Tuesday, August 8, 2017

Obsessive-compulsive disorder linked to inflammation in the brain


Published
By Tim Newman
1687



A common symptom of OCD is an obsession with cleanliness.
Obsessive-compulsive disorder is an intrusive condition that remains difficult to treat. This is due, in part, to the causes behind the disorder remaining hidden. Recent research, however, points the finger at brain inflammation.

Obsessive-compulsive disorder (OCD) is characterized by uncontrollable obsessions and compulsions. Individuals with OCD may experience intrusive thoughts that produce anxiety or a need to repeat certain actions to relieve pent-up anxiety.
Common obsessions in OCD revolve around cleanliness, sexual taboos, aggressive thoughts, and symmetry.
Affecting an estimated 1 percent of people in the United States, around half of OCD cases are classed as severe.
OCD is generally treated with talking therapies - in particular, a type of cognitive behavior therapy called exposure and response prevention is recommended. There are also some medications available, with selective serotonin reuptake inhibitors being the most commonly prescribed. Currently, however, therapies only work for around 70 percent of OCD-affected individuals.
One of the biggest stumbling blocks to finding good treatments is that the physical causes of OCD are not known.

Inflammation and OCD

Breaking research published this week in JAMA Psychiatry takes a look at the role of brain inflammation in OCD. The senior author of the study is Dr. Jeffrey Meyer, head of the Neuroimaging Program in Mood & Anxiety at the Centre for Addiction and Mental Health in Toronto, Canada.
Inflammation is a natural process; it is a normal component of the immune response and a standard reaction to injury. However, if the level of inflammation is inappropriate or continues for too long, it can have negative consequences. For instance, in a number of diseases including rheumatoid arthritis and atherosclerosis, inflammation is heavily involved.
Growing evidence suggests that certain psychiatric conditions may involve neuroinflammation, some of which include major depressive disorder, schizophrenia, and bipolar.
Dr. Meyer and his team set out to understand whether inflammation in the brain could play a role in the development of OCD. To this end, they recruited 40 participants, comprising 20 with OCD and 20 without. Each was scanned using positron emission tomography that had been adapted to pinpoint and measure inflammation in the brain.
Specifically, the researchers were able to selectively dye microglia, which are cells that act as the nervous system's most prominent immune defense and which are activated during inflammation. The researchers measured levels of microglia in six brain regions known to be important in OCD, including the orbitofrontal cortex and anterior cingulate cortex.
The results were clear: in the brain regions associated with OCD, individuals with the disorder had 32 percent more inflammation when compared with people without the condition.
"This finding represents one of the biggest breakthroughs in understanding the biology of OCD, and may lead to the development of new treatments."
Dr. Jeffrey Meyer

From inflammation to treatment

Another interesting finding was that individuals who reported the highest levels of stress when trying to stop themselves from acting on compulsions also had the highest levels of inflammation in a particular brain region.
As so many diseases involve inflammation, there are already a range of drugs designed to tackle it. Because these drugs already exist on the market, it may be a fruitful avenue of research in the hunt for more effective treatments for OCD.
"Medications developed to target brain inflammation in other disorders could be useful in treating OCD," Dr. Meyer says. "Work needs to be done to uncover the specific factors that contribute to brain inflammation, but finding a way to reduce inflammation's harmful effects and increase its helpful effects could enable us to develop a new treatment much more quickly."
Studies are now under way that examine the possibility of designing a blood marker test that could distinguish which patients would benefit most from anti-inflammatory drugs.
Although, as ever, more research is needed, this finding could mark a significant move forward in understanding and treating OCD.

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Breast-feeding mothers at lower risk of heart disease, stroke


Published
By Honor Whiteman
845
a mother breastfeeding her baby
Mothers who breast-feed their babies may be at lower risk of heart disease and stroke.
It is not only babies who benefit from breast-feeding; a new study finds that the practice may lower a mother's risk of heart disease and stroke.
What is more, researchers found that a mother's risk of heart disease and stroke further decreased with each additional 6 months of breast-feeding.
Study co-author Sanne Peters, Ph.D., of the University of Oxford in the United Kingdom, and colleagues recently published their findings in the Journal of the American Heart Association.
Heart disease is the leading cause of death for men and women in the United States. The Centers for Disease Control and Prevention (CDC) report that around 610,000 people die from heart disease every year, accounting for 1 in every 4 deaths.
Stroke is one of America's leading causes of disability. Each year, more than 795,000 people in the U.S. have a stroke. Of these, around 610,000 are first-time strokes.
Previous studies have indicated that women who breast-feed may experience short-term reductions in blood pressure, cholesterol, and weight loss, which may benefit cardiovascular health.
However, Dr. Peters and colleagues note that longer-term effects of breast-feeding on a mother's cardiovascular health remain unclear.

