Monday 26 May 2014

Everything you know about teenage brains is bullshit

Everything you know about teenage brains is bullshit

Kathryn Mills reports that discussion has become dominated by unconvincing 'experts' and scaremongering. The evidence is not in.

Forget what you've heard. We don't know much about how Internet use affects the brain
.
After years of being told that the Internet was rotting my brain, I decided to assess the damage by gathering the scientific evidence.

 My review of the published scientific literature found no evidence that typical Internet use harms the adolescent brain.
I'm a neuroscience student researching human brain development, specifically during the teen years.

 Our brain undergoes a lot of changes between childhood and adulthood, and the lab I work in is interested in how these changes relate to our ability to navigate the social world. It's fun work, especially because many people seem to be as interested in learning about the teen brain as I am.

Whenever I present my research to groups of parents or teachers, I'm usually asked a version of the question: "How are digital technologies affecting teenagers' brains?" Until I conducted this review, I would normally respond with a cautious, slightly dismissive, and utterly unhelpful answer: "We don't know."

Ways of knowing

Teachers possess valuable knowledge about young people and generational trends. Over 2,000 American middle and high school teachers responded to a recent survey by the Pew Research Center asking them how they felt the Internet (and other digital technologies) were affecting their students.

The majority of teachers (87%) felt that Internet use was creating an “easily distracted generation with short attention spans,” and 88% felt that “today’s students have fundamentally different cognitive skills because of the digital technologies they have grown up with.”

While surveys can tell us about how people perceive the world, the scientific method allows us to test these observations for their validity. As E. O. Wilson said, "the heart of the scientific method is the reduction of perceived phenomena to fundamental, testable principles." With this in mind, I set out to review the scientific evidence for the Internet's impact on the brain--specifically the teenage brain.

However, to do so I had to first figure out how to define Internet use.

The Internet

What does it mean to use the Internet?

 The Pew Research Center estimates around 87% of adults and 95% of teens in America are users. But Internet use is made up of multiple activities, and is different from video game use, computer use and screen time (all of which can occur offline). One of the most important parts of the scientific process is defining your variable of interest. For the purposes of this review, I defined Internet use as activities such as information gathering, entertainment, and communication accessed through the medium of the World Wide Web.

What I found

To find out if any scientific research had been conducted on this topic, I performed a simple search in the largest biomedical database for studies including the terms internet, adolescence (or teenager), and brain.
Then I looked through the 134 results to see if they were actually relevant.

 Most were not.

 The two studies I classified as empirical research studies did not measure brain changes in response to Internet use, but included experimental paradigms that could tell us something about the effects of Internet use. The studies that did relate Internet use to brain measures sampled an unrepresentative portion of the population, which means the results of these studies are unlikely to apply to most individuals.

The keyboard and the damage done

The Internet is sometimes compared to drugs like heroin, but I think it is much more like coffee (which an estimated 83% of American adults drink).

The studies that have investigated the effects of Internet use on the adolescent brain have focused on adolescents experiencing serious problems from their Internet use (sometimes referred to as Pathological Internet Use).

It might surprise some to hear that the majority of adolescents (95.6%) do not fall into this category.

Most adolescents, like adults, do not experience serious problems from Internet use. We might be using the Internet every day, but most of us are functional users. What this means is that the studies that have shown brain changes in individuals with disordered Internet use do not apply to most adolescents.

What we do know

While we may not know much about how the Internet affects brain development, there has been extensive work into how different Internet activities relate to the health and well-being of adolescents. Importantly, it is becoming clear that typical Internet use does not displace time spent doing IRL activities, such as participating in sports and clubs.

A review conducted five years ago found that communicating with friends through the Internet is related to increased levels of social connectedness in adolescents. And, as I'm sure many readers are already aware, danah boyd has recently written a fantastic book on social media use in adolescence that goes into unprecedented depth on this topic.

In the review, I describe a few studies that could tell us something about how the Internet might shape our way of interacting with the world. Although these studies cannot tell us if Internet use is creating a generation with “fundamentally different cognitive skills,” they suggest that our way of dealing with information might be changing in a world that favors certain skills.

Shaping the developing brain

Repeated experiences in the world will affect neural architecture on some level; such is the nature of our brain. This is true for a human brain of any age. However, the developing brain contains more capacity for change.
 Since experience partially determines what neural connections are kept and strengthened during adolescence, some adults are concerned that Internet use could be “rewiring” the brains of the current generation.
 This is exactly the kind of evidence that is lacking.

While Internet use is almost always thought of as harming the brain, this narrative is not extended to other activities such as musical training.

When I conducted a similar search, replacing the term Internet with music, I found quite a few studies examining how musical training relates to changes in brain measures and cognitive abilities in representative populations (non-professionals).

Perhaps future research examining Internet use can apply similar methods. However, it's important to note that studies showing simple correlations between brain measures and behavior cannot tell us if the behavior caused the change, or if the brain changes relate to well-being. Only longitudinal studies and studies that include measures of functional outcomes (e.g., cognitive measures and measures of well-being) can do that.

Absence of evidence is not evidence of absence 

 

 Just to be clear: I am not saying Internet use does not affect the developing brain. I just haven't found evidence to suggest that Internet use has or hasn't had a profound effect on brain development.

