Non-addictive, 'heroin-like' medicine may soon crush major depression

What could easily be the most important advance in the pharmacologic treatment of major depression and anxiety disorders is now unfolding.

A new investigational drug, currently known as ALKS 5461, could deliver all the mood-enhancing and anxiety-lowering effects that lead people to use opiates like heroin and Oxycontin—without the potential for getting high or addicted. That’s right: ALKS 5461 could be a non-abusable, non-addictive heroin-like compound.

ALKS 5461 is actually a combination of two molecules. The first is buprenorphine, which is already used to provide some of the benefits of opiates, without many of the worst side effects, allowing people to get off of street drugs (as an alternative to methadone). The second molecule is now known as ALKS 33—and that’s the magic part.

ALKS 33 interferes with the binding of buprenorphine to the receptors that are involved in making people feel euphoric. Those are the receptors also involved in getting people to crave opiates like alcoholics crave alcohol.

In a double-blind, placebo controlled study (meaning, the participants had no idea whether they were getting ALKS 5461 or a sugar pill), ALKS 5461 was rapidly effective in relieving symptoms in 32 patients with major depression. All 32 patients responded to the medicine—with results evident by seven days.

What’s more, all of them had failed to respond adequately to traditional antidepressants like Prozac or Effexor.

Ultimately, I believe ALKS 5461 could revolutionize the pharmacologic treatment of major depression and panic disorder and post-traumatic stress disorder and obsessive-compulsive disorder.

It should come as no surprise that ALKS 5461 is the brainchild of scientists at Alkermes Pharmaceuticals, the same company, which invented and markets Vivitrol, a monthly injection that can take away the “high” of using alcohol and street drugs—and in my opinion, ought to be something that every family member of every addict clamors to get their loved one to take.

If ALKS 5461 comes to market (and I believe it will), then that scourge we call major depression will be dealt a massive blow. It will still be imperative to use insight-oriented psychotherapy to get to the bottom of what unique psychological issues have fueled each person’s depression, but that should be easier—not harder—when folks aren’t struggling just to get out of bed and over to their psychiatrists’ offices.

Weight training: Do's and don'ts of proper technique

Effective weight training depends on proper technique. Follow these do's and don'ts to maximize your weight training program. 

You don't have to be a bodybuilder or professional athlete to reap the benefits of weight training. When done correctly, weight training can help you lose fat, increase your strength and muscle tone, and improve your bone density. If done incorrectly, however, weight training won't give you these benefits — and may even lead to injury.

Check your technique

You might learn weight training techniques by watching friends or others in the gym — but sometimes what you see isn't safe. Incorrect weight training technique can lead to sprains, strains, fractures and other painful injuries that may hamper your weight training efforts.
If you're just getting started, work with a knowledgeable weight training specialist — a physical therapist, athletic trainer or other fitness specialist who's familiar with proper weight training technique. If you've been using weights for a while, consider scheduling time with a trainer to demonstrate your technique and identify any changes you may need to make.

Weight training do's

When you're weight training, do:

• Lift an appropriate amount of weight. Start with a weight you can lift comfortably 12 to 15 times. For most people, a single set of 12 repetitions with the proper weight can build strength just as efficiently as can three sets of the same exercise. As you get stronger, gradually increase the amount of weight.
• Use proper form. Learn to do each exercise correctly. The better your form, the better your results — and the less likely you are to hurt yourself. If you're unable to maintain good form, decrease the weight or the number of repetitions. Remember that proper form matters even when you pick up and replace your weights on the weight racks. If you're not sure whether you're doing a particular exercise correctly, ask a personal trainer or other fitness specialist for help.
• Breathe. You might be tempted to hold your breath while you're lifting weights. Don't. Holding your breath can lead to dangerous increases in blood pressure. Instead, breathe out as you lift the weight and breathe in as you lower the weight.
• Seek balance. Work all of your major muscles — abdominals, legs, chest, back, shoulders and arms. Strengthen the opposing muscles in a balanced way, such as the front of the shoulder and the back of the shoulder.
• Rest. Avoid exercising the same muscles two days in a row. You might work all of your major muscle groups at a single session two or three times a week, or plan daily sessions for specific muscle groups. For example, on Monday work your arms and shoulders, on Tuesday work your legs, and so on.

Weight training don'ts

When you're weight training, don't:

• Skip your warm-up. Cold muscles are more prone to injury than are warm muscles. Before you lift weights, warm up with five to 10 minutes of brisk walking or other aerobic activity.
• Rush. Move the weight in an unhurried, controlled fashion. Taking it slow helps you isolate the muscles you want to work and keeps you from relying on momentum to lift the weight.
• Overdo it. For most people, completing one set of exercises to the point of fatigue is typically enough. Additional sets may only eat up your time and contribute to overload injury.
• Work through the pain. If an exercise causes pain, stop. Try it again in a few days or try it with less weight.
• Forget your shoes. Shoes with good traction can keep you from slipping while you're lifting weights.

