Prompt liver transplant boosts survival in heavy drinkers

Heavy drinkers who have severe liver inflammation are much more likely to survive if they get a prompt liver transplant than if they wait a few months, new research finds. Allowing some alcoholics with a potentially lethal form of liver disease to move up the waiting list for a transplant — a controversial area of transplant policy — would save lives, researchers suggest in the Nov. 10 New England Journal of Medicine.
About 10 to 15 percent of donor livers go to people whose liver disease stems directly from alcohol, says Robert Brown, a hepatologist at Columbia University in New York City who wasn’t involved in the new study. But the number is an estimate at best since many people who qualify for a transplant because of liver damage from other causes might also drink, he says.
In the United States, transplant guidelines require that alcoholics stay sober for six months before they can be placed on the waiting list for a liver transplant. Six months of abstinence and medication improve the health of many people with alcohol-related liver disease, but the delay can be fatal for those with a form of alcohol-induced liver inflammation that doesn’t respond to routine medication. About 70 to 80 percent of people with this condition, called severe alcoholic hepatitis, die within six months.
For the new study, physician Philippe Mathurin of the Claude Huriez Hospital in Lille, France, and his colleagues chose 26 patients to get a liver transplant within a few weeks of being diagnosed with alcoholic hepatitis. The patients had failed to respond to medication such as steroids, the typical treatment for the condition. The researchers also monitored 26 similar patients who didn’t receive transplants.
Six months after surgery, six of the 26 transplant patients had died, compared with 20 of the 26 who didn’t get a liver transplant.
These findings challenge the notion that transplant eligibility for all alcoholism-related liver patients must be linked to a prescribed abstinence period, Mathurin argues. But changing transplant guidelines takes years, he acknowledges, and the new data will need to be reproduced by other scientists. Ultimately, he says, patients on the waiting list for donor organs “need to be ranked by sickest-first and according to the severity of their disease, regardless of the cause.”
Underlying the U.S.’s six-months-sober policy is the assumption that alcohol-related liver disease is a self-inflicted problem, Brown says. “There is an inherent bias against alcohol as a reason for transplant.” He acknowledges that consuming alcohol is a deliberate act but notes that other factors that contribute to liver disease — obesity, smoking, sedentary lifestyle, hepatitis C — could also be seen as self-inflicted. In the study, three of the 26 transplant patients reported drinking at some point during the two years after the operation.
Surgeons have to make difficult assessments when determining how urgently a patient needs a transplant, Brown says, and the new data should be factored in. “When the likelihood of dying is 70 percent, the default has to be to transplant,” he says. Patients with severe alcoholic hepatitis who don’t respond to medication would constitute only a few percent of total liver transplants, he estimates.
The true prevalence of alcoholic hepatitis is unknown, but by some estimates it comprises 10 to 35 percent of all alcohol-related liver disease.

Hands off and on in schizophrenia

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HAND-Y SWITCHSimultaneous stroking of a visible rubber hand (left) and the unseen actual hand (right) of this graduate student caused him to perceive the fake appendage as his own. Schizophrenia patients experience a rubber-hand illusion especially easily and intensely, denoting a disturbance in their sense of body and self.People with schizophrenia rapidly and intensely perceive phony replicas of hands as their own, possibly contributing to this mental ailment’s signature hallucinations, a new study suggests.
In a series of tests, people with schizophrenia believed a rubber hand placed in front of them was theirs if the visible fake hand and the patient’s hidden, corresponding hand were simultaneously stroked with a paintbrush.
Mentally healthy people took longer to experience a less dramatic version of this rubber-hand illusion than schizophrenia patients did, but the effect’s vividness increased among healthy volunteers who reported magical beliefs, severe social anxiety and other characteristics linked to a tendency to psychosis, psychologist Sohee Park of Vanderbilt University in Nashville and her colleagues report online October 31 in PLoS ONE.
“Schizophrenia patients may have a more flexible internal representation of their bodies and a weakened sense of self,” Park says. “Even without psychosis, the rubber-hand illusion can be more pronounced in certain personality types.”
Mental health clinicians have written for several decades about a disturbed sense of self in schizophrenia. A team led by psychiatrist Avi Peled of Sha’ar Menashe Mental Health Center in Hadera, Israel, first reported a powerful rubber-hand illusion in the illness in 2000.
In further support of disturbed body perception in schizophrenia, Park — who directed the new study with graduate student Katharine Thakkar — notes that patients thought that their stationary, unseen hands moved an average of 2 centimeters closer to the rubber hand as they felt and watched brush strokes. Healthy participants reported a weaker version of this effect.
One patient, a 55-year-old man, felt that he floated above his own body and looked down on himself during the three-minute stroking procedure. In a follow-up session, this man had another out-of-body experience, in which he and the experimenter hovered above a lab table for several minutes.
An inability to perceive one’s body as one’s own in schizophrenia prompts heightened reactions to the sight of detached body parts, such as the rubber hand, proposes neurologist Peter Brugger of University Hospital Zurich in Switzerland. That would explain why simply looking at the fake appendage evoked a rubber-hand illusion in several patients in the new study, he says.
Park’s team studied 24 schizophrenia patients and 21 volunteers who had no mental disorders. Patients lived by themselves or in group homes and received antipsychotic medication and other services at an outpatient clinic.
A right-brain region previously linked to out-of-body experiences and representation of one’s body goes awry in schizophrenia, Park hypothesizes. Yoga or other body-awareness exercises may weaken this portion of schizophrenia’s grip, she suggests.
Peled proposes that a communication breakdown among sensory and association networks throughout the brain underlies schizophrenia. This can undermine a sense of body ownership, but patients more often hear tormenting voices and retreat from social life, he says.

