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Beware of Poisonous Caterpillar in Florida

25th Sep 2014 Diseases, Medical News

Recently there have been countless news stories about a spectacular caterpillar – the puss caterpillar. Children from Florida to Virginia have been stung and the excruciating pain has been landing them in the hospital. Some of these children had actively sought out to pet the caterpillar due to its “cute” fuzzy appearance. In fact, the caterpillar gets its name due to the fact that it resembles a “fluffy house cat” or even a “tiny Persian cat.” Other children came into contact when the insect fell from a tree and landed on them.

These caterpillars are generally an inch long at the largest and are covered in a thick coat of fur that can range from greyish-white to orangey-brown to charcoal. In addition to the fur their body tapers at the end, which can give it the appearance of having a tail. The fluffy hairs that cover the puss caterpillar hide a series of tiny, venomous spines that can stick in your skin.

The feeling is said to be similar to a bee sting, except worse, and immediately starts increasing to the point where it can even “make your bones hurt.” The degree of pain depends on where you’re stung, but it has been reported to take as many as 12 hours to begin to subside. On top of the intense pain, contact with the caterpillar’s bristles can cause fever, vomiting, convulsions, rashes, swelling, abdominal distress, blisters, and even chest pain, numbness, and difficulty breathing. However, each individual reacts to a different extent – some require medical treatment and other report only a mild itching or burning.

It may seem like more and more people are being stung recently, which is partly true. Like many other insect species, the puss caterpillar populations go through a “boom-and-bust” cycle. This means that the population can increase or decrease quite dramatically as environmental conditions change. Right now these conditions appear to be ideal for the caterpillars so the population has been on the rise.

The Poison Center of Tampa recommends that you use cellophane tape over the affected area and remove repeatedly to strip the spines from your skin. In addition, you can apply ice packs to reduce the stinging sensation and follow it up with applying a paste made of baking soda and water. Oral antihistamines, calamine lotion, hydrocortisone cream, and juice from the stems of comfrey plants can also be used to treat symptoms. It is recommended to watch for the caterpillars around trees like oak, elm, and citrus. They even tend to be found around common garden plants like rose bushes or ivy. Additionally, teach children what they look like and why they need to avoid touching them since the puss caterpillar’s fluff-ball appearance can be quite appealing.

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Starkey Halo

19th Sep 2014 Starkey Hearing Foundation

On March 31, Starkey introduced a hearing aid that is compatible with the iPhone, iPod touch, and iPad. In keeping with current technology trends they offer the ability to stream phone calls, FaceTime, music, and more directly to their hearing aid using Bluetooth. Users have the ability to control the device through the app (TruLink) or manually. Many hearing aids on the market have had the ability to work wirelessly, but they require a secondary device. Since this is often something that had to be worn around the neck many individuals find it more cumbersome than it’s worth. The Starkey hearing aid does not require any complicated set up or additional devices, making it easier to take advantage of all the features.

In addition to streaming phone calls and music, this hearing aid also has some additional features that make it a top-of-the-line product. They have improved the audibility of high-frequency sounds (like women’s and children’s voices) by lowering the frequency, they’ve developed a state of the art feedback canceller to eliminate buzzing and whistling, they provide sound compression technology to differentiate soft and loud noises, and the device has advanced noise reduction to make speech easier to hear in congested environments. In addition, the app has many different settings to allow for more adjustments and personalization than most hearing aids on the market.

The interface is intuitive and quick to use, giving users the flexibility they need to adapt to new situations. Individuals that have experienced hearing loss report that their hearing is back to “normal” and they can hear parts of conversations they would have missed otherwise. Users can use their iPhone as a microphone to stream sounds directly to the hearing aid as well. An example would be trying to hear a conversation in a noisy restaurant. You can use your iPhone to amplify the conversation you want by placing it closer to the people you want to hear and you can even disable the ear-level mic to block out ambient sounds.More great features include the ability to have Siri read your emails and texts to you, a “find-my-hearing-aid” feature to located misplaced hearing aids, and personalized geo-tags and settings based on coordinates. These geo-tags allows you to set hearing preferences for up to 20 locations of your choice.

The Starkey Halo hearing aids are available through your hearing care professional only, but the app is free to download from the app store.

