Healthcare News and Research

[*Anya*]

Topol on 5 Devices Physicians Need to Know About
Eric J. Topol, MD

I'm Dr. Eric Topol, Director of the Scripps Translational Science Institute and Editor-in-Chief of Medscape Genomic Medicine and theheart.org. In this series I will detail the driving forces behind what I believe is the biggest shakeup in the history of medicine.

What I'll be doing in these segments is outlining the parts of my book that represent the digital revolution occurring in the practice of medicine and how this revolution can radically improve the healthcare of the future. In this segment, I'd like to play the role of Dr. Gizmodo and show you many of the devices that I think are transforming medicine today. These devices represent an exciting opportunity as we move forward in the practice of medicine.

Let me just run through some of these. This is 2012, obviously, and this is something that we're going to build upon. You're used to wireless devices that can be used for fitness and health, but these are now breaking the medical sphere. One device you may have already noticed turns your smartphone into an electrocardiogram (ECG). The ECG adaptor comes in the form of a case that fits on the back of a smartphone or in a credit card-size version. Both contain 2 sensors. With the first model, you put the smartphone into the case and then pull up the app -- in this case I'm using the AliveCor app -- and put 2 fingers on each of the sensors to set up a circuit for the heart rhythm. Soon you'll see an ECG. What's great about this is you don't just get a cardiogram, which would be like a lead II equivalent; using the "credit card" version, you get all the V-leads across the chest as well. I have found this to be really helpful. It even helped me diagnose an anterior wall myocardial infarction in a passenger on a flight. It was supposed to be a nonstop flight, but, because of my diagnosis, it wound up stopping along the way. As an aside, after the passenger was taken off the plane to get reperfusion catheter-based therapy at a hospital, the pilots and flight attendants all wanted to have their cardiograms checked.

The second device I will show you is another adaptation of the smartphone, but this one is for measuring blood glucose. Obviously we do that now with finger-sticks, but the whole idea is to get away from finger-sticks. I'm wearing a sensor right now that can be worn on the arm. It also can be worn on the abdomen. What's nice about this is that I can just turn on my phone, and every minute I get an update of my blood glucose right on the opening screen of the phone. It's a really nice tool, because then I can look at the trends over the course of 3, 6, 12, or even 24 hours. It plays a big behavioral modification type of a role, because when you're looking at your phone, as you would be for checking email or surfing the Web, you also are integrating what you eat and your activity with how your glucose responds. This is going to be very helpful for patients -- not only those with diabetes, but also those who are at risk for diabetes, have metabolic syndrome, or are considered to be in the prediabetic state.

The third device I'd like to talk about is another device from the cardiovascular arena that comes in the form of an adhesive patch. It's called the iRhythm, and I tried this out on myself. It's really a neat device, because the results are sent by mail to the patient. You put it on your chest for 2 weeks, and then you mail it back. It's the Netflix equivalent of a cardiovascular exam. The company then sends the patient 2 weeks' worth of heart rhythm detection. I think it's a far better, practical way, as compared to the Holter monitor wireless device. It's not as time-continuous as the ECG or glucose device, but it's in that spectrum.

I want to now explain a fourth device, which I use on my iPad. This device allows physicians the ability to monitor patients in the intensive care unit on their iPads. I use it to monitor patients at the Scripps ICU. You can use it for any ICU that allows for the electronic transmission of data. Right now, I'm monitoring 4 patients simultaneously. You can change the field to monitor up to 8 patients simultaneously. This is a great way to monitor patients in the ICU because you can do it remotely and from anywhere in the world where you have access to the Web. This is just to give you a sense of what this innovative software sensor can do to change the face of medicine.

Finally, I wanted to describe is something that I've become reliant upon, and that's this high-resolution ultrasound device known as the Vscan. I use this in every patient to listen to their heart. In fact, I haven't used a stethoscope for over 2 years to listen to a patient's heart. What's really striking about this is that it's a real stethoscope. "Scope" means look into. "Steth" is the chest. And so now I carry this in my pocket, and it's just great. I still need a stethoscope for the lungs, but for the heart this is terrific. You just pop it open, put a little gel on the tip of the probe, and get a quick, complete readout with the patient looking on as well. I'm sharing their image on the Vscan while I'm acquiring it and it only takes about a minute. We validated its usefulness in an Annals of Internal Medicine paper, in July 2011,[1] describing how it compares favorably to the in-hospital ultrasound echo lab-type image. This could be another very useful device in emergency departments, where the wireless loops could be sent to a cardiologist. Another application it could be used for is detecting an abdominal aortic aneurysm. Paramedics who are out in the field, or at a trauma case, could use this to wirelessly send these video loops to get input from a radiologist or expertise from any physician for interpretation.

These are just a few of the gadgets that give you a feel for the innovative, transformative, and really radical changes that will be seen going forward in medicine. We'll be back soon with more on The Creative Destruction of Medicine. Until next time, I'm Dr. Eric Topol.

http://www.medscape.com/viewarticle/765017?src=ptalk

[*Anya*]

www.medscape.com
From Heartwire

Polypill for Primary Prevention: Largest-Yet Reductions in BP, Cholesterol in Small UK Trial

Lisa Nainggolan
July 19, 2012 (London, United Kingdom) — Results of the first trial to look at the effects of a polypill given to people solely on the basis of age for the primary prevention of CVD have shown the largest reductions in blood pressure and cholesterol levels of any polypill study to date [1].

On average, participants--who were aged >50--experienced a 12% reduction in BP and 39% fall in LDL cholesterol during the 12-week study, achieving levels typical of people aged 20, says lead author Dr David S Wald (Wolfson Institute of Preventive Medicine, London, UK), who together with colleagues, report the findings in PLoS One. "The health implications of our results are large. If people took the polypill long term from age 50, an estimated 28% would avoid or delay a heart attack or stroke during their lifetime and gain, on average, 11 years of life free of cardiovascular events," he told heartwire .

If people took the polypill long term from age 50, an estimated 28% would avoid or delay a heart attack or stroke during their lifetime.

Wald says the vision of his group at the Wolfson Institute is that everyone over a certain age, say 50 or 55 years, will take the polypill without necessarily having to see a doctor. They hope to file for UK regulatory approval for this use of their polypill, manufactured by the Indian company Cipla, within a year or so, once two further ongoing trials in India are completed.

The notion of a polypill for CVD prevention has been much debated since it was first proposed by Drs Nicholas Wald (a coauthor of the current study) and Malcolm Law (Wolfson Institute of Preventive Medicine) in 2003. A number of different formulations have been tested, in both primary and secondary prevention populations, and there are a handful of groups working on this concept worldwide. The idea is not without its detractors, however, with some arguing that the approach to give a polypill to all, as suggested by Wald et al, is far too radical. Many others working in the field believe the polypill is best placed as a treatment for secondary prevention, because those people would already be taking the individual components of a polypill. But critics feel that the global polypill approach is altogether misplaced and argue that individual risk assessment and reduction are the cornerstones of preventive cardiology.

Unique Crossover Design Gives the Most Accurate Results to Date

Wald says the polypill used in their study is three-layered and "easy to swallow"; it contains three BP-lowering medications--a calcium channel blocker, amlodipine 2.5 mg; an angiotensin-receptor blocker, losartan 25 mg; and a diuretic, hydrochlorothiazide 12.5 mg--along with the lipid-lowering simvastatin 40 mg.