Headache tree is a pain in the brain

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Scientists have deciphered how an ingredient in the bay laurel tree (Umbellularia californica) triggers headaches in some people.Dlanglois/Wikimedia Commons

One whiff of a plant known as the headache tree can spur intense, excruciating pain — and now scientists know why.  An ingredient in the tree sets off a chain of events that eventually amps up blood flow to the brain’s outer membrane.
Other headache triggers, such as chlorine, cigarette smoke and formaldehyde, interact with some of the same cellular machinery, suggesting they all work via the same pain-inducing mechanism.
In the new study, an international group of researchers extracted the plant compound umbellulone from dried bay laurel leaves and then exposed various mouse and rat cells to the compound.  Umbellulone tickles the same cellular detector that responds to painfully cold stimuli and the sinus-clearing scent of wasabi and mustard oil, the researchers report online October 27 in Brain.
Stimulating this chemical detector ultimately triggers the release of a particular protein implicated in migraine headaches, the researchers found. This protein prompts blood vessels to swell, and scientists think this swelling puts pressure on the skull and nerves, causing pain.
The new research is solid, says neuroscientist Peter Goadsby, director of the headache center at the University of California, San Francisco. Other irritants linked to headaches interact with the same chemical detector, and it may be a good target for therapy, Goadsby says.
The scent of the bay laurel tree, Umbellularia californica, had been anecdotally implicated as a headache trigger, but it took a self-experimenting headache-sufferer to bring the plant to the attention of researchers in the Headache Center at the University of Florence. Pierangelo Geppetti, who led the study, heard from a friend about a man who was trimming trees on his property and suddenly experienced a cold sensation in his left nostril and then excruciating pain around his left eye. In his youth, the man had regularly gotten cluster headaches, which are one-sided, intense bouts of exceptional pain that often recur in people who suffer from them.
Unlike a full-bore cluster headache, the man’s symptoms quickly faded, and he forgot about the episode. But a few months later when he was again working with bay laurel, the headache struck again.  This prompted him to experiment, intentionally sniffing the crushed leaves of the tree. The intense pain resumed and not long after, Geppetti heard the headache story from their mutual friend.  Intrigued, he began investigating the chemical compounds that might be responsible.

The Ultimate Remote Physiological Monitoring Biosensor Chip

With advancement in medical technologies and the idea to bring less complicated into the picture, the biomedical industry is seeing new innovations on daily basis.

Electric Potential Integrated Circuit (EPIC) is a latest biosensor by Plessey Semiconductors of Roborough, England which contactlessly measures minute changes in voltage levels of patient’s body with …
No electrical contact and gels.
No wires, leads, or medical tape.
No any need to remove the patient’s clothes.
This has to be an ultimate remote physiological monitoring sensor.

Electric Potential Integrated Circuit (EPIC)

Its a very sensitive, contactless digital voltmeter capable of measuring millivolt changes in electric fields, like a magnetometer detects changes in a magnetic field. The sensor has a huge input impedance (10s of gigaohms), so this enables to measure extremely low powered biomedical signals such as ECGs, EOGs etc.
Furthermore, the filtering technology does not allow the noise to obscure the signal of interest. So while monitoring ECG from a subject, the output doesn’t allow the electromyographic signals (due to respiration and body movements etc.) to obscure the ECG trace.

