Virtual Reality Reduces Phantom Pain in Paraplegics

https://goo.gl/fBXfZm

“We managed to provoke an illusion: the illusion that the subject’s legs were being lightly tapped, when in fact the subject was actually being tapped on the back, above the spinal cord lesion,” explains Blanke, lead author of the study and holder of the Foundation Bertarelli Chair in Cognitive Neuroprosthetics. “When we did this, the subjects also reported that their pain had diminished.”

Paraplegics suffer from no longer feeling their legs again, but the condition is often accompanied by neuropathic pain due to the spinal cord lesion. The patient feels pain originating from the legs, even though nothing else can be felt below the lesion. The sensation of pain is real and yet completely resistant to drug therapy. Now, virtual reality may be the key to providing pain relief for this type of pain, and the solution comes from restoring a sense of touch.

“We tapped the back of the subject near the shoulders and the subject experienced the illusion that the tapping originated from the paralyzed legs,” explains Polona Poeg, co-author of the study and now neuroscientist at the Lausanne University Hospital (CHUV). “This is because the subject also received visual stimuli of dummy legs being tapped, viewed through the virtual reality headset, so the subject saw them immersively as his or her own legs.”

The experimental setup involves a pair of dummy legs, a camera, virtual reality goggles and two rods. The legs are filmed by a camera. In real-time, the video is relayed into virtual reality goggles worn by the paraplegic patient. The subject sees the dummy legs viewed from above, as if looking down on one’s owns legs. With this setup in place, the scientist taps the patient’s back with one rod while simultaneously tapping the dummy legs with the other.

The subject therefore receives two stimuli, one tactile on the back, the other visual from the virutal reality display. Despite being consciously aware of being tapped on the back, the subject still begins to feel as though the tapping comes from the paralyzed legs.


There’s a Third, Newly-Identified Type of Diabetes

https://goo.gl/XRQb5W

Most people are familiar with type-1 and type-2 diabetes. Recently, though, a new type of diabetes has been identified: type-3c diabetes.

Type-1 diabetes is where the body’s immune system destroys the insulin-producing cells of the pancreas. It usually starts in childhood or early adulthood and almost always needs insulin treatment. Type-2 diabetes occurs when the pancreas can’t keep up with the insulin demand of the body. It is often associated with being overweight or obese and usually starts in middle or old age, although the age of onset is decreasing.

Type-3c diabetes is caused by damage to the pancreas from inflammation of the pancreas (pancreatitis), tumors of the pancreas, or pancreatic surgery. This type of damage to the pancreas not only impairs the organ’s ability to produce insulin but also to produce the proteins needed to digest food (digestive enzymes) and other hormones.

However, our latest study has revealed that most cases of type-3c diabetes are being wrongly diagnosed with type-2 diabetes. Only 3% of the people in our sample—of more than 2 million—were correctly identified as having type-3c diabetes.

Small studies in specialist centers have found that most people with type-3c diabetes need insulin and, unlike with other diabetes types, can also benefit from taking digestive enzymes with food. These are taken as a tablet with meals and snacks.

Researchers and specialist doctors have recently become concerned that type-3c diabetes might be much more common than previously thought and that many cases are not being correctly identified. For this reason, we performed the first large-scale population study to try and find out how common type-3c diabetes is.


Ketamine May Help Treat Pain in Migraine Suffers Unresponsive to Other Treatments

https://goo.gl/5zTXHS

Ketamine, a medication commonly used for pain relief and increasingly used for depression, may help alleviate migraine pain in patients who have not been helped by other treatments, suggests a study being presented at the ANESTHESIOLOGY 2017 annual meeting.

The study of 61 patients found that almost 75 percent experienced an improvement in their migraine intensity after a three- to seven-day course of inpatient treatment with ketamine. The drug is used to induce general anesthesia but also provides powerful pain control for patients with many painful conditions in lower doses than its anesthetic use.

“Ketamine may hold promise as a treatment for migraine headaches in patients who have failed other treatments,” said study co-author Eric Schwenk, M.D., director of orthopedic anesthesia at Thomas Jefferson University Hospital in Philadelphia. “Our study focused only on short-term relief, but it is encouraging that this treatment might have the potential to help patients long-term. Our work provides the basis for future, prospective studies that involve larger numbers of patients.”


