nurturing gift boxes for women to help ease their endometriosis symptoms.

For me, embracing my illness and turning it into a positive has been the key to finding freedom from it.'

To purchase Bridie's candles and find out more, visit thewellbeingwarrior.life.

HOW TO DEAL WITH ENDOMETRIOSIS SYMPTOMS AS: A MOTHER

Saskia Boujo, 39, London

Endometriosis symptoms hero: Surgery

'Bent double, lying on the bathroom floor, waiting for the painkillers to kick in – that’s how I remember the onset of my period most months. I found the only way to cope with the excruciating agony was to dose up on medication and stay glued to a burning hot, hot water bottle. My mum had experienced painful periods so I just thought that what I was going through was normal. Periods weren’t a topic that I discussed with my friends, so why should I have any reason to think otherwise?

But in 2011, enough was enough. It suddenly dawned on me that I was getting through packets of painkillers each month, my period was impacting on my social life and my career (I was a teacher at the time), and sex was not the enjoyable experience it should be. In fact, any activity that involved my pelvic area – including exercise – left me motionless and in pain. I knew I wanted children at some point so I booked an appointment with a gynaecologist to get myself checked out.

That’s when I was told that what I was experiencing were endometriosis symptoms.

RELATED STORY

Endometriosis vs PCOS: what’s the difference?

 

I had no idea what that meant but was at a stage where I was willing to do whatever was needed to get rid of the pain. For me, that meant a laparoscopy. But when I came around from the anaesthetic, I knew it hadn’t been as routine as the doctors had hoped.

In moments, the whole question of my fertility was over. I was told that the endometriosis had blocked my fallopian tubes, that they would need to be removed, and that I was infertile. Nothing can prepare you for that. For months, I mourned my loss. But I knew I was fortunate to still have eggs and a womb, meaning IVF was still an option. And, following the operation, my periods were completely pain-free.

My now ex-partner and I underwent IVF at The Lister Fertility Clinic and were successful the first time – our daughter Elise was born in 2012. I’ve since had further IVF treatment – with my now husband – and, despite having many failed attempts, we have two more beautiful girls, Uma, two and Lucille, five months.

Being able to have a family is a right that everybody should have. Some women with endometriosis symptoms do manage to conceive naturally and I’m sure that if I hadn’t been so brave to the pain and had got myself checked earlier, then perhaps I might not have had the problems conceiving that I did. But endometriosis isn’t a straight forward condition. There isn’t one symptom that makes it stand out – and it can be symptomless. And it’s easily confused with period pains – especially as so few women talk about it.

If there’s one thing I’ve learnt, it’s that if you experience any pain that doesn’t feel quite right, go and get it checked out. It’s important to listen to what your body is trying to tell you and remember that periods and women’s health issues aren’t taboo.

I’m determined that my girls will not go through the unnecessary agony that I did for so long. We owe it to future generations to be open. Together, we can break the stigma.'

Saskia runs mybeehive.co.uk, a website dedicated to supporting women through IVF. The Lister Fertility Clinic is part of HCA Healthcare UK.

HOW TO DEAL WITH ENDOMETRIOSIS SYMPTOMS AS: AN AUTHOR

Jessica Murnane (@jessicamurnane), author of One Part Plant Cookbookand founder of Know Your Endo

Endometriosis symptoms hero: Plant-based diet

'Like many women, it took a long time to be diagnosed with endometriosis.

For 10 years, I suffered with the symptoms. I never connected the dots, I thought these were just things that were 'normal' to my body.

But every day, I woke up in chronic pain. I was depressed. It impacted my relationships, my work. I tried conventional painkillers, yoga and therapy – nothing worked. So, seven years ago, my doctor recommended I have a hysterectomy at 33.

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How to eat for Endometriosis

 

Then a friend found a website, that talked about how a plant-based diet could help endometriosis symptoms. She suggested I give it a try. I really had zero faith that the diet would work but I committed to try to it for three weeks, knowing in the back of my mind, if it didn’t work, I'd just get the surgery.

Almost seven years later I'm still eating a plant-based diet and never got the hysterectomy.

I noticed results quickly. I could get up without pain, had more energy to exercise and felt happier than I had in ages. There is no cure for endometriosis – I have to manage my symptoms everyday, although 80% of them have disappeared.

Every single body is different, but no one can deny, inflammatory foods are our friends. Try swapping one of your meals each day to a plant-based, endometriosis diet-friendly one and go from there.'

Jessica's book One Part Plant: A Simple Guide to Eating Real, One Meal at a Time(£16.99, Bluebird) is out now. You can also find more information about endo and diet lifestyle tools at Know Your Endo.

 

March 3rd

People with the rare and fatal brain disorder Creutzfeldt-Jakob disease (CJD) show signs of the disease in their eyes, according to a new study.

The study found evidence of prions — the infectious proteins that cause the disease — in the eyes of nearly a dozen patients with CJD.

The findings suggest that patients' eyes could potentially provide a "window" to the brain that may help researchers diagnose the disease early, if new eye tests are developed. ['Eye' Can't Look: 9 Eyeball Injuries That Will Make You Squirm]

The results also raise concern about the potential for the disease to spread through routine eye exams or eye surgeries, during which equipment could become contaminated with prions, the researchers said.

The study, which was conducted by researchers at the National Institute of Allergy and Infectious Diseases, the University of California at San Diego and UC-San Francisco, was published yesterday (Nov. 20) in the journal mBio.

Prions in the eyes

Creutzfeldt-Jakob disease is a progressive neurological disorder that affects only about 1 in a million people worldwide each year, according to the National Institutes of Health (NIH). The disease, which is related to "mad cow disease" in cows, is caused by prion proteins that fold abnormally, leading to lesions in the brain.

The most common form of CJD is sporadic, which means that the disease does not appear to have a genetic or an environmental cause.

There is no treatment or cure for CJD, and the condition usually results in death within one year of diagnosis.

Previously, a small number of patients with CJD were found to have prions in their eyes. But it was unclear how common this occurrence was, or how widespread the prion proteins are throughout the eye. In addition, these earlier studies were done before the development of more sensitive tests for prions that are available today.

In the new study, the researchers analyzed the eyes of 11 patients who died from sporadic CJD and agreed to donate their eyes for research. The study is the largest to date to examine CJD patients' eyes for prions.

The researchers detected prions in the eyes of all 11 patients. What's more, they found prions in all eight regions of the eye that were tested, including the eye's cornea, lens, ocular fluid, retina, choroid (a part of the eye that contains blood vessels and connective tissue), sclera (the white of the eye), optic nerve (which connects the back of the eye to the brain) and extraocular muscle (which controls eye movement.)

The highest levels were found in the retina, the area of light-sensitive cells located at the back of the eye. In some cases, levels of prions in the retina were close to those seen in the brain, the researchers said.

New diagnostic test?

Currently, the only way to confirm a diagnosis of CJD is to test a sample of brain tissue after a person's death. But there are ways to diagnose probable or suspected cases while a person is alive, using analyses of the brain's electrical activity, brain scans or tests for prions in the cerebrospinal fluid.

Still, CJD remains difficult to diagnose, in part because the disease can cause a variety of symptoms, and the symptoms may resemble those of other, more common conditions. (Early symptoms can include anxiety, depression, memory loss, personality changes, vision problems, insomnia, impaired thinking and problems with muscle coordination, according to the Mayo Clinic.)

Given that high levels of prions were found in the retina, this finding "could potentially be exploited for the early diagnosis of prion disease" with certain eye tests, the researchers said. For example, an eye test that measures electrical responses in the cells in the retina may show abnormalities in people with CJD, the researchers hypothesized. Further studies would be needed to investigate how this test or other eye tests might be used to diagnose CJD.

The researchers also note that about 40 percent of patients with CJD experience eye symptoms, sometimes early in the course of their illness. Such eye symptoms might lead patients to have an eye exam, which, in turn, could lead to contaminated equipment that might spread the disease. The new finding "bolsters recommendations for single-use instruments or other decontamination procedures" following eye exams in patients with CJD, the researchers said.

 

Mar 1st

Crohn's and colitis explained

After seeing the toll that Crohn’s disease has taken on Dynamo, forcing the magician to put his career temporarily on hold, and with Jeremy Corbyn seen in late 2018 sporting a Crohn's and Colitis UK badge in parliament, interest surrounding the two illnesses have surged, but what exactly are they?

A form of Inflammatory Bowel Disease (IBD), Crohn’s is a chronic condition that causes inflammation in the digestive system, leaving sufferers with myriad symptoms that can severely inhibit their daily lives if not treated with the right medications. Colitis is similar in terms of symptoms and treatment, but one key difference is that it only affects the large intestine, whereas Crohn's can affect any part of the digestive tract.

According to Crohn’s and Colitis UK, there are at least 300,000 Britons diagnosed with an IBD and while symptoms are treatable, there are currently no known cures.

What are the symptoms?

Symptoms vary but can include diarrhoea, extreme fatigue and severe pain. They usually begin in childhood or early adulthood, according to the NHS.

In some cases, such as Dynamo’s, medications for Crohn’s can cause additional side effects, such as weight gain and arthritis.

So long as symptoms are controlled with appropriate medications, living with Crohn’s can be manageable.

However, symptoms can flare-up at sporadic intervals which can subsequently affect your work and social life.

How is it treated?

While the illness is currently incurable, it is often treated via medications designed to reduce inflammation in the digestive system, such as steroids.

Sometimes surgical action is necessary to remove a small part of the digestive system.

What is the cause?

The exact cause of Crohn’s is currently unknown, however, medical professionals speculate that contraction might have something to do with genetics or a defect in the immune system.

In terms of lifestyle choices, the NHS website states that smoking might also have a role to play, however, there is no evidence to suggest that a specific diet can cause the condition.

How is it diagnosed?

If you are experiencing symptoms such as prolonged diarrhoea, frequent stomach aches and unexpected weight loss, you are strongly advised to see a GP, who will be able to conduct tests to check for Crohn’s.

However, due to symptoms being similar to a plethora of other medical conditions, diagnosis for Crohn’s can be difficult and often delayed. 

Therefore, suspected sufferers who visit their GP may also be referred to a gastroenterologist who may then conduct a number of additional specialist tests such as an MRI scan, a colonoscopy and/or a biopsy - in which small pieces of the bowel are removed and subsequently examined.

 

Feb 25th

Who doesn't want to return to their childhood, with no adult responsibilities, bills to pay or nine-to-five to go to. But we forget how stressful childhood can be, and today more so than ever. YoungMinds, the children's mental health charity, says that a worrying 1 in 10 children and young people aged 5 - 16 suffer from a diagnosable mental health disorder, like stress, depression and anxiety – that's around three children in every class and the numbers look set to keep on rising.

Young people, like adults, experience stress, which can come from a variety of sources from bullying, sibling rivalry, parents getting divorced, moving house and peer pressure. These are all fairly normal parts of growing up, but because children now have less down time and expectations are so high, these ordinary problems can become magnified and less easy for them to deal with. Carole Spiers, Chair at the International Stress Management Association says, 'Parents are not trained to be parents and particularly in 2016, it's not an easy time to be a mum or dad

because there are so many distractions and probably 40 years ago it was that much easier. Parents need support, they need guidance and they need help.'

Here's how to spot the signs that something might be wrong in your children:

1. They want to skip school

It's no surprise to hear your child doesn't want to go to school the odd day, but if it becomes more frequent be aware that perhaps there's an underlying reason why they want to stay at home. So many things can cause of stress at school – exams, schoolwork, socially fitting in and at worst bullying.

Geraldine Walford, a consultant in child and adolescent psychiatry Dr Morton's – the medical helpline says that they may be stressed due to being at a different learning pace than others in their class. They may be very bright but a bit slower in reading for instance: 'They can easily be made to feel stupid and this puts them under great stress and they can start to be negative about school. Boys in particular can have problems with this and it can affect how they feel about other subjects too.'

2. Their grades are slipping

Another tell-tale sign of stress is how their grades are. If they used to be getting As and Bs and they start getting Cs and Ds, then ask yourself why. Carole says

'You don't just go from a grade A to a grade D, it doesn't just happen overnight. Watch the grades, watch their efforts, speak to the teachers and attend all parents evenings Make time to go into school.

Children can also feel huge pressure from their parents and teachers during exam time. A recent study carried out by the NSPCC found that academic worries were the biggest cause of stress for nearly 50% of children: 'I remember working at the Samaritans and having a child of 12 who was feeling suicidal, purely because the expectations of them was so high and they knew they hadn't done well in their grades and they didn't have the courage to speak to their parents. We had to intervene and speak to the parents who didn't realise they were putting so much pressure on their child.'

Gallery: 19 Natural Remedies for Anxiety [Health.com]

3. Their eating habits have changed

As with adults a big indicator of stress is how you relate to food. It can go two ways: a child can overeat, where they use food as a comfort or they can undereat and lose interest in eating altogether. Geraldine says: 'When you're a bit older, say aged nine or 10, food can be a real comfort, particularly when they can nip into the shop on the way home. Of course it doesn't help because they can put on weight and get bullied. It can also work the other way around where your child doesn't want to eat at all.'

4. They say they feel physically ill

Understand that 'feeling sick' may be caused by stress. Stress can appear as physical symptoms, such as headaches and tummy aches. If this happens more frequently or increases in certain situations, like before an exam, the child may be experiencing stress. They may also show their stress in physical behaviour, such as being more jumpy and less able to settle down.

