Monthly Archives: May 2014

Unusual Treatments For A Gastrointestinal Illness

Intestinal flora are microbes living in every human being's digestive tract that do the grunt work of digestion; they play an important role in breaking down the food people eat. These microbiota are also a part of the immune response, helping the immune system learn to properly distinguish friend from foe. One type of these microbes is a bacterium called Clostridium difficile. Normally, there is only a small population of this bacterium in the gut. When, however, other gut microflora are reduced or eliminated, typically by antibiotics, C. diff can get out of control, growing unchecked and causing serious illness. Symptoms of this include watery diarrhea, fever, and nausea. In some cases, a C. diff infection can result in colitis.

It can also result from colitis, as inflammatory bowel disease can trigger a C. diff infection. Abdominal or gastrointestinal surgery is another possible cause, particularly in patients who have experienced an infection already. A type of drug called a proton pump inhibitor is often prescribed for chronic indigestion, GERD, and other conditions; it can also make someone more prone to C. diff infection. Suppressing the immune system, such as through chemotherapy, also raises the risk.

The standard treatment for C. diff infection is easily administered and when it works—90 percent of the time—it works quickly and with no side effects. Despite this, the treatment sounds unappealing: fecal transplant. The microbes in the donated matter replace the gut flora the patient had lost, recolonizing the intestine and taking it back from C. diff. Recently, researchers have been looking for a synthetic substitute. Not just a joke-shop novelty, the synthetic version avoids the problem of pathogens from the donor being acquired by the recipient, as well as overcoming the aesthetic objection.

Another possible treatment being investigated involves llamas. A group of Canadian scientists who are studying llamas say they have found a type of antibody in the South American pack animals—shared by their cousins, camels, as well as by sharks—that may give information on how to stop C. diff from colonizing the gut when it is able to do so. The llama antibodies aren’t suitable for human use directly, but they may provide a blueprint to develop a synthetic treatment.

Staying Hydrated In Hot Weather

Summer heat means running around outside, and running around means perspiring, and perspiring, if care isn’t taken, means dehydration—and that can lead to brain damage and worse. Just a 1.5 percent loss of water can cause harm. Here are some ways to avoid getting dehydrated:

  • First and most obvious: drink plenty of fluids ideally water; carbonated drinks, alcohol, and drinks high in sugar can make things worse. Listen to thirst and drink something when it comes.
  • Eating fruit and other foods high in water can also help fend off dehydration. Fruit can also help maintain a proper electrolyte balance
  • Even without thirst as a trigger, experts recommend an additional liter of water per hour of exercise. It’s best to drink at least some of this water in advance.

Dehydration is a serious health risk. In addition to being thirsty—which is actually not always an effect of the condition—dehydrated people are logy and irritable. Another sign is dark yellow urine, as opposed to pale or clear, though someone suffering dehydration isn’t going to be urinating very often at all. Headaches, dizziness, and dry skin are also common.

People who are dehydrated should drink water, but slowly; it may seem better to get as much liquid as fast as possible, but that can actually overwhelm the body and cause drowning. Severe dehydration requires medical treatment. Signs include bloody stool or vomit, unusually dry eyes with no tears, sunken eyes, rapid heart rate, and going eight hours without urinating at all.

New Treatment Prospect For HIV Found Underwater

Victory in the war on AIDS may be closer than ever before. Researchers have found a source for a chemical that may hold the key to ending the disease once and for all. A protein newly discovered in a kind of coral seems to have the ability to stop HIV from being infectious, meaning it can not only be incorporated into the treatment of people who are already HIV-positive, it can also help prevent the transmission of the virus, even without barrier protection.

Coral are often associated with coral reefs. The animals are invertebrates, and live in colonies; individual animals, called polyps, gather together with thousands of identical siblings. The most common and best known types form the exoskeletons that are the reefs. After decades or even centuries of growth—the coral reproduce by cloning, as well as sexually by releasing spores—these reefs can grow to enormous size. Other coral, known as soft coral, are lacy and flexible rather than stony, waving along with the current. Almost all coral get nutrients from a symbiotic relationship with algae that live among them.

Researchers identified the proteins, called cnidarin, while looking at specimens of feathery coral—a type of soft coral—collected near Australia. They then isolated and purified cnidarin and tested it against laboratory strains of HIV. The proteins were soon determined to be capable of blocking HIV at concentrations of a billionth of a gram. HIV transmission starts with the virus attaching itself to a type of immune cell known as the T-cell. Cnidarin blocked this attachment, defeating the virus. Uniquely the proteins bind to the virus, preventing it from getting into the T cell. This may help avoid the drug resistance that is the bane of HIV research; because its mechanism of action is unlike anything that has been seen before, it does not appear to contribute to resistance.