Altered Tetanus Vaccine May Protect Against Allergies and Alzheimer’s

Crossover Treatment find of the week...

https://goo.gl/uKfN9n

Research from the Universities of Dundee and Oxford has shown how combining the tetanus vaccine with a viral particle that normally affects cucumbers can be used to treat psoriasis and allergies, and may even protect against Alzheimer’s disease.

Scientists led by Dundee’s Dr John Foerster and Oxford’s Professor Martin Bachmann, were able to take the protein coat of cucumber mosaic virus and incorporate a tetanus vaccine-derived protein structure known to stimulate the immune system in order to create vaccines to treat multiple chronic diseases.

The vaccine showed positive results in models of psoriasis and cat allergy and was shown to raise antibody levels thought to be beneficial in Alzheimer’s disease. These vaccines can be either preventative, which is the hope for Alzheimer’s but also therapeutic, meaning they can cure a disease like psoriasis after it has already been established.

Patients with Rheumatic Diseases Bail on Biosimilars

https://goo.gl/ct1jwo

Almost one-quarter (24%) of patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis who switched from infliximab (Remicade) to its biosimilar CT-P13 discontinued the biosimilar by 6 months, primarily for subjective reasons, Dutch researchers found.

"The discontinuation rate of 24% in the transition group is much higher than expected," the authors commented.

"In our view, the reason for the substantial discontinuation rate in open-label studies is the awareness of both patients and physicians of the transition to the biosimilar," they wrote.

In recent surveys, some patients expressed concerns about the safety and efficacy of biosimilars, suggesting that the lower cost might mean decreased efficacy.

"Pretreatment expectancy" is a recognized influence in treatment outcomes. "Patients' own negative expectations may induce negative symptoms (hyperalgesia or adverse events) during treatment, the so-called nocebo response," the researchers observed. In addition, adverse events that occur following the transition could be incorrectly attributed by patients to the treatment even if they are independent of the medication.



Mainstream telehealth needs vendors to address pain points

https://goo.gl/mA8Ria

Many of us are impatient for a future where telehealth reduces our visits to health professionals. Whether you are geographically isolated, tired of waiting hours in a waiting room for an overdue appointment or simply have felt the pain of dragging yourself from your sick bed to a doctor’s surgery to acquire a sick note for an employer, consumers are keen to see a change. Current health providers are expanding their services to include remote health. Health tech startups such as mediconecta and couch are creating new stand-alone services for remote care.

However substantial barriers exist for telehealth in practice according to a new survey of the 114 chief information officers, IT directors, telehealth managers and other professionals by the College of Healthcare Information Management Executives and KLAS.

About 59% of respondents listed reimbursement as a limitation, noting that some payers have been slow to reimburse telehealth visits1 and or reimburse at rates lower than face-to-face care. Most said integration between their electronic medical record and virtual care platform vendor was nonexistent or unidirectional. They also cited improved patient access as a major benefit, and three-quarters reported that they were actively planning to either expand the number of specialties served or expand patient access to providers using their present solution.  

According to Adam Gale, president of KLAS: “Telehealth holds enormous promise. However, the underlying technology needs to evolve faster. In particular, integration of telehealth with provider EMRs is still at a primitive level. Vendors need to step up in terms of technology and improved support.” 


Dietary Supplement Dampens Brain Hyperexcitability Seen in Epilepsy

Another interesting pharmacological crossover. Lots of people take glucosamine.....

https://goo.gl/TGoigg

Seizure disorders — including epilepsy — are associated with pathological hyperexcitability in brain neurons. Unfortunately, there are limited available treatments that can prevent this hyperexcitability. However, University of Alabama at Birmingham researchers have found that inducing a biochemical alteration in brain proteins via the dietary supplement glucosamine was able to rapidly dampen that pathological hyperexcitability in rat and mouse models.

These results represent a potentially novel therapeutic target for the treatment of seizure disorders, and they show the need to better understand the physiology underlying these neural and brain circuit changes.

