Meditation helps conflict veterans with PTSD, study finds

Transcendental meditation—the practice of effortless thinking—may be as effective at treating PTSD in conflict veterans as traditional therapy, US researchers said Friday, in findings that could help tens of thousands deal with their trauma.

Post traumatic stress disorder, a debilitating condition that can lead to psychosis, bipolar disorder or suicidal and homicidal thoughts, affects an estimated 14 percent of US veterans who serve in Iraq or Afghanistan.

The most common treatment for PTSD is a process known as prolonged exposure psychotherapy, which forces sufferers to re-experience traumatic events by confronting their memories of the conflict.

Researchers from three US universities decided to look into whether more everyday techniques, which help civilians lower their stress levels and increase focus and productivity, would work on traumatised veterans.

They trialed 203 former servicemen and women with PTSD, most of whom were receiving medication for their symptoms, and randomly assigned them courses of transcendental meditation, prolonged exposure therapy or a specialised PTSD health education class.

They found that 60 percent of veterans who did 20 minutes of quiet meditation every day showed significant improvement in their symptoms, and more completed the study than those given exposure therapy.

“Over the past 50 years, PTSD has expanded to become a significant public health problem,” Sanford Nidich, of the Maharishi University of Management Research Institute, told AFP.

“Due to the increasing need to address the PTSD public health care problem in the US, UK and worldwide, there is a compelling need to implement governmental policy to include alternative therapies such as transcendental meditation as an option for treating veterans with PTSD.”

Transcendental meditation involves effortlessly thinking of an idea or mantra to produce a settled, calmer state of mind—scientists call it “restful alertness”.

Unlike exposure therapy, meditation can be practised at home, takes up relatively little time, and researchers say it would be significantly cheaper than current treatment techniques.

It also avoids forcing combat veterans to relive their trauma in a bid to get better.

“Transcendental meditation is self-empowering, and can be practised just about anywhere at any time, without the need for specialised equipment or ongoing personnel support,” said Nidich, who was the lead author of the study published in The Lancet Psychiatry journal.

‘Gave me my life back’

The main problem with existing PTSD treatment, according to Nidich, is that forcing veterans to relive their trauma means many never finish the courses.

Exposure therapy, although officially approved as a treatment by the US Veterans’ Association, is ineffective in up to 50 percent of patients and drop-out rates range from 30-45 percent.

“New treatments, including options not involving exposure to the traumatic experience, are needed for veterans who do not respond to treatment or drop-out due to discomfort,” said Nidich.

One study participant, a 32-year-old navy veteran whom authors identified only as Ms. K, said learning the meditation technique had “given me my life back.”

After being diagnosed as having suffered sexual trauma while on military service, her symptoms worsened until she drank to excess every night and sought to avoid human interaction.

After the transcendental meditation course, “I began to come out of my nightmares and face the battle I had ahead,” she said.

She added she had since applied for a job in a hospital.

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Breast Cancer Recurrence Rate Not Up With Autologous Fat Transfer

THURSDAY, Nov. 15, 2018 — For patients with breast cancer, reconstruction with autologous fat transfer (AFT) seems not to increase the rate of locoregional recurrence versus conventional breast reconstruction, according to a study published online Oct. 10 in JAMA Surgery.

Todor Krastev, M.D., Ph.D., from the Maastricht University Medical Center in the Netherlands, and colleagues matched 287 patients with 300 affected breasts receiving AFT between 2006 and 2014 to 300 nonexposed control patients based on age, type of oncologic surgery, tumor invasiveness, and disease stage. AFT patients were followed for a mean of 9.3 years, including 5.0 years following AFT; control patients were followed for a mean of 8.6 years after primary surgery.

The researchers identified eight locoregional recurrences in the treatment group and 11 among the control group, for an unadjusted hazard ratio of 0.63 (95 percent confidence interval, 0.25 to 1.60; P = 0.33). In relevant subgroups based on the type of oncologic surgery, tumor invasiveness, or pathologic stage, there were no increased locoregional recurrence rates. With respect to distant recurrences or breast cancer-specific mortality, no increased risks were detected with AFT.

“In line with reported rates from other published matched cohorts, there is no clinical evidence so far to suggest that AFT leads to increased rates of cancer relapse in patients with breast cancer,” the authors write.

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Posted: November 2018

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E-alerts dramatically cut heart attack rate for people hospitalized with A-fib

(HealthDay)—A simple pop-up alert on a computer screen could help save the brains and hearts of many hospital-bound people with an irregular heartbeat, a new clinical trial reveals.

Rates for heart attack and stroke plunged by close to 90 percent in people helped by the new program, the study found.

The computer alert warns doctors of the high stroke risk borne by individual patients who suffer from atrial fibrillation, a quivering heart rhythm that allows blood to pool and clot inside the heart.