Also, I'm one scientist. It wouldn't surprise me if I missed relevant studies.

This is why I am maintaining a list of scientific studies relevant to this topic. If you know of any studies that could be added to this list, please submit them here.

 That way, whoever writes the next review can incorporate as much evidence as possible.
 

Conflict of Interest


I grew up on the Internet

Shortly after I gave a presentation on this topic at the 2014 SXSW Interactive Festival, my mother unearthed this video:


As you might be able to tell from her hair and voice, my mother spent a lot of time in the late 80s tech-nerd party scene. She's been working with computers for longer than I have been alive. I know I am biased; I think the Internet can't be so bad because I grew up on the Internet.

Whenever an adult asks me if Internet use is harming the teen brain, I am tempted to reveal that I have been using the Internet since I was 9 years old. I think I'm functional. However, treating anecdote with anecdote isn't going to solve this debate. Also, it's clear that Internet use was a fundamentally different experience back when I was a child (see video).

Fear of Internet will fade 


 As more digital natives populate science and positions of power, the fear that the Internet is harming the teen brain will fade. A newer technology will replace it. We can combat this endless cycle of technofear by including younger voices in debates on topics that concern them.
A great example of scientists listening to young people is a study conducted by Suparna Choudhury and colleagues, in which neuroscientists asked adolescents their thoughts on the science of the adolescent brain.

Open up the discussion

It's my hope that this article, and the review, will provoke discussion. Unfortunately, I feel that the discussion about how the Internet could be affecting brain development has been dominated by adult 'experts'. Young people's experiences and thoughts about this topic are valuable sources of knowledge. Without a doubt, Internet use affects our lives. However, we currently do not know how it is impacting brain development. So if anyone has ideas for experiments to test this, let's hear them.
Illustration: Rob Beschizza / Shutterstock

Published 7:49 am Thu, May 22, 2014

More at Boing Boing

Saturday 24 May 2014

Does Eye Color Predict Response to Pain?



This coverage is not sanctioned by, nor a part of, the American Pain Society.

Does Eye Color Predict Response to Pain?

Fran Lowry

May 14, 2014


TAMPA, Florida —
 The color of a person's eyes may predict how that person responds to pain.

"There may be certain phenotypes that predict or indicate a person's response to pain stimuli or drug treatment for pain," Inna Belfer, MD, PhD, from the University of Pittsburgh School of Medicine in Pennsylvania, told Medscape Medical News.

"Human pain is correlated with multiple factors like gender, age, and hair color," Dr. Belfer said here at the American Pain Society (APS) 33rd Annual Scientific Meeting.
"Researchers have found that red hair is associated with resistance to anesthetics and also to increased anxiety and darker eye color has been reportedly found to correlate with increased physiologic reactivity and drug-induced pupil dilation."

Dr. Belfer added that her anesthesiology colleagues reported noticing a similar association.
"They said that looking in the eyes of their patients tells them if they can expect more or less trouble during the procedures and they can tell who will develop more severe pain or who will respond differently to anesthesia and analgesia," she said.

To explore this association further, Dr. Belfer and her group studied eye color and pain-related traits in healthy women who were undergoing labor and delivery.

They assessed antepartum and postpartum pain, mood, sleep, and coping behavior in 58 women who gave birth at UPMC Magee Women's Hospital.
The women were grouped into 2 cohorts based on their eye color: 24 women in the dark group (brown or hazel eye color) and 34 women in the light group (blue or green eye color).

The women were profiled by using standard validated surveys, including the Brief Pain Inventory, PROMIS anxiety/depression/sleep scales, the Pain Catastrophizing Scale, and Quantitative Sensory Testing, to measure their response to pain.

The results showed that women with dark-colored eyes showed increased anxiety compared with women with light-colored eyes (P = .01).

Women with dark-colored eyes also trended toward increased sleep disturbance (P = .19) and less improvement in catastrophizing/rumination (P = .15) compared with women with light eye color.

Those with darker eyes also showed trends toward experiencing more pain than women with light eye color, both at rest (P = .28) and during movement (P = .22) after receiving epidural analgesia.

Darker-eyed women were less tolerant of heat pain and were also more likely to be depressed as a result of their pain than were light-eyed women, Dr. Belfer said.

"Due to the small sample size, we can't get compelling evidence for our findings, but we do feel that our study has revealed patterns that warrant further studies. We are going to see if there is a link between eye color and clinical pain in part 2 of this project, in men and in women, and in different pain models other than the labor pain model," Dr. Belfer said.

The reason for any differences in pain response could be genetic, Dr. Belfer said. "I specialize in the molecular physiology of pain and we think that there is a genetic background for these effects," she said.

Genetic Link Interesting

"Essentially what they are looking for are genetic correlates, how genes affect the response to pain," said Gregory W. Terman, PhD, MD, professor of anesthesiology, University of Washington, Seattle, asked by Medscape Medical News to comment on the study.

"This is interesting. If you can identify different genes that may be important, perhaps we can increase our understanding of the pain picture and why there are differences in the amount of pain some people can tolerate.
 In this case, they may be looking for yet another gene that is correlated with increased or decreased pain, and there are quite a few of those around," Dr. Terman, president-elect of the American Pain Society, said.

