Medicine posts
- April 18, 2010
- 02:51 PM
- 597 views
If You're Going to Taser a Sheep, at Least Do It Right!
by Isis the Scientist in On Becoming a Domestic and Laboratory Goddess...
On Friday I read with interest a post written by my dear SciBling DrugMonkey conducted by the folks at TASER International on the effects of the TASER on anesthetized, methamphetamine-intoxicated sheep. The TASER is a device used by law enforcement agents that uses an electrical shock to disrupt neuromuscular function and immobilize suspects.
Figure 1: The multi-shot TASER X3.According to Dr. Monkey, in this study (1), The study was conducted in Dorset sheep who were [isoflurane] anesthetized,
and administered 0, 0.5, 1.0 or 1.5 mg/kg of methamphetamine HCl
(curiously from dissolved Desoxyn, the approved pharmaceutical product)
in an IV infusion. The drug treatment was a between subjects factor (N=4
per group) and animals were monitored for "continuous blood
pressure, heart rhythm (one-lead), pulse oximetry, and capnography...
Arterial blood sampling was performed at baseline, 30 minutes after the
administration of the methamphetamine, and after each exposure from a
TASER X26".The authors looked at the number of sheep that developed abnormal heart rhythms from exposure to the TASER both with and without pre-intoxication with methamphetamine. They conclude that in small animals TASER exposure worsens the cardiac irritability induced by methamphetamine intoxication, but
that this is not seen in adult animals. DrugMonkey points out the need for these types of studies. Indeed, an article in the International Journal of Cardiology states: Read the rest of this post... | Read the comments on this post...... Read more »
Cevik, C., Otahbachi, M., Miller, E., Bagdure, S., & Nugent, K. (2009) Acute stress cardiomyopathy and deaths associated with electronic weapons. International Journal of Cardiology, 132(3), 312-317. DOI: 10.1016/j.ijcard.2008.12.006
Dawes, D., Ho, J., Cole, J., Reardon, R., Lundin, E., Terwey, K., Falvey, D., & Miner, J. (2010) Effect of an Electronic Control Device Exposure on a Methamphetamine-intoxicated Animal Model. Academic Emergency Medicine, 17(4), 436-443. DOI: 10.1111/j.1553-2712.2010.00708.x
- April 16, 2010
- 11:23 AM
- 956 views
Managing Multiple Myeloma: turning an acute cancer into a chronic disease
by Sally Church in Pharma Strategy Blog
The other day while travelling home on a long train journey, I was browsing the NY Times app on my iPhone and came across an interesting story about multiple myeloma in the Health section: "For many patients with cancers like...... Read more »
Kumar, S., Mikhael, J., Buadi, F., Dingli, D., Dispenzieri, A., Fonseca, R., Gertz, M., Greipp, P., Hayman, S., Kyle, R.... (2009) Management of Newly Diagnosed Symptomatic Multiple Myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines. Mayo Clinic Proceedings, 84(12), 1095-1110. DOI: 10.4065/mcp.2009.0603
- April 16, 2010
- 02:02 AM
- 732 views
Friday Weird Science: Smells Fishy? Check your semen.
by Evil Monkey in Neurotopia
Sometimes, Sci is simply inundated with weird science opportunities, and such a week is this one. There is SO MUCH WEIRD OUT THERE, you guys. This is great, as it keeps Friday Weird Science in business, but sometimes Sci has to file away so many for later that she loses track. Here's really hoping that she WON'T lose track, because she found some real beauties today. And this was one of the best one.
In response to a question from awesome reader and friend of the blog Pascale: Can I post on semen analysis and the importance of odor?
Oh yes, yes I can.
Chvapil, et al. "Studies on vaginal malodor: humans". Obstetrics and Gynecology, 1978.
Time for some historical, weird, and seminal (mwah ha ha ha) science! Read the rest of this post... | Read the comments on this post...... Read more »
Chvapil, M., Chvapil, T., & Eskelson, C. (1978) Studies on vaginal malodor. Archiv f�r Gyn�kologie, 225(2), 77-89. DOI: 10.1007/BF00670844
- April 15, 2010
- 07:59 PM
- 541 views
I get e-mail too!
by Kristopher Hite in Tom Paine's Ghost
T. G. Dobzhansky, a prominant evolutionary biologist once said...
"Nothing in biology makes sense except in the light of evolution"
Recently, I received a request from a Tom Paine's Ghost reader to answer some questions about public perceptions of evolution. The questions, along with my responses follow.