Doctors who received this alert were nearly three times as likely to prescribe blood thinners to hospitalized patients with a-fib, said Dr. Gregory Piazza, a cardiovascular specialist with Brigham and Women’s Hospital in Boston.

As a result, rates for heart attack and stroke among the a-fib patients fell by 87 percent and 88 percent, respectively, over the three-month trial, Piazza’s group reported Saturday at the American Heart Association’s annual meeting in Chicago.

The magnitude of the reduction in risk of these life-threatening health problems surprised researchers, as it was “really beyond what we expected to see with the increase of anticoagulation,” Piazza said.

Blood thinners are very important to prevent stroke in a-fib patients, but prior studies say at least 30 percent have not been prescribed such a medication, researchers said in background information.

For this study, Piazza and his team created a program that analyzes computer chart data of patients with atrial fibrillation to calculate what is known as a CHADS-VASC score.

This commonly used diagnostic algorithm assesses risk factors for stroke in a-fib patients, said Dr. Mary Norine Walsh, medical director of the heart failure and cardiac transplantation program at the St. Vincent Heart Center in Indianapolis.

The test program issues a pop-up alert to doctors indicating that their a-fib patient has a high CHADS-VASC score. It even estimates their annual risk of stroke.

The pop-up then requires doctors to either prescribe a blood thinner or give a reason why such a medicine shouldn’t be used. Possible reasons include “bleeding risk is too high,” “patient is at high risk for falls,” or “patient refuses anticoagulation.”

To see whether the alert would make a difference, the researchers randomly assigned 458 a-fib patients so about half would have their records reviewed by the program.

About 19 percent of patients in the alert group had a prescription for blood thinners during hospitalization, at discharge and three months later, researchers found. By comparison, only 7 percent of the control group had been prescribed blood thinners.

By three months after hospitalization, the alert group had a dramatic effect on patients’ odds for heart attack or stroke, although that didn’t translate to a lessening of the death rate, the team noted.

Still, the study showed that reminder systems like this actually really work to cut the odds for cardiac events, said Walsh, who is president of the American College of Cardiology.

“We as physicians can’t keep everything in our brains all the time,” she said. “It’s clear in medicine if we have reminders, we more commonly prescribe drugs and take action.”

But even though doctors are moving toward the use of electronic health records, it’s not clear how easily hospital data centers could incorporate such an alert into their usual systems, Walsh said.

“All electronic health records could do it probably, but not all are set up to do it,” Walsh said. “I can tell you, my electronic health record doesn’t do this kind of thing. It’s not an automatic thing that happens.”

Adding such an alert system might be costly for some hospitals, Piazza added.

“Implementation of alert-based [computerized decision support] requires an investment in programming and medical informatics infrastructure which may not be available at some medical centers,” Piazza said.

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Cocaine Cut With Anti-Worming Drug May Cause Brain Damage

THURSDAY, Nov. 8, 2018 — Cocaine is often cut with the anti-worming drug levamisole — and the combination is linked to brain damage, Swiss researchers report.

“We can assume from our findings that it is not just cocaine that changes the brain, but that the adulterant levamisole has an additional harmful effect,” said research leader Boris Quednow, from the University of Zurich.

“The sorts of cognitive impairment often exhibited by cocaine users may therefore be exacerbated by levamisole,” Quednow said in a university news release.

Cocaine is the second-most used illegal substance worldwide after marijuana. Local anesthetic agents, painkillers, caffeine and other substances are often added to street cocaine, the researchers said in background notes.

In Europe and the United States, levamisole is a common additive, possibly because it may increase or prolong cocaine’s effects, Quednow and his colleagues suggested.

The researchers analyzed hair samples to determine levels of cocaine and levels of levamisole in study participants. They ended up comparing 26 cocaine users with low levamisole exposure, 49 cocaine users with high levamisole exposure, and 78 people using no drugs.

In tests of mental and thinking skills, regular cocaine users scored worse on attention, working memory, long-term memory, and other mental functions compared to people who didn’t use cocaine. But those whose cocaine was cut with levamisole performed worst of all, according to the study.

Moreover, brain scans linked higher levamisole levels with impaired thinking and a thinned prefrontal cortex. This indicates levamisole has a toxic effect on the brain, the researchers concluded.

Although the study didn’t prove a cause-and-effect relationship, the authors called on public health officials to expand their drug-checking programs.

“Such programs mean users can have their drugs tested for purity and therefore avoid taking cocaine that has very high levels of levamisole,” Quednow said.

The findings were published recently in Translational Psychiatry.

More information

The U.S. National Institute on Drug Abuse has more about cocaine.

Posted: November 2018

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This Man Shamed His Wife for Having a Loose Vagina With a Ridiculous Gift

When your body pops out a baby, a lot of body areas change. Your stomach has to stretch to accommodate a small human, meaning loose skin is on the horizon. And your vagina has to expand during delivery, which is sure to change the shape and feel of things down there.

