Monthly Archives: October 2014

New Candidate For ALS Cause

Less than three months after the Ice Bucket Challenge raised unprecedented amounts of money for research into amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, researchers have announced a breakthrough. Scientists are saying they have new insight into possible causes of the condition, and may have a clearer understanding than ever before of what is responsible for the degenerative disease. Previously, it was recognized that malfunctioning neurofilaments in the motor neurons did not properly connect these neurons to the muscles, so they muscles could not respond to the impulses meant to move them. but the precise reason for the malfunction was a mystery. Now it is believed that the malfunction arises proteins that are supposed to protect the neurons are unstable, often due to a genetic mutation.

Lou Gehrig’s disease affects an estimated 30,000 Americans. People with the condition first experience weakness in the extremities, and as the disease progresses—as the superoxide dismutase proteins start to weaken and break down—more and more muscles start to atrophy. It starts in the arms and legs where the motor neurons are largest, and eventually the muscles used for breathing are affected and suffocation ensues.

Different forms of the disease have longer or shorter prognoses, but ALS is currently a terminal condition with no known cure. However, with a new understanding of what causes the motor neurons to fail, it may be possible to develop better treatments.

Right now, patients with ALS are given palliative care to alleviate the pain and discomfort, and assistive technology is used to help them maintain independence. However, some stroke drugs are being investigated as ways to slow the progress of the disease and possible reverse some of the damage. Moreover, since the SOD protein is dependent on copper, the metal is being looked at as a potential treatment, with a possibility that it will help maintain the proteins. Copper is normally toxic, so ways must be found to administer it in a way that it is useful, without it poisoning the patient. Stem cell research using bone marrow is also being undertaken, with clinical trials showing some success in regrowing the motor neurons.

Migraine Predicts Parkinson’s

Researchers believe they have found a connection between a tendency to get migraines and risk of Parkinson’s disease. In particular, people who get migraine with aura—an alteration in vision that often presages a migraine—are twice as likely to develop Parkinson’s later in life as people without migraines. Migraine affects an estimated 30 million people and is the most common brain disorder in adults, so potentially millions of people are at risk for Parkinson’s disease, as well as for the cardiovascular illnesses with which migraine is also associated.

In addition, people in the study with a family history of Parkinson’s were more likely to get migraines, providing more evidence of a connection. The reason for the link, if it exists, is not entirely clear, but one possibility is that dopamine, a messenger chemical in the brain that has been implicated as a major cause of Parkinson’s, is also involved in migraines. Past research has indicated that dopamine receptors may be involved in migraines.

The dopamine issues that cause migraines, however, are imperfectly understood themselves. Their causes—called triggers—vary from person to person. Among the most common migraine triggers are onions, alcohol, secondhand smoke, and MSG. Some chemical compounds are also common triggers, such as the nitrates used in curing meat or tyramine, which naturally forms in aged foods such as wine or certain cheeses. Stress is another frequent cause of migraines. A recent study found that referring to a stressful situation as a "headache" isn’t just a metaphor; people with more stress in their lives are more prone to headaches of the literal sort. With migraines, it seems the let-down after is a bigger problem, and keeping stress levels even is important for prevention.

In fact, avoiding triggers in general is the most effective way of preventing migraines. There is a learning curve to this, since avoiding triggers requires first determining what they are. However, once a patient’s triggers have mostly been determined, avoiding them can significantly reduce migraine instances. In addition, medications and medical devices are available to prevent migraines or lessen their severity or duration. Two new electromagnetic stimulation devices, for example, seem to be useful for stopping migraines as soon as they start, if not sooner.

Mononucleosis Is Widespread

Mononucleosis, or glandular fever, is a highly contagious disease. Called "the kissing disease," it can be transmitted through casual contact. It is caused by the Epstein-Barr virus or, in a minority of cases, cytomegalovirus, both of which are transmitted in saliva, and the latter of which can be passed in sexual intercourse. Transmission is most likely in the period between infection and the appearance of symptoms. though some studies suggest it remains contagious for as long as a year. Treatment is usually focused on the symptoms of the disease, which with rest generally clears up within about two weeks. Mononucleosis presents with flu-like symptoms, as well as fatigue and lethargy. In older patients, it often involves body pain, jaundice, and liver enlargement.

Mononucleosis is most serious in people older than 40. That’s because Epstein-Barr virus is one of the most commonly found viruses among humans, with almost everyone hosting the virus. Because the virus is so common, 90 percent of adults have developed an immunity, and so infectious mononucleosis is more common almost exclusive to people under teens and young adults.

