New Trigger of Alzheimer’s Identified: Stress


Story at-a-glance

  • According to recent research, stress appears to be related to the onset of Alzheimer’s disease, by triggering a degenerative process in your brain and precipitating disruption of your neuroendocrine and immune system
  • The researchers found that nearly three out of four Alzheimer’s patients had experienced severe emotional stress during the two years preceding their diagnosis, compared to just over one in four in the control group
  • Alzheimer’s disease currently afflicts about 5.4 million Americans, including one in eight people aged 65 and over
  • Research suggests the best hope is in prevention focusing on diet, exercise and staying mentally active
  • Avoiding gluten and casein appears to be of critical importance, as is making sure you’re getting plenty of healthful fats (including demonized saturated fats). Fasting also has a remarkably beneficial influence on your brain health.
  • Alzheimer's Disease

The connections between stress and physical and mental health are undeniable. Studies have found links between acute and/or chronic stress and a wide variety of health issues.

This includes reduced immune function, increased inflammation, high blood pressure, and alterations in your brain chemistry, blood sugar levels and hormonal balance, just to name a few.

According to recent research, stress also appears to be related to onset of Alzheimer’s disease, which currently afflicts about 5.4 million Americans, including one in eight people aged 65 and over.1

It is projected that Alzheimer’s will affect one in four Americans in the next 20 years, rivaling the current prevalence of obesity and diabetes. There is still no known cure for this devastating disease, and very few treatments. Alzheimer’s drugs are often of little to no benefit, which underscores the importance of prevention throughout your lifetime.

Fortunately, there’s compelling research showing that your brain has great plasticity and capacity for regeneration, which you control through your diet and lifestyle choices.

Avoiding gluten and casein, or wheat and dairy primarily, appears to be of critical importance, as is making sure you’re getting plenty of healthful fats (including demonized saturated fats). Casein is the primary protein found in dairy, and can be problematic for dairy intolerant individuals. However, it’s also found in human breast milk. Additionally, raw dairy is generally well tolerated by casein sensitive individuals, but contraindicated for those with a severe allergy.

Fasting also has a remarkably beneficial influence on your brain health. At the end of this article, I share my best tips for maintaining healthy brain function well into old age.

Stress May Be Related to Clinical Onset of Alzheimer’s Disease

Researchers in Argentina recently presented evidence suggesting that stress may be a trigger for the onset of Alzheimer’s disease. The research was presented at the annual World Congress of Neurology in Vienna. According to lead author, Dr. Edgardo Reich:2

“Stress, according to our findings, is probably a trigger for initial symptoms of dementia.

Though I rule out stress as monocausal in dementia, research is solidifying the evidence that stress can trigger a degenerative process in the brain and precipitate dysfunction in the neuroendocrine and immune system. It is an observational finding and does not imply direct causality. Further studies are needed to examine these mechanisms in detail.”

The study found that 72 percent—nearly three out of four—Alzheimer’s patients had experienced severe emotional stress during the two years preceding their diagnosis. In the control group, only 26 percent, or one in four, had undergone major stress or grief. Most of the stresses encountered by the Alzheimer’s group involved:

  • Bereavement; death of a spouse, partner, or child
  • Violent experiences, such as assault or robbery
  • Car accidents
  • Financial problems, including “pension shock”
  • Diagnosis of a family member’s severe illness

When you consider all the adverse biological effects that stress and anxiety causes, it might not be such a stretch that severe stress could trigger Alzheimer’s. For example, researchers have found links between emotional distress and physical pain,3 chronic inflammation4 and even stillbirths.5 

It can also wreak havoc on your gut health, which is critical to maintaining mental and physical health. Most recently, Forbes6 reported the findings of a study7 exploring the role of stress in rewiring your brain—in this case, altering your sense of smell:

“Two brain circuits that don’t typically “talk” to each other—one linked to our sense of smell and another linked to emotional processing—can become cross-wired when we experience stress-induced anxiety. The result is that stressful experiences transform normally neutral odors into bad ones…

‘After anxiety induction, neutral smells become clearly negative,’ explains Wen Li, a professor of psychology at the University of Wisconsin-Madison Waisman Center, who led the study. ‘People experiencing an increase in anxiety show a decrease in the perceived pleasantness of odors. It becomes more negative as anxiety increases.’”

How Stress Causes Disease

When you’re experiencing acute stress, your body releases stress hormones like cortisol, which prepare your body to fight or flee the stressful event. Your heart rate increases, your lungs take in more oxygen, your blood flow increases and parts of your immune system become temporarily suppressed, which reduces your inflammatory response to pathogens and other foreign invaders.

When stress becomes chronic, however, your immune system becomes less sensitive to cortisol, and since inflammation is partly regulated by this hormone, this decreased sensitivity heightens the inflammatory response and allows inflammation to get out of control. 

This is in large part how stress “predisposes” you to getting sick in the first place. And, in the event you do get sick, emotional stressors can make your symptoms worse, especially if the stress is severe or longstanding.

For example, research presented at this year’s annual meeting of the American Psychosomatic Society in Miami, Florida, found that ruminating on a stressful incident can increase your levels of C-reactive protein, a marker of inflammation in your body.8 It was the first study to directly measure this effect. Inflammation, in turn, is a hallmark of most diseases, from diabetes to heart disease, cancer, and Alzheimer’s.

Tips for Reducing Work Stress

Polls have shown that work is the number one source of stress in people’s lives. In a recent survey9 of more than 2,000 people, 34 percent of respondents reported that their work life was either “very” or “quite” stressful. One in five people also reported developing anxiety due to work-related stresses. In a related article, Forbes magazine10 lists nine tips to reduce work-related stress, such as:

  • Adding personal touches to your work space, such as photographs or art work, and live plants
  • Keeping your work space clean and organized
  • Learning to handle or ignore interruptions
  • Incorporating relaxation exercises into your work day
  • Improving your communication skills

Conquer Your Stress and Anxiety with Energy Psychology

While it’s not possible or even recommended to eliminate all stress from your life, you can provide your body with tools to compensate for the bioelectrical short-circuiting that takes place when you’re stressed. Using energy psychology techniques such as the Emotional Freedom Techniques (EFT) can help reprogram your body’s reactions to the unavoidable stressors of everyday life, thereby reducing your chances of experiencing adverse health effects. Exercising regularly, getting enough sleep, and meditation are also important “release valves” that can help you manage your stress.

