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  • December 15, 2014
  • 08:42 AM
  • 190 views

Who is Getting High in Europe (and Where)?

by William Yates, M.D. in Brain Posts

My research training is in psychiatric epidemiology. Alcohol and drug dependence have been two of my topic areas of research.So I found a recent novel study of the epidemiology of illicit drug use in Europe intriguing.Typical methods of looking for the prevalence of drug use in populations are direct diagnostic interviews and studies of emergency room attendees or autopsy cases with medical complications of drug use.However, Christopher Ort from Switzerland along with a host of European colleagues took an interesting approach to studying illicit drug use in European populations.They conducted population wastewater illicit drug concentration analyses using liquid chromatography. They examined changes in illicit drug concentrations over time and across a number of cities and regions in Europe.This approach is slightly messy (pun intended) but logically follows a reasonable argument: high illicit drug concentrations in waste water reflects high drug use in the population producing the waste.Their full text manuscript can be accessed by clicking on the PMID link below. But for the few lazy readers of my blog here are the five highest ranked European cities by the five illicit drug classes. This list is produced by me through the precise method known as "eyeballing" from charts in the manuscript. Countries are listed after municipalities where waste water was sampled when city first makes a list.CannabisAmsterdam, NetherlandsParis, FranceNovisad, SerbiaAntwerp, BelgiumUtrecht, NetherlandsAmphetaminesEindhoven, NetherlandsAntwerpGothenburg, SwedenNinove, BelgiumHelsinki, FinlandMethamphetaminePrague, Czech RepublicBudweis, Czech RepublicOslo, NorwayBratislava, SlovakiaDresden, GermanyCocaineAntwerpLondon, EnglandZurich, SwitzerlandAmsterdamBarcelona, SpainMDMA (Ecstasy)EindhovenUtrechtAmsterdamAntwerpZurich/Barcelona (Eyeball tie)The authors note their findings for the prevalence of illicit drugs in wastewater generally match regional prevalence estimates for drug use using other methods.They note wastewater samples can be done by day of the week to follow chronological patterns of drug use (no surprise levels of drugs in wastewater samples are higher on the weekend). Additionally, this approach may be a valuable secondary source of trends in regional drug use over longer periods such as years.  I found the differences in metabolite rankings for amphetamine versus methamphetamine interesting. The methamphetamine rank list is made up of more cities with lower per capita incomes. This suggests possible local production of methamphetamine while amphetamine is more likely diverted from pharmaceutical grade manufacture.This study did not include samples from the U.S., South America, Japan, China or Russia so it only reflects the cities listed in the methods section of the paper. Again, click on the citation PMID link below if you are interested in getting into more detail of this study. I would be interested in any comments from readers in Europe on whether these results seem valid.Image is from a Wikipedia Commons file showing tablets of ecstasy (MDMA) from a public domain file produced by the U.S. DEA.Follow the author on Twitter WRY999Ort C, van Nuijs AL, Berset JD, Bijlsma L, Castiglioni S,... Read more »

Ort C, van Nuijs AL, Berset JD, Bijlsma L, Castiglioni S, Covaci A, de Voogt P, Emke E, Fatta-Kassinos D, Griffiths P.... (2014) Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis. Addiction (Abingdon, England), 109(8), 1338-52. PMID: 24861844  

  • December 15, 2014
  • 05:45 AM
  • 120 views

Malocclusion, orthodontics and quality of life

by Kevin OBrien in Kevin OBrien's Orthodontic Blog

Malocclusion, orthodontics and quality of life? One of the most important areas of orthodontic research that needs to be carried out is to clearly identify the effects of treatment. I have highlighted this in previous posts on the “the great unanswered questions” and “papers that have influenced me”. When we consider this area, I feel […]
The post Malocclusion, orthodontics and quality of life appeared first on Kevin O'Brien's Orthodontic Blog.
... Read more »

