Sunday, March 7, 2010

Patience, meds remedy for Bell's palsy


Q: When I saw my cousin two days ago, she was fine. But yesterday her face looked strange — half her mouth and one of her eyelids was drooping. I thought she was having a stroke, but her doctor says she has Bell's palsy. What can you tell me about this condition?

A: Bell's palsy is a disorder in which damage to the facial nerve causes partial or total paralysis of one side of the face. As in your cousin's case, it can cause startling changes on the affected side. These include a drooping mouth, a sagging eyebrow and a drooping eyelid that prevents the eye from closing properly.

The good news is that Bell's palsy is not nearly as serious as it looks. Its symptoms are usually temporary, but they can be very distressing for patients. Because the facial nerve controls muscles of the face, Bell's palsy not only affects appearance, but also the ability to speak, eat, sleep or taste food. Saliva may dribble from the corner of the mouth. Recovery can take weeks — even months. During that time, many people restrict their activities, and some become socially isolated.

Bell's palsy usually begins without warning and may develop rapidly, often overnight. It may be preceded by symptoms suggesting a viral illness, such as fatigue or a headache. The facial weakness generally peaks within 24 hours, rarely worsening after that.

Most scientists believe that Bell's palsy is triggered by a viral infection that causes inflammation of the facial nerve. This nerve starts in the brain and winds its way through the bones of the skull to the muscles of the face. It's made of thousands of nerve fibers that carry signals to and from the facial muscles as well as the saliva and tear glands. It also plays a role in taste.

The drooping mouth and other symptoms develop when the nerve swells and gets pinched when it travels through a narrow passageway in the skull beneath the ear. The affected eye may appear teary but remains mostly dry and irritated because it cannot blink or close completely. Drooling is another common symptom. Some people experience numbness or ear pain on the affected side. They may also become overly sensitive to sound.
Doctors aren't exactly sure what causes Bell's palsy. In the past, scientists focused on herpes simplex type 1 virus, the virus that causes cold sores. Other viral suspects include herpes zoster, which causes chickenpox and shingles, and the Epstein-Barr virus, which causes mononucleosis. As a result, doctors often prescribed an antiviral medication, as well as a corticosteroid to quell inflammation. But evidence has begun to cast doubt on this approach.

In a 2007 study, 551 Bell's palsy patients were randomly assigned to take either a corticosteroid, an antiviral drug, both medications or a placebo. After nine months, 94 percent of patients who took the corticosteroid had recovered fully. Patients who took the antiviral drug did no better than those who took placebo pills. The drug combination was no better than taking the corticosteroid alone.

A similar trial of 829 patients in 2008 confirmed these results. Patients who took a corticosteroid made a complete recovery much faster than those who did not. There was no difference in recovery times between patients who received an antiviral drug and those who did not.

In 2009, the Cochrane Collaboration, an organization that evaluates medical research, weighed in on the issue. The group determined that antivirals are less effective than steroid drugs and no more effective than a placebo in bringing about a complete recovery. It also questioned whether herpes simplex virus causes Bell's palsy.
Your cousin was smart to see her doctor right away. Early treatment (within three days) with a steroid increases the chances of a full recovery. A doctor can also rule out conditions that cause similar symptoms, such as Lyme disease, other bacterial infections and some types of tumors. Stroke can cause facial symptoms like Bell's palsy, but it typically also affects the limbs on that side of the body as well as the ability to speak.

Most people start to get better within a couple of weeks and return to normal after several months. During that time, your cousin needs to keep her affected eye moist. She can use eye drops while awake and a special ointment at night. She may also need to wear an eye patch or other protective eyewear.

Recovery takes time and patience. Your support can help your cousin strike a note of optimism as she makes slow but steady progress.

