The ugly truth about summer allergies

As if a runny nose and red eyes weren’t enough to ruin your warm weather look, summer allergies can gift you with even more than you’ve bargained for this year. In fact, some unusual symptoms can leave you looking like you lost a round in a boxing ring.”Summer allergies can cause severe symptoms for some sufferers, and can be just as bad as the spring and fall seasons,” said allergist Michael Foggs, MD, president of the American College of Allergy, Asthma and Immunology (ACAAI). “Symptoms aren’t always limited to the hallmark sneezing, runny nose and watery eyes. Black eyes, lines across the nose and other cosmetic symptoms can occur.”Even if you’ve never before had allergies, they can suddenly strike at any age and time of year. You might want to consider visiting your board-certified allergist if these undesirable signs accompany your sniffle and sneeze.Allergic Shiner: Dark circles under the eyes which are due to swelling and discoloration from congestion of small blood vessels beneath the skin in the delicate eye area. Allergic (adenoidal) Face: Nasal allergies may promote swelling of the adenoids (lymph tissue that lines the back of the throat and extends behind the nose). This results in a tired and droopy appearance. Nasal Crease: This is a line which can appear across the bridge of the nose usually the result of rubbing the nose upward to relieve nasal congestion and itching. Mouth Breathing: Cases of allergic rhinitis in which severe nasal congestion occurs can result in chronic mouth breathing, associated with the development of a high, arched palate, an elevated upper lip, and an overbite. Teens with allergic rhinitis might need braces to correct dental issues. …

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What is the brain telling us about the diagnoses of schizophrenia?

Sep. 5, 2013 — We live in the most exciting and unsettling period in the history of psychiatry since Freud started talking about sex in public.On the one hand, the American Psychiatric Association has introduced the fifth iteration of the psychiatric diagnostic manual, DSM-V, representing the current best effort of the brightest clinical minds in psychiatry to categorize the enormously complex pattern of human emotional, cognitive, and behavioral problems. On the other hand, in new and profound ways, neuroscience and genetics research in psychiatry are yielding insights that challenge the traditional diagnostic schema that have long been at the core of the field.”Our current diagnostic system, DSM-V represents a very reasonable attempt to classify patients by their symptoms. Symptoms are an extremely important part of all medical diagnoses, but imagine how limited we would be if we categorized all forms of pneumonia as ‘coughing disease,” commented Dr. John Krystal, Editor of Biological Psychiatry.A paper by Sabin Khadka and colleagues that appears in the September 15th issue of Biological Psychiatry advances the discussion of one of these roiling psychiatric diagnostic dilemmas.One of the core hypotheses is that schizophrenia and bipolar disorder are distinct scientific entities. Emil Kraepelin, credited by many as the father of modern scientific psychiatry, was the first to draw a distinction between dementia praecox (schizophrenia) and manic depression (bipolar disorder) in the late 19th century based on the behavioral profiles of these syndromes. Yet, patients within each diagnosis can have a wide variation of symptoms, some symptoms appear to be in common across these diagnoses, and antipsychotic medications used to treat schizophrenia are very commonly prescribed to patients with bipolar disorder.But at the level of brain circuit function, do schizophrenia and bipolar differ primarily by degree or are there clear categorical differences? To answer this question, researchers from a large collaborative project called BSNIP looked at a large sample of patients diagnosed with schizophrenia or bipolar disorder, their healthy relatives, and healthy people without a family history of psychiatric disorder.They used a specialized analysis technique to evaluate the data from their multi-site study, which revealed abnormalities within seven different brain networks. Generally speaking, they found that schizophrenia and bipolar disorder showed similar disturbances in cortical circuit function. When differences emerged between these two disorders, it was usually because schizophrenia appeared to be a more severe disease. …

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US depression treatment demonstrated effective for UK

Aug. 19, 2013 — A US model of treating depression through a network of specialists could effectively be imported into the UK, new research has revealed.Collaborative care involves depressed people having access to a team of specialists, with advice and support often given over the phone. A trial led by Professor David Richards at the University of Exeter Medical School found that collaborative care led to improvement of depression symptoms immediately after treatment. Furthermore, 15 per cent more patients were still improved after 12 months, compared with those who saw their GP.Depression is a long-term and relapsing condition, and is set to be the second largest cause of global disability by 2020. At the moment, treatment for 85-95 per cent of UK cases is through GPs, but the organisation of care in this setting is not optimal for managing depression because of barriers between general and specialist health professionals, patients not taking their medication and limited specialist support for patients. In contrast, collaborative care involves a structured management plan, regular follow-ups with patients and better communication between health professionals. To achieve this, a care manager is appointed to act under the supervision of a specialist, and to liaise between GPs and mental health specialists.The findings of the CADET study are published in the BMJ online today, August 19. The study was funded by the UK Medical Research Council, managed by the National Institute for Health Research (NIHR), on behalf of the MRC-NIHR Partnership. Professor Richards also receives funding from the NIHR Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (PenCLAHRC).Professor Richards said: “This is one of the largest studies of collaborative care internationally, and demonstrates that it is as effective in the UK as it is in the US, and could reliably be imported. Importantly, patients also told us that they preferred the approach to their usual care. …

