Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Wednesday, July 26, 2017

Cause, Treatment, Cure -- Theoretically

"We are closing in on what could actually cause the problem. The public should embrace that and feel that we can start to do something about it."
Brian Balin, neuropathologist, The Philadelphia College of Osteopathic Medicine

"Alzheimer's is ripe for a breakthrough, which I will predict is going to come in [this area of research]."
Annelise Barron, professor of bioengineering, Stanford University

"The World Health Organization has declared Alzheimer's disease a priority. If we can find the link, we can help a lot of people."
"This is the reason more of us [in medical science] are trying to do something."
Judith Miklossy, Swiss researcher,  Alzheimer International Foundation and International Alzheimer Research Center, Switzerland
Chlamydia bacteria. Image: ZEISS Microscopy/Flickr
According to Dan Blazer, J.P. Gibbons professor of psychiatry emeritus at Duke University, no conclusive evidence relating to the benefit of brain games to offset the potential of acquiring Alzheimer's exists. Similarly there is no evidence that vitamins, supplements or cardiovascular drugs have the potential to reduce someone's risk of dementia. "We are still looking for a magic bullet, but we have not found it", he declares.

There are,  however, other researchers who are convinced that they are on another, unproven track that may very well yield results in the efforts to understand the cause and possible cure of Alzheimer's. A body of scientific research appears to point to microbes as a possible cause of the disease, and the ubiquitous herpes virus is regarded by these believers as one of the links. 

Should a proven link arise between microbes and Alzheimer's it could ultimately develop in hopes for treatments, even a cure, at the very time when the medical world remains puzzled over the growing prevalence of Alzheimer's. This is known as the pathogen theory, one that some leading researchers feel confident will eventually lead to increased scientific knowledge and a breakthrough in treatment.

The followers of the microbe-Alzheimer's connection have faced scientific skepticism from their peers, since what they believe does not fall within the sphere of the dominant theory that the cause of Alzheimer's is the accumulation of plaque-forming beta-amyloid and tangles in the brain. But it is the belief that these are side effects by Alzheimer's-microbe researchers, caused by infection or the body's immune response, not reflective of the root cause of Alzheimer's.

In this July 29, 2013 photo, a researcher holds a human brain in a laboratory at Northwestern University's cognitive neurology and Alzheimer's disease centre in Chicago. SCOTT EISEN / CP
Internationally, thirty-one Alzheimer's researchers forwarded an argument for greater focus on the microbe-Alzheimer's connection, urging the world of science to alter its focus relating to the disease, its onset and possible treatment. They point to decades of useless effort in the treatment and hopes of preventing the disease, that it is time now to reassess evidence hinting that Alzheimer's could have a connection to microbes.

Such a reversal in focus could lead to vaccines and improved diagnostics, leading to earlier treatment, they suggest. Despite their efforts to convince colleagues that their theory and data collected auger for a change in investigative tactics, the supporters of the Alzheimer's-microbe link experience outsider status as far as Alzheimer's research is concerned. But they remain determined to forge ahead.

Characteristics of Alzheimer's disease in the brain. Image by National Institute on Aging/NIH

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Tuesday, July 25, 2017

Acquiring Lifeskills, Prioritizing Needs

"Theoretically what we think is that buying time protects people from the negative effects of time stress in daily life. When feeling pressed for time, that seems to take a bit of a toll on people's day-to-day happiness."
"It's not what comes to mind to people as a way to increase their happiness and the rates at which people are engaging in this type of expenditure are surprisingly low."
"People who don't feel like they're rolling in dough may feel like that's a frivolous way to spend money but what our research is showing is that even if you don't have tons of money, using money to get rid of your disliked tasks may be a pretty smart decision."
"People may feel like I can do this so I should do this, and so I hope our research helps to break through that perhaps misguided cultural assumption."
Elizabeth Dunn, psychology professor, University of British Columbia

While most of us don't have digs as fancy as the Royal Yacht Britannia in Edinburgh, seen in this 2012 file photo, new happiness research finds that even people of moderate means would be wise to allocate a small amount of their budget to time-saving services that free them of disliked chores.
While most of us don't have digs as fancy as the Royal Yacht Britannia in Edinburgh, seen in this 2012 file photo, new happiness research finds that even people of moderate means would be wise to allocate a small amount of their budget to time-saving services that free them of disliked chores. (David Moir/Reuters)

A study was undertaken in Vancouver out of the University of British Columbia, headed by psychology professor Elizabeth Dunn. In the experimental study sixty people who formed the nucleus of the study were given $40 and advised that the money should be used to access anything they wanted to spend it on as long as it was a material object that they thought they might like. When the test subjects reported back they indicated they had bought items such as wine, clothing and board games.

That led to the researchers posing the question to their study group to enable them to judge the level of happiness that resulted from those people buying the things they had chosen to spend their study-accessed funds on. For the second weekend, once again the participants were given $40 to spend as they saw fit, only this time they were expected, they were informed, to use the money to achieve time-saving.

As an example, to take a taxi rather than using public transit, or arranging to have someone cut their grass rather than do it themselves, and in another instance use the services of a boy in the neighbourhood to run errands. That done, the researchers compared the group's stated level of happiness that followed both spending activities, week one and week two, with their different emphasis and targets.

The researchers discovered that people appeared to be much happier buying themselves 'time', rather than objects. Reportedly, two percent of the group only, claimed they would use money to buy things that would give them more time for themselves. Professor Dunn reached the conclusion that even those with ample disposable income preferred not to pay others to perform tasks, to save themselves time.

On The Money Happiness and Time
Researchers surveyed 6,000 people in Canada, the U.S. and Europe found that those who doled out cash to save them time on things such as the meal delivery service seen in this 2014 file photo, were happier than those who don't. (Matthew Mead/Associated Press)
Those who were able to afford to have their groceries delivered continued to go out to the supermarket to shop regardless, or continued parking their cars themselves rather than making use of valet parking. That same study made a survey of 850 millionaires in the Netherlands, only to discover that close to half preferred not to spend money outsourcing their most disagreeable tasks.

