Category Archives: SRxA

Fighting Flab with Flying Insects

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cicada 1If, like us, you live in the East Coast of the US, you’ve probably stated to see some of the billions of bug-eyed cicadas that have returned after a 17 year absence.   Cicada sightings are trending on Facebook and other social media sites, almost as frequently as reports of the devastation in Oklahoma and the outcome of the Jodi Arias trial.

I saw my first red eyed cicada on Sunday night…not while out walking my dogs or mowing my yard but in the Emergency Department of my local hospital!  While I’m not certain if it was there as a patient or a visitor, it caused one of my EMS colleagues to run screaming from the room.

This got me thinking about what will you do when ‘swarmageddon’ hits?

cicadapocolypse-537x357-1Will you be locking yourself inside out of terror and to avoid the potential ear trauma resulting from the insects’ loud mating noises, or, will you be embracing the winged critters as a diet delicacy?

That’s right!  Cicadas are an excellent source of nutrients and apparently one of the most versatile ingredients around. They can be deep fried, stir fried, skewered, blanched and even made into ice cream.

But you’ll need to be quick.  Just like another delicacy – truffles – the season will be short. By the end of June, the 2013 cicada invasion will come to a close, and it will be another 17 years before we see them again.

“Cicadas are the shrimp of the land,” says entomologist Isa Betancourt .  She explains: “They are arthropods, which means they have an exoskeleton. We regularly eat the arthropods of the sea … shrimp, lobster, and crabs.”

Better still, cicadas are high in protein and low in fat.  Apparently they have a delicate nutty flavor and buttery texture and are best when they first emerge from the ground in the morning, still soft after shedding their skin.

insect_plate_lAnd even though the thought of eating cicadas might give you the creeps, a U.N. report published this week, unrelated to cicadas, says consuming insects can help fight obesity.

More than 1,900 species of insects are eaten around the world, mainly in Africa and Asia. However, “in the West we have a cultural bias, and think that because insects come from developing countries, they cannot be good,” says  Arnold van Huis, one of the authors of the report, from Wageningen University in the Netherlands,

As well as helping in the costly battle against obesity, which the World Health Organization estimates has nearly doubled since 1980 and affects around 500 million people, the report said insect farming was likely to be less land-dependent than traditional livestock and produce fewer greenhouse gases.

It would also provide business and export opportunities for poor people in developing countries, especially women, who are often responsible for collecting insects in rural communities.

Mexican grasshoppers fried in chilis … could you?Van Huis said barriers to enjoying dishes such as bee larvae yogurt were psychological – in a blind test carried out by his team, nine out of 10 people preferred meatballs made from roughly half meat and half mealworms to those made from meat!

Share your cicada, and other insect, recipes and experiences with us.

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Dogs Double Risk for Distracted Driving

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teen texting and driving-resized-600Distracted driving is something we usually associate with teens and their cell phones, or frenzied mothers and their minivan full of kids.  However the National Highway Safety Traffic Administration defines it as “anything that could potentially remove a driver’s eyes from the road, their hands from the steering wheel or their concentration from the task of driving.”

And that includes pets…

While most states have enacted legislation to curb the use of cell phones while driving, only one – Hawaii – has laws that specifically restrict drivers from having a pet in their lap. But a new study could be about to change all that.  The University of Alabama at Birmingham, research enrolled 2,000 drivers age 70 and older, of whom 691 had pets. Participants took a survey on driving habits, and those with pets were asked about the frequency of driving with pets. They also underwent visual sensory and higher-order visual processing testing.

driving-with-dogsThe results showed that senior drivers who take a pet in the car are at increased risk for being involved in a motor vehicle collision. Both overall, and at-fault, crash rates for drivers 70 years or older were higher for those whose pet habitually rode with them.

More than half the pet owners said they took their pet with them in the car at least occasionally, usually riding on the front passenger seat or in the back seat.

“That is consistent with previous studies looking at all drivers, which indicate that slightly more than half of all drivers take a pet with them at times,” said Gerald McGwin, PhD, senior author of the study. “And it’s interesting to note that earlier surveys indicate that 83% of those surveyed agreed that an unrestrained dog was likely dangerous in a moving vehicle, yet only 16% have ever used any type of restraint on their own pet.”