The next step, say researchers, is to find ways to produce more of the protein without over-harvesting the coral itself. They need to produce more cnidarin not only to meet demand if it does prove to be viable, but to determine if there are any side effects if there are any other illnesses against which the protein might prove useful, and to gain a more precise understanding of how it works, with an eye towards replicating the effect.

Gluten Sensitivity And Celiac

More and more attention is being paid to the difference between celiac sprue and other forms of gluten sensitivity. The most important difference is that studies have found evidence for celiac, but not for other forms of gluten sensitivity. Instead, experts—inducing the researcher who first identified non-celiac gluten sensitivity—say, the two main culprits in non-celiac gluten sensitivity are a protein called fructan and related proteins, and a psychosomatic response.

As knowledge of celiac becomes more widespread, and gluten-free foods more commonly available in more varieties, a growing number of people are convincing themselves that gluten is inherently harmful, or that a broad range of physical and mental symptoms are caused by it. In some cases, this is little more than the power of suggestion compounded by an inability to do a truly controlled study, but research points to the involvement of a group of carbohydrates called fermentable oligo-di-monosaccharides and polyols, or FODMAPs. This group includes fructan in wheat, fructose in fruits, lactose in dairy products, and others. People who go on gluten-free diets often also reduce their consumption of FODMAPs, and attribute the improvement to the gluten restriction.

Interestingly celiac itself is underdiagnosed, according to researchers. Often, the inflammation is minimal, with no noticeable abdominal gas or cramping, bloated stomach, fatty or greasy stool, chronic diarrhea, or constipation. Moreover, someone who has been living with these symptoms all their life may not realize that they are abnormal, particularly if they are mild. However, even unnoticed celiac can cause problems in the long run. The inflammation, even if it produces no other symptoms, interferes with absorption, of the body getting nutrients from food, and this can result in malnutrition. There’s also evidence that poorly controlled celiac leads to a heightened risk of lymphoma.

While currently, "control" means a carefully monitored diet free of gluten, there are new therapies for celiac being researched. Scientists exploring exactly how gluten triggers the immune response that causes the inflammation could find ways to silence it. In another study, researchers found an enzyme that neutralizes the gluten, allowing the body to more easily break it down and preventing a reaction from occurring.

Not Just Shell-Shock

Post-traumatic stress disorder, or PTSD, is diagnosed from symptoms occuring after a traumatic event. Those symptoms generally relate to the event—recurring memories and flashbacks, avoiding discussing the event, or people and places assoiated with it, upsetting dreams. Other symptoms include irritability, despair, trouble sleeping, and emotional withdrawal. Symptoms usually start within a few months of the initial trauma, but sometimes can come years later. These symptoms can have repercussions; PTSD sufferers have substantially higher rates of divorce, unemployment, homelessness, and subtance abuse, and the substance abuse—occurring in more than a quarter of women and more than half of men with PTSD—exacerbates the other problems still further.

The condition is common among war veterans, but there are a lot of other traumas that can lead to PTSD. More than 12 percent of residents of lower Manhattan were found to have PTSD in the wake of 9/11, for example, in line with statistics showing as many as one-seventh of people who’ve been through some sort of trauma will deveop it. According to the Department of Veterans Affairs, people are more likely to develop PTSD if they were seriously hurt during a truamtic event, were directly in danger, felt helpless during the event, or had a severe reaction during the event, such as crying, shaking, vomiting, or dissociating from their surroundings. Long-lasting trauma, such as bullying (including on-line bullying), is also more likely to lead to the disorder.

Since so much of PTSD is tied to the memory of the event, one treatment technique that has been suggested is to diminish that memory. A drug has been found that, in combination with behavioral therapy, may be able to weaken memories of traumatic events if used shortly after the trauma occurs. Cognitive-brhavioral therapy is effective as a preventative measure, as well as in treatment, on its own. Exposure therapy, in which patients are deliberately triggered in a safe, supportive, and controlled environment can help in some cases when administered with professional guidance, though deliberately triggering PTSD without the patient agreeing in advance is likely to do more harm than good. Debriefing, allowing someone who has been part of a traumatic event to discuss and confront their response to it, was thought to be helpful in preventing its development, but research suggests it is not.