Because of the ubiquity of Epstein-Barr virus, the transmission of glandular fever is almost impossible to prevent. However, recent research into how it virus is able to get everywhere and escape detection by the immune system may be able help doctors develop a vaccine to stop it once and for all. The virus is able to conceal the proteins that the immune system looks for in order to eliminate the virus. With these proteins silenced, the virus becomes invisible to the immune cells. A vaccine for Epstein Barr—which would fight not only mono, but a number of other diseases, including some types of cancer—would have to make these proteins visible.

One thing that makes Epstein Barr relatively intractable is that it doesn’t die with the cell it infects. Instead, when the host cell undergoes apoptosis—a process of cell death infected cells go through to prevent the spread of the infectious agent—the virus can see it coming, and exhibit what researchers call an emergency replication process, allowing the infection to remain.

Bulimia Basics

As many as one percent of all women are believed to have bulimia, an eating disorder characterized by a cycle of binging and purging. Unlike anorexia, in which patients simply do not eat, people with bulimia eat normally or even excessively, then "purge" by forcing themselves often to vomit. Some bulimics purge using laxatives as well as or instead of emetics, or by exercising. Bulimia and anorexia can occur in the same person, part of a broader pattern of eating disorders; both are rooted in an obsession with food, calories, and control.

Although men can and do develop eating disorders, more than 80 percent of people with bulimia are female, although it is difficult to get exact figures for men even more than for women. There is a hereditary component to bulimia; people with bulimic relatives are likely to develop the disorder themselves. As with other eating disorders, bulimia owes a lot to the broader culture. Where thinness and beauty are highly prized, women tend to feel more pressure to develop the sort of obsession with weight that leads to bulimia. People with psychological and emotional issues, such as perfectionism, obsessive-compulsive disorder, poor impulse control, anxiety, or depression, are at risk for bulimia.

Bulimia can be dangerous. Purging through emesis can damage the esophagus and the teeth, and excessive laxative use can permanently alter the functioning of the digestive system. The binge-purge cycle puts a strain on the heart and can lead to dehydration. Signs of bulimia include secrecy, rushing to the bathroom immediately after meals, calluses on the knuckles, and fluctuations in weight. Unlike anorexics, bulimics are not necessarily underweight.

Treatment for bulimia can be a complex process. Beyond psychological help to fix the disordered eating itself—which can be a lifelong process—the actual purging is likely to have damaged the body, and this damage has to be repaired as much as possible. In addition, treating bulimia involves not only the patient but also her or his family and social circle; as with addiction, it is necessary for the patient to be surrounded by people who will encourage recovery, not relapse. The patient also needs to relearn normal, non-disordered eating habits to have a chance of fully recovering.

Stroke And Judgement

When blood carrying oxygen cannot properly get to the brain, it’s called a stroke. It is the fourth most common cause of death in the United States. People who lead sedentary lifestyles, are overweight, or have high cholesterol are likely to get strokes. Stroke often affects people with type 2 diabetes, obstructive sleep apnea, or cardiovascular disease. Tobacco smoke constricts the blood vessels and makes stroke more likely. Other risk factors are not about lifestyle in the same way. These fixed factors include being male, being over 55, being black, and having a family history of stroke or heart attack. People who have had a stroke already are more likely to have another, and should be especially careful.

Stroke, naturally, affects brain functioning. In particular, a stroke means a small portion of the brain is destroyed—how small a portion depends in part on how quickly someone with a stroke is able to get treatment. Often—though not always—stroke survivors experience some cognitive deficit after the incident. Now scientists have found that the reverse is also true: people with dementia or cognitive impairment may be at higher risk of stroke. The exact reason for this is unclear. It may be that both cognitive impairment and stroke are the result of cardiovascular problems. It is known that Alzheimer’s disease is associated with the same risk factors as type 2 diabetes, both of which have been linked with obesity.

Another thing stroke has been shown to effect is moral judgment. This has long been suspected—the stereotype of the elderly person who shows no signs of dementia but has no filter and is uninhibited—but actual evidence has been scant. now a study has quantified that. The researchers found that people who have survived strokes are less likely to punish people for bad intentions, provided those intentions were not realized, than people who have not had strokes. Study subjects were asked to evaluate the behavior of the protagonist in each of four scenarios: not causing harm, accidentally causing harm, a failed attempt to cause harm, and intentionally causing harm. The stroke patients were more forgiving in the third scenario than patients with no damage to the brain.