A survey of 6,000 people in Canada, the United States and Europe indicated that those whose financial situation was healthy and could see benefit accruing from spending discretionary income ridding themselves of dreaded chores still preferred not to. People who do spend money as a time-saving device spend typically $80 to $100 monthly, according to Professor Dunn, adding that even $40 is capable of opening up some spare time.

Professor Dunn's study team's reason that people have an aversion to paying for giving themselves extra time in that they harbour a feeling of guilt for spending funds unnecessarily, since they feel they could do these chores themselves. The team plans a follow-up study hoping to come to a better understanding of why people prefer not to spend money to buy time. Age, gender, ethnicity and other issues could be identified as drivers for that reasoning.

Possibly, it might be an issue of self-respect? That people understand that having certain life skills is a measure of their capability of looking after themselves responsibly? What Professor Dunn and her colleagues are actually engaging in is validation of present-day society's penchant for farming out aspects of their lives that they view as inconvenient, certain responsibilities that hinder their plans, for example.

And, as good an example as any is that children are now commonly farmed out to others for their care and nurturance, depending on non-family members to raise them at critical times in their young lives, rather than their parents, busy with their own lives, absent their children. This study in fact applauds such choices. As it gives a tacit approval rating to failing to acquire the requisite skills and understanding as a parent to fulfill parental obligations to their dependent children.

Another such measure is the extent to which people will not bother learning how to prepare basic, nutritional meals for themselves, vastly preferring to believe that such commonplace tasks central to human existence are too difficult, too much of a nuisance, too interfering in their freedom to disport themselves as they wish, rather than to feel obligated to their own needs, to fulfill them in the most basic of ways, such as meal preparation.

So spending disposable income, or ensuring that whatever money is available is earmarked for fast foods, convenience and pre-prepared foods, or eating out, rather than becoming familiar with simple and wholesome meal preparations. The assumptions that this research team reached simply reflect what they wanted to find to fit their theory.

 What they discovered is that some people recognize they should acquire the skills and discipline to be self-sufficient in these measurable ways if for no other reason than mere self-respect. And they find this somewhat wanting in their estimation, expressing the hope that their research leading to their theories will give people the justification to surrender their agency to others rather than be wholly responsible to and for themselves.




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Monday, July 24, 2017

Egg Donor for IVF? Be Alert and Be Aware -- as in Beware!

"We don't know, of course, whether there is a likely connection between their egg donation and breast cancer. The only way to have a real answer is to begin keeping track of egg donors and to gather information on the long-term health risks of egg donation. Until then, potential egg donors need more realistic and clear explanations about the lack of knowledge about such risks."
"Egg donors are just not on anyone's radar. It's not the same as sperm donation, which doesn't involve hormone injections or any invasive treatments."
"In my opinion, egg donors need to be treated like all other organ donors -- their health should be monitored."
"All women who undergo ovarian stimulation, especially more than once, should be told that their long-term health risks are unknown."
Dr. Jennifer Schneider, Arizona Community physician
Video for Dr. Jennifer Schneider, ivf safety
Left, Jessica Grace Wing, Right, mother Dr. Jennifer Schneider : Still from video

Several doctors at a London fertility clinic about 20 years ago wrote of the "tragic case of a young woman who died of cancer of the colon after successfully donating eggs to her younger sister". This was published in the journal Human Reproduction. Strangely enough, scientific medical curiosity has not been aroused to the extent where research dedicated to discovering how and why high levels of hormones administered to egg donors through IVF techniques has been a dormant issue. Not quite as though no one is interested because there could not possibly be any threat to the future health of such donors.

Perhaps it's because research funding is notoriously scarce. Perhaps it also owes greatly to the fact that funding often comes from pharmaceutical companies and since they're the producers of the chemical hormones used in the process they have no interest particularly in spending any of their profit to determine whether the technique and the material they provide hastens the deaths of young women. It would definitely produce bad press and depress sales of their product. And nor would clinics specializing in IVF feel inclined to push for research that might affect their bottom line.

So the anecdotal reports, troubling, but guesswork at best, although based on keen observation and the identification of cause-and-effect and related informed theories, is all that is available at the present time. And that's strange, since the technique involved in in-vitro fertilization and the hormones associated with it are so widely used, impacting on the lives of thousands of people, from donors to recipients, their families and the children born of IVF.

Donors are informed, if they ask, that no credible research exists that links IVF to any future health problems. Except that isn't the way it's relayed, instead, those questioning the safety of the technique are simply informed that there are no known issues; so rest assured and proceed. And that is precisely what Jessica Grace Wing experienced. A tall, attractive woman with an athletic build who was a student at Stanford University. She made multiple donations of her eggs as a way to help pay for her tuition. And her donations led to the birth of five healthy children to three families.

Her mother, a general physician, had asked her daughter if she was satisfied that egg donation was safe, to which the young woman responded she had been informed that it indeed is. Yet it appears that beyond the short-term effects of the hormone injections used to stimulate the release of multiple eggs at a time, there was really no research specifically examining the possible long-term effects on donors, so the issue, in fact, is a large, open vacuum.

At the age of 29, which was four years following her third egg donation, the young woman was diagnosed with metastatic colon cancer and despite the state-of-the-art treatment she was given, her life ended at age 31, in 2003. Her mother, Dr. Schneider, entertained doubts in her grief whether the extensive hormone treatments her daughter had been exposed to, really had no risks attached, that the growth of the cancer her daughter developed might have been stimulated by the hormones involved in the treatments.

A look through the research results produced nothing since there hadn't been any research to give results. Egg donors may have been experiencing malign effects, but no one had ever bothered keeping track. So she herself conducted a study leading her to advocate for a registry whose results could be of use not only to egg donors but to women wishing to postpone pregnancy freezing their eggs for future use. It has been 14 years since the death of her daughter, fourteen years of neglect to initiate a registry.