He agreed that trying to find correlations between patients and pain responses is a promising area of research.

This study was supported by the University of Pittsburgh Department of Anesthesiology Seed Award and New Competitive Medical Research Fund. Dr. Belfer and Dr. Terman have disclosed no relevant financial relationships.
 
American Pain Society (APS) 33rd Annual Scientific Meeting. Abstract 197. Presented May 1, 2014.

Tuesday 13 May 2014

The Most Important Heart Study 2014....This will give you choices to save your life

 Medscape Medical News from the

This coverage is not sanctioned by, nor a part of, the Heart Rhythm Society.

Is Atrial Fibrillation Necessary? The Most Important Study Presented at the Heart Rhythm Society 2014 Scientific Sessions

John Mandrola

DisclosuresMay 11, 2014
Most diseases have a turning point, a time when things begin to change.

What follows is a report on what I believe may be (pardon the big word) an inflection point in the way we think about the most common heart-rhythm disorder.

Dr Rajeev Pathak, an electrophysiology fellow in the laboratory of Prof Prashanthan Sanders in Adelaide, Australia, gave the presentation.

 It happened late in the afternoon, in a small room, nestled into a back corner of the massive convention hall. Even though this paper won the prestigious Eric Prystowsky award for outstanding clinical science, there were no press releases, no simultaneous publications, and nearly no attendees in the small room.
 Session chair Dr Francis Marchlinski (University of Pennsylvania, Philadelphia) remarked that it "was too bad more people weren't here to hear this."

Here's my recap of the Aggressive Risk Factor Reduction Study-Implications for Ablation Outcomes (ARREST-AF) trial[1]:

Background: Previous work from the Adelaide researchers has demonstrated the causative role of typical cardiovascular risk factors (obesity, high blood pressure, diabetes, smoking, alcohol, sleep apnea, etc) in promoting the substrate for atrial fibrillation.

 Last year at the Heart Rhythm Society 2013 Scientific Sessions, this group presented data showing that weight loss (in obese sheep) resulted in favorable structural and electrical properties of the atria[2]. Most notably, there was a reduction in interstitial fibrosis
.
They then demonstrated similar findings in humans. In this study [3], which was published in the Journal of the American Medical Association, they selected overweight AF patients on the waiting list for ablation and randomized them to either a physician-led lifestyle-intervention group or standard care.

 Both groups lost weight and improved on measures of overall health, but those in the aggressive-intervention group improved much more. Just like the sheep, humans who lost weight enjoyed shrinking LA volumes and striking drops in AF burden, with 30% of patients avoiding AF ablation altogether.

This work set the stage for ARREST-AF. Dr Sanders told me they figured if risk-factor modification worked before ablation, it would likely work after. The hypothesis, therefore, was that late recurrence of AF after ablation is due to progression of the underlying substrate, and aggressive risk-factor intervention would improve ablation outcomes.

Methods: Patients (n=165) were selected for the study after their first AF ablation if they had a body-mass index (BMI) >27 and one risk factor, such as hypertension, diabetes, sleep apnea, or abnormal lipids. All patients were offered aggressive risk-factor management in a physician-led clinic. The active-treatment group included 61 patients who accepted, while the 88 patients who refused made up the control group. The two groups were followed for two years, and the primary outcome measure was recurrence of AF.

Patients in the active-treatment group underwent intense lifestyle modification, which included active weight-management strategies and medical treatment of hyperlipidemia, glucose intolerance, high blood pressure, and sleep apnea. Tobacco and alcohol use were aggressively targeted. These primary therapies were accomplished in a separate clinic from electrophysiology. Dr Sanders emphasized that the Adelaide brand of risk-factor modification is unique and robust.

RFM=Risk-factor-modification group

Results:
The impact on risk factors was striking.

 Patients in the risk-factor-modification arm lost weight.
 Glycemic control improved, blood pressure dropped, and the percent of patients with nocturnal
 hypoxic episodes decreased.


Structural changes of the heart also were significant. Left atrial volume and LV diastolic volume decreased.
Using standard questionnaires, measures of AF symptom burden and global well-being also improved.

AF-free survival after a single ablation procedure was 62% for patients in risk-factor-modification group and 26% for the control arm. After multiple ablations, AF-free survival increased to 87% in the risk-factor-modification group vs 48% in the control arm. Said another way, Adelaide-style risk-factor management increased the success rate of AF ablation fivefold.


Conclusion: Risk-factor management improves outcomes after AF ablation and should be considered crucial when choosing a rhythm-control strategy. ( any rhythm-control strategy )

Comments:





I'm going to do something unusual. Rather than offer opinion, I'll present words from Dr John Day (Intermountain Health, Salt Lake City UT), who is president-elect of the Heart Rhythm Society and program director of this meeting.

During a session entitled "How to prevent and reverse AF," Dr Day gave one of the most unusual talks I have ever heard at a medical meeting. He started with a personal confession:
"Until a few years ago, my life was about ablating AF, thousands of ablations, three per day.
In the process of this, I didn't give a whole lot of thought as to how the patient got AF or what was happening to my life."
I was now hooked, utterly mesmerized. I thought to myself: is this really happening, or am I jet lagged?