EFT was developed in the 1990s by Gary Craig, a Stanford engineering graduate specializing in healing and self-improvement. It’s akin to acupuncture, which is based on the concept that a vital energy flows through your body along invisible pathways known as meridians. EFT stimulates different energy meridian points in your body by tapping them with your fingertips, while simultaneously using custom-made verbal affirmations. This can be done alone or under the supervision of a qualified therapist.11

By doing so, you help your body eliminate emotional “scarring” and reprogram the way your body responds to emotional stressors. Since these stressors are usually connected to physical problems, many people’s diseases and other symptoms can improve or disappear as well. For a demonstration, please see the following video featuring EFT practitioner Julie Schiffman, in which she discusses EFT for stress relief. However, for serious problems it is far preferable to see an experienced EFT therapist as there is a significant art to the process that requires a high level of sophistication if serious problems are to be successfully treated.

Tips for Maintaining Healthy Brain Function and Avoiding Alzheimer’s Disease

The beauty of following my optimized nutrition plan is that it helps prevent and treat virtually ALL chronic degenerative diseases, including Alzheimer’s disease. Remember, while memory loss is indeed common among Westerners, it is NOT a “normal” part of aging, and cognitive changes are by no means inevitable.

As explained by neurologist Dr. David Perlmutter in a recent interview, Alzheimer’s is a disease predicated primarily on lifestyle choices; the two main culprits being excessive sugar and gluten consumption. Another major factor is the development and increased consumption of genetically engineered (GE) grains, which are now pervasive in most processed foods sold in the US. His book, Grain Brain, provides a powerful argument for eliminating grains from your diet.

Knowing that it is a preventable disease puts the power into your hands. People who experience very little decline in their cognitive function up until their deaths have been found (post-mortem) to be free of brain lesions, showing that it’s entirely possible to prevent the damage from occurring in the first place… and one of the best ways to do this is by leading a healthy lifestyle.

    • Avoid Sugar and fructose. Ideally, you’ll want to keep your sugar levels to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you have insulin resistance or any related disorders.
    • Avoid gluten and casein (primarily wheat and pasteurized dairy, but not dairy fat, such as butter). Research shows that your blood-brain barrier, the barrier that keeps things out of your brain where they don’t belong, is negatively affected by gluten. Gluten also makes your gut more permeable, which allows proteins to get into your bloodstream, where they don’t belong. That then sensitizes your immune system and promotes inflammation and autoimmunity, both of which play a role in the development of Alzheimer’s.
    • Optimize your gut flora by regularly eating fermented foods or taking a high quality probiotic supplement.
    • Increase consumption of healthful fats, including animal-based omega-3. Beneficial health-promoting fats that your brain needs for optimal function include organic butter from raw milk, clarified butter called organic grass fed raw butter, olives, organic virgin olive oil and coconut oil, nuts like pecans and macadamia, free-range eggs, wild Alaskan salmon, and avocado.

Also make sure you’re getting enough animal-based omega-3 fats, such as krill oil. (I recommend avoiding most fish because, although fish is naturally high in omega-3, most fish are now severely contaminated with mercury.) High intake of the omega-3 fats EPA and DHA help by preventing cell damage caused by Alzheimer’s disease, thereby slowing down its progression, and lowering your risk of developing the disorder.

    • Reduce your overall calorie consumption, and/or intermittently fast. Contrary to popular belief, the ideal fuel for your brain is not glucose but ketones, which is the fat that your body mobilizes when you stop feeding it carbs and introduce coconut oil and other sources of healthy fats into your diet. A one-day fast can help your body to “reset” itself, and start to burn fat instead of sugar.

As part of a healthy lifestyle, I prefer an intermittent fasting schedule that simply calls for limiting your eating to a narrower window of time each day. By restricting your eating to a 6-8 hour window, you effectively fast 16-18 hours each day. To learn more, please see this previous article.

    • Improve your magnesium levels. There is some exciting preliminary research strongly suggesting a decrease in Alzheimer symptoms with increased levels of magnesium in the brain. Unfortunately, most magnesium supplements do not pass the blood brain levels, but a new one, magnesium threonate, appears to and holds some promise for the future for treating this condition and may be superior to other forms.
    • Optimize your vitamin D levels with safe sun exposure. Strong links between low levels of vitamin D in Alzheimer’s patients and poor outcomes on cognitive tests have been revealed. Researchers believe that optimal vitamin D levels may enhance the amount of important chemicals in your brain and protect brain cells by increasing the effectiveness of the glial cells in nursing damaged neurons back to health.

Vitamin D may also exert some of its beneficial effects on Alzheimer’s through its anti-inflammatory and immune-boosting properties. Sufficient vitamin D is imperative for proper functioning of your immune system to combat inflammation that is also associated with Alzheimer’s.

