Sunday, November 30, 2014

Study: A mother's presence soothes infants' brains

A study shows that a mother's presence and care can make an infant's pain go away and changes the infant's brain activity.

A mother's "TLC" not only can help soothe pain in infants, but it may also impact early brain development by altering gene activity in a part of the brain involved in emotions, according to new study from NYU Langone Medical Center.
By carefully analyzing what genes were active in infant rat brains when the mother was present or not present, the NYU researchers found that several hundred genes were more, or less, active in rat infants experiencing pain than in those that were not. With their mothers present, however, fewer than 100 genes were similarly expressed.
According to senior study investigator and neurobiologist Regina Sullivan, PhD, who is scheduled to present her team's findings at the Society for Neuroscience annual meeting in Washington, D.C., on Nov. 18, the research is believed to be the first to show the short-term effects of maternal caregiving in a distressed infant pup's brain. The study was also designed to support her research into the long-term consequences of differences in how mammals, including humans, are nurtured from birth.
"Our study shows that a mother comforting her infant in pain does not just elicit a behavioral response, but also the comforting itself modifies -- for better or worse -- critical neural circuitry during early brain development," says Sullivan, a professor at the NYU School of Medicine and its affiliated Nathan S. Kline Institute for Psychiatric Research.
For the study, researchers performed genetic analyses on tissue from the almond-sized amygdala region of the infant rat pups' brains that is responsible for processing emotions, such as fear and pleasure.
Sullivan, whose earlier research showed how the mother's presence controlled electrical signaling in the infant pup's brain, says her latest findings shed insight on the complexity of treating pain in newborns.
"Nobody wants to see an infant suffer, in rats or any other species," says Sullivan. "But if opiate drugs are too dangerous to use in human infants because of their addictive properties, then the challenge remains for researchers to find alternative environmental stimuli, including maternal presence, coddling, or other cues, such as a mother's scent, that could relieve the pain."
Sullivan cautions, however, that the long-term consequences of these genetic modifications must also be compared to the short-term benefits for tying pain stimuli during infancy to such a powerful symbol of safety and security as the infant's mother.
"The more we learn about nurturing the infant brain during infancy, the better prepared we are to deal long-term with treating problems that arise from pain, and physical and mental abuse experienced during infancy," says Sullivan.
Read more here

What is causing the global surge in ADHD diagnoses?

What is causing the global surge in ADHD diagnoses? This article believes it has to do more with marketing than medicine.

You can't catch attention deficit hyperactivity disorder (ADHD). Yet the diagnosis and treatment of this behavioral condition is spreading like a contagion -- surging as much as tenfold in some countries.
Call it an economic and cultural plague, but not necessarily a medical one, says Brandeis professor Peter Conrad. In a recent paper in the journal Social Science and Medicine, Conrad and coauthor Meredith Bergey examined the growth of ADHD in the United Kingdom, Germany, France, Italy and Brazil.
Until recently, North America tallied by far the most ADHD diagnoses, and the United States consumed 90 percent of all Ritalin, one of the most common ADHD drugs. ADHD diagnoses continue to grow in the U.S., but Americans account for only 75 percent of Ritalin users today.
Conrad and Bergey attribute ADHD's growth to five trends. Drug companies are effective lobbyists, and have spurred some countries to relax marketing restrictions on stimulants. Psychoanalytic treatment with talk therapy is giving way to biological psychiatry -- treating psychological problems with drugs. More European and South American psychologists and psychiatrists are adopting the American-based Diagnostic and Statistical Manual (DSM) standards, which are broader and have a lower threshold for diagnosing ADHD. Vocal ADHD advocacy groups work closely with drug companies to promote pharmaceutical treatment. Lastly, the easy availability of ADHD information and self-diagnosis via the Internet empowers consumers to ask for prescription treatment.
Many websites promoting ADHD drugs offer checklists with questions like these:
  • Do you fidget a lot?
  • Is it hard for you to concentrate?
  • Are you disorganized at work and home?
  • Do you start projects and then abandon them?
"These checklists turn all kinds of different behaviors into medical problems," Conrad says. "The checklists don't distinguish what is part of the human condition and what is a disease."
According to the study, in the U.K., diagnosis of the disorder in school-age children grew from less than one percent in the 1990s to about five percent today. In Germany, prescription ADHD drugs rose from 10 million daily doses in 1998 to 53 million in 2008.
Growth in Italy and France has been slower, in part due to those countries' more restrictive pharmaceutical drug laws. However, even those nations are becoming more lax, says Conrad. In Brazil, a rising number of ADHD advocacy groups, many with close ties to the pharmaceutical industry, are raising awareness of the disorder.
"There is no pharmacological magic bullet," says Conrad. No drug can account for nonmedical factors that may contribute to behavior. A fidgety student may be responding to the one-size-fits-all compulsory education system, Conrad says, not a flaw in his brain chemistry.
ADHD continues a long history of medicalizing behaviors, especially in the U.S., Conrad says. A century ago, masturbation was considered a disease. Men and women diagnosed with masturbatory insanity were institutionalized or subjected to surgical treatment.
"I think we may look back on this time in 50 years and ask, what did we do to these kids?" Conrad says.
Read more here

Why students need to get enough sleep

This article explains why it is so important for young adults, especially students, need to get enough sleep.