5. They don't sleep through the night

Children who are suffering from stress often have poor sleep – they don't sleep through the night, have difficulty getting off or at worst wet the bed. When a child isn't getting enough sleep everything manifests as it does with adults and it's often difficult to cope with everyday situations. If they appear sleepy or more tired the following day, consider how many hours downtime they're getting: 'Modern technology plays such a big part in this. Your child may be taking their phone and iPad into bed with them and it maybe stopping them from sleeping. As wonderful as modern technology is, it needs to be monitored.'

6. They have a negative outlook

Does your child appear sad and unhappy? Look at their behaviour and perhaps they're misbehaving to get your attention – but not even on a conscious level, says Geraldine. In a child who isn't usually badly behaved, it's an indicator.

Carole says that often a parent doesn't know what their child is getting caught up with, especially if they're working full time. 'You need to know the behaviour in your child normally to recognise any changes. It's often not what's being said that's important, but what's not being said.'

What to do if your child is suffering from stress

Carole says it's so important to listen to your child – often people don't ask them if there's something wrong and if you do, they may say 'nothing' but sometimes in order to get kids to talk, it's useful to spend individual time with them and get them to open up.

'Bake a cake, build some Lego, ask them general questions – like who sits next to you. Connect with them – they will open up when they have your individual attention.'

If you feel something is wrong, the first port of call would be to speak to your GP. Sometimes a child may be reluctant to go to the doctor, but you can go on a child's behalf and talk about it initially.

For parents who are finding it hard to cope and are concerned, YoungMinds runs a Parents Helpline (0808 802 5544), which offers information and advice to any adult worried about the emotional problems, behaviour or mental health of a young person up to the age of 25.

 

Feb 24th

Immune system discovery could lead to preventative drugs for allergies

The immune system is incredibly important, thanks to its role in fighting off dangerous invaders in our bodies. But sometimes it gets it wrong, targeting harmless proteins from things like nuts or dairy products and triggering allergic reactions that ironically can themselves be fatal. Now, researchers from Michigan State University have identified a mechanism that helps keep the immune system in check, potentially paving the way for drugs that could prevent allergic reactions before they start.

Currently, our best methods for dealing with allergies are just to avoid triggering substances, or failing that, using an EpiPen to lessen the reaction. But possible future treatments could include probiotics that keep allergens from getting into the bloodstream, skin patches that slowly desensitize the immune system to the offending proteins, nasal sprays that act like allergy vaccines, or even gene therapy injections that "turn off" the allergic response.

The new method identified by the Michigan State team could join that list. The researchers found what they call a control mechanism that can regulate the immune system's reaction to a foreign substance.

Mast cells are a type of immune cell that release chemicals like histamines in response to stressful conditions such as invading proteins, viruses or bacteria. The problem is that sometimes this goes into overdrive, releasing far too much and triggering the severe reaction. The new study found that this process is regulated by a cell receptor known as corticotropin-releasing factor 2 (CRF2).

"What we found is that the CRF2 receptor can act as an inhibitor, or a control point, in mast cells, which prevents them from becoming over-activated," says Adam Moeser, lead author of the study. "Up until now, no one has really understood the exact role this particular receptor plays on these important cells."

To test the function of the CRF2 receptor, the team isolated mast cells from mice, pigs and humans and blocked its function using drugs. Doing so increased the amounts of histamine released. That suggests that developing drugs that can do the opposite – ramp up the function of CRF2 – could be an effective way to regulate histamine levels and prevent allergic reactions.

"There's still more we want to know, like what factors – whether a person's sex or different types of stress – are involved in how this particular receptor works," says Moeser. "But now that we know the critical role it plays, a pharmaceutical company could potentially develop a drug that targets these specific cells. That would be the ultimate goal."

 

Feb 21st

The health benefits of eating chocolate

According to a nutritionist, chocolate can have some surprisingly positive effects on both your mental and physical wellbeing.

Chocolate is usually considered to be unhealthy and a naughty treat, but you might want to reconsider this assumption. From boosting your mood to helping alleviate a nasty cough, chocolate comes with a surprising number of health benefits.

Studies have shown that chocolate has the feel-good factor, thanks to a mix of mood-elevating chemicals, including caffeine, theobromine, tyrosine and tryptophan, and its delicious taste. Having said that, it's important to opt for dark chocolate with a high cocoa solid content, where possible, as it offers more health benefits than milk chocolate, it is also lower in fat and contains antioxidants

With the help of Ceitanna Cooper, Associate Nutritionist at AXA PPP healthcare, we've put together the top five health benefits of snacking on chocolate (a few squares or a small bar) as part of a well-balanced diet:

1. Chocolate can cheer you up

The taste, smell and texture of chocolate stimulates feel-good areas of the brain. Chocolate also contains tryptophan, an essential amino acid that stimulates production of serotonin, the brain's natural anti-depressant. Experts equate the delicious feelings it induces to those we experience when we fall in love.

2. Chocolate improves heart health

Eating chocolate can lower blood pressure, thin the blood (reducing stroke risk) and comes with anti-inflammatory benefits, thanks to a high content of chemicals called flavonoids.

'Flavonoids also seem to stimulate the body to make more nitric oxide, which helps to widen and relax blood vessels, which may help to lower blood pressure,' says Cooper.

3. Chocolate protects your arteries

Flavonoids in chocolate also help to stop LDL (dubbed the bad) cholesterol from oxidising, helping to prevent the furring up of arteries. Flavonoids contain more than 50 per cent of an unusual type of saturated fat called stearic acid, present in cocoa butter, that doesn't raise bad cholesterol and may even increase levels of the protective good cholesterol.

4. Chocolate calms coughs

Chocolate also contains a chemical called theobromine, which has been shown to suppress coughing by acting on the vagus nerve, which carries messages from the central nervous system to the brain.

5. Chocolate benefits the brain

A chemical called epicatechin - found in cocoa and green tea - may also help protect the brain against the formation of sticky proteins or amyloid plaques which develop in Alzheimer's disease.

There's no need to feel guilty about indulging your cravings now and then, as long as it's part of a well-balanced diet.

'We all know that too much sugary or fatty food can contribute to obesity and other health problems, but the good news for chocolate lovers is that small amounts can also have some health benefits,' says Cooper. 'So there's no need to feel guilty about indulging your cravings now and then, as long as it's part of a well-balanced diet.'

What sort of chocolate is best?

Generally, the darker the chocolate (look for 70% and above cocoa), the higher the flavonoid content. Flavonoids are found in foods like broccoli, onions, fruit, as well as tea, and may help protect people against some types of cancer and heart disease.

'It's most likely that you get more flavonoids in a dark chocolate that lists cocoa beans, cacao, chocolate liquor or cocoa mass on its ingredients list, so check the label,' says Cooper. 'Milk chocolate tends to have very few flavonoids and white chocolate has none.'

Does chocolate make a good snack?

Surprisingly, dark chocolate is classified as 'low GI' food, which means a small bar makes a suitable snack between meals, as it doesn't cause a rapid rise in blood sugar levels after being eaten. This is because the fat that it contains slows down the absorption of the sugar.

The caffeine content of chocolate has also been shown to help boost concentration and energy temporarily.

The caffeine content of chocolate has also been shown to help boost concentration and energy temporarily. But if you're curbing your caffeine intake then be sure to remember that chocolate counts as a caffeinated product!

If you eat it in small amounts, alongside a healthy, balanced diet, chocolate shouldn't contribute to weight gain and it will certainly not do you any harm.

 

Feb 20th

Unravelling the mystery of ‘deadly dreams’ syndrome

For decades, young men were dying in their sleep. Modern genetics and epidemiological detective work helped find an explanation.

In December 1981, the Centers for Disease Control (the name was amended to add “Prevention” in 1992) published a report detailing sudden, unexpected deaths during sleep among mostly young, male, Southeast Asian refugees in the United States. Thirty-three of those who died were from Laos, four were from Vietnam, and one was from Cambodia. “The abruptness of the deaths reported here is compatible with a cardiac dysrhythmia,” the report stated, “but the underlying mechanism remains unclear.” Proposed explanations included stress from immigration and resettlement, sleep abnormalities, undiagnosed heart defects, and dietary deficiencies, but nothing could be proven. So it began to be called sudden unexplained death syndrome, or SUDS, and was quickly recognized as a leading cause of death among young men from Southeast Asia.

What I left out is a recurring feature in which book authors are invited to share anecdotes and narratives that, for whatever reason, did not make it into their final manuscripts. In this installment, Sandeep Jauhar shares a story that didn’t make it into his latest book, “Heart: A History,” (Farrar, Straus and Giroux.)

Brugada syndrome is believed to be responsible for roughly 20 percent of deaths in patients with structurally normal hearts.

This syndrome, it turns out, had bedeviled Southeast Asians for generations. In the Philippines, it was called bangungot, the Tagalog word for nightmare. “Such ‘deadly dreams’ are well known among the lay people,” a Philippine medical journal noted as far back as 1917, “many of whom view them with sullen respect, if not frank terror.” In Thailand, it was called lai-tai; in Japan, pokkuri. Whatever the name, the syndrome was the same: sudden death of apparently healthy young men, often at night.

Halfway around the world, similar inexplicable symptoms were encountered in 1986 by Pedro Brugada, a cardiac electrophysiologist in the Netherlands, when a Polish engineer named Andrea Wockeczek barged into his office carrying his 3-year-old son. The boy, Lech, had been experiencing frequent fainting attacks. On several occasions, Wockeczek had performed chest compressions and mouth-to-mouth breathing to resuscitate him.

Wockeczek was tragically familiar with these attacks. His 2-year-old daughter, Eva, had died several months before under similar circumstances. Doctors at his local hospital in Poland were unable to explain why she had died, and they were similarly stumped by Lech’s symptoms. They suggested taking the boy to Brugada, who had developed a continent-wide reputation as an arrhythmia specialist.

Desperate to save his son, Wockeczek snuck him out of the country. The father was on the brink of a nervous breakdown, Brugada told me some years ago from the Cardiovascular Research and Teaching Institute in Aalst, Belgium, where he was then working. “He kept saying to me, ‘I cannot stay here and you have to take care of my son.’”

Brugada’s first impression was that Lech was perfectly healthy. He was large for his age, with deep-blue eyes and curly blond locks. His heartbeat sounded normal, too, but when Brugada examined his EKG, he saw a pattern that he had never seen before, highly unusual, shaped almost like a shark’s fin. “I was worried,” Brugada told me. “And the most worrisome thing, of course, was that there was the precedent of the daughter.”

Lech was admitted to the coronary care unit at the Maastricht University. For the first two days, he was fine. On the third day, however, he developed a sore throat and a mild fever. That night, telemetry alarms sounded. When a nurse got to his bedside, Lech was unconscious, and a monitor showed his heart was fibrillating. The nurse started CPR, and an external defibrillator shock was applied, restarting the tiny heart.

Brugada syndrome had bedeviled Southeast Asians for generations before being linked to European patients in the 1990s.

“This is how it went with Eva,’’ the hysterical father told Brugada, “and she died finally in spite of everything.”

After the arrhythmia, all manner of tests were performed. A catheter snaked into the boy’s heart revealed no coronary anomalies. X-rays and an echocardiogram were normal. Even tiny biopsies taken of his heart were negative.

Lech stayed in the hospital for several weeks. He had more episodes of cardiac arrest that were treated with cocktails of anti-arrhythmic drugs. In the end, a pacemaker was used to maintain a constant minimum heartbeat, because doctors observed that his arrhythmias often started during sleep, when his heartbeat slowed. (Implantable defibrillators were not yet widely available.)

Despite the prolonged investigation, the cause of the ventricular fibrillation remained undiagnosed. Father and son returned to Poland with a follow-up appointment with Brugada. (They eventually received asylum in the Netherlands on medical grounds.) When they returned to see Brugada, Wockeczek brought the EKG of his deceased daughter, Eva. It was identical to Lech’s.

Over the next few years, Brugada searched for this electrical pattern in other victims of cardiac arrest. “I looked everywhere for this EKG but I found nothing,” he told me. Then the EKGs of two patients, a man from the Netherlands and a man from Belgium who had both collapsed, came to his attention. He collected a few more of these unusual EKGs and, with his brother, Josep, published his results in the Journal of the American College of Cardiology. They said it “might constitute a distinct clinical and electrocardiographic syndrome.” It was soon dubbed Brugada syndrome, and it and SUDS, from Southeast Asia, were essentially shown by cardiologists and epidemiologists to be the same disease.

A few years later, scientists discovered that patients with the disease carry a mutation in a gene (called SCN5A) that controls the flow of sodium into heart cells, thus electrically activating them. Patients without the disease did not carry the mutation. Based on these and other observations, the scientists concluded that a mutation in SCN5A is responsible for the deadly arrhythmias in Brugada syndrome.

Once patients develop symptoms — unexplained fainting is most common — there is a 50-50 chance they will die within 10 years.