    • Keep your fasting insulin levels below 3. This is indirectly related to fructose, as it will clearly lead to insulin resistance. However other sugars (sucrose is 50 percent fructose by weight), grains and lack of exercise are also important factors. Lowering insulin will also help lower leptin levels which is another factor for Alzheimer’s.
    • Vitamin B12: In addition to the research presented above, a small Finnish study published in the journal Neurology12also found that people who consume foods rich in B12 may reduce their risk of Alzheimer’s in their later years. For each unit increase in the marker of vitamin B12, the risk of developing Alzheimer’s was reduced by two percent. Remember, sublingual methylcobalamin may be your best bet here.
    • Eat a nutritious diet, rich in folate, such as the one described in my nutrition plan. Vegetables, without question, are your best form of folate, and we should all eat plenty of fresh raw veggies every day. Avoid supplements with folic acid, which is the inferior synthetic version of folate.
    • Avoid and eliminate mercury from your body. Dental amalgam fillings, which are 50 percent mercury by weight, are one of the major sources of heavy metal toxicity. However, you should be healthy prior to having them removed. Once you have adjusted to following the diet described in my optimized nutrition plan, you can follow the mercury detox protocol and then find a biological dentist to have your amalgams removed.
    • Avoid aluminum, such as antiperspirants, non-stick cookware, vaccine adjuvants, etc.
    • Exercise regularly. It’s been suggested that exercise can trigger a change in the way the amyloid precursor protein is metabolized,13 thus, slowing down the onset and progression of Alzheimer’s. Exercise also increases levels of the protein PGC-1alpha. Research has also shown that people with Alzheimer’s have less PGC-1alpha in their brains and cells that contain more of the protein produce less of the toxic amyloid protein associated with Alzheimer’s. I would strongly recommend reviewing the Peak Fitness Technique for my specific recommendations.
    • Avoid flu vaccinations as most contain both mercury and aluminum, well-known neurotoxic and immunotoxic agents.
    • Eat blueberries. Wild blueberries, which have high anthocyanin and antioxidant content, are known to guard against Alzheimer’s and other neurological diseases. Like any fruit though, avoid excesses here.
    • Challenge your mind daily. Mental stimulation, especially learning something new, such as learning to play an instrument or a new language, is associated with a decreased risk of Alzheimer’s. Researchers suspect that mental challenge helps to build up your brain, making it less susceptible to the lesions associated with Alzheimer’s disease.
    • Avoid anticholinergic and statin drugs. Drugs that block acetylcholine, a nervous system neurotransmitter, have been shown to increase your risk of dementia. These drugs include certain nighttime pain relievers, antihistamines, sleep aids, certain antidepressants, medications to control incontinence, and certain narcotic pain relievers.

Statin drugs are particularly problematic because they suppress the synthesis of cholesterol, deplete your brain of coenzyme Q10 and neurotransmitter precursors, and prevent adequate delivery of essential fatty acids and fat-soluble antioxidants to your brain by inhibiting the production of the indispensable carrier biomolecule known as low-density lipoprotein.

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The Ugly Side of Statins.


Story at-a-glance

  • A review of the published statin research revealed a categorical lack of evidence to support the use of statin therapy in primary prevention of heart attacks
  • Statins may actually increase cardiovascular risk in women, the young and people with diabetes
  • The cholesterol-lowering drugs are also linked to an increased risk of cataracts, memory impairment, diabetes, erectile dysfunction and over 300 adverse health effects
  • Lifestyle changes were far more effective, and safer, for primary heart attack prevention than statin drugs.
  • Statin cholesterol-lowering drugs are among the most widely prescribed drugs on the market, bringing in $20 billion a year.1 They are a top profit-maker for the pharmaceutical industry, in part due to relentless and highly successful direct-to-consumer advertising campaigns.

    Statins

    One in four Americans over the age of 45 now takes statins, typically for theprimary prevention of heart attacks and strokes. Traditionally, primaryprevention usually involves healthy lifestyle choices that support heart health, things like eating right and exercising, yet here we have millions of Americans taking pills instead.

    Has anyone unbiased stopped to find out if these drugs are really the best method for heart attack prevention? After all, as researchers noted in theOpen Journal of Endocrine and Metabolic Diseases (OJEMD):2

    “…naive indiscriminate acceptance of novel mainstream therapies is not always advisable and prudence is required in unearthing harmful, covert side effects.”

    This is precisely the task that researchers from Ireland took on by completing an objective review of Pubmed, EM-BASE and Cochrane review databases.3Their results speak volumes…

    It is beginning to dawn on some clinicians that contemporary treatments are not only failing to impact on our most prevalent diseases, but they may be causing more damage than good. A perfect example of such an issue is the statin saga.”

    The Evidence Is In: Lifestyle Trumps Statins for Primary Heart Attack Prevention

    For a drug therapy that appears to offer little by way of primary prevention, the risks were alarming. For every 10,000 people taking a statin, there were:

    • 307 extra patients with cataracts
    • 23 additional patients with acute kidney failure
    • 74 extra patients with liver dysfunction

    The landmark review revealed “a categorical lack of clinical evidence to support the use of statin therapy in primary prevention.” They also found that statins actually increase cardiovascular risk in women, the young and people with diabetes. The review also showed that statin therapy increased:

    • Muscle fatigabilty by 30% with more than 11% incidence of rhabdomyolysis (a life-threatening muscle condition) at high doses
    • Coronary artery and aortic calcification
    • Erectile dysfunction, which is 10 times more common in young men taking the lowest dose of statin.
    • Diabetes
    • Cancer

    The researchers noted:

    There is increased risk of diabetes mellitus, cataract formation, and erectile dysfunction in young statin users, all of which are alarming. Furthermore there is a significant increase in the risk of cancer and neurodegenerative disorders in the elderly plus an enhanced risk of a myriad of infectious diseases. All side effects are dose dependent and persist during treatment.

    Primary prevention clinical results provoke the possibility of not only the lack of primary cardiovascular protection by statin therapy, but highlight the very real possibility of augmented cardiovascular risk in women, patients with diabetes mellitus and the young. Statins are associated with triple the risk of coronary artery and aortic calcification.

    These findings on statins’ major adverse effects had been under-reported and the way in which they [were] withheld from the public, and even concealed, is a scientific farce.

     Cardiovascular primary prevention and regeneration programmes, through life style changes and abstaining from tobacco use have enhanced clinical efficacy and quality of life over any pharmaceutical or other conventional intervention.”

    If You Take Statins, Your Vision Could Be at Risk

    The featured review found an increased risk of cataracts with statin use, and this was supported by a new JAMA study,4 which further revealed that the risk of cataracts is increased among statin users, compared with non-users. As a main cause of low vision among the elderly, cataract is a clouding of your eye lens.

    It has previously been hypothesized that statin antioxidant effects may slowthe aging process of the lens, but the current study revealed that they, instead, raise cataract risk, again calling into question the usefulness of statins for primary prevention of heart attacks. The researchers concluded:

    The risk-benefit ratio of statin use, specifically for primary prevention, should be carefully weighed, and further studies are warranted.”