Doctor led way in innovative memory loss, drug research

Dr. Jerry Buccafusco, a Regents professor and the director of the Alzheimer's Center at Medical College of Georgia, died early Saturday. His son says he was committed to his family. 
To many who knew him, Dr. Jerry Buccafusco is leaving behind a legacy in both his professional career and personal life.
"I believe this is a huge loss for us," said Dr. William Caldwell, the chairman of the Pharmacology and Toxicology Department at the Medical College of Georgia, where Buccafusco also worked. "He was a great person and friend.
"He's certainly been an outstanding teacher and scientist throughout his career."
Buccafusco, a Regents professor and the director of the Alzheimer's Center at MCG and husband of Regina Buccafusco, the chairwoman of the Columbia County Board of Education, died Saturday morning at his Evans home, surrounded by his family. He was diagnosed with advanced-stage liver and lung cancer less than two weeks ago.
In addition to leading the way in innovate research of diseases relating to memory loss, the 60-year-old also had worked on drug and substance abuse, his colleagues said.
"His research has really changed our understanding of diseases of memory loss and their treatment," Caldwell said. "He's been recognized by institutions and organizations all over the country for his work."
Buccafusco was the recipient of a number of honors and awards, including The New Investigator Award from the National Institute on Drug Abuse in 1980.
"He was always a big proponent of developing novel drugs for patients with Alzheimer's and memory disorders," said Dr. David Hess, the chairman of the Department of Neurology at MCG. "He was also a wonderful mentor."
At one time, Buccafusco served as chairman of the Department of Veterans Affairs Medical Center's research committee.
"He did a lot of good for the Augusta and the Medical College of Georgia research community," said Hess, the co-director of the Brain and Behavior Discovery Institute, where he also worked with Buccafusco. "It's a big loss."
Buccafusco's reach wasn't just limited to his laboratory. At home, the husband and father always made time for his family and those in the neighborhood who needed his help, said Buccafusco's eldest son, Chris.
"He was really committed to his family and to seeing them flourish," he said. "He was really perfect at balancing all of these things that he did."
He supported his wife in her campaigns and other endeavors, Chris Buccafusco said.
The avid sports fan was also a huge collector of comic books.
"He was a man of simple but deeply held pleasures," Chris Buccafusco said.
Platt's Funeral Home in Evans is in charge of arrangements. Visitation will be Monday evening at Platt's, with the funeral Tuesday at St. Mary on the Hill Catholic Church.