Brugada syndrome is now believed to be responsible for as many as 20 percent of deaths in patients with structurally normal hearts. Because of increased recognition, the number of diagnosed cases has grown exponentially over the past few decades. It is most common in Southeast Asia. However, it is plausible that in the United States, one person in 5,000 may be at risk. Although the disease usually strikes in early middle age, cases have been reported in babies only a few days old. SCN5A mutations have now been found in other sudden-death syndromes, including sudden infant death, or SIDS, suggesting that Brugada syndrome and SIDS may be linked. For now, the only effective treatment remains an implantable defibrillator.

Research into Brugada syndrome is an amazing example of how modern genetics and epidemiological sleuthing can shed light on disease, even one so steeped in mystery. As cardiology continues to advance, new diseases of the heart will be identified, and molecular genetics will allow us to foresee hereditary risks in ways we never thought possible. But resources are limited: It is estimated, for example, that more than 150,000 Americans may be at risk of sudden death from Brugada syndrome. If everyone was implanted with a $30,000 defibrillator, the cost could well run into billions of dollars. As was the case with Brugada syndrome, modern techniques may elucidate the cause of a disease or lead to treatments that will allow us to live with a disease but not necessarily lead to a cure. And so we may soon have to ask: Can we afford to know the truth about the many diseases for which we may be at risk?

Sandeep Jauhar is a cardiologist and director of the Heart Failure Program at Long Island Jewish Medical Center. He is a contributing opinion writer for The New York Times and the author of three books, most recently “Heart: A History.”

 

Feb 19th

Why The HPV Vaccine Being Offered To Boys Is Long Overdue

Together this will ensure that knowledge and evidence can inform all future interventions

Human Papillomavirus (HPV) is a viral infection that, in most of us at some time in our life, causes warts and verrucas. However, different types of the virus are able to cause cancers of the genital tract; predominantly cervical cancer, but also vulval, vaginal, penile and anal cancers.

Over the past 30 years, the prevalence and incidence of cervical cancer has declined; firstly due to an effective screening programme. From the age of 21, women are called every three to five years for a smear test. Here, a sample of cervical cells are examined the presence of HPV infection, and for pre-cancerous changes, allowing for early intervention should abnormalities be detected. Further research in this area led to the HPV vaccination, which was introduced into the UK in 2008. This vaccination programme targets adolescent girls, again to reduce the incidence of cervical cancer.

Two vaccines are commercially available: a bivalent vaccine protecting against the most common cancer-causing types (HPV16 and 18), and a quadrivalent vaccine protecting against two low-risk (HPV types 6 and 11). The UK programme uses the quadrivalent vaccine. Uptake of the vaccination has always been high, and the programme has proved to be highly effective for reducing cervical HPV infection worldwide.

Likewise, in mid-June 2018 Public Health England reported the results of a major study that showed a remarkable 82% decrease in the prevalence of cancer-causing HPV infections within the English female population; a fantastic outcome.

Despite these successes, in recent years HPV has been found to be associated with head and neck cancer arising in the tonsils and base of tongue. The incidence of these cancers is increasing significantly, and is predicted to soon overtake that of cervical cancer. Our team investigates the incidence of HPV infection in the mouth of the healthy population, how HPV infection causes head and neck cancer, and whether we can detect any pre-cancerous changes associated with the development of the disease.

These HPV-positive head and neck cancers seem to be linked with smoking, alcohol, and sexual behaviours. However, the most significant risk factor for this disease appears to be your gender, with men at a substantially increased risk of the disease. Regrettably, we don’t yet know why this is.

Because of this male dominance of HPV-positive head and neck cancer, there have been calls for the UK to follow the lead of Australia, New Zealand and Italy who have all adopted publicly-funded gender-neutral vaccination programmes. However, this was not considered cost-effective in England by the Joint Committee on Vaccination and Immunisation (JCVI). They said the high vaccination coverage of adolescent girls in England would give rise to a population immune to HPV that would be large enough to also offer protection for the male population; a concept called “herd immunity”.

Unfortunately, men typically present at the clinic with late stage head and neck cancer; a horrific disease that is difficult to treat, despite a better prognosis should you have head and neck cancer that is HPV positive. As such, the last few years has seen strong campaigns from a number of organisations to bring the issue of HPV vaccination for the male population to the forefront of the immunisation agenda.

I am delighted that we have had confirmation from the Government that they will uphold the recommendations of the JCVI and offer gender-neutral vaccination in England. This represents a huge step forward in proactively tackling HPV positive cancers, removing any gender bias associated with the vaccination programme. Despite this effective vaccine, it is imperative that women still attend their smear tests when recalled, and that research continues to advance our understanding of HPV-positive cancers, as well as to develop the vaccine further.

Together this will ensure that knowledge and evidence can inform all future interventions.

 

Feb 18th

Diverticulitis

About 1% of the UK population is likely to be hospitalised in their lifetime due to the condition. But scientists don’t know what causes it

 Diverticulitis is usually relatively straightforward to diagnose and treat. Illustration: Guardian Design

John Slater, a former railway worker who lives in Boston, Lincolnshire, was 40 when he first went to the doctor with gut problems. Along with “colossal” lower abdominal cramps, he had started passing blood from his rectum. His doctor thought he had irritable bowel syndrome (IBS) and then, when the bleeding worsened, an ulcer was suspected. It wasn’t until Slater ended up in A&E, after 12 years of debilitating symptoms, that a colonoscopy revealed adhesions in his bowel lining. “The walls were fused together,” is how Slater puts it.

The cause turned out to be a rare and extreme form of diverticulosis – a complication arising from the formation of pouches in the bowel lining known as diverticulitis. The presence of such pouches usually affects westerners over 50, with the incidence increasing with age.

A section of Slater’s small bowel had to be removed, along with his appendix. “There’s now a mesh attached to my spine to hold the bowel up,” he says. But two inoperable pouches remain. “I’m just waiting for one of them to suddenly wake up and then it will start again. I’m living day to day.” Meanwhile, he still has intermittent bleeding and is on medication for pain and to help his bowel function, along with a medium-fibre diet with plenty of fresh fruit, and wants to raise awareness of the condition.

While Slater’s case is unusual, diverticulosis is very common, says Robin Spiller, professor of gastroenterology at the University of Nottingham. “If you do postmortems on people, 40% of 65- to 74-year-olds will have diverticulosis, and many of them will never have had any symptoms.” Some people “have one little pouch which, of course, doesn’t do anything, while others can have 20-100 of them”. Most people remain blissfully unaware they have the pouches at all.

Trouble can occur when the pouches get pellets of fibrous material, known as fecaliths, lodged in them. This can be harmless, but will in some people lead to infection and inflammation and, in rare cases, perforation of the gut, causing intestinal waste to leak into the abdominal cavity.

Calculating how many of the 40% with diverticulosis will experience any trouble is difficult, Spiller says, “but it’s probably something like one in 10”. Hospitalisation will only be necessary when serious complications occur. “About 1% of the (UK) population could expect to be hospitalised with diverticulitis in their lifetime,” he says.

Much of the time, fecaliths lurking in diverticular pouches aren’t remotely sinister. The trouble occurs, Spiller says, “if food residue gets stuck in there and puts pressure on the lining, which is very thin. Then it might cause a break in the lining and that might let bacteria in and cause inflammation.” Sometimes the pouches bleed and the worst-case scenario, he says, is if the walls burst. That condition, known as peritonitis, can be life-threatening.

Diverticulitis is usually relatively straightforward to diagnose and treat, says Spiller. “You’ll get a fever, a raised white blood cell count, pain and tenderness – similar symptoms to appendicitis.” You might be hospitalised, but most cases can be treated with antibiotics. Infection can recur intermittently: “A quarter will get another attack in the next year.”

What is more difficult to diagnose is when patients have pain related to the diverticular pouches, but no infection. “There are people who get pain every day, which lasts a few hours, maybe precipitated by food. This is very difficult to distinguish from IBS,” says Spiller. In such cases, it may be that another underlying problem, such as “incoordinate contractions”, is causing both the pouches to form and the pain. Contractions in the bowel, Spiller explains, “are carefully controlled to move things along or hold them back. But if you have damage to the nerves, from ageing, for example, then these coordinations fail and that puts the pressure up.”

Part of the reason the risk increases with age is that connective tissue weakens. While on the outside this leads to skin wrinkles, says Spiller, “internally, a weaker colon wall can lead to pouch formation”.

Diverticulosis is a peculiarly western affliction, but Spiller says none of the theories about why this may be are proven by scientific study: “Many of them are probably wrong.” However, it is almost certainly linked to diet or environment. Diverticular disease is rare in Africa and Asia and studies have shown that the longer people from these areas live in North America or Europe, the higher their risk grows.

“Something has made our colons not as strong as they should be,” Spiller says.

A diet lacking in fibre gets most of the blame, but Spiller says the evidence is weak. The most-quoted study looked at data from 43,881 male healthcare professionals, but it only shows associations rather than causation. The study found that both consumers of high-fibre diets and dedicated exercisers had the lowest diverticular disease risks. “You could say these people were more health-conscious overall and most of their diseases are less,” says Spiller.

There are other elements of the western diet that could be weakening our guts. “It could be high fat,” says Spiller. “Some have argued that the bacteria are different in people with diverticulitis, but there’s very little evidence on that at the moment.” There may even be other, non-dietary aspects of the western lifestyle that have an effect.

The precise cause, he says, could only be established through long-term randomised trials with subjects consuming either a high-fibre or a low-fibre diet and then followed for 10-20 years – but this would be prohibitively expensive and unlikely to attract many participants. Meanwhile, this common condition, which Spiller says “can seriously impair the quality of life of elderly people, is neglected because it’s not an easy problem, and the fact that it doesn’t affect young people works against it. But I do think we need to raise awareness and more work should be done. It’s important.”

 

Feb 17th

How to overcome anxiety using CBT

Feeling anxious, uneasy or agitated and don't know where to turn? Anxiety is extremely common, but no less debilitating. Fortunately there are a number of ways to manage your anxious feelings using Cognitive Behaviour Therapy (CBT) techniques.

We speak to qualified CBT therapist Navit Schechter about how to use talking therapies to overcome anxiety and depression:

What is anxiety?

Anxiety is a normal emotion and one that we will all feel from time to time in our lives. We are designed to feel anxiety in response to dangerous situations as it helps guide us away from danger to safety.

Problems arise when the part of our brain that indicates to us that a danger is present is triggered, even when no real threat exists and the danger is only in our mind. This can happen as a result of biased and inaccurate predictions that something terrible will happen or that there will be a bad or catastrophic outcome.

What are anxiety symptoms?

Anxiety is often accompanied by physical symptoms such as feeling hot, an increased heart beat, increased breathing, dry mouth, feeling weak, feeling dizzy, loose bowels, feeling sick, difficulties concentrating, sweating and/or shaking and results in a desire to avoid that situation. This can lead to a negative cycle of anxiety where, by avoiding situations that scare us, we don't get the chance to recognise that the threats we have anticipated don't actually happen.

Anxiety can be mild and manageable and can also be extremely severe and debilitating impacting on every area of life affecting your ability to eat, sleep, concentrate, travel, enjoy life or even leave the house or go to work or school.

This can lead to longer term feelings of irritability, low self-confidence and relationship difficulties.

A number of anxiety conditions or disorders have now been recognised including phobias, social anxiety, generalised anxiety disorder (excessive worry), obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder and agoraphobia. CBT has been proven as an effective treatment in overcoming these anxiety problems.

What is cognitive behaviour therapy?

CBT is a type of talking therapy. It helps us to understand the problems we are experiencing by recognising that how we feel, what we think, what we do and how our body feels are all interconnected. When we feel down, anxious or worried we often have negative thoughts and do unhelpful things that create a vicious cycle of low mood and/or anxiety.

CBT helps you to recognise the vicious cycle that you are stuck in and understand what you need to do to break out of it.

Making changes in any of these areas leads to changes in the others and that is what we focus on in therapy.

There is a lot of research now that shows how effective CBT is in treating many common mental health problems such as depression and anxiety. It is recommended by the National Institute for Health and Clinical Excellence (NICE) as the most effective way to treat many common mental health problems.

Watch: 9 Signs You Could Be Having a Panic Attack [Health.com]

How can CBT help with anxiety?

In therapy, I would first help you to understand why you feel the way you do by understanding the interaction between your environment, your thoughts, feelings, actions and body sensations. Working together, we would then help you to make changes in how you think and what you do in order to change how you feel.

The strategies used in CBT have been proven to help to overcome anxiety and depression and together we would tailor these to your specific situation so that you can incorporate them into your daily life and find relief from the problems you are experiencing.

By the end of a course of therapy, we would have helped you to build a toolkit of psychological skills and strategies that you are able to use to deal with difficult situations and life events should they occur in the future. You will learn to become “your own best therapist” so that you feel more confident that you can deal with potential difficulties you may encounter in the future.

Who is CBT for?

CBT can be helpful for anyone. It is most commonly used for people who are experiencing depression or anxiety but can be useful for other problems too such as low self-esteem or other mental or physical health problems. CBT has shown to help children, young people, adults and older adults.

What to expect during a CBT session

CBT is collaborative, this means that we will be working together as a team to help you to move from the problems you are experiencing to your goals and how you would like things to be.

Therapy sessions are usually 60 minutes long. At the start of each session we would set an agenda for how we wanted to spend the session time which ensures that the sessions are as a relevant and helpful as possible for you. We would start the session by checking in with how you have been feeling over the past week and any changes you have experienced in the anxiety you have been feeling.