Donors are not hard to find since fertility clinics and agencies devoted to finding egg donors advertise that $5,000 to $7,000 is available to anyone wishing to take part, to produce eggs for IVF. Those British doctors who wrote of a patient dying of cancer of the colon post-egg donation, had made note of the fact that long-term safety concerns had been raised in the British Medical Journal in 1989 amid concern over the high levels of hormones donors were administered, but evidently not enough interest was raised.

So Dr. Schneider and two co-authors reported in Reproductive Biomedicine Online on five cases among egg donors who had been diagnosed with breast cancer, four of whom were absent any genetic risk for the disease. None of the women, all in their 30s, had received information relating to long-term risks inherent in donation of their eggs, simply since there was no information to share with them, or with women supplying their own eggs for IVF undergoing similar hormonal treatment as egg donors.
Containers where harvested eggs are frozen and stored for in vitro fertilization. Credit Raymond McCrea Jones for The New York Times


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Sunday, July 23, 2017

Causes of Dreaded Dementia : Prevention?

"Although the brain becomes smaller with age, the shrinkage seems to be fast-tracked in older adults with hearing loss, according to the results of a study by researchers from Johns Hopkins and the National Institute on Aging. The findings add to a growing list of health consequences associated with hearing loss, including increased risk of dementia, falls, hospitalizations, and diminished physical and mental health overall."
"For the study, Frank Lin, M.D., Ph.D., and his colleagues used information from the ongoing Baltimore Longitudinal Study of Aging to compare brain changes over time between adults with normal hearing and adults with impaired hearing. The Baltimore Longitudinal Study of Aging was started in 1958 by the National Institute on Aging to track various health factors in thousands of men and women."
"Previous research from other studies had linked hearing loss with marked differences in brain structure compared to those with normal hearing, both in humans and animals. In particular, structures that process information from sound tended to be smaller in size in people and animals with impaired hearing. Lin, an assistant professor at the Johns Hopkins University schools of medicine and public health, says it was unknown, however, whether these brain structural differences occurred before or after hearing loss."
Johns Hopkins Medicine ... January 22, 2014
Dementia Hearing Loss Link Hearing Aid Ear
Adults with hearing loss are significantly more likely than adults with normal hearing to develop dementia. Istock

"The sharpness of an individual’s hearing has cascading consequences for various aspects of cognitive function. We’re only just beginning to understand how far-reaching these consequences are."
"Even if you have just a mild hearing loss that is not being treated, cognitive load increases significantly. You have to put in so much effort just to perceive and understand what is being said that you divert resources away from storing what you have heard into your memory."
Brandeis University Professor of Neuroscience, Dr. Arthur Wingfield

There seems to be general agreement in the highly specialized medical/scientific community that a link between hearing loss and dementia has been firmly established. That there are many potential causes of dementia, among which are depression, smoking, a sedentary lifestyle, social isolation, high blood pressure, lack of formal education as a child, and lastly peripheral hearing loss.

The prestigious medical journal Lancet had decided to strike a commission of several dozen experts in the field of cognition and risks of age-related cognitive decline. When the report was completed smoking and obesity were listed as major factors in the prevalence of dementia onset. Both smoking and obesity are well enough known as lifestyle predictors of a whole host of physical ills, not the least of which are cancer, heart disease, diabetes and stroke.

The commission authors studied the preventable risk factors potentially leading to dementia, then they estimated how much risk they believed to represent the intensification of each factor in establishing dementia. They settled on a global "population attributable fraction" by which to measure each of the possible underlying drivers toward dementia. As, for example, eliminating smoking would result in how much of a reduction in dementia?

Smoking, as it turned out, using the yardstick of the highest-to-lowest PAF on the established formula, ranked number three, while late-in-life depression (considered to be a preventable social issue) came in at number four. Further down the list of triggers to dementia came social isolation and physical inactivity, and so did high blood pressure. As for the second-placed trigger for mental decline, lack of secondary education fit that niche.

Lack of formal childhood education was placed in the "lifestyle factor" category, the risk given a 60 percent likelihood of potentially precipitating mental decline. Leaving school before attaining age eleven scored a high PAF, and it was ascertained through the calculations that 40 percent of the world population bears this risk factor. None however, ranked as high for the potential to move individuals into mental decline as peripheral hearing loss.

Studies have established the theory that people suffering peripheral hearing loss at or around age 55 double the ordinary individual's risk of dementia. Peripheral deafness is defined as hearing loss with no obvious central nervous system or brain causation, and as such the use of a hearing aid would alleviate the loss. Even so, the Lancet group concludes that it is unknown whether hearing aids have the capacity in their function to aid in halting cognitive decline.

So then, though midlife deafness may contribute to dementia as some neurologists posit, because the effort in attempting to interpret speech monopolizes "cognitive resources", it is still a theory. Theories abound, including one that loss of hearing leaves  the individual feeling sad which ages the individual more swiftly. Still others feel that hearing loss might possibly represent one of dementia's early symptoms.

There is obviously a long way to go in understanding the process, let alone establishing that some cases of dementia can be preventable.

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Saturday, July 22, 2017

Mind and Body: Nurturing the Child

"The damage that happens to kids from the infectious disease of toxic stress is as severe as the damage from meningitis or polio or pertussis."
Dr. Tina Hahn, pediatrician, Caro, Michigan
  • More than 1 in 4 U.S. kids experience a serious traumatic event by the age of 16, including abuse, neglect and household or neighbourhood violence, according to the National Center for Child Traumatic Stress.
  • More than 1 in 5 children have experienced at least two of these traumas and are more likely than others to have school difficulties, along with health and behavioural problems, a 2014 study found.
  • Nearly half of U.S. children younger than 18 live in families at or near the poverty level, U.S. Census data show.
  • The number of U.S. children in foster care climbed steadily after 2011, reaching nearly 430,000 in 2015, the most recent government data show. Neglect was the reason in nearly two-thirds of cases, with most of the rest due to drug abuse, according to a 2016 government report. Authorities believe the opioid epidemic has contributed to the trend. CBC News
Safe spaces, quiet times and breathing exercises for preschoolers are designed to help kids cope with intense stress so they can learn.
Safe spaces, quiet times and breathing exercises for preschoolers are designed to help kids cope with intense stress so they can learn. (Chuck Burton/Associated Press)

Pediatricians in the United States were urged by the American Academy of Pediatrics in 2012 to make an effort to convince parents of young children along with the public that the long-term consequences of toxic stress does long-term harm of both physical and psychological values to children exposed to situations and circumstances that create an insecure and fearful environment for them in their most formative years.