The crash risk for drivers who always drove with their pets was double that of drivers who never drove with a pet, while crash rates for those who sometimes or rarely drove with pets were consistent with the rates for non-pet owners.

“This is the first study to evaluate the presence of pets in a vehicle as a potential internal distraction for elderly drivers,” said McGwin. “The increased crash rate for elderly drivers who always drive with pets is important in the context of increasing driver awareness about potentially dangerous driving habits. There is no direct evidence that driving with pets is or is not a threat to public safety, however, indirect evidence exists based on distracted driving research on texting, eating or interacting with electronics or even other passengers and there are certainly anecdotal reports in the news media of crashes and even fatalities caused by drivers distracted by a pet in the vehicle.”

dog in carThe authors suggest that when confronted with an increased cognitive or physical workload while driving, elderly drivers have exhibited slower cognitive performance and delayed response times in comparison to younger age groups. Adding another distracting element, especially an animal, provides more opportunity for an older driver to respond to a driving situation in a less than satisfactory way.

Given the current debate about all types of distracted driving, further study of pet-related distracted driving behaviors among drivers, is warranted to appropriately inform the need for policy regulation on this issue.

Do you have thoughts on driving with pets?  Please let us know.

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www.Can-I-Help-You-With-That?

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worldwideweb-20thbday-top640There’s days when reading the news makes you feel old. Today is one of those days.

It started out with the realization that the world wide web just celebrated its 20th birthday. Can it really be 20 years ago?  At launch, there were only 17 “subjects” on the Web, including music, law, religion, and literature. Today the internet is so ubiquitous that we take it for granted…unless of course it goes down, at which point we literally become paralyzed. iphone

Next, I heard that Apple has just declared the first iPhone obsolete.  Really?  What was considered so cutting edge a few short years ago is now obsolete!

So I guess I shouldn’t have been that surprised to hear that robots are ready to take over patient care.  Yes, I know that many of them already perform surgery, but hands-on patient care?

Apparently, roboticists are developing machines that can help patients with tasks, such as housework, feeding and walking. And, according to a Georgia Institute of Technology study, more than half of healthcare providers said that if they were offered an assistant, they would prefer it to be robotic rather than human.

However, they don’t want robots to help with everything.  Activities of daily living such as helping with housework and reminding patients when to take medication, were acceptable, but activities involving direct, physical interactions such as bathing, getting dressed and feeding, were considered better for human assistants.

This study mirrored the lab’s earlier research that found older people are generally willing to accept help from robots, but their preferences depended on the task. These tech-savvy seniors said they preferred robotic help over human help for chores such as cleaning and doing laundry. However, they preferred human help with bathing and getting dressed.

“One open question was whether healthcare providers would reject the idea of robotic assistants out of fear that the robots would replace them in the workplace,” said Tracy Mitzner, one of the study’s leaders and the associate director of Georgia Tech’s Human Factors and Aging Laboratory. “This doesn’t appear to be a significant concern. In fact, the professional caregivers we interviewed viewed robots as a way to improve their jobs and the care they’re able to give patients.”

robot giving medicationFor instance, nurses preferred a robot to help them lift patients from a bed to a chair. They also indicated that robotic assistants could be helpful with some medical tasks such as checking vitals. feeling oldJust like the internet it seems robots are going to take over our lives.

Not sure that I’m looking forward to a future where doctors have been replaced by nurses who have been replaced by robots… SRxA-logo for web

Fluffy Therapy

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animal-therapyThese days, therapy dogs and cats are often brought into health care facilities to help boost their health and happiness of people suffering from mental and physical illnesses or disabilities.

The results are often so amazing, they are almost inexplicable. I vividly remember, Laura, a patient from many years ago. She was a sweet old lady, who was deaf, dumb and blind and had recently been diagnosed with advanced breast cancer. Following surgery, in a strange hospital environment she seemed to be lost in her world of diminished senses, and appeared to be giving up. She wasn’t eating, or drinking. IV fluids were keeping her alive and diamorphine was keeping her pain free. Anticipating she didn’t have much longer to live, I called the next of kin listed in her records and spoke to her sister. The younger sibling, who lived half-way around the country, agreed to come but asked if she could bring Laura’s service dog. At the time, this was unheard of on a surgical unit and would certainly have been frowned upon by hospital authorities. Never one to follow the rules, and a self-confessed animal lover, I immediately agreed. I’d deal with the consequences later if need be.