The majority of each session would be spent either discussing and understanding why a problem might be persisting or helping you to learn how you can make the changes needed to feel better. There is always time for any questions you may have and we will always be working together to understand whats best for you.

Every CBT session ends with setting an out of session assignment. This is an important part of CBT as it lets you practise your new skills in your day to day life and helps you to experience change more quickly.

Mental health support

If you are feeling anxious or depressed, For additional support try one of the following resources:

Mental health support

If you are feeling anxious or depressed, For additional support try one of the following resources:

✔️ Anxiety UK: a charity which specifies in helping those suffering from anxiety.

✔️ The Samaritans: a charity providing support to anyone in emotional distress.

✔️ Mind: a charity that makes sure no one has to face a mental health problem alone.

✔️ CALM: helping to reduce stigma and reduce rates of male suicide.

 

Feb 11th

Getting less than seven hours' sleep a night could damage DNA 'beyond repair' and even lead to cancer

·       Researchers studied doctors in Hong Kong, some of who worked night shifts

·       Lack of sleep was shown to increase DNA damage by up to 30 per cent  

·       This causes genetic mutations which could lead to diseases such as cancer 

A lack of sleep could permanently damage DNA and increase the risk of cancer, scientists believe.

Sleep deprivation can also reduce DNA's ability to repair itself, possibly leading to genetic diseases, findings from a study suggest.

Researchers believe it is the first study of its kind to look into the effects of sleep deprivation on genes in young adults.

The research focused on doctors, known for having to adjust their sleep patterns due to night shift work, and the scientists do not know why a lack of sleep damages DNA.

The recommended amount of sleep is generally seven hours a night, but figures suggest adults routinely miss out on an hour or two.

+1

The study at The University of Hong Kong looked at 49 working doctors from two local hospitals, 24 of whom had to work overnight on-site calls.

When a doctor receives such a call – on average they get five to six per month – they must work from late afternoon to early morning the next day.

In the study the participants got between two and four hours of sleep during calls, with three getting as little as one hour's shut-eye.

The remaining 25 doctors were not expected to work these hours.

After three days of a good sleep, researchers took blood samples from all doctors.

Then, blood samples were taken the morning after a night shift when doctors were sleep deprived.

The findings, published in the journal Anaesthesia, showed doctors who worked night shifts had 30 per cent more breaks in their DNA compared to those who did not. 

What's more, the DNA damage increased a further 25 per cent after a night of sleep deprivation.

DNA repair was also lower in the doctors who didn't get adequate sleep, which can cause cell death.

The study authors wrote: 'DNA damage is a change in the basic structure of DNA that is not repaired when the DNA is replicated. 

'Double‐strand breaks are particularly hazardous, as repair failure causes genomic instability and cell death, whereas disrepair can lead to inappropriate end‐joining events that commonly underlie oncogenic transformation [cancer formation].

'Sleep deprivation in shift workers is associated with adverse health consequences. 

'Increased DNA damage has been linked to the development of chronic disease. 

'This study demonstrates that disrupted sleep is associated with DNA damage.'

Although the findings are preliminary, Dr Gordon Wong Tin-chun, co-author of the study and an associate professor at HKU's department of anaesthesiology, said there is an indication the sleep disruption is 'not good' for your genes.

He said: '[Such conditions] may increase chances of developing diseases from genetic mutations such as cancers.'

It is not clear, according to the researchers, why DNA damage occurs due to a lack of sleep. 

Dr Wong Tin-chun said the findings of the study might be applicable to people who had shift patterns similar to doctors, but that the study is hoped to raise awareness on the importance of getting enough sleep.

The study also highlighted that the doctors were 'young and healthy', and therefore more tolerant of a lack of sleep. 

'Maybe you should consider looking into your [sleep habits] and treating sleep with a bit more respect,' Dr Wong Tin-chun said.    

The recommended hours of sleep for people vary across age groups. An adult aged between 18 and 60 would need at least seven hours of sleep per night, according to the website of the US Centres for Disease Control and Prevention.

Figures from the Royal Society for Public Health estimate that the average person sleeps for 6.8 hours a night. 

However, it is recommended by the US Centres for Disease Control and Prevention to get at least seven hours per night, and the NHS recommends eight hours.

Regular poor sleep puts you at risk of serious medical conditions, including obesity, heart disease and diabetes.

It shortens your life expectancy, according to the NHS, and has previously been linked to a greater risk of cancer. 

More than 40million people suffer from long-term sleep disorders in the US, data from the CDC shows. While it is estimated there are 1.5million patients in the UK. 

 

Feb 9th

Why The Corners Of Your Mouth Crack — & How To Fix It

Just like chapped lips, it's easy to associate the development of dry, crusty patches on the corners of our mouths with exposure to extreme cold and dryness: too many nights in arid Palm Springs, or too many days fighting frostbite in New York. But it turns out that those flaky patches of skin anchoring our smiles aren't just an extension of dry, irritated lips gone rogue — and they're not cold sores, either. Rather, they come courtesy of a condition called angular cheilitis, which can stick around for weeks when left to heal on its own.

Not only are the scabs not particularly cute, but they turn things that should be pleasurable into painful tasks, like biting into a big, juicy burger or, uh, smiling. That's not exactly the kind of thing we're willing to put up with for weeks on end, so we talked to three experts — a dentist, a dermatologist, and a nutritionist — to help us understand how to shorten that hellish healing time, and prevent new outbreaks from happening in the first place.

What is it?

The first thing to know about angular cheilitis is that it’s perfectly normal. The condition is so common, in fact, it’s taught on day one of dermatology school, says S. Manjula Jegasothy, M.D., a Miami-based dermatologist. That’s because these annoying little sores stem from something as simple as drool (which, of course, is something we all do — and not just over the brothers Hemsworth). “Yeast is always present in the mouth and saliva, so when we drool in our sleep, it collects in the corners of the mouth, like rain in a gutter,” Dr. Jegasothy explains. This buildup of yeast causes dry, red flakes of skin to form. “Because the grooves in the corners of our mouth get deeper as we age, this can worsen the older we get,” she says.

Why do we get it?

Though these painful sores can be more likely to form in colder climates, the weather itself isn’t exactly to blame. For one, something as innocuous as dry indoor heating systems or a stuffy nose can cause us to sleep with our mouth open, Dr. Jegasothy says, making the corners of the mouth a perfect destination for traveling drool. As cosmetic dentist Brian Kantor, DDS, of New York’s Lowenberg, Lituchy & Kantor points out, overzealous lip licking can also lead to angular cheilitis (which makes us wonder if Cher or LL Cool J feel our pain, too?). “A person may lick their lips more in an attempt to soothe the pain or dryness of their lips,” he says. “This excess saliva will sit in the corners, which is the perfect warm environment for fungus like yeast to grow. Viruses and bacteria can also cause it to develop."

But that’s not all: Dr. Kantor also says those who regularly have oral thrush (also known as oral candidiasis, a yeast infection that develops on the inside of the mouth and tongue) or inflammatory illnesses, or take prescription drugs such as oral retinoids, corticosteroids, or antibiotics, are more susceptible to developing these corner sores. Those who wear wear braces or smoke, or live with anemia, diabetes, or cancer may also see the condition more frequently. Ditto for those who have an overhang of the upper lip, something that creates deeper angles at the corners of the lips.

Diet can also play a part. "A nutritional deficiency of B2, B3, B6, and iron can increase the risk of developing angular cheilitis," says Maya Feller, a New York-based registered dietitian and nutritionist who specializes in nutrition for chronic disease prevention. "High-carbohydrate diets, as well as glucose-rich diets, can also provide an environment where oral candidiasis can thrive.”

How can you prevent it?

If these raw, uncomfortable sores stem from yeast, wouldn’t the logical move be to simply blast the stuff from our saliva with some sort of super mouthwash? Not quite, says Dr. Kantor. “Candida is normal in the saliva and you don’t want to eradicate it completely, as it would disturb the normal flora of the mouth,” he says. “No mouthwash could or should be used to kill all of the candida in the mouth. Mouthwash also won’t help or hurt the angles of the mouth when you rinse.” To help keep our oral health and a yeast takeover in check, the dentist suggests maintaining good oral-hygiene habits: brushing twice a day, flossing, and rinsing with an antiseptic mouth rinse.

As Feller notes, more common-sense self-care, like rounding out your diet, can also help balance healthy flora in the mouth — something that may lead to fewer instances of corner sores. “From a nutritional standpoint, I would recommend following a balanced diet that provides an abundance of whole and minimally-processed foods including both non-starchy and starchy vegetables, legumes, and fruits,” she says. “For those at risk, such as those with a B vitamin deficiency, anemia, or diabetes, it's important to make sure that the gastrointestinal system is not compromised and that the body is absorbing all the foods and or supplements they are taking.”

You already have it — now what?

If angular cheilitis rears its ugly head even in the face of best practices, Dr. Jegasothy has one last — and somewhat surprising — line of defense. “Any over-the-counter athlete’s foot cream with butenafine 2%, like Lotrimin Ultra, will help,” she says. Never mind that the stuff may be built for the body part furthest from your face: Twice daily (morning and night) application of the antifungal medicine can regulate and diminish the sore, she says. The reality is that drool happens — even for those who practice all the good sense dietary, oral, and skin-care habits in the world.

 

Feb 6th

What drinking diet soda does to your body and brain

Artificial sweeteners are one of diet soda's main ingredients. But studies have shown that the artificial sweeteners within diet sodas can cause a series of health problems. We decided to take a look at what happens to the body when you only drink diet soda. Following is a transcript of the video.

In the early 1960s, a new kind of beverage took the stage.It wasn't a new shape, or color, or flavor. No, this was diet soda. And It. Was. Awesome.

With fewer calories and less sugar, diet soda promised to be a healthier alternative to regular soda. But like most promises in life that sound too good to be true, it probably is.

Can you tell the difference between a glass of regular and diet soda? Turns out, neither can your body. And that's where the trouble starts.

Until recently, everything we ate contained some amount of calories. When we ate something sweet, for example, the brain sent signals to our pancreas. Which started producing insulin, that stored the sugar molecules in our cells for energy.

So, when we drink diet soda, the sweetness tricks our body into thinking it's real sugar. But when those energy-packed calories don't arrive, the insulin has nothing to store.

Scientists think that repeatedly tricking our body this way could explain why study after study keeps finding the same thing: that drinking diet soda is associated with metabolic syndrome. Metabolic syndrome is a mix of conditions that includes: increased blood pressure, high blood sugar, and weight gain. Which can increase the risk of diabetes, heart disease, and stroke.

In fact, one study found that diet soda drinkers had a higher risk of stroke and dementia than regular soda drinkers. And for another 8-year-long study between 1979-1988, participants who started out at a normal weight and drank an average of 21 diet beverages a week faced DOUBLE the risk of becoming overweight or obese by the end of the study, compared to people who avoided diet beverages completely.

And while drinking diet soda with a meal may sound like a tasty, calorie-free alternative to plain water, a growing body of research is starting to find that this may be the WORST time to drink it. Because the fake calories in the diet soda could ultimately disrupt how many of the real calories we metabolize. Potentially leaving excess calories behind that we then store as fat.

Another issue could be the fact that artificial sweeteners in diet sodas can be tens to hundreds of times sweeter than sugar. So when we taste it, our brains anticipate more calories than what we give it. It's like when you go to a party expecting loads of food and you end up with a handful of veggies and vegan cheese. You're left unsatisfied and hangry. In the same way, artificial sweeteners can leave our brains wanting more, which studies have shown leads to increased appetite, and potential weight gain, in fruit flies, mice, and humans.

So if the reason you're drinking diet soda is to drop a few pounds, maybe stick to water.

 

Feb 4th

What stress does to the body

Your boss ominously requests an urgent meeting, your taxi is inching towards the airport with minutes to spare before your flight, or your football team have been granted a potentially game-winning penalty in the 91st minute. Your heart pounds, your stomach lurches, your hands turn clammy: the effects of stress are visceral and instantaneous.

When faced with a perceived threat, the body’s fight or flight system triggers in a well-choreographed sequence that has evolved over millions of years. “We’re here because our ancestors were so brave and could survive through times of terrible stress and threat,” says Carmen Sandi, who leads a behavioural genetics laboratory in Switzerland. “The problem nowadays is that we’re activating this ancient survival response in a job interview.”

In the modern world, where life-threatening situations are encountered rarely, stress itself has become the spectre. Last year, in the largest survey on the impact of stress, three in four Britons reported being so stressed that they had felt overwhelmed or unable to cope at least once over the last year. Studies across populations have linked extreme and chronic stress with heart disease, diabetes and mental health problems including depression. What is it doing to our bodies?

The moment we perceive a threat, the brain’s alarm system, a region called the hypothalamus, issues a series of commands designed to prepare us for fight or flight. Among the first to receive the alarm signal are the adrenal glands, which sit like little hats on top of the kidneys. Within seconds, they begin to pump out adrenaline, causing our heart and breathing to speed up and triggering the release of huge amounts of glucose from our liver.