Reader: How is evolution relevant to the lives of everyday people?
TPG: I will here talk about medicine, childhood obesity, and sex.
The first topic that springs to mind when I think about this question is antibiotics. Most people reading this will have, at one point in their life, been prescribed an antibiotic. The more people understand evolution the more likely they'll be to use medicine in a more effective manner. Rather than a doctor saying "take these pills twice a day everyday because I TOLD YOU SO" people who understand the underlying REASON they should take their entire course of prescribed medication will be more likely to do so. This in turn leads to a more aware and educated public who have the concerns of both society AND themselves in mind as they make health care decisions.
For people already fearful of pharmaceutical companies and medical doctors, it might be easy to misinterpret what I just said in the last few sentences to mean this..."understanding evolution will help people take more antibiotics" THAT IS NOT WHAT I AM SAYING. If fact, understanding evolution, and specifically the rapid evolution of asexual, gene swapping bacteria would make a person less likely to go ask for an antibiotic straight away. BUT, in the case that an antibiotic is in fact needed, that person would be more likely to use that medicine in a more effective manner.
Understanding evolution by natural selection does not mean individuals must succumb to the brutality of nature. Quite the opposite is true. Understanding evolution gives us the ability to reason our way out of the stone age and into an ever-updated age of enlightenment.
The next topic that comes to mind is obesity. Obesity is becoming a worldwide epidemic. It has become such a rampant scourge that children born today will be the first generation of Americans whose
life expectancy will actually be shorter than their parents’ life
expectancy. This is the first time mortality rate will have gone up since the industrial revolution. As the gap between third and first world narrows more and more people become obese. The reasons starving people still exist on earth is another topic based in politics an economics, and one Frances Moore Lappe addresses quite well. But here I am focused on evolution literally going haywire when it comes to the pre-loaded sweetness software that comes standard with nearly all homo sapiens operating systems. Why does simple sugar taste "good" or sweet - to most people? In the context of evolution this question has an answer. Sweet foods taste sweet because they have a lot of calories. Organisms that had an intrinsic desire to taste sweet things could survive and reproduce. Those unable and perhaps unwilling to seek out the nutrition they needed went extinct and therefore most humans now like the taste of sweet things. Why is fruit sweet and crushed seed bitter? For that answer one must take the evolutionary perspective of the plant in question. The plant wants the seeds to be transported, therefore it gives incentive to hungry animals to ingest the seed by coating it with sugary goodness - the fleshy part of most fruit. But if that animal happened to have the unfortunate accident of being born with a stomach enzyme that would destroy the seed's hard shell, then that animal would probably not live to pass its faulty genes on to the next generation. This is so because many plants have evolved to contain toxins in their seeds (IE apple seeds have cyanide inside them). This makes sense, because if every time an animal ate the fruit from a plant it destroyed the seeds then that plant would not survive to prosper on down through the generations, but if the plant had these toxins it would assure that only friendly animal stomachs transported their seeds to new planting grounds. Going back to obesity, the problem of rampant obesity arises in many cultures because calories become so easy to get and in such massive quantities that this once useful survival mechanism has turned into a health hazard.
Though there are many more human-centered topics an understanding of evolution would help us cope with I'll limit myself to three. The last being sex. I said before that understanding evolution does not mean we must all succumb to the brutality of nature. This is a funny argument in the daunting topic of human sexual interactions. As gross as this rhyme sounds, the "urge to merge" as my father so disgustingly put human inclination towards sex, is known to be built into the wiring of most human brains. Why do humans desire sex? Why do men cheat on their wives? Why do women cheat on their husbands? Why do people stay faithful to one another? - I'm not arguing that a cheating man or woman can plead - "evolution made me do it" but I am saying that evolution - "survival" - does play a big role. Just like humans have learned that eating food off the ground is not very healthy or safe, we've also learned that sleeping around is not very healthy or safe. Though evolution might make our brains want sex our reasoning brains tell us no (most of the time), or at least give us the insight to use birth control of some sort. There are several methods society uses to try and curb rampant sexual hedonism. Religions try by bringing in fear of eternal damnation, but understanding evolution gives a less fear-mongering lesson in why the monogamous mating strategy might be a good idea. Here I will digress a bit into my observations of society. I acknowledge that classic nuclear families (where man and wife stay together for their entire lives) do exist and I am happy to see those scenarios, but I also observe that it the real world many couples split even after having children. I'm not making a value judgment here but I am saying that society might become less judgmental of alternative family structures if the tendencies and behaviors built into all organisms were understood and appreciated more widely.