  • December 15, 2014
  • 04:45 AM
  • 147 views

Rates of medical illnesses in bipolar disorder

by Paul Whiteley in Questioning Answers

I've mentioned a few times on this blog that a diagnosis of autism or autism spectrum disorder (ASD) is by no means protective against any other diagnosis being received, be it based on a somatic illness or condition, or something more behaviourally defined.Reading through the paper by Liz Forty and colleagues [1] (open-access) it appears that a similar scenario might also pertain to other behaviourally-defined conditions as per the example of bipolar disorder (BD) and their conclusion: "Bipolar disorder is associated with high rates of medical illness."If I had a world of my own, everything would be nonsenseI was drawn to discuss this paper for a few reasons. First and foremost is the idea that a psychiatric diagnosis may actually place a person 'at risk' of a few important comorbidities above and beyond the presentation of their behavioural symptoms. We seem to be in an unfortunate situation these days that receipt of a psychiatric diagnosis seems to lead to a severe lack of appreciation that other symptoms or ailments of a more physical nature can also be present. Take for example the health inequalities which seem to be springing up as and when a diagnosis of schizophrenia is received (see here) and coincidentally in the same journal as the Forty paper, the study results from Mike Crawford and colleagues [2] concluding: "Assessment and treatment of common physical health problems in people with schizophrenia falls well below acceptable standards." Another reason I want to talk about the Forty paper is the fact that bipolar disorder (previously referred to as manic depression) has been described as occurring 'quite frequently' with regards to at least one part of the autism spectrum (see here). What this might suggest is that a co-occurrence of BD and something like Asperger syndrome might mean that said medical illness/conditions reported to be raised in BD would also be raised in BP + Asperger syndrome.The Forty paper is open-access but a few pointers might be useful...Based on quite an impressive participant number (N=1720) diagnosed with bipolar disorder, lifetime rates of self-reported medical illnesses were compared with data derived from participants diagnosed with unipolar depression (N=1737) and asymptomatic controls (N=1340) (both previously described in other work from some of the authors [3]).Participants were quizzed - yes, no or uncertain - over whether any of 20 health conditions had been diagnosed by a health professional including: "asthma, cancer, diabetes type 1, diabetes type 2, elevated lipids/high cholesterol, epilepsy, gastric ulcers, heart disease, hypertension, kidney disease, liver disease, memory loss/dementia, migraine headaches, multiple sclerosis, osteoarthritis, osteoporosis, Parkinson’s disease, rheumatoid arthritis, stroke, thyroid disease." All the 'uncertain' codings were "excluded from analyses for that medical illness".Results: "The most prevalent medical conditions in the bipolar sample were migraine headache (23.7%), asthma (19.2%), elevated lipids (19.2%), hypertension (15%), thyroid disease (12.9%) and osteoarthritis (10.8%)." Quite a few of these conditions were significantly more frequently reported in cases of BD over control groups (see Figure 1 here). I'll in particular highlight the findings for asthma and thyroid disease as being more commonly reported in the BD group.Authors also divided the BD group up into subgroups (BD1 and BD2) based on the severity of manic episodes, and reported that: "The rates of gastric ulcers, heart disease, Parkinson’s disease and rheumatoid arthritis were significantly higher in the bipolar II group." They also found that several variables seemed to be linked to an increased medical illness burden including: "a longer illness duration, a typically acute onset of mood episodes, a greater number of psychiatric in-patient admissions, deterioration in functioning, increased rates of anxiety disorder, suicide attempt, rapid cycling, and treatment with anxiolytics, mood stabilisers and electroconvulsive therapy (ECT)." Some of these variables also predicted the high medical illness burden group too.Reiterating the authors' sentiments about the need for such medical comorbidity to be taken into account by healthcare professionals "in order to improve outcomes for patients with bipolar disorder" these are important results. Assuming that there may be shared/overlapping genetic or biological mechanisms at work which influence risk of BD and also such medical comorbidity, one might think that future work would take this into account when looking at the possible underlying aetiology of BD. Such work might also accept the heterogeneity noted in BD as per similar sentiments when it comes to conditions like 'the autisms' (see here) and 'the schizophrenias' (see here).Asthma has been highlighted from the Forty results on the basis of the condition already showing something of an interesting 'link' with conditions like autism and attention-deficit hyperactivity disorder, ADHD (see here). Indeed, data from Taiwan (yes, further interrogation of the Taiwan National Health Insurance Research Database) concluded that a diagnosis of asthma might increase the risk of subsequent mood disorders (including BD) later in life [4]. Forty et al suggested that of the possible reasons why asthma might be more frequently present in BD "carbon dioxide hypersensitivity and corticosteroid therapy may partly explain this association." I'd be perhaps inclined to add that other [speculative] work looking at the link between autism and asthma for example, might also offer another potential explanation [5].Thyroid disease was also plucked out from the Forty data. The reason: some interesting data previously covered on this blog talking about autoimmune thyroiditis and various types of depression (see here). I'm not by the way saying that every case of thyroid disease in BD is due to such an autoimmune pathology, but as per other discussions, there might be quite a bit more to see when it comes to immune system function and behavioural and/or psychiatric diagnoses. At the very least, testing for said autoimmune issues might be considered for some.There is little more for me to say on this subject matter. This is by no means the first time that medical comorbidity has been linked to BD [6] and even more widely depression [7] and I very much doubt it will be the last. If there are lessons to be learned from this area of investigation, the primary one must be to look at mind and body when it comes to diagnosing and managing psychiatric issues such as bipolar disorder as per other examples.Oh, and I wonder if this would be a good time to introduce ... Read more »

Forty L, Ulanova A, Jones L, Jones I, Gordon-Smith K, Fraser C, Farmer A, McGuffin P, Lewis CM, Hosang GM.... (2014) Comorbid medical illness in bipolar disorder. The British journal of psychiatry : the journal of mental science. PMID: 25359927  

  • December 15, 2014
  • 02:31 AM
  • 142 views

Treatment for Elderly with Breast Cancer May Not Be as Effective

by Wiley Asia Blog in Wiley Asia Blog - Health Sciences

A new analysis has found that while clinical trial data support omitting radiation treatments in elderly women with early stage breast cancer, nearly two-thirds of these women continue to receive it. The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society.