Remember, the more you concentrate on proper weight training technique, the more you'll get from your weight training program.

 

Fix Your Form: How To Use The Assisted Pull-Up Machine

If you don't know your way around a weight room, heading to the gym can be intimidating -- and even dangerous. But paying attention to a few simple rules of proper technique can make you slimmer, stronger and healthier all over.

We spent an afternoon at Equinox with trainer and manager Rebecca Woll, learning the ins and outs of some of the most popular strength-training machines.
In the coming weeks, we'll be sharing Woll's thoughts on the biggest mistakes we all make while building muscle, plus her tips and tricks for better form. This week, we're perfecting the assisted pull-up
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The Faux Pas: "The assisted pull-up machine works the same muscle groups as the lat pulldown, however you're standing up, so you need to fire more muscles," says Woll. If you don't do so correctly, though, you'll find yourself drifting backwards as you pull yourself up. "That's really common," says Woll, as is allowing the elbows to pop out as you reach the top of the machine and the shoulders to scrunch up toward the ears.

The Fix: Keep the chin tucked as you pull yourself up. Concentrate on moving forward through the movement, says Woll. (The shortest distance between two points is a straight line, after all, she points out.) Allow the elbows to move only slightly away from the body at the top of the machine and remember to keep the shoulders back and down.Tell us how it goes in the comments below, and be sure to check back over the following weeks to fix your form on the row machine, the seated fly and more.

Bizarre tumor case may lead to custom cancer care

It's a medical nightmare:.
 a 24-year-old man endures 350 surgeries since childhood to remove growths that keep coming back in his throat and have spread to his lungs, threatening his life. Now doctors have found a way to help him by way of a scientific coup that holds promise for millions of cancer patients. The bizarre case is the first use in a patient of a new discovery: how to keep ordinary and cancerous cells alive indefinitely in the lab.

 

 

Dr. Richard Schlegel, left, and research associate Aleksandra Dakic in his laboratory at Georgetown University Medical Center in Washington in 2008. Georgetown University, via The Associated Press

 

The discovery allows doctors to grow "mini tumors" from each patient's cancer in a lab dish, then test various drugs or combinations on them to see which works best. It takes only a few cells from a biopsy and less than two weeks to do, with materials and methods common in most hospitals.

Although the approach needs much more testing against many different types of cancer, researchers think it could offer a cheap, simple way to personalize treatment without having to analyze each patient's genes.

"We see a lot of potential for it," said one study leader, Dr. Richard Schlegel, pathology chief at Georgetown Lombardi Comprehensive Cancer Center in Washington. "Almost everyone could do it easily."

An independent expert agreed.

For infections, it's routine to grow bacteria from a patient in lab dishes to see which antibiotics work best, Dr. George Q. Daley of Children's Hospital Boston and the Harvard Stem Cell Institute said in an email. "But this has never been possible with cancer cells because they don't easily grow in culture," he said.

The new technique may reveal in advance whether a person would be helped by a specific chemotherapy, without risking side effects and lost time if the drug doesn't work. "Pretty nifty," Daley wrote.

In the case of the 24-year-old, described in Thursday's New England Journal of Medicine, lab-dish tests suggested that a drug used to treat a type of blood cancer and some other unrelated conditions might help.

It's not a drug that doctors would have thought to try, because the man technically does not have cancer. But his lung tumor shrank after a few months of treatment, and he has been stable for more than a year. He still has to have operations to remove throat growths that keep coming back, but only about once every five months.

The man, an information technology specialist in suburban Washington who asked to remain anonymous to protect his privacy, has recurrent respiratory papillomatosis, or RRP. It's usually due to infection at birth with certain types of a virus, HPV, that causes genital warts.


The condition causes wartlike growths in the throat, usually around the voice box. These growths usually are noncancerous but can turn malignant, and even benign ones can prove fatal if they spread to the lungs. The main treatment is surgery, usually with lasers to vaporize the growths and keep them from choking off the airway or making it hard to talk.

About 10,000 or more people in the U.S. have the disease, said Jennifer Woo, president of the RRP Foundation. Woo, 29, is a medical student at Georgetown and one of the researchers on the study. She also has the condition but said it is confined to her throat and has required only about 20 surgeries so far.

The man in the study has a much more serious case.

"I was diagnosed when I was 3 or 4. At first, I had to have surgery every 7 to 10 days," the man said in a phone interview. "I get short of breath and my voice will get more hoarse."

Two years ago, the growths to his lungs became extensive and life-threatening, and his physician, Dr. Scott Myers, described the condition at a meeting of Georgetown hospital specialists. "It's crushing the airway," Myers said.

