Monthly Archives: October 2014

Chagas Disease Often Goes Unrecognized

Parasitic infections are rare in the United States, but one, called Chagas disease, is believed to be active in several southern states and as far north as the Washington, D.C., area. Also known as American trypanosomiasis, Chagas disease—named for the Brazilian doctor who first identified it more than a century ago—affects as many as 8 million people worldwide, mostly in Latin America, but increasingly in the United States and even Canada. The parasite, Trypanosoma cruzi, that causes the disease is spread through insect bites, as well as from pregnant women to their children, and though blood transfusions and organ transplants if they aren’t sufficiently screened.

Screening, sadly, is rare in the U.S., as doctors in this country are not all aware of the disease’s expanded range. Although Chagas disease can be fatal if let unchecked, it is quite easily cured if caught early. It is usually asymptomatic in its early stages, however, so screening for anyone who is at risk is important. Crudely constructed buildings in warm climates—mud or thatch structures, for example—often house the bugs that carry the parasite, so anyone who has spent significant amounts of time in such a building may be at risk. People who do show symptoms, such as eyelid swelling, enlargement of the liver or spleen, fever, fatigue, or rash should also be tested, especially if they’ve been in Central America.

Left untreated, Chagas disease can lead to colon inflammation or heart failure. This can happen years after the initial infection if it isn’t properly treated. Treatment involves anti-parasitic medication, and is highly likely to be effective if done in the immediate aftermath on the initial infection, during he first few weeks. However it is sometimes successful after the initial phase has passed but before the parasite has settled in. Once the disease has become chronic, the only real medical option is management of the symptoms, such as heart medication for patients whose hearts are effected. There is no vaccine currently available for the disease, and prevention generally involves using nets and insecticides to try to eliminate the insects that carry the disease.

Drug Abuse

It is difficult to establish how many people are affected by drug abuse. Drug users often do so in secret, and functional addicts may not be obvious to those around them. There is also an issue of definition—at what point is someone classified as an addict and at what point use becomes abuse are subject to debate. However, surveys have found that close to 10 percent of Americans age 12 and over use drugs, including unauthorized use of prescription medication, with 87 percent of them classified as addicts.

While the word "addiction" is often used to refer to a strong love or a habit, it has a narrower medical meaning. Drug addiction is a medical condition, and a drug addiction is more than just a drug use ritual or an inordinate fondness for them. Drug use certain can change the structure of the brain; in particular, the way it responds to stimuli. Eventually, rather than using the drug causing pleasure, the time between when the effects wear off and the next dose causes unpleasant physical and psychological symptoms, called withdrawal. At this point, the drug is used simply to eliminate these withdrawal symptoms.

Experts have noted that the concept of "drug abuse"—and the degree to which addiction is regarded as a problem—is tied into notions of "drug" and "abuse." Caffeine is, from a chemical and psychological perspective, a drug, and, from a neurological perspective, an addictive one. The feelings of being jittery and out of sorts before ones first cup of coffee are in part withdrawal symptoms. However, because it is legal practically everywhere, "caffeine addiction" is not regarded as abuse. On the other hand, regulated or illegal substances, such as cocaine, heroin, and crystal methamphetamine, are deemed drugs of abuse. Even marijuana, which is not addictive and generally considered less dangerous than alcohol, is considered subject to abuse, though alcohol is as well.

Turning Down Tourette Disorder

Most people think they know what Gilles de la Tourette syndrome is. However, the inappropriate and unprompted utterance of foul language, a symptom called coprolalia, that is the most characteristic symptom of the disease is not a common feature of the condition, let alone a necessary one. Tourette syndrome is actually primarily expressed in physical tics, repetitive movements compulsive such as eye blinks, face or hand movements, throat clearing, coughing, or sniffling. Though verbal tics are also part of the condition, these are far more often noises than bad words.

People with Tourette syndrome often also have obsessive-compulsive disorder, and there are some indications that the two conditions may be related. When the verbal tics are words—often, they are noises—those words seldom relate to the person’s thoughts at the time. However, the obsessive thoughts that commonly afflict people with OCD can come out in verbal tics of Tourette disorder, made all the worse by attempts to suppress them. While people with Tourette syndrome often have a limited ability to keep the tics under control for a short time, they often have the tics come back all the worse afterwords. However, most patients gradually learn to keep their symptoms more or less under control.

