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Evalytics 22 August at 07.36 AM

‘The greatest feeling in the world’: Deep brain stimulation helps stroke survivor regain independence


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What you need to know

In a significant step towards animal-human transplants, researchers at NYU Langone Health transplanted a genetically modified pig kidney into a brain-dead human and observed its normal functioning for over a month. This marks the longest a pig kidney has been able to function in a human. The experiment aims to address the dire shortage of transplantable organs by exploring the potential of using animal organs to save human lives. The study involves pigs genetically modified to better match human organs, and similar research is being conducted around the country to prepare for potential clinical trials in the future.
Doctors and advocates are calling for increased efforts to combat Chagas disease, a silent killer that can lead to serious heart disease and severe digestive problems. This disease, primarily affecting rural Latin America, is increasingly present in the United States, with over 300,000 cases estimated, though only 1% have been identified due to lack of awareness and testing. Advocates are pushing for better testing and treatment access, as well as supporting a new drug set for human trials next year.
The fires in Maui have raised concerns about long-term health risks due to the release of toxic chemicals into the air, water, and wreckage. Authorities have warned that the ash and dust from burned buildings may carry cancer-causing compounds like asbestos and lead, which were commonly used in construction before the 1970s. Additionally, the fires could have stirred up arsenic in the soil and released volatile organic compounds, increasing the risk of health issues including cancers, birth defects, and cognitive impairment.
Three influential medical organizations – the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association – have issued a joint plea for increased support and resources to address the growing crisis of pediatric mental health cases overwhelming emergency departments across the US. Approximately half a million children with mental or behavioral health conditions are evaluated in emergency departments every year, a number that has significantly increased over the past decade. The organizations call for community-based teams to respond to mental health crises in schools, doctors' offices, and homes, as well as the addition of pediatric mental health professionals to emergency departments to better manage these cases.
Three individuals, including one in New York's Suffolk County and two in Connecticut, have died from infections linked to vibriosis caused by Vibrio vulnificus bacteria found in seawater and raw or undercooked seafood. Officials have issued new guidance to prevent and diagnose this rare flesh-eating bacterial infection. Vibrio vulnificus infections are estimated to cause 80,000 illnesses and 100 deaths in the US annually, with the risk increasing from May to October due to warmer waters. Most people recover from mild infections, but serious cases can lead to intensive care or limb amputation, particularly for those with weakened immune systems.

Opinion

In this article, the author Dr. Sanjay Gupta reflects on their experiences while working on a podcast season about aging and the insights they gained from conversations with older individuals. He challenges the negative stereotypes and attitudes often associated with aging and share advice for approaching aging in a positive and healthy way.
  • Learn from Older Generations: The author emphasizes the importance of talking to people from older generations and learning from their experiences. Many preconceived notions about aging, such as inevitable aches and pains, may not hold true for everyone. The author's mother, a long-distance swimmer, and an explorer in their 70s and 80s all demonstrate the potential for vitality and activity in older age.
  • Attitude Matters: Attitudes about aging influence mindset and can impact lifespan. Positive self-perceptions of aging are linked to longer life. The author suggests resisting negative stereotypes and promoting positive age beliefs to foster better health outcomes.
  • Maintain Physical Health: The article stresses the importance of taking care of one's body through healthy habits such as eating well, getting enough sleep, managing stress, and regular exercise. Maintaining movement, even with simple activities like walking, contributes to overall well-being.
  • Community and Social Interaction: The author highlights the significance of a supportive community and social interactions in promoting healthy aging. Positive age beliefs and lifestyle choices are reinforced within a supportive social network.
  • Biological Research: The article discusses ongoing scientific research focused on understanding the biological processes of aging and how they can be targeted to extend healthspan and potentially lifespan. The author explores concepts like biohacking and the use of medications like metformin to address aging-related processes.
  • Embrace Aging: Ultimately, the author encourages readers to approach aging with a positive mindset, learn from the experiences of older individuals, and prioritize overall health and well-being. They suggest that aging can be a fulfilling and enriching phase of life when approached with the right attitude and lifestyle choices.

Enter evalytics labs

In a world where sedentary lifestyles and unhealthy dietary habits are becoming the norm, the rise of prediabetes has become a significant concern. Prediabetes is a condition in which blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. However, the good news is that prediabetes is reversible, and lifestyle modifications, particularly in terms of diet and exercise, play a crucial role in preventing its progression. In this article, we will delve into the connection between diet, exercise, and prediabetes, exploring how making positive changes can potentially lead to the reversal of this condition.
Read more stories like these with a subscription to our weekly newsletter for healthcare professionals MorningMed.

