5/16/2018

New cannabis patch for fibromyalgia pain and diabetic nerve pain treatment


5/04/2018

New App Could Make Cannabis Use Safer


‘Am I Stoned’ app designed to help users understand their impairment 

Article ID: 692768
Released: 16-Apr-2018 9:00 AM EDT


Newswise — Although cannabis, also known as marijuana, has been shown to impair memory, reaction time and attention, it is difficult to assess this impairment in a natural setting. Researchers have developed a prototype app called ‘Am I Stoned’ that could help cannabis users understand how the drug is affecting them through a series of phone-based tasks.
Elisa Pabon, a doctoral student at the University of Chicago, will present results from initial testing of the app at the American Society for Pharmacology and Experimental Therapeutics annual meeting during the 2018 Experimental Biology meeting to be held April 21-25 in San Diego.
“One of our long-term goals is for the app to improve the safety of cannabis use by making individual users more aware of their impairment,” said research team leader Harriet de Wit, professor in the Department of Psychiatry and Behavioral Neuroscience at the University of Chicago. “By gathering data from users in the field, the app will also contribute to the overall scientific knowledge in terms of how cannabis affects users.”
As a step towards developing a mobile phone app that could be used in a natural environment, the researchers examined the usefulness of various tasks in assessing impairment in a controlled laboratory environment. They asked 24 healthy non-daily cannabis users to consume a capsule containing a placebo or 7.5 or 15 milligrams of tetrahydrocannabinol (THC), the ingredient in cannabis that makes people high. The study participants then completed standardized computer-based tasks known to detect impairment as well as app-based tasks on an iPhone, which could be used for briefer assessments outside of the laboratory. Neither the participants nor the researchers knew who received the placebo and who received THC.
The researchers successfully detected impairments from THC using three of the four computer tasks and one of the iPhone tasks. The study also showed that users were generally aware of their impairment.
“The effects of THC on performance may be subtle, so we need highly sensitive tasks to detect impairments,” said Pabon. “It is likely that the computer tasks, which took 15 to 20 minutes to complete, were more sensitive to THC impairment because they provided more opportunity to detect a drug effect.” 
Although the app is not intended to predict a person’s ability to drive or engage in activities that may cause harm, the researchers do plan to use what they are learning to develop an app that people can use to assess their own performance. This would require a person to complete the tasks when sober to provide personalized baseline information that could be used in the future to assess their level of impairment after using cannabis.
The researchers plan to use the findings from this study to improve the sensitivity of the app-based tasks to detect THC-induced impairment so that they can eventually deploy the app in a more naturalistic setting.
Elisa Pabon will present the findings at 12:30–2:30 p.m. Tuesday, April 24, in Exhibit Halls A-D, San Diego Convention Center (poster C60 825.10) (abstract). Contact the media team for more information or to obtain a free press pass to attend the meeting.
This study was funded by National Institute of Drug Abuse.
Images available. 
About Experimental Biology 2018
Experimental Biology is an annual meeting comprised of more than 14,000 scientists and exhibitors from five host societies and multiple guest societies. With a mission to share the newest scientific concepts and research findings shaping clinical advances, the meeting offers an unparalleled opportunity for exchange among scientists from across the United States and the world who represent dozens of scientific areas, from laboratory to translational to clinical research.
About the American Society for Pharmacology and Experimental Therapeutics (ASPET)
ASPET is a 5,000 member scientific society whose members conduct basic and clinical pharmacological research within the academic, industrial and government sectors. Our members discover and develop new medicines and therapeutic agents that fight existing and emerging diseases, as well as increase our knowledge regarding how therapeutics affects humans. www.aspet.org
Find more news briefs and tip-sheets at: https://www.eurekalert.org/meetings/eb/2018/newsroom/

