31 Mar

Medical News Today: Computational model of the brain shows what triggers Tourette 'tics'

Tourette syndrome is a neurological disease in which patients make a series of repetitive, involuntary movements and sounds that are commonly referred to as ‘tics’. A new study uses a computational model to simulate the neurological basis for the illness, which could help researchers to design new therapies in the future.
[illustration of key brain areas involved in tourette tics]The new model shows that Tourette ‘tics’ are triggered by the interplay between key brain areas.
Image credit: Beste Ozcan

The Centers for Disease Control and Prevention (CDC) report that in the United States, 1 in 360 children aged between 6 and 17 years receive a Tourette syndrome diagnosis. However, the CDC also suggest that the numbers may be higher than this, as the disease often goes undiagnosed.

The tics that accompany the disease vary in complexity. Some of them can be fairly simple – such as blinking, for instance – while others may involve touching objects, repeating the same words, or making obscene gestures.

Some of the motor tics that occur in the disease – such as sniffing, blinking, grimacing, or shrugging – were, until now, thought to occur in a single area of the brain called the basal ganglia.

The basal ganglia is a group of interconnected subcortical nuclei – found at the base of the forebrain, deeply embedded in the brain’s hemispheres – that are involved in motor control and other executive functions and behaviors.

The new research, however, suggests that the syndrome is not restricted to a single region, but it may be associated with multiple areas of the brain that interact to cause the tics.

The findings were published in the journal PLOS Computational Biology, and the research team was led by Daniele Caligiore of the National Research Council in Italy.

Studying Tourette-related neural pathways using a computer simulation

Caligiore and team developed a computer simulation of the neural activity underlying the Tourette-related motor tics.

The new model builds on previous research that revealed the brain activity that accompanies motor tics in monkeys’ and rats’ brains. These previous studies suggested that signaling between the cortex, cerebellum, and basal ganglia might be responsible for the tics.

In the new study, Caligiore and colleagues adjusted the model to replicate the main functional and anatomical elements of the neural system examined in animal studies: the basal ganglia, the thalamus, the primary motor cortex, and the cerebellum.

Not only did the new model manage to reproduce the results of the monkey study, but it also served to highlight the key role played by the interaction between various brain regions in triggering the Tourette-related motor tics.

Specifically, the model revealed that the neural pathway connecting the subthalamus with the pons and the cerebellum – in tandem with the neural circuit going from the cerebellum to the thalamus and the cortex – may be responsible for the tics. Additionally, the study suggests that tics may be caused by a combination of abnormal dopamine signaling in the basal ganglia and activity in the cerebello-thalamo-cortical circuit.

As the authors explain:

“The model predicts that the interplay between dopaminergic signals and cortical activity may underlie the emergence of tic events, and that the anatomical connection linking subthalamic nucleus and cerebellum may support the involvement of the cerebellum in tic production. In this way, the model supports the claim […] about a possible involvement of the subthalamic-pons-cerebellar circuit in tic generation. ”

Study opens up new possibilities for treatment

To the authors’ knowledge, this is the first time that a computational model has been used to study these pathways. “This model represents the first computational attempt to study the role of the recently discovered basal ganglia-cerebellar anatomical links,” says the lead author of the study.

The findings have not only provided the basis for future experiments, but they also pave the way for novel therapies. As Caligiore and colleagues explain:

“The model predicts that tic production could be reduced by externally stimulating or inhibiting the primary motor cortex. These predictions could be important for identifying new target areas, aside [from] the traditional ones to design innovative system-level therapeutic actions.”

Additionally, the study’s lead author anticipates that the findings could help to create so-called virtual patients, which could serve to test therapies using computer models in a cost-effective and ethical way.

“These simulations can be performed with little costs and no ethical implications and could suggest promising therapeutic interventions to be tested in focused investigations with real patients,” Caligiore says.

Learn how brain chemical may help to treat tics in people with Tourette syndrome.

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31 Mar

Medical News Today: Five of the best apps to train your brain

It is no secret that as we age, our brain function declines. However, studies have suggested that keeping mentally active – particularly when older – can help to maintain cognitive functioning. Brain training apps are considered a useful aid for mental stimulation, but which one is right for you? We present our pick of five of the best brain training apps around.
[An illustration of a brain and technology]
Research has suggested that brain training may be beneficial for cognitive functioning.

Brain training is based on the premise that mental stimulation can improve neuroplasticity. This is the brain’s ability to form and reorganize connections between brain cells in response to new tasks.

While some studies have failed to find a link between brain training and improved cognitive functioning, other research has found the opposite.

A study published in PLOS One in 2013, for example, found that young adults who engaged in brain training games demonstrated improvements in brain processing speed, working memory, and executive functions.

It is not only young adults who might benefit from brain training. Research presented at the 2016 Alzheimer’s Association International Conference found that older adults who took part in ten 1-hour brain training sessions over a 5-week period were 48 percent less likely to develop cognitive decline or dementia over 10 years.

Such studies have fueled the development of hundreds of brain training apps, many of which claim to improve cognitive functions such as learning, memory, and concentration. With so many to choose from, however, how do you know which one is best for you?

Medical News Today have tried and tested five of the best brain training apps available to help you make an informed decision.

Lumosity: Colorful and fun

Considered by many as the “original” brain training app, Lumosity is used by more than 85 million people across the globe. The app consists of more than 50 colorful and fun minigames designed to train five cognitive functions: speed, memory, attention, flexibility, and problem-solving.

Lumosity’s games have been created with the help of more than 100 researchers from around the world. Furthermore, their website cites a study of more than 4,700 adults that found that brain training with Lumosity improved cognition more than crosswords.

[Lumosity iOS image]
Lumosity has more than 85 million users worldwide.
Image credit: Lumosity

With this in mind, we couldn’t pass up the opportunity to try the app for ourselves.

At sign-up, you are required to complete a “fit test,” which calibrates your speed, attention, and memory through three separate games.

Once the games are complete, users are shown how their results compare with those of other users in the same age group. This provides insight into the areas of cognition that require the most attention.

Each day going forward, Lumosity sends a reminder to complete a brain “workout.” The daily brain workout involves playing three minigames – five with the premium version – each focusing on the five cognitive functions.

One game we enjoyed was Train of Thought, which focuses on attention. In this game, the user must change the direction of train tracks, with the aim of guiding different colored trains to the correct home. We found that this game really challenged our concentration – although it could be frustrating at times.

Luminosity is an app that could easily appeal to both children and adults. Many of the games – such as Highway Hazards, a driving game that involves moving left or right to avoid road hazards – have a child-like appeal.

Lumosity is free to download on Android and iOS, though upgrading to a premium subscription costs $11.99 per month or $59.99 for 1 year.

Elevate: Boosting ‘productivity, earning power, and self-confidence’

While Elevate has fewer users than Lumosity, at 10 million downloads worldwide, it holds the title of iPhone’s best app of the year for 2014. So what makes it stand out?

