New treatment helps people fight phobias during sleep

A new treatment may make it possible for people to overcome phobias in their sleep, Medical Daily reported.

In a new study published in Nature Neuroscience, researchers from Northwestern Medicine tested the effects of gradual exposure therapy during sleep. The therapy, which involves exposing people to things they fear in small doses, has been previously shown to be effective at reducing fear responses.  However, it had never before been tested during sleep.

For the study, 15 healthy people were conditioned to develop a fear response to an image of a face. Every time researchers showed participants the image, they also administered a small electrical shock and exposed participants to a specific scent. Researchers then assessed participants’ fear responses by studying their perspiration levels and utilizing functional magnetic resonance imaging (MRI).

After these assessments, the researchers examined the participants as they slept, while re-exposing them to the same scent they had been conditioned to associate with fear. Researchers introduced the scent during slow wave sleep, the period of time during sleep when memory consolidation is thought to occur, according to Medical Daily.

“While this particular odorant was being presented during sleep, it was reactivating the memory of that face over and over again, which is similar to the process of fear extinction during exposure therapy,” study author Katherina Hauner, a postdoctoral fellow in neurology at Northwestern University’s Feinberg School of Medicine, told Medical Daily.

When the study participants woke up, they were exposed again to the image of the face that they had been conditioned to fear. However, their fear response was measurably lower compared to before they slept, according to researchers.

“If it can be extended to pre-existing fear, the bigger picture is that, perhaps, the treatment of phobias can be enhanced during sleep,” Hauner said.

Source: http://www.projectnola.com/the-news/news/42-fox-8/299040-new-treatment-helps-people-fight-phobias-during-sleep

Photo of pregnant weightlifter sparks heated debate

Pregnant Mom Lea-Ann Ellison lifting weights

Pregnant women are encouraged to stay fit and active during pregnancy to help reduce the risk to themselves and their unborn children. But 35-year-old weightlifter, Lea-Ann Ellison, has sparked a huge online debate after sharing photographs of her lifting heavy weights just two weeks before giving birth.

The Los Angeles mom-to-be can be seen hoisting kettle balls and barbells above her head. With the photos, she gave the statement, “I strongly believe that pregnancy is not an illness, but a time to relish in your body’s capabilities to kick .”

Within just hours of the CrossFit regime follower’s post, more than 500 shares had taken place. Within less than five days, nearly 17,000 shares had been counted. That has resulted in some vehemently opposed comments regarding her fitness routine, which is described as a ‘strength and conditioning program [adopted by many organizations, including] military special operations units, champion martial artists and professional athletes worldwide.’

User Amanda Cinq-Mars wrote: “This is actually sickening. I hope pregnant women around the world do not do this kind of crap…I am a crossfit enthusiast but I DO NOT recommend this at all. Doctors always strongly suggest to not lift heavy because you can sever your placenta and cause major damage and  early labor and miscarriage…Posting this picture [gives] people the wrong message that it is OKAY when it’s not!!!”

Another user, Stephanie Herrera wrote: “Sure you look and sound cool, but we’re only human…why would you risk hurting your baby just to stay in shape? That’s the stupidest thing I’ve ever heard. It’s not time to kick. It’s time to be protective of your unborn child.”

But not everyone has lashed out at the expectant Lea-Ann. In fact, she’s had some pretty strong supporters on her Facebook page.

Source: http://www.growingyourbaby.com/2013/09/20/pregnant-mom-sparks-online-debate-shares-photographs-weightlifting-just-weeks-due-date/

1 in 500 patients wakes up on operating table

One of the most disturbing surgical complications is also frighteningly common: As many as 1 in every 500 patients wakes up on the operating table and is at least dimly aware of what’s happening, according to a new survey of doctors.

The findings, published in the British Journal of Anesthesia, noted most patients say they are not distressed by the experience because they feel no pain and are not fully awake or aware of the circumstances.

But lead researcher Jaideep Pandit, an Oxford University anesthetist, said it happens far more frequently than past research has suggested. One reason: Only 1 in 15,000 patients who can remember at least some aspects of an operation mentions the experience to the doctor afterwards.

The experiences recalled by the patients: Vague awareness of conversations among the staff in the operating room and even the knife on their skin (but no pain). 

“The difference between the incidence of one in 500 and one in 15,000 suggests that even in the rare cases where patients are experiencing awareness, in most cases, the sensation is a ‘neutral’ one,” Pandit told the Independent on Sunday. 

“What we are possibly seeing is a third state of consciousness — dysanaesthesia — in which the patient is certainly aware of events but not concerned by this knowledge, especially as they are not in pain.” 

