The Truth Behind "Blue Zones"

For years, different diet trends and fads have appeared and been debunked. There is a continuous cycle of different recommendations because of the belief that diet is vital in achieving extreme old age. People are so invested in discovering the secret to living a long life that they have sought "Blue Zones." These are regions where people supposedly live longer due to healthy eating habits. However, recent research suggests that the data connected to extreme human aging needs to be revised. 

A study published in the American Journal of Health Promotion highlights the critical role of diet in preventing chronic diseases and supporting long-term health. It reinforces the idea that dietary patterns, such as the Mediterranean diet, which is rich in vegetables, olive oil, and lean proteins, are essential for longevity. The research suggests that a nutrient-dense, balanced diet can significantly reduce inflammation, enhance heart health, and prevent obesity, all contributing to a longer and healthier life.

However, Saul Justin Newman, a researcher at University College London, questions these popular narratives around extreme aging. In his analysis, he highlights how the data on centenarians in these "Blue Zones" are often unreliable because of poor record-keeping and pension fraud. Newman points out that many of the centenarians in Okinawa, Japan, were found to have been dead for years but are still listed as alive due to unregistered deaths. Similar issues were found in European regions like Sardinia and Ikaria. 

So the question is, how accurate are these claims about the "Blue Zone" diets, and can diet alone explain long lifespans? Is longevity more complicated, and is it also reliant on factors like wealth and healthcare? Newman's research suggests that while diet plays a role, the focus should also be on socioeconomic status and healthcare systems that allow people to thrive into old age. More financially stable people have better access to healthcare and a lifestyle that enables them to be less stressed, allowing them to live longer​. 

Although diet is important, more research and stricter research parameters are needed to analyze human diets and determine what can help with human aging. Researchers must also consider a more comprehensive array of dietary factors to understand what promotes human longevity.

UCL. (2024, September 16). Analysis: ‘The data on extreme human ageing is rotten from the inside out.’ UCL News. https://www.ucl.ac.uk/news/2024/sep/analysis-data-extreme-human-ageing-rotten-inside-out

Buettner, D., & Skemp, S. (2016). Blue Zones: Lessons From the World's Longest Lived. American journal of lifestyle medicine, 10(5), 318–321. https://doi.org/10.1177/1559827616637066

Do you have brain fog? You’re in luck!

 Do you have brain fog? You’re in luck!

Research suggests that intermittent fasting is a significant way to increase your cognitive abilities. The brain is always in need of high energy nutrients. So, when fasting takes place for about 12 hours, the body will use its glycogen deposits in the liver and instead ketone bodies will be released into the blood. The body switches from using glucose to using free fatty acids from the adipose tissue. This higher concentration will then fuel the brain with several neuroprotective effects. When the switch from glucose occurs, other signaling pathways are activated which will then give these effects from the switch. One effect is lowering the stress created by free radicals in the brain called “oxidative stress”. Another effect is reducing neuroinflammation and also increasing the synaptic function. Additionally, it has been used for effectively treating some brain diseases. (Brocchi, 2022)

These brain diseases involve some forms of epilepsy, Alzheimer’s, and Parkinson’s disease. With these diseases, intermittent fasting and a no carb or sugar diet can significantly slow their development. “Caloric restriction” and intermittent fasting go hand-in-hand to produce the desired results. High in fat and protein, the keto diet and fasting can be very beneficial for improving brain function and restoring long term memory. Testing is still ongoing in mice that shows that the molecule BHB (beta-hydroxybutyrate) will increase when fasting and on keto, so memory decline is prevented. (Quinton, 2024)

However, intermittent fasting and the keto diet cannot be overly used or used long-term. If they are abused then they will throw the body off of balance after a while and cause low blood pressure, malnutrition, and fatigue. These are obvious symptoms that can be avoided if fasting and dieting are done in correct intervals depending on the person. Fasting and dieting in this manner should be done with regards to the health and history of each individual. Additionally, the body needs glucose for many significant functions and can never fully rely on no-sugar or carb diet.