DocTheDog041_t607A few days later, Grace arrived on the ward with Honey, a calm and happy Golden Labrador. Without any directions, Honey led Grace straight to Laura’s bed and laid her big head on her mistresses’ frail outstretched arm. Laura’s eyes opened, she sat up, and began talking to the dog.

This wasn’t a miracle in the conventional sense, the dog had not restored the power of speech, it turned out that Laura, while blind, could hear and speak perfectly well. However, separated from her faithful companion, she’d become profoundly depressed, and simply stopped communicating.

Honey stayed in the hospital for several weeks, barely leaving Laura’s bedside, until they were both ready to go home. During those weeks, other patients benefitted from Honey’s presence too. Even the medical and nursing staff even seemed to be cheerier as they went about their work.  So not a conventional miracle, but one of the closest things I’ve ever seen to one.

Did I get into trouble for harboring and concealing a canine?  Sure!  Would I do it again?  In a heartbeat!

Therapy animal programs are designed to promote improvement in human physical, social, emotional, or cognitive function, according to the American Veterinary Medical Association. Therapy can occur in a group setting or individually, and can benefit patient populations from the young to elderly, to those in hospitals, nursing homes, assisted-living homes and rehabilitation facilities.

RojocroppedSo, I was more than a little curious when I read that Providence Children’s Center in Oregon is employing two unique therapy animals to help patients smile: an alpaca named Napoleon, and a llama named Rojo.  The unique pair light up every room they enter at the hospital.

“I never realized the power animals have to bring healing and joy to people like this,” said Kelly Schmidt, a social worker at the Children’s Center. “I truly believe they are given a purpose more than just entertainment.”

Rojo is an “old pro” at making children happier. From the day he was born in April of 2002, Rojo has enjoyed being around people of all ages. His owner, Lori Gregory, of Mtn Peaks Therapy Llamas and Alpacas in Vancouver, WA along with handler, Shannon Hendrickson, trained Rojo and entered him in local and state level fairs in the Public Relations and Handler Classes. While at the fair, a spectator observed Rojo’s exceptionally gentle temperament, and suggested that he become certified as a therapy animal. The rest, as they say, was history. Rojo even has his own Facebook page!

Gregory, just like the patients, feels a rush when she introduces her animals – which are often dressed in funny hats and other silly outfits – at hospitals and other medical facilities.  “When you realize that they have this amazing ability to create a natural response therapeutic-wise to get people to do things they normally wouldn’t do.”

napoleon alpacaHer stable also includes two other llamas and two more alpacas.  On its website, Mtn Peaks says its animals have made more than 650 therapeutic visits to patients since the organization was founded in 2007.  They add “Our Therapy Teams might take a walk with an adolescent struggling with difficult issues, or motivate a patient recovering from a stroke to reach farther, or calm a child with autism so that they can focus, and achieve new goals. By offering friendship and warm touch, our llamas help alleviate loneliness, lower blood pressure and reduce stress. Their presence brings a sense of normalcy to institutional settings.

therapy elephantIn researching this post, I also came across other unique therapy animals including miniature horses, elephants (which have been used in Thailand to help some children with autism), helper monkeys and animals with disabilities.

Have you worked with or been helped by therapy animals?  If so we’d love to hear from you and share your stories.

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Radioactive Bacteria:1 – Pancreatic Cancer:0

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pancreatic cancer facesYears ago, when I was just starting my healthcare career, I worked with a team specializing in the management of patients with pancreatic cancer.  Despite the dedication and compassion of our team, revolutionary surgical techniques, and top-notch palliative care, all too often our patients died. Even today, some 30 years later, pancreatic cancer has a poor prognosis. It’s seldom detected in its early stages, and often spreads rapidly. Signs and symptoms frequently don’t appear until the disease is advanced and surgical removal isn’t possible.

Pancreatic cancer touches so many people. It killed my childhood mentor and one of my best friends. It’s taken the lives of many household names, from astronauts to actors, entrepreneurs to opera singers.  For example, Patrick Swayze, Randy Pausch, Luciano Pavarotti, Dizzy Gillespie, Count Basie, Michael Landon, Joan Crawford, Sally Ride and of course, Apple CEO – Steve Jobs.