He added that problems in the way the anesthetic is given or even by genetic variation among surgical patients may cause some to react differently to the drugs.

For the survey, Pandit polled more than 7,100 anesthesiologists at 329 British hospitals.

Source: http://www.newsmaxhealth.com/Health-News/waking-during-surgery/2013/09/23/id/527243

 

FDA issues final rules governing mobile medical apps

The U.S. Food and Drug Administration issued final rules covering the development of mobile medical apps on Monday, saying it will focus it oversight on those apps that have the potential to harm consumers if they do not function properly.

The FDA has cleared about 100 mobile medical apps over the past decade, including products that can diagnose abnormal heart rhythms or help patients monitor their blood sugar. About 40 apps were cleared within the past two years.

The agency said it will not regulate the sale or general consumer use of smart phones or tablets or mobile app distributors such as the iTunes store or Google Play store.

It will, however, focus its enforcement on products that transform smart phones into devices the agency currently regulates, such as electrocardiography (ECG) machines that can determine whether a patient is having a heart attack.

The FDA will also focus on apps that would be used as an accessory to a regulated device, such as one that displays images used by physicians to make specific diagnoses.

Source: http://www.foxnews.com/health/2013/09/23/us-fda-issues-final-rules-governing-mobile-medical-apps/

Fatal rare brain disease confirmed; 15 possibly exposed

A neurosurgery patient treated at a New Hampshire hospital this spring did have a rare brain disorder known as Creutzfeldt-Jakob Disease, health officials confirmed Friday. That means that 15 other people in three states may have been exposed to the invariably deadly infection through potentially tainted surgical equipment.

Autopsy results came back positive for CJD from the National Prion Disease Pathology Surveillance Center and were reported to the New Hampshire Department of Health and Human Services and Catholic Medical Center, where the surgery took place.

Earlier this month, New Hampshire officials notified eight patients who may have been exposed to CJD through shared equipment. Five others in Massachusetts and two in Connecticut were also warned of the risk, health officials in those states said.

“Though we are not surprised by the test results, we are saddened by the toll this disease takes on families and our sympathies go out to all those affected,” said Dr. Jose Montero, New Hampshire’s director of public health, in a statement. There is no way to confirm the disease except through autopsy after a patient’s death.

The initial patient turned out to have sporadic CJD, which occurs spontaneously. It’s not the variant form of the disease that causes a human type of “mad cow disease” and is associated with eating beef contaminated with the cattle version of the infection, called bovine spongiform encephalotpathy, or BSE, experts said.

The problem arose because standard hospital disinfection techniques cannot eradicate the prion that causes CJD. A prion is a protein and the type that causes BSE and CJD is misfolded and somehow manages to transform other proteins into disease-causing shape.

The initial patient had surgery at Catholic Medical Center in Manchester, N.H., where eight others were also treated. The five Massachusetts patients underwent surgery at Cape Cod Hospital in Hyannis, while the two Connecticut patients were treated at the Veterans Affairs Hospital in West Haven, health officials said.

The Massachusetts and Connecticut patients were all treated using a guided imaging navigation system manufactured by Medtronic Inc., as well as the surgical tools that go with it, a company spokeswoman said. Other patients were treated with tools made by different manufacturers. Hospitals frequently share high-cost neurosurgery equipment on a fee-for-use or rental basis, which explains why they were used in more than one hospital.

The risk of infection is very low, noted Dr. Joseph Pepe, president and CEO of Catholic Medical Center. The eight New Hampshire patients were notified Friday of the autopsy results.

This is not the first time contaminated hospital equipment has been implicated in potentially spreading CJD. In 2000, 14 patients in two separate incidents were exposed. The Joint Commission, an accrediting agency, this month reiterated guidelines urging hospitals to have a high degree of suspicion about CJD even when the diagnosis is not confirmed and to follow World Health Organization and Centers for Disease Control guidance on sterilization or disposal of the tools.

CJD affects about one in a million people worldwide each year, experts say. In the most recent five-year period, between 279 and 352 cases were diagnosed in the U.S. annually, according to the Centers for Disease Control and Prevention. Early symptoms include rapidly failing memory and other cognitive problems. Personality changes, anxiety, depression, lack of coordination and visual disturbances often occur. There is no treatment and no cure. officials said.

Source: http://www.nbcnews.com/health

FDA Orders More Stringent Labeling For Opioid Drugs

The US Food and Drug Administration has announced safety labeling changes and post-market study requirements for extended-release and long-acting opioid analgesics

The US Food and Drug Administration has recently announced safety labeling changes and post-market study requirements for extended-release and long-acting opioid analgesics.