The app consists of more than 40 minigames designed to boost math and speaking skills, as well as improve memory, attention, and processing speed.

[Elevate app]
Elevate consists of more than 40 minigames designed to boost a variety of cognitive skills.
Image credit: Elevate

According to the app’s creators, “the more you train with Elevate, the more you’ll improve critical cognitive skills that are designed to boost productivity, earning power, and self-confidence.”

Just like Lumosity, Elevate encourages daily brain training, which involves the completion of three games, or five games with the “PRO” version.

Elevate has more of an adult feel than many of the other brain training apps; the minigames take a more serious approach, focusing less on colorful illustrations and more on text. Each game also comes with a brief description of its goal, such as “stop mixing up commonly confused words” and “improve your reading comprehension.”

One game we enjoyed was Error Avoidance, whereby the user is required to “keep” or “swap” two words in a passage of text within a set time. For example: “He fashioned the cookie doe into the shape of a grazing dough.” In this case, the two words would be swapped.

Elevate provides a daily, weekly, and monthly rundown of overall performance, as well as performance in five specific areas: writing, listening, speaking, reading, and math. If you’re feeling competitive, you have the option of comparing your performance with that of other users in the same age group.

Elevate is available to download for free on both Android and iOS. Upgrading to PRO costs $4.99 for 1 month or $39.99 for a year.

Peak: Flexible training and tracking

Rated by Google as one of the best Android apps for 2016, Peak offers more than 30 minigames to help improve concentration, memory, mental agility, language, and problem-solving.

[Peak app]
Peak’s brain training games have been created with the help of researchers from Yale and other universities.
Image credit: Peak

These games have been developed with the help of scientists from respectable universities across the globe, including Yale University in Connecticut and the University of Cambridge in the United Kingdom.

Like Lumosity, there are a number of games that may appeal to children and adults alike. One such game is Turtle Traffic – a mental agility game that requires the user to navigate a turtle through the sea and collect jellyfish.

Based on performance in baseline tests, a personalized workout plan is provided, although the user is not limited to this plan. In the “Pro” version, all games are available to play at any time.

The Peak creators recommend brain training for 3 days per week. One great feature of Peak is that you can select the days that you want to train and set reminders for these days.

Cognitive performance is also very easy to track. Not only does the app provide information on individual game performance, but it also provides data on overall performance in each of the five cognitive functions. Similar to the other brain training apps, you are also able to compare performance with other users.

Peak is available to download for free on Android and iOS. A 12-month subscription starts from $34.99, while 1 month starts from $4.99.

Fit Brains: Targeting emotional intelligence

Fit Brains is a creation of Rosetta Stone – an education technology software company best known for their online language courses.

[Fit brains app]
Fit Brains offers more than 60 minigames to help improve cognitive functioning.
Image credit: Fit Brains

This brain training app boasts the largest variety, with more than 60 minigames and more than 500 personalized training programs. With the input of neuroscientists, these games have been created to help exercise key cognitive functions, including concentration, memory, speed of thinking, and problem-solving.

What sets Fit Brains part from other brain training apps, however, is that it also targets emotional intelligence through games that focus on social skills, social awareness, self-awareness, and self-control.

One game we enjoyed at MNT was Speedy Sorts – a game that tests thinking speed by asking the user to arrange objects into the correct piles as quickly as possible.

Based on the results of each game played, the user is provided with a score out of 200 for each cognitive area. The app also compares individual results with those of other users.

Unlike many other brain training apps, Fit Brains also has a school edition – a brain training package that aims to boost the cognitive functions of schoolchildren.

Fit Brains is free to download on Android and iOS. An upgrade to premium costs $9.99 for a month and $49.99 for a year.

CogniFit: For consumers, scientists, and clinicians

CogniFit is perhaps the most advanced brain training app we reviewed, consisting of a variety of minigames designed to train more than 20 cognitive skills, including short-term memory, planning, hand-eye coordination, and auditory perception.

[CogniFit app]
CogniFit provides tools that researchers and healthcare professionals can use to assess cognitive functioning in patients.
Image credit: CogniFit

The CogniFit developers are keen to point out that all of their brain training tools have been validated by scientists – including researchers from the University of Washington and the Albert Einstein College of Medicine in New York. Furthermore, they state that the efficacy of their tools has been established through general population studies.

Interestingly, CogniFit also offers tools that researchers and healthcare professionals can use in order to study and assess cognitive function in patients.

MNT tested the brain training games for consumers, and we found them to be a good balance of fun and mental stimulation.

One game we enjoyed was Reaction Field, which tests response time, visual scanning, and inhibition – which is the ability to control impulsive behavior. This game is similar to Whac-a-Mole; the user is required to remember the color of a mole and tap on moles of the same color as they pop up from holes in the ground.

Individual cognitive performance is assessed using the Lumosity Performance Index, which is calculated using the average scores of all games played. Like the other brain training apps, you can also compare your performance against that of other users.

CogniFit is available to download for free on Android and iOS. A premium upgrade costs $19.99 for 1 month or $189.99 for a year.

Learn about five of the best meditation apps.

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31 Mar

Medical News Today: Mesothelioma shows promising response to existing immunotherapy drug

An existing immunotherapy drug called pembrolizumab appears to be effective in the treatment of malignant pleural mesothelioma, a rare and aggressive lung cancer that is primarily caused by exposure to asbestos. Writing in The Lancet Oncology, researchers describe the first study to show a positive result from using the antibody drug against this rare cancer.
doctor examines chest x-ray
Researchers say that the study results suggest that the immunotherapy drug shows promise as a second-line treatment for malignant pleural mesothelioma, a rare and aggressive lung cancer that can result from exposure to asbestos.

Malignant mesothelioma – commonly referred to as mesothelioma – is a rare cancer that arises in the mesothelium, the thin lining of tissue that covers the inside of the chest, the heart, the abdomen, and most internal organs.

Malignant pleural mesothelioma – in which tumors form in the pleura, the linings of the chest wall and lungs – is an aggressive cancer that accounts for 90 percent of malignant mesothelioma cases. Unfortunately, most patients do not survive for longer than a year.

The main risk factor for malignant pleural mesothelioma is inhalation of asbestos, and most cases in the United States have been linked to work-related exposure to high levels of the material.

Asbestos is a naturally occurring mineral that was once commonly used to make materials for a wide range of industries, including home and commercial construction. In the U.S., many buildings erected before 1980 contain asbestos, the fibers of which can become dislodged into the air through normal wear and tear.

When asbestos is inhaled, the tiny fibers travel to the ends of the small airways and enter the pleura that line the chest wall and lungs. The fibers damage the mesothelial cells and cause scarring (asbestosis), cancer (mesothelioma), or both.

Poor prognosis and no second-line treatments

One of the reasons that patients diagnosed with mesothelioma have such poor prospects is because the disease is often not spotted until it is well advanced.