Next, as he showed images of his diet at the time—doughnuts, pizza, and soda—he told the audience:
"At age 44, my health had hit rock bottom.

I was overweight. I had developed high blood pressure, high cholesterol, palpitations, insomnia, and even an autoimmune disease.

         And I was taking five medications.
        Something had to change." 
 
Stay with me. It gets better.

He described trying the usual diets and solutions, even the "gluten-free thing." Not much happened. Then he got interested in the famous book The China Study .
"I   became fascinated with some of these rural Chinese villages where people lived long lives, free of heart disease and cancer. I speak Chinese, and we visited these places multiple times. What I learned has taken my life in a whole new direction.
My entire perspective of AF has changed from one of ablation to one of . . . does AF even need to happen?"
Let me remind you that Dr Day is about to lead the world's most influential electrophysiology society.
Then he showed an incredibly professional four-minute video of a Chinese village. (He's writing a book, and this is likely the trailer.) Alongside rolling streams were smiling 100-year-old Chinese women. A calm female voice narrates . . .
"They have such a sense of peace about them."
Then this, in Dr Day's voice:
"Whether you are 40, or 50, or 60, or 70, it's never too late to make changes."
The video stops, but Dr Day continues:
"I   began to slow down. I started looking at the big picture, eating real food, sleeping. My extra weight came off without trying; my cholesterol fell nearly 100 points; my BP dropped 30 to 40 points and my CRP went below 1. "I now take no medications. I feel good."
 And for the win:
"This has changed my approach when I meet with patients. No longer is atrial fibrillation something that we just ablate."
 In an interview with me the next day, Dr Day said he thinks (in most cases) AF may be unnecessary.
Enough said.
JMM

TDNorth   Thank you; I will do the comments page tomorrow.

I am going to just be human here.
I have gone this way myself after a cardiac virus.

The prognosis conversation at the time?
Was that me living beyond 3 years wasn't likely without a heart transplant.
I'm almost in that 3 year neighbour hood , now.

A healthy reset doesn't have to be a fanatical calling.
It can be amazingly simple.
This page is about health science and....
Always check it out yourself.
There is a little bit more to it, 
But everyone is different.
We'll get there....


Live it, believe it

You Never Really Know a Man Until You Feel the Bumps on his Head


Phrenology Diagrams from Vaught’s Practical Character Reader (1902)


Illustrations from Vaught’s Practical Character Reader, a book on phrenology by L. A. Vaught published in 1902. As he confidently states in his Preface:

The purpose of this book is to acquaint all with the elements of human nature and enable them to read these elements in all men, women and children in all countries. At least fifty thousand careful examinations have been made to prove the truthfulness of the nature and location of these elements. More than a million observations have been made to confirm the examinations. Therefore, it is given the world to be depended upon. Taken in its entirety it is absolutely reliable. Its facts can be completely demonstrated by all who will take the unprejudiced pains to do so. It is ready for use. It is practical. Use it.


The theory that one can ascertain a person’s character by the shape of their features is disturbing to say the least.

You can see the book in its entirety, including many more diagrams, over in our post in the Texts collection.
- See more at: http://publicdomainreview.org/collections/phrenology-diagrams-from-vaughts-practical-character-reader-1902/#sthash.6pZrDn88.dpuf
The theory that one can ascertain a person’s character by the shape of their features is disturbing to say the least.

You can see the book in its entirety, including many more diagrams, over in our post in the Texts collection.
Housed at: Internet Archive | From: Library of Congress
- See more at: http://publicdomainreview.org/collections/phrenology-diagrams-from-vaughts-practical-character-reader-1902/#sthash.6pZrDn88.dpuf

Phrenology Diagrams from Vaught’s Practical Character Reader (1902)

Illustrations from Vaught’s Practical Character Reader, a book on phrenology by L. A. Vaught published in 1902. As he confidently states in his Preface:

The purpose of this book is to acquaint all with the elements of human nature and enable them to read these elements in all men, women and children in all countries. At least fifty thousand careful examinations have been made to prove the truthfulness of the nature and location of these elements. More than a million observations have been made to confirm the examinations. Therefore, it is given the world to be depended upon. Taken in its entirety it is absolutely reliable. Its facts can be completely demonstrated by all who will take the unprejudiced pains to do so. It is ready for use. It is practical. Use it.


The theory that one can ascertain a person’s character by the shape of their features is disturbing to say the least.

You can see the book in its entirety, including many more diagrams, over in our post in the Texts collection.
- See more at: http://publicdomainreview.org/collections/phrenology-diagrams-from-vaughts-practical-character-reader-1902/#sthash.6pZrDn88.dpuf

http://publicdomainreview.org/collections/phrenology-diagrams-from-vaughts-practical-character-reader-1902/

An Amazing and Ambitious Project.

What Will We be perceived as in 100 Years?