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Moderate exercise could be good for your tendons, research shows

Aug. 7, 2013 — Moderate exercise could be good for keeping your tendons healthy according to new research from the University of East Anglia funded by Arthritis Research UK.The onset of tendon disease has previously been associated with exercise. However new research published n the journal Molecular Cell Research shows that doing moderate exercise could help guard against and treat the painful and often debilitating condition.The research team showed that moving around decreases a group of enzymes (metalloproteinases) that degrade tendon tissue and increase tendon protein.Tendon disease is caused by damage to a tendon at cellular level. Symptoms include chronic pain, inflammation, stiffness and reduced function.Lead researcher Dr Eleanor Jones, from UEA’s school of Biological Sciences, said: “The onset of tendon disease has always been associated with exercise, however this association has not been fully understood. We have shown that moderate exercise has a positive effect on tendons.”The team used human Achilles tendon cells which were seeded in rat tail collagen gels. These were then subjected to levels of strain experienced by human tendons to simulate moderate exercise.”In this study we talk about moderately high exercise and we would consider running to be moderately high. But it’s important to remember that our research was carried out in the lab so to confirm this we would need to complete further clinical studies.”The new findings also reveal how genes are regulated by the activation of the protein TGF-β (transforming growth factor beta). By investigating this pathway, researchers hope to find out more about how exercise is associated with tendon disease.

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Adenoviruses may pose risk for monkey-to-human leap

July 25, 2013 — Adenoviruses commonly infect humans, causing colds, flu-like symptoms and sometimes even death, but now UC San Francisco researchers have discovered that a new species of adenovirus can spread from primate to primate, and potentially from monkey to human.UCSF researchers previously identified a new adenovirus in New World titi monkeys that killed most of the monkeys infected during an outbreak in a closed monkey colony in California in 2009. At the time, a research scientist who worked closely with the monkeys and a family member, both of whom were found to have antibodies to the virus, also became ill.In a new study, which appears July 24 in the online journal PLOS One, UCSF scientists exposed three marmoset monkeys to the same virus. All three developed a mild, “cold-like” respiratory illness and an antibody response to the infection, but were able to eliminate the virus within twelve days.The results conclusively demonstrate that the new virus is capable of infecting and causing disease across primate species, according to Charles Chiu, MD, PhD, director of the UCSF-Abbott Viral Diagnostics and Discovery Center, and the lead scientist of the new study.”This study raises more concerns about the potential of unknown viruses to spread from animals to humans,” said Chiu, who is an assistant professor of medicine at UCSF. “We still don’t understand the full extent of viruses that exist in the world and their potential to cause outbreaks in human populations.”Last year, Chiu and colleagues also identified another new adenovirus, named simian adenovirus C, which sickened four of nine captive baboons and killed two of them at a primate facility in 1997. Several staff members at the facility also complained of upper respiratory symptoms at the time of the outbreak. Re-examining the samples many years later, Chiu and his colleagues found antibodies targeted to simian adenovirus C in the human samples.Chiu concluded that staff members had been exposed to the new virus, and that the virus may have jumped from baboon to human, an idea also supported by follow-up experiments in which laboratory strains of simian adenovirus C efficiently infected both human and baboon cells.”Adenoviruses to date have not generally been linked to cross-species infections between monkeys and humans,” Chiu said.In light of these findings, however, he said the normal vigilance in tracking animal viruses that might also infect humans should extend beyond influenza and coronaviruses to include adenoviruses. Chiu is working on new computational techniques to more rapidly identify novel, disease-causing viruses.Viruses with RNA genes, including influenza viruses, make many errors in replicating their genetic material, and are thereby likely to generate new, mutated forms that alter their pathogenic nature, occasionally allowing them to infect new hosts.In contrast, viruses that use DNA as their genetic material, such as adenoviruses, are thought to have less chance of spreading between species because they replicate with fewer mutations that could serve as the basis for infection-enhancing changes.However, beyond mutation during replication, the mixing of genes though recombination of distinct virus species or strains also can give rise to new viruses that are more pathogenic or that infect across mammalian species. This applies to DNA viruses as well as RNA viruses, according to Chiu.In 2009, scientists demonstrated that a more virulent strain of human adenovirus arose from recombination with other distinct strains of milder human adenoviruses.”We believe that’s similar to what happened with the simian adenovirus C outbreak in Texas,” Chiu said. “This new virus likely formed when an existing adenovirus recombined with another, generating a new strain that was highly virulent to baboons.”