Inventors Have Patents, Would License Polypill

Wald says there are four main groups working on the polypill worldwide, including his in London. The others are groups led by Dr Salim Yusuf (McMaster University, Hamilton, ON), who are working with another Indian company, Cadila Pharmaceuticals; an Australian consortium led by Dr Anthony Rodgers (George Institute for Global Health, Sydney, Australia), who are developing the red heart pill with a third Indian firm, Dr Reddy's Laboratories; and a Spanish team, led by Dr Valentin Fuster (Mount Sinai Medical Center, New York, NY), who are working with the Spanish company Ferrer Pharmaceuticals.

The inventors of the polypill, Nicholas Wald and Law, have a patent granted in Europe and Canada, and one pending in the US, that covers all formulations currently being tested by other groups, says David Wald.

"So, in terms of approvals and marketing, any other polypill would need to seek a license from us or they would be infringing the patent in those markets," he explains. "But in all other countries, there is freedom to operate, and that was always our intention, that the intellectual property would remain free to developing countries." He told heartwire that he and Nicholas Wald have invested in development of the polypill and would hope to recover that investment, "but our overwhelming motivation is the public health objective."

Wald explains why aspirin was not included in their formulation: "We took a decision to leave aspirin out of a CVD prevention polypill because it is the only component that runs a reasonable chance of serious harm. Of course it's also useful in preventing heart attacks and strokes, but once you have achieved the large BP and cholesterol reductions that we have shown in our trial, the residual benefit you get from aspirin does not justify its risk in CVD prevention."

Aspirin is the only component of a polypill that runs a reasonable chance of serious harm.

In total, 86 participants who were already enrolled in a CVD-prevention program at the Wolfson Institute and had previously been taking the individual components of the polypill were randomized to the polypill or placebo for 12 weeks. They then crossed over and took the other treatment. Mean within-person differences in BP and LDL cholesterol at the end of each 12-week period were determined, and 84 of 86 participants completed the study.

The mean systolic BP reduction was 17.9 mm Hg, diastolic BP fell by 9.8 mm Hg, and LDL was cut by 1.4 mmol/L; these results are almost identical to those predicted when the polypill was first proposed by Wald and Law, say the researchers.

Although the trial was too short to assess the impact on CV events, sustained reductions in BP and cholesterol of this magnitude would reduce ischemic heart disease events by 72% and stroke by 64%, they estimate.

The fact that this is the only crossover trial of a polypill is an important design issue, says Wald, "because it has allowed us to produce highly accurate estimates of effectiveness, with a relatively small number of participants." Previous trials that used a parallel-group design have shown smaller effects, he notes, with as many as a quarter of participants in such trials not adhering to the allocated treatment. "We believe that our results are the most accurate, direct, observations of the use of a polypill to date," he notes.

We believe that our results are the most accurate, direct, observations of the use of a polypill to date.

However, the trial design also means there are some limitations, he says. First, the high adherence rate observed (98%) is likely a result of those in the trial previously having taken the individual components of the polypill and, as such, this adherence rate cannot be used to estimate compliance in the general population. Second, "the results on tolerability cannot be used to estimate the prevalence of side effects in people who have not previously taken polypill components," he says.

Side effects were more frequent with the polypill than placebo (29% vs 13%, p=0.01), although none were serious enough to cause discontinuation. Myalgia was more common with the polypill compared with placebo (11% vs 1.2%, respectively).

'No-Fuss' Approach Starting to Be Embraced by Medics

"Scientifically, age is the dominant risk factor in predicting whether somebody will or won't have a heart attack or stroke, so it makes sense to use it in the selection of people who are offered the polypill," Wald commented. "Information on a person's BP and cholesterol adds very little extra information and is not worth the cost and complexity."

I do not believe that everybody would choose to take [the polypill], but it's really up to the regulatory agencies to make it clinically available and the medical profession.

The idea that a polypill could be an acceptable treatment offered purely on the basis of age "is one that was initially rejected by the medical community, but now it is starting to be embraced," he notes. "People like the idea of a no-fuss approach to having access to preventive treatment that does not necessarily involve going to your doctor and certainly does not involve being labeled as a patient."

"I do not believe that everybody would choose to take [the polypill], but it's really up to the regulatory agencies to make it generally available, and the medical profession to provide people with the information on its effectiveness and the possibility of its side effects, then let individuals choose for themselves," he concludes.

Nicholas Wald jointly holds European and Canadian patents (EU1272220 priority date April 10, 2000) for a combination pill for CVD prevention (pending in the USA) and, together with David Wald, has an interest in its development. Cipla provided the pills used in their crossover trial free of charge.

References

1. Wald DS, Morris JK, Wald NJ. Randomized polypill crossover trial in people aged 50 and over. PLoS ONE 2012; 7:e41297. Available here.
Heartwire © 2012 Medscape

[Kobi]

Originally Posted by *Anya*

Topol on 5 Devices Physicians Need to Know About
Eric J. Topol, MD

I'm Dr. Eric Topol, Director of the Scripps Translational Science Institute and Editor-in-Chief of Medscape Genomic Medicine and theheart.org. In this series I will detail the driving forces behind what I believe is the biggest shakeup in the history of medicine.

What I'll be doing in these segments is outlining the parts of my book that represent the digital revolution occurring in the practice of medicine and how this revolution can radically improve the healthcare of the future. In this segment, I'd like to play the role of Dr. Gizmodo and show you many of the devices that I think are transforming medicine today. These devices represent an exciting opportunity as we move forward in the practice of medicine.

http://www.medscape.com/viewarticle/765017?src=ptalk

This is so cool. I no longer feel odd for having advocated computer chips in peoples bodies to house their medical information for ready access.

I also no longer feel odd for saying......health care needs one of those wand things like Dr. McCoy had in Star Trek. Who knew the wand thing was actually a combo smartphone/ipod/netflix thingy.

I promise to buy one of those fancy phones as soon as there is an app for a defibrillator.

[Kobi]

Two cases of people in Louisiana who died after contracting "brain-eating amoeba" infections from their own household water systems are prompting health officials to warn about a popular home remedy for treating sinus problems and allergies.

People who use neti pots to irrigate their nasal passages and sinuses should use only water that has been boiled, filtered or distilled, said the researchers at the Centers for Disease Control and Prevention who investigated the unrelated cases, which occurred months apart in 2011 in different parts of Louisiana.

The cases are the first evidence reported in the U.S. of municipal, disinfected tap water used in nasal irrigation causing infections of Naegleria fowleri, as the amoebas are properly called. The infections which pass into the brain from the nose are almost always deadly, with only one report of a survivor ever documented in the U.S., according to the CDC.

Infections have only been known to occur in cases in where water is forced up the nose, Yoder said. There have not been any cases where people contracted the infections by bathing or showering, and "there is certainly not a risk with drinking water," he said.

Pass it on: Neti pot users should use only sterile water, which has been boiled, distilled or filtered, the CDC says.

http://news.yahoo.com/brain-eating-a...111807585.html

[Kelt]

I'm not sure if this thread is the best place for this, but I couldn't think of where else would be.

I just found out that the "shingles" vaccine age limit has been lowered from 60 to 50. If you don't know what it is, check into it (zoster virus). If you have ever had chickenpox you carry the virus in your system. It usually only affects people who are over 60 years of age or have some compromise in their immune system.