Reader: Is evolution important for the public to understand? If so, why?
TPG: In my opinion, yes, it is extremely important for the public to understand evolution.
I think this because of the atrocities history has seen come out of the misunderstanding and misinterpretation of evolution, namely world war II and the holocaust. A most egregious misinterpretation of evolution is the fallacy that evolution has a goal. There is no such thing as "highly evolved" only highly adapted. People have, since the publication of On the Origin of Species tended to take the human-centered view intrinsic to most religious belief systems and apply it to the understanding of evolution. This type of misplaced certainty lead to the eugenics movement - technology misapplied in the most horrific way imaginable. The observation that organisms evolve via natural selection because of descent with modification does not mean humans are at the top of some scheme to get to an evolutionary apex. With this more sophisticated understanding of evolution one can easily see that some bacteria are far more adapted to their environments when compared to homo sapiens. In terms of survivability some extremeophile bacteria are far more likely to survive an extinction level event such as the disaster that lead to the annihilation of the dinosaurs.
It has taken hundreds of years for the concept that earth is NOT the center of the universe to be accepted. So the relatively nascent notion of evolution by natural selection (and its blind eye to human accomplishments) is only beginning to be comprehended and appreciated by the global population here in the year 2010. Sadly, in the United States acceptance of evolution is disturbingly low and could be playing a role in our rapidly declining position in the world regarding science math and engineering skills. Even more sad is the fact that leadership at the National Science Foundation (NSF) and a members of the National Science Board (NSB) - do NOT think data collected about the public understanding of evolution are real "indicators" of our national average understanding of science in general.
Reader: Natural selection, or survival... Read more »
Miller, J. (2006) SCIENCE COMMUNICATION: Public Acceptance of Evolution. Science, 313(5788), 765-766. DOI: 10.1126/science.1126746
Summers, R. (2005) Trichuris suis therapy in Crohn's disease. Gut, 54(1), 87-90. DOI: 10.1136/gut.2004.041749
- April 15, 2010
- 04:20 PM
- 1,881 views
New developments in castration resistant prostate cancer - MDV3100
by Sally Church in Pharma Strategy Blog
Last night I received an alert from Medivation announcing that an article would be published in today's online The Lancet regarding their prostate cancer agent, MDV3100. Sure enough, here's the article: Although the trial is an early phase I/II study,...... Read more »
Scher, H., Beer, T., Higano, C., Anand, A., Taplin, M., Efstathiou, E., Rathkopf, D., Shelkey, J., Yu, E., & Alumkal, J. (2010) Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1–2 study. The Lancet. DOI: 10.1016/S0140-6736(10)60172-9
- April 15, 2010
- 12:07 PM
- 833 views
Phonological Training Changes Brain Activation in Dyslexic Children
by Livia in Reading and Word Recognition Research
Note: Online Universities has included me in their list of top 50 female science bloggers. It’s not actually for this blog, but for my Brain Science and Creative Writing blog. Anyways, check out the list if you get a chance. There are lot of interesting bloggers.
Accessibility: Intermediate-Advanced
We’ve looked at the neuroscience of dyslexia and how the dyslexic brain processes words.