This happens to all moms who delivery their baby vaginally, and it’s nothing to be ashamed of. But one Reddit user found herself second guessing her own postpartum body changes after her husband dropped a not-so-subtle hint.

“This morning I woke up to a gift on my nightstand. It was a cute sparkly pink bag with a sweet note from my husband attached,” aaplmns wrote in a recent post. “Inside the bag was a Je Joue Mimi vibrator, panties, my favorite bath foam, and body butter from The Body Shop, two kinds of lube… and something called Like A Virgin 24 Hour Tightening Cream.”

Whoa, hold up. Was aaplmns’ husband actually vagina shaming her?

She went on to explain that she gave birth to her second child in July and had fourth degree vaginal lacerations (indicating that there was so much tearing, her vagina and rectum were no longer separated). That’s incredibly painful, but somehow aaplmns was back to having sex only six weeks postpartum, she wrote.

Needless to say, aaplmns has taken her husband’s gift pretty personally. “I’m so embarrassed,” she stated. “It’s hard to describe but I feel like less of a woman, like my time to be sexy and fun with my husband has passed. I’m even wondering if he’s thought about cheating.”

We have no clue why her husband thought gifting that cream was a good idea. Hate to break it to you, mister, but there’s exactly zero evidence showing creams like that even work.

“I know of absolutely no cream that would tighten your vagina,” Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine tells Health. Yep, it’s that simple.

Dr. Minkin says anyone who claims to see results from a product like the one aaplmns’ husband left for her is likely experiencing a placebo effect.

However, there is one thing that really can tighten your vagina postpartum, if this is something you want to do: kegel exercises. No familiar with kegels? They involve tightening and contracting the muscles that support your uterus, bladder, small intestine, and rectum. Doing them should feel similar to the way it feels when you clench to stop yourself from peeing.

If you want to give kegels a go, Dr. Minkin suggests doing about three sets of 10 every day. Everyone is different, but if you stick to it, you should start to notice a difference within a few months.

The only other thing that can truly tighten the vagina is surgery, Dr. Minkin says, but that should be reserved for extreme cases, like when a woman has given birth to multiple large babies. The procedure is called a “posterior repair” and is for patients with a medical need, like bowel dysfunction after delivery.

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The Pros & Cons of Co-sleeping With Older Kids

It makes sense to sleep with your child within their first few years of life. Your kids might be scared of the dark — which is a pretty common fear — and they could also be looking for attachment and safety. Yet at a certain point, your kids need to grow up and learn to sleep on their own.

“Children typically are taught to sleep in their own beds between ages 5 and 8 years old. Some parents need education on how to successfully do that, which is why they never teach their children or teach them too late,” licensed marriage and family therapist Katie Ziskind tells SheKnows. “I recommend parents start their child around age 5 in the child’s bed to teach their child that their bed is safe,” she says.

Not only will this improve your own quality of sleep (and probably your sex life!), but also, it’ll create a sense of independence for your child and help them learn to feel comfortable on their own.

If you’re struggling to say no — which can be hard when your kids are so darn cute — consider these pros and cons of letting older kids share your bed.

Pro: It fosters closeness

Co-sleeping does provide that bonding experience between parent and child — on both ends. Kids feel safe throughout the night. If a kid starts in the parents’ bed, the child will consider that bed to be theirs all the time. So, if a nightmare happens, the child can spend the whole night in the parent’s bed and feel protected, Ziskind explains.

If the kids start in their own beds but have a nightmare in the middle of the night, letting them join you could be the only way to mitigate their anxiety. “Kids need comfort. If your child wakes up crying, absolutely offer comfort, soothing and support by bringing them from their own room into your bedroom and into your bed for some cuddles,” she says.

Likewise, sometimes parents need some extra comfort. “For instance, if a parent has recently lost their spouse, they may want their child or teen to sleep with them for their own comfort, but this may not be in the best interest of the child,” says Ziskind.

Con: It also fosters dependence

It’s OK for your kids to feel dependent on you when they’re young; however, once they reach a certain age, it’s time to learn to take care of themselves. This isn’t to say they should be thrown on a subway or start walking home alone — they’re still young! — but learning how to clean up after themselves and withstand a night of darkness and potential terrors would be beneficial for both parents and child.

“Children need to learn independence and that they can be OK on their own and in the dark,” Ziskind says.

Con: It wreaks havoc on your sex life

Womp-womp. If you’re wondering why sexy-time has diminished, you can look to your co-sleeping habits with your children. “When kids sleep with parents, the parents lose out on intimate time. Children can weave their way into a marriage and cause parents to miss out on important alone time as adults,” she says.