Doctors suggested that the new lab method pioneered by Schlegel and others might help. It borrows an idea from stem cell researchers: adding mouse cells for nourishment, plus a chemical that prevents cell death to an ordinary lab culture medium. That enabled healthy and cancerous cells to keep growing indefinitely.

Researchers grew "mini tumors" from the man's lung mass and from healthy tissue and screened various drugs against them. One proved ineffective. Another worked against the tumor but at too high a dose to be safe. The third did the trick.
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A similar approach could let doctors screen drugs for cancer patients.

"What could be more personalized than taking this person's cell, growing it in culture, finding a drug to treat them and then treat them?" said Doug Melton, co-director of the Harvard Stem Cell Institute. The Georgetown method gives an answer quickly enough that it could save lives, he said.

Tyler Jacks, a cancer researcher at the Massachusetts Institute of Technology and former president of the American Association for Cancer Research, said the next step is to show that this could work for many different cancers and that it leads to better outcomes in patients.

The National Institutes of Health paid for much of this work and has already sent research teams to Georgetown to learn the method. About a dozen other universities have done the same, Schlegel said.
So far, his lab has grown prostate, breast, lung and colon cancer cells.
Georgetown University is seeking a patent on the method.

Marilynn Marchione of The Associated Press wrote this report. Malcolm Ritter contributed from New York.

African mice give clue to 'self-repairing skin'

“‘Scar free healing’ in mice may give clues to human skin repair,” BBC News has reported. The broadcaster says that scientists are interested in figuring out “how the healing takes place and if it could apply to people”.

While some species are known to be able to regenerate their skin and, in some cases, entire body parts, it is thought that this ability is limited in mammals. However, the researchers who carried out this study had heard reports that a particular mouse called the African spiny mouse does have this ability.

The researchers trapped a number of these mice in central Kenya and took them to a laboratory for further testing. They found that the mice have skin that tears away easily, enabling them to escape predators. The mice regenerate the lost skin, and even grow new hair, instead of forming a scar.

The study challenges some of the conventional wisdom surrounding wound healing and regenerative processes in mammals. It is hoped that new understanding of these biological processes could lead to new treatments for skin damage, scalding and burns in humans. But this research is at a very early stage and whether these processes will one day help the regeneration of human tissue remains to be seen.

Where did the story come from?

The study was carried out by researchers from the Universities of Florida, Wyoming and Nairobi. No information regarding the funding was listed in the publication.

The study was published in the peer-reviewed journal Nature.

This research was covered quite appropriately by the media, with the BBC being careful to emphasise that “working out what is happening and then trying to transfer the findings to people is likely to be a long journey”.

What kind of research was this?

This was an animal study that examined the wound healing ability of a specific type of mouse, called the African spiny mouse.

Several animals are able to lose (or ‘autotomise’) sections of tissue or whole limbs in order to escape capture by predators. After this tissue is lost, it is either:

• replaced through regeneration (as when salamanders – a type of lizard – regrow limbs), or
• is gone for good with a scar forming to seal the wound (as seen in most mammals)

This research looked at an unusual example of a mammal – the African spiny mouse – which is capable of regenerating lost tissue instead of simply forming a scar over the wound.

What did the research involve?

The researchers first set out to confirm anecdotal evidence (unverified ‘word-of-mouth’ reports) that the African spiny mouse does indeed autotomise its skin to evade predators. Once they had done this, they then examined the healing properties of these wounds, studying how quickly they healed as well as the processes involved. They also examined exactly how the tissue regenerated.

While most adult mammals are unable to regenerate skin and associated tissue after being injured, previous studies have shown that a few animals (including rabbits) are able to do so. To see if the African spiny mice exhibited the same capability, the researchers punched 4mm holes in the ears of the mice, and examined what types of tissues were regenerated.

What were the basic results?

The researchers found that handling of the African spiny mice often led to the tearing away of skin from the back, resulting in large open wounds. These wounds ranged from small areas to the loss of nearly 60% of the skin from the back. The researchers found that these wounds healed quickly, and that the mouse’s characteristic spiny hairs regrew as well, completely covering the wound.

When examining the wound healing process, the researchers found that, as with wound healing in other mammals, a scab formed quickly and bleeding stopped. However, new cells called epithelial cells formed on top of the wound after three days, more quickly than seen in other adult mammals. Also, as is seen in other rodents, the wound healed mainly by contracting, or shrinking the wound size. After 17 days, 95% of the wound closure had been due to this contraction of the tissue.

This is unlike other species, in which a thick web of collagen is laid down over the wound in order to seal it off and protect the body from infection, resulting in scarring. Because the mouse skin healed so quickly, less collagen was deposited, resulting in no visible scarring.