Even if you do not fit into this group you can get it. I have had it twice, both times in my forties, five years apart and had no other health issues. You don't want to get it. Check with your health care provider to see if it would be a good idea for you.

This change was made in March 2011, I have been told by two different pharmacies since then that the age was still 60. This is incorrect, you can now get it a participating Costco pharmacies (and probably others). Check your insurance, because this one isn't cheap without it. $188.00 Ouch.

Not giving medical advice, just encouraging folks to check into it this vaccine season and learn about it.

[Toughy]

I think this is the best place for this tidbit of happy information.

I get my health care at the San Francisco Veterans Administration Medical Center. Today at the VA it was Transgender Awareness Day and there was a half day mini conference (with CME/CEU) on Transgender Health with 3 presentations.It was a great conference and I talked about all of it in the Trans News thread, but I wanted to post this part here for a wider audience....

Marci Bowers, MD is probably the best known surgeon who does Sex Reassignment Surgery was one of the presenters. The best and most interesting thing I heard from her had to do with female genital mutilation/female circumcision. It seems the damage can be repaired and a woman will end up with normal looking and functioning genitalia. Yes it can be fixed with what she called 'a simple surgery'.The clitoris works and they can have vaginal penetration and even deliver a baby. She is the only surgeon (she knows about) in the US that is doing this surgery and she does every one of them pro bono. There are surgeons who Europe who do it and she went to Paris and trained. I was stunned and so were the rest of the audience.

[*Anya*]

Op Ed piece in NYTimes today, May 14, 2013:

Angelina Jolie's doctors estimated that She had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.

She recently underwent a double mastectomy to try to proactively beat the odds due to having an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting breast CA, on average. Her mom died of breast CA at age 56.


http://www.nytimes.com/2013/05/14/op...ice.html?_r=3&

[*Anya*]

Dementia rates drop sharply, as predicted

By Gina Kolata

A new study has found that dementia rates among people 65 and older in England and Wales have plummeted by 25 percent over the past two decades, to 6.2 percent from 8.3 percent, a trend that researchers say is probably occurring across developed countries and that could have major social and economic implications for families and societies.

Another recent study, conducted in Denmark, found that people in their 90s who were given a standard test of mental ability in 2010 scored substantially better than people who had reached their 90s a decade earlier. Nearly one-quarter of those assessed in 2010 scored at the highest level, a rate twice that of those tested in 1998. The percentage of subjects severely impaired fell to 17 percent from 22 percent.

The British study, published on Tuesday in The Lancet, and the Danish one, which was released last week, also in The Lancet, soften alarms sounded by advocacy groups and some public health officials who have forecast a rapid rise in the number of people with dementia, as well as in the costs of caring for them. The projections assumed the odds of getting dementia would be unchanged.

Yet experts on aging said the studies also confirmed something they had suspected but had had difficulty proving: that dementia rates would fall and mental acuity improve as the population grew healthier and better educated. The incidence of dementia is lower among those better educated, as well as among those who control their blood pressure and cholesterol, possibly because some dementia is caused by ministrokes and other vascular damage. So as populations controlled cardiovascular risk factors better and had more years of schooling, it made sense that the risk of dementia might decrease. A half-dozen previous studies had hinted that the rate was falling, but they had flaws that led some to doubt the conclusions.

Researchers said the two new studies were the strongest, most credible evidence yet that their hunch had been right. Dallas Anderson, an expert on the epidemiology of dementia at the National Institute on Aging, the principal financer of dementia research in the United States, said the new studies were “rigorous and are strong evidence.” He added that he expected that the same trends were occurring in the United States but that studies were necessary to confirm them.

“It’s terrific news,” said Dr. P. Murali Doraiswamy, an Alzheimer’s researcher at Duke University, who was not involved in the new studies. It means, he said, that the common assumption that every successive generation will have the same risk for dementia does not hold true.

The new studies offer hope amid a cascade of bad news about Alzheimer’s disease and dementia. Major clinical trials of drugs to treat Alzheimer’s have failed. And a recent analysis by the RAND Corporation — based on an assumption that dementia rates would remain steady — concluded that the number of people with dementia would double in the next 30 years as the baby boom generation aged, as would the costs of caring for them. But its lead author, Michael D. Hurd, a principal senior researcher at RAND, said in an interview that his projections of future cases and costs could be off if the falling dementia rates found in Britain held true in the United States.

Dr. Marcel Olde Rikkert of Radboud University Nijmegen Medical Center in the Netherlands, who wrote an editorial to accompany the Danish study, said estimates of the risk of dementia in older people “urgently need a reset.”

But Maria Carrillo, vice president of medical and scientific relations at the Alzheimer’s Association, an advocacy group, was not convinced that the trends were real or that they held for the United States.

The studies assessed dementia, which includes Alzheimer’s disease but also other conditions that can make mental functioning deteriorate. Richard Suzman, the director of the division of behavioral and social research at the National Institute on Aging, said it was not possible to know from the new studies whether Alzheimer’s was becoming more or less prevalent.

The British researchers, led by Dr. Carol Brayne of the Cambridge Institute of Public Health, took advantage of a large study that tested 7,635 randomly selected people, ages 65 and older, for dementia between 1984 and 1994. The subjects lived in Cambridgeshire, Newcastle and Nottingham. Then, between 2008 and 2011, the researchers assessed a similar randomly selected group living in the same areas.

“We had the same population, the same geographic area, the same methods,” Dr. Brayne said. “That was one of the appeals.”

But Dr. Carrillo questioned the data because many subjects had declined to be assessed: the researchers assessed 80 percent of the group it approached in the first round and 56 percent of those approached in the second. Her concern is reasonable, Dr. Brayne said, but the researchers addressed it by analyzing the data to see if the refusals might have skewed the results. They did not.

In the Danish study, Dr. Kaare Christensen of the University of Southern Denmark in Odense and his colleagues compared the physical health and mental functioning of two groups of elderly Danish people. The first consisted of 2,262 people born in 1905 who were assessed at age 93. The second was composed of 1,584 people born in 1915 and assessed at age 95. In addition to examining the subjects for physical strength and robustness, the investigators gave them a standard dementia screening test, the mini-mental exam and a series of cognitive tests.

The investigators asked how many subjects scored high, had scores indicating dementia and were in between. The entire curve was shifted upward among the people born in 1915, they discovered.

Dr. Anderson, of the National Institute on Aging, said the news was good.

“With these two studies, we are beginning to see that more and more of us will have a chance to reach old age cognitively intact, postponing dementia or avoiding it altogether,” he said. “That is a happy prospect.”

This article has been revised to reflect the following correction:

Correction: July 16, 2013

An earlier version of this article misspelled the name of the medical center where Dr. Marcel Olde Rikkert works. It is the Radboud University Nijmegen Medical Center in the Netherlands, not Nigmegen.

Published in the NYTimes.

[Greyson]

Jul 15, 8:28 PM EDT

STUDY: LATER RETIREMENT MAY HELP PREVENT DEMENTIA

BY MARILYNN MARCHIONE
AP CHIEF MEDICAL WRITER

BOSTON (AP) -- New research boosts the "use it or lose it" theory about brainpower and staying mentally sharp. People who delay retirement have less risk of developing Alzheimer's disease or other types of dementia, a study of nearly half a million people in France found.

