Tag: 3/3/21

Categories : Ethics and Law Neurodegenerative DiseasesTags :

Man With Motor Neuron Disease Presents His Case for Euthanasia

On By ModernMedia

At a hearing, a man with a deteriorating condition from motor neuron disease (MND), laid out why he wants the right to choose patient-assisted suicide.

Diethelm Harck, 71, is seeking a change in the laws surrounding euthanasia in South Africa. He is presenting his case alongside Dr Suzanne Walter, a palliative care specialist who has multiple myeloma. Both may not live long enough to see the outcome of their application, and have set up trust funds to assist the overturning of laws surround euthanasia and patient-assisted suicide in South Africa.

In his evidence, he said that he loves life “but my biggest fear is that when my love of life reaches the stage of fearing life, I will not be able to die.”

In the hearing via Zoom, Mr Harck said that he used to exercise daily but now takes three hours to complete a simple routine like getting up and making breakfast.Mr Harck said that his deterioration would be progressive; his muscles are weakening eventually he will be unable to breathe as his diaphragm will stop working.

“From what I have seen and witnessed, MND death is not peaceful,” he said. “I have seen a number of colleagues and [support] group members pass away. They had no way to communicate. And they could not breathe easily.”

Mr Harck continued, “We once visited a young girl suffering from MND, who was totally paralysed. She could only speak with the help of an eye gaze machine. When Lynn [Mr Harck’s life partner] asked her what she feared the most, she said not being able to die.”

Their application is being opposed by The Health Professions Council of South Africa and the Ministers of Health, Justice and the National Director of Public Prosecutions. They claimed that palliative care was available to most South Africans and that the right to life must be protected by the ban on euthanasia.

Source: Eyewitness News

Categories : Mental HealthTags :

Benefits from ‘Microdosing’ Could Just Be Placebo

On By ModernMedia

People who claim they derived benefits from ‘microdosing‘, very small quantities of psychedelic drugs may simply be explained by the placebo effect, a new study has found.

The illegal nature of the drugs used for microdosing posed a problem for the study: not only did it make it unethical for researchers to obtain the drugs themselves and distribute them, but also participants knew what they were taking because they had obtained the drugs themselves. so participants mixed their own supplies of pills with a number of placebo pills, thereby blinding themselves to the trial.

Those participants taking the real psychoactive drugs and those unknowingly taking the placebos reported similar psychological benefits. “Our results are mixed: on the one hand, we observed microdosing’s benefits in a wide range of psychological measures; on the other hand, equal benefits were seen among participants taking placebos,” explained study lead author and Balázs Szigeti, Research Associate at Imperial College London.

“These findings suggest that the benefits are not due to the drug, but rather due to the placebo-like expectation effects. Many participants who reported that they experienced positive effects while taking the placebo were shocked to learn after the study that they hadn’t been taking the real drug.”

Although the results are not as reliable as a placebo-controlled study due to the black market origin of the drugs, the team cautioned, it nevertheless reflected ‘real world’ microdosing and was inexpensive.

“The successful execution of this study could inspire similar studies in a broad range of scientific or medical contexts,” said senior author David Erritzoe, Clinical Senior Lecturer in Psychiatry at Imperial College London. “Accounting for the placebo effect is important when assessing trends such as the use of cannabidiol oils, fad diets or supplements where social pressure or users’ expectations can lead to a strong placebo response. Self-blinding citizen science initiatives could be used as an inexpensive, initial screening tool before launching expensive clinical studies.”

Source: News-Medical.Net

Journal information: Szigeti, B., et al. (2021) Self-blinding citizen science to explore psychedelic microdosing. eLife. doi.org/10.7554/eLife.62878

Categories : Cardiovascular Disease COVIDTags :

Study Shows That COVID Causes Heart Damage

On By ModernMedia

Heart problems in COVID are caused by the virus invading heart cells and causing damage, according to a new study.

Heart problems such as arrhythmia and lack of pumping ability were associated with COVID even at the start of the pandemic. However, it was not clear whether these effects were caused by the virus, or whether it was due to the body’s inflammatory response in mounting a defence against the virus. 

“Early on in the pandemic, we had evidence that this coronavirus can cause heart failure or cardiac injury in generally healthy people, which was alarming to the cardiology community,” said senior author Kory J Lavine, MD, PhD, an associate professor of medicine. “Even some college athletes who had been cleared to go back to competitive athletics after COVID-19 infection later showed scarring in the heart. There has been debate over whether this is due to direct infection of the heart or due to a systemic inflammatory response that occurs because of the lung infection.”

Dr Lavine, along with other researchers from the Washington University School of Medicine, engineered stem-cell derived tissue as a model for how human heart tissue contracts. Studying these heart tissue models, they came to the conclusion that the viral infection kills muscle cells as well as the muscle fibre units involved in heart muscle contraction. This cell death and muscle fibre destruction happened even without inflammation.

“Our study is unique because it definitively shows that, in patients with COVID-19 who developed heart failure, the virus infects the heart, specifically heart muscle cells,”  Dr Lavine said. “Inflammation can be a second hit on top of the damage caused by the virus, but the inflammation itself is not the initial cause of the heart injury.”

While other viral infections have been linked to heart damage, SARS-CoV-2 is unique in that monocytes and dendritic cells dominate the immune response, while other viruses that damage the heart attract T and B cells.