    Certain Statins May Impair Your Memory and May Even Lead to Amnesia

    Still more research revealed that rats taking the statin Pravachol (pravastatin) had impaired learning, with lower abilities to perform simple learning and memory tasks.5 This isn’t exactly news, as in 2012, the US Food and Drug Administration (FDA) announced it would be requiring additional warning labels for statins, one of which warned that statins may increase the risk of memory loss and confusion. The warnings, particularly the one for memory loss, came as the result of anecdotal reports compiled over the previous year…

    Interestingly, the animal study found no association between another statin drug, Lipitor, and impaired memory in the rats. But Dr. Duane Graveline, a medical doctor and former astronaut, has written an entire book on this very topic, titled Lipitor: Thief of Memory.

    In my interview with him, Dr. Graveline shared his powerful story about how Lipitor caused him severe global transient amnesia, which is what brought him out of retirement to investigate statins. There have been thousands of cases of transient global amnesia and other types of cognitive damage associated with statin use, reported to the FDA’s MedWatch site. It is believed that statin drugs damage your brain by creating a cholesterol deficiency.

    Insufficient cholesterol results in your brain not having the raw materials it needs to make biochemicals critical for memory and cognitive function, including coenzyme Q10 and dolichols, the latter of which carry the genetic instructions from your DNA to help create specific proteins in your body that are crucial for cognitive function, emotions and mood.

    High Cholesterol Levels May Be Protective

    Any discussion of statins would be incomplete without a discussion of cholesterol – the ‘villain’ that these drugs mercilessly lower. Many buy into the conventional belief that lower cholesterol equals a lower risk of heart disease, but this is not always the case. And, in fact, high cholesterol levels are indeed protective in some cases, whereas low cholesterol levels are very clearly linked to chronic disease. Writing in OJEMD, researchers explained:

    “Cholesterol is crucial for energy, immunity, fat metabolism, leptin, thyroid hormone activity, liver related synthesis, stress intolerance, adrenal function, sex hormone syntheses and brain function. When prescribing HMGCoA reductase inhibitors [statins] one needs to be cognizant of the fact that the body had increased its’ cholesterol as a compensatory mechanism and investigate accordingly.

    We seem to have fallen into the marketing trap and ignored the niggling side effects with regard to the HMGCoA reductase inhibitors. The only statin benefit that has actually been demonstrated is in middle-aged men with coronary heart disease. However, statins were not shown to best form of primary prevention.

    … In actual fact, high cholesterol levels have been found to be protective in elderly and heart failure patients and hypo-cholestereamic [low cholesterol] patients had higher incidence of intra-cerebral bleeds, depression and cancer. … We are observing the revealing of the utmost medical tragedy of all time. It is unprecedented that the healthcare industry has inadvertently induced life-threatening nutrient deficiency in millions of otherwise healthy people. What is even more disparaging is that not only has there been a failure to report on these negative side-effects of statins, there has actually been active discouragement to publish any negative studies on statins.”

    This is, in large part, why so many people are completely unaware that statin drugs have been directly linked to over 300 side effects,6 which include:

    Cognitive loss Neuropathy Anemia
    Acidosis Frequent fevers Cataracts
    Sexual dysfunction An increase in cancer risk Pancreatic dysfunction
    Immune system suppression Muscle problems, polyneuropathy (nerve damage in the hands and feet), and rhabdomyolysis, a serious degenerative muscle tissue condition Hepatic dysfunction. (Due to the potential increase in liver enzymes, patients must be monitored for normal liver function)

    Ask Yourself – and Your informed Physician — if You Really Need to Be Taking Statins

    I’ve long stated that the odds are very high — greater than 100 to 1 — that if you’re taking a statin, you may not even need it, as cholesterol is NOT the cause of heart disease. To further reinforce the importance of cholesterol, I want to remind you of the work of Dr. Stephanie Seneff, who works with the Weston A. Price Foundation.

    One of her theories is that cholesterol combines with sulfur to form cholesterol sulfate, and that this cholesterol sulfate helps thin your blood by serving as a reservoir for the electron donations you receive when walking barefoot on the Earth (also called grounding). She believes that, via this blood-thinning mechanism, cholesterol sulfate may provide natural protection against heart disease.

    In fact, she goes so far as to hypothesize that heart disease is likely the result of cholesterol deficiency — which of course is the complete opposite of the conventional view. So if your physician is urging you to check your total cholesterol, know that this test will tell you virtually nothing about your risk of heart disease, unless it is 330 or higher. HDL percentage is a far more potent indicator for heart disease risk. Here are the two ratios you should pay attention to:

    1. HDL/Total Cholesterol Ratio: Should ideally be above 24 percent. If below 10 percent, you have a significantly elevated risk for heart disease.
    2. Triglyceride/HDL Ratio: Should be below 2.

    Additional risk factors for heart disease include:

    • Your fasting insulin level: Any meal or snack high in carbohydrates like fructose and refined grains generates a rapid rise in blood glucose and then insulin to compensate for the rise in blood sugar. The insulin released from eating too many carbs promotes fat production and makes it more difficult for your body to shed excess weight, and excess fat, particularly around your belly, is one of the major contributors to heart disease
    • Your fasting blood sugar level: Studies have shown that people with a fasting blood sugar level of 100-125 mg/dl had a nearly 300 percent increase higher risk of having coronary heart disease than people with a level below 79 mg/dl
    • Your iron level: Iron can be a very potent oxidative stress, so if you have excess iron levels you can damage your blood vessels and increase your risk of heart disease. Ideally, you should monitor your ferritin levels and make sure they are not much above 80 ng/ml. The simplest way to lower them if they are elevated is to donate your blood. If that is not possible you can have a therapeutic phlebotomy and that will effectively eliminate the excess iron from your body

    Try This Instead for Primary Heart Attack Prevention

    Make no mistake about it, statin drugs are some of the most side effect-ridden medications on the market, and they frequently do more harm than good. Of utmost importance, statins deplete your body of CoQ10, which accounts for many of its devastating results. Therefore, if you take a statin, you MUST take supplemental CoQ10, or better, the reduced form called ubiquinol. If you are interested in optimizing your cholesterol levels (which doesn’t necessarily mean lowering them) and lowering your risk of heart disease and heart attacks, there are natural strategies available for doing so.