Post Polio Litaff, Association A.C _APPLAC Mexico

Mental, Not Physical, Fatigue Affects Seniors’ Walking Ability


Article ID: 692772
Released: 16-Apr-2018 9:00 AM EDT


Newswise — Low “mental energy” may affect walking patterns in older adults more than physical fatigue. 
New research about the relationship between walking ability and self-reported mood will be presented today at the American Physiological Society (APS) annual meeting at Experimental Biology 2018 in San Diego.
Researchers from Clarkson University in New York observed a group of older adults (average age 75) while they performed physically and mentally tiring tasks. The volunteers performed the physical task—a timed walking test at normal speed for six minutes—before and after the cognitive components. LED sensors embedded in the five-meter walking track captured gait speed and stride length. The cognitive portion of the test consisted of several math subtraction activities and visually identifying specific numbers and sequences on a computer screen. The volunteers reported their mood, motivation and energy levels after both the physical and cognitive tests. Vocabulary used to capture the participants’ mood included “a list of mood components such as tense, worn out, energetic, confused [and] lively,” explained Abigail Avolio, first author of the study.
The research team used a well-known correlation formula (Pearson correlation coefficient) to determine the relationship between self-reported mood and physical performance. There was no change in gait in relation to mental fatigue in the first 30 seconds of the follow-up walking test. However, walking speed and stride length later in the test period decreased significantly in people who reported more cognitive fatigue, but not in response to lagging physical energy levels.
More study is needed “to further evaluate why feelings of physical energy and fatigue are not related to gait,” the researchers wrote.
Abigail Avolio, an undergraduate student at Clarkson University, will present “Impact of mood after cognitive fatigue on gait in older adults” on Tuesday, April 24, in the Exhibit Hall of the San Diego Convention Center.
NOTE TO JOURNALISTS: To schedule an interview with a member of the research team, please contact the APS Communications Office or 301-634-7209. Find more research highlights in the APS Press Room.
About Experimental Biology 2018
Experimental Biology is an annual meeting comprised of more than 14,000 scientists and exhibitors from five sponsoring societies and multiple guest societies. With a mission to share the newest scientific concepts and research findings shaping clinical advances, the meeting offers an unparalleled opportunity for exchange among scientists from across the United States and the world who represent dozens of scientific areas, from laboratory to translational to clinical research. www.experimentalbiology.org
About the American Physiological Society (APS)
Physiology is the study of how molecules, cells, tissues and organs function in health and disease. Established in 1887, the American Physiological Society (APS) was the first U.S. society in the biomedical sciences field. The Society represents more than 10,500 members and publishes 15 peer-reviewed journals with a worldwide readership.
www.the-aps.org

Post Polio Litaff, Association A.C _APPLAC Mexico

5/01/2018

Wheelchairs Prohibited in the Last Place You’d Expect







Image
CreditStuart Briers
In March 2017, a woman met with the admissions coordinator at Madison York Assisted Living in Queens, inquiring about placement for her mother-in-law, who was using a wheelchair while recovering from hip surgery.
“Wheelchairs are not allowed in the facility,” the coordinator told her. “Walkers, canes, rollators, hemi canes, something like that is acceptable.” But, he went on, “we cannot accommodate a wheelchair-bound patient.”
In November, another woman seeking assisted living for her mother-in-law emailed the admissions coordinator at VillageCare at 46 & Ten in Manhattan. “We do not admit residents on wheelchairs,” the coordinator wrote back.
By phone, the woman explained that her mother-in-law had used a chair for decades and could transfer in and out without assistance. The coordinator wouldn’t budge. “We could not accept anyone in a wheelchair,” she said.

Excerpts from their recorded conversations are included in a federal lawsuit filed against those centers, claiming they discriminate against people in wheelchairs and are violating the Fair Housing Act, the Americans with Disabilities Act and other federal laws.
“People were being threatened with eviction, or actually evicted, for even part-time use of a wheelchair,” said Fred Freiberg, director of the anti-discrimination group, which brought the suit after receiving complaints from residents and families.
“It’s outrageous. They were told, ‘If you’re going to use a wheelchair, you can’t live here anymore.’”

“Many states have similar policies, though with different language, like ‘must be able to self-evacuate,’ which is often interpreted to mean ‘no wheelchairs,’” said Susan Silverstein, a senior lawyer for the AARP Foundation, which is representing the plaintiffs. “Facilities often justify their policies by citing state laws that are ambiguous.”
Administrators of the facilities named in the New York lawsuit, including Elm York Assisted Living and Madison York Assisted Living, (which share ownership with the other residence in Queens), often cited state laws as reasons to exclude wheelchair users, according to the complaint.
And in this case, they appear to be correct. New York State regulations governing “adult care facilities” and Medicaid-funded assisted living programs, which all four facilities are licensed to offer, do prohibit residents who are “chronically chairfast and unable to transfer” or require assistance to transfer — even when, as in this case, the buildings have elevators.
Those 40-year-old policies predate the federal laws barring discrimination based on disability, but the state has not revised them.