Fast facts about mesothelioma

  • Around 3,000 new cases of mesothelioma are diagnosed in the U.S. each year.
  • Rates of mesothelioma have leveled off and even reduced slightly in the U.S. in recent decades.
  • However, rates are still increasing in many other countries.

Learn more about mesothelioma

The standard treatment is first-line therapy that includes chemotherapy. There are currently no approved second-line treatments.

Researchers have looked at several other approved drugs, but the new study is the first to show promising results, as Dr. Evan Alley, lead author and chief of hematology and medical oncology at the Penn Presbyterian Medical Center of the University of Pennsylvania Health System in Philadelphia, explains:

“There have been a lot of studies looking at different drugs, but researchers have not seen positive results. But we’ve found this new class of drugs, checkpoint inhibitors, seems to be more effective than what’s been available in the past.”

Checkpoint inhibitors are drugs designed to help the body fight cancer by defeating certain mechanisms that cancer cells use to avoid being attacked by the immune system.

Some cancer cells have large amounts of a protein called PD-L1, which can bind to the checkpoint protein PD-1 on cancer-fighting T cells of the immune system. When this happens, it stops the T cell from attacking the cancer cell that the PD-L1 belongs to.

Pembrolizumab – which in the U.S. has the brand name Keytruda – is a drug that targets PD-1 and improves the immune response against cancers that are positive for PD-L1. It is already used to treat non-small cell lung cancer, melanoma, and some head and neck cancers.

Pembrolizumab promising as second-line therapy

In their study, Dr. Alley and colleagues use data from an ongoing multicenter international clinical trial that is testing the effectiveness and safety of pembrolizumab on patients with advanced PD-L1-positive solid tumors that have not responded to first-line treatment or for which treatment is not appropriate.

The data they assess concern 25 patients with malignant pleural mesothelioma, all over the age of 18. Upon enrolment – which started 2 years ago – patients received a dose of pembrolizumab every 2 weeks.

The results show that 14 of the patients experienced tumor shrinkage. Average overall survival was 18 months, during which around 6 months was progression-free. Since the start of the study, 14 patients have died and four were still receiving treatment as the researchers wrote up the results.

Dr. Alley sees these results as very promising: “Most patients who receive a second-line therapy have a life expectancy of about 6 or 7 months, so to have four patients still ongoing at 2 years is very encouraging.”

He adds that another encouraging result is the fact that none of the patients had to stop the immunotherapy because of side-effects. Some had to stop for a while, but they then resumed. “The drug appears to be well-tolerated,” he notes.

The common adverse reactions that the patients reported were dry mouth, nausea, fatigue, and loss of appetite.

More studies are now needed to support the findings before pembrolizumab can be considered as a second-line therapy for malignant pleural mesothelioma. Some have already started, and Dr. Alley says that there are also plans to start testing pembrolizumab with other treatments later this year.

“This study provides evidence that some patients can have long-term disease control with this drug, which we haven’t seen before. We need to better understand what we can do next to make immunotherapy more effective for more patients.”

Dr. Evan Alley

Learn why a gene-targeting drug looks hopeful in the treatment of mesothelioma.

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31 Mar

Medical News Today: Invasive lobular carcinoma: Symptoms, subtypes, diagnosis, and treatment

Invasive lobular carcinoma is a type of cancer that starts in the milk glands of the breast and spreads easily to surrounding tissue.

Invasive lobular carcinoma (ILC) may also be referred to as “infiltrating lobular carcinoma.” It affects about 1 out of 10 people diagnosed with invasive breast cancer.

As the name suggests, ILC frequently spreads out of the milk gland (lobule) where it forms, and may invade and infect other lymph nodes.

ILC is similar to other invasive breast cancers in that it can spread easily to other parts of the body. However, unlike other breast cancers, ILC does not cause a lump to form.

ILC is harder to detect than other breast cancers through traditionally used breast cancer screenings using mammograms and ultrasounds.

Similarly, as there is not normally a lump in the breast in cases of ILC, this again makes it harder to detect than other types of breast cancers.


[diagram showing breast cancer and lymph nodes]
ILC may not show any symptoms at first, but as it progresses can show signs such as swelling or a lump under the armpit.

In the earliest stages, ILC may not cause any signs or symptoms. However, as the cancer progresses the following may occur:

  • thickening on part of the breast
  • newly inverted nipple
  • swelling in part of the breast
  • change in skin texture of the breast
  • lump under the armpit
  • redness or scaliness in the breast skin
  • pain or irritation in the breast or nipple
  • discharge from the nipple that is not breast milk


A doctor will run a series of tests to diagnose ILC, which may include:

  • Mammogram: an X-ray is taken of the breast. Mammograms alone are not that good at detecting ILC, so they often need to be combined with other tests.
  • Ultrasound: sound waves are used to take pictures of the interior breast tissues. Like mammograms, these are not the most effective way to show ILC.
  • MRI: magnetic imaging is used to take pictures of the breast tissue and detect cancer if the results of other tests are unclear. They can also show how much of the breast is affected by the cancer and how far it may have spread.
  • Biopsy: involves removing and testing a sample of breast tissue. It can be done by surgery or a needle extraction. It can confirm the diagnosis of ILC and the subtype, of which there are several.

These tests are used alongside breast examinations, physicals, and blood tests. Together these tests can usually confirm:

  • whether someone has ILC
  • the amount it has spread
  • which stage it is (from 0 to 4)


[Invasive lobular carcinoma KGH 4 December 2005 wikicommons]
The subtypes of ILC are classified according to their growth pattern when seen under a microscope.
Image credit: KGH, 2005, December 4.

There are several different kinds of ILC. The subtypes are based on how the cancer cells look under a microscope.

Most commonly, ILC is made of small cells that invade the fatty tissue and ligaments around the milk ducts. In classic cases of ILC, the cancer cells look very similar to each other and grow in a single-file pattern.

Other types of ILC are classified according to their growth pattern. These include:

  • Solid invasive lobular carcinoma: the cancer cells grow in large sheets with little healthy tissue between them.
  • Alveolar invasive lobular carcinoma: cancer cells grow in groups instead of the classic singular pattern.
  • Tubulolobular invasive lobular carcinoma: has some of the growth pattern of classic ILC but some of the cancer cells also form small tube-like structures, known as tubules.


There are many treatment options to consider for ILC.

It can be hard to determine the extent of ILC and so this cancer tends to be treated aggressively. Surgical treatments are very common.

Different combinations of treatments may be recommended. These depend on a variety of factors including:

  • how aggressive the cancer is
  • how far it has spread
  • the stage of the cancer
  • a person’s overall health
  • personal preference

Depending on these factors ILC may be treated with a combination of the following:


[Mastectomy scar]
A mastectomy removes all of the breast tissue, not just the portion affected by cancer.

There are several different types of surgery that may be used to treat ILC. The surgical options may include:

  • Lumpectomy: removing a small portion of the affected breast.
  • Mastectomy: removing all the breast tissue including healthy tissue surrounding the cancer.

The surgery recommended will vary from person to person and depends largely on the stage of the cancer and how aggressive it is.