So, I was excited to hear about new research into a targeted anti-cancer therapy that promised limited side effects. The study, published April 22 in the Proceedings of the National Academy of Sciences found that treating mice with an attenuated, radioactively labeled bacteria –  Listeria monocytogenes - drastically reduced the number of metastases, while leaving normal tissue unscathed.

The notion of using bacteria to attack tumors is not new. Robert Hoffman, a cancer biologist at the University of California, San Diego, who was not involved in the current study, has shown that Salmonella can kill mouse cancer cells, including metastases of pancreatic cancer.

Other research has shown that a Listeria strain known as CRS-207 has the ability to stimulate an immune response in Phase 1 and 2 trials.

listeria.monocytogenesIn the new study, researchers at Albert Einstein College of Medicine have paired this technique with a radioactive isotope to selectively kill tumor cells, focusing on the metastatic cells that so often elude current treatment regimens.

It’s this combination of approaches that synergistically target metastases, that’s new. Claudia Gravekamp, an immunologist at Albert Einstein College of Medicine who led the study with nuclear medicine researcher Ekaterina Dadachova had previously demonstrated that an attenuated strain of Listeria monocytogenes, a type of bacterium that penetrates host cells during infection, selectively killed breast cancer cells without damaging normal tissue. The bacteria’s ability to target only diseased cells raised the possibility that it could be used to treat metastatic cancer by both directly killing cells and by carrying anti-tumor therapies—like radiation—to cancer cells.

pancreatic_cancerGravekamp and Dadachova tested the bacteria against highly metastatic pancreatic cancer in mice. First, they demonstrated that the bacteria proliferated well in the animals’ metastases, but poorly in the primary tumor, and not at all in normal tissues like spleen, suggesting the bacteria would be good candidates for delivering a therapy to far-flung metastases.

Then, the researchers armed the Listeria with the Rhenium-188, a radionuclide that kills cells by releasing DNA-damaging. Sure enough, regular injections of the Rhenium-188 labeled bacteria decreased metastases by 90% versus controls.

While this implies that bacteria have to potential to be used to deliver therapeutic radiation doses to metastases, the bacteria were administered before metastases were established, notes Donald Buchsbaum, a radiation biologist at the University of Alabama at Birmingham who was not involved in the study.  “So to some extent it’s a prevention model.”

Future work will need to focus on targeting established metastases, possibly by exploring other radioisotope options.  Gravekamp and Dadachova are currently refining their protocol and examining alternative radioisotopes to achieve a 100% reduction of metastases, but have high hopes for their bacteria.

Though primary tumors are often removed surgically, even small pieces left behind can produce new metastases. It might be possible that one day radioactive Listeria could be part of an “early second-line treatment after surgery to prevent further metastases,” says Gravekamp.

ListeriaWhich is great news in the war against cancer and not a bad deal for the Listeria bacteria which normally gets a bad rap for causing the infection listeriosis  – the leading cause of death among food-borne bacterial pathogens – responsible for approximately 2,500 illnesses and 500 fatalities annually in the United States.

Exciting stuff!

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Pumped Up about Promising new Parkinson’s Pump

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parkinson-disease60Parkinson’s disease, as many of our readers know is a chronic, progressive neurological disease that causes sufferers to lose control of body movements, resulting in tremors, muscle stiffness, loss of balance and a host of other problems. Currently, there is no cure for Parkinson’s disease and treatment options are limited. Therapy is directed at treating the symptoms that are most bothersome and for this reason, there is no standard or “best” treatment for that applies to every patient.

Treatment approaches include medications and surgery (deep brain stimulation) as well as general lifestyle modifications (rest and exercise), physical, occupational and speech therapy.

levodopaAmong the drug-related therapies, levodopa is considered one of the most effective for relieving the symptoms of Parkinson’s disease. It helps reduce tremor, stiffness, and slowness and helps improve muscle control, balance, and walking. Levodopa does not slow the disease process, but it improves muscle movement and delays severe disability. So far, levodopa, which had been used to treat Parkinson’s since the 1970’s, has only been available in pill form.

But a new Cleveland Clinic study finds that using a pump to administer a gel form of levodopa directly into the small intestine is much more effective.