Disabled by severe osteoporosis, the plaintiff lived at VillageCare for five years, until last spring when a urinary tract infection and its complications sent her to a hospital, then to a nursing home for rehabilitation.
After two months, according to the complaint, VillageCare told her she needed more assistance than it could provide, including help with “ambulation,” and told her she could not return. It began eviction proceedings, which her brother contested.
In December, the facility agreed to an in-person interview and assessment. The session — including cognitive tests, sitting and standing, and taking her shoes on and off — lasted four hours.
“It was grueling,” said her brother, who traveled from his Florida home to accompany her. “It was a very difficult thing, but my sister did it. She walked with her walker just fine.”
But VillageCare refused to readmit her, saying she needed assistance with activities of daily living, including “locomotion.” So she remains in a nursing home, where she is discouraged from walking at all, and worries that she may never go home.
“It’s very disheartening,” her brother said. “I keep telling her, ‘You’re going to be out any day,’ and I’ve been wrong.”


















































4/29/2018

Epstein-Barr virus linked to seven serious diseases




A far-reaching study conducted by scientists at Cincinnati Children's reports that the Epstein-Barr virus (EBV)—best known for causing mononucleosis—also increases the risks for some people of developing seven other major diseases.
Those diseases are:  (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), inflammatory bowel  (IBD), celiac disease, and type 1 diabetes. Combined, these seven diseases affect nearly 8 million people in the U.S.
Study results published April 12 in the journal Nature Genetics. The project was led by three scientists: John Harley, MD, PhD, Director of the Center for Autoimmune Genomics and Etiology (CAGE) at Cincinnati Children's and a faculty member of the Cincinnati VA Medical Center; Leah Kottyan, PhD, an immunobiology expert with CAGE; and Matthew Weirauch, PhD, a computational biologist with the center. Critical contributions were provided by Xiaoting Chen, PhD, and Mario Pujato, PhD, both also in CAGE.
The study shows that a protein produced by the Epstein-Barr virus, called EBNA2, binds to multiple locations along the human genome that are associated with these seven diseases.
Overall, the study sheds new light on how environmental factors, such as viral or bacterial infections, poor diet, pollution or other hazardous exposures, can interact with the human genetic blueprint and have disease-influencing consequences.
"Now, using genomic methods that were not available 10 years ago, it appears that components made by the virus interact with human DNA in the places where the genetic risk of disease is increased," Harley says. "And not just for lupus, but all these other diseases, too."
The full impact of this study could take years to explore. Here are some of the initial implications:
New concern about the 'kissing disease'
EBV is a strikingly common virus. In the US and other developed nations, more than 90 percent of the population becomes infected by age 20. In less-developed nations, 90 percent of people become infected by age 2. Once infected, the virus remains in people for their entire lives.
Mononucleosis, which causes weeks of extreme fatigue, is the most common illness caused by EBV. Mono was nicknamed the "kissing disease" years ago because the virus spreads primarily via contact with saliva.
Over the years, scientists have linked EBV to a few other rare conditions, including certain cancers of the lymphatic system. Harley, who has devoted much of his career to studying lupus, found possible connections between lupus and EBV years ago. That work includes proposing mechanisms that the immune system uses in response to the virus that lead to lupus, and showing that children with lupus almost always are infected with EBV.
Today's study adds weight to those lupus findings and adds six more well-known diseases to the list.
"This discovery is probably fundamental enough that it will spur many other scientists around the world to reconsider this virus in these disorders," Harley says. "As a consequence, and assuming that others can replicate our findings, that could lead to therapies, ways of prevention, and ways of anticipating disease that don't now exist."So far, no vaccine exists that will prevent EBV infection.
"I think we've come up with a really strong rationale for encouraging people to come up with more of an effort," Kottyan says. "Some EBV vaccines are under development. I think this study might well encourage them to push forward faster and with rededicated effort."
How EBV hijacks our immune system
When viral and bacterial infections strike, our bodies respond by commanding B cells within our immune systems to crank out antibodies to battle the invaders. However, when EBV infections occur, something unusual happens.