The push was on to call for new public policies and possible treatments geared at preventing or reducing the effects of stress in vulnerable child populations. Recent studies' outcomes appear to validate that the stress children suffer with lack of adequate nurturing, changes the body's metabolism, contributing to internal inflammation, potentially raising the risk of developing diabetes and heart disease.

Researchers at Brown University in 2015 reported findings of elevated levels of inflammatory markers in the saliva of children who had experienced some manner of adversity, including abuse. Animal study experiments suggest that persistent stress may have the capacity to alter brain structure where emotions and the regulation of behaviour is concerned.

"We know that if they don't feel safe then they can't learn", commented mental health specialist Laura Martin, of children who have experienced the treadmill of going in and out of foster homes, or the strained life they experience alongside parents struggling with drug and alcohol dependencies, supplemented by poverty, depression, and domestic violence. When they arrive at school they are unfocused and withdrawn.

This leads to social behaviours that become a problem the schools find they must deal with. Children who kick and scream at their classmates and their teachers. Aggressive discipline has been placed high on a shelf as a response that hasn't worked well in the past. Instead, methods whereby the children's insecurities can be addressed are attempted, in an effort to lead them away from the stress their normal lives burden them with.

At school, children in these programs called "trauma-informed" care, based on research pointing to potential biological dangers of toxic stress leading to a new approach for public health to identify and treat the effects of poverty, neglect, abuse and allied adversities, are leading the way. At home these children "never know what's going to come next", while at school there is quiet time and regularized routines, breathing exercises, and other aids to help angry children deal with conflicts.

Behind these new experimental teaching techniques is the acknowledged science that the brain and disease-fighting immune system, not yet fully formed at birth, remain vulnerable to damage from childhood adversity, according to studies, with the first three years the most critical. Children without nurturing parents or in the absence of other close relatives to step in to help cope with adversity are recognized as being most at risk.

Harvard University neuroscientist Charles Nelson explains that under normal stress conditions the response kicks in briefly to raise heart rate and levels of cortisol and allied stress hormones. But when that stress is severe and remains ongoing, the levels of stress have the potential to remain elevated, placing children in a persistent state of "fight or flight". Imaging studies show regions in the brain affecting emotions and behaviour tend to be smaller than normal in children who have suffered severe trauma.

Research carried out on neglected children in Romanian orphanages lead to the suggestion that early intervention may lead to a reversal of damage from toxic stress, so that orphans placed in the care of nurturing foster families before age two produced imaging scans years later demonstrating that their brains appeared similar to those of children never institutionalized. Whereas those children in foster care at a later age had diminished grey matter, their brains appearing similar to those of children remaining in orphanages.

"The science of how poverty actually gets under kids' skin and impacts a child has really been exploding", explained a former president of the American Academy of Pediatrics. The landmark U.S. government-linked research, called the Adverse Childhood Experiences study published in 1998 led the way to this later research, finding that adults exposed to neglect, poverty, violence, substance abuse, parents' mental illness and other domestic dysfunction were likelier than others to experience heart problems, diabetes, depression and asthma.

Adults with six or more such adverse childhood experiences in their early background died an average of twenty years earlier than those with no such adverse experiences, according to a follow-up study conducted in 2009.
Center on the Developing Child at Harvard University

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Friday, July 21, 2017

Living With Blacklegged Ticks

"There are a lot of ticks now that carry the bacteria that cause Lyme disease so we have to be able to provide some answers on how to better prevent infection and treat the disease."
"There are pockets of excellence in Canada on Lyme disease research but we want to bring them together to have more impact."
Dr. Mark Ouellette, scientific director, Institute of Infection and Immunity, Canadian Institutes of Health Research

"It's a complicated disease that is quite difficult to understand -- and it's turning out to be more complex than people originally thought."
Dr. Tara Moriarty, infectious disease researcher, University of Toronto
Lyme Disease
This is the two-year life cycle of ticks. (Centers for Disease Control and Prevention)

Awareness of Lyme disease spread through infected deer ticks has been an issue for decades. Less of an issue in Canada than it has been in the United States, until the blacklegged ticks, aka deer ticks, began spreading into Canada. And now that they have, and continue to spread more widely it is not only Canadians visiting deer-tick-vulnerable places in the United States that contract Lyme disease, but those being exposed to the ticks increasingly right in Canada.

It isn't of course, only humans that are susceptible to Lyme disease, but animals as well. And just as people are cautioned to be aware when they are in wooded areas, of the presence of deer ticks, and to check for ticks clinging to clothing or to human skin, veterinarians warn dog owners of the risks to animals, and that anyone spending time in forested areas would do well to check their dogs for ticks as well. For dogs there is an oral medication to protect against ticks.

For humans, avoidance is the key for the present time. Which is to be alert to the presence of these tiny ticks and if they are found, to remove them as expeditiously as possible, within a 24-hour window representing the time it takes for bacterial transmission once the tick has latched on to human skin. Those troublesome ticks can appear anywhere in an outdoor environment, but mostly in forests and tall grasses.