Cleveland Clinic could expand more in Las Vegas

Las Vegas -- In this desert town known for gambling and good times, the Cleveland Clinic Lou Ruvo Center for Brain Health is spurring intense hope for a different kind of economic future.
The once-booming local economy, largely dependent on the hospitality industry, has seen the number of visitors slow in recent years. Construction cranes along the famous Strip sit idle, Las Vegas' home foreclosure rates are among the nation's highest, and unemployment hit 13.1 percent in December.
So when the Clinic accepted the brain center as a gift last year and decided to expand the health system's neurological research and clinical practice there, local leaders immediately began to ask for an even stronger marriage.
Mayor Oscar Goodman, who had been trying to lure the Clinic to Las Vegas for nearly a decade, envisions a medical mecca with the Clinic at the helm. Clinic executives are mulling the idea, reviewing how adding to operations there could enhance its ability to serve patients, grow revenues and elevate its brand.
After frequent get-togethers and positive public dialogue this past year, Goodman describes his current relationship with the health system and its leader Dr. Toby Cosgrove as "a love-fest."
One Cleveland Clinic executive involved in the discussions characterizes local desire for the health system to expand as "rabid."
The Clinic beyond Cleveland The nearly $80 million Cleveland Clinic Lou Ruvo Center for Brain Health anchors the south end of the city-owned Symphony Park development and includes medical offices as well as an events hall for fundraising.
The Clinic has a confidential "exclusive negotiating agreement" with the city of Las Vegas' redevelopment agency to build on an additional 12 acres adjacent to the brain center.
Las Vegas officials say they expect the Clinic's site plan and development agreement to be submitted to the city by Oct. 1. The Las Vegas City Council could approve a plan by the end of the year.
"Having the western outpost for the Cleveland Clinic, in whatever form it ultimately takes, is huge," said Rita Brandin, development director of Symphony Park.
In many ways, the brain center and the Clinic's possible expansion in Las Vegas illustrates the health system's strategy to grow outside Greater Cleveland.
The project is low-risk on three fronts:
First, the building was a gift and that means the cost was low, with the Clinic only paying for staffing and medical operations. The Clinic's role in developing and managing a 360-bed hospital in Abu Dhabi, United Arab Emirates, echoes this financial strategy, as the hospital slated to open there in late 2012 will be paid for and owned by the government-sponsored Mubadala Healthcare.
Second, the Clinic has been able to leverage the existing expertise of its doctors and staff and expand its neurological operations -- a medical specialty that is a growing field, much like cardiovascular medicine was several decades ago.
Finally, because the brain center is part of a planned 61-acre luxury development and was designed by world-renowned architect Frank Gehry, it enhances the Clinic's branding strategy of "world-class care."
But, for a health system, the unsteady Las Vegas economy also poses challenges.
One doesn't have to look far to see that developing Symphony Park will be a Herculean effort. Within walking distance of the largely empty development is a dingy X-rated adult store and, nearby, an abandoned building with a bright yellow sign that reads: "This city block for sale."
The owner of that 3.25-acre block, Kevin Plencner, vice president of Oak Brook Realty Investments of Chicago, said it seems like the city is the only entity spending money. Plencner's land has two shuttered casinos and a closed convenience store on it.
Indeed, with the exception of historic casinos like the Golden Nugget on Fremont Street, there are few signs of any private investment in the downtown district that sits a few miles from the Strip.
If the health system decides not to expand, Goodman said: "I'll cry in my gin."
Local gossip columnist Robin Leach -- of "Lifestyles of the Rich and Famous" fame -- insists he has it from good sources that the Clinic plans to build a medical school and wellness institute at Symphony Park.
Clinic executives, so far, have not provided any public confirmation. They have held some meet-and-greet sessions with local health systems and are developing a small internship program with the University of Nevada School of Medicine.
Meanwhile, the Clinic is studying the market with a consultant and "finding out what specialties would make sense," said Clinic Chief of Operations William Peacock III during a recent interview with others at the center.
"When we conclude that effort we'll have a better idea of what might fit in some expanded presence out here," Peacock said.
Without missing a beat, Dr. Michael Modic, chairman of the Clinic's neurological institute, and chief emerging business officer, jumped in quickly, adding, "If any."
"We're going to do brain health, there's no question about it," Modic said. "It's still very open as to whether we go beyond this or just stay with what we're doing."
Of all the rumored ideas, an expansion of the Clinic's wellness business, and specifically the Lifestyle 180 program, seems most feasible, said Clinic Chief Wellness Officer Dr. Michael Roizen in a separate interview. The program, which is now offered at the Cleveland Clinic Wellness Institute in Lyndhurst, is designed to treat chronic disease through lifestyle changes.
In addition, said Roizen, the health system has learned a lot from wellness programs used by its own employees in Ohio -- from smoking cessation to weight-loss programs -- and hopes to be "able to bring that expertise to other businesses in Las Vegas."
The Clinic's Vegas outpost For now, though, Clinic officials are busy with a brain center that is busier than expected.
After opening a clinical floor in the brain center's office area in July, the Cleveland Clinic served 1,500 new patients in a little more than five months. It's on track to serve nearly 6,000 in 2010, said Dr. Randolph Schiffer, the Clinic's medical director for the brain center.
The center treats patients who suffer from a spectrum of neuro-degenerative disorders like Alzheimer's and Parkinson's diseases. So far, most patients are from the Las Vegas region with some from nearby states, such as Utah and California, though the center could eventually draw patients from across the West and even globally.
The building and all construction costs are being paid for by entrepreneur and brain center founder Larry Ruvo and his Keep Memory Alive organization.
The brain center was already under construction when Ruvo scored a last-minute meeting with Cosgrove, who happened to be in Las Vegas exploring the idea of opening a separate outpatient center. The two men hit it off so well that Cosgrove set aside ideas for the outpatient center and within months accepted the center as a philanthropic gift.
Clinic executives have been active partners in the design. Schiffer insisted, for example, that clinical floors have calm tranquility rooms to help patients and their families relax. The building also is equipped with electronic medical records, which means tests and scans of Las Vegas patients can be viewed and analyzed by Cleveland specialists.
The center's staff, as well as research, will link to the Clinic's larger neurological institute operations in Cleveland, Lakewood and Florida
But, for now, the building is recognized just as much for its celebrity trappings as it is for its medical care. The Gehry building has attracted celebrities -- if not patients -- from around the world, including former Mexican president Vicente Fox, former U.S. president George W. Bush and hip-hop performer, producer and businessman Sean "Diddy" Combs.
The center's shiny steel exterior was put together like a puzzle from 550 pieces designed in Germany, fabricated in China, and then shipped from a port in Los Angeles to Las Vegas. Each piece weighed 2,000 to 8,000 pounds.
The interior of the events hall, still under construction, has nearly 200 windows and a white finish on the walls that looks like drywall, but is actually a specialized acoustic material that cost more than $500,000.
Vegas style The events hall, which is scheduled to open in a few months, is part of the original vision for the brain center that Ruvo began creating before the Clinic entered the picture.
Ruvo, whose father succumbed to Alzheimer's several years ago, wanted to create a center that would combat the disease and help others. The high-energy businessman and senior managing director of Southern Wine & Spirits of Nevada is one of the most networked people in Las Vegas and, thus, the entertainment world. So, it's no surprise that Ruvo's vision quickly became reality.
Ruvo remains a partner in the operation and runs his Keep Memory Alive organization out of the top floor of the brain center. Keep Memory Alive, in turn, orchestrates the annual Power of Love charity gala, which raises money for the brain center.
The charity gala, held last weekend at the Bellagio casino, is by any measure an over-the-top Vegas event, complete with a red carpet and scantily dressed showgirls. With Ruvo as their host, Cosgrove, along with his wife, Anita, and a handful of other Clinic executives, found themselves as welcomed members of the Las Vegas scene at this year's gala -- it's a scene that Cosgrove succinctly summed up during the charity auction by saying, "It's not Cleveland, is it?"
Table and seat reservations for the gala ranged from $15,000 to $75,000 per table and $1,500 to $7,500 per seat -- with five glasses of wine pre-served at each of the 1,000 place settings.
Tennis power couple Andre Agassi and Stephanie Graf, as well as celebrities Danny DeVito, and Brad Garrett of the sitcom "Everybody Loves Raymond," walked the red carpet to help raise money. Artists, dancers and legendary crooner Barry Manilow entertained guests.
By the end of the evening, $27 million in donations had been raised for the center and its research.
Cosgrove, who was introduced as "the newest friend in town," told the crowd:
"I promise you, you will see something happen here that will make a major difference."