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Early detection and treatment of Alzheimer’s disease prevents psychological and behavioural symptoms

July 18, 2013 — Persons with Alzheimer’s disease are able to manage their everyday activities longer and they suffer from less psychological and behavioural symptoms if the diagnosis is made and treatment begun at a very early phase of the disease, indicates a recent study conducted at the University of Eastern Finland.Share This:The study followed persons with Alzheimer’s disease over a course of three years. The study participants were diagnosed either at the very mild or mild phase of the disease and treated within the standard healthcare system.According to the study, persons with a very mild Alzheimer’s disease at the time of the diagnosis and start of the Alzheimer’s disease targeted therapy are better able to manage their everyday activities than persons diagnosed at a more advanced phase of the disease. In addition, in relation to the stage of the disease, they also had less psychological and behavioural symptoms during the follow-up.According to the researchers, Psychologist Ilona Hallikainen and Adjunct Professor, Psychologist Tuomo Hänninen, the results show that an early detection of the disease is important. Persons with Alzheimer’s disease may be able to live at home longer if they are able to manage their daily activities and have less psychological and behavioural symptoms.In addition, the study enhanced knowledge about the use of common diagnostic tests during a follow-up. The results have been accepted for publication in the journal International Psychogeriatrics. Ms. Hallikainen presented the results at the Alzheimer’s Association International Conference (AAIC) in Boston on 17 July.Share this story on Facebook, Twitter, and Google:Other social bookmarking and sharing tools:|Story Source: The above story is reprinted from materials provided by University of Eastern Finland, via AlphaGalileo. Note: Materials may be edited for content and length. For further information, please contact the source cited above. Journal Reference:Ilona Hallikainen, Tuomo Hänninen, Mikael Fraunberg, Kristiina Hongisto, Tarja Välimäki, Asta Hiltunen, Pertti Karppi, Juhani Sivenius, Hilkka Soininen, Anne M. …

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Simple two-drug combination proves effective in reducing risk of stroke

June 26, 2013 — Results of a Phase III clinical trial showed that a simple drug regimen of two anti-clotting drugs — clopidogrel and aspirin — lowered the risk of stroke by almost one-third, compared to the standard therapy of aspirin alone, when given to patients who had minor or transient stroke symptoms to prevent subsequent attacks.Described this week in the New England Journal of Medicine (July 4, 2013 print issue), the clinical trial was conducted at multiple sites in China and designed in partnership with a physician at UC San Francisco.The trial involved 5,170 people who were hospitalized after suffering minor ischemic strokes or stroke-like events known as transient ischemic attacks, or TIAs, in which blood flow to the brain is briefly blocked. All patients were randomized into two groups and treated for three months with either aspirin alone or aspirin plus clopidogrel, which is marketed as Plavix. The three-month period following stroke is considered the most critical for medical intervention.Overall, 8.2 percent of patients taking both drugs suffered subsequent strokes in the three months of follow-up compared to 11.7 percent of patients taking aspirin alone.”The results were striking,” said S. Claiborne Johnston, MD, PhD, a professor of neurology and associate vice chancellor of research at UCSF who was a senior author on the study.The Chinese trial, called CHANCE (Clopidogrel in High-risk Patients with Acute Non-disabling Cerebrovascular Events), is nearly identical to a National Institutes of Health-sponsored trial that is already enrolling patients in the United States, including at UCSF, called POINT (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke).”If POINT confirms CHANCE, then we’re done — the two-drug combination becomes the standard of care,” said Johnston. “Anybody with a transient ischemic attack or minor stroke will get clopidogrel plus aspirin.”The POINT trial is important, said Johnston, because genetics, risk factors, and medical practice differences could all lead to differences in trial results in China compared to other countries. Johnston is the principal investigator of the POINT trial.Stroke in China and the United StatesStroke is a leading cause of death and disability worldwide and is the fourth leading cause of death in the United States.More than 795,000 people in the United States have strokes every year, and, in 2008 alone, some 133,000 cases were fatal, according to the U.S. Centers for Disease Control and Prevention. Another 300,000 people in the United States have TIAs each year.Many strokes are minor — shorter in duration than a full-blown stroke and usually have no lingering health impacts. In China, for instance, about 3 million new strokes occur every year, and about 30 percent of them are minor.The protocol for the CHANCE trial was developed by Johnston and colleagues at Tiantan Hospital in China. The lead author of the study was Yongjun Wang, MD, of Beijing Tiantan Hospital.China has many times more people who have strokes every year than the United States because of the size of the population and higher stroke rates, which allowed investigators to screen 41,561 patients in just three years at the 114 clinical sites, and enroll 5,170 patients in the trial.Increased Risk of Subsequent StrokeThe reason for minor attacks is much the same as a full-blown stroke: a blood clot causes a blockage in the blood vessels that feed oxygen-rich blood to the brain. …