Download Electric Potential Integrated Circuit (EPIC) Sensor Press Release

You can also view the block diagram and technical specifications from here.

Advantages & Applications

• Senses the electrical activity of skeletal muscles including those that control the eyes (EOGs).
• Assisting the disabled, quadriplegics can get the ability to control a cursor on a computer screen or operate a motorized wheelchair with a series of eye movements.
• In prosthetics, it could benefit amputees, who can be employed with a myoelectric hand working on the EMG signals from the residual limb.
• It can pick up minute changes in electric fields through walls. For example, it would allow a firefighter to tell whether someone is inside a smoke-filled room.

Hope, you like this article, keep sharing your views in the comments…

Sources:
IEEE Spectrum
Plessey Semiconductors Official Website

A particulate threat to diabetics

In a new study of people with diabetes, blood pressure rose in rough lockstep with short-term increases in soot and other microscopic air pollutant particles. Such transient increases in blood pressure can place the health of the heart, arteries, brain and kidneys at risk, particularly in people with chronic disease.
In contrast, when ozone levels climbed, blood pressure tended to fall among these people, independent of particulate levels. "And that was certainly not what we expected," notes study coauthor Barbara Hoffmann of the Leibniz Research Institute for Environmental Medicine in Düsseldorf, Germany.
Temperature also had an independent effect: A five-day average increase of 11.5 degrees Celsius, for instance, was associated with a small drop in blood pressure, Hoffmann and her colleagues report online October 21 in Environmental Health Perspectives.
Earlier studies suggested that particulates of the size measured in this study — just 2.5 micrometers in diameter — can hike blood pressure, particularly in people with diabetes.
To further investigate, Hoffman and her colleagues followed 70 Boston-area men and women, ages 40 to 85, with long-standing type 2 diabetes. All lived within 25 kilometers of a major air pollution monitoring station. Each participant submitted to repeated health tests at intervals of several weeks, which the researchers matched up with air pollution values from the preceding five days.
The team found pollution-related changes primarily in systolic blood pressure, the pressure exerted by the pumping action of each heartbeat. Systolic pressure is the top number in a blood pressure reading.
Since levels of particulates and ozone don’t necessarily track, one type of air pollutant cannot be expected to cancel out blood pressure alterations posed by the other, the researchers say. And ozone-associated drops in blood pressure aren’t necessarily beneficial. In fact, Hoffmann says, they offer additional evidence of a diabetes-related impairment in the ability of blood vessels to quickly adjust to changing environmental conditions by relaxing or constricting.
Changes in ozone and air pollution levels had no effect on people whose blood sugar was well controlled. Similarly, people with healthy baseline blood pressure readings exhibited little vulnerability to pollution.
"So especially if you want to positively influence your risk from air pollution," Hoffmann says, "it seems a very good idea to tightly control your blood pressure and your blood sugar."
The fact that a rise in concentrations of near-nanoscale particulates as small as 3.5 micrograms per cubic meter of air could raise systolic blood pressure “corroborates that current levels of particulate matter disrupt blood pressure control,” says physician Robert Brook of the Division of Cardiovascular Medicine at the University of Michigan Medical School in Ann Arbor. The new data, he maintains, confirm that short-term inhalation of fine airborne particulates at ambient levels — and perhaps traffic-related soot in particular — "have small but potentially clinically meaningful effects."

The sound of screech

In a study that borders on painful, people who listened to the sounds of nails and squeaky chalk dragged across a chalkboard have helped scientists pinpoint which frequencies cause people to cringe.
Two scientists who study icky sounds have figured out why fingernails dragged across a chalkboard make people’s skin crawl. It’s not the highest or lowest sounds in the squeak that are so annoying, but rather tones that lie in the range of a piano keyboard.
This makes sense because the human ear has evolved to be sensitive to these frequencies, says Christoph Reuter of the University of Vienna’s Musicological Institute. His colleague, Michael Oehler of the Macromedia University for Media and Communication in Cologne, Germany, will present the findings in San Diego November 3 at a meeting of the Acoustical Society of America.
But sound waves alone can’t account for the excruciating experience. Knowing that a screech comes from a chalkboard instead of a piece of contemporary music increases a listener’s discomfort, the researchers found.
“I’m also convinced that watching somebody scrape their nails on a chalkboard will make the experience even more unpleasant,” says Randolph Blake, a vision scientist at Vanderbilt University in Nashville. More than a quarter of a century ago, he and his colleagues first showed that filtering out the highest frequencies doesn’t make the fingernail-scraping sound any less chilling.
To pinpoint which frequencies are to blame, Reuter and Oehler played six different chalkboard squeaks to 104 unfortunate people who rated their discomfort. The researchers measured changes in 24 listeners’ vital signs and skin conductivity — indicators of stress — while replaying the two most annoying clips.
The shrill sounds contained frequencies ranging all the way to 12,000 hertz and beyond. Cutting out the lowest or highest frequencies didn’t change the listeners’ desire to gouge out their own eyes. But removing all tones between 2,000 and 4,000 hertz did make the experience a little more pleasant — or at least a little less hellish.
It may be that the ear canal naturally resonates with these frequencies, the researchers suggest. This amplifies many of the important sounds people pay attention to every day, including the human voice.
Josh McDermott, a hearing scientist at New York University who has studied other annoying noises like metal being dragged across glass, agrees with this explanation. He says this sensitivity is why people with noisy jobs tend to lose hearing in this frequency range first. McDermott himself has trouble hearing these frequencies — a fact he blames on his former career as a radio DJ.
“We’re learning that’s where some of these really annoying sounds pack most of their punch,” he says.