    • Reduce, with the plan of eliminating, grains and sugars in your diet, replacing them with mostly whole, fresh vegetable carbs and healthy fats. Also try to consume a good portion of your food raw.
    • Make sure you are getting enough high-quality, animal-based omega-3 fats, such as krill oil.
    • Other heart-healthy foods include olive oil, coconut and coconut oil, organic raw dairy products and eggs, avocados, raw nuts and seeds, and organic grass-fed meats.
    • Optimize your vitamin D levels.
    • Exercise daily, especially with high-intensity interval training (HIIT) exercises.
    • Avoid smoking or drinking alcohol excessively.
    • Be sure to get plenty of good, restorative sleep.

NASA raised thousands of jellyfish in space.


I Don’t Think You’re Ready for This, Jelly

NASA raised thousands of jellyfish in space. They ended up unfit for life on Earth.

A moon jelly, illuminated (Hans Hillewaert/Wikimedia Commons)

Since the early 1990s, we humans have been doing something both odd and eminently sensible: We’ve been launching jellyfish into space. And we have been doing so for science. During NASA’s first Spacelab Life Sciences (SLS-1) mission in 1991, NASA began conducting an experiment: “The Effects of Microgravity-Induced Weightlessness on Aurelia Ephyra Differentiation and Statolith Synthesis.” To carry it out, the space shuttle Columbia launched into space a payload of 2,478 jellyfish polyps—creatures contained within flasks and bags that were filled with artificial seawater. Astronauts injected chemicals into those bags that would induce the polyps to swim freely (and, ultimately, reproduce). Over the course of the mission, the creatures proliferated: By mission’s close, there were some 60,000 jellies orbiting Earth.

The point of all this, as the experiment’s title (sort of) suggests, was to test microgravity’s effects on jellyfish as they develop from polyp to medusa. And the point of that, in turn, was to test how the jellyfish would respond when they were back on Earth. Jellyfish, foreign to us in so many ways, are like humans in one very particular manner: They orient themselves according to gravity.

As the biologist RR Helm explains it:

When a jelly grows, it forms calcium sulfate crystals at the margin of its bell. These crystals are surrounded by a little cell pocket, coated in specialized hairs, and these pockets are equally spaced around the bell. When jellies turn, the crystals roll down with gravity to the bottom of the pocket, moving the cell hairs, which in turn send signals to neurons. In this way, jellies are able to sense up and down. All they need is gravity.

Humans, of course, are similarly sensitive. We sense both gravity and and acceleration using otoliths, calcium crystals in our inner ears that move ultra-sensitive hair cells, thus informing our brains which way gravity is pulling us. So if the space-raised jellyfish didn’t fully develop their version of gravity-sensors, the thinking goes, it’s likely that humans raised in microgravity would have similar trouble.

And here, according to Deep Sea News, is the result of the studies: The astro-jellies’ sense of gravity did, indeed, seem to be impaired by being raised in space. The results of the STS-1 experiment, published in the journal Advances in Space Research, noted that while the space-bred jellies were “morphologically very similar to those which developed on Earth,” their motor abilities were different on Earth than they were in microgravity. In a kind of lit review of the jelly experimentsHelm notes that “while development of the sensory pockets appears normal, many more jellies had trouble getting around once on the planet.” The difficulties included, alas, “pulsing and movement abnormalities, compared to their Earth-bound counterparts.”

Basically, the invertebrates had vertigo. (Or, as PopSci puts it: “As cool as being an astronaut baby sounds, the jellies didn’t develop the same gravity-sensing capabilities as their Earthly relatives.”) Which may not bode well for the vertebrate organisms that may be born in microgravity—space-faring humans among them.

Prevalence of Unruptured Cerebral Aneurysms in Chinese Adults Aged 35 to 75 Years: A Cross-sectional Study.


Background: The reported prevalence of unruptured cerebral aneurysms (UCAs) varies widely.

Objective: To measure the prevalence of UCAs by using 3-dimensional time-of-flight magnetic resonance angiography in adults aged 35 to 75 years.

Design: Cross-sectional study done between June 2007 and June 2011.

Setting: Two communities chosen at random from 2 districts (1 urban and 1 suburban) in Shanghai, China.

Participants: 4813 adults aged 35 to 75 years.

Measurements: Three-dimensional time-of-flight magnetic resonance angiography, interpreted by 3 observers blinded to the participants’ information, was used to identify the location and size of UCAs and to estimate the overall, age-specific, and sex-specific prevalence.

Results: 369 UCAs were found in 336 participants (130 men and 206 women); 4477 participants had no evidence of UCAs. The prevalence was 7.0% overall (95% CI, 6.3% to 7.7%), with 5.5% for men (CI, 4.6% to 6.4%) and 8.4% for women (CI, 7.3% to 9.5%). The overall prevalence of UCAs was higher in women than in men (P < 0.001) and peaked at ages 55 to 64 years in men and women. The UCAs were mostly located in the internal carotid artery (81%), and 90.2% had a maximum diameter less than 5 mm. Mean diameter was larger in women than in men (3.7 mm vs. 3.2 mm; P < 0.009).

Limitation: Participants were from 2 communities selected from 2 districts in Shanghai, and adults older than 75 years were not studied.

Conclusion: The overall prevalence of UCAs was 7.0% in Chinese adults aged 35 to 75 years, and most lesions had a diameter less than 5 mm.

Solar Analemma.


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Credits and Copyrights: V. Rumyantsev

Have you ever heard of an analemma? Most of the time when talking about this phenomena, we are talking about solar analemma, but any celestial object can create an analemma (assuming the proper conditions exist that is). Because of Earth’s tilted axis and its elliptical orbit, the sun changes position in the sky over the course of a year, this causes the sun to follow a curved path through the sky. When the position of the object is recorded at the same time each day over the course of a year, the end result is an analemma.

This particular picture was taken byVasiliy Rumyantsev in Crimea. This is the most complicated picture captured by this photographer. In order to capture an analemma, each picture must be taken from the same location at the same time for a year – this is no easy task. Between August 30, 1998 and August 19, 1999, Rumyantsev set out to capture the solar analemma. He obviously succeeded. The picture was taken every ten days, however, due to bad weather, shooting was prolonged one or two days in some cases (he only missed two exposures because of the weather). The end result is this magnificent 36 image composite of the solar analemma.