Staying Safe In The Sumertime

Summertime is time to talk about safety. With the kids not in school and the whole family venturing out of the house, staying safe this time of year has some unique challenges. Here are some tips to keep the season a happy one:

  • Insects are more than an annoyance; they can carry disease. Mosquitoes can carry West Nile virus, and fleas bites can lead to plague. That’s why insect repellant is so important.
  • Check for ticks and shower after walking in the woods to avoid Lyme disease.
  • It’s easy to forget after a long cold winter, but heat can be dangerous. Heat stroke, heat exhaustion, and heat cramps can all come on quickly. Spend some time in the shade.
  • Outdoor sandboxes can attract wild or feral animals; they won’t stick around, but they’ll leave mementos that kids probably shouldn’t be playing with, or in. Cover sandboxes that aren’t being played in.
  • At the pool, keep glass bottles and other dangerous, breakable items, as well as electronic devices such as music players, a safe distance from the water.
  • Apply sunscreen about half an hour before going outside, reapply after getting wet, even when the day’s plans don’t include sunbathing or lounging.
  • Be aware that even cooked food can cause bacterial infection when left out in the heat. Highly perishable foods such as eggs and dairy should not be left out more than an hour.
  • Filter water from streams or creeks before drinking it. Parasites aren’t generally visible, but they can still do a lot of harm.
  • However, don’t skip drinking water entirely. Still water without sugar is best, though it’s important to replenish electrolytes after sports or other strenuous activity. Alcohol may seem refreshing but it can make dehydration worse in the long run.
  • Check playground equipment before kids play on it—unpadded surfaces, loose ropes, unsecured bars or other parts, even hot metal, plastic, or wood can all be dangerous.

These tips can help keep summer safe, fun, and healthy.

Battling Arthritis

The most common and most familiar form of arthritis affects 27 million people in America. People tend to think of arthritis as something that just happens with age. Indeed, it’s sometimes referred to as wear-and-tear arthritis, and results in part from the protective layer of cartilage covering the ends of the joints getting ground down by use over time. However, it isn’t an inevitable part of aging. Not everyone gets arthritis when they get older, and there are even things that can be done to prevent it.

Obesity is a significant risk factor for arthritis, particularly in the knees. Some people think that exercise can be a contributing factor to arthritis, but there is no evidence of a connection, and no reason to believe that the benefits of exercise in terms of preventing obesity and easing the stress on the bones don’t outweigh any risk there may be. Repetitive stress to the joints, however, can increase the risk of arthritis.

Other risk factors can’t be controlled. While arthritis isn’t inevitable with age, the risk of developing it does increase over time as the cartilage degrades. People with bone deformities are more likely to get arthritis; the unusual shapes of the bone cause unusual wear patterns, weakening the layer of cartilage. Joint injuries, too, can lead to arthritis, though there is no sign of any link with cracking knuckles.

Research has also suggested a possible genetic link, not to arthritis itself but to being vulnerable to the disease. Arthritis does tend to run in families, and in particular siblings of arthritis sufferers tend to get it themselves as well. That may not be entirely down to heredity, however. In a study published earlier this year, researchers fund that while drug use does not lead to arthritis, parental drug abuse might.

The researchers discovered that people whose parents had used drugs or drank excessively while the patients were under 18 and living at home were almost 60 percent more likely to get arthritis. The patients’ own substance use appeared to have no significant effect on the likelihood of getting arthritis. The researchers warn that what they have discovered is only a statistical construct, and what, if any, causal relationship exists is unknown.

Treatments For Osteoporosis

Osteoporosis is a disease of aging. It’s the result of a natural process: bone tissue is actually constantly being destroyed and replaced, but around age 25 the breaking down starts to outpace the replacement. The reason osteoporosis is associated with old age is simply that it takes a while—often more than 20 years—for this to have a clear effect. Osteoporosis is also often thought of as a disease of women. This is mostly the case, but about a quarter of people with the condition are male. Osteoporosis can make a simple fall a devastating injury, as lowered bone mass makes the bones brittle and prone to injury. It also becomes harder for the skeleton to support the weight of the body, leading to various problems with such things as posture.

The usual treatment for osteoporosis is with medications called bisphosphonates, but these drugs can cause jaw and thigh problems, as well as having a host of side effects. These drugs work by slowing bone loss to give the regeneration process an opportunity to catch up. In rare cases, the problem is addressed from the other side, with medications being administered in order to accelerate bone regrowth rather than inhibit breaking it down. Sometimes the two re used in tandem. In some cases, surgery is performed. Surgeons are beginning to instigate ways to incorporate 3D printing technology to create artificial joints perfectly matched to the patient’s body and using the patient’s own stem cells.