Brocchi, Alex, et al. “Effects of Intermittent Fasting on Brain Metabolism.” Nutrients, vol. 14, no. 6, 17 Mar. 2022, p. 1275, https://doi.org/10.3390/nu14061275.

Quinton, Amy M. “Keto Diet Prevents Early Memory Decline in Mice.” UC Davis, 19 Mar. 2024, www.ucdavis.edu/health/news/keto-diet-prevents-early-memory-decline-mice.

Preventing Stress... With a Vaccine?

At this point in our lives, we are no strangers to stress. We know that in some ways acute or short term stress can be good, while chronic or long term stress can be harmful. In particular, chronic stress can cause harmful declines in health, and limit an individual’s life expectancy. More specifically, stress can cause the death of neurons in regions of the brain that are involved in memory such as the hippocampus and may even worsen damage from a stroke. Chronic stress also has a negative impact on our immune systems as it compromises our wound healing processes and makes us more susceptible to infections, limiting our bodies expected reactions to vaccines. Other than the direct impacts chronic stress has on our bodies, it is also often linked to systemic diseases such as obesity, type 2 diabetes, atherosclerosis, and hypertension. Knowing that chronic stress can be harmful to our bodies, what if we were able to prevent the negative impacts of it using a vaccine?

Glucocorticoids (GCs) are often used to combat the adverse effects caused by chronic stress in the stress response and in many ways can be used to mediate or prevent the effects of stress. On the other hand, increased levels of GCs can have detrimental effects and cause interruptions in the normal pathways and stress responses our body has. Using knowledge about GCs and the stress response, Drs. Sapolsky and Steinberg at Stanford University researched and created an “inducible vector system” that would block the damaging effects of GCs by turning them into protective signals ultimately enhancing the survival of neurons. There are other versions of this vector system that would be activated by oxygen deprivation or reactive oxygen species, releasing neuroprotective factors to each process that could result in injury or damage to the brain. The application of this vector system has not been applied to humans and has been researched in cell cultures and thought of hypothetically, yet it has coined the term “stress vaccine” as it would be a preventative counter to the effects of chronic stress if injected into a body. 

I am curious to see what you all think about the possibility of a “stress vaccine?” Is it necessary, and would it help? I am a bit torn as I feel that there are other ways to limit stress such as meditation, exercise, and other well known techniques to reduce stress. However, for individuals who stress may impact most, such as the alphas like we examined in class, or individuals experiencing homelessness or poverty, having the ability to receive direct help towards the effects of stress would lift a heavy weight off of their minds. Overall, would a “stress vaccine” be ethical to use and in what ways would it work?

Resource:
Ladd, J. M., & Ungar, L. D. (2012). An ethical take on the "stress vaccine". The virtual mentor : VM, 14(1), 60–67. https://doi.org/10.1001/virtualmentor.2012.14.1.oped2-1201

Sophia:)

"Ethically Impossible"

     Warning: the following blog may be disturbing.

    Throughout history, we have heard of many inhumane scientific studies such as The Little Albert Experiment, The Milgram Experiment, and The Stanford Prison Experiment.  One event in history that you may not have heard about is The Guatemala Sexually Transmitted Diseases Experiment that took place from 1946 to 1948. These experiments were conducted majorly by the US Public Health Service in Guatemala and were hidden for almost 60 years until a historian, Dr Susan Reverby, at Wellesley College in Massachusetts, discovered the studies while researching the Tuskegee studies of untreated syphilis (Zenilman, 2013). One of the main sexually transmitted infections that was being researched in Guatemala was also syphilis. 

    Syphilis is a bacterial sexually transmitted infection that if left untreated can cause serious health issue (Syphilis, n.d.) One of the serious health issues that syphilis can cause is meningovascular syphilis, which can occur within the first few months after infection. Symptoms of meningovascular syphilis include headache, stiff neck, nausea, vomiting, loss of vision or hearing, and stroke. During the Guatemala syphilis experiments, one of the physician's (whom I will not name) goals was to establish a human experimental model of secondary syphilis. Secondary syphilis being syphilis that has spread throughout the body, possibly turning into meningovascular syphilis. This was attempted through an injection of syphilis directly into the cerebrospinal fluid of participants. The majority of participants being mental patients, prisoners, Guatemalan Indians, and orphans. If one of the participants were to develop meningovascular syphilis, the syphilis bacteria would invade the brain and spinal cord through the cerebral spinal fluid (CSF) causing inflammation of the meninges arterial walls thus causing thrombosis and stroke (Neurosyphilis, n.d.). 