Blood is shunted away from the digestive system towards our arms and legs and the muscles around our small intestine contract, creating the feeling of a knot or fluttering in our stomach. For reasons that are not entirely understood – possibly the body’s way of trying to remove any harmful toxins – adrenaline loosens the bowel muscles, meaning that acute stress can leave us racing for the bathroom. Another unwelcome side-effect is sweat, which is more sudden and smells worse than the kind produced during exercise or in hot weather. While exercise sweat comes from the eccrine glands and contains mostly water, adrenaline activates the apocrine glands in the armpits, which release a milky-looking substance containing fats and proteins, fuelling bacteria.

Adrenaline also prompts a massive mobilisation of immune cells, which travel from the spleen and bone marrow where they are stored, into the bloodstream. “There’s an evolutionary theory that in the past social stress was often a predictor of trauma or violence,” says Ed Bullmore, a professor of psychiatry at the University of Cambridge, who is exploring the link between stress and the immune system. “When I’m standing up doing a public presentation, my [subconscious] looks at all these people staring at me and says ‘Maybe they’re going to attack’ – so my immune system ramps up in advance.”

While adrenaline floods the body within seconds, a second stress hormone, called cortisol, seeps into the bloodstream more gradually, peaking after 20-30 minutes. Cortisol changes the metabolism of cells, how cells function and alters the activity of DNA. In the brain, cortisol binds to neurons, altering normal thought processes including the way stressful events are recorded in our memories. Neuroscientists think the influence of cortisol could explain why our memories of traumatic or highly emotional events are often exceptionally vivid.

Is stress always bad?

Research suggests that some stress exposure is crucial for developing the resilience that allows us to cope with unexpected and challenging situations in the future. A 2013 review entitled “Understanding resilience” draws parallels with the way exposure to germs boosts the immune system, concluding: “Stress inoculation is a form of immunity against later stressors, much in the same way that vaccines induce immunity against disease.”

Adrian Wells, a professor of clinical and experimental psychopathology at the University of Manchester, agrees. He is concerned that the negative effects of stress are sometimes exaggerated and that an “epidemic of stress phobia” is turning situations that ought to be challenging or even exhilarating into something altogether more traumatic.

This view is backed by recent research showing that the way we think about stress can also determine its effects. In one study, a group of volunteers were given a series of anxiety-inducing tasks: singing karaoke (sober, in a laboratory setting), giving a speech and completing a difficult maths problem. Participants were split into three groups, who were instructed to say “I am excited”, “I am calm” or “I am anxious” before each task. Those who reframed their stress as excitement performed significantly better on all the tasks. For someone weighing up whether to apply for a job or take part in a race, say, the findings are an encouraging reminder that risks can open up rewarding opportunities. But it may not help with many other sources of stress – facing discrimination at work or caring for a parent with Alzheimer’s, for example.

There is growing evidence that when stress is extreme or unrelenting the health consequences can be significant. Stress increases blood pressure and temporarily makes the blood stickier and more likely to clot, meaning that, over prolonged periods, it can raise the risk of heart disease.

Scientists are also investigating the link between stress and type 2 diabetes. The possibility of a link has been speculated about for centuries, with the 17th-century English physician, Thomas Willis, attributing the condition to “sadness, long sorrow … and disorders of the animal spirits”. Recent studies have confirmed the connection; Japanese men working excessive overtime were more likely to become diabetic, for instance. However, it it not yet clear whether stress itself, or other lifestyle factors such as diet, lack of exercise and drinking alcohol, are to blame.Under normal circumstances, the stress response is designed to be self-limiting: a momentary surge of biological activity that quickly dissipates. This relies on a precisely choreographed sequence of hormone levels rising and falling by the right amount in the right order. Adrenaline triggers the release of immune cells, while cortisol, which lags behind, dampens down immune activity, bringing the body back to baseline. When people are relentlessly exposed to stress, though, this complex and finely balanced sequence can start to go awry.

One study, involving teachers who were either happy with their job or “burnt out”, found that the burnt out group had higher levels of inflammation, a sign that the immune system is being placed under strain. Similar findings have been made in people who are long-term caregivers and in those who had suffered serious trauma as children.

Bullmore believes that stress may leave an imprint on the immune system comparable to that left by an infectious disease, something he calls the “inflammatory memory of stress”. The theory is intriguing as it ties in with the recent discovery that inflammation in the body can have negative effects on mental health. It also challenges the traditional belief that the brain is sealed off from the rest of the body by what is known as the blood-brain barrier. Increasingly, scientists are showing links between mental and physical health. “The biggest single risk factor for depression is stress,” says Bullmore. Understanding better this connection could open up new opportunities for treatments targeting immune activity and could even make it possible to intervene before depression occurs in people at risk.

It’s personal

Scientists are also discovering that not everyone responds to stress in the same way. Sex hormones interact with stress hormones, which could explain why stress appears to manifest itself differently in men and women. Scientists at Rockefeller University in New York found that after prolonged stress, the brains of male and female rats began to rewire in subtly different ways. In female animals, neurons in the prefrontal cortex, the brain’s control centre, grew more connections to the amygdala, a brain region linked to emotion. However, in the male animals these connections did not change, while links to other brain areas became less functional.

Scientists are still trying to work out how such changes in brain circuitry affect how we feel and behave. Men are more likely to take it out through antisocial behaviour such as substance abuse whereas women are more likely to have a depressive episode,” says Bruce McEwan, a professor of neuroendocrinology at Rockefeller who led the experiment in rats.

A person’s genetic makeup also helps explain why some of us thrive on stress while for others it can be the trigger for a devastating mental illness. Natalie Matosin, a neuroscientist at the University of Wollongong, Australia, is investigating the cumulative effects of stress over a lifetime, based on physical and chemical clues left behind in brain tissue. She examines slivers of postmortem brain samples under the microscope, comparing the brains of healthy donors with those of people who were diagnosed with PTSD or depression. “I’ll look at how the quantity, shape of brain cells have changed,” she says. “Other times I’ll get just a couple of granules of tissue and look at the composition of proteins that make it up.”

One of the most startling discoveries focused on a gene called FKBP5, that is activated by circulating cortisol. Matosin and colleagues discovered that in people carrying a certain variant of this gene, the gene was switched on far more readily, amplifying the effect of cortisol as it courses through the body. “If you express too much of the gene it’s bad because it means you can’t switch off the stress response,” she says. “If you can’t switch off the stress response over an extended period of time, it can have an impact on the way your brain functions.”

People who carry the risk gene tend to have higher levels of cortisol and are also more likely to develop a psychiatric disorder after being exposed to very stressful circumstances. Like others in the field, Matosin hopes that it will one day be possible to identify those who are most vulnerable to stress and provide more effective treatments. “There are so many reasons that can cause psychiatric disorders and part of the reason we don’t have good treatments for them is that at the moment we’re just guessing,” says Matosin.

Stress is unavoidable and according to scientists the quest for a stress-free existence is likely to be futile. However, an emerging scientific understanding of stress could in future help protect us from its very darkest side.

Cortisol: Formula: CHO

Surges during times of stress, helping to increase the body’s metabolism of glucose, control blood pressure and reduce inflammation. After a stressful experience, levels should reduce. However, when people are continually under stress, the body’s balance can be derailed. Continually high levels have been linked to anxiety and depression. On the upside, light exercise and even laughter have been shown to reduce cortisol.

Adrenaline: Formula: CHNO

Causes the heart to start pumping rapidly and air passages to dilate (providing muscles with oxygen). It also reduces the body’s ability to feel pain, which is why people can be oblivious to an injury until after danger has passed. But if levels are continually elevated, studies suggest this could become detrimental, particularly to cardiac health.

Noradrenaline: Formula: CHNO

Chemically very similar to adrenaline, and does much of the same job but with more of an influence on blood pressure. Levels in the body follow a circadian cycle, being lowest during sleep and rising in the morning. During stressful situations, it acts in the brain to make us feel more alert and to enhance our ability to form memories.

Feb 3rd

Stem cell breakthrough could help cure type 1 diabetes

Scientists have edged one step closer to a major treatment for (and possibly cure for) type 1 diabetes. A UCSF team has claimed it's the first to turn human stem cells into the mature, insulin-producing cells that type 1 patients don't have. The key was to acknowledge a reality in the development of islets, or clusters of healthy beta cells (which generate insulin) in the pancreas. They separated partly differentiated pancreatic stem cells into islets, jumpstarting their development and leading to responses to blood sugar that more closely represented mature cells. Even alpha and delta cells grew more effectively, UCSF said.

The technique has only been tested in mice so far, but the results were positive. It took just a "matter of days" for implanted islets to produce insulin as well as the rodents' native cells.

If the research continues to bear fruit, though, it could offer a much more realistic solution for type 1 diabetes. Pancreas transplants can help, but they frequently fail and still require drugs that suppress your immune system. There are tests for safer and more targeted islet implants, but they still tend to require organs from dead donors. This breakthrough could lead to on-demand implants and make it relatively easy to gain (or regain) healthy insulin levels.

 

Feb 1st

9 facts (and myths) about cold sores uncovered

If you suffer from recurring cold sores, you might be starting to lose hope. But rest assured you are not alone. In the UK, up to 75 per cent of the population are believed to carry the cold sore-causing herpes simplex virus - and 20 per cent of these people repeatedly suffer with the painful condition.

However, there is still a lot of misunderstanding surrounding the subject. Consultant Dermatologist for Blistex Dr Emma Wedgeworth separates fact from fiction and debunks the common myths associated with cold sores:

️ Fact: cold sores are caused by a virus

It's true! These small, painful sores are caused by a virus. Once you have the virus, it stays in your skin for the rest of your life.

'Cold sores are caused by a virus known as the
 herpes simplex virus (HSV) which is a highly contagious infection,' says Dr Wedgeworth. 'There are 2 types of HSV - type 1 and type 2, with cold sores usually caused by HSV-1.'

Myth: cold sores appear from nowhere

It may seem like a cold sore comes out of the blue. But there are a few signs to look out for which are your body's way of telling you an outbreak is on the way.

'Tingling, itching, pain and numbness may all be signs that you are likely to develop a cold sore,' says Dr Wedgeworth. 'These symptoms may occur hours to days before an outbreak and are known as the prodrome.'

⚠️ Some people suffer from very frequent or severe outbreaks which may require taking tablets on a regular basis to stop the attacks from developing. This should only be considered for more severe cases.

️ Fact: You can stop cold sores developing

To prevent a cold sore outbreak, there are steps you can take. 'In terms of lifestyle, stress and being run down can contribute to the development of cold sores, so looking after yourself, eating well and getting plenty of sleep is important,' explains Dr Wedgeworth.

'Anti-viral treatment creams such as Blistex Cold Sore Cream can prevent cold sores from developing fully when used at the first sign of an outbreak (which is generally when you feel a 'tingle'),' she adds. 'The active ingredient Docosanol works earlier than other actives to penetrate the skin cell in the lip area to block the virus from entering.'


Myth: cold sores only develop on your lips

This may be a very common myth, but it's a myth all the same. 'While the herpes simplex virus type 1 is most likely to occur around the mouth, it can also occur anywhere on the body; often on the face or the fingers. Herpes simplex virus type 2 most often affects the genital region,' says Dr Wedgeworth.

️ Fact: cold sores are very common

You might find cold sores embarrassing, but the fact of the matter is that they're pretty common and nothing to be ashamed of. 'Cold sores are more common than you may think,' says Dr Wedgeworth. 'It is thought that the majority of people in this country have been exposed to the cold sore virus and a third of people will go on to develop symptoms at some stage.'

Getty ImagesJuan Jimenez / EyeEm

Myth: Cold sores only occur in winter

Because dry, cracked lips tend to occur in winter, people believe that cold sores only appear at this time of year, too. 'Many people may be surprised to hear that sunlight is a common trigger for cold sores, so if you do suffer from cold sores, using sun protection during summer months can be helpful,' says Dr Wedgeworth.

️ Fact: cold sores can take time to disappear

Unlike spots or dry lips, cold sores tend to stick around. 'The first time you get a cold sore it can last for quite a long time - up to two weeks - and can be more severe and painful,' explains Dr Wedgeworth. 'Once you have caught the virus, it sits within your body and can reactivate at any time. Subsequent episodes are often less severe and may only last a couple of days, although there is no hard and fast rule.'

Related Story

How to avoid dry lips this winter

 

Myth: you only catch cold sores by kissing

In the vast majority of cases, you catch a cold sore through any direct contact with the skin affected by the virus.

'In reality, kissing is the most likely way you would catch a cold sore, although if infected saliva or oral secretions were on a lipstick or cup that was immediately shared, there may be a very small risk of transmission,' says Dr Wedgeworth. 'It is worth noting that people may shed the virus even when they don't have signs of the cold sore.'

Myth: cold sores only develop on your lips

This may be a very common myth, but it's a myth all the same. 'While the herpes simplex virus type 1 is most likely to occur around the mouth, it can also occur anywhere on the body; often on the face or the fingers. Herpes simplex virus type 2 most often affects the genital region,' says Dr Wedgeworth.

️ Fact: cold sores are very common

You might find cold sores embarrassing, but the fact of the matter is that they're pretty common and nothing to be ashamed of. 'Cold sores are more common than you may think,' says Dr Wedgeworth. 'It is thought that the majority of people in this country have been exposed to the cold sore virus and a third of people will go on to develop symptoms at some stage.'