Please scope out this wonderful site





Phrenology Diagram




Phrenology Diagram

Phrenology Diagram


Phrenology Diagrams from Vaught’s Practical Character Reader (1902)


Illustrations from Vaught’s Practical Character Reader, a book on phrenology by L. A. Vaught published in 1902. As he confidently states in his Preface:

The purpose of this book is to acquaint all with the elements of human nature and enable them to read these elements in all men, women and children in all countries. At least fifty thousand careful examinations have been made to prove the truthfulness of the nature and location of these elements. More than a million observations have been made to confirm the examinations. Therefore, it is given the world to be depended upon. Taken in its entirety it is absolutely reliable. Its facts can be completely demonstrated by all who will take the unprejudiced pains to do so. It is ready for use. It is practical. Use it.


The theory that one can ascertain a person’s character by the shape of their features is disturbing to say the least.

You can see the book in its entirety, including many more diagrams, over in our post in the Texts collection.
- See more at: http://publicdomainreview.org/collections/phrenology-diagrams-from-vaughts-practical-character-reader-1902/#sthash.6pZrDn88.dpuf

Phrenology Diagrams from Vaught’s Practical Character Reader (1902)


Illustrations from Vaught’s Practical Character Reader, a book on phrenology by L. A. Vaught published in 1902. As he confidently states in his Preface:

The purpose of this book is to acquaint all with the elements of human nature and enable them to read these elements in all men, women and children in all countries. At least fifty thousand careful examinations have been made to prove the truthfulness of the nature and location of these elements. More than a million observations have been made to confirm the examinations. Therefore, it is given the world to be depended upon. Taken in its entirety it is absolutely reliable. Its facts can be completely demonstrated by all who will take the unprejudiced pains to do so. It is ready for use. It is practical. Use it.


The theory that one can ascertain a person’s character by the shape of their features is disturbing to say the least.

You can see the book in its entirety, including many more diagrams, over in our post in the Texts collection.
- See more at: http://publicdomainreview.org/collections/phrenology-diagrams-from-vaughts-practical-character-reader-1902/#sthash.6pZrDn88.dpuf

OOPPS Maybe It's Catching.....

Eurosurveillance

Eurosurveillance, Volume 19, Issue 18, 08 May 2014

Rapid communications

Laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Malaysia: preparedness and response, April 2014
  1. Ministry of Health Malaysia

Citation style for this article: Premila Devi J, Noraini W, Norhayati R, Chee Kheong C, Badrul AS, Zainah S, Fadzilah K, Hirman I, Lokman Hakim S, Noor Hisham A. Laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Malaysia: preparedness and response, April 2014. Euro Surveill. 2014;19(18):pii=20797. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20797
Date of submission: 25 April 2014

On 14 April 2014, the first laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was reported in Malaysia in a man in his mid-fifties, who developed pneumonia with respiratory distress, after returning from a pilgrimage to Saudi Arabia. The case succumbed to his illness three days after admission at a local hospital. The follow-up of 199 close contacts identified through contact tracing and vigilant surveillance did not result in detecting any other confirmed cases of MERS-CoV infection.

Here we report a laboratory-confirmed case of Middle East respiratory syndrome (MERS-CoV) in a patient returning to Malaysia from an Umrah pilgrimage in Saudi Arabia.

Case report and travel history

Case report

On 9 April 2014, a man aged in his mid-fifties, on treatment for diabetes, presented at the emergency department of a public hospital in Malaysia with complaints of cough, fever and shortness of breath.

Clinical investigation showed the patient to be afebrile with a temperature of 36.7°C and radiographic evidence of pneumonia. The next day, the patient was hospitalised, and because he had been travelling to Saudi Arabia 13 days prior, he was managed in an isolation room for suspected possible MERS-CoV infection.
The staff of the local hospital and caring for the patient complied with infection prevention and control procedures according to national guidelines [1].
The patient was treated for a provisional diagnosis of community-acquired pneumonia. As bacteriological (culture of blood samples) investigation yielded negative results, the patient was treated with oseltamivir.
 On 10 April 2014, due to worsening of his condition he was intubated. However, the patient developed consecutive multi-organ failure and his condition further deteriorated.

On 13 April 2014, throat samples were taken and he passed away on the same day.

Laboratory investigation

Diagnosis of MERS-CoV was confirmed by polymerase chain reaction (PCR) in the hospital laboratory on 14 April 2014.
A real-time reverse-transcription PCR (rRT-PCR) screening assay targeting upstream of the envelope gene (upE assay) and a rRT-PCR confirmatory assay targeting the open reading frame (ORF)1a yielded positive results.
On 15 April 2014 sample was sent to the Institute for Medical Research (IMR), Kuala Lumpur, for sequencing of genes that code for the nucleocapsid (N) and RNA-dependent RNA polymerase (RdRp) proteins of the MERS-CoV [2].

Travel history

The travel history of the case was obtained from interviewing a relative who travelled with him. The interview was carried out using the standard questionnaire recommended by the World Health Organization (WHO) [3]. The case travelled to Saudi Arabia from 15 to 28 March 2014 to perform the Umrah pilgrimage with a group of 17 fellow pilgrims. Following the Umrah rituals on 26 March, he visited a camel farm in Saudi Arabia, where he patted camels and consumed unpasteurised camel milk sold by vendors at the farm. On 28 March, the case and his travel group boarded a flight from Jeddah, Saudi Arabia, to Istanbul, Turkey, and took another connecting flight from Istanbul to Malaysia where they arrived on 29 March 2014.
The case was well during his travel and went back to his village on same day of arrival. The patient started feeling unwell on 4 April 2014, and sought treatment in a private clinic on 7 April 2014. At the private clinic he complained of body aches and was given analgesics.