Earth’s solar analemma has an apparent shape of a figure eight, resembling the geometric figure known as a “Lemniscates of Bernoulli” (now, that is a cool sounding name). So, how does this shape change as you move around the globe? First, in the northern hemisphere, the smaller loop always appears north of the larger loop. However, at the equator it would be horizontal, and in the southern hemisphere the larger loop is seen north of the smaller loop. Second, you’d only be able to observe half of the analemma at the poles. Also, if you view the analemma at noon it will be upright, whereas viewing it in the early morning/evening will result in it tilting to one side or another.

Mice modeling schizophrenia show key brain network in overdrive.


Working with mice genetically engineered to display symptoms of schizophrenia, neuroscientists at theRIKEN-MIT Center for Neural Circuit Genetics at the Picower Institute for Learning and Memory at MIT have uncovered a faulty brain mechanism that may underlie schizophrenia and other psychiatric disorders in humans.

The study, to appear in the Oct. 16 issue of Neuron, is the first to tie a specific brain network abnormality to schizophrenia, whose symptoms range from disorganized thinking, hallucinations and paranoia to an inability to plan for the future.

“Our study provides new insight into what underlies schizophrenia’s disordered thinking and zeroes in on a new target for future investigation into the neural basis of a cognitive disorder that affects more than 1 percent of the world’s population,” said Susumu Tonegawa, director of the RIKEN-MIT Center for Neural Circuit Genetics and senior author of the study.

Animal studies typically assess the neural mechanisms of the disease’s cognitive and behavioral symptoms through a combination of genetic and pharmacological treatments and behavioral testing. However, the complex nature of disorganized thoughts has made these studies challenging.

Human patients with cognitive disorders such as autism spectrum disorders and schizophrenia show abnormal neural activity in what’s known as the default mode network (DMN)–a network that includes the prefrontal cortex and the hippocampus, the brain structure believed to process memories. Because the DMN is involved in recall and future planning actions, understanding how it processes information and interacts with other brain areas could explain what goes awry in brain disorders.

A crucial communication window

RIKEN-MIT neuroscientists have created a genetically modified mouse with a gene mutation that some schizophrenia patients also harbor—the absence of the normal gene for an enzyme called calcineurin, which plays a crucial role in synaptic plasticity for learning and memory. The mice exhibit behavioral and cognitive abnormalities associated with schizophrenia.

After normal mice run a maze, their brains enter a resting state and start processing information related to the task they just performed, even reliving the route as if replaying a mental video. This kind of information processing plays a critical role in normal brain function, possibly as a window for communication between the neocortex, where long-term memory is stored, and the hippocampus. But in mice modeling schizophrenia, electrical activity in the hippocampus, one of the main components of DMN, surges when it should be idling.

“Our study demonstrated an increase in neural activity in the hippocampus during awake resting periods,” said study co-author Junghyup Suh. “More important, we demonstrated–for the first time–disrupted information processing in single cells as well as neural circuits.”

When rodents run a maze, neurons within the hippocampus exhibit location-specific responses known as place fields. In normal animals, these location-specific responses are replayed in a series during rest periods following the task performance. However, the genetically altered mice did not reactivate place cells in an ordered manner after the task; they reactivated all these cells at an abnormally high level and almost simultaneously.

“Our study provides a novel way to look into the actions of current drugs and treatments and may lead to new insights for improved treatment of psychiatric disorders,” Suh said.

This work was supported by RIKEN Brain Science Institute and the National Institutes of Health. This press release was written by Debbie Halber.

Reference

  • Junghyup Suh, David J. Foster, Heydar Davoudi, Matthew A. Wilson and Susumu Tonegawa.
    “Impaired hippocampal ripple-associated replay in a mouse model of schizophrenia”.
    Neuron,10.1016/j.neuron.2013.09.014

Metoclopramide: No Link Seen With Birth Defects, Stillbirth.


Women prescribed the antiemetic agent metoclopramide during pregnancy appear to be at no significantly increased risk for adverse outcomes, including spontaneous abortion, stillbirth, and infants with congenital malformations, according to results from a new study from Denmark.

The study was published in the October 16 issue of JAMA.

Metoclopramide, a drug frequently used for nausea and vomiting in pregnancy, is thought to be safe, but information on the risk of specific malformations and fetal death is lacking,” write Björn Pasternak, MD, PhD, from the Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark, and colleagues.

The authors note that most women who experience nausea and vomiting during pregnancy can be conservatively managed with a variety of approaches. However, 10% to 15% eventually need to be treated with drugs. Physicians often try treatment with antihistamines and vitamin B6 first, but if those options fail, metoclopramide is often the next choice.

The authors note that previous studies focusing on relatively small numbers of pregnancies have found no problems with metoclopramide.

“Although these findings are generally reassuring and indicate that metoclopramide does not increase the risk of congenital malformations when these outcomes are assessed in aggregate, malformations are a heterogeneous group of disorders and preferably should be studied individually,” the authors write. “Furthermore, no sufficiently powered study has investigated the risk of fetal death associated with metoclopramide exposure in pregnancy.”

To close that gap in knowledge, Dr. Pasternak and colleagues used nationwide health databases covering 1997 to 2011 to identify more than 1.2 million pregnancies and compared pregnancy outcomes of women who took metoclopramide with those who did not.

They say they found no significant association between metoclopramide use and malformations overall (prevalence odds ratio, 0.93; 95% confidence interval, 0.86 – 1.02) in matched cohorts. Among 28,486 women who took metoclopramide during their first trimester of pregnancy, 721 delivered infants with a major congenital malformation, an incidence of 25.3 cases per 1000 births (95% confidence interval, 24.5 – 27.1). The incidence among the matched cohort of women who did not take the drug was about the same: 3024 malformations reported among 113,698 women, or 26.6 cases per 1000 births.

Moreover, the investigators found no evidence that metoclopramide was associated with any of 20 other individual categories of malformation, including neural tube defects, transposition of great vessels, ventricular septal defects, atrial septal defects, tetralogy of Fallot, coarctation of the aorta, cleft lip, cleft palate, anorectal atresia/stenosis, and limb reduction.

In addition, they report, no association was seen between use of the drug and increased risk for spontaneous abortion, preterm birth, low birth weight, fetal growth problems, or stillbirth.