They don't fly, and depend on animals or people passing by so that when they brush past where the ticks are perched with their front legs outstretched on grasses or leaves, they find their victims. Insect repellent is recommended, containing DEET, as is wearing long sleeves and long pants whenever in wooded areas. If a companion animal picks up an infected tick (not all deer ticks are infected with the Lyme bacteria) it can be easily transferable to a human.
Tick bite
Health authorities have found an increase in cases of Lyme disease and blacklegged ticks. A tick bite can leave a bull's-eye-shaped rash on the skin. (CBC)

And nor do all people who have been bitten by an infected tick suffer Lyme symptoms. It is a small minority of people who develop the hard-to-treat and painful form of the disease. Scientists do not yet know whether Lyme disease leaves biomarkers in the bloodstream representing an opportunity for doctors to diagnose Lyme while yet in its earliest, treatable stages. There is more not known about Lyme disease and its threatening effects than is yet known.

And it is precisely the need to know what it is about the bacteria Borellia burgdorferi that makes people so ill when it spreads within the human body. Dr. Moriarty's laboratory has discovered that in laboratory test mice, obesity and diabetes cause greater susceptibility to the bacteria and it can be the cause of bone loss as well, in mice.

The federal government has just announced a new initiative to spur Lyme disease research to create a network  to establish a nation-wide cohort of patients for the purpose of studying and tracking their experiences with Lyme disease to better understand how the disease manifests itself in those it infects, how to best diagnose and treat it, and how it persists even in people who have received treatment.

Lyme disease cases in Canada saw 144 diagnoses in 2009. An increase in prevalence and diagnoses raised that number to 917 in 2015, and growing nationwide. Estimates by public-health researchers now posit that 80 percent of Eastern Canada's population will live in areas where the ticks have established themselves by 2020, as opposed to the 18 percent represented in 2010 living in areas at risk of Lyme disease exposure.

Authorities caution people that ticks should be removed with tweezers grasping the head, to ensure that the entire tick, a member of the arachnid family, is removed. Discovered in its early stages, the illness the disease creates with flu-like symptoms generally is successfully treated with antibiotics. Untreated, arthritis can ensue, along with numbness, paralysis, heart disorders and neurological problems.

How to avoid tick bites

The best way to prevent Lyme disease is to prevent tick bites by:
  • covering up
  • using insect repellent
  • double-checking yourself
  • washing and drying thoroughly
  • checking your pets

Cover up

Your clothing gives you an important layer of protection. Make sure to wear:
  • light-coloured clothing so you can spot ticks and remove them before they bite
  • a long-sleeved shirt or jacket tucked into long pants
    • tuck the pants into your socks for extra protection
  • socks and closed footwear

Use insect repellent

Use an insect repellent, or bug spray, containing DEET or Icaridin on clothes and exposed skin. Always read the label for directions on how to use it.

Double-check yourself

When you go to an area where blacklegged ticks live, check – and recheck – yourself by:
  • paying close attention to areas such as your scalp, ankles, armpits, groin, naval and behind your ears and knees
  • using a mirror to check the back of your body or having someone else check for you
When you’ve double-checked yourself, don’t forget to do the same for children in your care.

How to remove a tick

Removing a tick is the same for humans and animals. Follow these steps to remove ticks:
  1. If the tick is attached to you, use fine-tipped tweezers or tick removal tool to grasp the tick as close to your skin as possible. Do not use your fingers.
  2. Pull the tick straight out, gently but firmly making sure to remove the entire tick (including the head). Don't squeeze it – avoid crushing the tick’s body.
  3. After removing the tick, place it in a secure container, such as a screw-top bottle used for medication.
  4. Give the tick to your health care professional or local health unit.
  5. Thoroughly clean the bite site with rubbing alcohol and/or soap and water.

Lyme disease symptoms

Common symptoms include:
  • fever
  • headache
  • muscle and joint pain
  • spasms, numbness or tingling
  • facial paralysis
  • fatigue
  • swollen glands
  • expanding skin rash
People with Lyme disease often see symptoms within 1-2 weeks. But symptoms can appear as early as 3 to 30 days after a bite from an infected blacklegged tick.
Province of Ontario website

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Thursday, July 20, 2017

Child Sunscreen Concerns

"It [reaction to sunscreen] could be an allergy to a part of the sunscreen that's not a UV absorber. It could be to a fragrance or a preservative or some other compound used in making up a lotion or a cream."
"[Risk of skin damage from the sun] is worse than the risk of sunscreen use."
Dr. Cheryl Rosen, dermatologist, Toronto Western Hospital
Complaints about the sunscreen include an allegation that it caused 14-month-old Kyla Cannon in Botwood, N.L., to develop a facial burn and blisters.
Complaints about the sunscreen include an allegation that it caused 14-month-old Kyla Cannon in Botwood, N.L., to develop a facial burn and blisters. (Rebecca Cannon/Facebook)

The issue is that some sunscreens have been linked to reactions in children. Sunscreen use is widely recommended by health professionals to ensure that children responding to their freedom to be out playing in the summer sun, do not sustain damage to their skin through burns from penetrating rays hitting their tender, vulnerable skin. The concern goes quite beyond sustaining painful sunburns, and on toward the potential of subsequent long-lasting DNA damage.

"Overall, sunscreens are very safe" assures Dr. Jennifer Beecker, national chairwoman for the Canadian Dermatology Association's program for sun awareness. She stresses the requirement that parents be aware their sun-exposed children need a sunscreen coverage of SPF 30 or greater, but that sunscreen needs to be used discreetly, alongside other measures to protect from sun exposure. That children should be taught to use shade if available, and to be aware that the sun's rays are at their most piercing during the hours of 11:00 a.m. to 3:00 p.m., daily.

The merits of wearing clothing ensuring the least exposure to the sun's rays, when applicable, are not to be overlooked, nor is the use of a head covering and eye protection; hat and sunglasses. All of the above apply to infants under six months of age, with the exception of sunscreens for which research has never been undertaken relating to the safety of sunscreens for the very young. Parents of children who had experienced burns and blisters with the application of Banana Boat products alerted Health Canada to problems they had experienced.

Recently Health Canada had received 139 complaints concerning lotions produced by U.S.-based Edgewell Personal Care. A whopping 133 of those complains were conveyed to Health Canada since May 11, leading a spokesperson for the agency to note it had undertaken a review of the company's laboratory documents confirming a product meets specifications, called certificates of analysis. Their tests to date have identified no issues of concern with the products.