Earlier this year the Center for Disease Control’s Vital Signs report showed that prescription painkiller overdoses killed nearly 48,000 women between 1999 and 2010. The new regulations aim to cut the number of deaths per year from opioid dependence.

“The FDA is invoking its authority to require safety labeling changes and post-market studies to combat the crisis of misuse, abuse, addiction, overdose and death from these potent drugs that have harmed too many patients and devastated too many families and communities. Today’s action demonstrates the FDA’s resolve to reduce the serious risks of long-acting and extended release opioids while still seeking to preserve appropriate access for those patients who rely on these medications to manage their pain,”FDA Commissioner Margaret Hamburg said.

Oxycontin, Opana ER, Embeda, Palladone and MS Contin fall into this class of drugs. The medications contain narcotics such as oxycodone or morphine.

One warning restricts the use of these painkillers to those who need it on daily basis, long-term pain management and for whom non-narcotic drugs haven’t worked.

A second warning targets pregnant women to the danger of narcotic withdrawal syndrome in their newborns.

The FDA is requiring the drug companies that make these product to conduct further studies and clinical trials as more information’s is needed to assess the serious risks associated with long term use of ER/LA opioids.

“The FDA remains committed to improving the safety of opioids and to continuing to engage in efforts to evaluate and mitigate the risks associated with opioid use,” said Dr Douglas Throckmorton, deputy director for regulatory programs in the FDA’s Center for Drug Evaluation and Research.

Source: http://www.counselheal.com/articles

For black infants, a precarious start in life

Samantha Bradley holds her 1-year-old son, Adris, in Long Beach, Calif. Adris, born premature, required heart and eye surgery.

Samantha Bradley was only six months pregnant. She had already miscarried once. She knew she needed to get to an emergency room.

“I was in tears,” she said. “The only thing I could think was, ‘Get me to a hospital.’ ”

On vacation in Palm Springs, Bradley and her sister rushed to a nearby hospital. About 30 minutes later, Bradley gave birth to her son, Adris. The baby weighed just 1 pound, 8 ounces — a little more than a bag of coffee.

Adris would spend four months in the hospital, undergoing surgery to close a valve near his heart and eye surgery caused by a disease common in premature infants.

Black women like Bradley are 1½ times as likely as white women to give birth prematurely, and their babies are more than twice as likely to die before their first birthday.

Researchers once blamed a lack of prenatal care for the disparity. Now, research shows that the explanation is much more complex, rooted in the years before the women even get pregnant. Black women are more likely to be poor, have less education, lack health insurance and have chronic conditions such as diabetes and obesity.

“They are coming into the pregnancy at higher risk,” said Kay Johnson, who chairs the advisory committee on infant mortality for the U.S. Department of Health and Human Services. “By the time they see a doctor, seven months is too short to repair long-term adverse health.”

The leading causes of infant mortality are preterm birth and low birth weight. Even if premature children survive, they can face lifelong health or developmental problems.

The nation’s health care overhaul is expected to help close racial gaps by increasing access to preventive care, health insurance and family planning, Johnson said. The government also is investing in projects to reduce preterm birth and infant mortality.

“While there are all these medical risk factors, there are a whole bunch of other social risks,” said Erin Saleeby, director of women’s health programs for the Los Angeles County Department of Health Services. “The medical side of it will never be enough.”

Socioeconomics and medical care don’t fully explain why black women disproportionately lose their babies. Even black women who are highly educated are at higher risk than white women with less education.

That may be because of the cumulative effects of racism and stress, said Johnson, citing research on the subject.

Meridith Merchant, 42, a licensed psychologist who lives in Los Angeles, said she did all she was supposed to do during her pregnancy in 2005, eating well and attending all her prenatal appointments.

When she was 6½ months pregnant, her water broke. At Cedars-Sinai Medical Center, she gave birth to a girl, Nailah Asha, who weighed just 2 pounds.

Nailah spent five months in the neonatal intensive care unit, until she could eat and breathe on her own.

Merchant and her husband spent long hours at the hospital. Nailah was born with heart defects, and several weeks after her birth, she tested positive for Down syndrome.

She went home after five months but had trouble gaining weight. One day, Merchant was holding Nailah when her body went limp. Merchant called 911. Her daughter died at the hospital of an intestinal disorder. It was one day before her first birthday.

Every year, Merchant said, she commemorates Nailah’s birthday.