A brief timeline of the case’s travel, possible exposure to the virus, healthcare contacts and diagnosis is detailed in the Figure.


Figure. Timeline of possible exposure to Middle East respiratory syndrome coronavirus (MERS-CoV), travel, healthcare contacts and diagnosis of a case of MERS-CoV, Malaysia, March–April 2014


 
 

Monday 12 May 2014

Pretzel Logic. I'm not Eating That. When In Doubt, Ask Frank



If 'normal' is what the food industry decides to feed us, then it would be normal for 1.2 billion people to smoke, because that's the number of cigarettes the tobacco industry decides to sell us. 

Pink Slime is a legitimate and valuable food. 

I'm not fat, I'm Pre-  Diabetic. Take this.....
 No, I was fat!

"Without deviation from the norm…" – Frank Zappa motivational inspirational love life quotes sayings poems poetry pic picture photo image friendship famous quotations proverbs

 

Galantamine; Recall Enhancer and Daily Focus



Galantamine: therapeutic effects beyond cognition.

Author information

Abstract

Decline in cognitive function, especially memory, is the core feature of Alzheimer's disease (AD).

However, other characteristic aspects of the disease are also important.

These include patients' activities of daily living (ADL), including quality of sleep, behavioural disturbances and the impact of the disease on the caregiver.

Therefore, increasing attention is being paid to clinically meaningful outcome measures, such as the Disability Assessment for Dementia (DAD) scale, the Neuropsychiatric Inventory (NPI), caregiver time and the Pittsburgh Sleep Quality Index (PSQI).

Galantamine is a new treatment for AD that combines modulation of nicotinic receptors with inhibition of acetylcholinesterase. The present review outlines the positive and sustained effects of this agent on patients' behaviour and daily functioning as well as on caregiver time.

 In studies of up to 5 months' duration, galantamine-treated patients had a significantly better outcome on ADL than placebo-treated patients, and after 12 months of treatment with galantamine, patients' functional ability was preserved. Galantamine also significantly benefits behavioural disturbances in patients with AD. These functional and behavioural benefits are associated with a decrease in the burden on caregivers, as indicated by a reduction, relative to placebo, in the time spent supervising and assisting patients.

 These clinical benefits are not offset by disruption of patients' sleep, as has been reported with other cholinergic treatments.
PMID:
10971049
[PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances

LinkOut - more resources




What it really Takes to Fly a $35 Million Dollar Fighter Jet, for 72 Hhrs



Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review.

Pharmacol Res. 2010 Sep;62(3):187-206. doi: 10.1016/j.phrs.2010.04.002. Epub 2010 Apr 21.

Author information

Abstract

The term neuroenhancement refers to improvement in the cognitive, emotional and motivational functions of healthy individuals through, inter alia, the use of drugs.
Of known interventions, psychopharmacology provides readily available options, such as methylphenidate and modafinil.

Both drugs are presumed to be in widespread use as cognitive enhancers for non-medical reasons.

Based on a systematic review and meta-analysis we show that expectations regarding the effectiveness of these drugs exceed their actual effects, as has been demonstrated in single- or double-blind randomised controlled trials.
 Only studies with sufficient extractable data were included in the statistical analyses.

 For methylphenidate an improvement of memory was found, but no consistent evidence for other enhancing effects was uncovered.

 Modafinil on the other hand, was found to improve attention for well-rested individuals, while maintaining wakefulness, memory and executive functions to a significantly higher degree in sleep deprived individuals than did a placebo.

However, repeated doses of modafinil were unable to prevent deterioration of cognitive performance over a longer period of sleep deprivation though maintaining wakefulness and possibly even inducing overconfidence in a person's own cognitive performance.


Copyright 2010 Elsevier Ltd. All rights reserved.
PMID:
20416377
[PubMed - indexed for MEDLINE]

Thursday 8 May 2014

When Western Psychiatry is in disarray, who do you turn, too? Not Dr. Phil

I welcome real input in this area.


360dgsofhealth@gmail.com 


After several years of working  in this area, I welcome others new real experiences, stuff that really works for all parties, the new, the old ands so on.

This brain and body gives us all a broad spectrum of behaviours to shape our, mostly, changing existence.

There is no normal.

There is no super pill.

I will begin salting this Blogspot with some first hand experience and jumping off points.

The human condition is fluid.

The commercialized mainstream view of what our species should be is more than a little whacked.
It's been more than a few  centuries of weird.

Always be curious,try to look over the horizon and while keeping an eye to the past.

Having said that, some times , my mind it wanders.....two hemispheres, fundamentally at ODDS.

And for a brief moment I pine for the reality of early Baywatch

Monday 5 May 2014

Is there a link between soft drinks and erectile dysfunction? What about gum that goes 'Squirt' in your mouth?



Is there a link between soft drinks and erectile dysfunction?