Tourette syndrome and OCD are often treated together, as treatment for the compulsive behavior will also help reduce the frequency or severity of tics. Mild cases of the condition can often be treated with therapy; for more severe cases, medication may be needed to help control the symptoms. As with ADHD, stimulant medications may be a counter-intuitively effective treatment option that can provide some relief. Botox injections in the relevant muscles won’t do much to stop the impulses behind motor tics, but the injection can stop the tics themselves. Medications to block the neurotransmitter dopamine do lessen those impulses.

Another chemical in the brain that seems to be involved with Tourette syndrome is gamma amino-butyric acid, or GABA, a neurotransmitter related to anxiety. Electrical brain stimulation has been proposed to help regulate GABA, increasing levels of the chemical to turn down the movements and tics of Tourette syndrome.

Signs Of Fibromyalgia

There are as many as 15 million Americans suffering the chronic disease fibromyalgia, a mysterious—and often doubted—pain condition that primarily affects middle-aged women who are also suffering from an anxiety or stress disorder. Although it frequently strikes people with a mental condition, fibromyalgia is not psychosomatic. However, some patient advocates believe that one reason it is often met with skepticism from doctors is because it so frequently afflicts women, and there is a long and troubling history of male doctors dismissing complaints of female patients, or suspecting them of merely "wanting attention." With fibromyalgia, this skepticism is compounded by there being no clear physical cause of the syndrome and it being difficult to diagnose objectively.

However, recent research is making it clearer that there is an actual disease, that the symptoms are not simply psychosomatic or invented, and that there may be a way to observe signs of the disease beyond merely asking the patient what he or, more often, she feels—an notoriously unreliable diagnostic technique even in patients whom doctors consider credible. Most research on fibromyalgia has linked it to difficulties with correctly processing pain signals from he nerve endings, leading to increased sensitivity—touches that people without fibromyalgia might not even notice are experienced by patients as intensely painful. A team of Swedish researchers has found that the brain areas that process pain have abnormally few connections with other parts in fibromyalgia patients. This means that the brain may not recognize touch properly, and treat it as pain.

In fact, it isn’t only pain signals that are disrupted. Reward sensations also appear to be affected. The reward signals are lessened as the pain response is heightened, studies suggest. In addition, other perceptual systems are often dyfunctional in fibromyalgia patients. Sight and sound are hampered as well as touch. The researchers who discovered this believe that fibromyalgia occurs when he developing brain doesn’t notice these common sensory inputs, and never learns to correct for them. In people without fibromyalgia much of this fades into the background, like zeroing out a kitchen scale. When this zeroing out never occurs, people end up excessively sensitive to these signals.

Why Men Die From Breast Cancer

One in every eight women gets breast cancer, but what is often overlooked is that around one man in 1000 will develop the disease as well—and, since it is so often thought of as a women’s illness, it is usually diagnosed later if at all, in men, making it more difficult to treat successfully, and more burdensome to treat at all. Male and female breast tissue are very similar in all but functionality, meaning that the cancer develops much the same way.

However, Women are routinely screened, while men almost never are. That’s why almost 450 men a year die from breast cancer. In fact, as deadly as breast cancer is in women, it has a far lower survival rate in men. Men are typically farther along than women at diagnosis, so it is important for men to recognize the signs and risks.

Male and female breast cancers have significant overlap in risk factors, but there are some differences. Estrogen levels are linked with the disease, but whereas estrogen levels in women are high as a matter of course, it is less common for men. However, estrogen exposure could still lead to breast cancer. Gynecomastia—having large, female-looking breasts—increases the risk; this is often a result of obesity, though certain medications or medical conditions can also cause breast tissue to develop. A chromosomal abnormality called Klinefelter’s syndrome will make breast cancer more likely. The BRCA gene mutations responsible for about five percent of breast cancer cases in women have a similar effect in men. Injury to the testicles can affect hormone production, as can liver disease, and that in turn can raise cancer risk.

The symptoms are similar: a lump in the breast tissue, reddened or scaly patches on the skin, changes to the skin or to the nipple, puckering, or inversion of or discharge from the nipples. The primary difference is that men are less likely to do self-exams and less likely to be routinely tested for breast cancer until there;s a clear indication that something is wrong. On the other hand, the smaller breasts of most men make symptoms of cancer easier to notice. However, this smaller size also means the cancer can progress faster and spread more easily.

Halloween Safety Tips

Halloween doesn't have to be scary. Following some simple tips can help give parents—and everyone—peace of mind this trick or treat night.