The Facts Behind Leukemia

Each year, 3,500 American children are diagnosed with leukemia, a form of cancer that affects the bone marrow, which is responsible for white blood cells. Because white blood cells are so important to the immune system, leukemia can open the door to opportunistic infections. Symptoms include painless swollen lymph nodes, bleeding or bruising easily, joint pain, unexplained rapid weight loss, weakness, fatigue, and night sweats. It is one of the commonest types of childhood cancer—one in every four pediatric cancer patients is diagnosed with leukemia. However, while leukemia is generally presented as a childhood cancer 90 percent of leukemia cases are diagnosed in adults, and adults typically have a different form of the disease.

In fact, the risk of leukemia actually rises with age. The reason it is associated with children is not because it is particularly common among children, but because it is one of the few cancers to affect children in significant number at all. The causes of leukemia re not known, except for a handful of causative factors that account for a very small percentage of cases. However there are known risk factors in addition to age. Certain chemicals, such as benzine, can lead to leukemia, as can some chemotherapy drugs used to treat cancer elsewhere in the body. Radiation exposure is also a risk factor. Certain genetic disorders can lead to leukemia, and it can run in families.

One commonly blamed culprit is power lines, but scientists have found the grid innocent in causing leukemia. In the latest of a number of studies seeking to get to the bottom of the purported link, children in Great Britain born between 1962 and 2008 were no found to be more likely to be diagnosed with leukemia if they grew up near overhead power lines than their peers who were raised father away.

Recent research into how the body fights off leukemia has presented researchers with a possible new avenue of treatment for the disease. The immune system looks for a chemical signature that identifies lymphoma, and then destroys it. However, when leukemia is treated by chemotherapy, this isn’t necessarily enough to eradicate the surviving few tumor cells. By mimicking this signature, doctors can keep the immune cells responsible for protecting against leukemia to remain on guard.

Protection Through Detection

Breast cancer is easily treated—if it’s spotted in time. That means keeping an eye out for the early signs and symptoms such as lumps, unusual changes in breast size or shape, redness or pits developing in the breast that give it the texture of an orange skin, other changes in the skin especially around the nipple, and bloody discharge. Many women first realize they have breast cancer due to spotting a lump in the breast tissue, either by chance, or when pointed out by an intimate partner, or during a deliberate self-examination.

One in eight women will develop breast cancer, but some are more at risk than others. Hormone are known to play a role in the development of breast cancer, meaning fluctuations in hormones can affect risk. Women who have had more periods—women who had early menarche, has late menopause, or never had children—are at higher risk. The hormone connection is also why women on hormone replacement therapy are more likely to get breast cancer. Of all types of cancers, breast cancer has one of the most direct genetic links, though women without the "breast caner genes" can develop it as well; while only about ten percent of patients have the mutations associated with cancer, women who do have the mutations are almost certain to develop cancer.

That’s why genetic testing is so often performed on women who fear they might get breast caner, especially if there is a family history. However, not having the mutation doesn’t mean a woman is in the clear. Medical professionals recommend that women between the ages of 50 and 74 get mammograms every two years, and younger women who are at risk for any reason. Women over 74 are not advised to get screened, because at that age the treatment itself becomes dangerous.

Breast cancer responds to chemotherapy and radiation therapy, but treatment often involves mastectomy, the complete removal of one or both breasts. This is particularly common if the cancer is recurring or if there is considered to be a high risk of recurrence, though breast cancer frequently recurs anyway. Recently, scientists have started to understand how breast cancer spreads to other organs, and begun to develop strategies to stop it, which could point the way to new treatments in the future.

Finding Depression

Depression is a disease. It goes beyond simply being sad, or in a down mood—it is the result of chemical abnormalities in the brain. Sometimes people are born with these abnormalities, sometimes they come about due to another illness, or life experiences, and often, scientists believe it is a combination of these factors: people are born with a predisposition—which is sometimes genetic and sometimes not—to develop these abnormalities in response to events and circumstances.

Depression can be debilitating, even deadly. That’s why it’s important to identify it so appropriate treatment can be obtained. Symptoms of depression include the obvious sadness, lack of motivation, and changes in appetite—either an increase or lowered—but there can also be physical effects. Depressed people often experience otherwise inexplicable aches, and often fail to connect these to their mental state. Sleep problems are also common; as with appetite, this can take the form of insomnia or of sleeping too much. Depression might also bring anxiety, restlessness, and difficulty making decisions.