Proteins are the workhorses of living cells, and their activities are tightly and rapidly regulated in responses to changing conditions. Adding or removing a phosphoryl group to proteins is a well-known regulator for many proteins, and it is estimated that human proteins may have as many as 230,000 sites for phosphorylation.

An Alzheimer's Drug Has Been Found to Help Teeth Repair Themselves in Just 6 Weeks

Odd drug crossover effect of the week.......

https://goo.gl/Z78jkL

Dental fillings may soon be left in the ash heap of history, thanks to a recent discovery about a drug called Tideglusib.

Developed for and trialled to treat Alzheimer's disease, the drug also happens to promote the natural tooth regrowth mechanism in mice, allowing the tooth to repair cavities.

Tideglusib works by stimulating stem cells in the pulp of teeth, the source of new dentine. Dentine is the mineralised substance beneath tooth enamel that gets eaten away by tooth decay.

Teeth can naturally regenerate dentine without assistance, but only under certain circumstances. The pulp must be exposed through infection (such as decay) or trauma to prompt the manufacture of dentine.

But even then, the tooth can only regrow a very thin layer naturally - not enough to repair cavities caused by decay, which are generally deep. Tideglusib changes this outcome because it turns off the GSK-3 enzyme, which stops dentine from forming.

In the research, the team inserted small, biodegradable sponges made of collagen soaked in Tideglusib into cavities. The sponges triggered dentine growth and within six weeks, the damage was repaired.

The collagen structure of the sponges melted away, leaving only the intact tooth.

Thus far, the procedure has only been used in mouse teeth.

Allergy Drug Improves Function in Patients with Chronic Injury from Multiple Sclerosis

https://goo.gl/qbi1FA

In light of previous laboratory studies of the antihistamine compound at UCSF, the researchers said, the drug most likely exerted its effect by repairing damage MS had inflicted on myelin, an insulating membrane that speeds transmission of electrical signals in the nervous system.

The drug tested in the trial, clemastine fumarate, was first identified as a candidate treatment for MS in 2013 by UCSF’s Jonah R. Chan, PhD, Debbie and Andy Rachleff Distinguished Professor of Neurology, vice chief of the Division of Neuroinflammation and Glial Biology, and senior author of the new study. First approved by the U.S. Food and Drug Administration (FDA) in 1977 for allergies, the drug has been available over the counter in generic form since 1993.

The researchers said that the Phase II results, published online on Oct. 10, 2017, in The Lancet, are the first in which a drug has been shown to reliably restore any brain function damaged by a neurological disease in human patients.

“To the best of our knowledge this is the first time a therapy has been able to reverse deficits caused by MS. It’s not a cure, but it’s a first step towards restoring brain function to the millions who are affected by this chronic, debilitating disease,” said the trial’s principal investigator, Ari Green, MD, also Debbie and Andy Rachleff Distinguished Professor of Neurology, chief of the Division of Neuroinflammation and Glial Biology, and medical director of the UCSF Multiple Sclerosis and Neuroinflammation Center.

Chan and Green are co-directors of the UCSF Small-Molecule Program for Remyelination, and both are members of the UCSF Weill Institute for Neurosciences.

The new results are particularly notable, Chan said, because patients in the trial had suffered from MS symptoms caused by injury to myelin for years. “People thought we were absolutely crazy to launch this trial, because they thought that only in newly diagnosed cases could a drug like this be effective – intuitively, if myelin damage is new, the chance of repair is strong. In the patients in our trial the disease had gone on for years, but we still saw strong evidence of repair.”


Scientists reverse advanced heart failure in an animal model

This is an exciting possibility. Heart failure is debilitating and lacks effective restorative treatments.....

https://goo.gl/oFP99y

This is a video

Researchers have discovered a previously unrecognized healing capacity of the heart. In a mouse model, they were able to reverse severe heart failure by silencing the activity of Hippo, a signaling pathway that can prevent the regeneration of heart muscle. Read more: https://surg.ws/2xB9J9J 

Original Article: http://www.nature.com/nature/journal/...