Category: Health

Sept. 16, 2022 – I want to tell you a story about forgetfulness and haste, and how the combination of the two can lead to frightening consequences. A few years ago, I was lying in bed about to turn out the light when I realized I’d forgotten to take “my pill.”

Like some 161 million other American adults, I was then a consumer of a prescription medication. Being conscientious, I got up, retrieved said pill, and tossed it back. Being lazy, I didn’t bother to grab a glass of water to help the thing go down. Instead, I promptly returned to bed, threw a pillow over my head, and prepared for sleep.

Within seconds, I began to feel a burning sensation in my chest. After about a minute, that burn became a crippling pain. Not wanting to alarm my wife, I went into the living room, where I spent the next 30 minutes doubled over in agony. Was I having a heart attack? I phoned my sister, a hospitalist in Texas. She advised me to take myself to the emergency room to get checked out.

If only I’d known then about “Duke.” He could have told me how critical body posture is when people swallow pills.

Who’s Duke?

Duke is a computer representation of a 34-year-old, anatomically normal human male created by computer scientists at the IT’IS Foundation, a nonprofit group based in Switzerland that works on a variety of projects in health care technology. Using Duke, Rajat Mittal, PhD, a professor of medicine at the Johns Hopkins School of Medicine in Baltimore, created a computer model called “StomachSim” to explore the process of digestion.

Their research, published in the journal Physics of Fluids, turned up several surprising findings about the dynamics of swallowing pills – the most common way medication is used worldwide.

Mittal says he chose to study the stomach because the functions of most other organ systems, from the heart to the brain, have already attracted plenty of attention from scientists.

“As I was looking to initiate research in some new directions, the implications of stomach biomechanics on important conditions such as diabetes, obesity, and gastroparesis became apparent to me,” he says. “It was clear that bioengineering research in this arena lags other more ‘sexy’ areas such as cardiovascular flows by at least 20 years, and there seemed to be a great opportunity to do impactful work.”

Your Posture May Help a Pill Work Better

Several well-known things affect a pill’s ability to disperse its contents into the gut and be used by the body, such as the stomach’s contents (a heavy breakfast, a mix of liquids like juice, milk, and coffee) and the motion of the organ’s walls. But Mittal’s group learned that Duke’s posture also played a major role.

The researchers ran Duke through computer simulations in varying postures: upright, leaning right, leaning left, and leaning back, while keeping all the other parts of their analyses (like the things mentioned above) the same.

They found that posture determined as much as 83% of how quickly a pill disperses into the intestines. The most efficient position was leaning right. The least was leaning left, which prevented the pill from reaching the antrum, or bottom section of the stomach, and thus kept all but traces of the dissolved drug from entering the duodenum, where the stomach joins the small intestine. (Interestingly, Jews who observe Passover are advised to recline to the left during the meal as a symbol of freedom and leisure.)

That makes sense if you think about the stomach’s shape, which looks kind of like a bean, curving from the left to the right side of the body. Because of gravity, your position will change where the pill lands.

In the end, the researchers found that posture can be as significant a factor in how a pill dissolves as gastroparesis, a condition in which the stomach loses the ability to empty properly.

How This Could Help People

Among the groups most likely to benefit from such studies, Mittal says, are the elderly – who both take a lot of pills and are more prone to trouble swallowing because of age-related changes in their esophagus – and the bedridden, who can’t easily shift their posture. The findings may also lead to improvements in the ability to treat people with gastroparesis, a particular problem for people with diabetes.

Future studies with Duke and similar simulations will look at how the GI system digests proteins, carbohydrates, and fatty meals, Mittal says.

In the meantime, Mittal offers the following advice: “Standing or sitting upright after taking a pill is fine. If you have to take a pill lying down, stay on your back or on your right side. Avoid lying on your left side after taking a pill.”

As for what happened to me, any gastroenterologist reading this has figured out that my condition was not heart-related. Instead, I likely was having a bout of pill esophagitis, irritation that can result from medications that aggravate the mucosa of the food tube. Although painful, esophagitis isn’t life-threatening. After about an hour, the pain began to subside, and by the next morning I was fine, with only a faint ache in my chest to remind me of my earlier torment. (Researchers noted an increase in the condition early in the COVID-19 pandemic, linked to the antibiotic doxycycline.)

