Posts tagged with "Study"

When life leaves you off-balance: New research focuses on ‘dizziness of unknown cause’

August 6, 2019

When life leaves you, literally, “in the lurch”—suffering from functional dizziness that cannot be linked to an organic cause, no matter how many doctors you may visit or tests you may take—is there any hope for recovery?

For the very first time, researchers at the Technical University of Munich (TUM) in Germany say the answer is yes: Results of a study released on August 5 indicate that people who frequently feel light-headed, woozy, or unbalanced may be suffered from perception disorders.

Specifically, they have found symptoms that resemble those associated with dizziness due to organic causes-but that, instead, are caused by a malfunctioning of the processing of sensory-motor signals in the brain.

The Munich researchers already had postulated several years ago that such functional disorders might be caused by faulty processing of sensory stimuli. The team, headed by Professor Nadine Lehnen, senior physician for Psychosomatic Medicine at the TUM University Hospital rechts der Isar [located to the right of the Isar river], was able to provide more support for this theory by conducting an experimental pilot study.

Eight patients with functional dizziness, along with 11 healthy subjects, participated in the study. The researchers also used data from patients whose dizziness had been linked with organic defects—and who had previously taken part in the same experiment. Those patients had either a cerebellar disorder or a complete loss of functioning vestibular (equilibrium) nerves.

During the experiment, the participants sat in a dark room looking straight ahead while lights were flashed to their right and their left. They then were asked to look in the direction of the light points. Their eye and head movements during the gaze shifts were recorded. The subjects then were fitted with a weighted helmet to alter the inertia of their head. This resulted in significant head wobbling. The experiment was performed with and without the helmet.

Whereas the healthy subjects quickly adapted their movements to the new circumstances and managed to stop their head from wobbling, all the subjects with functional dizziness found the task difficult to perform. What surprised the research team was the fact that the latter behaved in exactly the same way as subjects with dizziness due to massive organic defects.

“Our results clearly show that functional dizziness is manifested exactly like severe physical disorders, for example after complete functional loss of the vestibular nerves. This reflects how severely impaired these people are,” Professor Lehnen said in a press release..

Based on previous experience, which is stored in the brain in the form of learned models, people have a certain expectation about the sensory impressions evoked by a movement. This expectation is compared with information from the vestibular organs. If the head behaves differently than normal, the two sets of information no longer match. This creates an imbalance between expectation and reality, a state known as prediction error.

“Healthy people can easily perceive this error, process it and adapt their movements accordingly. Patients with functional dizziness, by contrast, do not appear to process sensory-motor impressions correctly. They rely primarily on their stored model, but it no longer matches the new reality,” Nadine Lehnen explains.

Can the condition be improved? She notes, “We were excited to observe that they are still able to learn—albeit only to a limited degree.” It would therefore be important to treat such patients using therapeutic approaches that take into account this processing deficit. A large-scale study is planned to corroborate the recent findings.

Research contact: Nadine.Lehnen@mri.tum.de

Cold comfort: Incoming medical students should be tested for empathy, study says

August 5, 2019

We’ve all been there—especially the women among our readers: Sitting in a doctor’s office and explaining our symptoms to a medical professional who is completely dismissive, disinterested, and in disbelief.

Worse yet is the practitioner who blames the patient for the condition—and lets her (or him) know about it through insolent or disdainful body language and comments.

Heather Cianciolo says she can tell within minutes if she’s going to like a doctor. “Ten minutes into a doctor’s appointment and I know if it’s going to be a waste of my time,” she said. “It’s a warning sign if someone doesn’t come in and ask me about me—{but rather] just starts talking at me.

“And it happens a lot,” she told The Chicago Tribune for a recent story.

The 46-year-old Oak Park, Illinois, woman—who has long suffered from migraine headaches— said she had to “go through” several specialists who didn’t listen to her before finding one she loves who is now her primary care physician.

“She listens and then she will explain her thinking. She expresses an interest in what’s happening,” Cianciolo said. “If you’re not going to take the time to answer my questions, why would I entrust my health care to you?”

Experts say the ability for doctors to build a rapport with their patients helps build trust and, in turn, improves patient outcomes.

In fact, Mohammadreza Hojat—a research professor of psychiatry and human behavior at Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia who recently designed a questionnaire for  more than 16,000 students of osteopathic medicine—suggests that a norm-level of empathy could (and should) be required for all incoming medical students nationwide, according to the report by the Tribune.

Once a norm-level is established, Dr. Hojat suggests, medical schools should use the data to assess for empathy, alongside academic measures like college transcripts and MCAT scores, when considering medical school applicants.