Humans need sleep. Young adults especially need it, and more  of it if possible. While growth spurts may be over, teenaged brains are still developing, and they will not fully mature until a person’s mid-20s, at the least. While students are in school trying to expand their minds, the very structure of their brains is expanding at the same time. Young adults need to balance academics with their sleep, which actually aids in learning and development. It may often seem like these two activities are at odds with each other, but their correlation is important.
Young adults have odd sleeping schedules, and it is not completely their fault. Developing brains of adolescents are wired to go to sleep later. When combined with heavy collegiate workloads, freedom from parental restrictions and the atmosphere of the city that never sleeps, it is no wonder that NYU students often go to sleep extremely late. While late bedtimes alone can be troubling, affecting everything from throwing off our circadian rhythms to our immune systems, this issue is compounded during the winter time. Moreover, students from warmer regions with longer days and shorter nights may not be aware of the effects the winter can have on one’s system. By going to bed late, young adults exacerbate these effects, which can lead to medical issues.
Seasonal affective disorder — a form of depression caused by changes in seasons — is among the potential complications. It can be triggered by a variety of factors, including an unnatural sleep schedule and decreased exposure to light. Symptoms of seasonal affective disorder usually manifest during fall and winter, and deficient sleep during this period can make individuals more vulnerable to depression. Research indicates that going to bed late when the sun sets later is not necessarily problematic. An 11 a.m. wake-up time gives one plenty of sunlight to maintain proper Vitamin D levels and circadian rhythm. Going to bed late when the sun goes down early is a recipe for disaster, however, because an 11 a.m. wake-up time means five hours of sunlight at the most. Students should be wary of seasonal affective disorder and take sleep seriously. Depression in the middle of a semester can jeopardize both academics and social life.
In college, personal well-being is seldom prioritized. This should not be the case — sleep is an essential tool for physical and mental health. Sleeping in late for Palladium brunch rather than waking up to an early breakfast may seem preferable, but a balanced sleep schedule can literally make winter much brighter. Suspend late-night study sessions, close Netflix and go to sleep — your mind and body will be grateful.
Read more here

Brain development in people with autism

This article discusses how brains develop in people with autism.

Geneticists at Heidelberg University Hospital's Department of Molecular Human Genetics have used a new mouse model to demonstrate the way a certain genetic mutation is linked to a type of autism in humans and affects brain development and behavior. In the brain of genetically altered mice, the protein FOXP1 is not synthesized, which is also the case for individuals with a certain form of autism. Consequently, after birth the brain structures degenerate that play a key role in perception. The mice also exhibited abnormal behavior that is typical of autism. The new mouse model now allows the molecular mechanisms in which FOXP1 plays a role to be explained and the associated changes in the brain to be better understood.
"While these kinds of results from basic research cannot be directly translated into treatment, they are still quite valuable for the affected individuals or in this case, for their parents and family. For many of them, it is important to be able to specifically put a name to the disorder and understand it. It can make dealing with it easier," said Professor Gudrun Rappold, Head of the Department of Molecular Human Genetics at Heidelberg University Hospital and senior author of the article. The results have now been published in a preliminary online version in the journal Molecular Psychiatry in cooperation with Miriam Schneider, Institute of Psychopharmacology at the Central Institute of Mental Health in Mannheim, and Dr. Corentin Le Magueresse, German Cancer Research Center (DKFZ) and Professor Hannah Monyer, Department of Clinical Neurobiology, Heidelberg University Hospital and DKFZ in Heidelberg.
Autism is a congenital perception and information-processing disorder in the brain that is frequently accompanied by intellectual disability and in rare cases, superior intelligence and special gifts such as photographic memory. The disorder is characterized by limited social interaction, repetitive behavior and language impairment. Furthermore, a wide range of other disturbances can occur. "Today, in addition to the defect in the FOXP1 gene, we are familiar with other genetic mutations that cause autism or increase the risk of this kind of disorder. However, we are only able to understand how they affect the molecular processes in the neurons, brain development and behavior for a few of these mutations," Rappold said.
This is also the case for FOXP1. Back in 2010, clear signs that structural flaws in this protein play a role in autism and mental disability had been discovered. But what role does it play in the healthy brain? What signal pathways is it involved in? Which other proteins does it interact with and exactly what damage is caused by its absence? The new mouse model has helped to shed light on these questions. The researchers discovered that the mice were born with a normally developed brain for the most part. During the course of the first weeks of life, the striatum, which is important for perception and behavior, degenerates. In a centrally located brain structure as well -- the hippocampus -- which is indispensable for developing long-term memory and recall, microscopically visible changes occur that can also impact signal processing. It could be proven, for example, that in the affected neurons the impulse conduction is changed through which signals are transmitted between neurons.
In addition to the striatum, the ventricles of the brain are degenerated; these are adjacent structures in the murine brain. "Enlarged ventricles were also detected in humans with a FOXP1 mutation," explained Dr. Claire Bacon, who works in the Molecular Human Genetics Department and is first author of the publication. The changes also trigger abnormal behavior that is comparable to the symptoms of autistic patients. The mice barely noticed their fellow mice and did not attempt to make contact to them. Further symptoms include stereotypical compulsive repetitive behaviors, hyperactivity and disturbed nestbuilding behavior.
The researchers now intend to study to what extent the communication of noise by FOXP1 mice (mice communicate via noises in the ultrasonic range) is impaired and whether there are also parallels to the disturbances in patients with FOXP1 mutation in this area as well. In addition, they plan to characterize the newly identified genes impacted by the FOXP1 in the brain and find out which signaling cascades and response paths are disrupted. In this way, they hope to find starting points for a specific treatment. "However, we first have to understand exactly how these changes occur before we can develop treatment concepts," Rappold stressed.
Read more here