Cent European J Urol. 2011;64(3):140-143. Epub 2011 Sep 6.

Adamowicz J, Drewa T.

Abstract

This review focuses on the potential role of soft drinks, particularly the sugar component, in the pathogenesis of erectile dysfunction (ED).

We analyzed the hypothetical link between metabolic disorders, induced by sweetened soft drinks overconsumption, and ED.

High caloric intake, high refined-carbohydrates, and high fructose corn syrup (HFCS) content and less satiety are main factors responsible for metabolic disorders contributing to ED development.

Regular diet mistakes among human males, such as soft drink consumption, may lead to slow and asymptomatic progression of ED, finally resulting in full claimed manifestation of ED.

KEYWORDS:

erectile dysfunction, metabolic syndrome, obesity, squirt

PMID:
24578881
[PubMed - as supplied by publisher]
PMCID:
PMC3921721

Publication Types

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Sunday 4 May 2014

Cognitive Enhancers Exceed Expectations, Mostly



Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review.

Repantis D1, Schlattmann P, Laisney O, Heuser I.



Pharmacol Res. 2010 Sep;62(3):187-206. doi: 10.1016/j.phrs.2010.04.002. Epub 2010 Apr 21.


Author information

Abstract

The term neuroenhancement refers to improvement in the cognitive, emotional and motivational functions of healthy individuals through, inter alia, the use of drugs.

 Of known interventions, psychopharmacology provides readily available options, such as methylphenidate and modafinil.

 Both drugs are presumed to be in widespread use as cognitive enhancers for non-medical reasons. Based on a systematic review and meta-analysis we show that expectations regarding the effectiveness of these drugs exceed their actual effects, as has been demonstrated in single- or double-blind randomised controlled trials.

Only studies with sufficient extractable data were included in the statistical analyse

For methylphenidate an improvement of memory was found, but no consistent evidence for other enhancing effects was uncovered.

Modafinil on the other hand, was found to improve attention for well-rested individuals, while maintaining wakefulness, memory and executive functions to a significantly higher degree in sleep deprived individuals than did a placebo. However, repeated doses of modafinil were unable to prevent deterioration of cognitive performance over a longer period of sleep deprivation though maintaining wakefulness and possibly even inducing overconfidence in a person's own cognitive performance.
Copyright 2010 Elsevier Ltd. All rights reserved.
PMID:
20416377
[PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances

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Androgen Therapy in Men with Testosterone Deficiency




Androgen therapy in men with testosterone deficiency: can testosterone reduce the risk of cardiovascular disease?

Diabetes Metab Res Rev. 2012 Dec;28 Suppl 2:52-9. doi: 10.1002/dmrr.2354.

Author information

  • Global Medical Affairs Men's Healthcare, Bayer Pharma AG, Muellerstrasse 178, Berlin, Germany. farid.saad@bayer.com

Abstract

Obesity, hypertension, insulin resistance (IR), dyslipidaemia, impaired coagulation profile and chronic inflammation characterize cardiovascular risk factors in men. Adipose tissue is an active endocrine organ producing substances that suppress testosterone (T) production and visceral fat plays a key role in this process.

 Low T leads to further accumulation of fat mass, thus perpetuating a vicious circle. In this review, we discuss reduced levels of T and increased cardiovascular disease (CVD) risk factors by focusing on evidence derived from three different approaches.
(i) epidemiological/ observational studies (without intervention);
(ii) androgen deprivation therapy (ADT) studies (standard treatment in advanced prostate cancer); and (iii) T replacement therapy (TRT) in men with T deficiency (TD).

In epidemiological studies, low T is associated with obesity, inflammation, atherosclerosis and the progression of atherosclerosis. Longitudinal epidemiological studies showed that low T is associated with an increased cardiovascular mortality. ADT brings about unfavourable changes in body composition, IR and dyslipidaemia. Increases in fibrinogen, plasminogen activator inhibitor 1 and C-reactive protein have also been observed. TRT in men with TD has consistently shown a decrease in fat mass and simultaneous increase in lean mass.

 T is a vasodilator and in long-term studies, it was shown to reduce blood pressure.
 There is increasing evidence that T treatment improves insulin sensitivity and lipid profiles.
 T may possess anti-inflammatory and anti-coagulatory properties and therefore TRT contributes to reduction of carotid intima media thickness.

We suggest that T may have the potential to decrease CVD risk in men with androgen deficiency.


Copyright © 2012 John Wiley & Sons, Ltd.
PMID:
23280867

Valid 6 Year Testosterone Therary Study Chronicals Positive Results



Effects of long-term testosterone therapy on patients with "diabesity": results of observational studies of pooled analyses in obese hypogonadal men with type 2 diabetes.

Author information

Abstract

To investigate effects of long-term testosterone (T) therapy in obese men with T deficiency (TD) and type 2 diabetes mellitus (T2DM), data were collected from two observational, prospective, and cumulative registry studies of 561 men with TD receiving T therapy for up to 6 years.

 A subgroup of obese hypogonadal men with T2DM was analyzed. Weight, height, waist circumference (WC), fasting blood glucose (FBG), glycated haemoglobin (HbA1c) blood pressure, lipid profile, C-reactive protein (CRP), and liver enzymes were measured.