Breast-feeding and cardiovascular health

To get a better understanding of this association, the researchers analyzed the data of 289,573 Chinese women who were part of the China Kadoorie Biobank study. All women were free of cardiovascular disease at study baseline, and almost all of them had children.
As part of the study, the women were required to provide information on their reproductive history, including whether or not they breast-fed their children and the duration of breast-feeding.
The researchers also looked at the incidence of heart disease and stroke among the women over 8 years of follow-up.
The team found that, overall, women who had breast-fed their children were at 9 percent lower risk of heart disease and 8 percent lower risk of stroke, compared with women who had never breast-fed.
Looking at the results by breast-feeding duration, the study revealed that women who had breast-fed their children for 2 years or longer were 18 percent less likely to develop heart disease and 17 percent less likely to have a stroke, compared with non-breast-feeding mothers.
For every 6 additional months of breast-feeding, the risks of heart disease and stroke were reduced by 4 percent and 3 percent, respectively.
After accounting for a wealth of cardiovascular disease risk factors, including smoking, diabetes, and high blood pressure, the results remained.

Metabolism 'reset' may explain findings

The researchers are unable to pinpoint the precise mechanisms behind their findings, but they speculate that the lower risk of heart disease and stroke among breast-feeding mothers may be down to a metabolism "reset" after pregnancy.
"Pregnancy changes a woman's metabolism dramatically as she stores fat to provide the energy necessary for her baby's growth and for breast-feeding once the baby is born. Breast-feeding could eliminate the stored fat faster and more completely," explains Dr. Peters.
Furthermore, the team notes that breast-feeding mothers may be more likely to adopt health behaviors that aid their cardiovascular health, compared with non-breast-feeding mothers.
While the study is observational and cannot prove cause and effect, the researchers believe that their results provide further evidence of the benefits of breast-feeding, particularly for a longer duration.
"The findings should encourage more widespread breast-feeding for the benefit of the mother as well as the child."

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A partner's touch relieves pain, study shows


Published
By Ana Sandoiu

3205


partners holding hands
The touch of our romantic partner helps to alleviate pain, suggest the results of a new study.

Lovers' heartbeats and respiration patterns tend to synchronize when the partners are simply in each other's presence. But what does the role of touch play in this synchronization, and what happens when one of the partners is experiencing pain?

Have you ever noticed that when you walk alongside your partner, your steps tend to synchronize? Or that when you speak to a close friend, you tend to adopt the same posture as them?
The scientific name for this is "behavioral synchrony," and it refers to the human ability to synch up with other people for the sake of living in a society.
Some studies have shown that people are not only able to synchronize their behavior, but that they can also sync up their physiology.
"Interpersonal synchronization" can manifest in various ways. For example, when people watch the same movie, their brain activitysynchronizes. Similarly, when lovers stare into each other's eyes, their hearts quite literally beat as one.
New research carried out by scientists at University of Colorado (CU) Boulder explores the role of touch in driving interpersonal synchronization in the context of pain.
The team was led by Pavel Goldstein, a postdoctoral pain researcher in the Cognitive and Affective Neuroscience Lab at CU Boulder, and the findings were published in the journal Scientific Reports.
Dr. Goldstein explains what prompted his research, saying, "My wife was in pain, and all I could think was, 'What can I do to help her?' I reached for her hand and it seemed to help. I wanted to test it out in the lab: can one really decrease pain with touch, and if so, how?"

Studying pain and touch in couples

Dr. Goldstein and colleagues gathered 22 heterosexual couples for their study, who were all aged between 23 and 32.
The researchers asked the couples to participate in a range of tests that replicated the experience of being in a delivery room.
The female participants were assigned the role of "pain receiver," while the men were "pain observers."
Dr. Goldstein and team recorded the participants' respiration rates and heartbeats using an electrocardiogram under both pain and no pain conditions, as well as in both touch and no touch conditions.
Under the no pain condition, the couples either sat together without touching, sat together while holding hands, or were in separate rooms. In the pain scenario, all three situations were repeated, but the woman was subjected to "mild heat pain" for 2 minutes.

