Chapter 16. None

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Michaeleen Doucleff It began with anxiety and depression. A few months later, hallucinations appeared. Then the Texas man, in his 40s, couldn't feel the left side of his face. He thought the symptoms were because of a recent car accident. But the psychiatric problems got worse. And some doctors thought the man might have bipolar disorder. Cattle feeding practices have been changed in an effort to halt the spread of mad cow disease. Eventually, he couldn't walk or speak. He was hospitalized. And about 18 months after symptoms began, the man died. An autopsy confirmed what doctors had finally suspected: the human version of mad cow disease, called variant Creutzfeldt-Jakob disease.* The case, published Wednesday in the journal Emerging Infectious Diseases, is only the fourth one diagnosed in the U.S. In those previous cases, people caught the disease in another country. Right away the man's diagnosis raised a new question: How did a rare disease linked to contaminated beef in the U.K. more than a decade ago get to a Texas man? Back in the early '80s, British ranchers noticed some of their cows were dying of a strange neurological disease. The cows became aggressive. They couldn't walk. Eventually, scientists figured out the culprit. A rogue protein formed large clumps in the brain and spinal cord. Over time, the clumps spread throughout the brain and damaged tissue. © 2015 NPR

Keyword: Prions
Link ID: 20812 - Posted: 04.18.2015

By SABRINA TAVERNISE E-cigarettes have arrived in the life of the American teenager. Use of the devices among middle- and high school students tripled from 2013 to 2014, according to federal data released on Thursday, bringing the share of high school students who use them to 13 percent — more than smoke traditional cigarettes. About a quarter of all high school students and 8 percent of middle school students — 4.6 million young people altogether — used tobacco in some form last year. The sharp rise of e-cigarettes, together with a substantial increase in the use of hookah pipes, led to 400,000 additional young people using a tobacco product in 2014, the first increase in years, though researchers pointed out the percentage of the rise fell within the report’s margin of error. But the report also told another story. From 2011 to 2014, the share of high school students who smoked traditional cigarettes declined substantially, to 9 percent from 16 percent, and use of cigars and pipes ebbed too. The shift suggested that some teenage smokers may be using e-cigarettes to quit. Smoking is still the single-biggest cause of preventable death in the United States, killing more than 480,000 Americans a year, and most scientists agree that e-cigarettes, which deliver the nicotine but not the dangerous tar and other chemicals, are likely to be far less harmful than traditional cigarettes. The numbers came as a surprise and seemed to put policy makers into uncharted territory. The Food and Drug Administration took its first tentative step toward regulating e-cigarettes last year, but the process is slow, and many experts worry that habits are forming far faster than rules are being written. Because e-cigarettes are so new, scientists are still gathering evidence on their long-term health effects, leaving regulators scrambling to gather data. © 2015 The New York Times Company

Keyword: Drug Abuse
Link ID: 20811 - Posted: 04.18.2015

By Lenny Bernstein The dangers associated with night-time breathing disturbances, such as obstructive sleep apnea, are well known: increased risk of high blood pressure, heart attack, stroke and diabetes, not to mention sometimes dangerous daytime drowsiness, according to the National Heart, Lung and Blood Institute. Now a study suggests that such sleep conditions can hasten the onset of both Alzheimer's disease and "moderate cognitive impairment," such as memory loss, by quite a few years. But in a bit of good news, it concludes that using a continuous positive airway pressure (CPAP) machine, the treatment of choice for sleep apnea, can prevent or delay cognitive problems. A team of researchers led by Ricardo Osorio, an assistant professor of psychiatry at NYU Langone Medical Center determined that the sleep disturbances brought on mild cognitive impairment at least 11 years earlier in groups of people enrolled in a long-term Alzheimer's disease study, even when they controlled for other factors. In the largest group, that meant self-reported or family-reported cognitive problems, such as memory loss, at about 72 instead of 83. The same was true for Alzheimer's disease itself, which started in one group at a little older than 83, instead of about 88, when other factors were ruled out. The study was published online in the journal Neurology. It could be that the intermittent cutoff of oxygen to the brain is responsible for the problems, or the sleep disruption itself may be affecting cognition, Osorio said. Studies are underway to determine the cause.