Even with a mastectomy, surgical treatment of breast cancer is considered a local treatment. This is because it affects only the areas of the body where the cancer is active.


Radiation therapy is another local cancer treatment. During radiation, the cancer is targeted using high-powered, focused beams of radiation aimed directly at the affected areas.

Radiation is normally used in conjunction with surgery for treatment of ILC.


Chemotherapy kills cancer cells with the use of very powerful drugs.

Like radiation, chemotherapy is not normally the first course of action for ILC. However, it may be prescribed to shrink an area of ILC prior to surgery. It can also be used after surgery to kill any cancer cells that may remain.

Hormone therapy

Most ILC is hormone receptor positive, making hormone therapy a viable treatment option.

Before beginning hormone therapy, the ILC will be tested to see if the hormone receptors are present on the cancer cells. If they are, hormones will be given that block the cancer’s ability to use the body’s circulating hormones to grow and spread. Hormone therapy for ILC is normally used with surgery to treat this kind of cancer.


How soon the cancer is diagnosed, and how quickly treatment is started, affect the outlook for those people who are diagnosed with ILC.

In most cases, earlier diagnosis and treatment may result in a better outlook.

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31 Mar

Medical News Today: Exercises for improving bladder control

The main muscles responsible for holding the urine in when a person doesn’t want to urinate are the pelvic floor muscles.

Ideally, these muscles allow a person to release urine when they’re ready. However, some people have weakened pelvic floor muscles. As a result, they may leak urine or have difficulty controlling the flow of their urine.

While there are many treatments for an overactive bladder or affected bladder control, one approach is to perform pelvic floor exercises. These exercises are aimed to strengthen the pelvic floor muscles and, ideally, the bladder.

The pelvic floor muscles go around the urethral opening, vagina, and rectum in women. Like all exercises, they require frequent practice to strengthen the muscles and keep them strong.

Kegel exercises

[man pees into urinal in a restroom]
Ideally, the pelvic floor muscles hold urine in until a person is ready to urinate.

Doctors often recommend Kegel exercises as a means to strengthen a person’s ability to start and stop their urine stream.

However, the pelvic floor muscles can be difficult to target through Kegels. That’s why it’s important to first complete an exercise to identify these muscles. People can follow these steps to do so:

  • While preparing to urinate, focus on stopping the urine stream. People should think carefully about tightening only the muscles that stop their urine stream, not on other nearby muscles such as the legs, buttocks, or stomach.
  • Also focus on the sensation of the pelvic floor muscles pulling inward, stopping the urine stream or at least slowing it. Men will see the penis and scrotum move slightly when the proper muscles are tightened.

Once a person has identified the proper pelvic floor muscles, they can focus on performing Kegel exercises twice daily.

To perform the exercise, people should:

  • squeeze the same muscles used to stop the flow of urine
  • hold for 3 seconds
  • release the muscles
  • repeat this action 25 times

As the muscles get stronger, a person can increase the frequency to 25 to 50 repetitions for two to three times each day.

People who practice Kegel exercises should refrain from attempting to perform them while urinating, other than to practice initially “finding” the muscles. Kegels while urinating can affect a person’s ability to completely empty their bladder, which could potentially lead to a bladder infection.

Pelvic floor exercises

[doctor points the bladder out to a patient]
A doctor can help someone identify their pelvic floor muscles if they are having trouble.

In addition to Kegel exercises, there are other methods to target the pelvic floor muscles. Examples include the following two exercises:

Short contractions

Short contractions work the fast-twitch muscles located in the pelvic floor. Instead of focusing on holding the muscle contraction, the goal for this exercise is to tighten the muscles as quickly as possible, then release the muscles.

To perform short contractions, people should:

  • Take a deep breath in and exhale while tightening the pelvic floor muscles as fast as possible, imagining they are lifting the muscles upward.
  • Inhale while releasing the pelvic floor muscle contraction.
  • Repeat the exercise 10 times and complete a total of three sets.

People should aim to complete the exercises twice a day.

Long contractions

Long contractions are intended to help a person ultimately achieve a pelvic floor contraction that lasts 10 seconds.

To perform, people should tighten the pelvic floor muscles and hold the contraction as long as possible. A person may have to start at 3 seconds, then increase over time. Repeat for 10 repetitions of three sets.

The National Association For Continence recommend performing the short and long contractions in the same exercise period.

The exercises may take about 3 to 6 months before a person may see a noticeable difference. To continue to challenge the muscles, people can try performing the exercises in different positions, such as when sitting, standing, or lying down.

Why might people need these exercises?

An inability or difficulty controlling urine flow is known as urinary incontinence. There are many reasons why urinary incontinence may occur, some of which may respond to exercises for bladder control.

[pregnant woman needs to urinate]
There are a variety of reasons why someone would be unable to control their bladder, including pregnancy and childbirth, which can weaken the muscles.

Examples can include:

  • pregnancy and childbirth, which can stretch and weaken the pelvic floor muscles
  • long-term constipation, which can place added pressure on the bladder
  • long-term urinary tract infections or inflammation of the urinary tract
  • weight gain that places extra pressure on the bladder
  • surgery to the vagina in women or prostate surgery in men

While exercises for bladder control can be very effective in reducing the incidence of urinary incontinence and leakage, they are unfortunately often performed incorrectly. As a result, a person may find them ineffective in treating loss of bladder control.

Specialists can help a person learn how to properly perform these exercises. An example is a pelvic floor specialist. These specialists are usually physical therapists who obtain additional certifications in pelvic floor therapy.

Ideally, completing exercises for bladder control will allow a person to go longer between bathroom visits and experience fewer incidences of incontinence.

Are there gender differences in exercises for overactive bladder?

Both men and women can experience overactive bladder and urinary incontinence and benefit from exercises. However, women traditionally have greater difficulty singling out the muscles that should be tightened to strengthen the pelvic floor.

When this is the case, a doctor or pelvic floor therapist can use certain tools to help a woman identify the appropriate muscles. One example is a vaginal cone, which can be inserted into the vagina. If a woman is correctly tightening the pelvic floor muscles, the cone will stay in place.

Another option is biofeedback, which involves inserting a pressure sensor into the vagina. When a woman is correctly contracting the pelvic floor muscles, the pressure sensor will read at an expected level. A doctor can also use biofeedback for men by inserting the pressure sensor into the rectum.

Additional treatment options

Exercises are an excellent, nonsurgical way to work to relieve overactive bladder and incontinence symptoms. These exercises can be used as a complementary therapy to additional treatments that can be used to treat incontinence.

Examples include:

  • Dietary changes: Reducing the intake of foods known to cause bladder irritation and reducing fluid intake before a person goes to bed can reduce the incidence of overactive bladder, especially at night.
  • Medications: Medications can reduce spasms that cause the bladder to excessively contract and relax. Examples of these medications include oxybutynin, solfienacin, or tolterodine.
  • Surgery: If a person’s symptoms do not respond to non-invasive treatments, surgeries to repair pelvic organs can help. Other surgical approaches can vary based on the likely cause of a person’s incontinence.