Study: Older women with sleep disordered breathing find it harder to perform activities

A study shows that older women who have sleep disordered breathing find it harder to perform daily activities.

Older women with disordered breathing during sleep were found to be at greater risk of decline in the ability to perform daily activities, such as grocery shopping and meal preparation, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of California, San Francisco.
The study was published Nov. 6 in the online edition of the Journal of the American Geriatrics Society.
The findings are notable given the aging of the population -- an estimated 3.7 million Americans will turn 65 in 2015, and by 2030, 19 percent of the U.S. population will be 65 or older -- and the fact that sleep-disordered breathing is treatable. Older adults are as much as four times as likely as middle-aged individuals to have problems with breathing during sleep.
Sleep-disordered breathing involves repeated interruptions or decreases in breathing during sleep, which often leads to fragmented sleep and hypoxemia, or low blood oxygen levels. Doctors rate the severity of sleep-disordered breathing with the apnea-hypopnea index (AHI), which reflects the number of breathing interruptions (apneas) and the number of significant decreases in breathing (hypopneas) per hour of sleep.
The study found that women with an AHI on the moderate to severe side, with 15 or more breathing disruptions per hour of sleep, had a 2.2 times greater odds of decline in daily activity functions during the evaluation period, which averaged five years between baseline evaluation and follow-up.
"Because sleep-disordered breathing can be treated effectively, it is possible that treatment could help prevent decline in important areas of functioning that allow older adults to remain independent," says Adam Spira, PhD, an associate professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health and the study's lead author. "As is often the case, more research is needed to investigate this possibility."
Because the study was observational, the researchers can't conclusively state that sleep-disordered breathing caused the functional decline, but the research does point to a strong link.
Earlier studies involving older men have linked sleep-disordered breathing with frailty and death. The authors believe this is one of the first studies to assess the impact of sleep-disordered breathing on decline in older women's ability to perform basic functions associated with independent living.
The study included 302 women, with a mean age of 82.3 years. At the start of the study, participants underwent an in-home sleep evaluation. They were also asked whether they had any difficulty performing daily activities, including heavy housework, shopping and preparing meals, or any challenges with mobility, such as walking several blocks or climbing or descending stairs. Participants' self-reported daily activities and mobility were assessed once again in a follow-up evaluation.
The researchers say they believe it is the low blood-oxygen levels caused by sleep-disordered breathing that cause the trouble with daily tasks, and not sleep fragmentation, which is also increased by sleep-disordered breathing.
The authors note that women who reported no difficulties with daily activities during their baseline evaluation but a moderate-to-high AHI had a somewhat higher risk of reporting deterioration in daily-activity function in the follow-up evaluation. No links between sleep-disordered breathing severity and decline in mobility were observed.
Read more here

Sleep apnea surgery in children helps improve asthma control

Removing a child's tonsils and adenoids for sleep apnea can help his or her asthma control.

Researchers from the University of Chicago found that surgical removal of the tonsils and adenoids in children suffering from sleep apnea is associated with decreased asthma severity. The study was published in PLOS Medicine (November 4, 2014).

In the first year after the operation, the children who had their tonsils and adenoids removed had a 30% reduction in acute asthma exacerbations and a 38% decrease in acute status asthmaticus, episodes of severe asthma that do not respond to repeated courses of therapy.

"Several small studies have described a strong association between obstructive sleep apnea and asthma, two common inflammatory conditions that impair breathing in children. But we wanted to test the strength of the connection when studied in a much larger population," said lead study author Rakesh Bhattacharjee, MD, an assistant professor of pediatrics at the University of Chicago and an authority on pediatric sleep medicine, in a statement.

Obstructive sleep apnea is affects an estimated 2% to 3% of all children. The removal of the adenoids and tonsils, known as surgical adenotonsillectomy, is considered standard therapy.

Asthma is the third-most prevalent chronic pediatric disease in the U.S., affecting an estimated 7.1 million according to the Centers for Disease Control and Prevention and is the third-most common cause of hospitalization of U.S. children younger than age 15.

In the study, researchers also noted that pediatric patients who received the surgery had a 36% reduction in asthma-related hospitalizations and a 26% decline in asthma-related emergency room visits. Children who did not have the surgery did not have significant reductions in these categories.