Results published in 2004 from a large, randomized clinical trial showed that adding radiation therapy to surgery plus tamoxifen does not reduce 5-year recurrence rates or prolong survival in elderly women with early stage tumors. Despite the findings, many doctors still administer radiation to these patients.... Read more »

  • December 14, 2014
  • 01:28 PM
  • 184 views

Scientists find a drug (currently used) to turn white fat to brown

by Dr. Jekyll in Lunatic Laboratories

It seems like we’ve been on a weight loss campaign here at the labs, but there just has been so much new and interesting research on the subject to report on, this is no exception. Researchers have uncovered the mechanism by which white fat cells from humans (an important distinction) gets reprogrammed to become browner.... Read more »

Anne Loft, Isabel Forss, Majken Storm Siersbæk, Søren Fisker Schmidt, Ann-Sofie Bøgh Larsen, Jesper Grud Skat Madsen, Didier F. Pisani, Ronni Nielsen, Mads Malik Aagaard, Angela Mathison.... (2014) Browning of human adipocytes requires KLF11 and reprogramming of PPARγ superenhancers. Genes . info:/10.1101/gad.250829.114

  • December 14, 2014
  • 04:48 AM
  • 149 views

Beware the inflated science related press release!

by Paul Whiteley in Questioning Answers

I'm not normally minded to post on a Sunday (day of rest and all that) but I did want to bring your attention to the results presented by Petroc Sumner and colleagues [1] (open-access) concluding that: "Exaggeration in news is strongly associated with exaggeration in press releases" when it comes to the media reporting of [some] health-related science news.The idea behind this particular study - which has been summarised pretty well in some of the accompanying media and in an editorial in the publishing journal [2] - was to look at the contribution of the press release (the 'look at me' part of some science publishing) to those sometimes 'inflated' health science headlines which we all encounter on a day-to-day basis. The results suggested that whilst [some] journalists and editors might need a refresher course on some of the basics of science (including the concept of probability and risk), academic press offices and even the very academics behind said research might also have to shoulder some responsibility (bearing in mind correlation is not the same as causation!) So when for example, a mouse study correlating the presence of compound X with improvement in the [mouse] condition Y is interpreted as meaning that compound X is the elixir of life for Homo sapiens and that we should instantly rush out and buy as much of it as we can afford, look to the press release before blaming the newspaper. I exaggerate of course with that example.So as not to keep you from your Sunday breakfast or that magnificent Sunday lunch you no doubt have planned/are eating, I'm not going to say much more about this topic aside from making two additional points:(a) Post-publication peer-review is mentioned somewhere in one of the texts. Although this is traditionally meant to imply that researchers who have a beef about some study or interpretation of results send a letter to the publishing (or other) journal outlining their issues, there are quite a few other mediums these days which seem to get the job done just as well. You are reading one of those mediums - yes, bloggers of the world unite - and how on occasion, blog entries have talked about press releases and peer-reviewed results not quite tallying together. I dare say someone somewhere might eventually start a blog titled something like: 'pressing ahead: press release vs. actual results' if it hasn't already been done. Other social media might also play an important role in highlighting discrepancies.(b) Although interesting, the Sumner results perhaps leave out one very important variable in this scientific producer - consumer relationship: the consumer. You might well scoff that anyone without a PhD or related qualification 'doesn't understand science' but I would say that you are wrong. Although there are people out there who actually believe the term 'scientifically proven', as if God himself endorsed the product, I'd suggest that there are enough people who don't believe every headline they read and are vocal enough to say so. Search engines such as Google do a pretty good job of ensuring that anyone researching a scientific claim important to them (which most people do these days) quickly get both sides of the story. In that respect, an inflated press release (which are also generally detectable on the web) will probably not stay inflated for too long. Probably less so, after this and other research [3] starts to percolate through the web...Without further ado, I'll leave you to finish of your 'super-food' packed Sunday lunch. And just in case anyone is interested, a few things to bear in mind when reading and interpreting science...----------[1] Sumner P. et al. The association between exaggeration in health related science news and academic press releases: retrospective observational study. BMJ 2014; 349: g7015.[2] Goldacre B. Preventing bad reporting on health research. BMJ 2014; 349: g7465.[3] Woloshin S. et al. Press releases by academic medical centers: not so academic? Ann Intern Med. 2009 May 5;150(9):613-8.----------Sumner, P., Vivian-Griffiths, S., Boivin, J., Williams, A., Venetis, C., Davies, A., Ogden, J., Whelan, L., Hughes, B., Dalton, B., Boy, F., & Chambers, C. (2014). The association between exaggeration in health related science news and academic press releases: retrospective observational study BMJ, 349 (dec09 7) DOI: 10.1136/bmj.g7015... Read more »