If overactive bladder or poor bladder control affect a person’s quality of life, they should seek medical treatment.

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31 Mar

Medical News Today: How to use long-acting insulin: Types, frequency, peak times, and duration

Long-acting insulin can help to stabilize blood sugar levels throughout the day, with only one or two shots.

Fast-acting insulin replaces the surge of insulin that a healthy pancreas would release at mealtime. In contrast, long-acting insulin mimics the low-level flow of insulin normally released between meals and overnight.

In this way, long-acting insulin works to establish a healthy baseline blood sugar level for the body to work around.

Using long-acting insulin

A syringe in a vial
Long-acting insulin cannot be ingested so an injection using a needle and syringe is a common delivery method.

Long-acting insulin cannot be delivered in pill form because it would be broken down in the stomach. Instead, it must be injected into the fatty tissue under the skin. From here, it can be gradually released into the bloodstream.

Delivery methods

According to the National Institute of Diabetes and Digestive and Kidney Diseases, there are a few ways to deliver long-acting insulin. These include:

  • Needle and syringe: a dose of insulin is drawn from a vial into a syringe. Different types of insulin must not be mixed in the same syringe.
  • Pen: this can be loaded with a cartridge containing a premeasured dose, or prefilled with insulin and discarded after use.
  • Injection port: a short tube is inserted into the tissue beneath the skin. Insulin can be delivered using either a syringe or a pen. This only requires the skin to be punctured when the tube needs to be replaced.

Injection sites

Long-acting insulin can be injected into the abdomen, upper arms, or thighs.

Abdomen injections deliver insulin into the blood most quickly. The process takes a little more time from the upper arms, and it is even slower from the thighs.

It is important to stay consistent with the general injection area, but the exact injection site should be rotated frequently. Repeat injections at the same spot on the skin can cause lumps to develop under the skin, making it harder for the insulin to work.


injection in arm
Long acting insulin may be injected into the thigh and upper arm but abdomen injections are most effective.

Each type of long-acting insulin has its own suggested dose. These vary depending on whether the diabetes is type 1 or type 2, as well as for people who have never used insulin before.

When a person is starting to use new insulin, it is recommended that they begin with a smaller percentage of the target dose.

This is so that the body has time to adapt to the drug. That dosage is then gradually increased under the guidance of a doctor.

Long-acting insulin dosage may also be adjusted if diet or amount of daily physical activity changes, or if a person becomes ill. This is because these factors all affect blood sugar levels.

Adjustments can also be made to address any negative reactions to insulin, such as weight gain.

Finding the ideal long-acting insulin regimen is a trial and error process that requires careful monitoring of blood sugar levels.

How long-acting insulin works

According to the American Diabetes Association, the periods that long-acting insulin works for differs from insulin that is faster-acting in three main ways:

  • Onset: how quickly a dose of insulin begins to work. Short and rapid-acting insulin starts to lower blood sugar levels within 15 to 30 minutes. Long-acting insulin takes effect several hours after injection.
  • Peak time: when a dose of insulin has its strongest effect. Rapid and short-acting insulin peaks at around one to three hours after injection. Long-acting insulin does not have a peak time. It works to lower blood sugar levels at a fairly stable rate throughout the day.
  • Duration: how long the effects of an insulin injection last. Faster-acting insulin can control blood sugar levels for only a few hours. Long-acting insulin can work for around 24 hours or more, depending on drug type.

Long-acting insulin cannot stabilize post-meal blood sugar spikes. So, it is usually necessary for people with type 1 diabetes to supplement their long-acting insulin regimen.

They can do this by injecting short-acting or rapid-acting insulin directly before eating.

Different types

Doctor holding vial of insulin
The FDA recommends three forms of insulin.

When scientists create long-acting insulin, they change the structure of natural insulin. This is so that it can be absorbed into the bloodstream more gradually.

The United States Food and Drug Administration (FDA) explain that there are three forms of long-acting insulin currently on the market:

  • detemir
  • glargine
  • degludec

Below is a summary detailing how each of these work.


This insulin works over the course of the day. Here are some additional details about how it works:

  • Duration: 18 to 24 hours.
  • Administration: can be taken once or twice daily, at the same time each day.
  • Brand name: Levemir.


When injected, insulin glargine forms clusters in the fatty tissue beneath the skin. These clusters break down slowly, so that small amounts of insulin are released into the bloodstream gradually.

  • Duration: up to 24 hours.
  • Administration: taken once daily, at the same time each day.
  • Brand names: Lantus, Toujeo, and Basaglar.


This type of insulin works by slowing down the rate at which insulin molecules are absorbed into the bloodstream.

  • Duration: up to 42 hours.
  • Administration: taken once daily, and it can be at different times each day.
  • Brand name: Tresiba.

Some research suggests that degludec works better than the older versions of long-acting insulin. However, because of pricing and health insurance coverage, insulin degludec is not very affordable.

According to an article recently published in Business Insider, Basaglar is currently the most affordable brand of degludec long-acting insulin.

Alternatives to injections

Insulin replacement therapy is not always necessary for people with type 2 diabetes. However, it is unavoidable for people with type 1 diabetes, as their bodies can no longer naturally produce insulin.

Long-acting insulin is not the only option for stabilizing blood sugar levels throughout the day. The main alternative currently available is the insulin pump.

The pump delivers small amounts of insulin into the fatty tissue under the skin, working to mimic the way that the pancreas works. The pump is unable to monitor blood sugar levels, so the user must press a button for insulin to be released before each meal.

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31 Mar

Medical News Today: High-dose vitamin C makes cancer treatment more effective, trial shows

Common treatment options for cancer, such as chemotherapy and radiation therapy, can be expensive and sometimes ineffective. However, a new clinical trial tests the effect of high-dose vitamin C in combination with standard treatment on health outcomes for patients with cancer.
[orange with vitamin C pills ]
A new clinical trial shows that a high dose of vitamin C can improve health outcomes for patients who are undergoing conventional cancer treatment.

In the 1970s and 1980s, Nobel Prize winner Linus Pauling, together with surgeon Ewan Cameron, first hypothesized the clinical benefits of vitamin C for treating people with cancer.

Since then, further studies in animals and cancer cell cultures suggested that a high concentration of ascorbic acid might prevent and treat cancer.

More recent studies have examined the combined effect of high-dose vitamin C and conventional cancer treatment. Some of this research showed that patients who received the combined treatment had a slower progression of the disease, while others have suggested that the side effects of chemotherapy were less pronounced among those who also took high doses of vitamin C.

To obtain a high dose in these studies, vitamin C is usually administered using intravenous infusion. Vitamin C has a short half-life of only 2 hours in the human body, which is why it must be administered in high doses as a treatment.

A new clinical trial studies the effect of giving between 800 and 1,000 times the daily recommended dose of vitamin C to patients with brain and lung cancer.