"Our study adds weight to the growing sense that obstructive sleep apnea aggravates asthma and further tips the balance toward early identification of obstructive sleep apnea," Dr. Bhattacharjee said. "This will help physicians advocate for surgical intervention, not just to eradicate sleep-disordered breathing, but also to reduce asthma severity and decrease reliance on medications in asthmatic children."

Data on more than 40,000 children between the ages of 3 and 17, obtained from Truven Health's MarketScan databases were included in the study. More than 13,500 U.S. children with asthma who underwent removal of their adenoids and tonsils as treatment for obstructive sleep apnea were included. Asthma symptoms from the year before surgery to the year afterward were compared. Researchers also matched those results to the results of more than 27,000 children with asthma who still had their tonsils and adenoids.

Overall, adenotonsillectomy brought significant improvement: The frequency of acute status asthmaticus dropped almost 40%, from 562 in the year before surgery to 349 in the year after. In children who did not have surgery, such severe asthma attacks also decreased but by only 7%, from 837 to 778.

Acute asthma exacerbations fell from more than 2,200 before surgery to 1,566 after, a 30% reduction. Exacerbations for children who did not have surgery also fell from 3,403, to 3,336, a 2% drop.

Also decreasing significantly for those children who had the surgery was the incidence of secondary asthma outcomes, such as acute bronchospasm and wheezing, while rates were unchanged for those who did not. Prescription refills followed the same pattern.

The authors' concerns about the MarketScan database included that it only includes those patients with private insurance and a lack of available data why patients underwent adenotonsillectomy.

Despite the limitations, they emphasize the many plausible connections that link obstructive sleep apnea to asthma:
  • Both are inflammatory diseases.
  • Both share risk factors, such as allergies, obesity, and exposure to tobacco smoke.
  • Severe obstructive sleep apnea is often associated with poorly controlled asthma.
A prospective, randomized, controlled clinical trial is still needed to show a direct causal relationship, Dr. Bhattacharjee noted.

Read more here

Differences in sleep issues between women and men

This article explains the differences in sleep issues faced by women and men.

As a nation we are severely sleep-deprived. According to data from the Centers for Disease Control and Prevention, as much as a third of all Americans do not get the recommended seven hours of sleep a night.
"One of the myths is that we can power through or sleep when we're dead," Dr. Charles Czeisler, chair of the National Sleep Foundation and director of sleep medicine at Harvard Medical School, told "CBS This Morning." "But of coursewe'll get there faster if we don't get enough sleep. "
Women and men run into different roadblocks when it comes to their quest for a good night's sleep.
Women are more likely to toss and turn frequently and fight bouts of insomnia, a result of differences in hormonal regulation. Estrogen tends to shorten the length of the sleep cycle, which is why women often report that they experience sleep troubles around the time of menstruation, pregnancy or menopause.
According to a poll taken by the National Sleep Foundation, 63 percent of women versus 54 percent of men experience insomnia at least few nights a week. Women are also more likely to experience daytime sleepiness.
"One of the things is the internal clock controls the timing of sleep," said Czeisler. "It runs faster in women than it does men. It's only about a tenth of an hour but it adds up so that women, in general, their internal clocks are set to about an hour or an hour and half earlier than men, and that means it wakes them up earlier in the morning and it's harder to stay awake in the evening."
On the other hand, anatomical differences in men mean they're more likely to have sleep apnea -- a result of more fat deposit around the neck. Approximately 17 percent of men and 9 percent of women are diagnosed with sleep apnea, a type of sleep disorder that is caused by infrequent or paused breathing.
"If you crowd out the airway then you're going to have trouble when you sleep," said Czeisler. "One out of 3 men and about 1 out of 6 women suffer from disturbed sleep disordered breathing. But unfortunately, because it tends to be viewed as a male dominated disease women are much less likely to be diagnosed. Only 1 out of 10 women compared with men get diagnosed for sleep apnea."
Regardless of these challenges, everyone can take a number of measures to avoid sleep deprivation. Czeisler says good sleep hygiene is essential, such as going to bed at the same time each night to regulate your circadian rhythm. Some people find it helpful to set an alarm for bedtime. Creating a bedroom that's conducive to sleeping is also essential: remove all electronics from the bedroom and keep your room cool and dark.
Read more here

Study: Genetic cause for childhood epilepsy

A recent study found a new genetic cause for childhood epilepsy.