Keyword: Sleep
Link ID: 20810 - Posted: 04.18.2015

by Jessica Hamzelou An exoskeleton that enables movement and provides tactile feedback has helped eight paralysed people regain sensation and move previously paralysed muscles "I FELT the ball!" yelled Juliano Pinto as he kicked off the Football World Cup in Brazil last year. Pinto, aged 29 at the time, lost the use of his lower body after a car accident in 2006. "It was the most moving moment," says Miguel Nicolelis at Duke University in North Carolina, head of the Walk Again Project, which developed the thought-controlled exoskeleton that enabled Pinto to make his kick. Since November 2013, Nicolelis and his team have been training Pinto and seven other people with similar injuries to use the exoskeleton – a robotic device that encases the limbs and converts brain signals into movement. The device also feeds sensory information to its wearer, which seems to have partially reawakened their nervous system. When Nicolelis reassessed his volunteers after a year of training, he found that all eight people had regained sensations and the ability to move muscles in their once-paralysed limbs. "Nobody expected it at all," says Nicolelis, who presented the results at the Brain Forum in Lausanne, Switzerland, on 31 March. "When we first saw the level of recovery, there was not a single person in the room with a dry eye." When a person's spinal cord is injured, the connection between body and brain can be damaged, leaving them unable to feel or move parts of their body. If a few spinal nerves remain, people can sometimes regain control over their limbs, although this can involve years of rehabilitation. © Copyright Reed Business Information Ltd.

Keyword: Robotics
Link ID: 20805 - Posted: 04.16.2015

A study using mice has uncovered a possible cause of Alzheimer’s disease, and suggests that a drug currently being investigated in human clinical trials to treat cancer could prevent the illness. The research has been heralded as offering hope of finding new treatments for dementia, an illness that affects 850,000 people in the UK. The findings, by Duke University in America and published in the Journal of Neuroscience, are surprising, according to one of the authors, as they contradict current thinking on the disease. The research suggests that in mice with Alzheimer’s disease certain immune cells that normally protect the brain begin abnormally to consume an important nutrient called arginine. By blocking this process using the drug difluoromethylornithine (DFMO), memory loss and a buildup of sticky proteins known as brain plaques were prevented. The study used a type of mouse in which a number of important genes had been swapped to make the animal’s immune system more similar to a human’s. Senior author Carol Colton, professor of neurology at the Duke University School of Medicine, and a member of the Duke Institute for Brain Sciences, said: “If indeed arginine consumption is so important to the disease process, maybe we could block it and reverse the disease.” It was previously thought the brain releases molecules that ramp up the immune system, apparently damaging the brain, but the study found a heightened expression of genes associated with the suppression of the immune system. Author Matthew Kan said: “It’s surprising because [suppression of the immune system is] not what the field has been thinking is happening in AD [Alzheimer’s disease].” © 2015 Guardian News and Media Limited

Keyword: Alzheimers
Link ID: 20802 - Posted: 04.15.2015

By JAMES GORMAN Studies of hunters and gatherers — and of chimpanzees, which are often used as stand-ins for human ancestors — have cast bigger, faster and more powerful males in the hunter role. Now, a 10-year study of chimpanzees in Senegal shows females playing an unexpectedly big role in hunting and males, surprisingly, letting smaller and weaker hunters keep their prey. The results do not overturn the idea of dominant male hunters, said Jill D. Pruetz of Iowa State University, who led the study. But they may offer a new frame of reference on hunting, tools and human evolution. “We need to broaden our perspective,” she said. Among the 30 or so chimps Dr. Pruetz and her colleagues observed, called the Fongoli band, males caught 70 percent of the prey, mostly by chasing and running it down. But these chimps are very unusual in one respect. They are the only apes that regularly hunt other animals with tools — broken tree branches. And females do the majority of that hunting for small primates called bush babies. Craig Stanford, an anthropologist at the University of Southern California who has written extensively on chimp hunting and human evolution, said the research was “really important” because it solidified the evidence for chimps hunting with tools, which Dr. Pruetz had reported in earlier papers. It also clearly shows “the females are more involved than in other places,” he said, adding that it provides new evidence to already documented observations that female chimps are “much more avid tool users than males are.” All chimpanzees eat a variety of plant and animal foods, including insects like termites. And all chimpanzees eat some other animals. The most familiar examples of chimpanzee hunting are bands of the apes chasing red colobus monkeys through the trees in the rain forests of East Africa. © 2015 The New York Times Company