  • December 13, 2014
  • 01:51 PM
  • 187 views

High fat diet leads to brain inflammation and obesity

by Dr. Jekyll in Lunatic Laboratories

The stomach strikes again, or so it seems. We’ve already covered how your stomach seemingly controls your brain and your blood-brain barrier, but now it seems that what you eat –not too indirectly related to your stomach– might make you fatter, but not in the way you might be thinking thinking. What you are eating may be causing inflammation in the brain.... Read more »

  • December 13, 2014
  • 11:56 AM
  • 172 views

Animal Research Sheds Light on Harmful Mood Disorders in New Mothers

by Wiley Asia Blog in Wiley Asia Blog - Social Science

In the days shortly after giving birth, most mothers experience a period of increased calmness and decreased stress responses, but around 20% of mothers experience anxiety. Some women may become depressed, and around one in a thousand can develop psychosis. The latest evidence indicates that these distressing responses to motherhood are still poorly understood, but that animal research could provide valuable clues to their causes.

Writing in the British Journal of Pharmacology, Dr David Slattery and Dr Clara Perani highlight that anxiety, depression and psychosis during this ‘postpartum’ period of life not only affect the well-being of the mother but also place at risk the long-term health of the infant. Infant care and bonding can also be altered, which in turn may lead to long-term behavioural and emotional problems for the child.... Read more »

Perani, C., & Slattery, D. (2014) Using animal models to study post-partum psychiatric disorders. British Journal of Pharmacology, 171(20), 4539-4555. DOI: 10.1111/bph.12640  

  • December 13, 2014
  • 05:19 AM
  • 151 views

Social communication disorder (SCD) reviewed

by Paul Whiteley in Questioning Answers

Sometimes I believe in as many as six impossible things before breakfast.A micropost if you will, for today, and a link to a potentially very important paper by Lauren Swineford and colleagues [1] (open-access) talking about the diagnostic concept: social (pragmatic) communication disorder (SCD) and it's various crossings with language impairments and autism spectrum disorder (ASD).SCD, as I've indicated in other posts (see here and see here) is something that the autism community in particular, is going to be hearing a lot more about in the coming years, derived from the latest DSM-5 schedule.Just one choice quote to offer from the Swineford paper: "Evidence of SCD was provided in the DSM-5 field trials, which indicated that a decrease in DSM-IV ASD diagnoses was accounted for by movement to SCD diagnostic category." Yes, it appears that this is already happening...Some music then... Johnny Marr - Getting Away With It.----------[1] Swineford LB. et al. Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category. Journal of Neurodevelopmental Disorders 2014, 6:41.----------Swineford, L., Thurm, A., Baird, G., Wetherby, A., & Swedo, S. (2014). Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category Journal of Neurodevelopmental Disorders, 6 (1) DOI: 10.1186/1866-1955-6-41... Read more »

  • December 12, 2014
  • 10:35 PM
  • 208 views

Guns And Controllers: Do Violent Video Games Cause Aggressive Behaviour? A Review Of Meta-Analytic Research

by Alexis Delanoir in How to Paint Your Panda

There is a lot of debate over whether or not violent video games manifest in violent behaviour. Consensus has not entirely been reached, but some suggest that the literature provides solid evidence for the hypothesis in question. In this post I examine meta-analytic reviews of the literature and weigh their significance, coming to the conclusion that violent video games most likely do cause aggressive behaviour and other negative social outcomes.... Read more »

  • December 12, 2014
  • 12:37 PM
  • 181 views

Long Sperm Are Winners

by Elizabeth Preston in Inkfish



It's tough to be sperm. Your entire existence centers on one race that you will almost definitely lose. You don't even get to take a warmup lap. Nevertheless, a glance at your competitors waiting at the starting line might give you some hints about who has an advantage. One factor that helps sperm win races is length—and not only for the reasons you might guess.

Long sperm generally have longer tails. This ought to make them faster and more powerful swimmers, which studies have confirmed.... Read more »

Clair Bennison, Nicola Hemmings, Jon Slate, & Tim Birkhead. (2014) Long sperm fertilize more eggs in a bird. Proceedings of the Royal Society B: Biological Sciences. info:/10.1098/rspb.2014.1897

  • December 11, 2014
  • 08:27 PM
  • 183 views

Depression And Stress/Mood Disorders: Causes Of Repetitive Negative Thinking And Ruminations

by Alexis Delanoir in How to Paint Your Panda

Repetitive Negative Thinking (RNT) has been suggested to be of clinical significance as a transdiagnostic process. Research has been conducted to explain the causes of RNT and ruminations but is limited. This article explores the causes and possible solutions to RNT, as well as its clinical implications concerning mood and stress disorders such as major depressive disorder (MDD).... Read more »