And, in the interest of accuracy, my pill problem began above the stomach. Nothing in the Hopkins research suggests that the alignment of the esophagus plays a role in how drugs disperse in the gut – unless, of course, it prevents those pills from reaching the stomach in the first place.

Friday, September 16, 2022 (Kaiser News) — Before polio vaccines became available in the 1950s, people wary of the disabling disease were afraid to allow their children outside, let alone go to school. As polio appears again decades after it was considered eliminated in the U.S., Americans unfamiliar with the dreaded disease need a primer on protecting themselves and their young children — many of whom are emerging from the trauma of the covid-19 pandemic.

What is poliomyelitis?

Polio is short for “poliomyelitis,” a neurological disease caused by a poliovirus infection. Of the three types of wild poliovirus — serotypes 1, 2, and 3 — serotype 1 is the most virulent and the most likely to cause paralysis.

Most people infected with poliovirus don’t get sick and won’t have symptoms. About a quarter of those infected might experience mild symptoms like fatigue, fever, headache, neck stiffness, sore throat, nausea, vomiting, and abdominal pain. So, as with covid-19, people who don’t have symptoms can unknowingly spread it as they interact with others. But in up to 1 in 200 people with a poliovirus infection, the virus may attack the spinal cord and brain. When it infects the spinal cord, people may develop muscle weakness or paralysis, including of the legs, arm, or chest wall. Poliovirus may also infect the brain, leading to difficulty breathing or swallowing.

People can develop post-polio syndrome decades after infection. Symptoms may include muscle pain, weakness, and wasting.

People with poliomyelitis may remain wheelchair-bound or unable to breathe without the help of a ventilator for the rest of their lives.

How does polio spread?

The virus that causes polio spreads through the “oral-fecal route,” which means it enters the body through the mouth by way of the hands, water, food, or other items contaminated with poliovirus-containing feces. Rarely, poliovirus may spread through saliva and upper respiratory droplets. The virus then infects the throat and gastrointestinal tract, spreads to the blood, and invades the nervous system.

How do doctors diagnose polio?

Poliomyelitis is diagnosed through a combination of patient interviews, physical examinations, lab testing, and scans of the spinal cord or brain. Health care providers may send feces, throat swabs, spinal fluid, and other specimens for lab testing. But because polio has been vanishingly rare in the United States for decades, doctors may not consider the diagnosis for patients with symptoms. And tests for suspected polio must be sent to the Centers for Disease Control and Prevention, since even academic centers no longer perform the tests.

How can poliovirus transmission be prevented?

The CDC recommends that all children be vaccinated against polio at ages 2 months, 4 months, 6 to 18 months, and 4 to 6 years, for a total of four doses. All 50 states and the District of Columbia require that children attending day care or public school be immunized against polio, but some states allow medical, religious, or personal exemptions. The Vaccines for Children program provides polio vaccine free of charge for children who are eligible for Medicaid, uninsured, or underinsured, or who are American Indian or Alaska Native. Most people born in the United States after 1955 likely have been vaccinated for polio. But in some areas the vaccination rates are dangerously low, such as New York’s Rockland County, where it is 60%, and Yates County, where it is 54%, because so many families there claim religious exemptions.

There are two types of polio vaccine: killed, inactivated polio vaccine (IPV) and weakened, live, oral polio vaccine (OPV). IPV is an injectable vaccine. OPV may be given by drops in the mouth or on a sugar cube, so it’s easier to administer. Both vaccines are highly effective against paralytic poliomyelitis, but OPV appears to be more effective in preventing infection and transmission.

Both the wild poliovirus and the live, weakened OPV viruses can cause infection. Because IPV is a killed virus vaccine, it cannot infect or replicate, give rise to vaccine-derived poliovirus, or cause paralytic poliomyelitis disease. The weakened, OPV viruses can mutate and regain their ability to cause paralysis — what’s called vaccine-derived poliomyelitis.