What to Watch For

Stan Nicholas, a musician who had been playing guitar for over 40 years, suffered a stroke in 2017 that left him unable to regain full use of his body through physical and occupational therapy alone. However, he became one of the first people in the world to participate in a groundbreaking study that involved implanting a device in his brain and chest to stimulate brain function and regain physical abilities lost due to the stroke.
Key takeaways
  • This procedure, known as deep brain stimulation, involved placing an electrode in a part of his cerebellum called the dentate nucleus. The cerebellum is responsible for balance, walking, and hand movements. The dentate nucleus collects information from the cerebellum and helps translate it to the cerebral cortex, potentially allowing for the effects of stimulation to extend to other parts of the brain.

  • After months of physical therapy and having the deep brain stimulation system turned on, Nicholas started to regain movement in his left hand and arm. Activities such as cooking, cleaning, and walking became easier for him. He reported a significant improvement in his quality of life, estimating that he was 40% to 50% better than after physical therapy alone.

  • The results of this study, published in the journal Nature Medicine, offer hope for thousands of people who have been left disabled by strokes. The deep brain stimulation procedure, when combined with physical therapy, could potentially become a standard treatment for stroke recovery in the future. Doctors and researchers involved in the study see deep brain stimulation as a promising avenue for improving movement and quality of life for stroke survivors, even years after their initial strokes.

Challenge Yourself

Is There a Doctor in the House?
Take our weekly quiz and see how you stack up against your peers
A 23-year-old man comes to the office because of a 7-day history of fever, crampy abdominal pain, and diarrhea. He says the abdominal pain worsens with oral intake. He has been having 8 to 10 episodes of diarrhea daily. He has not traveled recently and has had no sick contacts. Medical history is unremarkable, and he takes no medications. He does not smoke cigarettes, drink alcoholic beverages, or use illicit drugs. He is not sexually active. Vital signs are temperature 38.3°C (101.0°F), pulse 118/min, respirations 18/min, and blood pressure 108/58 mm Hg. Bowel sounds are hyperactive. The abdomen is diffusely tender to palpation; no masses are palpated. Neither the liver edge nor the spleen can be palpated. Digital rectal examination shows grossly bloody stool. A stool culture is obtained, and empiric pharmacotherapy is initiated.

Which of the following microorganisms is the most likely cause of this patient's condition?

ACampylobacter jejuni
BCandida albicans
C  Enterovirus
DGiardia lamblia


SURPRISING DISCOVERIES

Being in good physical shape has been shown to significantly reduce the risk of nine types of cancer, according to a study published in the British Journal of Sports Medicine. The research tracked over 1 million young men in Sweden for an average of 33 years, following their fitness levels from a mandatory military fitness test at around 18 years old. The study found that high levels of cardiorespiratory fitness in young adulthood were associated with a 19% lower risk of head and neck cancer, a 20% lower risk of kidney cancer, and a 42% lower risk of lung cancer (attributed largely to smoking habits), among other findings.
A study published in JAMA Network Open highlights that during the severe RSV (respiratory syncytial virus) season last winter, a significant number of infants in intensive care with RSV were previously healthy and full-term. The study, based on data from over 600 infants across the US, reveals that RSV can severely affect young, healthy babies, causing breathing difficulties and sometimes requiring intubation. This reinforces the need for preventive strategies for all infants, as RSV infections can lead to hospitalizations and even deaths in children under five.
A study published in the journal Neurology suggests that the first Alzheimer's drugs designed to slow the disease's progression, Eisai's Leqembi and Biogen's Aduhelm, may only be available to a small proportion of patients. The study indicates that less than 1 in 10 patients with mild cognitive impairment or early-stage Alzheimer's disease might be eligible for these drugs. Clinical trial exclusion criteria, which prioritize patients with fewer underlying health conditions, might inadvertently limit access to the treatments for a significant portion of the population. The study underscores the need for careful patient selection in trials and highlights that as researchers learn more about these treatments, more patients might meet the criteria for treatment.
A meta-analysis of 17 studies has suggested that blue light-blocking glasses, often marketed as reducing eyestrain and improving sleep, might not provide these benefits. The study found that these glasses likely don't effectively reduce digital eyestrain, help with alertness, or improve sleep. The limited efficacy of the glasses is attributed to factors such as the relatively low amount of blue light emitted by screens and the glasses' limited ability to block blue light. Researchers recommend focusing on factors like screen distance, lighting, and adopting better sleep habits to address these issues instead.


Thank you for reading! More next week,
My best wishes for a productive and idea-filled week ahead. Thanks for your ongoing efforts to improve the lives of the patients we all serve. Please send any news, comments, suggestions and ideas to hello@morningmed.email.
Quiz answer: The correct answer is A) "Campylobacter jejuni"

 

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