 “There are two components of medicine. One component is the science of medicine and one component is the art of medicine,” Dr. Hojat told the Tribune. “When it comes to art of medicine, it is about interpersonal relationships and empathy, and we have no method in place” to measure that in medical students’ applicants.

Although empathy can be taught, Hojat said, students who already come to medical school with a strong sense of empathy will make better doctors. And he noted that, although the study focused on students of osteopathic medicine, the tool should be used by traditional medical schools.

Dr. John Prescott, chief academic officer at the Association of American Medical Colleges, said in a statement that “humanism and empathy are critical qualities required of tomorrow’s physicians.” But the statement also claimed that medical schools already look at a “holistic review of applicants … which looks beyond grades and test scores.”

And Jean Decety, a University of Chicago neuroscientist who studies empathy, told the news outlet that, although he hadn’t read the study, his work has shown that empathy only is important for “certain types of physicians.”

In fact, he said, some students will go into specialties that don’t require strong interpersonal skills—for example, radiologists who mostly read images, or surgeons who require excellent technical skills but not necessarily a lot of empathy.

“That’s what you want from your surgeon,” he said.

The study was published July 25 in The Journal of the American Osteopathic Association.

Research contact: @chicagotribune

‘Smart cars’ are too ‘demanding and confusing’ for older drivers

August 2, 2019

“It was a comedy of errors,” said a 71-year-old participant in a recent study conducted by the University of Utah on behalf of the AAA Foundation for Traffic Safety—during which, among other things, he was asked to program car’s infotainment system.

The new AAA car safety study suggests that tech-laden “smart” cars are too distracting, which can undermine efforts to keep roadways safe, especially when those getting behind the wheel are aged 55 and over, NBC News reports.

Indeed, the researchers say that all of the bells and whistles on new cars may be perceived as demanding and confusing by older drivers.

“The technology we’re putting in cars today [is] unsafe for all of us to use, especially for older adults,” said Jake Nelson, AAA Director of Traffic Safety Advocacy and Research. “Our advice to consumers is that just because technology is built into your car doesn’t mean that it’s safe to do those things.”

In the study, drivers were divided into two groups— a younger group (ages 21 to 36) and an older group (ages 55 to 75). Each participant was asked to drive a 2018 car equipped with a number of “smart” features, including navigation screens and voice activation controls.

Among the tasks drivers were asked to complete: sending a text message, programming music, programming a navigation system, and placing a call.

Overall, the study found, older drivers experienced higher levels of cognitive and visual demand, compared to younger drivers. These differences were even more pronounced for older drivers when completing any in-vehicle information system task, or IVIS. But the study found that older and younger drivers both found some tech features challenging and time-consuming.

“Given the demands associated with IVIS tasks,” the study concluded, “drivers of all ages should use these infotainment technologies only for legitimate emergencies or urgent, driving-related purposes.”

Paul Brown, a 71-year-old retired attorney who resides in Salt Lake City, is one of the drivers who took part in the study. “I don’t need something that is going to do everything for me and distract me while I’m driving,” Brown said. “Quite frankly, when I was driving, I found myself feeling as if I was driving dangerously because of all of those distractions.”

Brown said he found the large display screen situated to the right of the steering wheel in the cars he drove for the study especially distracting.

“If I was driving that kind of car, I would probably put a napkin or blanket or something over that screen so that I could concentrate on driving the car,” Brown said, adding that he prefers older, simpler cars.

Nelson said that making cars more user-friendly for older drivers ultimately makes cars safer for everyone. “If we can design a system to make it so that utilizing a car’s features is no more distracting than tuning your radio, if we can achieve that for the older adult driver, we can all benefit from that,” Nelson said.

Research contact: @NBCNews

Bitter pills: High dementia risk linked to category of prescription drugs called anticholinergics

June 27, 2019

Prescription pills that many people take for what ails them actually may be putting them at risk for dementia, results of a study conducted by the UK’s University of Nottingham, Aldermoor Health Centre, and University of Oxford have demonstrated.

The drugs—anticholinergics—are widely prescribed for such conditions as  urinary incontinence, overactive bladder, chronic obstructive pulmonary disorder, depression and psychosis, gastrointestinal conditions, and the involuntary muscle movements associated with Parkinson’s disease. Examples include atropine, bentropine mesylate, clidinium, dicylomine, oxybutynin, scopolamine, solifenacin, and tiotroplum—but there are many more.

Anticholinergic drugs are used to block the action of acetylcholine—a neurotransmitter, or chemical messenger, that transfers signals between certain cells to affect your body functions, according to Healthline.

The investigation—published on June 24 in the Journal of the American Medical Association–Internal Medicinefound that patients over the age of 55 who took anticholinergic medication each day for more than three years had a 50% greater risk of developing dementia.