Neurologist Hubert Fernandez, MD, who led the study, says, “The levodopa pump decreased or improved what we call the ‘bad time’ in Parkinson’s patients by up to four hours per day.” The levodopa can control this ‘bad time’ — the tremors, muscle spasms and other movement disorders that makes it difficult for Parkinson’s patients to function on a daily basis.

parkinsons-gel-drug-pump-190x155“This is an amazing finding,” says Fernandez. “We know of no other oral therapy that will improve the bad time in Parkinson’s by an average of four hours daily.”

The levodopa pump is external. It sits in a pouch under the patient’s shirt and provides a steady dose of the drug. The levodopa gel is administered directly into the small intestine, where most of the drug is absorbed. The constant dose makes the body’s movements more controlled and predictable, making it easier for people with the disease to plan and go about their day without worrying that the drug’s effects will wear off.

“The biggest advantage of the levodopa is its efficacy,” Dr. Fernandez says. “We’re trying to deliver it on a continuous basis so the patients don’t need to take it every hour.” parkinsons gel pump

69-year-old Bob Van Housen has been living with Parkinson’s disease for over 12 years.  Prior to enrollment in the study he was having to take up to five levodopa pills every three hours to control his symptoms. Even then, his symptoms progressed to the point where it was hard to keep up.  “He was ‘off’ for at least seven hours,” said Van Housen’s wife, Carol. “Seven hours is a long time to not be able to function every day.”

The couple often had to cut their trips together short and limit their social outings outside of the house. Van Housen says that being part of the trial at Cleveland Clinic has been life-changing. “We can predict better how I’m going to feel and how I’m going to act and can plan trips and work around those times when I otherwise would have been problematic.”

The gel pump which is not yet available in the United States is currently under review by the Food and Drug Administration. Let’s hope it doesn’t hit any hurdles along the way, so others with Parkinson’s can avoid the roller-coaster of symptoms and enjoy the type of benefits that Bob has experienced.

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Should You Stay or Should You Go?

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family presence during resuscitation2Picture this familiar scene. A critically injured person is wheeled into the emergency room by paramedics. Concerned, shocked and occasionally hysterical family members rush to the patient’s side. An army of doctors, nurses and techs begin emergency resuscitation efforts, inserting breathing tubes, CPR, starting IV’s, drawing blood, administering drugs and other fluids.  One of these health care professionals, nodding toward the family and screaming “Get them out of here!”

We’ve all see it… either in real life or on TV.

Cutting to the next scene, the family is escorted into a stark family crisis room. While healthcare staff work desperately to resuscitate the patient, a social worker updates the family on their progress. If the patient dies, staff  make him as presentable as possible, and then invite the family in to say good-byes. The social worker supports the family during this difficult time, and the code team return to their care of other patients.

For decades, this approach seemed to work well. The common wisdom was that if we did let the family in during the code, they’d either get in the way or become so distraught that we’d have more patients on our hands. Furthermore, we felt we were doing the family a greater service by letting them see their loved one only after we’d removed tubes and lines, even though the calm scene we produced was in total contradiction to actual events.

But recently, this traditional approach has been questioned. It turns out that many family members want to be present during resuscitation efforts, rather than hidden away in a side room.

family presence during resuscitationAnd even though health care professionals are still divided on whether families should be present, most agree the issue must be addressed.

Now, research is starting to question whether family members be allowed to remain in the room as these potentially lifesaving efforts begin?

A two-year study led by a researcher Jane Leske PhD, has shown that family members – parents, spouses, fiancées and adult children – of trauma patients, can benefit by being present during critical moments of care.

“Those who do choose to do it really want to be there,” says Leske, professor of nursing at the University of Wisconsin-Milwaukee. “They want to watch everything and get information. It lowers their anxiety and stress to see that everything possible is being done. Seeing is believing.”

However, family presence during resuscitation is controversial and underutilized. Indeed, many health care professionals and hospitals argue against it, concerned that the procedures may be too traumatic for family witnesses, or that family members may become emotionally out of control and interfere with care.

Leske conducted this study in collaboration with medical staff at a facility where families have the option of staying and observing resuscitation efforts. It compared outcomes for family members of patients, ages 18-93, with critical injuries from gunshot wounds or motor vehicle accidents at a Southeast Wisconsin Level 1 trauma center.  The center had offered family presence during resuscitation for more than two years by the time Leske’s study began.

cpr_pr.299225225_stdThe study focused on 140 family members over age 18, divided in two roughly equal groups – those who opted to remain with the victim during resuscitation; and those who chose not to, or were not able to reach the emergency department in time. Researchers interviewed family members within 72 hours after admission to the surgical intensive care unit, to discuss the family’s coping resources, communication and anxiety levels.