The EBV virus invades the B cells themselves, re-programs them, and takes over control of their functions. The Cincinnati Children's research team has discovered a new clue about how the virus does this, a process that involves tiny proteins called .
Our bodies have about 1,600 known transcription factors at work within our genome. Each cell uses a subset of these to become what they are and to respond to their environment. These proteins constantly move along the strands of our DNA, turning specific genes on and off to make sure cells function as expected.
Credit: Cincinnati Children's
However, when the transcription factors change what they do, the normal functions of the cell can also change, and that can lead to disease. The Cincinnati Children's team suspects that the EBNA2 transcription factor from EBV is helping change how infected B cells operate, and how the body responds to those infected cells.
The new paper shows that seven seemingly unrelated disease states actually share a common set of abnormal transcription factors, each affected by the EBNA2 protein from the Epstein-Barr virus. When these EBNA2-related clusters of transcription factors attach themselves to one portion of the genetic code, the risk of lupus appears to rise. When those same transcription factors land on another part of the code, the risk of multiple sclerosis appears to rise. And so on.
"Normally, we think of the transcription factors that regulate human gene expression as being human," Kottyan says. "But in this case, when this virus infects cells, the virus makes its own transcription factors, and those sit on the human genome at lupus risk variants (and at the variants for other diseases) and that's what we suspect is increasing risk for the disease."
New leads emerge for improving treatment
It remains unclear how many cases of the seven diseases listed in the study can be traced to prior EBV infection. More genomic analyses involving many more patients with these diseases will be required to make reliable estimates.
"The impact of the virus is likely to vary across the diseases," Harley says. "In lupus and MS, for example, the virus could account for a large percentage of those cases. We do not have a sense of the proportion in which the virus could be important in the other EBNA2-associated diseases."
However, the breakthrough identification of specific transcription factors connected to EBV infections opens new lines of study that could accelerate efforts to find cures.
"This same cast of characters is a villain in multiple immune-related diseases," Weirauch says. "They're playing that role through different ways, and doing it at different places in your genome, but it's the same sinister characters. So if we could develop therapies to stop them from doing this, then it would help multiple diseases."
A number of compounds—some experimental, some approved as medications for other conditions—already are known to be capable of blocking some of the high-risk transcription factors listed in the paper, Weirauch says. Teams at Cincinnati Children's have begun deeper studies of some of these compounds.
Findings go far, far beyond EBV
While the EBV-related findings involved more than 60 human proteins linked to seven diseases, the Cincinnati Children's research team already has taken a huge next step. They applied the same analytic techniques to tease out connections between all 1,600 known transcription factors and the known gene variants associated with more than 200 diseases.
The results of that massive cross-analysis also appear in today's study. Intriguing associations were documented involving 94 conditions.
"Our study has uncovered potential leads for many other diseases, including breast cancer," Harley says. "We cannot possibly follow up on all of these, but we are hoping that other scientists will."
After devoting decades of research to hunting down the causes of lupus, Harley says this study represents the most important discovery of his career. "I've been a co-author in almost 500 papers. This one is more important than all of the rest put together. It is a capstone to a career in medical research," he says.
Software behind discoveries to be made public
Detecting and tracking the activities of these transcription factors took years of work involving dozens of laboratory and computational experts.
The project required gathering massive sets of genetic data, then analyzing every genetic change affecting the activity of the . Doing this required creating two new algorithms, called RELI and MARIO, which were developed at Cincinnati Children's by Weirauch and colleagues.
Both software tools and a related website will be made publicly available.
"We are going to great lengths to not only make the computer code available, but all of the data and all of the results," Weirauch says. "We think it's an interesting approach that could have implications for many diseases, so we're contacting experts on the various diseases and sharing the results and seeing if they want to collaborate to follow up on them."
More information: John B. Harley et al, Transcription factors operate across disease loci, with EBNA2 implicated in autoimmunity, Nature Genetics (2018).  DOI: 10.1038/s41588-018-0102-3 