Teenage smoking leads to increased susceptibility to alcohol withdrawal in adulthood

Washington, Mar 7 : Smoking cigarettes in adolescence makes people more susceptible to the negative effects of alcohol withdrawal later in life, Baylor University researchers have said.

Scientists have found that the chronic exposure to nicotine during adolescence in animal models caused a nicotine-induced change in brain development that led to increased vulnerability to alcohol withdrawal in adulthood.

It is the first study to look at the combined effect of nicotine and alcohol exposure during the adolescent developmental period on the severity of a subsequent withdrawal from alcohol in adulthood.

This study provides evidence that the developing adolescent brain is susceptible to the actions of nicotine and that the effects of that early exposure can result in changes that can be seen in adulthood, said Dr. Jim Diaz-Granados.

Perhaps the most interesting finding is the group that was exposed to nicotine and alcohol during adolescence did not show the same effect as the nicotine-only group. This suggests that there is an interaction between the actions of the two drugs during this developmental period, he added.

The researchers exposed animal models to nicotine while others were given saline.

Furthermore, half were given alcohol and the other half were given saline, with the treatment lasting approximately one week. After six weeks, all were exposed to 64 hours of alcohol.

On removal, the researchers measured the severity of alcohol withdrawal.

Those exposed to nicotine only during adolescence showed the most severe withdrawal symptoms, while those exposed to nicotine and alcohol during adolescence did not.

Diaz-Granados said one outcome of alcohol withdrawal is nervous system hyperexcitability and those that had been exposed to nicotine during adolescent development suffered more severe alcohol withdrawal-related hyperexcitability.

The results are another important indication that drug use during adolescent brain development can have long-term consequences as compared to drug use during adulthood, said Diaz-Granados.

The results are documented in the journal Alcohol.

Growing Support for 'Hobbit' as Distinct Species

Here is what other scientists have discovered about Homo floriensis, "the hobbit":
—An analysis of the teeth from at least three hobbits found traits similar to early Homo species or Australopithecus, which lived in Africa between 3.8 million and 2.9 million years ago. The research by Peter Brown and Tomoko Maeda in Australia was published in the Journal of Human Evolution.
—Dean Falk and her colleagues at the Washington University School of Medicine in St. Louis found that the hobbit's brain looked nothing like that of a sick modern human. While small, it had a wrinkled surface and highly developed frontal lobe, characteristics consistent with the capabilities for higher thinking.

—One of the most definitive findings came two years ago when Matthew W. Tocheri, of the Smithsonian's National Museum of Natural History, published his findings in the journal Science. He found the hobbit's left wrist was indistinguishable from an African ape or early hominid and nothing at all like that seen in modern humans and Neanderthals. "It sealed the deal for me," he says.
— Harvard University biologist Daniel Lieberman and Columbia University anthropologist Ralph Holloway both started off skeptical but now agree with Tocheri that the hobbit is a new species. Holloway, though, has not ruled out that the brain may have been diseased.