It's by far the largest study to look at this, and researchers say the conclusion makes sense. Working tends to keep people physically active, socially connected and mentally challenged - all things known to help prevent mental decline.

"For each additional year of work, the risk of getting dementia is reduced by 3.2 percent," said Carole Dufouil, a scientist at INSERM, the French government's health research agency.


Read more:
http://hosted.ap.org/dynamic/stories...07-15-20-28-50

[Kobi]

Originally Posted by Greyson

Jul 15, 8:28 PM EDT

STUDY: LATER RETIREMENT MAY HELP PREVENT DEMENTIA

BY MARILYNN MARCHIONE
AP CHIEF MEDICAL WRITER

BOSTON (AP) -- New research boosts the "use it or lose it" theory about brainpower and staying mentally sharp. People who delay retirement have less risk of developing Alzheimer's disease or other types of dementia, a study of nearly half a million people in France found.

It's by far the largest study to look at this, and researchers say the conclusion makes sense. Working tends to keep people physically active, socially connected and mentally challenged - all things known to help prevent mental decline.

"For each additional year of work, the risk of getting dementia is reduced by 3.2 percent," said Carole Dufouil, a scientist at INSERM, the French government's health research agency.


Read more:
http://hosted.ap.org/dynamic/stories...07-15-20-28-50

I don't know that the researchers proved working in ones later years influences dementia related diseases. I'm not fond of studies that use records (as opposed to interviewing people) as the source of their data. There are too many unknown and unaccounted for variables.

What they have reproven (ad nauseum) is that "being physically active, socially connected and mentally challenged - all things known to help prevent mental decline."

Baby boomers are proving one doesn't have to work to stay physically active, socially connected, and mentally challenged.

[Greyson]

Originally Posted by Kobi

What they have reproven (ad nauseum) is that "being physically active, socially connected and mentally challenged - all things known to help prevent mental decline."

Baby boomers are proving one doesn't have to work to stay physically active, socially connected, and mentally challenged.

Kobi, I tend to agree with you. There was another article posted at the same site that talked about retirees can stay active physically and mentally. Many are doing it through volunteer work, social activism, part-time employment, etc.

Reading many of your posts, I don't think you have to worry about dementia. You still got it.

[Kobi]

Originally Posted by Greyson

Kobi, I tend to agree with you. There was another article posted at the same site that talked about retirees can stay active physically and mentally. Many are doing it through volunteer work, social activism, part-time employment, etc.

Reading many of your posts, I don't think you have to worry about dementia. You still got it.

Greyson, you are always the gentleman. My giant, invisible bunny friend Harvey and I thank.......oooo look a squirrel.

Disclaimer: It is 2:30am. The mind goes weird places.

[*Anya*]

11 Reasons You Should Be Having More Orgasms

The Huffington Post | By Renee Jacques

Posted: 11/05/2013 1:54 pm EST | Updated: 11/05/2013 3:05 pm EST

Orgasm Health Benefits

Clearly, we don't need to convince you to have sex. It's hard-wired into our brains to propagate the species. And anyway, it feels pretty awesome. But here's more good news: Having an orgasm could help improve your health.

One of the main reasons orgasm feels so good is because your brain releases the pleasure hormone oxytocin when you climax. Oxytocin is also called the "love hormone" because of its important role in facilitating social bonding between humans. Most of the following points revolve around the release of oxytocin. Read on to discover eleven ways achieving an orgasm can make your life so much better...

1. Orgasms relieve stress.

In sexologist Beverly Whipple's book, "The Orgasms Answer Guide," she cites a study done by Carol Rinkleib Ellison in 2000, in which Ellison interviewed 2,632 women between the ages of 23 and 90 and found that 39 percent of those who masturbate reported that they do it in order to relax. Whipple says this is all because of oxytocin. When someone orgasms, she explains in her book, "the hormone oxytocin is released from nerve cells in the hypothalamus (a region of the brain) into the bloodstream."

"Orgasm relives tension as oxytocin stimulates feelings of warmth and relaxation," Ellison herself wrote in an informational report compiled by Planned Parenthood.

Additionally, research gathered in a study by scientists at Groningen University in the Netherlands found that when women experience an orgasm, the amygdala, the part of the brain associated with fear and anxiety, shows little to no activity.

2. An orgasm could make your significant other less likely to cheat.

Researchers in Germany decided to conduct an experiment in 2012 testing the power of oxytocin. They believed that high doses of the "love hormone" would cause men to consider going outside of their relationships, so they gave oxycotin to a group of (heterosexual) men and introduced them to a very attractive woman. The subjects were asked to determine when the attractive woman was at an "ideal distance" or an "uncomfortable distance."

Those who took oxycotin and were in monogamous relationships ended up distancing themselves about four to six inches farther than those who took oxytocin and were single. The researchers hypothesized that instead of oxytocin causing coupled men to cheat, it instead compelled them to hold on tighter to the bond they have already formed with their girlfriends.

3. The female orgasm could make men focus better.

There is so much power in the orgasm that an organization in San Francisco, called One Taste, is devoted to the practice of "orgasmic meditation," in which two partners focus on achieving the female orgasm. Recently, actress and former Playmate, Karen Lorre, revealed to HuffPost Live that she has 11 orgasms a day due to One Taste's new meditation practices. Even men have claimed that they receive health benefits by just pleasuring a woman. In a New York Times article on One Taste, a man confessed that "fixing his attention on a tiny spot of a woman's body improves his concentration at work."

4. Orgasms could help with insomnia.

Would you rather take a sleeping pill or have a mind-blowing orgasm to help you catch some Zzs? We think we know the answer. In her book, Whipple cites another study done by Ellison in which she reported that 32 percent of 1,866 U.S. women said they masturbate in order to facilitate falling asleep.

Why? No one knows for sure, though some researchers and sex therapists theorize that the release of other neurochemicals, like endorphins, can have a sedative effect, reported Self.

5. A man's orgasm could (maybe) make a woman less depressed.

A controversial study of college students in relationships at the State University of New York in Albany showed that women who had sex without condoms had fewer signs of depression than women who used condoms or refrained from sex, even when researchers controlled for relationship status and other personal factors.

What does this mean? Semen, resulting from the male orgasm, could be an effective antidepressant for women. That said, unprotected sex is NOT something we'd recommend -- after all, an STD or unplanned pregnancy can surely also contribute to depression, along with other medical and social risks.

The lead psychologist of the study, Gordon Gallup, told New Scientist that he believes the reason semen has the potential to lift a woman's mood is because of the several mood-altering hormones found in it. Gallup said that most of these hormones were found in the women's blood shortly after ejaculation.

6. Orgasms help alleviate pain.

“There is some evidence that orgasms can relieve all kinds of pain -- including pain from arthritis, pain after surgery and even pain during childbirth,” Lisa Stern, a nurse practitioner who works with Planned Parenthood, told Woman's Day. That's thanks to pain-relieving oxytocin and endorphins, reported MSNBC contributor Brian Alexander. Alexander cited research from Beverly Whipple, who found that women's pain tolerance and pain detection increased by 74.6 percent and 106.7 percent respectively, when those women masturbated to orgasm.

7. They could help men get over their colds faster.

A study at a German university studied 11 men who were asked to masturbate until completion. Blood was drawn continuously throughout the process, and it was discovered that sexual arousal and orgasm increased the number of "killer" cells called leukocytes. This means that when men are sick, an orgasm could initiate components of their immune system that could help them get over that bug sooner.