The new research was led by scientists at the University of Iowa in Iowa City, and the results were published in the journal Cell Press.

Vitamin C passes human safety trial

As part of the human safety trial, 11 patients with brain cancer who were undergoing standard chemotherapy and radiation therapy were also administered three weekly intravenous infusions of vitamin C for 2 months, and then two weekly infusions for 7 months.

Each infusion raised the patients’ blood levels of vitamin C to 20,000 micromoles (μM). The average level of vitamin C in adults is approximately 70 μM.

Overall, the treatment was tolerated well. The team noted very few minor side effects, such as dry mouth or rare and brief episodes of high blood pressure.

This safety test was the first phase of a series of clinical trials that will investigate whether high-dose vitamin C can effectively increase the lifespan and quality of life for patients that are being treated with chemotherapy and radiation therapy.

For now, the data from the phase I trial show that patients with glioblastoma survived for 4 to 6 months longer than the average survival time noticed in patients who undergo conventional treatment alone. Specifically, patients who also received high doses of ascorbic acid survived for 18 to 22 months compared with 14 to 16 months, which is the typical survival rate for glioblastoma.

For the upcoming phase II of the clinical trials, the scientists will examine the effects of vitamin C in participants with stage 4 lung cancer as well as in those with highly aggressive brain tumors, such as glioblastoma.

How vitamin C weakens cancer cells

The mechanism that might explain the potential efficacy of vitamin C in treating lung and brain cancer relates to the cancer cells’ metabolism.

As a consequence of the faulty metabolism that occurs inside the cancer cells’ mitochondria, these cells produce abnormally high levels of so-called redox active iron molecules. These molecules react with vitamin C and form hydrogen peroxide and hydrogen peroxide-derived free radicals.

Scientists think that these free radicals drive cancer cell death by damaging the cells’ DNA. The free radicals are also thought to weaken the cancer cells and make them more vulnerable to radiation therapy and chemotherapy.

“This paper reveals a metabolic frailty in cancer cells that is based on their own production of oxidizing agents that allows us to utilize existing redox active compounds, like vitamin C, to sensitize cancer cells to radiation [therapy] and chemotherapy.”

Garry Buettner, study co-author

Co-senior author Douglas Spitz also comments on the significance of the findings:

“This is a significant example of how knowing details of potential mechanisms and the basic science of redox active compounds in cancer versus normal cells can be leveraged clinically in cancer therapy,” he explains. “Here, we verified convincingly that increased redox active metal ions in cancer cells were responsible for this differential sensitivity of cancer versus normal cells to very high doses of vitamin C.”

If the approach proves effective in future clinical trials as well, the new treatment could also be significantly less costly than the standard treatment. To put this into perspective, 9 months of intravenous vitamin C treatment as part of the phase II trial currently costs less than one dose of chemotherapy.

“The majority of cancer patients we work with are excited to participate in clinical trials that could benefit future patient outcomes down the line. Results look promising but we are not going to know if this approach really improves therapy response until we complete these phase II trials.”

Bryan Allen, co-senior author

Learn how vitamin C can target and kill cancer stem cells.

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30 Mar

Medical News Today: Frequent urination in women: Causes and treatment

Urination is the body’s way of getting rid of excess water as well as wastes. While this is an important function for survival, urinating too frequently can interfere with a woman’s quality of life.

Frequent trips to the bathroom, not sleeping through the night, or refraining from going places for fear that they will leak urine, are often familiar to women who experience frequent urination.

Each person may urinate a different number of times per day depending on how much they drink and how well their kidneys work. According to the Cleveland Clinic, the average person should urinate somewhere between between six and eight times in a 24-hour period.

While an individual is occasionally likely go more frequently than that, daily incidences of urinating more than eight times may signal a concern for too-frequent urination.

Causes and risk factors

Sometimes, frequent urination is due to drinking too many drinks that are known to increase urine production or irritate the bladder. Examples include excess caffeine intake through coffee, tea, and certain soft drinks.

[woman sitting on a toilet]
Frequent trips to the toilet can be caused by a variety of conditions, including excessive caffeine intake, bladder stones, and UTIs.

However, frequent urination may also be due to a number of medical conditions. Examples include:

Obesity is another factor. Excess weight can place extra pressure on the bladder. The result can be weaker pelvic floor muscles and a need to urinate more frequently.

Another risk factor for frequent urination is pregnancy. The growing uterus can place extra pressure on the bladder during pregnancy. As a result, a woman may have to go to the bathroom more frequently.

According to one study, an estimated 41.25 percent of pregnant women experience an increase in urinary frequency during pregnancy. Of these women, an estimated 68.8 percent report the increase in frequency causes them discomfort or distress.

Menopause can also affect bladder control. When women no longer have their periods, their bodies stop making estrogen. This hormone can impact the lining of the bladder and urethra. As a result, a woman may experience the need to urinate more frequently.

Another risk factor for frequent urination is a history of vaginal childbirth. Childbirth can weaken the pelvic floor muscles that hold the bladder in place.

Sometimes, however, frequent urination may be due to damage to the nerves in the bladder as well. Sometimes a woman does not experience problems with bladder control immediately after giving birth, but she may experience symptoms years later.

Symptoms and complications

[toilet paper roll on a yellow background]
Additional symptoms, such as pain or the inability to control one’s bladder, can help the doctor identify the cause of the frequent urination.

A woman may have additional symptoms besides how often she urinates. This may give doctors a clue as to the potential cause of her frequent urination.

Examples include:

  • a changing color to the urine, such as red, pink, or cola-colored
  • experiencing a sudden, strong urge to urinate
  • having trouble completely emptying the bladder
  • leaking urine or losing control over one’s bladder altogether
  • pain or burning when urinating

Complications associated with urinary frequency often depend on the condition’s underlying cause. For example, if a woman’s frequent urination is due to a urinary tract infection, she could experience a severe and systemic infection if left untreated. This could damage her kidneys and cause narrowing of the urethras.

If urinary frequency occurs on its own with no immediately treatable illness, it can affect a woman’s quality of life. A woman may not be able to sleep well due to having to wake up to go to the bathroom very often. She may also refrain from social events for fear of having to go to the bathroom too frequently.

These complications can all have an effect on a woman’s sense of well-being.

When to see a doctor

If frequent urination is accompanied by symptoms of possible infection, women should see their doctor. Examples include fever, pain when urinating, and pink- or blood-tinged urine.

Painful urination or pelvic pains are also causes for concern, along with frequent urination. A woman should also see her doctor any time that she experiences symptoms that are uncomfortable to her or that interfere with her quality of life.

Often, there are lifestyle and medical means to treat frequent urination so that a woman does not have to suffer with the symptoms.

How is frequent urination diagnosed?

A doctor will start to diagnose potential underlying causes for frequent urination by asking questions about a woman’s health history.