Touch restores synchronicity, eases pain

The study confirmed previous findings and showed that couples do synchronize physiologically just by being in each other's company.
When the woman was subjected to pain and her partner did not touch her, that physiological coupling was considerably diminished. However, when the male partner held her hand, heart rates and respiration rates synched up again, and the woman's pain was reduced. Additionally, holding hands increased the male partner's empathy.
Overall, touch seems to play a key role in interpersonal synchronization, as it increased physiological coupling regardless of whether the woman was in pain or not.
This confirms Dr. Goldstein's previous research, in which he showed that the more empathetic a man is toward a woman, the less pain the woman feels.
It appears that the more physiologically synched we are, the more our pain subsides. However, the researchers do not know whether lower-intensity pain increases interpersonal synchronicity, or whether it is the other way around.
"It could be that touch is a tool for communicating empathy, resulting in an analgesic, or pain-killing, effect," Dr. Goldstein says. Interpersonal coupling may also enhance the analgesic effects of touch using the autonomic nervous system, the authors hypothesize.
Dr. Goldstein also supposes that interpersonal synchronization may affect a brain region called the anterior cingulate cortex, which has been associated with decision-making, social interactions, pain perception both in oneself and in others, and empathy.
But more research is needed, he concedes, to understand the precise mechanism by which a partner's touch helps to diminish pain.
Limitations of the study include the fact that it did not examine same-sex couples or the effect of touch on men experiencing pain.

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The top five social media tools for physicians

Published
By Lisa Chontos
131
Female doctor with tablet
Social media platforms allow doctors to connect with colleagues and patients.
Whether you are an avid tweeter, write a blog, or are a novice to professional social media, your online presence has the power to connect you with potential patients just down the street or colleagues working on similar research across the world.
Having a strong online voice is part of your brand. Any communication by or about you, such as your name being listed on your practice's website, is part of your brand.
Taking control of how you are perceived by others helps to build your professional reputation. Whether you want to expand your practice, find colleagues to collaborate with, or are looking for career opportunities, your reputation is key to achieving your goals.
In a recent article on branding, we brought you tips on how to define and establish your brand. Here, we delve deeper into how to capitalize on the most useful professional social media platforms for physicians.

LinkedIn: Bringing the world to you

Linked in full logo left
LinkedIn is the world's largest professional network, with more than 500 million registered users worldwide.
Half of these users are college graduates, and 45 percent report household incomes of $75,000 or more per year.
Kevin Pho, M.D. - an internal medicine physician and co-author of the book Establishing, Managing and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices - sees several benefits from having a LinkedIn profile. "LinkedIn is a low-threat, low-resource, high-yield action," he said.
Unlike physician rating sites, a social media profile offers more control over how you are presented, Dr. Pho explained. Also, LinkedIn profiles are ranked highest out of all social media platforms, reducing the impact of negative news or physician rating sites.
After registering at LinkedIn.com, create the most thorough profile possible, recommended Jeffrey Benabio, M.D., in an article published on Medjobnetwork.com.
The more complete your profile is, the higher it ranks. The basic information to share is your education, medical expertise, areas of interest, professional experience, the address and phone number of your practice, and links to your website (if you have one).
To make the most of your LinkedIn profile, follow these simple steps:
  • Upload a picture of yourself looking professional but approachable.
  • Personalize your headline.
  • Add keywords, including the name and location of your practice.
  • List at least five of your strongest skills as a physician.
  • Search for colleagues already on LinkedIn and invite them to connect.
  • Join LinkedIn groups that match your interests.
  • Be active by commenting on others' posts and sharing articles of interest, including your own.
  • Finally, customize your profile URL, and include it in your email signature.
LinkedIn allows you to build up a substantial network of connections, communicate directly with other members, post updates, share stories from other outlets, and importantly, track who has viewed your profile.