“This study provides further evidence that doctors should be careful when prescribing certain drugs that have anticholinergic properties,” Tom Dening, one of the authors and head of the Center for Dementia at the University of Nottingham, said in a press release. “However, it’s important that patients taking medications of this kind don’t just stop them abruptly, as this may be much more harmful. If patients have concerns, then they should discuss them with their doctor to consider the pros and cons of the treatment they are receiving.”

According to a report by Newsweek, the researchers analyzed medical data on nearly 59,000 people with dementia, which they collected between January 2004 and January 2016. Of the records they analyzed, the average age of patients was 82 and about 63% of them were women.

Approximately 57% of the patients in the study received a prescription for at least one strong anticholinergic drug, one to 11 years before being diagnosed with dementia. Although the link found between the drugs and development of dementia appears strong, the researchers noted that their findings are associations and do not show that the drugs cause dementia.

“Further research is needed to confirm whether or not the association between these drugs and risk of dementia is causal. These drugs are prescribed for a number of health conditions and any concerns patients might have about them should be discussed with their doctors,” Professor Martin Rossor, NIHR National Director of Dementia Research, based in London, told Newsweek.

Research contact: @Newsweek

Nut case: Walnuts are found to suppress breast cancer growth

April 2, 2019

New research conducted by Marshall University in Huntington, West Virginia, has found that walnut consumption may suppress the growth of breast cancers.

Led by W. Elaine Hardman, Ph.D., a professor in the Department of Biomedical Sciences at the Marshall University Joan C. Edwards School of Medicine, a Marshall University team revealed that consumption of two ounces of walnuts a day for about two weeks “significantly changed gene expression in confirmed breast cancers.”

This clinical trial is the latest of a series of related studies at Marshall University related to dietary walnut links to tumor growth, survival, and metastasis in breast cancer. The work is described in a March 10 paper published in the journal Nutrition Research.

“Consumption of walnuts has slowed breast cancer growth and/or reduced the risk of mammary cancer in mice,” Hardman said. “Building on this research, our team hypothesized that walnut consumption would alter gene expression in pathologically confirmed breast cancers of women in a direction that would decrease breast cancer growth and survival.”

In this first clinical trial, women with breast lumps large enough for research and pathology biopsies were recruited and randomized to walnut consuming or control groups. Immediately following biopsy collection, women in the walnut group began to consume two ounces of walnuts per day until follow-up surgery. Pathological studies confirmed that lumps were breast cancer in all women who remained in the trial. At surgery, about two weeks after biopsy, additional specimens were taken from the breast cancers.

Changes in gene expression in the surgical specimen compared to baseline were determined in each individual woman in walnut-consuming (n = 5) and control (n = 5) groups. RNA sequencing expression profiling revealed that expression of 456 identified genes was significantly changed in the tumor due to walnut consumption. Ingenuity Pathway Analysis showed activation of pathways that promote apotosis [cell death] and cell adhesion; and inhibition of pathways that promote cell proliferation and migration.

“These results support the hypothesis that, in humans, walnut consumption could suppress growth and survival of breast cancers,” Hardman said. “Additional research through a larger-scale study would be needed to clinically confirm that walnut consumption actually does reduce the risk of breast cancer or breast cancer recurrence.”

The study was funded, in part, by the California Walnut Commission, which also provided the walnuts. The CWC did not influence the development of the study, analyses of the data or decision to publish the results. All data is available online.

Research contact: hardmanw@marshall.edu

No bones about it: Slip-and-fall injuries up among seniors who walk dogs to stay active

March 8, 2019

Nothing is more likely to get a senior citizen out of the house for a walk and some fresh air than attending to the needs of his or her dog (and best friend). What’s more, taking Rover for a ramble offers an opportunity to socialize with nearby neighbors and pet owners, especially if the weather is good.

So it seems to be a win-win situation on both sides of the leash. Or is it?

While walking a dog provides older Americans with a valuable outlet for regular, physical activity, findings of a Penn Medicine study indicate that fractures related to these walks more than doubled between 2004 and 2017 in patients 65 and older.

The study — published on March 6 in JAMA Surgery—established that, in this population, 78% of the fractures occurred in women, with hip and upper extremity breaks being the most common.

The rise in injuries in this population is a result of two trends, the researchers say: increased pet ownership and a greater emphasis, in recent years, on physical activity at older ages.

“Dog walking, which has repeatedly demonstrated social, emotional and physical health benefits, is a popular and frequently recommended activity for many older Americans seeking new ways to stay active,” said the study’s lead author Kevin Pirruccio, a second-year medical student in the Perelman School of Medicine at the University of Pennsylvania. “This study highlights that while there are undoubtedly pros to dog walking, patients’ risks for falls must be factored into lifestyle recommendations in an effort to minimize such injuries.”