8. Steady orgasms could help you live longer.

In 1997, a group of researchers in Wales decided to look into the relationship between orgasms and mortality. They studied the sexual frequency of 918 men between the ages of 45 and 59. They evaluated those who died from coronary heart disease and discovered that those who had two or more orgasms a week died at a rate half of those who had orgasms less than once a month. The researchers concluded that "sexual activity seems to have a protective effect on men's health."

While women's orgasms have not been studied as extensively, Howard S. Friedman, PhD, and author of "The Longevity Project: Surprising Discoveries for Health and Long Life," decided to look into research conducted on couples. He cited a marital satisfaction study conducted by Stanford psychologist Lewis Terman in 1941, looking at the sex lives of 1,500 Californian couples. Terman recorded the frequency of orgasms these women had. Twenty years later, Friedman and his colleagues studied the death certificates of each of the women in Terman's study. What they discovered was that the women who reported a frequency of orgasm during intercourse tended to live longer than those who reported being less sexually fulfilled.

9. Orgasms will also stimulate your brain.

Orgasms sure get your blood flowing, and that doesn't exclude blood flow to your brain. In August, Rutgers researchers Barry Komisaruk and Nan Wise, asked female subjects to masturbate while lying in a MRI machine that measured blood flow to the brain. When the females orgasmed, it increased blood flow to all parts of the brain while allowing nutrients and oxygenation to all parts of the brain.


10. Orgasms could keep you looking young.

Forget Botox, just have an orgasm. Dr. David Weeks, a British consultant clinical psychologist and former head of old age psychology at the Royal Edinburgh Hospital, spent 10 years quizzing thousands of men and women of differing ages about their sex lives. He discovered that those between the ages of 40 and 50 who reported having sex 50 percent more than other respondents looked younger. While this study does not explicitly state the specifics as to why orgasms could make you look younger, Weeks says this could be because intercourse releases the human growth hormone, which makes skin look more elastic.

11. They just get better as you age.

There's no reason to stop having sex when you get older. In fact, you are more likely to enjoy it even more as you enter old age. A study in The American Journal of Medicine found that sexual satisfaction in women increases with age. Researchers from the University of California studied 806 women living in a planned community home.

The study measured the sexual activity of these women who had a median age of 67 and were all postmenopausal. The findings reported that sexually satisfaction actually increased with age, with approximately half of the women over 80 years old reporting sexual satisfaction almost always or always.

So, never stop having orgasms!

http://www.huffingtonpost.com/2013/1...ef=mostpopular

[*Anya*]

Dog and human brain link revealed, pet dogs took part in the MRI scanning study

Last updated Feb 20, 2014, 4:52 PM PST

By Rebecca Morelle

Science reporter, BBC World Service

Devoted dog owners often claim that their pets understand them. A new study suggests they could be right.

By placing dogs in an MRI scanner, researchers from Hungary found that the canine brain reacts to voices in the same way that the human brain does.

Emotionally charged sounds, such as crying or laughter, also prompted similar responses, perhaps explaining why dogs are attuned to human emotions.

The work is published in the journal Current Biology.

Lead author Attila Andics, from the Hungarian Academy of Science's Eotvos Lorand University in Budapest, said: "We think dogs and humans have a very similar mechanism to process emotional information."

Eleven pet dogs took part in the study; training them took some time.

"We used positive reinforcement strategies - lots of praise," said Dr Andics.

"There were 12 sessions of preparatory training, then seven sessions in the scanner room, then these dogs were able to lie motionless for as long as eight minutes. Once they were trained, they were so happy, I wouldn't have believed it if I didn't see it."


The canine brain reacted to voices in the same way that the human brain does
For comparison, the team looked at the brains of 22 human volunteers in the same MRI scanners.

The scientists played the people and pooches 200 different sounds, ranging from environmental noises, such as car sounds and whistles, to human sounds (but not words) and dog vocalisations.

The researchers found that a similar region - the temporal pole, which is the most anterior part of the temporal lobe - was activated when both the animals and people heard human voices.

"We do know there are voice areas in humans, areas that respond more strongly to human sounds that any other types of sounds," Dr Andics explained.

"The location (of the activity) in the dog brain is very similar to where we found it in the human brain. The fact that we found these areas exist at all in the dog brain at all is a surprise - it is the first time we have seen this in a non-primate."


The team used a variety of techniques to train the dogs
Emotional sounds, such as crying and laughter also had a similar pattern of activity, with an area near the primary auditory cortex lighting up in dogs and humans.

Likewise, emotionally charged dog vocalisations - such as whimpering or angry barking - also caused a similar reaction in all volunteers,

Dr Andics said: "We know very well that dogs are very good at tuning into the feelings of their owners, and we know a good dog owner can detect emotional changes in his dog - but we now begin to understand why this can be."

However, while the dogs responded to the human voice, their reactions were far stronger when it came to canine sounds.

They also seemed less able to distinguish between environmental sounds and vocal noises compared with humans.

About half of the whole auditory cortex lit up in dogs when listening to these noises, compared with 3% of the same area in humans.

Commenting on the research, Prof Sophie Scott, from the Institute of Cognitive Neuroscience at University College London, said: "Finding something like this in a primate brain isn't too surprising - but it is quite something to demonstrate it in dogs.

"Dogs are a very interesting animal to look at - we have selected for a lot of traits in dogs that have made them very amenable to humans. Some studies have show they understand a lot of words and they understand intentionality - pointing."

But she added: "It would be interesting to see the animal's response to words rather than just sounds. When we cry and laugh, they are much more like animal calls and this might be causing this response.

"A step further would be if they had gone in and shown sensitivity to words in the language their owners speech."

Dr Andics said this would be the focus of his next set of experiments.


BBC © 2014

[*Anya*]

Last updated Feb 23, 2014, 6:28 PM PST

By Toby Macdonald

With every decision you take, every judgement you make, there is a battle in your mind - a battle between intuition and logic.

And the intuitive part of your mind is a lot more powerful than you may think.

Most of us like to think that we are capable of making rational decisions. We may at times rely on our gut instinct, but if necessary we can call on our powers of reason to arrive at a logical decision.

We like to think that our beliefs, judgements and opinions are based on solid reasoning. But we may have to think again.

Prof Daniel Kahneman, from Princeton University, started a revolution in our understanding of the human mind. It's a revolution that led to him winning a Nobel Prize.

His insight into the way our minds work springs from the mistakes that we make. Not random mistakes, but systematic errors that we all make, all the time, without realising.

Prof Kahneman and his late colleague Amos Tversky, who worked at the Hebrew University of Jerusalem and Stanford University, realised that we actually have two systems of thinking. There's the deliberate, logical part of your mind that is capable of analysing a problem and coming up with a rational answer.

This is the part of your mind that you are aware of. It's expert at solving problems, but it is slow, requires a great deal of energy, and is extremely lazy. Even the act of walking is enough to occupy most of your attentive mind.

Daniel Kahneman's insights into the mind spring from the systematic errors we make all the time
If you are asked to solve a tricky problem while walking, you will most likely stop because your attentive mind cannot attend to both tasks at the same time. If you want to test your own ability to pay attention, try the invisible gorilla test devised by Chris Chabris, from Union College, New York, and Daniel Simons from the University of Illinois.