Myth: Cold sores only occur in winter

Because dry, cracked lips tend to occur in winter, people believe that cold sores only appear at this time of year, too. 'Many people may be surprised to hear that sunlight is a common trigger for cold sores, so if you do suffer from cold sores, using sun protection during summer months can be helpful,' says Dr Wedgeworth.

️ Fact: cold sores can take time to disappear

Unlike spots or dry lips, cold sores tend to stick around. 'The first time you get a cold sore it can last for quite a long time - up to two weeks - and can be more severe and painful,' explains Dr Wedgeworth. 'Once you have caught the virus, it sits within your body and can reactivate at any time. Subsequent episodes are often less severe and may only last a couple of days, although there is no hard and fast rule.'

In the vast majority of cases, you catch a cold sore through any direct contact with the skin affected by the virus.

'In reality, kissing is the most likely way you would catch a cold sore, although if infected saliva or oral secretions were on a lipstick or cup that was immediately shared, there may be a very small risk of transmission,' says Dr Wedgeworth. 'It is worth noting that people may shed the virus even when they don't have signs of the cold sore.'

Jan 29th

Why women get lower abdominal pain

Whether it's the dull ache from a heavy period or the uncomfortable sensation of bloating that has us wanting to crawl into the foetal position, unfortunately for many women, lower abdominal pain is a feeling never too far away.

In the majority of cases, it's commonly brought on by menstruation, a diet of too many pulses and beans (resulting in constipation), or annoying urinary tract infections (UTIs), and can be cured with a couple of paracetamol tablets, a long sit on the loo or prescriptive antibiotics from a medical professional.

However, sometimes it's difficult to diagnose the exact location, cause and cure for lower abdominal pain, when there's so many reasons as to why it could be happening.

As a result, we've spoken to the UK's top medical professionals specialising in gastroenterology, urology and sexual health to find out how to distinguish the causes of lower abdominal pain, indications you might require further medical assistance and how to treat the problem.

Abdominal pain: Digestive system

According to statistics from the NHS, irritable bowel syndrome (IBS) is thought to affect up to 'one in five people' at some point in their life and commonly shows signs for people between the ages 20-30.

Surprisingly, around twice as many women are affected as men, which might explain why women are more likely to be heard complaining of stomach cramps and bloating.

However, pain in the abdomen isn't always related to IBS, as Dr John O'Malley, ex-secretary of the Primary Care Society for Gastroenterology explains.

Causes of lower abdominal pain

'The main cause for abdominal pain is commonly IBS, resulting in stomach cramps, bloating, constipation and diarrhoea,' says Dr O'Malley.

'However, not everything that sounds like IBS is IBS. What's increasingly being diagnosed nowadays is inflammatory bowel disease (IBD), due to improved awareness and methods to detect it, which can result in symptoms such as bloody diarrhoea.

'There's also irritable bowel syndrome with constipation (IBS-C) and irritable bowel syndrome (IBS-M) which can see symptoms of both diarrhoea and constipation.

Where you'd feel digestive pain

'Of course, there isn't a prescriptive route to the cause of lower abdominal pain but you can locate your bowel by placing your hands above your right and left hip. The bowel can be found in line anywhere from the navel down to the genitals.

'Pain on the left might indicate large bowel problems while pain on the right could suggest issues in or around the intestine.'

What the pain commonly feels like

'Pain often ranges from a mild ache to excruciating, depending on the problem.

'Bloating – when spasm causes air in the bowel to expand – normally causes mild pain, while intense pain could be a result of colonic spasm (spontaneous spasms of the colon) and even appendicitis when acute (inflamed).

Would cutting our certain food types help?

'There's an increasing number of people who come into a surgery admitting they've cut out certain foods from their diet to test whether they're allergic. Let's be clear, you should never cut out major food groups without seeking a dietician's advice.

'For example, if you have coeliac disease (a sensitivity to gluten), you might have difficulty absorbing calcium, which could result in osteoporosis, so it's important to cut out food as and when necessary, with medical assistance.'

How to solve the problem?

'A doctor would first ask for a patient's medical history, touching on the likes of past digestive issues, a travel history (as some problems might arrive from post-infective bowel syndrome), family illnesses, sex, drugs and smoking.

'An examination would confirm or help build on knowledge learned from listening to a patient's medical history. If there were concerns of a potential inflammation in the bowel, various blood, urinal and vaginal samples might be taken, as well as a test for coeliac disease.

'The most important thing to remember is no one should have to put up with pain. If you have any symptoms that concern you, seek medical advice and understand what is happening in your body,' he adds.

Abdominal pain: Reproductive organs

Period pain (when the muscular wall of the womb tightens) is a common occurrence in menstruating women from the puberty to menopause, but can sometimes be triggered by an underlying medical condition, often known as secondary dysmenorrhoea, resulting from conditions such as endometriosis, fibroids and pelvic inflammatory disease.

Therefore, it's important to monitor any changes in period pain or your periods that might indicate something more serious might be happening internally.

Professor Claudia Estcourt from the British Association of Sexual Health and HIV (BASHH) says: 'The key thing when assessing pain related to the reproductive system – be it in the ovaries, uterus or fallopian tubes – is to keep tabs on any changes.

'For example, if you've never had period pain and suddenly find your periods are uncomfortable or result in uncharacteristic pain over several months or cycles, it's a good idea to take action.'

Causes of lower abdominal pain

Depending on the age of the woman, we might need to exclude pregnancy by doing a pregnancy test. Pregnancy itself shouldn't be painful, but we would need to think about a range of different causes if the woman was pregnant and sometimes treat her with different drugs which wouldn't harm her pregnancy.

After that a doctor's next action would be to establish if the pain is coming from the gut, the reproductive tract or the kidneys and bladder.

Symptoms to monitor include:

Whether you're feeling sick, losing weight, experiencing constipation and diarrhoea pain during menstruation that isn't normal for you

Bleeding in between, after or during sex

·       Pain with sex, often experienced as 'deep pain' which if severe would mean that penetrative sex is just too uncomfortable or painful

·       Sharp pain in the ovaries

Pain during or after sexual intercourse

'If a woman reveals she's never had painful vaginal intercourse but is now experiencing discomfort, she might have an infection in the uterus or fallopian tubes.

'Pain during sexual intercourse can occur when the uterus or ovaries are inflamed, and cause pain when the penis hits the cervix. If a woman has pain during or after sex or experiences bleeding, they should visit their GP.

What the pain commonly feels like

'Pinpointing the origin of pain might be good indication of cause but, not always. In terms of the reproductive organs, if a woman was experiencing dull, sharp or constant pain due to sex or a change in (worse) period pain, it would be a red flag.

'It's always worth having an STI screen to rule out any infections that might give rise, if left untreated to pelvic inflammatory disease, ectopic pregnancies and long term lower abdominal pain. It's easy and quick to do this in a sexual health clinic.

How to solve the problem

'When a woman visits a doctor, she should expect to be asked questions to pinpoint possible causes for the pain including questions about her reproductive, urinary, digestive systems. The doctor might also check her mood is ok as some psychological problems can manifest themselves in a physical symptom of lower abdominal pain in some women.

'Once pregnancy is ruled out, we might ask to examine the woman's abdomen which would involve feeling a woman's stomach to locate any tenderness, swelling or pain. A doctor would press on the lower stomach with their fingers to feel if added pressure illicits pain or if there were any abnormal lumps and bumps.

PINPOINTING THE ORIGIN OF PAIN MIGHT BE GOOD INDICATION OF CAUSE BUT NOT ALWAYS

'In some cases, we would ask to do a gentle internal examination with a speculum to look inside the vaginal and at the cervix and to take STI samples and a bimanual examination which involves a doctor inserting her forefinger and middle finger into the vagina (with gloves on) and then pressing the top of the pelvis with their other hand to palpate the organs.

'This gently compresses the organs between top & bottom hands so it's easier to find a potential cause of pain.

'Depending on the results from STI, urine samples and examinations, it might then be necessary to investigate further and this might include ultrasound scans,' she notes.

Abdominal pain: Urinary issues

Anyone who has endured the pain from cystitis (caused by a bacterial infection) will be well-accustomed to the agonising, burning sensation when passing water or the urgency of needing the toilet.

Unfortunately, cystitis is more common in women than men for several reasons, one being the fact our the urethra is much shorter and closer to the back passage.

Causes of lower abdominal pain

Miss Mary Garthwaite, Consultant Urological Surgeon at James Cook University Hospital, Middlesbrough, reveals the most common causes of risk factors for cystitis in women include sexual activity, hormonal changes during pregnancy and secondary to the menopause, bowel issues resulting in either such as constipation and or diarrhoea and being generally run down (lowered immune system).

'However, some women seem more prone to UTIs than we can currently explain, without any obvious risk factors,' she adds.

When bacteria builds up in the urine bladder or urethra, it causes the bladder to become inflamed and more sensitive, resulting in the symptoms of cystitis.

'Bladder pain syndrome – a chronic bladder condition – is rare but can happen in the absence of infection for some patients and leave patients with a chronically painful sensitive water pipe urethra and bladder.

'It's often difficult to diagnose the pain in the bladder pain syndrome so it's usually a matter of first excluding what it isn't.'

Where you'd feel urinary pain

'Cystitis-related pain can be found very low down in the middle of the tummy below the public bone. To locate the bladder area, press on the middle of your bikini line.

'If it's a severe infection you might get loin pain which can go off to one side at and round to your the lower back. You may feel as if you kidneys are aching.'

Should you go to the doctors with a UTI?

If you're systematically systemically well (not feverish, eating and drinking normally) but have irritating bladder symptoms you think might be due to infection, first increase the amount of fluid you're drinking. By doing so, you're diluting the urine which can help settle the pain and literally flush out the bugs trying to cling to the bladder wall.

'Taking some simple pain killers such as paracetamol might also help with discomfort. The pain should be monitored for 24 hours in order to see if it improves or worsens.

'If symptoms get worse over 24 hours, speak to a pharmacist. If but you're still systemically well, a pharmacist might recommend over the counter treatments which can be dissolved in water –therefore encouraging you to drink more – which can help settle symptoms by changing the acid balance of the urine.

SOME WOMEN SEEM MORE PRONE TO UTIS THAN WE CAN CURRENTLY EXPLAIN, WITHOUT ANY OBVIOUS RISK FACTORS

'If you start to feel achey or fluey and the burning pain is becoming too much to cope with, book a doctor's appointment and be prepared to take a urine specimen along with you. You may need a short course of antibiotics'.

'You should also consult your doctor if you see bright red, visible blood in your urine. Bugs that cause cystitis sometimes cause the bladder lining to inflame and bleed (haemorrhagic cystitis) but it's important to inform your GP and ensure there isn't a more serious problem occurring'.

'A good rule of thumb is, if you have more than two separate urine infections within six months that really affect you, seek medical advice.'

 

 

Jan 28th

The way we eat is killing us – and the planet

The distinguished medical journal The Lancet has issued not one but two apocalyptic warnings about our food in under a month. One of its special commissions reported earlier this month that civilisation itself was at risk from the effects of the current food system on both human health and the Earth’s ecosystems.

This week comes the next instalment from another special Lancet commission which finds that pandemics of obesity and malnutrition are interacting with climate change in a feedback loop and represent an existential threat to humans and the planet. The modern western diet has become a highly damaging thing that needs a complete overhaul if we are to avoid potential ecological catastrophe. It concluded that we need to halve global meat consumption, and more than double the volume of whole grains, pulses, nuts, fruit and vegetables we eat.

Cue howls of indignation from big food and its cheerleaders, the libertarian right. Those nanny statists have gone nuts eating their own double dose of nuts! Cue cries of distress from champions of local, low-impact agriculture who include grass-fed animals, and their meat and manure, in their sustainable mix. These self-appointed experts don’t understand farming! Cue grim food wheels with only a quarter of a rasher of bacon or a fifth of an egg a day. Those miserabilist medics want us all to go vegan!

Yet the evidence that our diets are the largest cause of climate change and biodiversity loss is now overwhelming. The global food system is responsible for up to 30% of total greenhouse gas emissions, the livestock sector on its own accounting for about half of that total or 14.5%. The modern western way of eating is also making very large numbers of people fat and sick as other parts of the world adopt it.

Diet-related diseases now cause roughly 11 million deaths a year as preventable cancers, heart disease and strokes, obesity and diabetes have spread along with our way of eating. More than 800 million people are estimated to be chronically undernourished, and 2 billion suffer from micronutrient deficiencies, yet at the same time 2 billion are overweight or obese. In poorer counties you can even find obesity and stunting within the same family as calorie-heavy but nutrient-light processed industrialised foods are adopted.

In other words, something has gone horribly wrong and we don’t have much time to fix it. The so-called “reference diet”, published in the first Lancet report,, has caused uproar in some quarters. This is a theoretical attempt to answer the Malthusian question: if the global population reaches 10 billion by 2050 (as is anticipated), will there be enough food to meet everyone’s basic nutritional needs without cutting down more forest, polluting more water courses and generally destroying the planet? The answer it comes up with is yes, but only if we share things out differently, and stop feeding a quarter of the world’s grain to animals.

The reference diet models each person globally having 14g of red meat a day, 29g of chicken, a fraction of an egg, 250g of dairy, a little fat or oil, very little sugar, and lots of grains and lentils, vegetables and nuts. And here’s where the trouble begins, because calculated day by day and universally these allocations make for a pretty depressing plateful.