“These safety data may help inform decision making when treatment with metoclopramide is considered in pregnancy,” the authors conclude.

This study was supported by a grant from the Danish Medical Research Council. The authors have disclosed no relevant financial relationships.

Source: JAMA.

 

 

 

 

Severe Sepsis Strategy Significantly Reduces Mortality.


Patients with severe sepsis or septic shock triaged and managed using 4 clinical goals were significantly less likely to die in hospital than patients who did not meet all 4 objectives, a new prospective study shows.

The take-home message is “simple saves,” said Jason D’Amore, MD, from North Shore University Hospital and Long Island Jewish Medical Center in Manhasset, New York.

He explained that the strategy his team developed is easier than targeting specific physiologic goals for patients with sepsis. The work, known as the Early Sepsis Prophylaxis Study, is in contrast to other efforts over the past decade, which manage sepsis using early physiologic-directed therapy.

Here at the American College of Emergency Physicians 2013 Scientific Assembly, Dr. D’Amore reported that his team evaluated all-cause in-hospital mortality using registry data from a healthcare system that include 11 acute care facilities, 3 tertiary centers, and 700,000 emergency department visits per year.

They assessed the impact of goal compliance in 5787 adults who either presented to the emergency department with severe sepsis or septic shock or developed these conditions during hospitalization.

Their sepsis bundle consists of 4 clinical goals:

  • blood cultures before antibiotics
  • lactate before 90 min
  • intravenous (IV) antibiotics before 180 min
  • 30 cc/kg of IV fluids before 180 min

In-hospital all-cause mortality was significantly lower when the goals were used than when they were not (22.6% vs 26.5%; P = .0005).

The strategy was fully implemented in January 2012. Mean in-hospital mortality for this patient population dropped from 30% in the first quarter of 2012 to 23% in the fourth quarter of 2012.

Table. Performance of the Sepsis Management Strategy

Measure

First Quarter

Last Quarter

Patients in full goal compliance (%)

32.4

57.1

Mean time

 

 

   To antibiotic administration (min)

140

102

   To fluid bolus (min)

96

71

   From lactate order to result (min)

45

54

 

On multivariate regression analysis, complete compliance with the goals was associated with a survival odds ratio of 1.194 (1.04 – 1.37; P = .013), even after adjustment for factors such as age, admission to the intensive care unit, vasopressor initiation, central venous catheter insertion, and monitoring of central venous pressure and central venous oxygen saturation.

The overall absolute risk reduction for in-hospital mortality was 3.9% (1.7% – 6.0%).

 

We’re not asking people to do anything other than take a good hard look at a patient, give timely antibiotics, timely fluids, and then remain vigilant.

 

On the basis of these figures, the team calculated the number of patients needed to treat to see a survival benefit. “Every 26 times we complete a bundle, we think we have an opportunity to save a life. That’s meaningful,” Dr. D’Amore said.

“We’re not asking people to do anything other than take a good hard look at a patient, give timely antibiotics, timely fluids, and then remain vigilant about decompensation,” he explained.

This study “certainly shows that the bundle improved care, relative to historic outcomes. We still don’t know if there’s an opportunity to improve this even more,” said session moderator Alan Heffner, MD, from the Carolinas Healthcare System in Charlotte, North Carolina.

Future research could evaluate whether the strategy combined with physiologic parameters or goal-directed therapy improves outcomes in patient with severe sepsis, Dr. Heffner added.

Source: American College of Emergency Physicians (ACEP)

Study Shows Higher Rate of Unruptured Cerebral Aneurysm.


A large survey of adult residents of China has determined that the prevalence of unruptured cerebral aneurysms (UCAs) is 7%, that UCAs increase with age, and that they seem to be more common in women.

This prevalence rate is higher than in previous research, in some cases more than twice as high, probably at least in part because researchers used high-resolution magnetic resonance angiography (MRA) to detect UCAs, said lead author Ming-Hua Li, MD, PhD, professor and chairman of Neuro-radiology, Shanghai Jiao Tong University, China.

Of these, though, only about 8.7% were judged to be at any imminent risk for rupture, they note.

The study was published in the October 15 issue of the Annals of Internal Medicine.

High Diagnostic Accuracy

This new analysis included 4813 residents aged 35 to 75 years from 2 Shanghai districts: Changning, an economically well-developed urban area, and Zhabei, a less developed suburban area. This age group represents the range that is most clinically significant in terms of screening, said Dr. Li. Those younger than 35 years are less likely to have UCAs and those older than 75 have a shorter life expectancy, he said.

Participants completed a standard questionnaire to provide demographic information, personal and family medical history, and lifestyle risk factors, and they underwent a physical examination.

The researchers used 3-dimensional (3D) time-of-flight MRA with a voxel size of less than 0.7 mm. To evaluate UCAs, they applied 3D volume rendering and single artery highlighting. This imaging modality was proven in a previous study by the same research group to have very high diagnostic accuracy for detecting intracranial aneurysms compared with 3D digital subtraction angiography (DSA), said Dr. Li.

In the current study, 3 radiologists who were blinded to participants’ information determined the location and size of the UCAs.

UCAs were defined as abnormal focal dilatations of a cerebral artery with attenuation of the vessel wall or an infundibulum in patients without a history of subarachnoid hemorrhage (SAH). Aneurysms were categorized as less than 3 mm, 3 mm to less than 5 mm, 5 mm to less than 10 mm, or 10 mm or more.

The survey excluded UCAs with a diameter of less than 2 mm because, as Dr. Li explained, aneurysms with such a small diameter are difficult to diagnose with the spatial resolution of the imaging modality used.

Aneurysm Sites

Aneurysms were morphologically classified as regular (saccular), irregular (lobular), or fusiform. Sites were classified as internal carotid artery (including the posterior communicating artery), anterior cerebral artery (including the anterior communicating artery), middle cerebral artery (including the MI-2 bifurcation), and vertebrobasilar artery.

The researchers found that 130 men and 206 women had UCAs, with excellent interobserver agreement. The prevalence of UCAs was 7.0% (95% confidence interval, 6.3% to 7.7%).