Ehring, T., & Watkins, E. (2008) Repetitive Negative Thinking as a Transdiagnostic Process. International Journal of Cognitive Therapy, 1(3), 192-205. DOI: 10.1680/ijct.2008.1.3.192  

Gibb, B., Grassia, M., Stone, L., Uhrlass, D., & McGeary, J. (2011) Brooding Rumination and Risk for Depressive Disorders in Children of Depressed Mothers. Journal of Abnormal Child Psychology, 40(2), 317-326. DOI: 10.1007/s10802-011-9554-y  

  • December 11, 2014
  • 07:14 PM
  • 147 views

Chronic fatigue syndrome by ASIA?

by Paul Whiteley in Questioning Answers

Unicorns, I love them. Unicorns, I love them. ASIA, in the context of this post, does not refer to the continent but rather the suggestion of an: ‘autoimmune (auto-inflammatory) syndrome induced by adjuvants’ and some potentially contentious findings reported by Nancy Agmon-Levin and colleagues [1].Describing a small cohort of participants diagnosed with chronic fatigue syndrome (CFS) and/or fibromyalgia (FM), the authors put forward the idea that "some cases CFS and FM can be temporally related to immunization, as part of ASIA syndrome", more specifically following hepatitis B vaccination (HBVv). They report on a latency period (the interval between exposure and clinical appearance of symptoms) ranging "from days to a year" with a mean temporal period of around 38 days. They also report specific manifestations of symptoms (neurological, fatigue, muscoskeletal and gastrointestinal) and importantly that: "Autoantibodies were detected in 71 % of patients tested". Autoantibodies by the way, refers to antibodies against self tissue as per what has been noted in various autoimmune conditions/diseases. The authors conclude: "ASIA criteria were fulfilled in all patients eluding the plausible link between ASIA and CFS/FM."OK. There are a few words of caution that one needs to exercise with this kind of work before anyone gets too enthusiastic. This was an information-gathering study, so authors were specifically describing their cohort of participants "following HBVv immunization". There were no control groups, so one also needs to be aware of that.A quick trawl of the other research literature on the topic of ASIA reveals however that this is not the first time that this concept has cropped up in the peer-reviewed science sector. Shoenfeld &Agmon-Levin [2] (the same authors on the current paper) first advanced the concept of ASIA or [Yehuda] Shoenfeld's syndrome a few years back. Based on the examination of four conditions: "siliconosis, the Gulf war syndrome (GWS), the macrophagic myofasciitis syndrome (MMF) and post-vaccination phenomena" they concluded that some commonalities were present and ASIA was born. An editorial accompanying their paper [3] kinda said it all: "It is an intriguing issue and one that is likely to be provocative and lead to further biologic and molecular investigations". I might also direct you to other discussions titled: What is ASIA?Since then, a number of articles have appeared discussing ASIA / Shoenfeld's syndrome. Bassi and colleagues [4] reported findings involving a mouse model of lupus - "a lupus-prone murine model" - injected with complete Freund's adjuvant (CFA) (an immunostimulant). They reported that: "the injection of CFA in NZB/NZWF1 mice accelerated autoimmune manifestations resembling 'ASIA' syndrome in humans." A more thorough review of the animal model findings can be found in the article by Cruz-Tapias and colleagues [5].The types of adjuvant noted as being potentially connected to ASIA have also been discussed, as per the article by Vera-Lastra and colleagues [6]. Squalene, aluminum hydroxide and silicone are mentioned. Squalene with regards to Gulf-War syndrome was something which particularly stuck out to me given my previous interest in this collection of symptoms present for some post Operation Desert Storm (see here). Although the source of some speculation, papers such as the one from Pamela Asa and colleagues [7] noting that squalene antibodies were linked to the "majority of symptomatic GWS patients" is an interesting finding. For balance, I will also refer you to the paper by Lippi and colleagues [8] standing up for squalene.The paper from Perricone and colleagues [9] (open-access) brings us back to the involvement of ASIA in the 'mosaic of autoimmunity' and how genetics and environment might merge. The discussions move into various areas including that of anti-phospholipid syndrome (Hughes syndrome) as well as other well-known autoimmune areas (e.g. coeliac disease). Connective tissues disorders also discussed in the Perricone paper also bring in one reason why hepatitis B vaccine was also considered in the starting paper in question, as per the report by Perricone and Shoenfeld [10] and their discussions on hepatitis B vaccine and 'undifferentiated connective tissue disease' as being: "Another brick in the wall of the.. ASIA". Further research has added to such sentiments [11].As things stand with the body of research detailing ASIA, I don't think that this is a concept we can readily discard as being potentially real and relevant to at least some clinical presentation potentially including CFS/FM. I know to talk adverse effects from vaccination, or their adjuvants, can stir up some heated discussions in some quarters (see here) but even in contentious areas covering something like autism or autistic presentation, science might still have a role to play [12]. I say this reiterating the important value of vaccination as per this CDC infographic.This is also the second time that I've talked about vaccination and autoimmunity as potentially being linked on this blog as per another contentious paper in another contentious area (see here). It strikes me that there is quite a bit more to do in looking at any possible connection, particularly when one considers that ASIA has been similarly discussed (albeit in case studies) with other biologics in mind [13].Music: The Ragtime Gals and a certain celebrity..----------[1] Agmon-Levin N. et al. Chronic fatigue syndrome and fibromyalgia following immunization with the hepatitis B vaccine: another angle of the 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' (ASIA). Immunol Res. 2014 Nov 27.[2] Shoenfeld Y. & Agmon-Levin N. 'ASIA' - autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun. 2011 Feb;36(1):4-8.[3] Meroni PL. Autoimmune or auto-inflammatory syndrome induced by adjuvants (ASIA): old truths and a new syndrome? J Autoimmun. 2011 Feb;36(1):1-3.[4] Bassi N. et al.... Read more »