Keyword: Evolution; Sexual Behavior
Link ID: 20800 - Posted: 04.15.2015

By Laura Sanders To drive a rat to drink, make it smoke first. Rats dependent on nicotine escalate their drinking more quickly than rats that haven’t been exposed to nicotine, researchers report in the April 15 Journal of Neuroscience. The results help explain why alcohol and tobacco addictions in people often go hand in hand. After nicotine injections, rats that had previously been exposed to alcohol dosed themselves with more alcohol than rats unexposed to nicotine did. Scientists were able to curb this booziness: Rats injected with a compound that made brain cells ignore nicotine did not boost their intake of alcohol. The double whammy of nicotine and alcohol dependence may be due to a select group of nerve cells throughout the rat brain that respond to this nicotine-aided drinking, Olivier George of the Scripps Research Institute in La Jolla, Calif., and colleagues found. If a similar response happens in humans, studying these particular nerve cells might ultimately lead to better ways to curb both alcohol and tobacco dependencies, the researchers write. R. Leão et al. Chronic nicotine activates stress/reward-related brain regions and facilitates the transition to compulsive alcohol drinking. Journal of Neuroscience. Vol. 35, April 15, 2015. doi:10.1523/JNEUROSCI.3302-14.2015. © Society for Science & the Public 2000 - 2015.

Keyword: Drug Abuse
Link ID: 20799 - Posted: 04.15.2015

Daniel Cressey Experiments that use only a small number of animals are common, but might not give meaningful results. Replace, refine, reduce: the 3 Rs of ethical animal research are widely accepted around the world. But now the message from UK funding agencies is that some experiments use too few animals, a problem that leads to wastage and low-quality results. On 15 April, the research councils responsible for channelling government funding to scientists, and their umbrella group Research Councils UK, announced changes to their guidelines for animal experiments. Funding applicants must now show that their work will provide statistically robust results — not just explain how it is justified and set out the ethical implications — or risk having their grant application rejected. The move aims to improve the quality of medical research, and will help to address widespread concerns that animals — mostly mice and rats — are being squandered in tiny studies that lack statistical power. “If the study is underpowered your results are not going to be reliable,” says Nathalie Percie du Sert, who works on experimental design at the National Centre for the Replacement, Refinement and Reduction (NC3Rs) of Animals in Research in London. “These animals are going to be wasted.” © 2015 Nature Publishing Group

Keyword: Animal Rights
Link ID: 20798 - Posted: 04.15.2015

By VIRGINIA HEFFERNAN Most newly stylish coinages carry with them some evidence of grammatical trauma. Consider “affluencer,” “selfie,” “impactful.” Notes of cynicism and cutesiness come through. But every now and then a bright exception to this dispiriting routine appears. A rookie word makes its big-league debut, a stadium of pedants prepares to peg it with tomatoes and — nothing. A halfhearted heckle. The new word looks only passably pathetic. Maddeningly, it has heft. “Mindfulness” may be that hefty word now, one that can’t readily be dismissed as trivia or propaganda. Yes, it’s current among jaw-grinding Fortune 500 executives who take sleeping pills and have “leadership coaches,” as well as with the moneyed earnest, who shop at Whole Foods, where Mindful magazine is on the newsstand alongside glossies about woodworking and the environment. It looks like nothing more than the noun form of “mindful” — the proper attitude toward the London subway’s gaps — but “mindfulness” has more exotic origins. In the late 19th century, the heyday of both the British Empire and Victorian Orientalism, a British magistrate in Galle, Ceylon (now Sri Lanka), with the formidable name of Thomas William Rhys Davids, found himself charged with adjudicating Buddhist ecclesiastical disputes. He set out to learn Pali, a Middle Indo-Aryan tongue and the liturgical language of Theravada, an early branch of Buddhism. In 1881, he thus pulled out “mindfulness” — a synonym for “attention” from 1530 — as an approximate translation of the Buddhist concept of sati. The translation was indeed rough. Sati, which Buddhists consider the first of seven factors of enlightenment, means, more nearly, “memory of the present,” which didn’t track in tense-preoccupied English. “Mindfulness” stuck — but may have saddled the subtle sati with false-note connotations of Victorian caution, or even obedience. (“Mind your manners!”) © 2015 The New York Times Company