A research team led by scientists at the Scripps Translational Science Institute (STSI) has used whole genome sequencing to identify a new genetic cause of a severe, rare and complex form of epilepsy that becomes evident in early childhood and can lead to early death.
The researchers found a mutation in the KCNB1 gene after mapping the DNA of a 10-year-old girl who suffers from epileptic encephalopathy. The findings were reported in the October edition of the peer-reviewed medical journal Annals of Neurology.
The KCNB1 gene encodes the Kv2.1 voltage-gated potassium channel, which regulates the flow of potassium ions through neurons, affecting how the cells communicate with one another. The voltage-gated potassium channel also regulates potassium flow in the kidney, which affects potassium excretion and fluid balance.
The link between the KCNB1 mutation and epileptic encephalopathy has opened new treatment options for the young patient, said Robert Bjork, MD, her physician and a member of the Scripps Memorial Hospital La Jolla staff.
Earlier this year, "her prognosis was grim and appeared hopeless when she was experiencing many convulsive seizures, could barely eat or drink, and had 'drop attacks' where she would abruptly drop to the floor up to 25 times a day," he said.
Given continued close medical monitoring, an expanded medical treatment team, a uniquely designed home-school program and avoidance of dehydration, Dr. Bjork is optimistic that she can be kept out of harm's way and her status will improve over time.
Case part of IDIOM Study
The research was part of STSI's IDIOM Study, an ongoing project that uses whole genome sequencing to help determine the causes and treatments of idiopathic diseases -- those serious, rare and perplexing health conditions that defy a diagnosis and standard treatment.
"We are continuing to learn the impressive power of whole genome sequencing for making a difficult -- and heretofore impossible -- diagnosis," said Eric Topol, MD, who is the director of STSI and chief academic officer of Scripps Health.
STSI is a National Institutes of Health sponsored consortium led by Scripps Health in collaboration with The Scripps Research Institute (TSRI). Through this innovative partnership, Scripps is leading the effort to translate genetic and wireless medical technologies into high-quality, cost-effective treatments and diagnostics for patients.
To validate their findings, STSI researchers teamed with colleagues at Northwestern University Feinberg School of Medicine in Chicago, who had previously looked at similar KCNB1 mutations. The Northwestern colleagues were listed as co-authors of the journal report, along with contributors from the University of California, San Diego; Kennedy Krieger Institute; Johns Hopkins University; and Vanderbilt University.
Potential benefits of discovery
The benefits of discovering the role of KCNB1 mutations in epileptic encephalopathy reach far beyond the STSI research case, said Ali Torkamani, director of genome informatics at STSI and an assistant professor of integrative, structural and computational biology at TSRI.
"These findings can serve as a model on how to treat this particular form of epilepsy in other patients," he said. "The KCNB1 mutations also might have a role as a diagnostic biomarker for this condition, and they could help to direct the discovery and testing of new drugs to treat epilepsy."
Read more here

ADHD stimulants often abused by college students

This article discusses how stimulant use for ADHD is often abused by college students.

Nearly one in every five college students abuses prescription stimulants, according to a new survey sponsored by the Partnership for Drug-Free Kids. The survey also found that one in seven non-students of similar age also report abusing stimulant medications.
Young adults aged 18 to 25 report using the drugs to help them stay awake, study or improve their work or school performance. The most commonly abused stimulants are those typically prescribed for attention-deficit/hyperactivity disorder (ADHD), such as Adderall,Ritalin and Vyvanse, the survey found.
"The findings shed a new and surprising light on the young adult who is abusing prescription stimulants," said Sean Clarkin, director of strategy and program management for the Partnership for Drug-Free Kids. "While there is some 'recreational' abuse, the typical misuser is a male college student whose grade point average is only slightly lower than that of non-abusers, but who is juggling a very busy schedule that includes academics, work and an active social life."
Clarkin said the findings point to the need for parents and educators to increase their efforts to help young people develop effective time-management skills to balance academics, work and social activities.
"The profile that emerges is less that of an academic 'goof-off' who abuses prescription stimulants to make up for lost study time than a stressed out multitasker who is burning the candle at both ends and trying to keep up," Clarkin said.
The nationally representative study, conducted by independent researcher Whitman Insight Strategies, surveyed more than 1,600 young adults online this past summer, including approximately 1,000 college students.
Half of the students reported they took stimulant drugs to study or improve their academic performance, the survey noted. And, the survey found that two-thirds of those students believed the drugs helped them get a better grade or be more competitive at school or work. Around 40 percent took the drugs to stay awake. About a quarter of abusers said they took the stimulants to improve their work performance, according to the study.
These are the same reasons former user Linda Stafford said she began using the drugs.
Stafford began taking Adderall and Vyvanse without any prescriptions while she was a college student in Statesboro, Ga.
"I wanted to go to school, work and party, and Adderall helped me to focus pretty well at first," Stafford said. In reality, however, she said taking the stimulant did not change her test grades much. "Then," she said, "I got hooked."
Stafford began experiencing depression, paranoia and social anxiety and became unable to communicate even with her closest loved ones, she said.
"I was totally incapable of handling life," Stafford said. "I could not manage a simple job, my class assignments or relationships. Adderall was the center of my life."
Stafford has since been through recovery and uses a support network and support groups to manage, but her story is one that Miami University staff psychiatrist Dr. Josh Hersh has heard often.
"These survey findings have confirmed a lot of the things I have seen clinically," Hersh said. "Young adults are mainly using prescription stimulants to improve academic and work performance and to stay awake."
Although Hersh said some of the students taking these drugs may feel the invulnerability of youth, others are simply desperate to juggle everything even while they know the possible risks of taking the drugs, such as anxiety or panic attacks even with occasional use.
"The fact that students often use these drugs around deadlines, when their natural adrenaline is already high, elevates the risk even more," Hersh said. "Sporadic use can lead to severe sleep deprivation and cause stimulant-induced psychosis, when a student gets paranoid and may hallucinate."
He said snorting the pills can lead to internal nasal damage and regular use can lead to addictions that are destructive and difficult to treat.
Even young adults who are legally prescribed stimulants for specific health conditions can risk becoming more addicted, as happened to the son of Kathleen Dobbs, a retiree who co-founded the grass roots coalition Parent to Parent, Inc.
Her son was diagnosed with ADHD at age 8 and began taking Ritalin at age 10, but by high school doctors switched him to various other drugs before Dobbs requested no more prescriptions. By then, however, he was seeking out Ritalin from classmates and then moved on to cocaine to "feel normal," Dobbs said.
"Children with ADHD will do anything to fit in, to be able to learn and be like other kids," said Dobbs, adding that the addiction tore their family apart. "When you have a child who is addicted, it is like a bomb goes off in your home and everyone scatters. I prayed and did all the right things, but it creeps into your life and destroys your entire family and leaves you with pain and loss."
Her son is now married, sober and in ongoing recovery, but she recommends that parents remain vigilant and educate themselves about drugs, especially those their children are prescribed.
The survey found that 28 percent of people legally prescribed stimulants have exaggerated their symptoms to get a larger dose. The same percentage reported sharing their medicine with friends. Just over half the adults surveyed said stimulants were easy to obtain, usually from friends, and most said their friends abused them as well.
Red flags that parents can watch for in their children, Hersh said, include having dilated pupils, anxiety or manic behavior, talking about not sleeping for days and "crashing" when home from college, such as sleeping often and having difficulty concentrating.
Read more here