But then there is another system in your mind that is intuitive, fast and automatic. This fast way of thinking is incredibly powerful, but totally hidden. It is so powerful, it is actually responsible for most of the things that you say, do, think and believe.

And yet you have no idea this is happening. This system is your hidden auto-pilot, and it has a mind of its own. It is sometimes known as the stranger within.

Most of the time, our fast, intuitive mind is in control, efficiently taking charge of all the thousands of decisions we make each day. The problem comes when we allow our fast, intuitive system to make decisions that we really should pass over to our slow, logical system. This is where the mistakes creep in.

Our thinking is riddled with systematic mistakes known to psychologists as cognitive biases. And they affect everything we do. They make us spend impulsively, be overly influenced by what other people think. They affect our beliefs, our opinions, and our decisions, and we have no idea it is happening.

It may seem hard to believe, but that's because your logical, slow mind is a master at inventing a cover story. Most of the beliefs or opinions you have come from an automatic response. But then your logical mind invents a reason why you think or believe something.

Dr Laurie Santos studies monkeys to learn how deep seated our biases really are
According to Daniel Kahneman, "if we think that we have reasons for what we believe, that is often a mistake. Our beliefs and our wishes and our hopes are not always anchored in reasons".

Since Kahneman and Tversky first investigated this radical picture of the mind, the list of identified cognitive biases has mushroomed. The "present bias" causes us to pay attention to what is happening now, but not to worry about the future. If I offer you half a box of chocolates in a year's time, or a whole box in a year and a day, you'll probably choose to wait the extra day.

But if I offer you half a box of chocolates right now, or a whole box of chocolates tomorrow, you will most likely take half a box of chocolates now. It's the same difference, but waiting an extra day in a year's time seems insignificant. Waiting a day now seems impossible when faced with the immediate promise of chocolate.

According to Prof Dan Ariely, from Duke University in North Carolina, this is one of the most important biases: "That's the bias that causes things like overeating and smoking and texting and driving and having unprotected sex," he explains.

Confirmation bias is the tendency to look for information that confirms what we already know. It's why we tend to buy a newspaper that agrees with our views. There's the hindsight bias, the halo effect, the spotlight effect, loss aversion and the negativity bias.

This is the bias that means that negative events are far more easily remembered than positive ones. It means that for every argument you have in a relationship, you need to have five positive memories just to maintain an even keel.

We feel the pain of financial loss much more than the pleasure of a gain
The area of our lives where these cognitive biases cause most grief is anything to do with money. It was for his work in this area that Prof Kahneman was awarded the Nobel Prize - not for psychology (no such prize exists) but for economics. His insights led to a whole new branch of economics - behavioural economics.

Kahneman realised that we respond very differently to losses than to gains. We feel the pain of a loss much more than we feel the pleasure of a gain. He even worked out by how much. If you lose £10 today, you will feel the pain of the loss. But if you find some money tomorrow, you will have to find more than £20 to make up for the loss of £10. This is loss aversion, and its cumulative effect can be catastrophic.

One difficulty with the traditional economic view is that it tends to assume that we all make rational decisions. The reality seems to be very different. Behavioural economists are trying to form an economic system based on the reality of how we actually make decisions.

Dan Ariely argues that the implications of ignoring this research are catastrophic: "I'm quite certain if the regulators listened to behavioural economists early on we would have designed a very different financial system, and we wouldn't have had the incredible increase in the housing market and we wouldn't have this financial catastrophe," he says.

These biases affect us all, whether we are choosing a cup of coffee, buying a car, running an investment bank or gathering military intelligence.

Humans aren't the only species that shows loss aversion.

So what are we to do? Dr Laurie Santos, a psychologist at Yale University, has been investigating how deep seated these biases really are. Until we know the evolutionary origins of these two systems of thinking, we won't know if we can change them.

Dr Santos taught a troop of monkeys to use money. It's called monkeynomics, and she wanted to find out whether monkeys would make the same stupid mistakes as humans. She taught the monkeys to use tokens to buy treats, and found that monkeys also show loss aversion - making the same mistakes as humans.

Her conclusion is that these biases are so deep rooted in our evolutionary past, they may be impossible to change.

"What we learn from the monkeys is that if this bias is really that old, if we really have had this strategy for the last 35 million years, simply deciding to overcome it is just not going to work. We need other ways to make ourselves avoid some of these pitfalls," she explained.

We may not be able to change ourselves, but by being aware of our cognitive limitations, we may be able to design the environment around us in a way that allows for our likely mistakes.

Dan Ariely sums it up: "We are limited, we are not perfect, we are irrational in all kinds of ways. But we can build a world that is compatible with this that gets us to make better decisions rather than worse decisions. That's my hope."

HORIZON: How You Really Make Decisions is on Monday 24 February, 9pm, BBC2

BBC © 2014

[*Anya*]

Last updated Feb 27, 2014, 3:03 AM PST

By James Gallagher

Health and science reporter, BBC News

How the creation of babies using sperm and eggs from three people will be regulated in the UK has been announced.

The draft rules will be reviewed as part of a public consultation and could come into force by the end of 2014.

Doctors say three-person IVF could eliminate debilitating and potentially fatal diseases that are passed from mother to child.

Opponents say it is unethical and could set the UK on a "slippery slope" to designer babies.

Using the parents' sperm and eggs plus an additional egg from a donor woman should prevent mitochondrial disease.

Mitochondria are the tiny, biological "power stations" that provide energy to nearly every cell of the body.

One in every 6,500 babies has severe mitochondrial disease leaving them lacking energy, resulting in muscle weakness, blindness, heart failure and even death.

As mitochondria are passed down from mother to child, using an extra egg from a donor woman could give the child healthy mitochondria.

However, it would also result in babies having DNA from two parents and a tiny amount from the donor as mitochondria have their own DNA.

Scientists have devised two techniques that allow them to take the genetic information from the mother and place it into the egg of a donor with healthy mitochondria.

The Department of Health has already backed the technique and says this consultation is not about whether it should be allowed, but how it is implemented.

The regulatory body, the Human Fertilisation and Embryology Authority, will have to decide in each cases that there is a "significant risk" of disability or serious illness.

It is anticipated that only the most severely affected women - perhaps 10 cases per year - would go ahead.

The regulations suggest treating the donor woman in the same manner as an organ donor.

Any resulting children will not be able to discover the identity of the donor, which is the case with other sperm and egg donors.

Prof Doug Turnbull, who has pioneered research in mitochondrial donation at Newcastle University, said: "I am delighted that the government has published the draft regulations.

"This is very good news for patients with mitochondrial DNA disease and an important step in the prevention of transmission of serious mitochondrial disease."

The chief medical officer for England, Prof Dame Sally Davies, said: "Allowing mitochondrial donation would give women who carry severe mitochondrial disease the opportunity to have children without passing on devastating genetic disorders.

"It would also keep the UK at the forefront of scientific development in this area.

"I want to encourage contributions to this consultation so that we have as many views as possible before introducing our final regulations."

Dr David King, the director of Human Genetics Alert, said this was a decision of "major historical significance" which had not been debated adequately.

"If passed, this will be the first time any government has legalised inheritable human genome modification, something that is banned in all other European countries.

"The techniques have not passed the necessary safety tests so it is unnecessary and premature to rush ahead with legalisation.