Another surgical technique uses a dissolving material to create a scaffold for new bone to grow on. This, too, uses stem cells to create what is essentially cloned tissue, ensuring an exact match to the patient, who is both donor and recipient. This helps minimize the likelihood of problems after the surgery. This material has only recently been perfected, and there are no long-term reports indicating how effective the technique is over time.

Preventing osteoporosis is easier than treating it. Prevention has had snags, however. While vitamin D from sunlight can help preserve bone tissue, vitamin D supplements seem to have little effect on osteoporosis risk. Calcium, on the other hand, does help prevent osteoporosis from developing. There has long been speculation in the medical community that calcium supplements might lead to heart disease, but a recent study found no link, meaning calcium supplements are a good plan to lower osteoporosis risk.

Anxiety Disorders

Almost everyone gets tense sometimes, such as before a job interview or a first date, when performing, in new situations. However, for many people, that nervousness is a more or less permanent state of existence, with no clear cause or source. The symptoms of this heightened state disrupt sleep, harm functioning, and take a lot of energy, and the reaction is completely disproportionate to whatever there is—if anything—to be nervous about. These are indications of an anxiety disorder, one of a handful of related health conditions collectively called anxiety.

One type is generalized anxiety disorder, in which nonspecific life events and general existence lead to a permanent and unjustified state of worry. "Unjustified" does not mean, however, that someone who actually has something to worry about can’t have an anxiety disorder as well. In fact, anxiety is often kicked off by an actual worry that simply develops into a habit of mind or mental pattern. Once developed, however, this pattern can be difficult to get out of, even in the absence of anything real to latch on to, or legitimate causes for concern are blown out of proportion. Generalized anxiety can sometimes cause physical symptoms, such as aching, sweating, or nausea.

Another common form of anxiety is panic disorder, or a tendency to suffer panic attacks. Panic attacks don’t always indicate panic disorder. They can be brought on by any form of acute stress, and when the stressful situation goes away, the attacks do as well. In panic disorder, these attacks are recurring and have no obvious cause and the attacks themselves—and their unpredictability—become sources of stress. People with panic disorder grow to fear and dread panic attacks, and worry about when the next one will strike, which can hasten it.

Anxiety does respond to treatment. Cognitive behavioral therapy, which concentrates on getting the patient to break out of mental patterns and teaching coping skills, is actually pretty close to the ideal approach for panic and anxiety disorders. In addition, antidepressants and anti-anxiety medications can help. Medications called benzodiazepines can help calm disproportionate worry in the moment, but they have high addiction potential and need to be used only sparingly.

The Truth About Back Pain

Back pain is ubiquitous. Because a number of things can cause back pain, almost everyone will experience it. That’s why back pain is one of the most common complaints that bring people to the doctor’s office. Perhaps because of its ubiquity, a number of myths and old-wives’ tales have sprung up around pain in the lower back.

For example, many people believe that the problem is the desk chair, and the solution is to replace the chair with something else. While it is true that until relatively recently, office chair’s design was built around the perceived status rather than the comfort, of the sitter, the solution usually proposed, sitting on an exercise ball, does little to help the back. Similarly, stretching and massage might seem like good strategies to fight pain in the back, but in fact, when there is inflammation of the nerves, stretching will only make things worse, and when the pain is caused by muscle spasms in certain areas, massage will do nothing.

The good news is that surgery is not an inevitability. In most cases, back pain can be treated medically or with simple lifestyle changes. Sometimes, over-the-counter painkillers can be enough to provide relief. Stronger medication, and anti-inflammatory drugs, are also used. Sometimes, simply avoiding heavy lifting and making sure not to sit too long can help the pain go away for good. Even exercise can help—in one study, people who were on temporary medical leave due to back pain were able to return to work in two-thirds as much time if they exercised. Exercise helps people heal faster, and the endorphins can take the edge off the pain.

Regular exercise is also suggested for avoiding back pain in the first place. Aerobic exercises help build muscle and bone strength, improves endurance, and enhances flexibility. It can also help keep weight under control, which means less strain on the back while standing and walking. Even something as simple as good posture can help ease the strain—indeed, that is what makes it good posture. Slouching contorts the back muscles and holds them in an unnatural position. Perhaps one of the most famous pieces of advice to avoid back pain is to lift with the knees. Lifting heavy objects by bending forward at the waist means the muscles in the back end up doing all of the work; crouching, grasping the object, and hoisting it while rising to a standing position buts much of the burden on the less fragile leg muscles.