Source: http://www.timesdispatch.com/news

Vaccine ‘clears HIV-like virus’ in monkeys

The researchers now want to move from monkeys to test the vaccine in humans

A vaccine for the monkey equivalent of HIV appears to eradicate the virus, a study suggests.

Research published in the journal Nature has shown that vaccinated monkeys can clear Simian Immunodeficiency Virus (SIV) infection from their bodies.

It was effective in nine of the 16 monkeys that were inoculated.

The US scientists say they now want to use a similar approach to test a vaccine for HIV in humans.

Prof Louis Picker, from the Vaccine and Gene Therapy Institute at Oregon Health and Science University, said: “It’s always tough to claim eradication – there could always be a cell which we didn’t analyse that has the virus in it. But for the most part, with very stringent criteria… there was no virus left in the body of these monkeys.”

Search and destroy

The research team looked at an aggressive form of virus called SIVmac239, which is up to 100 times more deadly than HIV.

Infected monkeys usually die within two years, but in some inoculated primates the virus did not take hold.

It maintains an armed force that patrols all the tissues of the body, all the time, indefinitely”

Prof Louis Picker Oregon Health and Science University

The vaccine is based on another virus called cytomegalovirus (CMV), which belongs to the herpes family.

It used the infectious power of CMV to sweep throughout the body. But instead of causing disease, it has been modified to spur the immune system into action to fight off the SIV molecules.

“It maintains an armed force, that patrols all the tissues of the body, all the time, indefinitely,” explained Prof Picker.

The researchers gave rhesus macaque monkeys the vaccine, and then exposed them to SIV.

They found that at first the infection began to establish and spread. But then the monkeys’ bodies started to respond, searching out and destroying all signs of the virus.

Of the monkeys that successfully responded to the vaccine, they were still clear of infection between one-and-a-half and three years later.

Prof Picker said his team was still trying to work out why the vaccination worked in only about half of the monkeys.

“It could be the fact that SIV is so pathogenic that this is the best you are ever going to get.

“There is a battle going on, and half the time the vaccine wins and half the time it doesn’t,” he said.

Human trials

The researchers are now testing the vaccine to see if it can be used after SIV exposure to treat and potentially cure infected monkeys.

They also want to see if the technique could work in humans.

Prof Picker said: “In order to make a human version we have to make sure it is absolutely safe.

“We have now engineered a CMV virus which generates the same immune response but has been attenuated [modified to lose its virulence] to the point where we think it is unequivocally safe.”

This would first have to pass through the regulatory authorities, but if it does, he said he hoped to start the first clinical trials in humans in the next two years.

Commenting on the research, Dr Andrew Freedman, from Cardiff University School of Medicine, said: “This suggests that prophylactic vaccines – vaccines designed to prevent infection – using CMV vectors may be a promising approach for HIV.

“While they may not prevent the initial infection, they might lead to subsequent clearance, rather than the establishment of chronic infection.”

Source: http://www.bbc.co.uk

Brain Activity Found Beyond EEG ‘Flat-lined’ Deep Coma

Scientists say they’ve discovered a totally new kind of brain activity lurking beyond the “flat-lined” state seen in deep comas.

A team of Canadian and Romanian researchers found evidence of cerebral activity both in a human coma patient and in 26 cats induced by drugs into an incredibly deep (but reversible) coma. They describe the new phenomenon, which they’ve dubbed “Nu-complexes,” in a paper published Wednesday in the journal PLoS ONE.

Initial stages of comas are comparable to deep sleep, but if a person progresses into a deeper and deeper quietude, the brain state alters more dramatically. In cases of very deep comas, an electroencephalogram (EEG) monitor will render a flat line (also called an isoelectric line), marking a state in which the brain’s electrical activity has either stopped or is so low it is virtually undetectable. This is considered one of the boundary lines between having a living brain and brain death, but is not the only criteria that doctors use to declare someone brain-dead; there usually has to be evidence of structural damages in the brain as well.

This new research suggests that cerebral activity can revive after the flat-lined state, under certain conditions. The work started when Romanian doctor and study coauthor Bodan Florea observed unusual brain activity in a hospital patient who went into a coma following a heart attack.

Source: http://www.ibtimes.com

Hot exercise classes catching on like fire

Mimi Benz discovered her fervor for hot exercise by accident. She had taken heated yoga classes but had never thought to combine high temperatures with her true passion, indoor cycling, until the air conditioning broke during a cycling class at her gym.

From that first hot ride, she was hooked.

“I loved it,” says Benz, explaining that with a heated workout she didn’t have to waste time warming up. “It improves blood flow throughout your body, so you go into a high-calorie burn more quickly. And it feels really good afterwards.”