When they examined tissue regeneration after the loss of skin from the back, the researchers found that new skin cells and hair follicles (the cells embedded in the skin, from which hairs grow) were also regenerated in the deposited sections of collagen.

The African spiny mice were able to regenerate the lost ear tissue, growing new skin, hair follicles, fat cells, muscle and cartilage instead of forming scars. This finding was similar to previous results in rabbits.

Finally, during the ear experiment, the researchers found evidence to suggest that the tissue regeneration was due to the formation of a blastema, which is a group of cells that are responsible for the regrowth of lost limbs in salamanders.

How did the researchers interpret the results?

The researchers say their results suggest that the African spiny mouse uses a balance of scarring and tissue regeneration in wound healing. They say this “indicates that mammals may have a higher capacity for regenerations than was previously believed”.

Conclusion

This was an early stage animal study that describes an unusual phenomenon in mammal wound healing and provides a basis for future studies. These studies are likely to investigate the molecular processes that underpin the skin and hair regeneration in the African spiny mouse.

The researchers say that future investigations will focus on how the mice are able to control scar formation, and that this may “shed light on how regeneration and scarring can be balanced in the face of infection and inflammation”. They also say that this should allow for further research into tissue regeneration in mammals, and that the African spiny mouse may prove quite useful in finding ways to promote tissue regeneration instead of scarring.

When the molecular pathways that underlie the wound healing processes seen in African spiny mice are more thoroughly understood, researchers may begin to study whether they can be applied to wound healing and regenerative medicine in people. However, it is likely to be a long time until this intriguing piece of research leads to medical applications.

Scar free healing' in mice may give clues to human skin repair, says study

Mice with brittle skin, which tears off in order to escape predators, may offer clues to healing wounds without scarring, according to US researchers.

 Some African spiny mice lost up to 60% of the skin from their backs, says the study published in the journal Nature.

Unlike wounds in other mammals, the skin then rapidly healed and regrew hairs rather than forming a scar.

Scientists want to figure out how the healing takes place and if it could apply to people.

Salamanders, some of which can regrow entire limbs, are famed for their regenerative abilities. It has made them the focus of many researchers hoping to figure out how to produce the same effect in people.

 Mammals, however, have very limited ability to regrow lost organs. Normally a scar forms to seal the wound."

This study shows that mammals as a group may in fact have higher regenerative abilities then they are given credit for," said Dr Ashley Seifert from the University of Florida.

Regeneration hub 

 As well as rapid skin healing, the mice were also able to heal large circular holes punched in their ears - they regenerated hair follicles, sweat glands and cartilage.

Tests showed the mice produced a "regeneration hub" known as a blastema in order to repair the injury. It is this bundle of stem cells that is also used by the salamander to rebuild missing body parts.

Dr Seifert told the BBC: "It is thought that one of the main constraints on regenerating appendages in humans, or mammals for that fact, is the failure to form a blastema."

He wants to investigate how the structure forms in these mice.

Another difference was in the web of proteins that holds cells in place - the extracellular matrix.

He said: "These mice appear to deposit extracellular matrix into their wounds at a slower rate than mice, pigs or humans.

"Although many scienctists are trying to speed up the healing process, our studies on spiny mice and salamanders show that slowing things down is the path towards regeneration."

 However, working out what is happening and then trying to transfer the findings to people is likely to be a long journey.

 Commenting on the study, Elly Tanaka, from the Technische University Dresden, said: "These studies suggest that the pathways leading to regeneration, at least of the skin, that are normally associated with amphibians are also accessible in mammals."

She added that harnessing the process "in a controlled manner in other wound situations may help to promote scarless healing.''

Popping pills for sleep may be bad for health

London: Popping pills to overcome insomnia may not be good for your health in the long run.

 For instance, eight out of 10 cases of insomnia were caused by underlying health problems, either physical or mental, that should be addressed, according to the Royal Pharmaceutical Society.

Attempting to treat sleeplessness without tackling its root cause was potentially dangerous. Causes of insomnia can include asthma, heart disease, anxiety or depression, the society said.

 A survey of 2,077 adults found 51 percent of insomniacs had bought over-the-counter sleeping remedies without seeking advice from a doctor or pharmacist beforehand. Three in 10 said they had taken them for more than a month without advice, and a further 14 per cent for over six months, the Telegraph reports.

Paul Johnson, a community pharmacist, said: "It`s worrying that so many people are over-using sleeping remedies. They can be effective for short-term treatment of mild insomnia but should not be taken for long periods without advice because they can hide a serious health problem which could get worse if it remains untreated."

He said there were a number of simple techniques people could use to get a better night`s sleep, including going to bed and getting up at the same time each day, avoiding caffeine and alcohol in the evenings, and eating heavily late.