“COVID-19 is causing a different immune response in the heart compared with other viruses, and we don’t know what that means yet,” Dr Lavine said. “In general, the immune cells seen responding to other viruses tend to be associated with a relatively short disease that resolves with supportive care. But the immune cells we see in COVID-19 heart patients tend to be associated with a chronic condition that can have long-term consequences. These are associations, so we will need more research to understand what is happening.”

Source: News-Medical.Net

Journal information: Bailey, A. L., et al. (2021) SARS-CoV-2 Infects Human Engineered Heart Tissues and Models COVID-19 Myocarditis. JACC: Basic to Translational Science. doi.org/10.1016/j.jacbts.2021.01.002.

Categories : Mental Health NeurologyTags :

Repurposed Drug Exploits Ion Channel in The Brain To Treat Depression

On By ModernMedia

Researchers from the Icahn School of Medicine at Mount Sinai Hospital have repurposed a drug to treat depression by using an ion channel that is a completely different mechanism than regular antidepressants.

A study demonstrated that a drug called ezogabine, which opens KCNQ2/3 type of potassium channels in the brain, is linked to significant improvements in depressive symptoms and anhedonia (a lack of ability to feel pleasure) in patients with depression. Anhedonia is a complex, core symptom of depression and is associated with poor outcomes such as increased risk of suicide and reduced responsiveness to antidepressants.
Ezogabine is an anticonvulsant for epilepsy treatment; this novel application in treating depression opens up the investigation of the KCNQ2/3 channel as a potential drug target.

“Our study is the first randomized, placebo-controlled trial to show that a drug affecting this type of ion channel in the brain can improve depression and anhedonia in patients. Targeting this channel represents a completely different mechanism of action than any currently available antidepressant treatment,” said Professor James Murrough, MD, PhD, at the Icahn School of Medicine at Mount Sinai, and senior author of the paper.

The KCNQ2/3 channel belongs to the KCNQ (or Kv7) family of ion channels which are important controllers of brain cell excitability and function in the central nervous system, affecting brain cell function by controlling electrical charge flow across the cell membrane in the form of potassium (K+) ions. Previous research in mice also showed involvement of KCNQ2/3 in depression. Mice that were more resilient to stress had increased KCNQ2/3 channels in their brains.

“We viewed enhanced functioning of the KCNQ channel as a potential molecular mechanism of resilience to stress and depression,” said Ming-Hu-Han, PhD, who also discovered that by increasing the activity of this channel, such as by administering ezogabine, to depressed mice, the drug acted as an antidepressant.

A trial with adult human patients showed that, compared to placebo, those treated with ezogabine showed a large reduction in a number of key measures of depression severity, anhedonia, and overall illness severity.
“The fundamental insight by Dr Han’s group that a drug that essentially mimicked a mechanism of stress resilience in the brain could represent a whole new approach to the treatment of depression was very exciting to us,” said Dr Murrough.

In collaboration with Dr Han, Dr Murrough carried out a series of human studies, with an initial open-label (no placebo) study in patients with depression providing initial evidence that ezogabine could improve symptoms of depression and anhedonia.

“I think it’s fair to say that most of us on the study team were quite surprised at the large size of the beneficial effect of ezogabine on clinical symptoms across multiple measures related to depression. We are greatly encouraged by these findings and the hope they offer for the prospect of developing novel, effective treatments for depression and related disorders. New treatments are urgently needed given that more than one-third of people suffering from depression are inadequately treated with currently approved therapeutics.”

Source: Eureka Alert

Categories : Environmental Effects Neurodegenerative DiseasesTags :

With Climate Change, Heat May Worsen Multiple Sclerosis Symptoms

On By ModernMedia

As average global temperatures increase due to climate change, multiple sclerosis (MS) patients can experience worsening symptoms resulting in an increase in hospital visits.

Some 60% to 80% of MS patients experience heat sensitivity. Increased body temperature slows or stops nerve signals in damaged nerves, which has a number of impacts such as blurred vision and other neurological effects. Heat sensitivity is also correlated with fatigue. Together with fatigue, divided attention from heat sensitivity can contribute to falls.

“We know that heat sensitivity is common in multiple sclerosis, and climate scientists expect that periods of anomalously warm weather will become more frequent with climate change,” said study author Holly Elser, PhD. of Stanford University School of Medicine. “Our study suggests that warming trends could have serious health implications over the long term for people living with MS.”

The study defined anomalously warm weather as a month in which local average temperatures were higher than the long-term average temperature for that month by at least 1.5C.

The researchers drew data on insurance claims for 106 225 people with MS living in the US, and then calculated the estimated effect of anomalously warm weather on MS-related emergency department, inpatient and outpatient visits. Then, the number of medical visits for each person during anomalously warm weather periods was compared to those for periods of normal weather periods.

During anomalously warm weather periods, there was a 4% increased chance of an emergency department visit compared to periods of normal weather. Participants had a 3% increased chance of having an inpatient visit and a 1% increased chance of having an outpatient visit during anomalously warm periods compared to periods of normal weather.

Researchers estimate that during the follow-up period, anomalously warm weather periods were linked to an estimated excess of at least 592 emergency department visits, 1260 inpatient visits and 1960 outpatient visits related to MS.

“While the relative increase in risk of visits is small, the associated absolute effect on people with MS and the health care system is meaningful,” concluded Dr Elser.

Source: Medical Xpress