Post Polio Litaff, Association A.C _APPLAC Mexico

The Polio Crusade

THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/

Erradicación de La poliomielitis

Polio Tricisilla Adaptada

March Of Dimes Polio History

Dr. Bruno

video

movie

movie2

A 41-year-old man developed an acute illness at the age of 9 months during which, following a viral illness with headache, he developed severe weakness and wasting of the limbs of the left side. After several months he began to recover, such that he was able to walk at the age of 2 years and later was able to run, although he was never very good at sports. He had stable function until the age of 18 when he began to notice greater than usual difficulty lifting heavy objects. By the age of 25 he was noticing progressive difficulty walking due to weakness of both legs, and he noticed that the right calf had become larger. The symptoms became more noticeable over the course of the next 10 years and ultimately both upper as well as both lower limbs had become noticeably weaker.

On examination there was wasting of the muscles of upper and lower limbs on the left, and massively hypertrophied gastrocnemius, soleus and tensor fascia late on the right. The calf circumference on the right exceeded that on the left by 10 cm (figure1). The right shoulder girdle, triceps, thenar eminence and small muscles of the hand were wasted and there was winging of both scapulae. The right quadriceps was also wasted. The wasted muscles were also weak but the hypertrophied right ankle plantar flexors had normal power. The tendon reflexes were absent in the lower limbs and present in the upper limbs, although the right triceps was reduced. The remainder of the examination was normal.

Figure 1

The patient's legs, showing massive enlargement of the right calf and wasting on the left

Questions

1
What is that nature of the acute illness in infancy?
2
What is the nature of the subsequent deterioration?
3
What investigations should be performed?
4
What is the differential diagnosis of the cause of the progressive calf hypertrophy?

Answers

QUESTION 1

An acute paralytic illness which follows symptoms of a viral infection with or without signs of meningitis is typical of poliomyelitis. Usually caused by one of the three polio viruses, it may also occur following vaccination and following infections with other enteroviruses.1 Other disorders which would cause a similar syndrome but with upper motor neurone signs would include acute vascular lesions, meningoencephalitis and acute disseminated encephalomyelitis.

QUESTION 2

A progressive functional deterioration many years after paralytic poliomyelitis is well known, although its pathogenesis is not fully understood.2 It is a diagnosis of exclusion; a careful search for alternative causes, for example, orthopaedic deformities such as osteoarthritis or worsening scoliosis, superimposed neurological disorders such as entrapment neuropathies or coincidental muscle disease or neuropathy, and general medical causes such as respiratory complications and endocrinopathies.3

QUESTION 3

Investigations revealed normal blood count and erythrocyte sedimentation rate and normal biochemistry apart from a raised creatine kinase at 330 IU/l (normal range 60–120 IU/l), which is commonly seen in cases of ongoing denervation. Electromyography showed evidence of denervation in the right APB and FDI with polyphasic motor units and complex repetitive discharges, no spontaneous activity in the left calf and large polyphasic units in the right calf consistent with chronic partial denervation. Motor and sensory conduction velocities were normal. A lumbar myelogram was normal. Magnetic resonance imaging (MRI) scan of the calves is shown in figure2.

Figure 2

Axial T1 weighted MRI scan (TR 588 ms, TE 15 ms) of the calves, showing gross muscle atrophy and replacement by adipose tissue on the left, and hypertrophy of the muscles on the right, with only minor adipose tissue deposition

QUESTION 4

The differential diagnosis of the progressive calf hypertrophy is given in the box.

Causes of calf muscle hypertrophy

Chronic partial denervation

  • radiculopathy

  • peripheral neuropathy

  • hereditary motor and sensory neuropathy

  • spinal muscular atrophy

  • following paralytic poliomyelitis

    Neuromyotonia and myokymia

  • Isaac's syndrome

  • generalised myokymia

  • neurotonia

  • continuous muscle fibre activity due to: chronic inflammatory demyelinating polyradiculopathy, Guillain Barre syndrome, myasthenia gravis, thymoma, thyrotoxicosis, thyroiditis

    Muscular dystrophies

    Myositis

    Infiltration

  • tumours

  • amyloidosis

  • cysticercosis

    Link here