Keyword: Stress
Link ID: 20797 - Posted: 04.14.2015

Fred Powledge I think I knew what was happening even before my head bounced off the hard kitchen counter on its way to the even harder stone floor. I was rapidly losing my connection with reality. My wife, Tabitha, later estimated that I was out for 10 minutes. When I emerged from unconsciousness I heard the sirens on the street in front of the house. It seemed as if half of Tucson's fire department was streaming through the front door. I was scared. At my age, which is old, you laugh at any childlike faith in your immortality. In this case, what brought on the unconsciousness was apparently a quick turn of my head while reaching for an onion to peel for the night's dinner, followed by the knockout blow from hitting the floor. I was scared. At my age, which is old, you laugh at any childlike faith in your immortality. An enormous hook and ladder and an ambulance were drawn up in front of the house, sirens winding down. The commotion was embarrassing, but it was comforting to know that my wife was in the next room, had called for help, and that 911 had responded to her call as it was supposed to. The emergency room doctor said I had a concussion — a blow to the head that our new and improved language calls a MTBI. This scared me as much as the ambulance ride itself, since it stands for "Mild Traumatic Brain Injury." © 2015 NPR

Keyword: Brain Injury/Concussion
Link ID: 20795 - Posted: 04.14.2015

by Penny Sarchet You've got a splitting migraine. If you were offered a sugar pill, would you bother taking it? What if you were told your genetic make-up means it is very likely to make you feel better? This is one of the questions raised by the burgeoning effort to understand which genes influence the placebo effect, and how these genes – collectively known as the placebome – determine a person's susceptibility to the phenomenon. There are tremendous differences in the placebo effect between individuals, says Kathryn Hall of Harvard Medical School. "It can vary from no measurable response to someone getting significantly better." Having drawn together all the studies carried out so far, Hall says there is reasonable evidence for at least 11 genes that influence a person's susceptibility. This is enough to warrant discussing the use of genetic screening to assess how likely a person is to respond to a placebo treatment, such as a sugar pill or saline injection. The idea is that this could lead to more personalised treatments for conditions like pain syndromes, migraines, depression, irritable bowel syndrome and even Parkinson's disease, symptoms of which seem to be relieved by placebo in some individuals. It could also lead to the design of more balanced clinical trials. Your personality can help you guess whether you're among the estimated third of the population who are placebo responders. Being agreeable, extroverted and open to new experiences all appear to be associated with placebo susceptibility. Although brain imaging techniques can also indicate a person's likely susceptibility, a genetic read-out would offer a convenient, easily applicable and clearly codified measure. © Copyright Reed Business Information Ltd