They contain some odd judgments. Why favour industrialised chicken? Why palm oil? They are plain weird if you try to interpret them as daily instructions without thinking about the diet as a whole or what’s available to people locally – hence the one-fifth of an egg, the quarter rasher of bacon. People don’t shop and eat by numbers and fractions. And the fact that nutrition epidemiology – the study of patterns in diet and disease – has got it wrong before does not help. Remember when fears about dietary cholesterol were used to condemn eggs? These instructions sound top down and, worse, appear to throw responsibility back to the individual.

But that is to miss the point of these instructions. They are calculations that give a sense of the scale of the problem and a science-based framework for political action. Contrary to some claims, the Lancet commission that undertook the modelling, supported by the philanthropic EAT Foundation, received no funding from industry. And the uncomfortable truth is that meat, and specifically the meat from intensively-fed livestock, processed in the way it generally is in the western diet, is a hotspot when it comes to greenhouse gas emissions and ill health. Well-produced meat and dairy can have a place, but it will be a small one, and it is expensive.

Our diets are out of kilter with what’s good for both us and the planet because powerful vested interests and misplaced economic incentives have driven them in that direction, and this is the thesis underlying the commission’s findings. The equivalent of $500bn in agricultural subsidies goes each year to the wrong sort of food – corn, soya, meat and dairy, as cheap raw materials for intensive livestock production and for highly processed foods. About $5tn a year goes in subsidies to the fossil fuels which industrialised agriculture uses so profligately. Big food has spent hundreds of millions advertising unhealthy food and lobbying to block the sort of measures that might help shift consumption.

Although individuals can make a difference by modifying their diets, and send clear demands for action to politicians , we cannot redraw the food system on our own. That will require not just governments, but global agreement.

The Lancet says the problem is so big and so urgent that we need an intergovernmental convention to agree a way forward, in the way that the Intergovernmental Panel on Climate Change or the World Health Organization’s Framework Convention on Tobacco Control have. Expect plenty of hysterical, dark-money opposition to that. The Lancet, founded in the 19th century, caused uproar back then by publishing the unwelcomenews that food was routinely adulterated. It has once again kickstarted a vital debate about how we eat. If it all sounds too gloomy, it’s worth remembering that the modern western diet is a recent invention. The separation of livestock from the land only took off in the 1950s, thanks to cheap energy to keep animals housed, to synthetic fertilisers increasing grain production for feed, and to mass production of antibiotics to control disease. It’s not so very long since most people ate in the way we now need to rediscover.

Jan 26th

“But because he was put on IV straight away, it has not been too bad. The antibiotics saved him.

“If the doctor hadn’t sent us up to the hospital it could have been a very different story.

“You wouldn’t think that this is what a kiss can do.

“He has been in unbelievable pain. He has been constantly screaming. He can’t eat. He can’t move his legs.”

Louise said she was told by doctors that Laaston’s herpes were probably caused by coming into contact with somebody with a cold sore, but she still has no idea who.

She added: “It could have been anyone. The doctors asked me if I had had a cold sore and I’ve never had one, but I could still be carrying the virus.

“All the staff at the hospital have been brilliant. It’s down to them that he got the antibiotics so quickly.

“It was hard work to get a cannula in because of his skin and his little veins, but they did it.

“Looking at his skin, it could take him months to get better.

I want people to know how dangerous it can be. It’s not something you expect. I will never give my baby a kiss on the lips again, and I won’t let anybody else do it.

“I definitely don’t want to go through this again.”

Dr Benjamin Butler-Reid, of Highfield Surgery, Blackpool, said: “Cold sores are caused by the herpes simplex virus and it is easy to spread by skin contact.

“In adults, it rarely causes serious disease and can be managed by a cream or patches that your pharmacist can provide.

“Some groups are more vulnerable to the virus, such as pregnant women, immunosuppressed patients and babies.

Jan 24th

From insomnia to cold hands and feet, The major signs of a slow metabolism - and how you can fix it

·       Metabolism relates to the body producing energy from fat, sugar and protein 

·       A fast metabolism involves the body efficiently processing energy 

·       A slow metabolism sees the body 'hanging' onto unwanted calories 

·       Signs of a slow metabolism include insomnia, cold hands and feet  

·       Boost your metabolism with vegetables, lean protein, healthy fats and nuts

·       Metabolism is a complex chemical process relating to the body's ability to produce energy from fat, sugar and protein.

·       A fast metabolism sees the body efficiently processing energy, whereas a slow metabolism sees the body 'hanging' onto unwanted calories.

·       Signs of a slow metabolism can include weight gain, insomnia, cold hands and feet.

·       According to Australian clinical nutritionist Rebecca Miller, the effects can be reversed - provided you follow a few key pointers.

·       So what should you do? 

·       'The thyroid gland's main responsibility is to convert calories into energy, to power the cells and organs in your body, and your metabolism is the rate at which this happens,' Rebecca told FEMAIL.

·       If your thyroid function is below par, your metabolism will slow as a result. 

·       What are the statistics? 

·       What are the signs of a slow metabolism? 

·       Symptoms can include any of the following:

·       * Insomnia

·       * Cold hands and feet

·       * Weight gain

·       * Muscle cramps and weakness

·       * Loss of libido

·       * Dry or gritty eyes

·       * Difficulty swallowing

·       * Excessive tiredness

·       * Breathlessness, dizziness and palpitations

·       * Constipation

·       * Loss of appetite 

·       * Hair loss (especially the outer third of eyebrows)

·       Source: Rebecca Miller, Clinical Nutritionist, and Founder and Director of Health with Bec  

·       'This is an extremely common issue, with 1.6 billion people worldwide thought to be at risk for thyroid dysfunction,' Rebecca said.

·       'The World Health Organisation estimates that 750 million people are living with thyroid condition right now.' 

·       What are the key signs of a slow metabolism? 

·       Weight gain is just one of the many signs of a slow metabolism.

·       According to Rebecca, other signs include excessive tiredness, cold hands and feet, insomnia, slow movements, thought and speech, along with the sensation of pins and needles.

·       Breathlessness, dizziness and palpitations are also common, as well as muscle cramps and weakness, low basal temperature, loss of libido, dry or gritty eyes and a hoarse voice.

·       Other symptoms include difficulty swallowing, hair loss (especially the outer third of eyebrows), dry skin, headaches, muscle and joint pain, blurred vision, loss of appetite, constipation, irritable bowel syndrome and weakened immunity.   

What are the signs of a slow metabolism? 

Symptoms can include any of the following:

* Insomnia

* Cold hands and feet

* Weight gain

* Muscle cramps and weakness

* Loss of libido

* Dry or gritty eyes

* Difficulty swallowing

* Excessive tiredness

* Breathlessness, dizziness and palpitations

* Constipation

* Loss of appetite 

* Hair loss (especially the outer third of eyebrows)

How can you boost your metabolism? 

Luckily, there are many things you can do to help speed up your metabolism.

'Minimising stress, prioritising sleep, drinking lots of water, exercising regularly, increasing muscle mass and visiting your GP for check-ups can definitely assist,' Rebecca told FEMAIL.

Alongside this, maintaining your well-being and enjoying a diet rich in micro-nutrients will also result in optimal thyroid function.

What are the best foods to boost your metabolism?  

'You need to load up on vegetables, fruit, lean protein, healthy fats and nuts,' Rebecca said.   

What are easy ways to boost your metabolism? 


Assuming there are no medical issues, ways to boost our metabolism include: 

1. Get moving – exercise plays a huge role in our metabolic health. Our bodies need to be moving daily! 

2. Eat more plant foods – plant foods provide amazing prebiotics (otherwise known as fibre) which nourish the gut cells and keep our gut (and body) healthy 

3. Reduce your intake of white processed carbohydrates - as they overload our blood with sugar and provide very little nutrition for the body 

4. Eat what you need – listen to your body. Make sure that every day you are experiencing feelings of hunger and fullness. Really tune in to what your body is telling you – it will guide you as to how much food you really need. 

5. Drink enough water – being dehydrated can also make us feel sluggish. Make sure you regularly sip on water throughout the day. Cups of tea can also count towards your fluid intake

Source: Karina Savage, Paediatric Dietitian from Smartbite Nutrition

Iodine: Kelp, spirulina, chlorella and other sea vegetables.

Selenium: Brazil nuts, sardines and pasture-raised chicken, turkey and eggs.

Zinc: Organic eggs, wild caught salmon, grass fed beef and organic meat, pumpkin, chia seeds, spinach and almonds.

Vitamin A: Orange vegetables and dark leafy greens.

Vitamin D: Wild caught salmon, sardines, egg yolk, fermented dairy and mushrooms.

Vitamin E: Raw almonds, dark leafy greens, mustard greens, avocado and olives.

Vitamin K: Fermented dairy, grass-fed beef, butter and cheese from grass-fed animals, organic eggs.

Iron: Grass-fed beef and organic meat, chicken, duck, turkey, fish, quinoa, lentils, nuts and leafy greens.

B-complex: Grass-fed beef, poultry and fish, organic eggs and dairy products.

Tyrosine: Soybeans, beef, lamb, pork, fish, chicken, nuts, seeds, eggs, dairy, avocado.

Vitamin C: Most fruits and vegetables. Richest sources include all types of berries, citrus fruits. Watermelon, capsicum, leafy greens, broccoli, Brussels sprouts and cauliflower.

Omega 3 fatty acids: Wild caught fish (especially fatty fish including salmon, tuna and mackeral), flaxseed, chia seeds and walnuts.

What are easy ways to boost your metabolism? 


Assuming there are no medical issues, ways to boost our metabolism include: 

1. Get moving – exercise plays a huge role in our metabolic health. Our bodies need to be moving daily! 

2. Eat more plant foods – plant foods provide amazing prebiotics (otherwise known as fibre) which nourish the gut cells and keep our gut (and body) healthy 

3. Reduce your intake of white processed carbohydrates - as they overload our blood with sugar and provide very little nutrition for the body 

4. Eat what you need – listen to your body. Make sure that every day you are experiencing feelings of hunger and fullness. Really tune in to what your body is telling you – it will guide you as to how much food you really need. 

5. Drink enough water – being dehydrated can also make us feel sluggish. Make sure you regularly sip on water throughout the day. Cups of tea can also count towards your fluid intake

 

Jan 23rd

Five easy lifestyle changes to make your day healthier

Cold weather, less sunshine, festive excess - winter can come as a shock to the system, making January feel like a very long month. But here we reveal our expert tips on diet, exercise and general wellbeing so you can sail smoothly through winter and right into spring.

7am: Consider supplements

During the winter months, less light reduces our source of vitamin D. This in turn affects the absorption of other important vitamins such as vitamin A, iron and calcium.

You might want to try Lemlift, a food supplement created to support the normal function of the immune system, containing both vitamin C and zinc. 

Cold weather, less sunshine, festive excess - winter can come as a shock to the system, making January feel like a very long month. But here we reveal our expert tips on diet, exercise and general wellbeing so you can sail smoothly through winter and right into spring.

7am: Consider supplements

During the winter months, less light reduces our source of vitamin D. This in turn affects the absorption of other important vitamins such as vitamin A, iron and calcium.

You might want to try Lemlift, a food supplement created to support the normal function of the immune system, containing both vitamin C and zinc. 

Diet is an important factor when it comes to staying fit and healthy and supporting our immune systems, with the NHS stating that eating your five-a-day contributes towards fighting serious illnesses such as strokes, heart disease and cancer.

With this in mind, try to eat plenty of vegetables, including fibre-rich cabbage, spinach, and kale, red meat, which is rich in vitamin B12, and fish, milk, eggs and cheese.

7pm: Exercise regularly

As well as eating healthily, being physically active plays a vital role in keeping your immune system in shape. The key is to plan a routine to fit in with your winter lifestyle. You don’t have to pound the pavement on dark nights in zero temperatures, instead, take your exercise indoors and join a gym, sign up for a class or invest in some home fitness equipment.

Consider joining a yoga or dance class, plan a weekly swimming night or take up boxing, aerobics or fencing. Be flexible about timings – if the dark winter nights don’t inspire you, opt for a lunchtime class or gym session instead.

Treat yourself to a steam room or sauna afterwards, a great way to relax tense muscles and alleviate stress – the high temperatures will also detox your body.

11pm: Balance sleep patterns

Colder days and darker evenings might make us want to curl up and sleep, but over-sleeping could end up making you feel more sluggish during the day. A healthy diet and regular exercise will help to boost your energy to combat daytime tiredness, getting fresh air and sunlight – no matter how little – will also give you a lift. Don’t be tempted to over-eat stodgy or sugary foods however, as this may disrupt sleep patterns.

 

Jan 22nd

A remarkable new study shows stem cells can reverse MS in some patients

A majority of patients in a small trial who got stem cell transplants after chemo saw their quality of life and disability improve.

A majority of patients in a small trial who got stem cell transplants after chemo saw their quality of life and disability improve.

By the time Amanda Loy turned 28, her multiple sclerosis had progressed to the point that she could no longer work full time. Her hands and legs felt numb all the time, her bladder always felt full, and she had to rely on a cane to walk for more than 10 minutes. After she gave birth to a son a year later, in 2008, the symptoms worsened. It was around then that she decided to travel from her home in Anchorage, Alaska, to Chicago to inquire about a new treatment she’d heard about at a Seattle hospital. 