People who are exhibiting these or any other signs of depression, or who are undergoing stress but aren’t noticing symptoms, might benefit from getting screened for depression. In fact, more and more experts are recommending screening for all adults who have access to mental health care, whether or not they are showing any signs of depression. Mental illnesses in general, and depression in particular, are difficult to spot, both because they come on so gradually, and because they affect the area that notices symptoms, and screening people who thing they are health could have enormous public health benefits. Screenings are confidential and generally take less than an hour.

Now screening may be easier still. Researchers have developed a blood test that they say will help spot signs of depression as it starts to develop more easily than talk- and questionnaire-based screening techniques, and even spot people who are prone to depression before they experience it. The blood test looks for molecules in the blood that are characteristic of depression, can help differentiate types of depression, and may be able to help predict which course of treatment is likely to be most effective. Scientists say the test demonstrates that depression is an actual illness with a biochemical basis.

Understanding SIDS

Babies sometimes die, unpredictably, and doctors aren’t really sure why. Sudden infant death syndrome, or crib death, strikes about 2,500 children a year, between one and 12 months old, but because the cause is so hard to pin down, it is almost impossible for pediatricians to prevent or predict. Researchers have traced it to difficulties regulating the carbon dioxide content of blood, but it is not clear why that happens. The strongest hypothesis involves abnormalities in the brain that interfere with proper breathing, or premature babies whose brains are not fully developed at birth, and so less expert in controlling respiration.

Recent research suggests that crib death babies show similar signs as babies who were accidentally asphyxiated, suggesting that oxygen deprivation is at the root of the deaths. The study compared deaths from SIDS to infant deaths from head trauma, infection, drowning, and asphyxiation. Death by asphyxiation leaves behind a chemical calling card in the brain that is seldom present in other types of infant fatalities. The researchers found this same chemical signature present inn the brains of infants who had does of SIDS.

This improved understanding may be able to help medical professionals get a better grasp on what advice to give to parents that can help prevent crib death. There are some recommendations that are already known to reduce the incidence of SIDS. Babies should be put to sleep on their backs. Particularly if crib death is a form of asphyxiation, it is better for a child too young to roll over not to be facing the mattress. According to some studies, a baby sleeping face-down has as much as 12 times the risk of SIDS. Similarly, a crib is actually a safer place for the baby to sleep than a big soft bed. Newborns who sleep in the same room as at least one parent are less prone to crib death.

The same room, however, does not mean the same bed. Despite the benefits of proximity, more than two thirds of infants who dies were in bed with their parents at the time of death, according to a study. Different research found that babies who co-sleep have five times the SIDS risk of those in their own cribs.

Schizophrenia Split In Eight

About 3 million Americans suffer the mental illness that is probably most like what the phrase calls up: schizophrenia. This is a condition of disordered perceptions—the split from reality that gives the condition its name—difficulty with large tasks, and emotional impairment. People with schizophrenia frequently have difficulty with organized thinking, auditory hallucinations, and paranoia.

It’s not clear what causes schizophrenia It is most likely a combination of a biological predisposition set off by environmental triggers. There is evidence of a genetic link—immediate family members of schizophrenic people are likely to develop schizophrenia themselves, and identical twins, who share the same genes, have a 50 percent chance of exhibiting the disease—but there are also other factors at work. Socially isolated people are likely to be schizophrenic, which suggests that it may be as much a retreat as a disease, or else that contact with others is needed to help keep a person’s thoughts on track. In addition, people who grew up in urban areas are also more prone to the illness. For reasons not clearly understood, schizophrenia is more likely to strike people born in the winter or spring months.

Now researchers have found indications that there disease called schizophrenia is actually eight separate conditions, all with overlapping symptoms and causes, that have simply been lumped together. Though this is not the first study to suggest that the name "schizophrenia" has been used to refer to more than one separate disease, this is the first to find as many as eight, as well as being the strongest evidence found to date to support the existence of the distinction, The differences, the researchers say, are in the genetics; the study found that people with the same clusters of schizophrenia symptoms had similar genes sets of schizophrenia.

The genetic basis for the differences is a major part of the reason the disparate conditions have been so long aggregated under one name. The Before the science of genetics was developed, the idea of the similar conditions having different genetic bases could not be understood, and the conditions, having similar apparent causes—the same sorts of environmental triggers for the genetic tendencies—appeared to be one illness.