In 2011, Benz opened the Sweat Shoppe, a heated indoor cycling studio in North Hollywood.

“I wasn’t sure how people would respond, so in the beginning we had half heated classes and half non-heated classes.” But the demand for heated classes was so high that by 2013 they’d eliminated non-heated rides from the schedule.

As the demand for hot workouts continues to rise, heated studios are popping up all over, offering everything from traditional Bikram yoga, which started the hot exercise trend with a regimented sequence of yoga postures performed in a 105-degree room with 40% humidity, to hot power yoga, hot Pilates and hot barre. Some classes even incorporate hot weightlifting.

Bikram’s static poses can be sustained at over 100 degrees, but more dynamic classes are typically in the 95-degree range, and the Sweat Shoppe’s SweatCycle classes top out at 85 degrees. “If you go hotter, that’s nuts” and not safe, says Benz.

The allure of heat

As for why people love the heat so much, Benz says it’s partly a psychological response to sweat streaming from your pores. “People feel they’ve accomplished more if they’re drenched. It is very addictive; a lot of our clients can’t cycle anywhere else because they’re so used to riding in a heated environment.”

Laurel Hilton, a writer and hot-yoga enthusiast from Mill Valley, Calif., agrees that once you go hot it’s hard to go back. “I’m addicted to sweating. In the heat you get a sort of exhausted euphoria. You almost feel like you’re floating during practice. Without heat, it’s just not the same experience.”

After becoming acclimated to high temperatures, working out in the heat gets easier. “It’s the same thing any football coach knows,” says Craig Crandall, director of the Thermoregulation Laboratory at the University of Texas Southwestern Medical Center at Dallas. “When you take [players] out in the beginning of the season, you can’t work them out hard. They’ll die.” But give them a chance to acclimate, and they’ll be able to push themselves.

Another reason people are attracted to heated workouts: If a heat-acclimated person does the usual workout in a cool environment, it will be a breeze in comparison, says Benz.

Does heat make a better workout?

Though many heated exercise champions believe they’re burning more calories because their hearts are beating faster, that’s not true, says Crandall. “It’s oxygen uptake that determines the number of calories burned, not heart rate.” When people exercise in the heat, they lose blood volume as they sweat, so the amount of blood ejected per heart beat decreases. To compensate, the heart rate increases. For a given workload, a person’s heart rate will always be higher in the heat.

“We know exercising in heat will cause a slightly higher oxygen uptake, but [the difference is] very small, less than 10%,” and likely to be offset by a decreased workload, Crandall says.

Another common misconception is that sweating profusely “detoxifies” the body. “That’s silliness,” says Crandall. “I don’t know of any toxins that are released through sweat.” He adds that the function of sweating is to cool you down, not clean you out.

So is there any physiological benefit to working out in the heat? Crandall says the benefit is heat acclimation itself, which improves sweating efficiency, increases blood flow to the skin and expands blood volume, bringing more blood to the muscles.

There is some evidence that heat acclimation can boost athletic performance. A 2010 study looking at elite cyclists found that those who added a 10-day heat training regimen to their normal training routine saw a 7% increase in their performance. The performance-boosting effects lasted one to two weeks after heat exposure.

But Santiago Lorenzo, the study’s lead author, former Olympic decathlete and a professor of physiology at Lake Erie College of Osteopathic Medicine in Erie, Pa., cautions, “The results we saw apply to highly trained cyclists. How to translate this to someone of average fitness or a weekend warrior? Chances are it would still work—but we need studies to confirm that.”

Safety during heated exercise

“Even if you’re running in the desert or an area with high humidity, you still usually have a draft to cool you off,” says Shannan Lynch, director of education for Mad Dogg Athletics Inc. “But when you sit in a heated room without airflow, the temperature can get dangerously hot.”

The conditions can lead to reduced blood flow to your skin, thus less cooling, and eventual heat exhaustion or even heat stroke. Warning signs include a dry mouth, headache, increasing fatigue, nausea and dizziness.

If you exercise in the heat, Lynch says, replace the fluid that you lose. Weigh yourself before and after. American College of Sports Medicine guidelines recommend that people drink 20 to 24 ounces of water or sports beverage for every pound they lose.

As far as contraindications for heated exercise, “If you have any kind of heart condition, only try it after you get the green light from a physician,” Lynch says, adding. “Pregnant women should not be exercising in a heated environment.”

Source: http://www.latimes.com/health/la-he-sweat-it-20130914,0,522826.story