... Read more »
Shaywitz BA, Shaywitz SE, Blachman BA, Pugh KR, Fulbright RK, Skudlarski P, Mencl WE, Constable RT, Holahan JM, Marchione KE.... (2004) Development of left occipitotemporal systems for skilled reading in children after a phonologically- based intervention. Biological psychiatry, 55(9), 926-33. PMID: 15110736
- April 15, 2010
- 11:02 AM
- 991 views
The molecular genetics of aggressive B-cell lymphomas
by Sally Church in Pharma Strategy Blog
As many readers here on PSB know, I've not been a big fan of genome-wide molecular profiling, preferring an oncogene addiction approach to drug development and targeted cancer therapies. However, every once in a while something comes along that stops...... Read more »
Lenz, G., & Staudt, L. (2010) Aggressive Lymphomas. New England Journal of Medicine, 362(15), 1417-1429. DOI: 10.1056/NEJMra0807082
Friedberg, J., Sharman, J., Sweetenham, J., Johnston, P., Vose, J., LaCasce, A., Schaefer-Cutillo, J., De Vos, S., Sinha, R., Leonard, J.... (2009) Inhibition of Syk with fostamatinib disodium has significant clinical activity in non-Hodgkin lymphoma and chronic lymphocytic leukemia. Blood, 115(13), 2578-2585. DOI: 10.1182/blood-2009-08-236471
- April 15, 2010
- 10:06 AM
- 957 views
The Four Dimensions of a Breast Cancer Genome
by Daniel Koboldt in Massgenomics
Published today in the journal Nature is the whole-genome sequencing of a basal-like breast cancer tumor, metastasis, and xenograft. There’s also a News and Views article by Joe Gray of Lawrence Berkeley National Laboratory, as well as a news feature on large-scale cancer projects.
This study is a bit unlike our previous cancer genomes (AML1 and [...]... Read more »
Li Ding, Matthew J. Ellis, Shunqiang Li, David E. Larson, Ken Chen, John W. Wallis, Christopher C. Harris, Michael D. McLellan, Robert S. Fulton, Lucinda L. Fulton, Rachel M. Abbott, Jeremy Hoog, David J. Dooling, Daniel C. Koboldt, Heather Schmidt, Joell. (2010) Genome remodelling in a basal-like breast cancer metastasis and xenograft. Nature, 464(15), 999-1005. info:/10.1038/nature08989
- April 14, 2010
- 02:40 AM
- 1,633 views
Individual Differences in Empathy
by Dr Shock in Dr Shock MD PhD
Empathy or the ability to appreciate someone else’s emotions and express this emotional awareness is a capacity that differs amongst individuals.
Cognitive empathy refers to imaginatively understanding another person’s thoughts, feelings and actions. Emotional empathy is feeling the emotion of another person, but maintaining a compassionate, other-focused perspective
Cognitive empathy can be tested with facial expression recognition. [...]
Related posts:Patient Doctor Relationship: Can We Teach Empathy at Med School?
Patient Doctor Relationship Series: Empathy
The Neurobiology of Empathy through Pain Research
... Read more »
Besel, L., & Yuille, J. (2010) Individual differences in empathy: The role of facial expression recognition. Personality and Individual Differences. DOI: 10.1016/j.paid.2010.03.013
Lee, S., Guajardo, N., Short, S., & King, W. (2010) Individual differences in ocular level empathic accuracy ability: The predictive power of fantasy empathy. Personality and Individual Differences. DOI: 10.1016/j.paid.2010.03.016
- April 14, 2010
- 01:41 AM
- 640 views
Binge Eating, Bulimia, and Reward Sensitivity
by Evil Monkey in Neurotopia
You all may remember that Sci's recent posts have focused on eating, overeating, and dopamine. Today, Sci continues this trend. Honestly, she couldn't stop thinking about it. How is overeating like addiction? How is it different? And so she began to look up a bunch of papers on binge eating and dopamine.
I was particularly interesting in the changes in food intake and reward associated responses in people with eating disorders like bulimia nervosa and anorexia nervosa. There are many hypotheses as to why these eating disorders exist, ranging from problems with society (which can certainly contribute to the incidence of the disorders), to hypotheses of obsessive control akin to the compulsions seen with OCD, to increased sensitivity to reward, to decreased sensitivity to reward.
This increased/decreased sensitivity to reward (some people have seen decreased sensitivity to reward in rats, along with increased self-administration of pleasurable things, but what this actually translates to in humans can be difficult to interpret) was particularly interesting, and so Sci was very glad when she came across this study.
Schienle et al. "Binge-Eating Disorder: Reward Sensitivity and Brain Activation to Images of Food ", Biological Psychiatry, 2008.