  • December 11, 2014
  • 12:31 PM
  • 132 views

Kidney Donors Over 60 Have Good Recipient Results

by Cristy at Living Donor 101 in Living Donors Are People Too

A single transplant center analysis of 181 living kidney donors categorized by age revealed that “donor age…was not a risk factor for patient or graft survival”. The death-uncensored graft survival rates in the 3 subgroups (.39; 40-59; 60+) were 64.5%, 76.0% and 90.9%, respectively, whereas their mean estimated glomerular filtration rates 1 year after transplantation were 40.7 …
Continue reading »
The post Kidney Donors Over 60 Have Good Recipient Results appeared first on Living Donors Are People Too.
... Read more »

  • December 11, 2014
  • 12:08 PM
  • 159 views

What makes us fat, OR food vs. physiology

by Dr. Jekyll in Lunatic Laboratories

There is a heir of mystery surrounding weight loss and fat in general. Have you ever heard you have all the fat cells you’ll ever have — that’s false by the way. Then there is fad diets like gluten free — proven to do nothing unless you actually have a diagnosed gluten allergy — or adkins, but now researchers believe they’re on track to solve the mystery of weight gain – and it has nothing to do with indulging in holiday eggnog.... Read more »

Woeller CF, O'loughlin CW, Pollock SJ, Thatcher TH, Feldon SE, & Phipps RP. (2014) Thy1 (CD90) controls adipogenesis by regulating activity of the Src family kinase, Fyn. FASEB journal : official publication of the Federation of American Societies for Experimental Biology. PMID: 25416548  

  • December 11, 2014
  • 05:09 AM
  • 130 views

Low bone mineral density and non-coeliac gluten sensitivity and autism?