Which has led Health Canada to conduct screening of its own of Banana Boat samples to be able to identify "all drugs present, whether they appear on the label or not". All active ingredients in the products are also being analyzed, so a thorough investigation is being carried out. In its defense, Banana Boat Canada claims its products reflect a neutral pH range and thus cannot be the cause of chemical burns. They do posit that some people may be sensitive to a particular ingredient possibly triggered by sun exposure.
Rebecca Cannon Banada Boat sunscreen
Health Canada says at least 14 of the complaints it received involve claims that using the sunscreen resulted in burned or blistered skin. (Charlene Fudge/Facebook)

Best practice, according to dermatologists, is to place sunscreen on a discrete portion of skin to determine whether it is tolerated, after which more can be tested on a larger area of the skin to clear the product of any possible doubts over whether a reaction would ensue with its use. Dr. Beecker also recommends that parents look for sunscreens that are free of fragrance, with fewer preservatives. One preservative in particular she advises avoiding is methylchloroisothiazolinone, known "to have a very high rate of allergy".

Which then naturally begs the question: if so, they why is it commonly used? A combination of vitamin E and acetic acid -- tocopheryl acetate -- is frequently contained by many cosmetic creams, which also has the potential to become a skin irritant for some people. As for "natural" ingredients such as aloe, chamomile and feverfew, these too are known to potentially be problematical when they act as "photo sensitizers", where their use for some people translates to being more susceptible to the sun's rays.

The risk of damage from prolonged, direct exposure to the sun's rays cannot be overstated. Skin damage has the potential to lead to skin cancer, including deadly melanoma, the seventh most commonly diagnosed type of cancer in Canada, a diagnosis that has risen over the past several decades.

Ryan Truman Banana Boat sunscreen
Ryan Truman's parents say their 3-year-old son developed red skin and his face swelled up after using Banana Boat sunscreen. (Rory and Monika Truman)

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Wednesday, July 19, 2017

The Case Against Artificial Sweeteners as Sugar Substitutes

"I think a lot of people consuming them kind of assume they’re harmless because they contain zero calories. But what the evidence is suggesting is maybe there’s more to the story than that."
"The message is there isn’t strong evidence for a benefit from these products – and there’s potential evidence for harm."
"I’m going to say that you should drink water."
"The results [of the new review] showed a statistically significant association between consumption of artificial sweeteners and higher risks of diabetes, heart disease and increased weight gain."
"Given the widespread and increasing use of artificial sweeteners, and the current epidemic of obesity and related diseases, more research is needed to determine the long-term risks and benefits of these products." 
Dr.Meghan Azad, assistant professor of pediatrics and child health, University of Manitoba

A new study published in the Canadian Medical Association Journal carried out by University of Manitoba researchers reviewing the effects of sugar substitutes in an effort to avoid using sugars in diet-conscious consumers' food choices has concluded that these artificial sweeteners may be responsible for making people gain weight, and increasing as well the onset risks inherent in high blood pressure, diabetes and cardiovascular events such as heart attack and stroke.

While hard-and-fast evidence is as yet elusive, and the study's lead author calls for ongoing research, a leading theory is that the use of sweeteners changes the body's metabolic processes, leading to functional anomalies which confuse the brain and the body's capacity to respond to, and process sugar.

Artificial sweeteners like aspartame represent the most widely used food additives globally. They're found in over six thousand products worldwide as substitutes for sugar in "no sugar added" foods such as ice cream, yogurt and granola bars.

The presence of artificial sweeteners in foods is so ubiquitous that when urine and blood samples are taken from people who state they never use such additives, trace amounts nonetheless show up. "People are consuming them without knowing it", stated Dr. Azad, study lead author.
 
Diet Coke is poured on a Big Gulp cup at a 7-Eleven store     Joe Raedle / Getty Images
A study published in the journal Nature two years earlier had discovered that sugar substitutes act on gut bacteria. Mice fed saccharin for 11 weeks showed alterations in their gut microbiome, and became pre-diabetic, leading Dr. Azad to wonder whether evidence could be found for similar effects in people. This led her and her colleagues to perform a systematic review and meta-analysis (study of earlier studies) to assess the effects of long-term, regular consumption of sweeteners on cardio-metabolic health conditions.

Of 37 studies reviewed which reflected the involvement of over 400,000 people, seven of the studies represented randomized controlled trials involving approximately a thousand people followed for an average of six months. The studies concluded that sweeteners did not demonstrate a consistent effect of weight loss.

Another thirty longer and larger observational studies which had people responding with information relating to their use of artificial sweeteners and who were then followed for an average of ten years, showed a 14 percent rise in diabetes in "high" consumers (people having a diet soft drink at least once or more daily).
 
splenda-rf-getty.jpg
Artificial sweeteners are synthetic food additives that provide a sweet taste to mimic sugar, while containing significantly fewer calories. / Mario Tama/Getty Images
Compared to those reporting never or rarely consuming sugar substitutes, a 32 percent increased risk of coronary heart disease, heart failure and other cardiovascular problems assailed the artificial sweetener users who also evidenced a 31 percent increase in risk of metabolic syndrome, representing a group of conditions which include hypertension and abnormal cholesterol raising the risk of heart disease and stroke.