She and her research team found a number of benefits to having family members present, and no drawbacks.

They concluded that while families can benefit from being present during resuscitation, it’s also important that the hospital have policies and procedures in place on when and how to allow the option. For example, family presence during resuscitation should not be permitted when family members are intoxicated, extremely agitated or emotionally unstable.

Other researchers agree. A large French study published last month in the New England Journal of Medicine concluded that relatives who did not witness CPR had post-traumatic stress disorder (PTSD)–related symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medico-legal claims.

What are your thoughts on this?  Would you want to stay…or walk away.  Let us know.

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Bullseye! Lyme Disease Without the Rash

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Lyme disease BullseyeWith the weather finally starting to warm up, if you’re anything like me, you probably can’t wait to get outdoors and get active. However, and with apologies for being a Debbie Downer, we want to remind you that warmer weather also means that ticks become more active and are more likely to bite you, your kids and your pets. Just being outside in the garden could put you at risk of tick-borne diseases such as Lyme.

Should you contract Lyme disease, quick diagnosis and treatment are essential to avoiding long term complications. However, the diagnostic process may be delayed if the skin rash caused by Lyme disease does not have the typical bull’s-eye appearance.

A Research Letter just published in the CDC journal Emerging Infectious Diseases, shows that Lyme disease has been identified in patients with skin lesions that more closely resemble the classic signs of conditions such as contact dermatitis, lupus, insect or spider bites.

Based on these findings they urge doctors to consider Lyme disease when presented with patients complaining of such lesions, particularly when they have been in an area where Lyme disease is endemic.

The research team led by Steven E, Schutzer, MD, Professor of Medicine at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School, studied 14 patients.

borrelia_burgdorferiAn advanced diagnostic technique, based upon polymerase chain reaction (PCR) testing was used to identify Borrelia burgdorferi, the bacterium that causes Lyme disease. Unlike existing methods, the new technique is able to detect evidence of B. burgdorferi early, even in cases where the bacterium is still at low levels in the bloodstream, and sooner than traditional antibody tests, which may require several weeks before becoming positive. It also is able to distinguish between new infections and prior exposure to B. burgdorferi.

Of the patients analyzed, ten were found to have strong microbiologic evidence of Lyme disease, despite the fact that they had presented with skin lesions that differed markedly from the classic bull’s-eye pattern. In fact, not all patients with Lyme disease will even have a rash.

tick biteBased on this finding, Schutzer says, “Doctors who see a rash in a patient who has been in an area where Lyme disease frequently occurs should be alert to the fact that the Lyme disease rash does not have to look like a bull’s-eye, ring-within-a ring. The rash may look different. Doctors should search carefully both for other signs that might suggest Lyme disease, such as flu-like symptoms, and equally for signs that may point towards other conditions. Early diagnosis of most diseases gives the best chance for a cure. This is especially true for Lyme disease.”

So, this summer, make sure your doctor isn’t in a rush to take any rash decisions about ruling out a diagnosis of Lyme Disease.

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Put on the red light

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asleep-at-deskWe’ve all been there, some of us more often than others. You know what I’m talking about. That mid-afternoon moment where we find ourselves crashing at our computers. Or nodding off into our notebooks.

And it’s not just our productivity that’s affected.  It turns out that acute or chronic sleep deprivation and the resulting fatigue is one of the leading causes of workplace incidents and related injuries. Most performance failures, including car accidents, occur in the mid-afternoon hours known as the “post-lunch dip.”  Typically this occurs sometime between 2-4 p.m., or about 16-18 hours after the previous night’s bedtime.

Now a new study from the Lighting Research Center [who knew there was such a thing?]  at Rensselaer Polytechnic Institute – the nation’s oldest technological university - suggests that there may be a way to alleviate afternoon accidents.  Their research shows that exposure to certain wavelengths and levels of light have the potential to increase alertness during the post-lunch dip. These results pave the way for a non-pharmacological intervention to increase alertness during the daytime.