Nearness key in microbe DNA swaps

Bacteria are more likely to exchange genetic information with their neighbors than with their relatives, a new study shows.
Researchers also found that bacteria living in and on humans are more likely to swap genes than are bacteria that live in soil, oceans or other environments. Exceptions to the neighborhood-only swap-meet rule are genes that confer an evolutionary advantage, such as the ones that make bacteria resistant to antibiotics.
Unlike animals, which can share genes only within species, bacteria readily exchange bits of DNA with other kinds of microbes. Previous evidence had indicated that gene swapping (which scientists call horizontal gene transfer) was mostly limited to closely related bacteria. The new finding that environment plays a bigger role than relatedness in determining swapping partners may be important for tracking antibiotic resistance and disease-causing genes among microbes.
“It’s quite intuitive that bacteria living together would have more chance to exchange,” says Gurvan Michel, a biochemist at the French National Center for Scientific Research marine biological station in Roscoff. “But nobody has really proven this idea before.”
That doesn’t mean relatedness has no importance. “This is not an either-or story,” says David Relman, a microbiologist and infectious disease specialist at Stanford University and the Veteran’s Affairs Palo Alto Health Care System. It could be that closely related species living in the same ecological niche are even more likely to swap genes than nonrelated organisms are, he says.
Inspired by a study Michel and his colleagues published last year showing that genes for digesting seaweed could be transferred from marine algae to bacteria in the intestines of sushi eaters (SN: 5/8/10, p.13), MIT evolutionary biologist Eric Alm set one of his students the task of finding other examples of genes recently swapped between unrelated bacteria.
“We were looking for five to 10, but he came back within a week and said there were 8,000 or something. We thought it was a mistake,” Alm says.
In the end, Alm and his colleagues scoured the genetic blueprints of 2,235 types of bacteria and found 10,770 recently swapped genes. Bacteria that live in or on humans were 25 times more likely to swap genes than ocean or soil bacteria, the researchers report online October 30 in Nature. And bacteria living on the gums were more likely to exchange genes with other gum bacteria than with those in the nose or vagina. The more the researchers subdivided the niches that bacteria inhabit, the more likely the gene transfer, Alm says. The pattern holds even down to how much oxygen bacteria can tolerate. Bacteria with low oxygen tolerance swap more often with other oxygen-averse bacteria than with oxygen lovers.
Disease-causing bacteria are more likely to exchange genes with other pathogenic bacteria than with friendly bacteria. The team found 13 genes shared among bacteria that cause meningitis, even though those bacteria are not otherwise related to each other. The finding suggests that researchers looking for new disease-control strategies may be able to look for swapped genes in unrelated microbes that cause similar ailments, Alm says.
Genes that did make the leap between environments were likely to be ones that make microbes resistant to antibiotics. The team uncovered 42 antibiotic-resistance genes that had recently been transferred between farm animal microbes and human-associated bacteria.
“Which is kind of scary,” Alm says, “because it means that antibiotic-resistant strains don’t have to make it into humans. They can just transfer genes to human bacteria.”
Concrete evidence of gene swapping between microbes from farm animals and humans has been hard to find, says Gautam Dantas, a microbial genomicist at Washington University School of Medicine in St. Louis who studies antibiotic resistance. “To the scientist in the field there has not been much doubt that the abuse of antibiotics in agriculture has exacerbated antibiotic resistance in humans,” he says. “We’ve basically been choosing cheap meat over human health.”