Study shows many fire fighters have sleep disorders

A recent study reveals that many fire fighters suffer from sleep disorders.

Sleep disorders are independent risk factors for heart attacks and motor vehicle crashes, which are the two leading causes of death for firefighters in the United States. In a national sample of almost 7,000 firefighters, researchers at Brigham and Women's Hospital (BWH) examined the prevalence of common sleep disorders and their association with adverse health and safety outcomes and found that sleep disorders are highly prevalent, and associated with substantially increased risk of motor vehicle crashes and cardio-metabolic diseases among firefighters.

Findings of the study, led by Laura K. Barger, PhD, associate physiologist in BWH's Division of Sleep and Circadian Disorders, are published in the Journal of Clinical Sleep Medicine on November 13, 2014.
"Our findings demonstrate the impact of common sleep disorders on firefighter  and safety, and their connection to the two leading causes of death among firefighters," said Barger. "Unfortunately, more than 80 percent of firefighters who screened positive for a common sleep disorder were undiagnosed and untreated."
Based on specific criteria, 66 US fire departments were selected to participate in a workplace based sleep disorders screening and educational program. Approximately 7,000 firefighter participants were assessed for common sleep disorders. Firefighters were also surveyed about health and safety, and documentation collected for reported crashes.
Participants reported current health status, previous diagnoses of sleep and other medical disorders, the likelihood of falling asleep while driving, , near crashes, and injuries.
Researchers found that a total of 37.2 percent of firefighters screened positive for sleep disorders including , insomnia, shift work disorder and restless leg syndrome. Firefighters with a sleep disorder were more likely to report a motor vehicle crash and were more likely to report falling asleep while driving than those who did not screen positive. Additionally, firefighters with sleep disorders were more likely to report having cardiovascular disease, diabetes, depression and anxiety, and to report poorer health status, compared with those who did not screen positive.
"Occupational sleep disorder screening programs can identify individuals who are vulnerable to adverse safety and health consequences, including those that are leading causes of death in ," stated Charles Czeisler, PhD, MD, FRCP, chief, BWH Division of Sleep and Circadian Disorders. "This study provides the rationale for further research evaluating the effectiveness of occupational  management programs on disease risk, mental health and safety outcomes."
Read more here

Teenagers proscribed anti-anxiety or sleep medications more likely to abuse them

When teenagers are proscribed anti-anxiety or sleep medication, they are more likely to abuse those drugs later in life.