(Sci will admit her brain activated really hardcore looking at that. Soooo much chocolate...) Read the rest of this post... | Read the comments on this post...... Read more »
Schienle, A., Schäfer, A., Hermann, A., & Vaitl, D. (2009) Binge-Eating Disorder: Reward Sensitivity and Brain Activation to Images of Food. Biological Psychiatry, 65(8), 654-661. DOI: 10.1016/j.biopsych.2008.09.028
- April 13, 2010
- 01:21 PM
- 500 views
Health Behaviors More Important than Socioeconomic Status
by Shaheen Lakhan in Brain Blogger
Many studies have reported that socioeconomic status is a predictor of morbidity and mortality. Now, a large-scale, longitudinal study asserts that the association may be more related to health behaviors than socioeconomic status. The study, published in the Journal of the American Medical Association (JAMA), reports that assessment of health behaviors over time lessens the [...]... Read more »
Goldfarb-Rumyantzev, A., Rout, P., Sandhu, G., Khattak, M., Tang, H., & Barenbaum, A. (2010) Association between social adaptability index and survival of patients with chronic kidney disease. Nephrology Dialysis Transplantation. DOI: 10.1093/ndt/gfq177
Singh, T., Givertz, M., Semigran, M., DeNofrio, D., Costantino, F., & Gauvreau, K. (2010) Socioeconomic Position, Ethnicity, and Outcomes in Heart Transplant Recipients. The American Journal of Cardiology, 105(7), 1024-1029. DOI: 10.1016/j.amjcard.2009.11.015
Stringhini, S., Sabia, S., Shipley, M., Brunner, E., Nabi, H., Kivimaki, M., & Singh-Manoux, A. (2010) Association of Socioeconomic Position With Health Behaviors and Mortality. JAMA: The Journal of the American Medical Association, 303(12), 1159-1166. DOI: 10.1001/jama.2010.297
Turrell, G., Kavanagh, A., Draper, G., & Subramanian, S. (2007) Do places affect the probability of death in Australia? A multilevel study of area-level disadvantage, individual-level socioeconomic position and all-cause mortality, 1998-2000. Journal of Epidemiology , 61(1), 13-19. DOI: 10.1136/jech.2006.046094
Warner, E., & Gomez, S. (2010) Impact of Neighborhood Racial Composition and Metropolitan Residential Segregation on Disparities in Breast Cancer Stage at Diagnosis and Survival Between Black and White Women in California. Journal of Community Health. DOI: 10.1007/s10900-010-9265-2
- April 12, 2010
- 04:44 PM
- 1,281 views
Excess Weight Predicts Younger Age at Hip and Knee Replacement
by Travis Saunders, MSc in Obesity Panacea
Given that I have put myself out of commission due to a musculoskeletal injury I acquired over the weekend, I thought a discussion of joint injuries and such would be most appropriate in my Robaxocet induced state.Just last week Travis discussed the issue of injuries associated with exercise among obese individuals. In that post, based on recent evidence, Travis concluded:"...in overweight and obese individuals, exercise (in the form of walking) has little or no association with injury or illness."
However, there still remains the issue of various musculo-skeletal problems which appear to happen at a high rate among those individuals carrying excess weight, independent of their activity level.Knee and hip osteoarthritis, for example, are quite commonly listed as a frequent medical consequence of obesity. A new study from our neck of the woods (Ontario, Canada) sought to determine the effect of weight status on the age at which individuals elected to have knee or hip replacement surgery.
Read the rest of this post... | Read the comments on this post...... Read more »
Gandhi, R., Wasserstein, D., Razak, F., Davey, J., & Mahomed, N. (2010) BMI Independently Predicts Younger Age at Hip and Knee Replacement. Obesity. DOI: 10.1038/oby.2010.72
- April 12, 2010
- 01:41 PM
- 1,102 views
Monday Pets: Biological Evidence That Dog is Man's Best Friend
by Jason Goldman in The Thoughtful Animal
The party isn't over yet! Here's another helping of Monday Pets. Enjoy!
Wild Dog crawled into the Cave and laid his head on the Woman's lap... And the Woman said, "His name is not Wild Dog any more, but the First Friend."
--Just So Stories, Rudyard Kipling.
Archaeological evidence indicates that dogs were already a part of human society around the end of the Ice Age. Small dog skeletons have been unearthed in human communities as far back as 6- to 12-thousand years ago in Europe, the Middle East, and China. The jawbone of a domestic dog was found in a late Paleolithic grave in Germany, and dated to around 14 thousand years ago. And there is the famous site at Ein Mallaha (Eynan, in Hebrew), in Northern Israel where an elderly human and a 4-5 month old puppy were buried together, 10- to 12-thousand years ago.
Figure 1: From the site at Ein Mallaha. The person's left hand is placed on the body of a 4-5 month old puppy.