Examples of these questions may include:

  • When did you first notice your symptoms starting?
  • What makes your symptoms worse? Does anything make them better?
  • What medications are you currently taking?
  • What is your average daily food and drink intake?
  • Do you have any symptoms when you urinate, such as pain, burning, or sensations that you are not emptying your bladder completely?

A doctor may take a urine sample for evaluation. A laboratory can identify the presence of white or red blood cells as well as other compounds that should not be present in urine that could indicate an underlying infection.

Other testing may include cystometry, or the measure of pressure in the bladder, or cystoscopy, which involves using special instruments to look inside the urethra and bladder.

Other diagnostic methods may depend upon a woman’s specific symptoms.

Treatments and preventive techniques

If a urinary tract infection is causing a woman’s frequent urination, taking antibiotics to cure the infection may help.

[many cups of coffee caffeine]
Lifestyle changes like avoiding coffee and other caffeinated beverages may help reduce the frequency of trips to the bathroom.

Other treatments and preventive techniques for frequent urination that is not due to infection include:

  • Lifestyle modifications: Avoiding foods and drinks known to irritate the bladder can help a woman experience fewer episodes of frequent urination. Examples include avoiding caffeine, alcohol, carbonated beverages, chocolate, artificial sweeteners, spicy foods, and foods that are tomato-based.
  • Adjusting patterns of fluid intake: Avoiding drinking too much water before bedtime can reduce the likelihood of waking up at night to go to the bathroom, for example.
  • Bladder retraining: Bladder retraining is another method to reduce the amount of times a woman goes to the bathroom per day. To accomplish this, she will void on a regular schedule instead of always waiting until she feels the need to urinate.

If possible, a woman should use techniques such as relaxation to see whether the need to urinate passes if she feels the need to go before the scheduled time. Women should not start a bladder-retraining schedule without discussing it with their doctor first.

In addition to these methods, doctors can prescribe medications that reduce bladder spasms and encourage relaxation of the bladder. This has the effect of reducing the urges to have to go to the bathroom.

Examples of medications used to treat urinary frequency include:

  • imipramine (Tofranil)
  • mirabegron (Myrbetriq)
  • oxybutynin (Ditropan)
  • tolterodine extended-release (Detrol)

Sometimes a doctor will recommend injections of botulinum toxin (BOTOX), which can reduce the incidence of bladder spasms. BOTOX can also relax the bladder so that it can become fuller before a woman has the urge to urinate.

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30 Mar

Medical News Today: Feeling lonely may worsen cold symptoms

Sore throat, runny or stuffed nose, cough, headache – the symptoms of the common cold have gripped us all at one point or another. According to a new study, however, the severity of such symptoms may depend on one’s feelings of loneliness.
[A woman with a cold blowing her nose]
Feeling lonely may exacerbate cold symptoms, new research suggests.

Led by researchers from Rice University in Houston, TX, the study found that people who felt lonely reported worse cold symptoms than individuals who did not feel lonely.

Study co-author Angie LeRoy, a graduate psychology student at Rice University, and colleagues recently reported their results in the journal Health Psychology.

According to a 2016 survey, around 72 percent of people in the United States report feeling lonely. Of these individuals, around 31 percent report feeling lonely at least once a week.

Feeling socially isolated can take its toll on psychological well-being, raising the risk of anxiety and depression, but its effects do not end there.

Loneliness can have serious implications for physical health, too. A study reported by Medical News Today in 2016, for example, associated loneliness with an increased risk of heart disease and stroke.

“Research has shown that loneliness puts people at risk for early death and other physical illnesses,” LeRoy notes. “But nothing had been done to look at an acute but temporary illness that we’re all vulnerable to – the common cold.”

For their study, LeRoy and colleagues investigated how feelings of loneliness might affect the risk of catching the common cold, as well as the severity of cold symptoms.

Quality, not quantity of social networks affects severity of cold symptoms

To reach their findings, the researchers enrolled 159 individuals aged between 18 and 55, of whom around 60 percent were men.

Participants were given nasal drops that induced a cold, before being quarantined in a hotel room for 5 days.

The loneliness of each subject was assessed at study baseline using the Short Loneliness Scale and the Social Network Index. During the 5-day study period, participants were asked to report their symptom severity.

Around 75 percent of participants developed a cold following nasal drop administration.

The team found that the risk of developing a cold was no different between lonely and non-lonely participants.

However, participants who reported feeling lonely at study baseline reported greater severity of cold symptoms than subjects who did not feel lonely. The size of subjects’ social networks appeared to have no influence on symptom severity.

“We looked at the quality of people’s relationships, not the quantity,” says LeRoy. “You can be in a crowded room and feel lonely. That perception is what seems to be important when it comes to cold symptoms.”

“We think this is important, particularly because of the economic burden associated with the common cold. Millions of people miss work each year because of it. And that has to do with how they feel, not necessarily with how much they’re blowing their noses.”

Angie LeRoy

Findings may not be limited to the common cold

The team cites previous studies that have associated feelings of rejection or other psychosocial factors with worse physical and mental health, which may explain the current findings. However, the team says that such an effect is unlikely to be limited to the common cold.

“A predisposition, whether it’s physical or mental, can be exaggerated by a subsequent stressor,” says study leader Chris Fagundes, a psychologist at Rice University. “In this case, the subsequent stressor is getting sick, but it could be the loss of a loved one, or getting breast cancer, which are subjects we also study.”

Fagundes adds that physicians should consider patients’ psychological health when assessing them for illness. “It would definitely help them understand the phenomenon when the person comes in sick.”

Learn how using nonsteroidal anti-inflammatory drugs during a cold may raise the risk of heart attack.

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30 Mar

Medical News Today: Reverse zoonosis: Can you make your pet sick?

For good reason, there is a great deal of interest in the transmission of diseases from animals to humans. Recently, however, medical researchers have started to ask the opposite question: can we make animals sick?
[Kitten being checked by doctor]
The transmission of diseases from humans to animals is a growing area of concern.

Swine and bird flu are two of the most recent and startling examples of animals passing diseases to humans.

Other unpleasant pet-to-human medical problems include ringworm, roundworm, and hookworm, as well as beaver fever, toxoplasmosis, and rabies.

Although these animal-to-human transmissions are relatively well described, pathogenic traffic in the opposite direction is much less well understood.

In this Spotlight feature, we will investigate whether pathogens can travel from humans to animals in a process referred to as reverse zoonosis, or anthroponosis.

A review of current literature on this topic, published in PLOS One in 2014, identified a wealth of examples. They found cases of bacteria, viruses, parasites, and fungi jumping from human hosts to animal-kind to occur across 56 countries on every continent with the exception of Antarctica.

The importance of reverse zoonoses

Reverse zoonosis is not just an interesting concept; it is an important global issue. Animals bred for food are transported far and wide, interacting with wild species that they would never naturally have encountered. With a rapid growth in animal production and an increase in the movement of both animals and people, a human pathogen within an animal could potentially move thousands of miles in just 24 hours.

For instance, during the H1N1 influenza pandemic of 2009, the virus was able to travel the breadth of the planet and from pigs to humans in a matter of months.