Doximity: Catering to HCPs

doximity logo left
While LinkedIn is low in physician resources, Doximity is high.
Similar to LinkedIn but exclusive to healthcare professionals in the United States, Doximity connects more than 800,000 of them - 600,000 of which are physicians.
"Doximity has emerged as the core professional profile for doctors and one that's totally within the physician's control," said Bryan Vartabedian, M.D. - director of community medicine for the Division of Gastroenterology, Hepatology and Nutrition for Texas Children's Hospital in Houston - in his blog. "It's the first place I go to update my professional status as it changes."
Creating your profile is easy; you can automatically upload your CV. Conveniently, Doximity keeps your CV updated by scanning the web for information about your latest achievements.
It doesn't stop there. Doximity profile updates are also immediately reflected in U.S. News & World Report physician profiles.
Including your clinical interests allows you to receive the most relevant referrals and news from their DocNews newsfeed. The site also lets you know when your work is being discussed in online conversations.
In addition to connecting physicians with job offers, the site offers CME/CE credits, a residency navigator, and an annual salary survey.
For communicating with your patients, a free digital fax and messaging service provides HIPAA-secure communication from any mobile device. Another tool displays your office number when you call patients from your cell phone.
Between its far-reaching network and well-conceived resources, Doximity expands your influence while boosting your practice on the most practical levels.

Twitter: Big impact in tiny bites

Twitter logo white on blue
With 328 million active users, Twitter is well suited to physicians who want to network, learn, or teach.
The microblogging site lets you make an impact in 140-character posts called "tweets." Quotes and attached media are excluded from the character count. While anyone can read tweets, only registered users can post them.
Tweets often include photos and links. Hashtags (such as #cancer) identify terms and help to organize information. The names, or "handles," of other users are preceded by the @ symbol (such as @mnt).
Physicians usually follow other physicians, allowing them to interact with colleagues interested in the same news, advances, or advocacy.
"On Twitter you can follow thought leaders in any area of medicine and healthcare," Dr. Pho explained. "I have a Twitter list that has 40 healthcare thought leaders that I follow dozens of times a day. To me it's one of the most powerful ways to stay up to date in my area of medicine and healthcare."
Twitter can also bring you the latest news from major medical journals, including pre-published articles as well as policy updates and educational events.
The platform is especially useful for getting insight into patients' perspectives, as many patients and advocacy groups tweet regularly.
Through Twitter, you can even attend medical conferences virtually, by following attendees' tweets. Sharing research findings is easy and can lead to new collaborations.
In 2015, the California Academy of Family Physicians (CAFP) took to Twitter for vaccine legislation.
Up for debate was a bill that would end personal belief exemptions for vaccines. Going up against thousands of Twitter comments opposing the bill, the CAFP formed a coalition with pediatricians and public health officials, tweeting to educate patients and the media.
The result saw California become the third state to ban personal belief exemptions for vaccines.
To add your voice to Twitter, sign up for a free account on Twitter.com. Then, create a profile that includes your name, credentials, and a picture. Search by using hashtags to find the topics most pertinent to you.
Begin by following the physicians and thought leaders who interest you, and "retweet" the most insightful ones. Once you start tweeting your own thoughts and links to original articles, be ready to field the responses.
A record of all your tweets is conveniently stored on your home page.

YouTube: Patients see you in action

You Tube logo small left
While Twitter plugs you into the latest research and gives you a forum to share yours, YouTube can be even more personal.
A short video introducing yourself allows potential patients to start getting to know you before even making an appointment.
YouTube videos can also be a way to educate patients about your services, without any overt marketing.
Orthopedic surgeon C. Noel Henley, M.D., uses YouTube videos to put patients at ease about their upcoming surgeries.
On his blog, he said, "This week, my patient requested a specific procedure. We agreed it should be done, and [...] I fired up my iPad in the office and showed him a 2-minute video of the procedure I created and uploaded to YouTube using free software [...] He was crystal clear on the procedure and prepared for what will happen in a few weeks."
In addition to educating and reassuring existing patients, a YouTube channel can also bring new clients to your door. Using video clips, you can explain illnesses, perform exercises, or demonstrate early detection techniques.
Dr. Henley wrote, "YouTube sends my practice website a large percentage of my best monthly traffic. Last month, the visitors from my YouTube channel stayed on my website longer than most people, and viewed more pages than average."
"This makes sense: a person who watches one of my videos is already interested in my information and wants to know more - before they arrive on my website. If you want to be found by patients, you need to be on YouTube before your local competition figures this out."
To get started, sign up for a free YouTube account. Search for channels relevant to your field, and see what the competition is doing.
Once you're ready to try your hand at it, invest in a high-quality camera. Ensure that you have enough lighting and excellent audio. Choose a setting appropriate to the topic. Videos can be edited with a free tool such as iMovie or Windows Movie Maker.
To get the most out of your channel:
  • Add a professional profile picture to help legitimize your channel.
  • Link back to your practice website, to your other social media accounts, and to similar YouTube channels.
  • End the video by encouraging viewers to subscribe to your channel and directing them to your website.
  • Take advantage of YouTube's free tracking tool to see which videos are most popular. This shows you what additional videos and web pages your viewers might like.