Since 2000, only IPV has been given in the United States. Two doses of IPV are at least 90% effective and three doses of IPV are at least 99% effective in preventing paralytic poliomyelitis disease. The United States stopped using OPV due to a 1-in-2,000 risk of paralysis among unvaccinated persons receiving OPV. Some countries still use OPV.

Vaccination against polio began in 1955 in the United States. Cases of paralytic poliomyelitis disease plummeted from over 15,000 a year in the early 1950s to under 100 in the 1960s and then down to fewer than 10 in the 1970s. Today, poliovirus is most likely to spread where hygiene and sanitation are poor and vaccination rates are low.

Why is polio spreading again?

The World Health Organization declared North and South America polio-free as of 1994, but in June 2022, a young adult living in Rockland County, New York, was diagnosed with serotype 2 vaccine-derived poliovirus. The patient complained of fever, neck stiffness, and leg weakness. The patient had not traveled recently outside the country and was presumably infected in the United States. The CDC has since started to monitor wastewater for poliovirus. Poliovirus genetically linked to the Rockland County case has been detected in wastewater samples from Rockland, Orange, and Sullivan counties, demonstrating community spread as far back as May 2022. Unrelated vaccine-derived poliovirus has also been detected in New York City wastewater.

How do I know if I’ve been vaccinated against polio?

There is no national database of immunization records, but all 50 states and the District of Columbia have immunization information systems with records going as far back as the 1990s. Your state or territorial health department may also have records of your vaccinations. People immunized in Arizona, the District of Columbia, Louisiana, Maryland, Mississippi, North Dakota, and Washington can access their immunization records using the MyIR Mobile app, and those who got vaccines in Idaho, Minnesota, New Jersey, and Utah can do so using the Docket app.

You may also ask your parents, your childhood pediatrician, your current doctor or pharmacist, or the K-12 schools, colleges, or universities you attended if they have records of your vaccinations. Some employers, like health care systems, may also keep records of your vaccinations in their occupational health office.

There is no test to determine if you’re immune to polio.

Do I need a polio vaccine booster if I was fully vaccinated against polio as a child?

All children and unvaccinated adults should complete the CDC-recommended four-dose series of polio vaccinations. You do not need an IPV booster if you received OPV.

Adults who are immunocompromised, traveling to a country where poliovirus is circulating, or at increased risk for exposure to poliovirus on the job, such as some lab workers and health care workers, may get a one-time IPV booster.

How is polio treated?

People with mild poliovirus infection don’t require treatment. Symptoms usually go away on their own within a couple of days.

There is no cure for paralytic poliomyelitis. Treatment focuses on physical and occupational therapy to help patients adapt and regain function.

Why hasn’t poliovirus been eradicated?

Smallpox is the only human virus to have been declared eradicated to date. A disease may be eradicated if it infects only humans, if viral infection induces long-term immunity to reinfection, and if an effective vaccine or other preventive exists. The more infectious a virus, the more difficult it is to eradicate. Viruses that spread asymptomatically are also more difficult to eradicate.

In 1988, the World Health Assembly resolved to eradicate polio by 2000. Violent conflict, the spread of conspiracy theories, vaccine skepticism, inadequate funding and political will, and poor-quality vaccination efforts slowed progress toward eradication, but before the covid pandemic, the world had gotten very close to eradicating polio. During the pandemic, childhood immunizations, including polio vaccinations, dipped in the U.S. and around the world.

To eradicate polio, the world must eradicate all wild polioviruses and vaccine-derived polioviruses. Wild poliovirus serotypes 2 and 3 have been eradicated. Wild poliovirus serotype 1, the most virulent form, remains endemic only in Pakistan and Afghanistan, but vaccine-derived polioviruses continue to circulate in some countries in Africa and other parts of the world. A staged approach involving the use of OPV, then a combination of OPV and IPV, and then IPV alone would likely be needed to finally eradicate polio from the planet.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Sept. 16, 2022 – All day long, your brain cells are sending and receiving messages through electrical and chemical signals. These messages help you do things like move your muscles and use your senses – as you taste your food, feel the heat coming off a stove, or read the words on this page.