On top of the increasing animal trade, we have an ever-growing pet industry. An estimated 68 percent of people in the United States owned a pet in 2015 and 2016, up from 56 percent in 1988. Humans, animals, and disease are more entwined than ever.

Understanding how diseases work across all scenarios is essential for the future success of the human food chain and our survival as a species.

Although guidelines, protocols, and legislation attempt to keep on top of the increased movement of animals across the planet, the size of the issue is immense. Above and beyond legal farms and markets, zoos and aquariums, there is also an illegal meat trade that has the potential to affect the situation significantly. For instance, some estimate that 5 tons of illegal bushmeat move through Paris’ Roissy-Charles de Gaulle airport every week in personal luggage.

Early research into human to animal pathogens

The fact that diseases can pass from humans to animals is, perhaps, not such a surprise. An estimated 61.6 percent of human pathogens are regarded as multiple species pathogens and are able to infect a range of animals. Also, over 77 percent of pathogens that infect livestock are multiple species pathogens.

Although investigating these interactions is not a new endeavor, interest in the field has grown and developed over recent years. One of the earliest studies demonstrating reverse zoonosis was conducted in 1988 and looked at dermatophytes – fungi that cause superficial infections of the skin, nails, and hair – including Microsporum and Trichophyton. The authors found that these fungi could be transmitted from animal to animal, human to human, animal to human, and human to animal.

In the mid-1990s, focus moved from fungal reverse zoonoses to bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and Mycobacterium tuberculosis.

In the late 1990s, interest in viruses picked up, peaking during the 2009 H1N1 swine flu pandemic. From 2000, studies began to emerge investigating the ability of certain parasites to pass from human to animal, including Giardia duodenalis (the parasite responsible of giardiasis) and Cryptosporidium parvum (a microscopic parasite that causes the diarrheal disease cryptosporidiosis).

Below, we outline a selection of pathogens that have been observed jumping the gap between human and animal.

MRSA transferred from humans to their pets

MRSA is sometimes called a “superbug” because of its resilience to antibiotics. Infections caused by MRSA are notoriously difficult to treat and have the potential to be fatal.

Although cases of MRSA in the U.S. appear to be declining, it is still a significant public health concern.

A study, published in the journal Veterinary Microbiology in 2006, looked at MRSA in pets and its transmission between humans and animals. They concluded that:

“Transmission of MRSA between humans and animals, in both directions, was suspected. MRSA appears to be an emerging veterinary and zoonotic pathogen.”

The paper mentions a specific case in which a couple was repeatedly infected with MRSA. The re-infections only stopped once their dog was identified as the source and treated. It is presumed that the dog was initially infected by the couple and then passed the infection back to them each time they had been successfully treated.

With the inherent difficulties of treating MRSA, it is a genuine concern if animals – and particularly pets – are able to contract and transmit the pathogen. As the authors write: “The emergence of MRSA in household pets is of concern in terms of animal health, and perhaps more importantly, the potential for animals to act as sources of infection or colonization of human contacts.”

Tuberculosis in a Yorkshire terrier

[Yorkshire terrier panting]
Humans are capable of spreading TB across the species barrier.

A paper, published in 2004, describes the case of a 3-year-old Yorkshire terrier who arrived at the University of Tennessee College of Veterinary Medicine with anorexia, vomiting, and a persistent cough.

After running a barrage of tests – including, sadly, an eventual postmortem – the authors concluded that it had contracted tuberculosis (TB) (Mycobacterium tuberculosis). The dog’s owner had been receiving treatment for TB for 6 months. This was the first documented transmission of TB from human to canine.

Cats are also susceptible to TB, but they most commonly catch cattle TB (M. bovis) or, more rarely, a version of the disease carried by birds (M. avium).

Dogs are not the only animals that can be affected by humanborne TB. There have been a number of documented cases of elephants contracting TB from humans, including three from an exotic animal farm in Illinois.

Cats catching flu from humans

In 2009, the first recorded case of fatal human-to-cat transmission of the H1N1 flu virus occurred in Oregon. The owner of the cat had a severe case of influenza and had to be taken to the hospital. Her cat – an indoor cat with no exposure to other people or animals – later died of pneumonia caused by an H1N1 infection. Details of the case were published in the journal Veterinary Pathology.

In 2011 and 2012, researchers identified more than 13 cats and one dog with pandemic H1N1 infection that appeared to have come from human contact. Interestingly, the animals’ symptoms were similar to those experienced by human carriers – rapidly developing respiratory disease, a lack of appetite and, in some cases, death.

Fatal respiratory illnesses in chimpanzees

Of all the animals, gorillas and chimpanzees are perhaps most susceptible to human ailments, thanks to their similar genetic and physiological makeup. They are known to be vulnerable to a number of human diseases, including measles, pneumonia, influenza, a range of viruses, bacteria, and parasites.

Due to poaching, habitat loss, wildlife parks, zoos, and bushmeat hunting, humans more frequently come into close proximity with primates. Because of this, cross-species transmission of diseases is becoming a pressing concern.

In 2003, 2005, and 2006, outbreaks of fatal respiratory disease struck the wild chimpanzees at the Mahale Mountains National Park in Tanzania. Although measles and influenza were both considered, no evidence to support them as the cause could be found.

Researchers analyzed stool samples from affected and nonaffected individuals, and they identified that a human-related metapneumovirus – a virus that causes an upper respiratory infection – was to blame.

This dwindling population of chimpanzees was being decimated by a cold transferred to them by humans.

Similarly, in 2009, an outbreak of human metapneumovirus infection in Chicago, IL, spread from infected zookeepers to a group of captive chimpanzees. All seven became ill, and one died as a result.

African painted dogs

African painted dogs are an endangered species of wild dog. As part of the conservation effort, a study published in 2010 investigated the parasites present in the species’ feces.

Infection by Giardia duodenalis, a parasite that lives in the small intestine, was found in 26 percent of wild animals and 62 percent of captive animals.

[African painted dog]
It is thought that human parasites put African painted dogs at an increased risk of extinction.

Although common in domestic cats and dogs, G. duodenalis is not a parasite naturally found in African painted dogs. Additionally, the strains of parasite found in the dogs’ feces were of a subtype commonly associated with humans, rather than the subtypes usually seen in pet dogs.

Symptoms of the disease can include diarrhea, nausea, abdominal discomfort, and reduced appetite.

The authors concluded that the parasites had entered the population from human-dog interactions and, from then on, were passed from dog to dog, becoming a new potential threat to their already uncertain future.

Although research into reverse zoonosis is relatively scant, it is an important and urgent field of study. If human pathogens are able to infect other species, and these species are able to interact with humans and travel great distances, it is a pandemic waiting in the wings.

We already know that the flu virus can mutate quickly, and by living in different species, it has the chance to change and mutate in ways that it could not in humans. As these pathogens change, they might become less dangerous to humans. On the other side of the coin, however, some might become increasingly deadly.

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