Hootsuite: Tying it all together

Hootsuite logo left
When using multiple social media platforms, one simple tool can make you much more efficient: Hootsuite.
While both free and paid versions are available, the free version allows you to manage three social media profiles and track follower growth.
It also shows you which content you post is most popular, lets you schedule content to post, and integrates two RSS feeds that find and share content from sources you choose.
Dr. Pho turns to the tool to monitor Twitter conversations, as well as any mentions of his handle and his name, and to manage pages and posts on various social media platforms.
"The free version is powerful enough for the majority of physicians," said Dr. Pho. "It's an essential social media tool and I highly recommend it to any physician using social media."
As you ease into social media, start small. Dr. Vartabedian noted, "It doesn't take much. Share your successes and tell some stories on a LinkedIn page and a Twitter account, and you're off to the races."

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Sunday, August 6, 2017

Could a green tea extract help to treat tooth sensitivity?

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Researchers have developed a protective material using the most active polyphenol found in green tea: epigallocatechin-3-gallate.
Available treatments for tooth sensitivity are lacking in a number of ways, such as being ineffective and predisposing patients to bacteria and cavities. But researchers have now developed a new material to better protect sensitive teeth, using green tea polyphenols.
For people with tooth sensitivity, drinking something either too hot or too cold causes sharp and often intolerable pain. Tooth sensitivity and toothache reportedly affect well over 25 percent of people in the United States.
The reason that tooth sensitivity occurs is because the protective enamel layer on the tooth's surface gets eroded, thereby exposing the tooth's next layer of bony tissue, which is called dentin.
Dentin contains small tubes that are empty inside, and when the ends of these microtubes are open, they allow for hot or cold liquids to go straight to the tooth's nerve - thus causing a sharp, jolting pain.
People with sensitive teeth are also more prone to developing cavities due to these microtubules being exposed to bacteria.
Currently available treatments are based on the occlusion, or closing, of these microtubules using a material called nanohydroxyapatite. However, this material is neither resistant enough nor able to block bacteria from penetrating it.
With daily tooth erosion and abrasion from tooth brushing, the blocked microtubules quickly get worn away, and more aggressive bacteria such as Streptococcus mutans can pierce through the microtubules' "seal."
Due to the vulnerabilities of conventional treatment, a team of researchers - led by Dr. Cui Huang, of Wuhan University in China - set out to explore alternative therapies.
A new study detailing this innovation has been published in the journal ACS Applied Materials & Interfaces.

Developing a new biomaterial

Dr. Huang and colleagues set out to create a "versatile biomaterial" using the traditional material nanohydroxyapatite but adding a key ingredient: a green tea compound.
The compound is called epigallocatechin-3-gallate (ECGC), and it is the most active polyphenol in green tea. Previous studies have shown that this compound can effectively battle S. mutans.
The scientists encapsulated this mix into so-called mesoporous silica nanoparticles (MSN).
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Due to the medium size of their pores (or mesoporosity) and their surface properties, MSNs are widely used as drug carriers.
As the authors explain, they chose MSNs because they have been shown to have unique resistance to harmful, cavity-inducing acid, as well as demonstrating a "superior mechanical strength."
Using a technique called confocal laser scanning microscopy, the researchers tested the ability of the newly developed biomaterial to block the formation of the biofilm that S. mutans normally forms on the dentin's surface.
Additionally, they performed biological assays and cytotoxicity tests on pulp tissues of extracted premolars and third molars, or wisdom teeth.

Material releases EGCG for 96 hours

The tests revealed that the new biomaterial successfully blocked the dentin's microtubules and reduced dentin permeability. Additionally, the material released EGCG continuously for more than 96 hours.
The material also proved to be resistant to erosion and abrasion, as well as protecting against the S. mutans biofilm.
The material "significantly [inhibited] the formation and growth of S. mutans biofilm on the dentin surface," the authors write. To their knowledge, this is the first time that such results have been obtained.
Dr. Huang and colleagues are hopeful that this material will successfully treat tooth sensitivity.
"Thus, the development of [the new material] bridges the gap between multifunctional concept and dental clinical practice and is promising in providing dentists a therapeutic strategy for the management of the dentin surface to counter dentin hypersensitivity and caries."
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