Keyword: Pain & Touch
Link ID: 20794 - Posted: 04.14.2015

|By Andrea Alfano To scratch an itch is to scratch many itches: placing nails to skin brings sweet yet short-lived relief because it often instigates another bout of itchiness. The unexpected culprit behind this vicious cycle, new research reveals, is serotonin, the so-called happiness hormone. Scientists thought itch was merely a mild form of pain until 2009, when Zhou-Feng Chen and his colleagues at the Center for the Study of Itch at Washington University in St. Louis discovered itch-specific neurons in mice. Though not identical, itch and pain are closely related; they share the same pathways in certain brain areas. Because of the doubling up, activating one suppresses the other, which is why scratching blocks the itch sensation momentarily. The act, however, also triggers the release of the chemical serotonin, which helps to alleviate pain. It is that burst that makes scratching feel good, but recent work by Chen's group showed that it exacerbates the itch-scratch cycle, too. Itch-sensing neurons have a set of receptors that facilitates pain relief and another that induces itch. Serotonin can bind only to the pain-related receptor, but because the two sets sit close to each other and physically interact, the chemical's arrival indirectly enhances the itch pathway. When Chen and his colleagues activated both receptors simultaneously in mice, the rodents scratched much more than if the itch-inducing receptor was turned on alone. In another experiment, mice lacking the cells that produce serotonin scratched less than normal mice when exposed to a skin irritant. The findings were published in the journal Neuron. © 2015 Scientific American

Keyword: Pain & Touch
Link ID: 20793 - Posted: 04.14.2015

Boer Deng Universities in the United States employ many more male scientists than female ones. Men are paid more, and in fields such as mathematics, engineering and economics, they hold the majority of top-level jobs. But in a sign of progress, a 13 April study finds that faculty members prefer female candidates for tenure-track jobs in science and engineering — by a ratio of two to one. That result, based on experiments involving hypothetical job seekers, held true regardless of the hirer’s gender, department, career status or university type, researchers report in the Proceedings of the National Academy of Sciences1. “We were shocked,” says Wendy Williams, a psychologist at Cornell University in Ithaca, New York, and a co-author of the study. With fellow Cornell psychologist Stephen Ceci, she surveyed 873 tenure-track faculty members in biology, psychology, economics and engineering at 371 US universities. One experiment presented participants with three hypothetical job candidates, of which two were identical except for their gender. Another experiment added descriptions of marital and parental status, to test whether underlying assumptions about gender choices affected hiring. “You don’t frequently see that level of attention and sophistication” in statistical analysis, says Robert Santos, vice-president of the American Statistical Association in Alexandria, Virginia. Nothing seemed to sway study participants’ preference for female job candidates. The authors say that this is interesting given their previous finding that a relatively low percentage of female PhDs in the social and biological sciences secure academic positions — in part because they are less likely than men to apply for these jobs. Other research suggests that in the physical sciences, women and men are just as likely to secure a tenure-track position within five years of earning a PhD. © 2015 Nature Publishing Group

Keyword: Sexual Behavior
Link ID: 20792 - Posted: 04.14.2015

By David Grimm The U.S. Department of Agriculture has launched an investigation into Harvard University’s New England Primate Research Center after several suspicious deaths at the Southborough, Massachusetts, facility. The inquiry coincides with a series of articles published by The Boston Globe, which has uncovered a number of potential animal welfare violations at the center, including a dozen dehydrated squirrel monkeys found dead in their cages or euthanized because of poor health between 1999 and 2011. In several cases it appears that the animals were not given water or were unable to drink due to malfunctioning water lines. In one incident, a monkey’s tooth caught in her jacket, preventing her from drinking. Some of these animals were the subject of a 2014 Veterinary Pathology paper on the impact of dehydration on lab animals. The journal says it is now investigating this study. The primate center is set to close at the end of next month, though—according to the Globe—the university blames finances, not animal care problems. © 2015 American Association for the Advancement of Science