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Puccio Study FA

19th Sep 2014 Diseases, Friedreich's Ataxia

A recent breakthrough in Friedreich’s ataxia (FA) research gives hope that gene therapy can prove be an effective treatment for the disease. A team led by Hélène Puccio, Ph.D., has demonstrated that gene therapy can be used to reverse heart damage caused by FA and correct mitochondrial metabolism. Dr. Puccio works as the head of a research team at the Institute of Genetics and Molecular and Cellular Biology located at the University of Strasbourg, France, as well as research director at the Insititute de Santé et de la Recherche Médicale (INSERM.) She and her team have concentrated their research on the pathophysiological mechanisms involved in recessive ataxias, like FA, in order to develop new animal and cell models.

Friedreich’s ataxia is rare, but one of the more common recessive ataxias – found in 1 in every 50,000 births. It is caused by a mutation in the frataxin (FXN) gene, which in turn causes a decrease in the amount of frataxin produced. The lack of frataxin disrupts the mitochondria that are responsible for the cell’s energy production, and, unfortunately, heart tissue is particularly vulnerable.

While FA causes progressive neurodegeneration that starts as impaired balance and coordination, it also impairs heart function and can contribute to diabetes. Most patients require a wheelchair after about 10-20 years of disease progression, but complications with the heart lead to death in more than half of individuals, and often before the age of 35.

Dr. Puccio’s team used a harmless viral vector to insert a normal copy of the problematic gene in the heart cells of FA mouse models. Since these mice show the same heart symptoms as human patients suffering from the disease the results are especially promising. The virus used was an adeno-associated virus (AAV) since it is known to effectively and efficiently target heart cells and express therapeutic diseases. This virus was modified to render it harmless and only capable of inserting the normal FXN gene copy into the cells.

One single intravenous injection was not only able to prevent the development of heart disease in the mice, but it quickly and completely reversed the heart damage in advanced cases. Within three weeks the mice appeared to have completely restored heart and mitochondrial function and their heart tissue appeared similar to healthy mice.

Since this is the first time that gene therapy has produced such a fast and complete remission of heart disease in an animal model work is rapidly being done to begin clinical studies. There is also hope that this technique can be used to prevent or even correct damage to the spinal cord and cerebellum.

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FARA Energy Ball Research Panel

19th Sep 2014 Diseases, Friedreich's Ataxia

There were many excellent speakers at this year’s FARA Energy Ball that covered a wide variety of topics – from recent scientific breakthroughs to first-hand experiences of those suffering from the disease. Three leaders in the Friedreich’s ataxia research community spoke regarding current genetic approaches to therapies and shared some of their most recent findings.

One of the speakers was Joel Gottesfeld, Ph.D. Dr. Gottesfeld currently works as a professor in the Department of Molecular Biology at the Scripps Research Institute. He studies several genetic human diseases – one of which is Friedreich’s ataxia. In addition to studying general characteristics of this disease Dr. Gottesfeld and his staff are working to develop new treatments.

Their research has led to the discovery of a new group of histone deacetylase (HDAC) inhibitors. These small molecules were found to reverse the heterochromatin-mediated silencing of the frataxin (FXN) gene. Further research with mouse models has shown that these HDAC inhibitors can cross the blood brain barrier, do not appear to cause toxicity at expected therapeutic levels, and do act as HDAC inhibitors in the mouse brain. Even more promising, they demonstrated that the HDAC inhibitors increased the FXN gene expression and protein in the blood cells of FA patients.

Another speaker was Hélène Puccio, Ph.D. Dr. Puccio is the head of a research team at the Institute of Genetics and Molecular and Cellular Biology located at the University of Strasbourg, France, as well as a research director at the Insititute de Santé et de la Recherche Médicale (INSERM.) She has concentrated her research on the pathophysiological mechanisms involved in recessive ataxias, like Friedreich’s ataxia, in order to develop new animal and cell models.

During one of her studies she and her colleagues were able to use mice with no frataxin in their heart to demonstrate that gene therapy can be used to reverse heart damage and correct the mitochondrial metabolism. This finding leads to the possibility of using gene therapy as a treatment for the disease.