Mariana Figueiro, LRC Light and Health Program director, has previously conducted studies that show that light has the potential to increase alertness at night. Exposure to strong levels of white light at night increases performance, elevates core body temperature, and increases heart rate.

light-therapy2In most studies to date, the alerting effects of light have been linked to its ability to suppress the circadian rhythm regulating hormone – melatonin, the levels of which are typically lower during the daytime, and higher at night. However, results from a previous study by Figueiro demonstrated that acute melatonin suppression is not needed for light to affect alertness during the nighttime. While both short-wavelength (blue) and long-wavelength (red) lights increased measures of alertness, only short-wavelength light suppressed melatonin.

Based on this finding the researchers hypothesized that if light can impact alertness via pathways other than melatonin suppression, then certain wavelengths and levels of light might also increase alertness during the middle of the afternoon.

During the study, participants experienced two experimental lighting conditions in addition to darkness. Long-wavelength “red” light and short-wavelength “blue” light were delivered to the corneas of each participant by arrays of light emitting diodes (LEDs) placed in light boxes. Participant alertness was measured by electroencephalogram (EEG) and subjective sleepiness (KSS scale).

The team found that, compared to remaining in darkness, exposure to red light in the middle of the afternoon significantly improves alertness.

red-light_2725743Co-author Levent  Sahin, a doctoral student  at the Lighting Research Center, was interested in this study from a transportation safety perspective, and what the results could mean to the transportation industry. “Safety is a prerequisite and one of the most important quality indicators in the transportation industry,” said Sahin. “Our recent findings provided the scientifically valid underpinnings in approaching fatigue related safety problems in 24 hour transportation operations.”

Those of us who remember the lyrics of the 1978 Police hit Roxanne – “You don’t have to put on the red light,” may need to rethink…

Even though the present results don’t fully explain the underlying mechanisms of light-induced changes in alertness it seems we could all benefit from a little red light on our desks.

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The Skinny on Breakthrough Myelin Sheath Disorders

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MYELIN SHEATH DISORDERSIn patients with multiple sclerosis, cerebral palsy, and other rare genetic disorders known as leukodystrophies, the myelin sheath – the fatty covering that acts as an insulator around nerve fiber is progressively destroyed. Without this vital insulation, brain impulses to the rest of the body are lost leading to debilitating symptoms such as loss of muscle tone, movement, gait, speech, vision, hearing, ability to eat, and behavioral changes.

So we were very excited to learn that researchers at Case Western Reserve School of Medicine have discovered a technique that can directly convert skin cells to the type of brain cells destroyed in myelin disorders.

This amazing new technique involves converting fibroblasts – an abundant structural cell present in the skin and most organs – into oligodendrocytes, the type of cell responsible for myelinating the neurons of the brain.

“Its ‘cellular alchemy,’” explains Paul Tesar, PhD, assistant professor of genetics and genome sciences at Case Western Reserve School of Medicine “We are taking a readily accessible and abundant cell and completely switching its identity to become a highly valuable cell for therapy.”

axons-and-oligodendrocytesIn a process termed “cellular reprogramming,” researchers manipulated the levels of three naturally occurring proteins to induce fibroblast cells to become precursors to oligodendrocytes (called oligodendrocyte progenitor cells, or OPCs).  Tesar’s team, rapidly generated billions of these induced OPCs (iOPCs). They also showed that iOPCs could regenerate new myelin coatings around nerves after being transplanted to mice – a result that offers hope the technique might be used to treat human myelin disorders.

When oligodendrocytes are damaged or become dysfunctional in myelinating diseases, the insulating myelin coating that normally coats nerves is lost. A cure requires the myelin coating to be regenerated by replacement oligodendrocytes.  Until now, OPCs and oligodendrocytes could only be obtained from fetal tissue or pluripotent stem cells. These techniques have been valuable, but with limitations.

“The myelin repair field has been hampered by an inability to rapidly generate safe and effective sources of functional oligodendrocytes,” explained co-author and myelin expert Robert Miller, PhD. “The new technique may overcome all of these issues by providing a rapid and streamlined way to directly generate functional myelin producing cells.”

BC7251-001This initial study used mouse cells. The critical next step is to demonstrate feasibility and safety using human cells in a lab setting. If successful, the technique could have widespread therapeutic application to human myelin disorders.

These are exciting times. The progression of stem cell biology is providing therapeutic opportunities that a decade ago would not have been thought possible. As always SRxA’s Word on Health, will bring you further developments on this story as soon as they’re released.

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