 A total of 156 obese, diabetic men with T deficiency, aged 61.17±6.18 years, fulfilled selection criteria. Subsequent to T therapy, WC decreased by 11.56 cm and weight declined by 17.49kg (15.04%). Fasting glucose declined from 7.06±1.74 to 5.59±0.94mmol/L (P < 0.0001 for all). HbA1c decreased from 8.08 to 6.14%, with a mean change of 1.93%. Systolic and diastolic blood pressure, lipid profiles including total cholesterol: HDL ratio, CRP, and liver enzymes all improved (P < 0.0001).

Long-term T therapy for up to 6 years resulted in significant and sustained improvements in weight, T2DM, and other cardiometabolic risk factors in obese, diabetic men with TD and this therapy may play an important role in the management of obesity and diabetes (diabesity) in men with T deficiency.
PMID:
24738000
[PubMed]
PMCID:
PMC3967627
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Saturday 3 May 2014

Cheap Drug Improves Social Function



Cheap Drug Improves Social Function and More in Autism

Off label drug use being recognized for improving Cognitive focus , Social function..

 

Daniel M. Keller, PhD
May 01, 2014

PHILADELPHIA — An old, generic drug shows it may still have legs in a new indication. A recent study shows a single dose of propranolol improves social functioning and some aspects of cognition in high-functioning individuals with autism spectrum disorder (ASD).

"It's pretty low risk. That's the handy thing. It's been used for pediatric migraine for decades," senior author David Beversdorf, MD, associate professor of radiology, neurology, and psychological sciences at the University of Missouri in Columbia, told Medscape Medical News.

Results were presented here during the 66th American Academy of Neurology (AAN) Annual Meeting.

General Social Outcomes 

Propranolol is a nonselective β-adrenergic antagonist with anxiolytic properties that blocks the noradrenergically mediated sympathetic response system. It has been reported to improve verbal fluency and working memory in ASD.

To see whether it could improve performance on social and cognitive tasks in ASD, Rachel Zamzow and colleagues performed a study using a single-dose challenge of propranolol, 40 mg, or placebo given to 20 high-functioning individuals with ASD (mean age, 21.39 ± 4.55 years; all IQ >85) over 2 study sessions.

Drug or placebo was administered in a counterbalanced, double-blind manner.
Half received propranolol first, half placebo first. Before the challenge, electrocardiography and galvanic skin responses were measured after an acclimatization period.
Sixty minutes after the challenge, to allow peak drug effects to occur, participants performed several tasks. As a test of sociability, 6 domains of the General Social Outcomes Measure (GSOM) were scored on a 0 to 2 scale each, for a total potential score of 12.

On the basis of a conversation of the patient with the researcher about a chosen topic, the domains were staying on topic, sharing information, reciprocity, transitions/interruptions, nonverbal communication, and eye contact. Cognitive tasks involved solving anagrams and aspects of verbal memory.

"We did get a significant improvement in...general social outcomes measures, which actually was a bit of a surprise to us because this is a single-dose study," Dr. Beversdorf said.

We did get a significant improvement...which actually was a bit of a surprise to us because this is a single-dose study. Dr. David Beversdorf

Participants performed significantly better on the overall sociability (GSOM) score when administered propranolol compared with placebo.

The only individual domain showing a significant difference was the nonverbal communication score (P = .04), with a trend for better performance on the sharing information score (P = .09).

Participants also had less latency on the anagram-solving task when they received the drug.
Table. Task Performance
Task
Propranolol
Placebo
P Value
GSOM total score
9.4
8.6
.03
Cognitive task



   Anagram solving—mean latency (s)
17
21
.045
   Anagram solving— mean discrimination indexa
11.75
11.35
.09
aHopkins Verbal Learning Test.

The researchers also observed a positive relationship between heart rate variability and response to propranolol for the GSOM total score (P = .03).

Dr. Beversdorf said he has also done studies with nadolol, a β-blocker that acts only peripherally, not centrally, to lower heart rate and blood pressure, "and it had a similar effect."

Long-Term Effects?
Sana Bloch, MD, assistant clinical professor of neurology at Albert Einstein College of Medicine, Bronx, New York, pointed out to Medscape Medical News that the study used a single dose of propranolol, and what really matters is whether it can produce long-term benefit with continued dosing.

He noted that it may be hard to get commercial funding for longer-term studies of an off-patent drug, so funding may have to come from the government.

"But it's a very important factor because when you have high-functioning Asperger patients, the 1 thing they're missing is their sociability," he said. "If this takes care of the sociability, they become much more functional individuals."
He said there is definitely need for a medication that can improve sociability in high-functioning patients with Asperger's, "which is a good percentage" of them.

He said up to now, people have tried to improve social interaction in patients with ASD using antidepressants, "and we see that may make things worse."
 Neuroleptics have also been tried but can cause major problems.

There was no commercial funding for the study. Dr. Beversdorf and Dr. Bloch have disclosed no relevant financial relationships.
American Academy of Neurology (AAN) 66th Annual Meeting. Abstract I4-1.002. Presented April 28, 2013.

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