If we could better understand how those messages are sent and received, we’d gain powerful insights into the brain-body connection and shed light on what’s happening when those connections aren’t working – as with brain diseases such as Alzheimer’s and Parkinson’s.

To that end, neuroscientists at Cedars-Sinai in Los Angeles have built computer models of individual brain cells – the most complex models to date, they say. Using high-performance computing and artificial intelligence, or AI, the models, as described in the journal Cell Reports, capture the shape, timing, and speed of the electrical signals that brain cells called neurons fire.

The new research is part of a decades-long pursuit among scientists to understand the inner workings of the brain, not just cognitively but biologically, genetically, and electrically.

The most famous early researchers were Alan Lloyd Hodgkin, Andrew Fielding Huxley, and John Carew Eccles, who won the 1963 Nobel Prize in Medicine for their discoveries about nerve cell membranes.

“Today is a unique moment when detailed, single-neuron data sets are available in large quantities and for many cells,” says study author, Costas Anastassiou, PhD, a research scientist in the Department of Neurosurgery at Cedars-Sinai. “The size and speed of today’s computers allows us to explore [detailed] mechanisms at a single-cell level – for every cell.”

How Do You Model Brain Cell Activity Using a Computer?

Turns out, the electrical pulses neurons use to communicate can be replicated using computer code.

“We replicated the distinct voltage waveforms and time trajectories of these pulses using mathematical equations,” says Anastassiou. Then they built computer models using data sets from experiments in mice.

These experiments measure certain things in the cells – like their size, shape, and structure, or how they respond to changes. Each cell model combines all these elements and can help reveal how they connect.

Computer models can reconcile two critical pieces of information: the cellular makeup (building blocks of brain cells) and the patterns observed during brain activity. With the computer’s help, links between the data sets become clear. This could help pave the way to discover what actually causes the brain to change, the researchers say – a crucial step when looking at disorders.

What Can Computers Tell Us About the Human Brain?

One of the exciting potential uses of the brain cell models would be to test all kinds of theories about brain disorders that would be difficult or impossible to create through experiments in the lab. Beyond that, the work can lead to new insights about the brain: how similar or different brain cells are, what connects or makes them different, and what that means across a spectrum of properties.

Computers and mathematics are telling stories about the brain, and Anastassiou says for him, the fascination comes from the simplicity of the outcome and the richness of their impacts.

“I have always been fascinated by the question of how mathematical equations represent living, computing, biological cells – particularly so for the brain, the epicenter of what makes us human,” he says.

Sept. 16, 2022 – You brought your computer home from work “for 2 weeks” in March 2020 and stayed home for 2 years. Schools went virtual. Club meetings got canceled. Gyms closed.

Friends and family became off-limits. Remember avoiding other people on the street?

It’s gotten better since the outbreak, but we’ve remained in relative isolation far longer than expected. And that’s a little sad – and bad for us. Turns out avoiding a virus can harm your health, because togetherness and connection are foundations of our well-being.

“We as humans are engineered by evolution to crave contact with other humans,” says Richard B. Slatcher, PhD, a professor of psychology at the University of Georgia. “This has been called the ‘need to belong,’ and it’s up there as a basic need with food and water.”

Makes sense: Primitive humans who banded with others were more likely to find food, protect each other, and survive to pass along their genes, he says.

When we were suddenly thrust into isolation in 2020, social ties were already fraying. The book Bowling Alone came out 2 decades earlier. Author Robert D. Putnam lamented the decline in “social capital,” the value we get from connections and our sense of community support. The Atlantic ran a story called “Why You Never See Your Friends Anymore” months before any of us heard of COVID-19.

The pandemic sped up those feelings of isolation. Even after getting vaccinated and boosted, many of us feel we’re not connecting as we would like. And for some, politics has deepened that divide.

Should we care? Yes, say the experts. Social relationships are strongly linked to health and longevity. A famous study published in 2010 in PLOS Medicine concluded that social connections were as important to health as not smoking and more impactful than exercise.

That review, which drew on data from 148 studies, found that people with stronger social relationships were 50% more likely to survive over the 7.5-year follow-up (that is, not die from such causes as cancer or heart disease), compared to those with weaker ties.