Some evidence exists that dogs were the first animals to be domesticated, and until now, humans have only succeeded in domesticating around 20 different animal species. Compared with those other species (such as sheep, goats, pigs, cows, horses, donkeys, and camels), only dogs (and to some extent, cats, though at the risk of alienating readers, I maintain that cats are evil) have established for themselves a social niche within human society. Dogs were not only bred for companionship; some dogs were bred for hunting, guarding, or herding. More recently, dogs have worked as service dogs or drug-sniffing dogs. The question remains: Why do dogs have such apparent psychological effects on humans? Read the rest of this post... | Read the comments on this post...... Read more »
NAGASAWA, M., MOGI, K., & KIKUSUI, T. (2009) Attachment between humans and dogs. Japanese Psychological Research, 51(3), 209-221. DOI: 10.1111/j.1468-5884.2009.00402.x
- April 12, 2010
- 08:09 AM
- 762 views
The potential for PI3K pathway inhibitors in Lung Cancer
by Sally Church in Pharma Strategy Blog
Life is about stories, events and even coming back full circle sometimes. I experienced that moment of déjà vu this morning on opening a link to an article that a colleague kindly sent from Avrum Spira's lab that was published...... Read more »
Gustafson, A., Soldi, R., Anderlind, C., Scholand, M., Qian, J., Zhang, X., Cooper, K., Walker, D., McWilliams, A., Liu, G.... (2010) Airway PI3K Pathway Activation Is an Early and Reversible Event in Lung Cancer Development. Science Translational Medicine, 2(26), 26-26. DOI: 10.1126/scitranslmed.3000251
- April 11, 2010
- 10:27 PM
- 1,983 views
"Sleeping Beauty Paraphilia" and Body Image Disturbance After Brain Injury
by The Neurocritic in The Neurocritic
Brain injuries caused by strokes, tumors or head trauma can, on occasion, result in Unusual Changes in Sexuality, as discussed in an earlier blog post. A new case report by Bianchi-Demicheli et al. (2010) describes a unique paraphilia1 in a married 34 year old man. The authors called it Sleeping Beauty paraphilia:This [man] felt sexually aroused from seeing sleeping women as well as from taking care of their hands and nails while they were asleep.The patient came to the attention of the authors when he was brought to the emergency psychiatric unit after assaulting his wife with pepper spray while wearing a latex mask.2 More details of the case are as follows:His marriage had been in crisis for several years because over the time the patient developed a particular and progressive sexual deviant behaviour. He felt sexually aroused from seeing sleeping women as well as from taking care of their hands and nails while they were asleep, beginning mostly with the right hand. In the first time of his marriage he could control these fantasies, but over the years he lost the control of his sexual urges and he must irresistibly act his deviant behaviour. In order to realize his uncontrollable impulse, he was used to provide his wife sleeping pills to satisfy his paraphilia. In the first time his wife used to agree to take sleeping pills, but later she refused to bend to man’s freakish will. The man began secretly to administer benzodiazepines since the dosage of 23 mg of Bromazepam.In September 2006, his wife discovered this practice and refused to take sleeping pills and the couple entered in a very strong conflict.The assault occurred because the woman refused to comply with her husband's "freakish will":Because of the extremely powerful obsession with sleeping women and painting their nails, the patient disguised himself with a latex mask an attacked his wife, as she returned from work, with an Olerosin Capsicum (OC) spray, to anaesthetize her. During this episode, his wife succeeded in taking off his mask, escaped and called the police who brought him to the psychiatric emergencies.The psychiatric exam and laboratory tests all came out as normal. The patient reported no family history of mental illness. However, he sustained a head injury at the age of 10 which resulted in a four day coma.3 He was given a neurological exam, including an MRI, which showed "moderate atrophy in the fronto-parietal region with a diffuse and severe white matter injury compatible with his previous head trauma (Figure 1)." I don't know that I would characterize the white matter damage as severe, but then again I'm not a neuroradiologist.Figure 1 (Bianchi-Demicheli et al., 2010). On the T2 images (A–C) one notes atrophy in the parietal and frontal lobes as well as subcortical lesions in the frontal white matter (arrows B,C); FLAIR also shows multiple subcortical white matter lesions (arrows: D); DTI [dffusion tensor imaging] demonstrates a decrease of the fractional anisotropy in the areas seen on the right (E: arrow) and on the left (F: arrow).Bianchi-Demicheli et al. (2010) linked the fronto-parietal damage to