Keyword: Animal Rights
Link ID: 20791 - Posted: 04.14.2015

By STEVEN QUARTZ and ANETTE ASP THE gaping inequality of America’s first Gilded Age generated strong emotions. It produced social reformers like Jane Addams, anarchist agitators like Emma Goldman, labor leaders like Eugene V. Debs and Progressive politicians like Theodore Roosevelt. By the 1920s, sweeping legislation regulating food and drugs and breaking up corrupt trusts had been passed. The road to the New Deal was paved. But our current Gilded Age has been greeted with relative complacency. Despite soaring inequality, worsened by the Great Recession, and recent grumbling about the 1 percent, Americans remain fairly happy. All of the wage gains since the downturn ended in 2009 have essentially gone to the top 1 percent, yet the proportion of Americans who say they are “thriving” has actually increased. So-called happiness inequality — the proportion of Americans who are either especially miserable or especially joyful — hit a 40-year low in 2010 by some measures. Men have historically been less happy than women, but that gap has disappeared. Whites have historically been happier than nonwhites, but that gap has narrowed, too. In fact, American happiness has not only stayed steady, but converged, since wages began stagnating in the mid-1970s. This is puzzling. It does not conform with economic theories that compare happiness to envy, and emphasize the impact of relative income for happiness — how we compare with the Joneses. A new neuroscience of consumer behavior reinforces our argument. In one experiment, we used functional magnetic resonance imaging (fMRI) to understand our brains’ reaction to perceived coolness. We selected students from the Art Center College of Design in Pasadena, Calif., and asked them to rate, from uncool to cool, hundreds of images from the following categories: bottled water, shoes, perfumes, handbags, watches, cars, chairs, personal electronics and sunglasses. We also included images of celebrities (actors and musicians). The cooler objects typically weren’t the more expensive ones: our subjects rated a Kia hatchback above a Buick sedan, for example. © 2015 The New York Times Company

Keyword: Emotions
Link ID: 20790 - Posted: 04.13.2015

By MALIA WOLLAN “A polygraph is nothing more than a psychological billy club used to coerce and intimidate people,” says Doug Williams, a former Oklahoma City police detective and polygraph examiner who for 36 years has trained people to pass the lie-detector test. The first step is not to be intimidated. Most tests include two types of questions: relevant ones about a specific incident (“Did you leak classified information to The New York Times?”) and broader so-called control questions (“Have you ever lied to anyone who trusted you?”). The test assumes that an innocent person telling the truth will have a stronger reaction to the control questions than to the relevant ones. Before your test, practice deciphering between the two question types. “Go to the beach” when you hear a relevant question, Williams says. Calm yourself before answering by imagining gentle waves and warm sand. When you get a control question, which is more general, envision the scariest thing you can in order to trigger physiological distress; the polygraph’s tubes around your chest measure breathing, the arm cuff monitors heart rate and electrodes attached to you fingertips detect perspiration. What is your greatest fear? Falling? Drowning? Being buried alive? “Picture that,” Williams says. He used to advise trainees to clench their anus but has since concluded that terrifying mental imagery works better. Williams, who is 69, may be among the more vitriolic critics of polygraphs, which he refers to as “insidious Orwellian instruments of torture,” but their reliability has long been questioned elsewhere, too. Federal legislation prohibits most private employers from using polygraphs. The U.S. Supreme Court has ruled that lower courts can ban them as evidence, and the scientific community has repeatedly raised concerns about their ability to accurately detect lies. © 2015 The New York Times Company

Keyword: Stress
Link ID: 20789 - Posted: 04.13.2015

by Catherine Brahic TRANSLUCENT comb jellies are some of the most primitive animals on Earth, yet they have remarkable nervous systems. Controversial data discussed at a meeting in London last month proposes that their neurons are unlike any others on Earth. This could be evidence that neurons evolved more than once in the history of animal life. The suggestion that neurons evolved in parallel multiple times has divided biologists for over a century. Ultimately, Erich Jarvis of Duke University in North Carolina told a Royal Society conference in March, the question relates to how special we are. If neurons evolved several times on our planet, then it becomes more likely that they could evolve elsewhere in the universe. Until recently, the consensus has leaned towards a very Darwinian story. In this scenario, sometime around 600 million years ago, the common ancestor to all animals gave rise to some organisms with simple neural networks. Central nervous systems arose later, allowing for greater coordination and more complex behaviours. These perhaps started out as tight balls of neurons, but eventually gave rise to the magnificently complex primate brain. This single origin scenario offers a tidy explanation for why some animals, like sponges and flat, simple placozoans, still don't have neurons: they must have branched off before these evolved and are relics of ancestral animals (see diagram). The story was somewhat turned on its head by the recent whole genome sequence of comb jellies. These small marine animals look like jellyfish but in fact seem to be only distantly related. They use a neural network just beneath their skin and a brain-like knot of neurons at one end to catch food, respond to light, sense gravity and escape predators. © Copyright Reed Business Information Ltd.