Evidence continues to come in. The American Heart Association published a statement this August saying social isolation and loneliness are associated with a 30% increased risk of heart attack and stroke.

“Given the prevalence of social disconnectedness across the U.S., the public health impact is quite significant,” Crystal Wiley Cené, MD, chair of the group that wrote the statement, said in a news release.

The organization said data supports what we suspected: Isolation and loneliness have increased during the pandemic, especially among adults ages 18 to 25, older adults, women, and low-income people.

Your Shrinking Circle

In the first year of the pandemic, there was a slight uptick in loneliness and psychological distress and a slight decrease in life satisfaction, according to a 2022 study in the Journal of Epidemiology & Community Health.

For about 1 in 4 people, social circles shrank, says study author Emily Long, PhD, “even after lockdown restrictions were eased.”
When your circle shrinks, you tend to keep those closest to you – the people who probably are most like you. You lose the diversity in opinion and point of view that you might get chatting with someone in your pickleball league, say, or even a stranger.

“Our exposure to diverse people, lifestyles, and opinions dropped significantly,” says Long. Many of us have seen ties with others weaken or sever altogether over disagreements about COVID restrictions and vaccinations.

This happened with acquaintances, once-close pals, or family members as their views on hot-button topics came to the forefront – topics we may have avoided in the past to keep the peace.

Some of these relationships may not be rebuilt, Long says, though it’s too early to say.

How to Make Better Connections Online

Many of us jumped online for our social interaction. Did Zoom and Instagram and Facebook help us connect?

Sure, in a way.

“It might be more difficult at times, but people can establish meaningful relationships without being physically close,” says John Caughlin, PhD, head of the Communication Department at the University of Illinois Urbana-Champaign, who studies “computer-mediated communication.”

It all depends on how you use it. Late-night “doom scrolling” is not relationship-building. But you can forge new or stronger connections via social media if you’re “treating each other as people,” he says.

Here’s one way: Don’t tap a lazy “like” on a post, but instead leave a thoughtful comment that adds value to the conversation. Maybe chime in with your experience or offer words of support. Give a restaurant recommendation if they’re traveling.

But remember that social media became a minefield during the pandemic, Caughlin says. People blasted out their views on staying home, vaccinations, and masks. You quickly learned who shared your views and rethought your relationship with others.

It’s tempting to view social media as a scourge. But that may just be our inherent panic-button reaction to newish technology, Caughlin says. Surprisingly, overall research – and there has been a lot – has shown that social media has little impact on well-being, he says.

A recent meta-analysis from Stanford University on 226 studies from 2006 to 2018 looked for a link between social media use and well-being. What they found: zero. Some studies show a link between social media and anxiety and depression, true, but that may be because those who have depression or anxiety are more likely to spend more time on social as a way to distract themselves.

Make Someone Happy, Including You

Does this sound familiar? You tend to keep up with friends as a social media voyeur rather than, say, calling, texting, or meeting face-to-face. If that sounds like you, you’re not alone.

But if you reverse course and start reaching out again, it’s likely that both you and the other person will benefit. New research from the American Psychological Association on nearly 6,000 people found that when someone reaches out to us – even if it’s with a quick text – we deeply appreciate it. The study was not only about the pandemic, but researchers say that the results could help people rebuild relationships, especially if they’re not confident about trying.

At the same time, Slatcher, the Georgia professor, notes that more screen time “is not the solution” to loneliness or separation.

“All the work out there has shown that social media use isn’t associated with people being happier or less depressed,” he says.

According to Slatcher, the two key parts of building and maintaining relationships are:

• Self-disclosure, which means sharing something about yourself or being vulnerable by letting others know personal information.
• Responsiveness, which simply means reacting to what someone is saying, asking follow-up questions, and maybe gently sharing something about yourself, too, without taking over the conversation.

These happen in person all the time. On social, not so much.

“Both men and women feel happier when they feel emotionally close with another person, and that’s more difficult to do online,” Slatcher says.

Turns out the strongest connections – those best for your well-being – happen when you put the phone down.