behavioral disinhibition and a specific disturbance in body image, which was revealed by neuropsychological testing:The patient was diagnosed with a moderate dysexecutive syndrome and a very specific body image disorder characterized by an incomplete mental image of his hands, mostly the right (i.e., personal representational hemineglect), as ascertained by his graphical representation of his body parts.The clinical hypothesis was that the paraphilia might be related to his post-traumatic disturbed body image and more specifically to the incomplete hands representation.One puzzling aspect of this case is why the "Sleeping beauty paraphilia" became uncontrollable only in adulthood, showing a progressive escalation during his marriage. This might be suggestive of a neurodegenerative disorder, but that was not part of his diagnosis. And I'm not sure why an old traumatic brain injury would have lead to "moderate" atrophy in the fronto-parietal region. I might have expected more involvement of the orbitofrontal cortex (e.g. Burns & Swerdlow, 2003), given the nature of the patient's behavioral changes. However, many other examples of impulsive sexual offenses (Langevin, 2006) are even less obviously related to neurological status (e.g. after head injuries when the damage might not be visible on an MRI scan, and of course the population of offenders who have never sustained a TBI). Since the lesions were distributed and not focal, a final mystery is why the body image disturbance was confined to the right hand (implying a left hemisphere origin). This type of personal representational hemineglect (neglect for a mental representation of one side of the body) is most often associated with lesions in the right hemisphere (Ortigue et al., 2006).A final comment concerns the sort of urges or behaviors that are categorized as paraphilias. What is considered acceptable can vary widely across cultures and subcultures (Bhugra et al., 2010) and across individuals. If the patient of Bianchi-Demicheli et al. found a partner willing to have her fingernails done while sedated with sleeping pills, perhaps the classification would change from paraphilic disorder (see Footnote 1 below) to something that might be considered strange and paraphilic to most people, but causing no distress to the two willing participants.Footnotes1 According to DSM-IV, paraphilias are defined as recurrent, and intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Changes in this set of diagnoses are being discussed for the new DSM-5 (currently under development):The Paraphilias Subworkgroup is proposing two broad changes that affect all or several of the paraphilia diagnoses, in addition to various amendments to specific diagnoses. The first broad change follows from our consensus that paraphilias are not ipso facto psychiatric disorders. We are proposing that the DSM-V make a distinction between paraphilias and paraphilic disorders. A paraphilia by itself would not automatically justify or require psychiatric intervention. A paraphilic disorder is a paraphilia that causes distress or impairment to the individual or harm to others. One would ascertain a paraphilia (according to the nature of the urges, fantasies, or behaviors) but diagnose a paraphilic disorder (on the basis of distress and impairment). In this conception, having a paraphilia would be a necessary but not a sufficient condition for having a paraphilic disorder. 2 No mention of whether or not it was a Prince Charming mask.3 The authors did not speculate too much on the Freudian im... Read more »
Bianchi-Demicheli F, Rollini C, Lovblad K, & Ortigue S. (2010) "Sleeping Beauty paraphilia": deviant desire in the context of bodily self-image disturbance in a patient with a fronto-parietal traumatic brain injury. Medical science monitor : international medical journal of experimental and clinical research, 16(2). PMID: 20110923
- April 11, 2010
- 01:44 PM
- 498 views
Editorial Peer Reviewers' Recommendations at a General Medical Journal: Are They Reliable and Do Editors Care?
by Martin Fenner in Gobbledygook @ Nature Network
Peer review is central to how we evaluate science and therefore how journal papers, grants and jobs are awarded. Peer review is done in many different ways, and has dramatically changed in the last 25 years. But the purpose...... Read more »
Kravitz, R., Franks, P., Feldman, M., Gerrity, M., Byrne, C., & Tierney, W. (2010) Editorial Peer Reviewers' Recommendations at a General Medical Journal: Are They Reliable and Do Editors Care?. PLoS ONE, 5(4). DOI: 10.1371/journal.pone.0010072
- April 10, 2010
- 10:03 AM
- 963 views
Irreversible Effects of Previous Cortisol Excess on Cognitive Functions in Cushing’s Disease
by Laika in Laika's Medliblog
April 8th is Cushing’s Awareness Day. This day has been chosen as a day of awareness as it is the birthday of Dr. Harvey Cushing, a neurosurgeon, who discovered this illness.