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Tuesday, July 18, 2017

Controlling Society's Troublesome Children

"[Increase in weight and BMI in children irrespective of the type of SGA treatment] remains of great concern given that childhood obesity can adversely affect nearly every organ system."
University of Montreal research study

"Some kids need these medications to function and to go to school and do well. I don't want people to stop their children's medication if they need it."
"But there are things parents can do to [ensure their children] live healthy lives and [to] prevent some of these side effects. They just need to ask."
"Often these kids will stay on these medications for years, and not be reviewed. We've had kids on them for over seven years."
Dr. Dina Panagiotopoulos, pediatric endocrinologist, B.C. Children's Hospital, Vancouver

"[Weight gains of] this enormous magnitude [can set children up for a future with diabetes and cardiovascular disease] This is a terrifying study."
"[Antipsychotics are being] wildly and recklessly overused, very often by primary care doctors with little expertise or time, under the influence of drug company aggressive marketing."
"It's a form of social control. It's medicalizing problems that are social problems."
"[In instances where extreme behaviour cannot be controlled by other means] that medication may be worth it, despite all the risks. But this should be a very last resort, not a first reflex."
Dr. Allen Frances, professor emeritus, Duke University, Durham, North Carolina
Potent antipsychotics given to children as young as two can lead to significant weight gain, according to new Canadian research into a class of drugs that one prominent American psychiatrist says are being used as tools of "social control."  Getty Creative Images

Researchers from the University of Montreal initiated a study in concern over side effects, whether one drug alone was prescribed, or switched or combined with other antipsychotics prescribed as treatment for children diagnosed with attention deficit hyperactivity disorder (ADHD), aggression and behaviour problems. They took samples of children's height, weight and blood, searching for side effects. And they discovered that after 24 months of antipsychotic treatment, the mean weight of those children increased by 28 pounds (12.8 kilograms).

Of the young people being followed, twenty-three percent became overweight or obese, with close to ten percent developing impaired fasting glucose, a precursor to developing diabetes. The frequency with which children diagnosed with "disruptive behaviour disorder" in ADHD were prescribed antipsychotic medications was found to go beyond mood disorders or actual psychotic conditions, even though national guidelines recommend that these drugs not be used for behaviour problems in children.

Yet children as young as two years of age are being prescribed these powerful drugs meant to be prescribed to adults with serious psychotic issues. Second-generation antipsychotics (SGAs) use for children with ADHD has undergone an exponential growth, prescriptions seeing an 18-fold increase in British Columbia alone in the years 1996 to 2011. Right across Canada in the time frame 2005 to 2009 there was a 114 percent increase in recommendations for children in the use of psychotic drugs to manage their disruptive behaviour.

At Hotel-Dieu de Levis hospital in Quebec 147 children between the ages of ten to sixteen were treated in the years 2005 and 2013, part of a program meant to track the metabolic effects of second-generation antipsychotics on being treated for the first time with these mood-altering drugs that were at one time reserved to treat schizophrenia in adults, and now being prescribed "off-label" for an unapproved age range to adolescent boys and girls and even younger children, for aggression and behavioral problems.

The SGA drugs marketed in Canada include clozapine, risperidone and quetiapine, none of which are authorized for use under age 18 other than aripiprazole, approved for the treatment of schizophrenia in 15 to 17-year-olds. The Montreal study marking the weight increase, published by the Canadian Journey of Psychiatry, warns of serious complications that include high blood pressure, fatty liver disease and increased risk of heart disease and stroke "from childhood onward".

Dr. Panagiotopoulos at B.C. Children's Hospital studied a theory that these drugs affect brain chemicals that function to control hunger and satiety, disrupting normalcy. Her research team found that the actual caloric intake is not seen to sufficiently account for the weight increase, leading to the suspicion that the drugs may affect a child's resting energy expenditure, so that they burn fewer calories. Her research confirms that antipsychotic drugs are now being prescribed to preschool children.

It is vital, she states, that children be monitored every three months during the first treatment year, and thereafter at least once annually. Dr. Frances at Duke University points out that in his experience the reckless overuse of these drugs often targets poor children and children in foster care, as a form of social control.

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Monday, July 17, 2017

"Ego-Driven" Yoga Injuries

Getty Images

"Poses associated with pain first noticed during class appeared to be typical of standard yoga participation."
"Participants may overexert themselves, take a class that is too advanced or try to attain a position they are not prepared for."
"The risks for traumatic, acute injuries may be small, but participants should participate conscientiously to improve or avoid musculo-skeletal pain. Those with existing pain should be even more careful."
"Indeed, 20.9 percent of participants in the current sample reported existing pain that was exacerbated by yoga participation."
Hidden Risks of Yoga study, published in the Journal of Bodywork and Movement Therapies
yoga injury

Studies exist that document yoga's functionality in diminishing back, neck and joint pain. Many yoga practitioners styling themselves as practised yoga instructors boast that they have the knowledge to help people attain improved posture, strength, flexibility and balance. Among these yogis may be some whose knowledge fails to match their enthusiasm, let alone their promises of no-pain guidance in yoga.

Millions of people don't hesitate to place their trust in the healing and restorative powers of yoga, unfailingly attending their local yoga studies, trusting that the training and experience of the instructor who leads their classes does truly reflect what the public relations and advertising boasts claim from among the many and varied yoga practises and certification programs.

But the fact is that people do sustain injuries during their yoga classes, and so the authors of this new study, coming from Boston, New York and Sydney, Australia, collaborated in reviewing published literature studying the issue. Through their reviews they discovered yoga-related injuries reported to range from 2.4 percent annually ranging up to 21.3 percent representing lifetime injuries.

They decided to use questionnaires, sending them out to several thousand participants from among whom they sought volunteers willing to report their yoga habits and any pain that might be associated with them. Another questionnaire followed up a year after, to the 354 recreational yoga practitioners who had agreed to take part in the study.

Respondents, mostly female, had an average age of 45.7 with about ten years of yoga experience which they practised three hours weekly, on average. And of that number the majority (86.7 percent) faithfully reported experiencing pain in at least one area of the body, along with many (65.8 percent) feeling that practising yoga improved their discomfort.

On the other hand, 10.7 percent claimed that it was yoga itself that caused their pain, with a third claiming the pain they suffered mitigated against their practising yoga for as long as three months at a time. Roughly 50 percent of those injured stated they sustained their injuries during a yoga class, with another 21 percent adding that yoga worsened existing pain.
Photo: Heidi Kristoffer

Practising yoga was most likely to relieve pain and discomfort in the back and neck for practitioners, while the most common injury sites turned out to be the wrists and hands. The study authors specifically mentioned other studies that named headstands, shoulder stands, the lotus position, half lotus position, forward bends, backward bends and handstands to have been noted for their propensity to increase risk of injury.