Cullan & Cullan M.D., J.D . - Brain Injury

Few things can be as damaging and dangerous as a brain injury. For seniors residing in nursing homes, brain injuries can be life threatening and should be prevented at all costs.

One of the dangerous things about a brain injury is that it can be very difficult to identify. In addition to this, brain injuries can result from any number of circumstances. In nursing homes, falls or other head trauma to the head can cause the brain to collide with the inside of the skull, causing many different problems.

One of the ways you can spot a brain injury is by the symptoms a victim will have. Not all signs of brain injury are physical, like a bump or cut on the head, some of the other signs of a brain injury include:

- Memory Loss
- Headache
- Mood Changes
- Nausea
- Sensory Problems
- Confusion

If you have a loved one in a nursing home, you should make yourself aware of any brain injury symptoms so that they can be diagnosed as soon as possible. Brain injuries can have a large impact on a person's ability to accomplish everyday tasks, and they can even lead to blood clots in brain, coma, or even wrongful death.

Nursing homes are designed so that brain injuries and other types of personal injuries should never happen. Unfortunately, many nursing homes allow their patients to be at risk; some of the most common causes of brain injuries include:

- Falling out of bed from lack of bed rails
- Slipping on wet floors
- Falls from overmedication
- Faulty equipment

If your loved one has suffered a brain injury and you believe it was caused by the nursing home facility or staff, you should contact an experienced attorney as soon as possible. Not only is handling a brain injury claim a time-sensitive matter, but it is important that the parties who caused your loved one's injury be held responsible.

A nursing home abuse attorney will work with you, the nursing home, insurance companies, and doctors to determine exactly who is responsible for the brain injury. Nursing homes can be intimidating and difficult to get information from, which is why a nursing home abuse lawyer can help you.

If you live in the Phoenix, Arizona area and have a loved one who has suffered a brain injury at a nursing home, please visit the website of the Phoenix nursing home abuse lawyers who are also doctors, Cullan & Cullan M.D., J.D.

Chondriotin Sulfate Combats Brain & Mental Health Diseases

Brain and mental health
Brain and mental health
The post-mortem analysis of the brains of schizophrenics when compared to normal brains reveals severe dysregulation in the matrix outside of brain cells that hold them together in important regions of the subconscious brain (associated with memory, learning and the processing of stress). The finding is the first of its kind and essentially it means that the “roads and highways” that hold brain cells in position are at least as important as the neurotransmitter status, that up to now, has received most of the attention.

The researchers studied the chondroitin sulfate structure of the important matrix between brain cells that enables the actual structure of a part of the brain. They concentrated on looking at two important brain regions, the entorhinal cortex (behavior and memory) and the amygdala (anxiety, compulsions, hostility, stress response). They discovered that the glial cells expressed up to 15 fold normal activity with chondroitin sulfate. This means that the brain of those patients with schizophrenia were trying desperately to repair their cellular matrix and restore brain function, an attempt that clearly was not working, although ongoing. This can be concluded by the fact that these brain area's physical mass, as compared to controls, was less than normal.

Since glial cells regulate both brain repair and brain inflammation, it is obvious that significant mental problems involve excessive inflammation with a lack of repair. Something is getting in their way, even if the glial cells are trying to make a repair.

This study is relevant to everyone as it is likely that part of the lessening of nervous system function involves glial cell interaction with the chondroitin sulfate rich structure of the cellular matrix between brain cells. Therefore it can be said that any level of mental health issues ranging from ADHD to depression to anxiety, and nerve transmission problems will have at least part of the problem the structural integrity of the brain cell matrix, directly affecting synaptic plasticity and overall brain health.
Chondroitin sulfate benefits

A lot of people already know that chondroitin sulfates are good for their joints, as a matter of fact it is used as an alternative medicine to treat osteoarthritis. However fewer seem to understand that they are vital for the healthy structure of their arteries. While this story is still at its beginning, they may actually turn out to be vital to mental health! To be sure, any solution that facilitates the restoring of the physical structure of the brain and the proper structural framework of any one brain part is going to be more likely to lend to better overall connectivity and fewer mental health issues.
Side effects of chondroitin sulfate

Side effects are usually mild. The most common complaints are gas, indigestion, nausea, heartburn and softening of the stool.