Nearly a dozen years on, Loy is now back to working full time as a teacher in the radiology program at the University of Alaska. She runs half-marathons and plays soccer with her son, who is 10. She no longer takes MS medications. Her only lingering symptom is some mild nerve pain from time to time.

“It sounds so dramatic, but [the treatment] gave me my life back,” she said.

The treatment is an experimental chemotherapy and hematopoietic stem cell transplant offered in the first randomised trial comparing the outcomes of patients receiving the treatment to patients who took standard MS medications.

The results of the trial appeared Tuesday in the journal JAMA, and they are impressive: Among the 55 patients in the control group who took medication, 34 saw their disease worsen. But for the 55 (including Loy) who received the chemo and stem cell transplant, only three got worse. The rest saw their quality of life and disability improve.

It’s the best evidence to date that the treatment works for patients with what’s called “relapsing remitting” MS. “I do think it’s going to change the natural history of MS,” said Northwestern University stem cell researcher Richard Burt, the study’s lead author and Loy’s doctor. “When you use it in the right group of patients with MS, you get these really gratifying results.”

Doctors still don’t know whether the therapy will work for people with other forms of MS. They don’t know if the risks of a transplant (which include death) will always outweigh the benefits. Still, turnarounds this dramatic for patients with MS are rare — and worth examining.

Doctors running the trial did not expect such dramatic improvements in the patients treated with stem cell therapy

MS affects about 2.3 million people around the world, particularly women in more temperate climates like Canada and the northern US.

Instead of protecting the body from foreign invaders, in patients with MS, the immune system turns on its host, in particular damaging the myelin, a protective coating around the nerve fibres in the brain and spinal cord.

Eventually, these attacks can severely damage and destroy the nerves and myelin, interrupting the communication between the brain and body and leading to symptoms like numbness, trouble walking, and even blindness.

But not all patients’ symptoms manifest in the same way. People with “relapsing remitting” MS — or 85 percent of people with the disease — experience it in fits and starts: their symptoms show up for a few days or weeks, followed by weeks, months, or even years of remission.

For most patients with this version of the disease, those periods of remission get smaller over time and eventually disappear, moving them into another phase of the disease known as “secondary progressive MS.”

Loy and the other patients in the trial had relapsing-remitting MS. Loy had tried medication, and nothing worked.

Burt told her the best she could hope for from the stem cell transplant was that her symptoms wouldn’t worsen. “I didn’t really expect all of these improvements. I went into it thinking, ‘If I at least don’t get worse from this point, that’ll be okay,’” she said. “So all the improvements have been totally unexpected but a nice surprise, that’s for sure.” 

How stem cells changed Loy’s immune system

The road to Loy’s stem cell transplant wasn’t straightforward. She found out about the approach a couple of years after her diagnosis, and contacted a hospital in Seattle to inquire about another similar study in 2010. “They weren’t taking new patients, but they told me there’s this guy in Chicago I might look into,” she said.

That guy was Burt, at Northwestern. So she went to meet him in 2010 and found out she qualified for his study. But she was randomly assigned to the control group — and at first, she didn’t get the treatment.

Within two years, though, her MS symptoms worsened. Burt asked her to come back to Chicago to assess her disability, and determined she could transfer over to the treatment group. In 2012, she travelled to Chicago for a transplant.

The treatment involved four major steps: Doctors first put her through a short course of chemotherapy to stimulate the production of hematopoietic stem cells, which are the cells responsible for regenerating the immune system. They then hooked Loy up to a machine that cycled through her blood to collect the stem cells, which were frozen. Another higher dose of chemo wiped out Loy’s immune system.

“I had a hard time with the chemo,” Loy recalls. “It made me really, really sick and pretty miserable-feeling — nausea, vomiting.”

Then her stem cells were thawed and transplanted back into Loy, just like a blood transfusion. She was so tired from the chemo that she napped through the transfusion.

But then something amazing happened: Right after getting the transplant, Loy noticed her MS-related bladder symptoms had gone away. And with a year, all her other symptoms — fatigue, heat intolerance, numbness, nerve pain — improved or dissolved.

The only side effect from the treatment, she said, was temporary menopause during the chemo — but that also went away quickly and had no effect on her fertility. Common side effects in the other patients in the transplant group of the trial were infections (such as chest colds and urinary tract infections) and electrolyte disorders. No one died as a result of the transplant.

Not every MS patient will be eligible for this treatment

The study that gave Loy the chance to reverse MS was impressive — an international, multi-centre, blinded, randomised trial conducted at four centres: in Chicago, at the Sheffield Teaching Hospitals NHS Foundation Trust & University of Sheffield in England, at the University of Uppsala in Sweden, and at the University of São Paulo in Brazil. Patients were enrolled at each of these hospitals between 2005 and 2016 and followed up for at least one year to see whether their disease had progressed.

The study built on decades of basic research about MS, stem cells, and the immune system, including years of experience using the treatment in patients with blood and bone marrow cancers like leukaemia and lymphoma. It also built on earlier research examining this approach to treating MS, such as a rigorous 2016 study out of Canada in which 70 percent of the 24 patients who received chemotherapy and stem cell bone marrow transplant saw the progression of their disease halted or reversed. Esteemed medical specialists at the time called that study a “miracle.”

“This is one of the first pieces of proof that, yes, patients who have aggressive MS do better after a transplant than with the standard therapy.”

 

“Everyone is hesitating to use the ‘c-word,’ but these patients are cured,” Michael Rudnicki, director of the Regenerative Medicine Program and the Sprott Centre for Stem Cell Research at the Ottawa Health Research Institute, told me in 2016.

This week, I circled back to a patient I’d profiled then, Jennifer Molson, who had a turnaround as miraculous as Loy’s — and she was still doing well, with no new MS symptoms. “I just walked up six stories in heels because we had a fire alarm,” she told me.

Previous studies, like the 2016 paper, had followed people with MS who got the treatment — and shown similarly impressive results — but they lacked a control arm for comparison. And that’s what makes this new study special, said Harry Atkins, a stem cell transplant physician and scientist at the Ottawa Hospital in Canada who led the 2016 study.

“It’s the best evidence comparing stem cell transplants to standard therapy,” Atkins said. “This is one of the first pieces of proof that, yes, patients who have aggressive MS do better after a transplant than with the standard therapy.” (There was another randomised trial published a few years back, but it was marred with methodological problems that Burt’s paper overcame, Atkins said.)

The new study also focused on the most important outcome in MS: disease progression. “They’ve shown that in the conventionally treated arm of the study, those patients continue to deteriorate compared to the transplant patients — many of whom have stabilised or gotten better over the follow-up period.”

But the treatment isn’t for everyone, and there are important limitations to the study. Burt focused on the subset of patients with relapsing-remitting MS, who had at least two flare-ups in the past year. “It’s clearly beneficial in those patients, but whether the risks and benefits balance out in patients with more conventional MS wasn’t addressed,” he said.

Another limitation is that since the study was designed, new MS drugs have come on the market. These drugs appear to be more effective than older drugs, Atkins said, and it’s possible they might compare favourably to transplants in a head-to-head study, but that hasn’t been done yet.

What’s more, in early studies of stem cell transplants for MS, 5 percent of patients died. In the past five to seven years, that mortality rate has dropped to 1 to 2 percent — particularly as the chemo regimens have become less toxic — “but it’s not zero,” said Atkins. “So that’s where this whole idea of matching the risk to the outcome or benefits we expect is important.”

So doctors don’t know whether that risk-benefit ratio makes sense in patients who have less aggressive forms of MS (meaning they have fewer relapses) or how soon after a diagnosis the treatment should be applied.

There’s also the problem of insurance coverage. While’s Loy’s therapy was mostly paid for by her health insurance plan, that’s not true for all patients. And she had to pay out of pocket the $10,000 to $20,000 (£7,800 to £15,500) in travel costs to Chicago, the kind of urban research hub that tends to offer the treatment but can be out of reach for many Americans.

“This study shows a broad benefit for patients,” Atkins added. “It opens up stem cell transplant to be a more widely applied treatment. But there are lots of other questions.”

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.

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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.

 


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.

 


July 29th 2017 repeated for information

Cold sore virus kills baby

August 11th 2016

John and Louise Wills had no idea how lethal a simple kiss to a baby could be before losing their child.

Baby Eibhlín was just 12 days when she died from the common cold sore virus –  and now they’ve called for increased awareness to prevent other parents suffering the same ordeal.

Sharing their story to highlight the hidden danger, they have created a website in Eibhlín’s memory and are asking the public to support and share.

‘We are sharing our story in Eibhlín’s memory so we can create awareness about the dangers of cold sores and new born babies. We want all parents, parents-to-be and any medical staff working with them to be made aware of the risks so no one else ever has to face what we have gone through,’ said John on RTÉ One.

Born in November 2015 by an emergency C-Section in The National Maternity Hospital, their baby Eibhlín weighed a healthy 7lb 11oz.

After birth she was sent to the Neonatal Intensive Care Unit as a precautionary measure as she had become a little distressed prior to delivery but after five nights in hospital she came home.

Initially all appeared well and there was no cause for alarm until 11pm that night when her colour suddenly changed and she became listless.

John and Louise headed to Tallaght A&E where Eibhlín was immediately seen but was pronounced dead at 1:09am a week to the day since she had come home from hospital.

A post-mortem identified the cause of death as the Herpes Simplex Virus 1 (HSV-1) which is more commonly known as the Cold Sore Virus.  In Eibhlín’s case it was Disseminated Neonatal Herpes Simplex Virus 1, which incubates for a time and results in multiple organ failure but there are no symptoms until it is too late.

While this type of death is rare it is even rarer in Eibhlín’s case as 90% of these infections come from the mother. But Louise was found not to have carried the virus. 

‘Eibhlín contracted the virus postnatally and, although we may never know from whom or exactly when it happened, we know from tests that the virus was already in her system when she came home from the maternity hospital with us,’ Louise said.

Since Eibhlín’s death John and Louise have discovered that acquiring accurate statistics on new born babies with the cold sore virus in Ireland is difficult and are calling for the Minister for Health to make this more transparent.

As a legacy for Eibhlín, Louise said they now want to ensure the general public is aware how lethal a cold sore can be to a new born baby.

In order to create greater public and professional awareness and education John and Louise’s aims are as follows:

·        To provide an information leaflet with Eibhlín’s story and website details in the welcome packs issued to mothers-to-be in Ireland’s maternity hospitals

·        To ensure that Eibhlín’s story is mentioned in the ante natal classes

·        To place information posters in clinics

·        To remind visitors to mums and babies not to visit if they have a current cold sore

·        To provide more information to student midwives/ nurses/ healthcare workers 

·        To ensure consultants include Herpes Simplex Virus and Eibhlín’s story in lectures/ educational forums

·        To encourage GPs to discuss the virus with expectant mothers, and after the birth of their baby, to be mindful if they or close family and friends suffer from cold sores.

·        To place posters and/or leaflets in GP surgeries

They also aim to encourage maternity hospitals to include a specific infection protocol that applies to any staff member with active Herpes Simplex Virus working with new born babies and to ensure Infection Control sections of maternity hospital websites provide relevant information for patients and visitors.

 

Feb 17th 2017

Virsaviya is just like any other seven-year-old-girl - she likes dancing, drawing and ponies.

But as this incredible footage shows, the brave girl was born with an extraordinary condition which means her heart is outside her chest.

The little girl suffers from thoraco-abdominal syndrome or Pantalogy of Cantrell - a condition that occurs in less than 1 in a million births.

Speaking to the BBC, she said: "This is my heart. I'm the only one that has this."

Virsaviya's heart can be visibly seen beating underneath her rib cage with only a thin layer of skin to protect it.

She adds: "When I'm getting dressed, I put soft clothes on to not hurt my heart.

"I walk around, I jump, I fly, I run, I'm not supposed to run but I love running."

When Virsaviya was born in Russia, doctors warned mum Dari Borun to prepare for the worst.

She said: "Doctors told me Virsaviya had a really rare condition. But they said she won't survive. When I saw the first time how her heart was beating, of course to me it was something special.

"It meant that Virsaviya's alive and she can breathe and she can live."

Dari moved her from Russia to the US in the hope she could have surgery but she was told that Virsaviya wasn't strong enough because of problems with her blood pressure.

She added: "We came from Russia to the US but when doctors checked her they said they could not help her. I was really upset about that because they kept telling me she will die soon.

 

"It's not easy for Virsaviya to live with her heart on the outside because it's really fragile. She has to be careful as of course she can fall and it can be really dangerous - she can die from that."

Now the family have moved to Hollywood in the hope that medications can bring her blood pressure down enough to operate.

"I like to draw Jesus, ponies and angels," said Virsaviya.

"I don't go to the school and I don't go to the ballet but I want to do it at home.

"My heart is right here.

"It's outside of my chest and I really love my mom , she's always touching my heart because she likes it."

Virsaviya's heart, about the size of a fist, has always been outside of her chest since birth.

She is expected to require several very complicated operations .

The cheerful and talented child who loves dolphins, dogs, horses and Beyonce has had her entire life documented on her mother's instagram account.

For earlier medical news see the medical home page

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