  • Young children should not be carving pumpkins—they can use markers or paint, but no blades. Slightly older children should only use a knife under adult supervision.
  • Candle-lit pumpkins should not be left unattended, and care should be taken that leaves, bits of paper, or other flammable things don't blow in.
  • Instead of candles, consider lighting jack o'lanterns with electric lights or glow sticks.
  • All decorations should be secured so they don't pose a threat to trick-or-treaters or other visitors, block the door, or wander across the property line
  • Never use indoor lights outdoors.
  • Kids should be in light colors, if possible, or costumes with reflective tape. At the very least, they should be carrying something well-lit.
  • Costume props and other accessories should be soft, particularly if designed to look like blades
  • A costume with a cape or long dress is a potential tripping hazard, both for the wearer and for those near them.
  • Makeup is preferable to masks, to keep peripheral vision clear.
  • Test makeup on the skin beforehand, to look for potential allergic reactions. Makeup should be removed after coming home to avoid irritating the skin.
  • Trick-or-treaters should plan a route and stick to it, keeping to well-lit streets.
  • Group sizes should be small enough that it's possible for everyone to keep track of everyone else.
  • Young children should be supervised while trick-or-treating, and should never go into someone else's house without a chaperone—or uninvited, of course.
  • If there's a town curfew on Halloween, it should be obeyed.
  • Treats should be checked over and rationed, not torn through in a single night. Unwrapped food should be tossed.
    • These tips can help kids and adults stay safe Halloween night, and make the holiday fun.

Hearing Loss

With age, often, comes hearing loss. There are two main reasons for this. First, as a person ages, everything becomes less flexible. That includes the eardrum, a membrane that works by vibrating in response to sound—as the eardrum becomes stiffer and less able to vibrate, it becomes less able to detect sound and transmit it to the brain.

The other reason is a life of noises. Loud noise damages the ears. The damage may be minor, but it is also lasting, and it accumulates. After a lifetime of listening to loud noises, a person's hearing will start to deteriorate. In fact, more and more people are being diagnosed with hearing loss at younger ages than before. This is partly due to more sensitive and reliable tests, which people are undergoing earlier in life, but it's also because of the loudness of modern living, particularly headphones.

Often, however, hearing loss in teenagers is missed. Because it is thought of as a condition, if not fate, or old people, hearing loss is not always even suspected in young people, despite more than half of all people with some form of hearing difficulty having developed it in childhood. Compounding this, many adolescents have difficulty noticing or recognizing hearing loss and adequately conveying that to medical professionals. In principle, young patients will be asked questions designed to find those who may need more objective audiological testing. However, the questions asked are not always useful for patients in that age range, leading to underdiagnosis.

Moreover, noise-induced hearing loss can start as young as age 20. This occurs when the "hair cells" within the ear are damaged by exposure to loud sounds. The hair cells, once destroyed, do not recover, leading to a permanent reduction in auditory acuity. This doesn't merely damage the ability to hear, it actually changes the way the brain processes speech. Not only do sounds not get through as efficiently, when they do get through, they are not processed correctly. However, new medical techniques may hold out hope for recovering hearing ability lost to noise. Researchers have developed a clear picture of the structure of the cells supporting these hair cells, and had some success in repairing them in experimental animals.

Stuttering And Stigma

It is estimated that 70 million people worldwide stutter when they speak—not a momentary pause or repetition as they organize their thoughts, but a chronic, ongoing difficulty with the flow of their speech. That means repeating sounds, prolonging sounds, or unnatural, unneeded, and unintended pauses between syllables and words. Almost all children speak this way when they’re first learning, but about one percent of the time, it does not resolve itself. Stuttering can interfere with clear communication, and what’s more, the embarrassment it can cause may lead people to avoid talking, which in turn means avoiding social and professional situations that require speaking in front of others, which can seriously hold people who stutter back in their lives and careers.

The good news is that recent research shows preschoolers who stutter actually do better in school, and academically and socially. Although speech therapy is recommended for older children who stutter, it is not considered necessary for very young children, according to the study, and may even be harmful. Instead, the researchers recommend waiting a full year before starting the child in speech therapy in most cases. The exceptions are if the child exhibits distress at stuttering or shows unusual shyness or reluctance to talk as a result. It is also important for parents not to shame or stigmatize the child for stuttering, which itself may cause distress.