by Paul Whiteley in Questioning Answers

"An elevated frequency of bone mass loss in NCWS [non-celiac wheat sensitivity] patients was found; this was related to low BMI [body mass index] and was more frequent in patients with NCWS associated with other food sensitivity".There is no Easter Bunny. There is no Tooth Fairy. There is no Queen of England.That was the conclusion reached by Antonio Carroccio and colleagues [1] (open-access) looking at a small group of participants diagnosed with something which seems to fall into a growing spectrum of gluten-related conditions (gluten being the protein found in various cereal crops). The eagle-eyed out there will have spotted how the authors talk about non-celiac 'wheat' sensitivity over and above non-celiac gluten sensitivity as per the idea that: "it is not known what component of wheat causes the symptoms in NCGS patients".Whilst interesting results, I was actually more intrigued at their possible implications for something like parts of the autism spectrum, on the back of other peer-reviewed research on a possible link with gluten/wheat. I'll take you back to the paper by Ludvigsson and colleagues [2] - discussed in this post - as a starting point and the idea that something not-quite-coeliac-disease (the archetypal autoimmune gluten related condition) might be linked to some cases of autism. The paper by Caio and colleagues [3] (see this post) then suggested that for those presenting with anti-gliadin antibodies as part of NCGS, the use of a gluten-free diet might help dissipate said antibodies, which although not specific to such a scenario with autism in mind, was potentially 'transferable' in light of gluten antibodies being reported in some autism.Low bone mineral density talked about in the Carroccio paper as being potentially linked to NCWS (or NCGS if you so wish) is also something that has been discussed with autism in mind down the years. I've covered a few papers in this area on this blog, most notably the paper from Hediger and colleagues [4] (see here for the blogpost) and the paper by Neumeyer and colleagues [5] (see here for my take) which indicated that bone mineral density might be lower in cases of autism. Although the gluten (and casein) free diets have been 'blamed' for these results, it appears that nutritional deficiency related to such dietary interventions might not be as serious as some would lead us to expect. If you don't believe me, take a look at my discussion of some peer-reviewed work in this area. The idea also that vitamin D might be lower in quite a few cases of autism is also worthwhile mentioning too bearing in mind the connection between calcium, vitamin and 'strong bones'. Exercise as also playing a role in good bone health also comes into view with autism too.Marrying the two area together - NCGS and low bone mineral density - with a perspective on at least some autism, may then not seems as outlandish as you might think. Carroccio et al suggest "the role of malnutrition seems very important in our study group" based on their BMI findings. Further they suggest that: "Dietary support should be strongly recommended at the time of NCWS diagnosis, whatever is its pathogenesis." BMI is a bit of mixed bag when it comes to autism as per some of my own work in this area [6] but I'd struggle to argue with their suggestion of appropriate dietary support as and when something like NCGS (or NCWS) is detected on top of a diagnosis of autism.And then there's gut permeability issues to also consider...Music: Katie Melua - The Flood.----------[1] Carroccio A. et al. Risk of low bone mineral density and low body mass index in patients with non-celiac wheat-sensitivity: a prospective observation study. BMC Med. 2014 Nov 28;12(1):230.[2] Ludvigsson JF. et al. A Nationwide Study of the Association Between Celiac Disease and the Risk of Autistic Spectrum Disorders. JAMA Psychiatry. 2013. Sept 25.[3] Caio G. et al. Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity. BMC Gastroenterol. 2014 Feb 13;14(1):26.[4] Hediger ML. et al. Reduced bone cortical thickness in boys with autism or autism spectrum disorder. J Autism Dev Disord. 2008 May;38(5):848-56.[5] Neumeyer AM. et al. Bone density in peripubertal boys with autism spectrum disorders. J Autism Dev Disord. 2013 Jul;43(7):1623-9.[6] Whiteley P. et al. Body mass index of children from the United Kingdom diagnosed with pervasive developmental disorders. Pediatr Int. 2004 Oct;46(5):531-3.----------Carroccio A, Soresi M, D Alcamo A, Sciumè C, Iacono G, Geraci G, Brusca I, Seidita A, Adragna F, Carta M, & Mansueto P (2014). Risk of low bone mineral density and low body mass index in patients with non-celiac wheat-sensitivity: a prospective observation study. BMC medicine, 12 (1) PMID: 25430806... Read more »

  • December 10, 2014
  • 04:51 PM
  • 149 views

Worms’ “mental GPS” could help improve mental health

by Dr. Jekyll in Lunatic Laboratories

Imagine this, you’ve misplaced your cell phone. You start by scanning where you remember leaving it: on your bureau. You check and double-check the bureau before expanding your search around and below the bureau. Eventually, you switch from this local area to a more global one, widening your search to the rest of your room and beyond.... Read more »

Adam J Calhoun, Sreekanth H Chalasani, Tatyana O Sharpee. (2014) Maximally informative foraging by Caenorhabditis elegans. eLife. info:/http://dx.doi.org/10.7554/eLife.04220#sthash.lVQ5aANV.dpuf

  • December 10, 2014
  • 03:54 PM
  • 187 views

Depressed? Laughing gas might help

by Dr. Jekyll in Lunatic Laboratories

Nitrous oxide, or laughing gas, has shown early promise as a potential treatment for severe depression in patients whose symptoms don’t respond to standard therapies. In other words, it might actually live up to it’s name and as they say laughter is the best medicine. The pilot study is believed to be the first research in which patients with depression were given laughing gas.... Read more »

Nagele P, Duma A, Kopec M, Gebara MA, Parsoei A, Walker M, Janski A, Pahagopoulos VN, Cristancho P, Miller JP, Zorumski CF, Conway C . (2014) Nitrous oxide for treatment-resistant major depression: a proof-of-concept trial. Biological Psychiatry. DOI: http://dx.doi.org/10.1016/j.biopsych.2014.11.016  