Finally, Massimo Pandolfo, MD works for Université Libre de Bruxelles at the Hôspital Erasme and has been the principal investigator of the European Friedreich’s Ataxia Consortium for Translational Studies (EFACTS.) Dr. Pandolfo led an international collaboration that discovered the FA gene back in 1996 and has continued to contribute in many ways over the years. He has been working with everything from research trials to clinical care for patients. In addition, he has contributed to our understanding of the disease process, clinical characteristics, and has helped to advance drug development.

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FA Dyclonine Study Review

19th Sep 2014 Diseases, Friedreich's Ataxia

Freidreich’s ataxia (FA) is a recessive disease causing progressive damage to the nervous system. It is the most prevalent inherited cause of ataxia and affects about 1 in 50,000 people in the United States. Despite its prevalence, there is no cure or treatment beyond supportive care.

A recent article was published in the Human Molecular Genetics journal in regards to a potential new therapy for FA. The drug, dyclonine, was developed for use as a topical anesthetic and is found in the over the counter throat lozenge, Sucrets, as well as some Cepacol throat sprays. FA is caused by a genetic deficiency in the mitochondrial protein frataxin (FXN) and dyclonine was noticed to increase FXN protein in animal models. When the drug was given a mouse model of FA it prevented a performance decline during balance beam tests. A proof-of-concept clinical study was performed on eight patients, which showed an increase in buccal cell FXN.

Mice used in this study were tested with level balance beams of varying thickness that required them to walk from one end to the other in order to seek shelter. Mice were timed and video recorded in order to count the number of foot slips. The individual in charge of recording the data was blinded to which treatment group the mouse was in. Mice that were dosed with dyclonine had statistically significant improvements. Not only did their performance on the beams not worsen like the affected controls, but they even improved their time to cross.

The second part of the study involved using dyclonine as an oral rinse, since that is already FDA-approved, and then swabbing the cheeks for buccal cells. The cells were compared to pre-treatment cells from the same patients. Six of the eight showed an increase in FXN, two showed no increase, but two healthy controls showed increased levels. Interestingly, the patients with the most neurological impairment were the ones that showed the highest increase from the dyclonine mouth rinse. Neurological impairment was determined with a FARS (Friedreich’s Ataxia Rating Scale) score.

What’s next? Further clinical studies are required to see if the results achieved from the oral rinse can be duplicated systemically and show the same improvements as observed in the mouse model. Additionally, optimal dosing, toxicology, and pharmacokinetics all need to be studied and better understood before testing can proceed. Despite the questions that still need addressed, dyclonine could be a new treatment option for people affected by Friedreich’s ataxia.

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Enterovirus 68

19th Sep 2014 Diseases, Enterovirus 68

A rare respiratory illness has been all over the news recently, especially with the addition of two new states – Oklahoma and Pennsylvania. These states have recently been added to the growing group with confirmed cases of enterovirus 68. The other states include New York, Alabama, Indiana, Louisiana, Colorado, Illinois, Iowa, Kansas, Kentucky, and Missouri. Georgia, Michigan, Ohio, and Utah suspect that they have cases, but it has not been confirmed yet.

Enteroviruses are incredibly common, however enterovirus 68 is a rarer strain that can cause breathing problems in children. It was first isolated in California in 1962 and has generally turned up in sporadic, isolated instances. It usually surfaces later in the enterovirus season, which is equivalent to August-September in the Northern hemisphere. Outbreaks have become more common in the 21st century and have included countries like the Philippines, Japan, the Netherlands, and in multiple US states.

In general, children under 5 years of age are the most at risk, but the disease has been found in older children and adults with asthma as well as immunosuppressed adults. The disease causes typical respiratory illness symptoms.

There is no vaccine or treatment beyond supportive care, so it is recommended to use common sense and good hygiene for protection. Since the virus is spread through saliva, phlegm, and stool you should wash your hands regularly, cough or sneeze into your arm (not your hands) and avoid prolonged exposure with sick people. If you are ill try to avoid prolonged contact with immunocompromised individuals, very young children, and infants. The disease generally runs it course without any complications and very few people need to be hospitalized.

While enterovirus 68 has been a hot topic recently, it appears that the number of children with the illness has peaked toward the end of August. More states may be added to the list, but it should not be taken as a sign that the disease is suddenly spreading to new locations. Since only the CDC and a handful of other laboratories are able to test for this particular strain there is a backlog of samples.

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