The medical community may be inadvertently creating a new generation of illegal, recreational drug users by prescribing anti-anxiety or sleep medications to teenagers, say University of Michigan researchers.
Teens prescribed anxiety or sleep medications are up to 12 times more likely to abuse those drugs than those who had never had a prescription, either by using someone else's prescription pills or to get high or experiment, according to a study from the U-M School of Nursing.
Nearly 9 percent of the 2,745 adolescent study participants had received a prescription for anxiety or sleep medications during their lifetime, and more than 3 percent received at least one prescription during the three-year study period.
"I recognize the importance of these medications in treating anxiety and sleep problems," said the study's first author Carol Boyd, the Deborah J. Oakley Professor of Nursing. "However, the number of adolescents prescribed these medications and the number misusing them is disturbing for several reasons."
Anxiety and sleep medications can be addictive or even fatal when mixed with narcotics or alcohol, said Boyd, who is also a professor of women's studies and research professor at the Institute for Research on Women and Gender and at the U-M Addiction Research Center in the Department of Psychiatry.
"What happened to [actor] Heath Ledger could happen to any teen who is misusing these medications, particularly if the teen uses alcohol in combination with these drugs," Boyd said.
Examples of anti-anxiety medications include Klonopin, Xanax and Ativan; sleep medications include Ambien, Restoril and Lunesta. These are controlled substances partly because of the potential for abuse, and it's a felony to share them, Boyd said.
The U-M study included students from five Detroit-area schools grouped into three categories: those never prescribed anxiety or sleep medications; those prescribed those medications within the three-year study period; and those previously prescribed those medications but not during the study period.
Key findings include:
Adolescents prescribed anxiety medications during their lifetime, but not during the study, were 12 times more likely to use someone else's anxiety medication than participants who had never been prescribed such drugs.
Those prescribed anxiety or sleep medications during the study period were 10 times more likely to abuse them within two years, to get high or to experiment, than teens without prescriptions.
White students were twice as likely as black students to use others' medications, and females older than 15 and teens who had prescriptions for longer periods of time were more likely to abuse the medications.
It's the first longitudinal study to determine whether teens' recent medical use of anxiety or sleep medications is associated with later taking somebody else's prescription medication illegally, either for self-treatment or recreational use.
Boyd said the group intended to write a paper about teens abusing their own prescriptions, but changed course when the results became clear.
"I looked at these numbers and said, 'There's a story here.' It just catches you off guard that so many adolescents are being prescribed these medications," Boyd said. "Why is it that our youth are anxious and sleepless? Is it because they are under stress, consuming too much caffeine or seeking an altered state? "
The study recommends better education for parents and adolescents prescribed these medications, monitoring refills and making it standard practice to give teens a substance use assessment before prescribing these drugs.
Boyd's co-authors include Elizabeth Austic, Quyen Epstein-Ngo, Philip Veliz and Sean Esteban McCabe of the U-M Institute for Research on Women and Gender. Epstein-Ngo also has appointments at the U-M Injury Research Center and Institute for Clinical and Health Research.
Read more here

Brain damage from mild concussions

This article explains how football players can have brain damage from milder concussions.

A new, enhanced MRI diagnostic approach was, for the first time, able to identify significant damage to the blood-brain barrier (BBB) of professional football players following "unreported" trauma or mild concussions. Published in the current issue of JAMA Neurology, this study could improve decision making on when an athlete should "return to play."
According to Prof. Alon Friedman, from the Ben-Gurion University Brain Imaging Research Center and discoverer of the new diagnostic, "until now, there wasn't a diagnostic capability to identify mild brain injury early after the trauma. In the NFL, other professional sports and especially school sports, concern has grown about the long-term neuropsychiatric consequences of repeated mild Traumatic Brain Injury (mTBI) and specifically sports-related concussive and sub-concussive head impacts."
The paper, published by researchers at Ben-Gurion University of the Negev (BGU) and Soroka University Medical Center, describes a new diagnostic approach using Magnetic Resonance Imaging (MRI) for detection and localization of vascular pathology and blood-brain barrier breakdown in football players.
The images from the Ben-Gurion University of the Negev JAMA Neurology study represent Blood-Brain Barrier (BBB) Permeability in Football Players (A) vs. a control group (B). The players in the pathological-BBB group (B) presented focal BBB lesions in different cortical regions including the temporal (player 4), frontal (player 5), and parietal (player 6) lobes. Both gray and white matter were involved.
"The goal of our study was to use our new method to visualize the extent and location of BBB dysfunction in football players using Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) on a Phillips 3-T Ingenia. Specifically, it generates more detailed brain maps showing brain regions with abnormal vasculature, or a 'leaky BBB.' "
Study participants included 16 football players from Israel's professional football team, Black Swarm, as well as 13 track and field athletes from Ben-Gurion University who served as controls. All underwent the newly developed MRI-based diagnostic.
The DCE-MRIs were given between games during the season and revealed significant damage.
Forty percent of the examined football players with unreported concussions had evidence of "leaky BBB" compared to 8.3 percent of the control athletes.
"The group of 29 volunteers was clearly differentiated into an intact-BBB group and a pathological-BBB group," Friedman explains. "This showed a clear association between football and increased risk for BBB pathology that we couldn't see before. In addition, high-BBB permeability was found in six players and in only one athlete from the control group."
Friedman also explains that not all the players showed pathology. This indicates that repeated, mild concussive events might impact some players differently than others. This level of diagnosis of individual players can provide the basis of more rational decision making on "return to play" for professionals as well amateurs of any age.
"Generally, players return to the game long before the brain's physical healing is complete, which could exacerbate the possibility of brain damage later in life," says Friedman.
A decade of research in the BGU Laboratory for Experimental Neurosurgery has shown that vascular pathology, and specifically dysfunction of the blood-brain barrier (BBB), plays a key role in brain dysfunction and degeneration, and may be an underlying cause of neurodegenerative complications after brain injuries.
The BBB is a highly selective permeable membrane that separates circulating blood from extracellular fluid. It protects the brain by preventing many dangerous substances from penetrating, and therefore is not meant to be damaged.
Medical researchers, including Friedman's group at BGU, are working to find ways to find drugs that will target the BBB and facilitate its repair, allowing for the prevention of Alzheimer's disease and other brain-related disease.
"Prof. Friedman has been able to conduct this breakthrough brain research using the state-of-the-art MRI machine donated as a result of contributions from American Associates, Ben-Gurion University of the Negev (AABGU)," explains Doron Krakow, AABGU executive vice president. "We believe that with continued support, Prof. Friedman and the DCE-MRI can help render more accurate and informed decisions by athletes and others exposed to mild concussions about when to resume activities."
Read more here

Saturday, November 29, 2014

Looking for a Star! LVN Position

Looking for a Star!