Cushing’s disease is a rare hormone disease caused by prolonged exposure to high levels of the stress hormone cortisol in the blood, whereas Addison’s disease [...]... Read more »
Tiemensma J, Kokshoorn NE, Biermasz NR, Keijser BJ, Wassenaar MJ, Middelkoop HA, Pereira AM, & Romijn JA. (2010) Subtle Cognitive Impairments in Patients with Long-Term Cure of Cushing's Disease. The Journal of clinical endocrinology and metabolism. PMID: 20371667
Patil CG, Lad SP, Katznelson L, & Laws ER Jr. (2007) Brain atrophy and cognitive deficits in Cushing's disease. Neurosurgical focus, 23(3). PMID: 17961025
- April 9, 2010
- 12:38 PM
- 1,249 views
Staircase Signs - Easiest Physical Activity Intervention. Ever.
by Travis Saunders, MSc in Obesity Panacea
Image by Randy Son of Robert.
I love simple physical activity interventions. We all know that physical activity is a good thing, and yet it can be really difficult for people to increase their physical activity levels, especially over the long-term. So it's exciting whenever any intervention is shown to be effective, but even more so when it is simple. And an intervention that is both simple and inexpensive is pure gold. I wrote about one such intervention a few weeks ago, when I described a British study that showed that simply painting lines on a school-yard playground resulted in a dramatic increase in physical activity levels during recess. The intervention was simple, it was inexpensive and extremely easy to implement, and yet it had an impressive positive impact. What more could you ask for?
Earlier this week I came across a similarly simple intervention published in the Journal of Physical Activity and Health, this time focused on adults. In this new study, Megan Grimstvedt and colleagues placed signs near the elevators of 4 university buildings in San Antonio. The sign said simply "Walking up stairs burns almost 5 times as many calories as riding an elevator" and included an arrow directing people to the nearest staircase, as well as a cartoon of the school mascot walking up a flight of stairs. Two of the buildings had very visible staircases, while two of the buildings had staircases that were relatively hidden. The buildings with hidden staircases had an additional sign on the staircase door to tell people that the stairs were accessible (e.g. no fire alarm would sound). The researchers then positioned themselves in "inconspicuous" locations for 2 hours per day, Monday-Thursday, and tallied the number of people using the staircase and elevator.
Read the rest of this post... | Read the comments on this post...... Read more »
Megan E. Grimstvedt, Jacqueline Kerr, Sara B. Oswal, Donovan L. Fogt, Tiffanye M. Vargas-Tonsing, & Zenong Yin. (2010) Using Signage to Promote Stair Use on a University Campus in Hidden and Visible Stairwells. Journal of Physical Activity and Health, 232-238. info:/
- April 9, 2010
- 08:00 AM
- 496 views
Pulling The Plug Too Soon?
by Shaheen Lakhan in Brain Blogger
The findings of the new study show that, even when no physical movement or observable response to stimuli are present, means exist to permit some individuals to respond sufficiently to prove that they understand their condition and may wish to continue treatment.... Read more »
Monti, M., Vanhaudenhuyse, A., Coleman, M., Boly, M., Pickard, J., Tshibanda, L., Owen, A., & Laureys, S. (2010) Willful Modulation of Brain Activity in Disorders of Consciousness. New England Journal of Medicine, 362(7), 579-589. DOI: 10.1056/NEJMoa0905370
Andrews K, Murphy L, Munday R, & Littlewood C. (1996) Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ (Clinical research ed.), 313(7048), 13-6. PMID: 8664760
- April 9, 2010
- 03:30 AM
- 721 views
The Gambler Redux
by Jason Goldman in The Thoughtful Animal
We shall begin with an homage to the great Lady Gaga:
Now that that has been taken care of, let us continue…
A few days ago I wrote about an initial attempt to create an animal model of the Iowa Gambling Task (IGT). Initial attempts are always tough, and I think they overall did a good job, [...]... Read more »
Zeeb, F., Robbins, T., & Winstanley, C. (2009) Serotonergic and Dopaminergic Modulation of Gambling Behavior as Assessed Using a Novel Rat Gambling Task. Neuropsychopharmacology, 34(10), 2329-2343. DOI: 10.1038/npp.2009.62
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