Parents need to have firm boundaries about their bed being theirs and theirs alone. “If parents are struggling and are in conflict in their marriage, I often see one parent be passive-aggressive by bringing a child into the parent’s bed to block intimacy,” Ziskind adds. This will only exacerbate the sexual drought and cause tension in the relationship.

Con: It causes you to skimp on sleep

Co-sleeping can also mess with your shut-eye and prevent you from getting those 7 to 8 hours of sleep you need each night to wake up feeling restored. (And as busy parents, you really need those!)

Kids can be noisy, take up room on the bed to limit space for parents and be needy when scared. These distractions can make bedtime hard for parents, explains Ziskind. What’s more, since you’re missing out on regular sex, you’re not able to active feel-good hormones, such as oxytocin, the love hormone, to help you snooze faster and soundly throughout the night.

The takeaway? If your kid is really struggling at a young age, it’s OK to bend the rules. However, once kids turn 5, it’s smart to create some rules, educating kids on sleeping alone and prioritizing alone time for your and your S.O.

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Spinal stimulation helps men with paraplegia walk again

Many years previously, the three men sustained injuries in the cervical area, or neck region, of their spinal cords that had left them paralyzed in their lower bodies.

The new “therapeutic framework” responsible for their rehabilitation is called Stimulation Movement Overground (STIMO).

It is the result of a collaboration between Ecole Polytechnique Fédérale de Lausanne (EPFL) and the Lausanne University Hospital (CHUV), both in Switzerland.

Two journals, Nature and Nature Neuroscience, have now published study papers about the new stimulation approach.

What is remarkable about the new method — and distinguishes it from two recently published studies from the United States on a similar topic — is that the men could move their legs when the electrical stimulation to the spinal cord was switched off.

In one of the study papers, the researchers explain the importance of “preserving proprioception” in order to restore movement control in humans with spinal cord injury.

The need to ‘preserve proprioception’

Proprioception is somebody’s ability to sense bodily position and movement by processing signals that come from their body itself, as opposed to its environment. Scientists often describe it as a “sixth sense.”

Some who have written about it have cited the example of a man who, despite being able to make his muscles contract, was effectively immobile after an “infection deprived him of the sense of position, movement, and touch in his body” — or his proprioception.

The researchers in Switzerland maintain that if electrical stimulation of the spinal cord does not have the right combination of precise location targeting and timing of pulses, it can interfere with proprioception.

The STIMO method can overcome this by using “burst stimulation and spatiotemporal stimulation profiles.” Using simulations, the researchers showed that it enabled “robust control over motor neuron activity.”

“The exact timing and location of the electrical stimulation,” explains co-author Jocelyne Bloch, a professor and neurosurgeon at CHUV, who carried out the implant surgery, “are crucial to a patient’s ability to produce an intended movement.”

Swiss watch precision

Senior study author Prof. Grégoire Courtine, a neuroscientist at EPFL, notes that, following years of researching animal models, they “were able to mimic in real time how the brain naturally activates the spinal cord.”

He suggests that the precise combination of location and timing of the impulses is what helped generate new nerve connections.

Prof. Bloch says that it has to be “as precise as a Swiss watch.” The implants consist of a series of electrodes that target specific groups of leg muscles.

“Selected configurations of electrodes are activating specific regions of the spinal cord, mimicking the signals that the brain would deliver to produce walking,” she adds.

The three men had to learn how to time their intention to walk with the stimulation pulses. After only 1 week of this “calibration” phase, all three were walking with “body-weight support.”

All the patients could walk using body-weight support within 1 week. I knew immediately that we were on the right path.”

Prof. Jocelyne Bloch

Within 5 months, their “voluntary muscle control improved tremendously,” says Prof. Courtine. “The human nervous system responded even more profoundly to the treatment than we expected.”

The men showed no fatigue in their leg muscles and were walking hands-free for more than a kilometer during their rehabilitation sessions.

‘Activity-dependent plasticity’

The intense and lengthy sessions helped the men’s nervous systems to trigger “activity-dependent plasticity” and reorganize nerve fibers. This is what led to improved movement ability, even in the absence of stimulation.

The team now wants to translate the findings into tailored treatments that can be used in hospitals and clinics.

The scientists are also now developing “next-generation neurotechnology,” which they hope to test soon after injury when there is a greater chance of recovery because the affected tissue has not started to die off.

According to estimates from the National Spinal Cord Injury Statistical Center at the University of Alabama at Birmingham, there are about 288,000 people living with spinal cord injury in the U.S. Every year, medical professionals diagnose around 17,700 new cases, of which 78 percent are in males.

Injury incurred during vehicle crashes account for most (38 percent) cases of spinal cord damage in the U.S., followed by falls (32 percent). Other relatively common causes include wounding from gunshots and other violent acts (14 percent), together with injuries that occur during sports or recreation (8 percent).

The following video from EPFL summarizes the research and illustrates the progress that the three men made during their rehabilitation.

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