  • December 10, 2014
  • 11:46 AM
  • 129 views

Prescription Opiate Abuse: High-Risk Populations

by William Yates, M.D. in Brain Posts

Prescription opiate abuse is a significant problem in the United States.I have previously written about this issue in several previous posts.One important factor for clinicians and patients is the need to identify high-risk populations that may be more vulnerable to opiate abuse and dependence.One obvious group would be those with alcohol or another non-opiate abuse diagnosis. Additionally, some psychiatric disorders are associated with increased risk for substance abuse including opiate abuse.Given these high-risk markers, it would be encouraging if there would be evidence prescription opiate use is limited in those with substance abuse or a primary psychiatric disorder.Unfortunately, there is not much evidence for restriction of opiate prescribing in high-risk populations.Daniel Hackman and colleagues found the opposite finding in a study of patients with a substance abuse or primary psychiatric diagnosis in a dual diagnosis clinic.Patients (N=201) in this clinic had prescription drug use reviewed for a period of 12 months and found the following key findings:Subjects received an average of 4.0 prescriptions for an opiate by medical personnel not associated with the dual diagnosis clinicThese prescriptions resulted in the dispensing of an average of 213 opioid pillsConcurrent benzodiazepine prescriptions were also common in this populationMedicare or Medicaid coverage was associated with higher rates of opiate prescription compared to patients without insurance coverageThere are several take-home messages from this study.First, some high-risk populations for opiate abuse seem to be more likely to get prescription opiates from a medical provider. From the current study, it does not appear clinicians are restricting prescription opiates to those most likely to misuse or abuse these drugs.Second, concurrent benzodiazepine and opiate prescription use is common in this dual diagnosis group. This is important because accidental overdose deaths commonly find the combination of opiates and benzodiazepines in toxicology analysis.I am not suggesting that no legitimate reasons exist for careful opiate prescription use for the treatment of pain in those with a dual diagnosis. However, this population needs to be carefully assessed and monitored when prescribing opiates in the clinical setting.Readers with more interest in this topic can access the free full-text manuscript by clicking on the PMID link in the citation below.Photo of a tiger from the San Antonio zoo is from the author's files.Follow the author on Twitter WRY999Hackman DT, Greene MS, Fernandes TJ, Brown AM, Wright ER, & Chambers RA (2014). Prescription drug monitoring program inquiry in psychiatric assessment: detection of high rates of opioid prescribing to a dual diagnosis population. The Journal of clinical psychiatry, 75 (7), 750-6 PMID: 25093472... Read more »

  • December 10, 2014
  • 11:06 AM
  • 159 views

Incentives in the Treatment of Cocaine Dependence

by William Yates, M.D. in Brain Posts

Relapse rates are high in treatment samples of adults with cocaine dependence.Cognitive behavioral therapy (CBT) is a common standard of care for cocaine dependence.A recent clinical trial from Switzerland examined the use of financial prize incentives to augment standard CBT in the treatment of cocaine dependence.Sixty subjects participated in this trial with the following inclusion criteria: least 18 years of age, had a DSM-IV diagnosis of cocaine dependence with at least one positive cocaine urine drug screen at baseline.Exclusion criteria included: current psychotic disorder, current severe alcohol or benzodiazepine dependence, serious medical illness, pathological gambling, language impairment, methylphenidate use and active homelessness.All subjects received 18 manual-based CBT sessions over 24 weeks targeted towards a goal of cocaine abstinence.Half of the subjects received an additional treatment intervention labelled prize-based contingency management: Subjects with cocaine negative urine samples (taken twice weekly in weeks 1-12 and weekly during weeks 13-24) were eligible to earn prizesPrizes were determined from a patient drawing from 500 chips in a bowl250 chips were non-winners219 had a value of $2 traded for food or hygiene rewards30 had a value of $20 with a voucher for prizes in this price rangeOne jumbo prize valued at $500 was present and could be traded for a television or vacation prizeInterestingly, the number of chips that was drawn started at one with the first cocaine free drug sample and increased by one with each consecutive negative sample up to a maximum of 15 chips.Subjects relapsing after a period of abstinence returned to a one chip reward restart with the next clean urine sample.The study failed to find a large statistically significant effect for the addition of prize-based contingency management.However, those in the prize-based contingency management group had higher rates of clean urine samples beginning at weeks 8, 9 and 10 as well as several other later time points.Additionally, the prize group had higher cocaine clean urine rates at 6 months follow up (66% vs 45%) although this did not reach statistical significance.One issue with this study is the small sample size with limited power to detect clinically significant differences between treatment. The trend for improvement with adding the prize intervention suggests the potential merit of conducting a similar study using larger samples, possibly in several settings and nations.The authors note the cost for the incentives in their design averaged $576 over the 24 week study. This additional cost is non-trivial and will need to be examined in larger samples.Readers with more interest in this clinical trial can access the free full-text manuscript by clicking on the free full-text link in the PMID link below.Photo of fall foliage is from the author's files and includes Google plus enhancement.Follow the author on Twitter WRY999.Petitjean SA, Dürsteler-MacFarland KM, Krokar MC, Strasser J, Mueller SE, Degen B, Trombini MV, Vogel M, Walter M, Wiesbeck GA, & Farronato NS (2014). A randomized, controlled trial of combined cognitive-behavioral therapy plus prize-based contingency management for cocaine dependence. Drug and alcohol dependence, 145C, 94-100 PMID: 25456571... Read more »

Petitjean SA, Dürsteler-MacFarland KM, Krokar MC, Strasser J, Mueller SE, Degen B, Trombini MV, Vogel M, Walter M, Wiesbeck GA.... (2014) A randomized, controlled trial of combined cognitive-behavioral therapy plus prize-based contingency management for cocaine dependence. Drug and alcohol dependence, 94-100. PMID: 25456571  

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