"The techniques are unethical according to basic medical ethics, since their only advantage over standard and safe egg donation is that the mother is genetically related to her child.

"This cannot justify the unknown risks to the child or the social consequences of allowing human genome modification."

BBC © 2014

http://www.bbc.com/news/health-26367220

[*Anya*]

Last updated Mar 6, 2014, 3:55 AM PST

By James Gallagher

Health and science reporter, BBC News

HIV budding out of a T-cell, part of the immune system.

Doctors have used gene therapy to upgrade the immune system of 12 patients with HIV to help shield them from the virus's onslaught.

It raises the prospect of patients no longer needing to take daily medication to control their infection.

The patients' white blood cells were taken out of the body, given HIV resistance and then injected back in.

The small study, published in the New England Journal of Medicine, suggested the technique was safe.

Some people are born with a very rare mutation that protects them from HIV.

It changes the structure of their T-cells, a part of the immune system, so that the virus cannot get inside and multiply.

The first person to recover from HIV, Timothy Ray Brown, had his immune system wiped out during leukaemia treatment and then replaced with a bone marrow transplant from someone with the mutation.

Now researchers at the University of Pennsylvania are adapting patients' own immune systems to give them that same defence.

Millions of T-cells were taken from the blood and grown in the laboratory until the doctors had billions of cells to play with.

The team then edited the DNA inside the T-cells to give them the shielding mutation - known as CCR5-delta-32.

About 10 billion cells were then infused back in, although only around 20% were successfully modified.

When patients were taken off their medication for four weeks, the number of unprotected T-cells still in the body fell dramatically, whereas the modified T-cells seemed to be protected and could still be found in the blood several months later.

Replacement therapy?
The trial was designed to test only the safety and feasibility of the method, not whether it could replace drug treatment in the long term.


Prof Bruce Levine, the director of the Clinical Cell and Vaccine Production Facility at the University of Pennsylvania, told the BBC: "This is a first - gene editing has not to date been used in a human trial [for HIV].

"We've been able to use this technology in HIV and show it is safe and feasible, so it is an evolution in the treatment of HIV from daily antiretroviral therapy."

He says the aim is to develop a therapy that gets people away from expensive daily medication.

"What if we can now take the leap to an upfront treatment that can last for years?"

Such a treatment will be expensive so any benefit will depend on how long people could be freed from drugs and how long that protection would last.

Prof Levine argues this could be several years, which might save money in the long term.

Commenting on the findings, Prof Sharon Lewin from Monash University in Australia, told BBC News: "The idea of modifying a T-cell to make it resistant and showing it is feasible and they survive - that's exciting in itself.

"What most people are aiming for in HIV is a way you take treatment for a short period of time and that keeps the virus under control."

She said drug treatment would not be replaced by this, especially in the early stages of the infection.

But it might lead to people eventually replacing drugs with an immune upgrade, but "it's still a long way off".

[*Anya*]

March 27, 2014

The two human cases are linked to nine cases of Mycobacterium bovis infection in cats in Berkshire and Hampshire last year.

Both people were responding to treatment, PHE said.

It said the risk of cat-to-human transmission of M. bovis remained "very low"

Dr Dilys Morgan, Public Health England: These are the first documented cases of cat-to-human transmission...”

M. bovis is the bacterium that causes tuberculosis in cattle, known as bovine TB, and other species.

Transmission of M. bovis from infected animals to humans can occur by breathing in or ingesting bacteria shed by the animal or through contamination of unprotected cuts in the skin while handling infected animals or their carcasses.

Screening tests
The nine cases of M. bovis infection in cats in Berkshire and Hampshire were investigated by PHE and the Animal Health and Veterinary Laboratories Agency (AHVLA) during 2013.

The findings of the investigation are published in the Veterinary Record on Thursday

What is tuberculosis?

Tuberculosis (TB) is an infectious disease caused by a germ which usually affects the lungs.

Symptoms can take several months to appear and include

•Fever and night sweats

•Persistent cough

•Losing weight

•Blood in your phlegm or spit

Almost all forms of TB are treatable and curable, but delays in detection and treatment can be damaging.

TB caused by M. bovis is diagnosed in less than 40 people in the UK each year. The majority of these cases are in people over 65 years old.

Overall, human TB caused by M. bovis accounts for less than 1% of the 9,000 TB cases diagnosed in the UK every year.

Those working closely with livestock and/or regularly drinking unpasteurised (raw) milk have a greater risk of exposure.

Public Health England
Screening was offered to people who had had contact with the infected cats. Following further tests, a total of two cases of active TB were identified.

Molecular analysis showed that M. bovis taken from the infected cats matched the strain of TB found in the human cases, indicating that the bacterium was transmitted from an infected cat.

Two cases of latent TB were also identified, meaning they had been exposed to TB at some point, but they did not have the active disease.

PHE said it was not possible to confirm whether these were caused by M. bovis or something else.

No further cases of TB in cats have been reported in Berkshire or Hampshire since March 2013.

'Uncommon in cats'
Dr Dilys Morgan, head of gastrointestinal, emerging and zoonotic diseases department at PHE, said: "It's important to remember that this was a very unusual cluster of TB in domestic cats.

"M. bovis is still uncommon in cats - it mainly affects livestock animals.

"These are the first documented cases of cat-to-human transmission, and so although PHE has assessed the risk of people catching this infection from infected cats as being very low, we are recommending that household and close contacts of cats with confirmed M. bovis infection should be assessed and receive public health advice."

Out of the nine cats infected, six died and three are currently undergoing treatment.

Prof Noel Smith, head of the bovine TB genotyping group at the AHVLA, said testing of nearby herds had revealed a small number of infected cattle with the same strain of M. bovis as the cats.

However, he said direct contact between the cats and these cattle was unlikely.

"The most likely source of infection is infected wildlife, but cat-to-cat transmission cannot be ruled out."

Cattle herds with confirmed cases of bovine TB in the area have all been placed under movement restrictions to prevent the spread of disease.

http://www.bbc.com/news/health-26766006

[*Anya*]

Doctors implant lab-grown vagina

Last updated Apr 10, 2014, 5:45 PM PST

By James Gallagher

Health and science reporter, BBC News

Experts said the study, published in the Lancet, was the latest example of the power of regenerative medicine.

In each woman the vagina did not form properly while they were still inside their mother's womb, a condition known as vaginal aplasia.

Current treatments can involve surgically creating a cavity, which is then lined with skin grafts or parts of the intestine.

The scaffold is made of a biodegradable material

Doctors at Wake Forest Baptist Medical Centre in North Carolina used pioneering technology to build vaginas for the four women who were all in their teenage years at the time.

Scans of the pelvic region were used to design a tube-like 3D-scaffold for each patient.

A small tissue biopsy was taken from the poorly developed vulva and grown to create a large batch of cells in the laboratory.

Muscle cells were attached to the outside of the scaffold and vaginal-lining cells to the inside.

The vaginas were carefully grown in a bioreactor until they were suitable to be surgically implanted into the patients.

One of the women with an implanted vagina, who wished to keep her name anonymous, said: "I believe in the beginning when you find out you feel different.

"I mean while you are living the process, you are seeing the possibilities you have and all the changes you'll go through.

"Truly I feel very fortunate because I have a normal life, completely normal."

'An important thing'

All the women reported normal sexual function.