A Surprising Bright Spot in Pandemic Connection

We felt more divided than ever during the pandemic, something affirmed by Pew research. By some measures, Americans have the lowest levels of social trust since World War II, says Frederick J. Riley, executive director of Weave: The Social Fabric Project at The Aspen Institute. If neighbors within a community don’t trust each other, they can’t trust society at large.

But it’s not all bad news.

Researchers have seen connections within communities get stronger during the pandemic, Riley says. These are the people who run errands for elderly neighbors, donate supplies and clothes, set up family-friendly meetups, build community gardens, and more.

The “we’re all in this together” mindset arose early in the pandemic, Long and colleagues found. A meta-analysis in 2022 in Psychological Bulletin found that there’s been more cooperation among strangers. This may be due to greater urbanization or living alone – distance from our close-knit crew forces some to cooperate with others when they wouldn’t otherwise.

This, too, is healthy: A sense of belonging in your community, or “neighborhood cohesion,” as a 2020 study from Canadian researchers points out, has been linked to a lower risk of strokes, heart attacks, and early death. It also helps with mental health.

You can tap into this by, say, volunteering at your child’s school, attending religious services, joining a fitness group, or going to festivals in your city. These deliver a sense of identity, higher self-esteem, and can lower stress and make you feel less lonely, the study authors say. It also fosters a sense that we can make meaningful change in our towns.

Certainly, we’ve all been arguing a lot these days – gun control, abortion, politics. Riley says deeper issues, such as a sense of community safety and creating a better place for kids to grow up, help us transcend these hot-button issues.

Sharing goals brings people together, he says, and that’s fueled by that innate urge for connection and togetherness.

“I am really optimistic for what the future will hold,” he says. “We’ve been in this place [of social distrust] before, and it’s the people in local communities showing that anyone can stand up and make the place they live in better.”

Sept. 16, 2022 – You’ve been doing deep focus work all day. Now you’re mentally fried. Wiped out. Exhausted. But you’re trying to wrap up a project. Should you power through?

New science has the answer: No, you should not.

In a Current Biology study, French researchers found that doing mentally hard tasks for more than 6 hours leads to a buildup in the brain’s prefrontal cortex of glutamate, a molecule involved in learning and memory, that can be toxic in high levels.

“Fatigue might be an adaptation to reduce the accumulation of glutamate,” says study author Antonius Wiehler, PhD, a researcher at the Paris Brain Institute. In other words, that tired feeling could be your brain’s way of telling you to stop so your glutamate levels won’t get any higher.

The researchers divided 40 people into two groups. One group spent more than 6 hours on mentally draining assignments, while the other was given easier tasks to do.

At the end of the day, the group that had to think hard showed more signs of fatigue, including reduced pupil dilation (linked to lower levels of effort, Wiehler explains) and a tendency to favor fast rewards and less effort.

For example, they chose to receive a smaller amount of money right away versus a larger amount later. And they were more likely than the other group to choose a lower difficulty level for a 30-minute task, and a lower resistance level for a 30-minute ride on a stationary bike.

In other words, they made choices that called for less self-control and therefore less effort.

“It must have become more costly for them to apply control,” says Wiehler.

Using magnetic resonance spectroscopy, the researchers also monitored the brain chemistry of the people studied, spotting the higher glutamate levels in the hard thinkers.

“It is important to limit glutamate release,” Wiehler says, explaining that’s because glutamate is a useful resource inside cells, but potentially toxic in excess outside or between cells.

How Can You Restore Brain Function?

One takeaway from this research: You are not a machine. You need rest to restore your brain after a mentally tough day.

“Breaks and sleep are important,” Wiehler says. So, make sure you’re taking 10- to 15-minute breaks throughout the day and getting that solid 8 hours of shut-eye at night.

And try to make important decisions when you’re rested, he suggests.

You might consider planning meals ahead of time to avoid eating unhealthy food after a hard day, or you can try exercising earlier so you can bring more effort to your workout.

Still, Wiehler notes that more research is needed to show that these tips can help.

“We’ll ask the questions: How is [glutamate level] restored during sleep? How long does [sleep] have to be? How long should breaks be?”