That can be difficult for parents who themselves remember stutter and feeling stigmatized for it. Indeed, stuttering has been found to have a genetic component, in that a predisposition to develop a stutter is passed down in the genes. Sometimes, particularly in people genetically prone to stuttering, stress can trigger it. In the past, left-handed children were frequently forced to use their right hands, and this often led to a stutter developing.

Regardless of the cause, stuttering is treatable, even if not wholly curable. Speech therapy can lead to noticeable improvement in fluency at any age. Often, it is a vicious cycle—stutterers experience stress when speaking, which exacerbates the stutter—and the most effective therapy has as its goal breaking that cycle. Support groups are particularly good for this. As fear of stuttering recedes, the stutter itself lessens.

A New Understanding Of Hantavirus

Hantavirus is a infectious agent first discovered along the Hantan River in in South Korea. Depending on which specific kind of hantavirus is involved, infection generally results in one of two illnesses.

One, found primarily in Europe and Asia, is called "hantavirus hemorrhagic fever with renal syndrome." It is sometimes fatal, and may completely destroy the kidneys. With medical care, however, it is survivable. Treatment to protect renal function including dialysis, makes it possible for the patient to live until the disease starts to clear up on its own.

The other disease, more common in the Americas, is called "hantavirus pulmonary syndrome." This, as the name suggests, is a pulmonary disease, causing flu-like symptoms. It has lead to around 200 deaths in the United States, around a third of people who have been diagnosed with the pulmonary disease in the 20 years since it was first identified as a separate condition. The various kinds of hantavirus are transmitted through rodent droppings, which can get into poorly protected food supplies, particularly when a person is camping.

Earlier this year, researchers announced that they had developed a model of how a hantavirus infection spreads within the body. The research team said they now have a more complete understanding of where a hantavirus infection starts, of how it triggers a potentially fatal immune response, and of the link between hantavirus infection and pneumonia. This clearer picture of the disease could potentially lead to better, more efficient, and more effective treatments.

Earlier research demonstrated how cholesterol provides hantavirus with some of the resources it needs for its attack on the body of its host. Hantavirus uses one of the proteins responsible for cholesterol production as a handhold into cells in the pulmonary system The researchers found that drugs affecting this protein provide some measure of defense against hantavirus infection. They further found that cholesterol-lowering statin drugs can also help provide similar protection. This is important, because hantavirus, like many viruses, is notoriously difficult to treat directly. It becomes resistant to drugs within a short time, making a direct approach not useful in the long term. By using statins to root out the viruses’ support system, doctors may be able to treat this highly deadly disease more effectively.

Walnuts And Alzheimers

Scientists have long touted the health benefits of walnuts. They are replete with omega-3 fatty acids, a type of lipid molecule that helps fight several types of mental illness and can reduce symptoms of inflammatory disease. Walnuts also provide antioxidants, which are good for heart health. Another component is a compound that prevents stroke by making the arteries less prone to clotting. The vitamin E in walnuts also prevents clotting, by preventing the development of plaques along artery walls. Walnuts lower blood pressure, and are particularly helpful in stopping blood pressure elevation as a response to stress, meaning walnuts can help people deal with stress better. Now researchers are adding another important item to the walnut’s resume. Walnuts may be able to help slow the progression of Alzheimer’s disease.

The same plaques that vitamin E prevents on artery walls can affect the brain as well. Indeed, substances that prevent arteriosclerosis have long been known to hep prevent Alzheimer’s as well. Similarly, there has known to be a connection between omega-3s and Alzheimer’s prevention. However, the study is among the first to specifically show walnuts as being effective at preventing—or slowing—Alzheimer’s. The scientists found that the antioxidants and omega-3 fatty acids found in walnuts improved learning and memory in laboratory animals with a condition analogous to Alzheimer’s disease in humans. The specimens who had been get walnuts showed improved cognitive functions compared to their peers with the same Alzheimer’s analogue who had not been given walnuts.

Other foods also have Alzheimer’s-fighting properties. Any food rich in antioxidants, omega-3 fatty acids, or both can help prevent dementia. Omega-3s are particularly important because the brain is largely composed of lipid molecules, and omega-3s provide it with the raw material it needs to function. Omega-3s are commonly associated with salmon and other fish, which are have high levels of the compounds eicosapentaenoic acid and docosahexaenoic acid. Berries are another good source for omega-3s; like walnuts, they contain alpha-linoleic acid, one of the most common and most healthful of the Omega-3s. The spice turmeric, common in Indian cuisine, also has many health benefits, including fighting Alzheimer’s disease.