Keyword: Evolution
Link ID: 20786 - Posted: 04.11.2015

Robin McKie, science editor A smile is the universal welcome, the writer Max Eastman once remarked. But how sure can we be that a person’s smile is genuine? The answer is the empathy test, created by psychologist Richard Wiseman, which probes our ability to appreciate the feelings of others – from their appearance. A photographer asks a subject to imagine meeting an individual they don’t like and to put on a fake smile. Later the subject sits with a real friend and as they converse, the photographer records their genuine smile. Thus two versions of their smile are recorded. The question is: how easy is it to tell the difference? “If you lack empathy, you are very bad at differentiating between the two photographs,” says Wiseman, who teaches at the University of Hertfordshire. But how do professions differ in their ability to spot a fake? And in particular, how do scientists and journalists score? Neither are particularly renowned for their empathy, after all. Last month’s Scientists Meet the Media party, for which the Observer is the media sponsor, gave Wiseman a perfect opportunity to compare the two professions. At the party, hosted by the Science Museum in London, some of Britain’s top researchers mingled with UK science journalists. About 150 guests were shown photographs of subjects with fake and genuine smiles. Guests were then asked to spot the false and the true. The results were intriguing. © 2015 Guardian News and Media Limited

Keyword: Emotions
Link ID: 20785 - Posted: 04.11.2015

Leana Wen Every doctor and nurse in our hospital's emergency room knew Jerome. He was one of our regulars. In his 20s, he had back problems that led him to become addicted to prescription painkillers. That habit proved too expensive, and he switched to heroin. Jerome used to come to the ER nearly every week. Often, he just wanted a sandwich and someone to talk to. He had lost his job and his home. Several months ago, he decided he had to quit heroin. We helped him with health insurance so that he could find a primary care doctor. Our social worker connected him with addiction treatment, including medications and mental health counseling. He was also working on rekindling a relationship with his estranged family. One day, paramedics brought Jerome to the ER. They had found him in an abandoned building. He'd relapsed and was shooting heroin. A friend saw him unconscious and called for help. By the time paramedics arrived, he wasn't breathing and his heart had stopped beating. In the ER, we tried to resuscitate him for nearly an hour. We weren't successful. In Baltimore, where I serve as health commissioner, more people die from drug and alcohol overdoses than from homicide. In 2013, there were 246 deaths related to drugs and alcohol, compared with 235 homicides. © 2015 NPR

Keyword: Drug Abuse
Link ID: 20783 - Posted: 04.11.2015

By Jennifer Couzin-Frankel Sudden death, a mysterious and devastating outcome of epilepsy, could result from a brain stem shutdown following a seizure, researchers report today in Science Translational Medicine. Although the idea is still preliminary, it’s engendering hope that neurologists are one step closer to intervening before death strikes. Sudden unexpected death in epilepsy (SUDEP) has long bedeviled doctors and left heartbroken families in its wake. “It’s as big a mystery as epilepsy itself,” says Jeffrey Noebels, a neurologist at Baylor College of Medicine in Houston, Texas, and the senior author of the new paper. As its name suggests, SUDEP attacks without warning: People with epilepsy are found dead, often following a seizure, sometimes face down in bed. Many are young—the median age is 20—and patients with uncontrolled generalized seizures, the most severe type, are at highest risk. About 3000 people are thought to die of SUDEP each year in the United States. And doctors have struggled to understand why. “How can you have seizures your whole life, and all of a sudden, it’s your last one?” Noebels asks. In 2013, an international team of researchers described its study of epilepsy patients who had died while on hospital monitoring units. In 10 SUDEP cases for which they had the patients’ heart function and breathing patterns, the authors found that the patients’ cardiorespiratory systems collapsed over several minutes, and their brain activity was severely depressed. “Their EEG went flat after a seizure,” says Stephan Schuele, an epileptologist at Northwestern University Feinberg School of Medicine in Chicago, Illinois, who wasn’t involved in the study. © 2015 American Association for the Advancement of Science

Keyword: Epilepsy
Link ID: 20782 - Posted: 04.10.2015