In interviews with yoga instructors, issues such as excess effort, poor techniques and inadequate instruction were cited as additional sources of injury, to which was added "ego-driven" performance. It seems logical enough to reach the conclusion that the widespread belief in yoga as being a remedy for what ails, convinces people to feel they are safe in making efforts to go beyond their physical limits.

Even so, injury rates sustained in the practise of yoga are seen to compare with those sustained through other forms of exercise.

A University of Sydney study found yoga caused musculoskeletal pain – mostly in the arms – in more than 10% of participants. Photograph: Bartlomiej Zborowski/EPA

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Sunday, July 16, 2017

Society's Killers-by-Default?

Bottles of painkillers
Photo: The Atlantic
Big Pharma is being introduced through the courts to the power of public concern over their products. The drugs, OxyContin, Percocet, Opana and a generic version of oxycodone are not illegal, they have a place in responsible use by medical professionals when the attributes they are capable of are called upon to ease peoples' suffering and pain. But their manufacturers deliberately and with the prospect of enriching themselves, launched public relations blitzes convincing prescribing doctors that these opiates are 'less addictive' than others which have been a bane to society, not a boon.

Public authorities are alarmed throughout North America at the carnage that the drugs' dependencies are wreaking through drug overdose deaths. The general public has been made aware that they live in a time where the "culture of drug dependence, dysfunction and death" has affected the larger society, not only drug addicts dealing with mental instability, crime and profit, feeding addictions, but ordinary, middle-class and upper-middle class professionals who have lost their way, becoming hopelessly in the thrall of death-delivering medications.
"[The opioid epidemic was produced by a] fraudulent scheme [engineered by Purdue Pharma, Mallinckrodt Pharmaceuticals and Endo Pharmaceuticals] to mislead doctors and the public about the need for, and addictive nature of opioid drugs."
"They put millions of dollars into advertising. They put lots of sales forces out there. And they supported legislation that made this stuff far more available than it was before. And it's not enough to say, 'Well, people misused it'."
"When you put way too many drugs, for way too many bad reasons, into way too many people's hands, prescribed by way too many people, you get what we have in our area, which is an epidemic."
Barry Staubus, District Attorney, Sullivan County, northeast Tennessee
Photo: The Atlantic

The entire world knows about the legal battles undertaken by various governmental bodies to punish tobacco manufacturing giants in 1998 when they were accused on the evidence which revealed they were in the business of deceiving the public trust about tobacco addiction. They were ordered to pay out over $200-billion in fines to aid government in cost outlays associated with providing health care to smokers whose lung cancer was directly attributable to scientifically validated and acknowledged carcinogens present in cigarettes.

A new battle  has been mounted by public authorities whose areas have been hit with the still-emergent epidemic of drug overdoses. Attorneys general of Ohio, Missouri, Mississippi and Oklahoma, along with counties in California and New York among others, have launched lawsuits against the offending pharmaceutical giants. This is just the beginning. There will be an increasing number of lawsuits. And, as with the battle against tobacco manufacturers when those suits have been settled, individual civil suits will be launched.

In 2015, opioid overdoses caused the deaths of 33,000 people in the United States. This is fast becoming a crisis of intense and untenable proportions, no little of the sense of urgency to do something to ameliorate the situation and name and punish the perpetrator, that white-middle-class suburbanite communities with political influence, has persuaded politicians of all stripes to become involved, as the issue keeps gaining momentum.

There is no disagreement among public health experts to the obvious; that legal painkillers are the cause of a crisis where prescription opioids steadily gained prominence through wide prescription practices, habituating users to search out ever more powerful drugs, leading them on to heroin. OxyContin maker Purdue was persuaded to plead guilty in 2007 to a criminal felony, admitting to fraudulent practices, inaccurately promoting its product as less likely to be abused than other drugs, leading to a $600-million settlement.

"The drug companies are not utterly defenceless. There are issues they can raise and they're pretty good at it", observed University of Kentucky law professor, Richard Ausness. All they have to do is point out that prescription opioids have a distinct purpose, aiding patients in coping with pain issues, as long as they are used responsibly, and therefore they have a place for good health reasons in the prescription pharmacopoeia.
Prescription and illegal opioids are commonly abused because they are so addictive. <br /><br />Opioid medications bind to the areas of the brain that control pain and emotions, driving up levels of the feel-good hormone dopamine in the brain's reward areas and producing an intense feeling of euphoria.<br /><br />As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dependence and, later, addiction.
Prescription and illegal opioids are commonly abused because they are so addictive, binding to areas of the brain that control pain and emotions. Photo CNN

They were given a scientifically-approved clean bill of  health when government health regulators themselves studied, then endorsed prescription opioids, releasing them for wide use. In any event, it is medical professionals themselves who stand between the manufacturers and the patients. "Unlike tobacco companies, our products are medicines approved by the FDA, prescribed by doctors, and dispensed by pharmacists, as treatments for patients suffering pain. [The company] vigorously [denies allegations, and is] committed to working collaboratively to find solutions [to the crisis]", Purdue huffed righteously.

The maker of Percocet and Opana, Endo Pharmaceuticals, chooses to side-step any awkward acknowledgement of impending litigation: "Our top priorities include patient safety and ensuring that patients with chronic pain have access to safe and effective therapeutic options". How can any one argue with that selfless, public-service-focused statement, of a totally innocent manufacturer whose only interest in producing drugs is to serve the public?

Ohio Attorney General Mike DeWine announced Wednesday the state is suing five pharmaceutical companies, claiming the companies knowingly understated the addiction risks of prescription opioid medication.
Ohio Attorney General Mike DeWine announced Wednesday the state is suing five pharmaceutical companies, claiming the companies knowingly understated the addiction risks of prescription opioid medication.(Jackie Borchardt, cleveland.com)

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