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Stroke symptoms associated with developing memory and thinking problems, even without stroke

June 19, 2013 — People who experience any stroke symptoms — but do not have a stroke — may also be more likely to develop problems with memory and thinking, according to new research published in the June 19, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.Share This:”‘Silent strokes’ that cause small areas of brain damage have been tied to memory and thinking problems, but it has been difficult to study these ‘silent strokes’ due to the cost and inconvenience of obtaining brain MRIs,” said study author Brendan J. Kelley, MD, of the University of Cincinnati and a member of the American Academy of Neurology. “With this study, we found that a quick, seven-question test can be a cost-effective tool to help identify people at increased risk of developing dementia.”For the research, 23,830 people from the REGARDS study with an average age of 64 with no memory problems who had never had a stroke completed the stroke symptoms questionnaire at the start of the study and every six months for at least two years. The questionnaire asks about symptoms of stroke or transient ischemic attack (TIA), or a “mini-stroke” where symptoms resolve quickly with no permanent damage. The participants’ memory and thinking skills were also tested yearly. During the study, 7,223 people had stroke symptoms.The study found that people who had stroke symptoms were more likely to develop memory and thinking problems. Caucasians who had stroke symptoms were twice as likely to develop cognitive problems (11 percent) as Caucasians who did not have stroke symptoms (5 percent). African-Americans who had stroke symptoms were nearly 70 percent as likely to develop thinking problems (16 percent) as African-Americans who did not have stroke symptoms (about 10 percent).”Our study highlights the importance of discussing stroke-like symptoms with your family doctor, even if they don’t last long. These symptoms can be a warning sign that a person is at increased risk of stroke or problems with thinking or memory,” said Kelley.The REGARDS study was supported by the National Institute of Neurological Disorders and Stroke, National Institutes of Health and Department of Health and Human Services.Share this story on Facebook, Twitter, and Google:Other social bookmarking and sharing tools:|Story Source: The above story is reprinted from materials provided by American Academy of Neurology (AAN). Note: Materials may be edited for content and length. …

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Mindfulness can increase wellbeing and reduce stress in school children

June 19, 2013 — Mindfulness — a mental training that develops sustained attention that can change the ways people think, act and feel — could reduce symptoms of stress and depression and promote wellbeing among school children, according to a new study published online by the British Journal of Psychiatry.With the summer exam season in full swing, school children are currently experiencing higher levels of stress than at any other time of year. The research showed that interventions to reduce stress in children have the biggest impact at this time of year. There is growing evidence that mindfulness-based approaches for adults are effective at enhancing mental health and wellbeing. However, very few controlled trials have evaluated their effectiveness among young people.A team of researchers led by Professor Willem Kuyken from the University of Exeter, in association with the University of Oxford, the University of Cambridge and the Mindfulness in Schools Project, recruited 522 pupils, aged between 12 and 16 years, from 12 secondary schools to take part in the study. 256 pupils at six of the schools were taught the Mindfulness in Schools Project’s curriculum, a nine week introduction to mindfulness designed for the classroom.Richard Burnett who co-created the curriculum said: “Our mindfulness curriculum aims to engage even the most cynical of adolescent audience with the basics of mindfulness. We use striking visuals, film clips and activities to bring it to life without losing the expertise and integrity of classic mindfulness teaching.”The other 266 pupils at the other six schools did not receive the mindfulness lessons, and acted as a control group.All the pupils were followed up after a three month period. The follow-up was timed to coincide with the summer exam period — which is a potential time of high stress for young people. The researchers found that those children who participated in the mindfulness programme reported fewer depressive symptoms, lower stress and greater wellbeing than the young people in the control group. Encouragingly, around 80% of the young people said they continued using practices taught in MiSP’s mindfulness curriculum after completing the nine week programme. Teachers and schools also rated the curriculum as worthwhile and very enjoyable to learn and teach.Lead researcher Professor Kuyken said: “Our findings provide promising evidence of the effectiveness of MiSP’s curriculum. …

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