Vaginal aplasia can lead to other abnormalities in the reproductive organs, but in two of the women the vagina was connected to the uterus.

There have been no pregnancies, but for those women it is theoretically possible.

The scaffold is placed in an incubator

Dr Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest, told the BBC News website: "Really for the first time we've created a whole organ that was never there to start with, it was a challenge."

He said a functioning vagina was a "very important thing" for these women's lives and witnessing the difference it made to them "was very rewarding to see".

This is the first time the results have been reported. However, the first implants took place eight years ago.

'Most important questions'

Meanwhile, researchers at the University of Basel in Switzerland have used similar techniques to reconstruct the noses of patients after skin cancer.

The other side of the scaffold is coated with smooth muscle cells before it is incubated a second time

It could replace the need to take cartilage from the ribs or ears in order to rebuild the damage caused by cutting the cancer away.

Prof Martin Birchall, who has worked on lab-grown windpipes, commented: "These authors have not only successfully treated several patients with a difficult clinical problem, but addressed some of the most important questions facing translation of tissue engineering technologies.

The steps between first-in-human experiences such as those reported here and their use in routine clinical care remain many, including larger trials with long-term follow-up, the development of clinical grade processing, scale-out, and commercialisation."

BBC © 2014

[Kobi]

REDWOOD CITY, Calif. — Each morning around 6, Mary Ellen Snodgrass swallows a computer chip. It’s embedded in one of her pills and roughly the size of a grain of sand. When it hits her stomach, it transmits a signal to her tablet computer indicating that she has successfully taken her heart and thyroid medications.

“See,” said Snodgrass, checking her online profile page. With a few swipes she brings up an hourly timeline of her day with images of white pills marking the times she ingested a chip. “I can see it go in. The pill just jumped onto the screen.”

Snodgrass — a 91-year-old retired schoolteacher who has been trying out the smart pills at the behest of her son, an employee at the company that makes the technology — is at the forefront of what many predict will be a revolution in medicine powered by miniature chips, sensors, cameras and robots with the ability to access, analyze and manipulate your body from the inside.

As the size and cost of chip technology has fallen dramatically over the past few years, dozens of companies and academic research teams are rushing to make ingestible or implantable chips that will help patients track the condition of their bodies in real time and in a level of detail that they have never seen before.

Several have been approved by the Food and Drug Administration, including a transponder containing a person’s medical history that is injected under the skin, a camera pill that can search the colon for tumors, and the technology, made by Proteus Digital Health, that Snodgrass is using. That system is being used to make sure older people take their pills; it involves navigating a tablet and wearing a patch, which some patients might find challenging.

Scientists are working on more advanced prototypes. Nanosensors, for example, would live in the bloodstream and send messages to smartphones whenever they saw signs of an infection, an impending heart attack or another issue — essentially serving as early-warning beacons for disease. Armies of tiny robots with legs, propellers, cameras and wireless guidance systems are being developed to diagnose diseases, administer drugs in a targeted manner and even perform surgery.

But while the technology may be within reach, the idea of putting little machines into the human body makes some uncomfortable, and there are numerous uncharted scientific, legal and ethical questions that need to be thought through.

What kind of warnings should users receive about the risks of implanting chip technology inside a body, for instance? How will patients be assured that the technology won’t be used to compel them to take medications they don’t really want to take? Could law enforcement obtain data that would reveal which individuals abuse drugs or sell them on the black market? Could what started as a voluntary experiment be turned into a compulsory government identification program that could erode civil liberties?

In 2002, when silicon chips containing their medical records were injected into some Alzheimer’s patients, it was deeply unsettling to privacy advocates. Several states subsequently passed legislation outlawing the forced implantations, and the technology never took off.

Marc Rotenberg, executive director of the Washington-based Electronic Privacy Information Center, said he worries about the coercive use of the chips — whether they are implanted for a few months or permanently, or are swallowed and last in the body only about a day.

“There’s something very troubling about a chip being placed in a person that they can’t remove,” he said.

Proponents of the technology, however, say the devices could save countless lives and billions of dollars in unnecessary medical bills.

Eric Topol is the director of the Scripps Translational Science Institute in La Jolla, Calif., and has written a book about the digital revolution in health care. He said he believes the science is moving so quickly that many of these gadgets will be ready for commercial use within the next five years.

“The way a car works is that it has sensors and it tells you what’s wrong. Why not put the same type of technology in the body? It could warn you weeks or months or even years before something happens,” Topol said.

Refining the technology

The ingestible chip that Snodgrass is using — it was the first smart pill to be approved by the Food and Drug Administration and the European Union, in 2012 and 2010, respectively — is still being tested by a handful of doctors and hospitals, as the company continues to refine its software. Proteus officials say they hope to make it more widely available within the next year.

Britain’s National Health Service has begun using the technology with heart patients to figure out whether it can increase compliance with prescribed medication. Swiss pharmaceutical giant Novartis has said it would seek FDA clearance to use the Proteus chips in the medications it makes for transplant patients to minimize the chance of organ rejection.

In the United States, the focus has been the elderly.

Made entirely of edible ingredients, the one-square-millimeter chip has copper on one side and magnesium on the other, and it is activated when it comes into contact with stomach acids. It’s used in conjunction with a patch, which is shaped like a large Band-Aid and worn on the torso. For five minutes after being swallowed, the chip sends out a unique 16-digit code that is picked up by the patch, which in turn beams the information to a nearby smartphone or tablet — where it can be shared via the Internet with family members, doctors and the company.

The patch contains additional sensors that tracks things such as temperature, heart rate, movement (whether someone is standing, sitting or lying flat) and sleep.

George Savage, a co-founder and chief medical officer of Proteus, said studies show that 50 percent of patients do not take their medications as prescribed and that allowing doctors to see whether patients actually take the drugs — and their reactions to the medicine — could help them figure out better treatments.

“It may be wasteful for an oncologist to see a particular patient every few months. Maybe all they need is a nurse if everything is going well,” Savage said. “Or, maybe if they are not taking their medications, they need a psychologist or social worker instead.”

On a recent weekday, Snodgrass’ son, Doug Webb, a 62-year-old electrical engineer, brought up a Web page with his mother’s name and a slew of charts and numbers. Snodgrass is in good health for her age and pretty good about taking her medications, but she lives alone. Webb worries that she might accidentally skip some doses as she gets older.

“With all the traffic here, I can only make it down to see her once a week, so this is a way for me to check in on her more often,” Webb said.

His mother has been taking the smart pills since December, so Webb knows her schedule well. A few months ago, after Webb’s stepfather was diagnosed with stage 4 colon cancer, Webb could see the effects of that news in his mother’s data: She was sleeping irregularly and sometimes could not get in her daily walk around the golf course near her house because she didn’t want to leave his side. One day, she forgot to take her pills and didn’t realize it until Webb pointed out a gap in her data.

“Sometimes I see very strange numbers and I’ll call her up and say, ‘What’s going on?’ ” he said.

On this day, Webb could see that his mother has taken one set of pills shortly after 6 a.m. and another at 10 a.m. It looked like she had been reading in her chair in the morning as usual and had been pretty active the rest of the day, taking more than 5,000 steps. All in all, he thought, it looked like she had had a good day. But just to make sure, he made it a point to remind himself to call her during his commute home.

http://www.washingtonpost.com/nation...5c0_story.html