The study team, which included senior author Jaimo Ahn, an associate professor of Orthopaedic Surgery, and Yeo Myoung Yoon, a research assistant at Penn, reviewed all fractures in the 65-and-older population related to “pet products” in the National Electronic Injury Surveillance System database of the United States Consumer Product Safety Commission. The entries the team found— stretching across roughly 100 participating hospitals’ emergency departments—corresponded to 32,624 cases in the United States, overall.

Fracture injuries linked to walking leashed dogs were found to have increased significantly from 1,671 cases in 2004 to 4,396 in 2017—a 163% increase. About half of the injuries were related to people’s upper extremities; fractures of the wrist, upper arm, finger and shoulder were the most common in that category.

Specifically, seniors fractured their hip most often, accounting for 17% of the injuries in the database. This is particularly concerning as mortality rates related to hip fractures in the in patients over 65 are close to 30%. Why hip injuries among older people can be so deadly has to do with the possibility of setting off a domino-effect of factors that relate to poorer health, such as a sudden lack of mobility and activity.

While the numbers are sobering, the researchers believe that their count of dog walking injuries may actually be low. The study only examined reported fractures and those who went to an emergency room. Debilitating tendon or muscle damage and those who may refuse or seek out other avenues of care were not included in the study.

The researchers don’t want to keep seniors from walking dogs or owning them. But they hope their study and others that build off of it provide grounds for deeper considerations about the risks everyone faces as they grow older.

Research contact: Francis.Otto@pennmedicine.upenn.edu

Knowing just one gay person shifts attitudes

February 12, 2019

It’s not what you know, but who you know that gets you in the door, or that moves a social effort forward. Most of us are familiar with this “old saw”—and now,  Daniel DellaPosta of Penn State University has proven it true again.

DellaPosta—an assistant professor of Sociology at Penn and an affiliate of the university’s Institute for CyberScience—has found that people who meet and become acquainted with at least one gay person are more likely to later change their minds about same-sex marriage; and become more accepting of gay and lesbian people in general,

 Indeed, friendship bonds that may seem superficial at first glance could be just deep enough to produce attitude changes that help spark social transformations.

According to DellaPosta, sociologists have long proposed that when people establish certain relationships, they may change their attitudes about issues, often referred to as the contact effect. However, prior to this study, the theory had yet to be rigorously tested.

“What I thought we needed in this area was a test of the contact hypothesis that was conservative — perhaps overly conservative—using the most stringent test we could possibly devise,” said DellaPosta.

DellaPosta examined data from the 2006, 2008, and 2010 editions of General Social Survey (GSS), a sociological survey of opinions that Americans hold on a range of issues.

In 2006, about 45% of the people who had a gay or lesbian acquaintance expressed support for same-sex marriage. By 2010, that figure had increased to 61%. In 2006, only 22% of people who did not have a gay or lesbian acquaintance said they approved of same-sex marriage. That number fell to 18% in 2010.

DellaPosta said that the survey data does not reveal exactly when these relationships were established, which makes the test more rigorous.

“By taking people in that 2006 baseline who were acquainted with gay and lesbian people and comparing them with other people who were similar in all visible regards, including their measured attitude toward same-sex marriage and gay and lesbian people at that 2006 baseline, who were not acquainted with gay and lesbian people, you can get a really conservative test of the contact hypothesis,” said DellaPosta, who reported his findings in a recent issue of the journal Socius.

The findings could shed light on how “coming out” among gay and lesbian people impacts the general acceptance of gay and lesbian people. In the 1973 GSS, just 11% of Americans believed that “homosexuality is not wrong at all.” By 2016, that number had grown to 52%.

DellaPosta suggests that coming out may facilitate more contact with gay and lesbian people, which then accelerates an attitude change about issues that affect the gay community.

Further, DellaPosta suggested that the contact with a gay person does not even need to be especially deep for the contact effect to appear.

“If you have very superficial contact, like just seeing someone from an out group in the grocery store or on the subway, you may focus more on selective behaviors that reinforce your prejudices—like someone dressing, talking or acting in a way that reinforces some negative stereotype of that group,” said DellaPosta.

“But, if you take the next level to mere acquaintanceship—someone whose name you know, someone who, if you saw them on the street, you might stop and chat with them for a moment—the contact effect sets in because when you suddenly have to interact with someone from an out group as an individual, it forces you to reconsider your biases.”

According to DellaPosta, having a closer, deeper bond with a gay or lesbian acquaintance did not result in an even larger shift of attitude toward same-sex marriage. He added that the contact effect actually is larger for people who have a low probability of having a gay or lesbian acquaintance.

Research contact: djd78@psu.edu