This is a higher prevalence than in other studies, probably because the researchers used 3D high-resolution MRA, which enabled them to detect small UCAs, Dr. Li speculated. “Those small UCAs could possibly be missed on 2D invasive angiography due to overlapping,” he said. “In addition, we excluded volunteers younger than 35, who are less likely to have UCAs. This could potentially lead to higher prevalence in our survey compared to studies with a wider age range.”

The prevalence of unruptured UCAs in North America is still unknown, said Dr. Li.

The prevalence was higher in women (8.6%) than in men (5.5%) (P < .001). “We hypothesized that decreases in estrogen concentration and estrogen-receptor density may contribute to an increased risk of cerebral aneurysm development in women,” said Dr. Li.

The prevalence of UCAs increased with age and peaked at ages 55 to 64 years in both men and women. This, said Dr. Li, is in line with a meta-analysis published in Lancet Neurology in 2011.

The majority (90.2%) of the UCAs were less than 5 mm in diameter. The mean maximum diameter of the aneurysm sac was 3.5 mm, and the diameter was larger in women.

Most aneurysms (81%) were located in the internal carotid artery (ICA), with more than half (53.9%) in the C5–C6 segments of the ICA. A possible explanation for this, said the authors, is that the study excluded ruptured aneurysms, which are most often located in the anterior or posterior communicating arteries. In addition, the MRA technology allowed for visualization of more UCAs in the siphon segment of the internal carotid artery.

The researchers found that 8.7% of the detected lesions were potentially risky in that they were large, lobulated aneurysms or grew during follow-up and so may have been prone to rupture.

The patients with these aneurysms potentially in danger of rupture are being followed closely, said Dr. Li. “We currently follow up those patients annually by 3D MRA if the lesions remain stable — so no growth or daughter-sac formation. If lesion growth is detected at follow-up, we suggest further treatment accordingly.”

The study did not show an association between the prevalence of aneurysms and hypertension or cardiovascular disease. This was a cross-sectional study that mainly focused on the prevalence of UCAs, explained Dr. Li, adding that the association between risk factors such as hypertension and cardiovascular disease and development of UCAs in Chinese adults needs to be explored in other longitudinal studies.

The findings may not apply to the general population or to populations outside of China, said the authors.

No Higher

R. Loch Macdonald, MD, PhD, Keenan Endowed Chair in Surgery and head, Division of Neurosurgery, St. Michael’s Hospital, and professor of surgery, University of Toronto, Ontario, Canada, who has a special research interest in cerebral aneurysms, doesn’t believe that the prevalence of aneurysms is any higher in China than elsewhere in the world.

“I suspect they are not more common compared to other geographic regions and ethnicities or races and that the difference is due to a selected older population and more sensitive screening test,” used in the current study, said Dr. Macdonald when approached by Medscape Medical News for a comment.

He pointed to a previously published meta-analysis that found 3% of the population harbored an aneurysm, adjusted to a population with a mean age of 50 years that was 50% male, and expanded on why the numbers in the current study might be much higher.

“They may have found a higher incidence due to inclusion of only patients aged 35 to 75 years,” he added. “Second, the distribution of aneurysms includes many more very small proximal carotid aneurysms. These may not have been diagnosed as frequently before by other methods, so this new screening study may have detected more due to increased sensitivity of the screening method.”

Source:Medscape.com

Choosing Wisely: ACEP Lists 5 Tests to Question


The American College of Emergency Physicians (ACEP) issued a list of 5 tests and procedures that may not be cost-effective in some situations. The ACEP announced this list, which reflects its participation in the ABIM Foundation‘s Choosing Wisely campaign, at the opening session of their annual meeting in Seattle, Washington.

To lower healthcare costs and improve patient care, ACEP recommends that clinicians avoid these interventions when appropriate, after discussing that decision with patients and educating them regarding the rationale.

“ACEP needed a strategy to determine what emergency physicians could do to improve efficiency and reduce cost without affecting the quality of care we deliver,” ACEP Cost Effectiveness Task Force Chair David Ross, MD, an emergency physician in Colorado and medical director for more than 50 emergency medical services agencies in Colorado Springs, said in a news release. “The challenge also was to identify real cost savings, but also to develop consensus among emergency physicians.”

The ACEP board of directors approved the following 5 Choosing Wisely recommendations for patients seen in the emergency department:

1.      For patients with minor head injury who are deemed to be at low risk for skull fractures or hemorrhage, based on validated decision rules, clinicians should avoid head computed tomography scans. The majority of minor head injuries do not result in brain hemorrhage.

2.      For stable patients who can urinate on their own, clinicians should avoid placing indwelling urinary catheters for either urine output monitoring or patient or staff convenience.

3.      For patients likely to benefit from palliative and hospice care services, clinicians should not delay in engaging such services when available. Early referral from the emergency department can improve quality, as well as quantity, of life.

4.      For patients with uncomplicated skin and soft tissue abscesses successfully treated with incision and drainage, clinicians should provide adequate medical follow-up but avoid antibiotics and wound cultures.

5.      For children with mild to moderate, uncomplicated dehydration, clinicians should avoid giving intravenous fluids before a trial of oral rehydration therapy.

“Emergency physicians are dedicated to improving emergency care and to reducing health care costs,” ACEP President Alex Rosenau, DO, said in a news release. “These recommendations are evidence-based and developed with significant input from experts.”

An expert panel of emergency physicians and the ACEP board of directors reviewed pertinent research and input, including a survey of all ACEP members, before developing the recommendations.

In its Choosing Wisely campaign, the ABIM Foundation aims to facilitate discussion among physicians and patients about appropriate use of tests and treatments and avoidance of these interventions when the harms may outweigh the benefits.

More than 80 national, regional, and state medical specialty societies and consumer groups have joined Choosing Wisely since the campaign began in April 2012, but ACEP held off until February 2013. The delay resulted from potential conflicts of the Choosing Wisely strategy with the unique goals of emergency medicine and from concerns that the campaign does not advocate for medical liability reform.

“Overuse of medical tests is a serious problem, and health care reform is incomplete without medical liability reform,” said Dr. Rosenau. “Millions of dollars in defensive medicine are driving up the costs of health care for everyone. We will continue to encourage the ABIM Foundation and its many partners in this campaign to lend their influential voices to the need for medical liability reform.”

Source: American College of Emergency Physicians.