Job opportunity for LVN in a pediatric speciality clinic in the Memorial City Area. 

Required experience: 3-5 years working in pediatrics, proficiency in EMR use, and staff management experience. 

Background in pediatric neurology, sleep medicine, psychiatry, and/or behavioral pediatrics a plus.

Please send resume and cover letter to attn: 

Miangela Kanaway

Saturday, November 22, 2014

TED Talk:One more reason to get a good night’s sleep - Loss of sleep is a waste!

Loss of sleep is a waste! Get rid of the day's garbage....seriously...

This is a great talk!


Jeff Iliff: One more reason to get a good night’s sleep

. It's something we spend about a third of our lives doing, but do any of us really understand what it's all about?
0:19Two thousand years ago, Galen, one of the most prominent medical researchers of the ancient world,proposed that while we're awake, our brain's motive force, its juice, would flow out to all the other parts of the body, animating them but leaving the brain all dried up, and he thought that when we sleep, all this moisture that filled the rest of the body would come rushing back, rehydrating the brain and refreshing the mind. Now, that sounds completely ridiculous to us now, but Galen was simply trying to explainsomething about sleep that we all deal with every day. See, we all know based on our own experiencethat when you sleep, it clears your mind, and when you don't sleep, it leaves your mind murky. But while we know a great deal more about sleep now than when Galen was around, we still haven't understood why it is that sleep, of all of our activities, has this incredible restorative function for the mind.
1:17So today I want to tell you about some recent research that may shed new light on this question. We've found that sleep may actually be a kind of elegant design solution to some of the brain's most basic needs, a unique way that the brain meets the high demands and the narrow margins that set it apart from all the other organs of the body...
Link here

Friday, November 21, 2014

Medication to help children with life threatening seizures

Research has shown that an investigational medication can help treat children with potentially life threatening seizures.

In its first clinical application in pediatric patients, an investigational medication developed and manufactured at UC Davis has been found to effectively treat children with life-threatening and difficult-to-control epileptic seizures without side effects, according to a research report by scientists at UC Davis and Northwestern University.
The investigational formulation of allopregnanolone was manufactured by UC Davis Health System's Good Manufacturing Practice Laboratory. Two children were treated with the allopregnanolone formulation, one at UC Davis Children's Hospital, the other at the Ann & Robert Lurie Children's Hospital in Chicago. Both children were weaned from general anesthetics and other seizure treatments and their seizures resolved. In both instances the children are recovering.
The research is published online in Annals of Neurology, an official journal of the American Neurological Association and the Child Neurology Society.
Super-refractory status epilepticus is a condition diagnosed in patients with refractory status epilepticus being treated with infusions of general anesthetics when seizures continue for longer than 24 hours, despite anesthesia, or when seizures recur on reduction or withdrawal of the anesthesia. Super-refractory status epilepticus has high morbidity and mortality. There are no Food and Drug Administration (FDA)-approved treatments for the condition.
Allopregnanolone is a positive allosteric modulator of GABAA receptors in the brain. Research in animals has shown that allopregnanolone protects against seizures and can stop status epilepticus. Although the allopregnanolone used to manufacture the investigational treatment was produced by chemical synthesis according to procedures regulated by the FDA, it is synthesized normally in small quantities in the body from progesterone.
"Our laboratory studies have shown that allopregnanolone is effective in stopping status epilepticus that is refractory to treatment," said Michael Rogawski, professor in the UC Davis Department of Neurology and a co-author of the report.
In both of the clinical cases, the patients continued to have seizures despite weeks of intensive treatment with medications, including infusion of anesthetics. Emergency treatment with the investigational medication was approved by the FDA; the two patients received the medication over a five-day period, during which time both were weaned from anesthetics and other seizure medications. Status epilepticus did not recur after treatment. There were no adverse drug effects, the researchers said.
Mortality rates in super-refractory status epilepticus can be as high as 50 percent, and those who survive experience high rates of subsequent neurological impairment. The authors note that progesterone and ganaxolone, a chemical analog of allopregnanolone, have been studied in clinical trials for epilepsy and have shown benefit. Researchers at UC Davis, led by Rogawski, currently are investigating the use of allopregnanolone as a treatment for traumatic brain injury.
"Neurosteroids, including allopregnanolone, are a promising treatment for epilepsy and refractory status epilepticus that may overcome resistance to benzodiazepines and barbiturates and facilitate the withdrawal of these agents by preventing rebound seizures, a key problem in treatment of super-refractory status epilepticus," Rogawski said.
Read more here