    Overall, 1,308 participants were enrolled in these studies. Although the physician who conducted these studies claimed that every participant was later treated for the infection, documentation found that only 678 participants (52%) were treated (Zenilman, 2013). Studies such as the one described do not serve any purpose other than to show us how twisted and horrible scientific studies can be if we do not take ethics into consideration. For the Guatemala studies mentioned, there was physical evidence that the physician's involved knew this was inhumane and wanted to keep these studies hidden. Had it not been for Dr Susan Reverby, these documents may have never been discovered. Although in 2010 President Barack Obama issued a public apology to the country of Guatemala, and deemed these studies "Ethically Impossible" it does not take away from the fact that these studies should have not been conducted in the first place. Ultimately, the Guatemala syphilis studies were inconclusive and did not produce any useful medical information. 

Zenilman, J. (2013). The Guatemala Sexually Transmitted Disease Studies: What Happened. Sexually Transmitted Diseases, 40(4), 277–279. https://doi.org/10.1097/OLQ.0b013e31828abc1b

Syphilis. (n.d.). Retrieved October 7, 2024, from https://www.who.int/news-room/fact-sheets/detail/syphilis

Neurosyphilis: What It Is, Types, Symptoms & Treatment. (n.d.). Cleveland Clinic. Retrieved October 7, 2024, from https://my.clevelandclinic.org/health/diseases/24772-neurosyphilis

Can you Handle the Heat?

 With the constant rising temperatures, it is important to listen to our bodies and understand how our nutrition and supplements impact us. Dizziness, delirium, headaches, vomiting are common symptoms one feels when heat starts impacting us. We are often told that as long as we stay out of the sun and hydrate our bodies can regulate our internal temperatures but what happens when our supplements or medication cause our body to misunderstand information.

Patients with common medications such as antipsychotics or cardiovascular medication have been hospitalized at higher rates for heat related symptoms such as the ones mentioned above. Although the direct mechanism is still unknown in regard to the different medication available, information such as body’s fluid levels and sweat production are know to be the direct link. In the article it states, “Chlorpromazine an antipsychotic used to treat psychiatric condition including schizophrenia is one example… the medication can suppress sweating and divert blood flow away from the skin”. This shows that the blood flow regulation and change can impact the normal flow and pattern of our physiology.

There are many challenges when studying heat regulation symptoms due to the variation of temperatures and heat tolerance. The impact of underlying condition also further make studying the relationship more difficult due to not having a control group such as a healthy individual due to the inability to predict how an individual with the disease may react to the medication or heat test.

This is brought concern as many patients wonder if their drugs are to be stopped or changed. Despite the significant increase in heat stress risk there has been no true evidence to indicate the termination of drugs within patients due to the amount of factors that contribute to someone’s inability to regulate their body temperature such as age, preexisting conditions and medications.

This bring me back to the idea of listening to our bodies and taking extra measures to really care for not only ourselves but those around us. Especially being that we still have so much which is not understood both in terms of medicine and interpersonal relationships.

Jesús, Erin Garcia de. “Your Medications Might Make It Harder for You to Beat the Heat.” Science News, 13 Aug. 2024, www.sciencenews.org/article/heat-medicine-disease-climat-change. 

CTE and the Dangers of Contact Sports

As an avid sports fan, I have to admit that I love watching the NFL. The thrill of cheering on your favorite team and seeing your favorite players develop into superstars is one of the greatest feelings ever! However, there is a growing concern for the well-being and future of many athletes. Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease caused by repeated head injuries. These injuries create microscopic bleeding and protein deposits called tangles that damage the structural integrity and function of the brain. The symptoms of CTE often occur well after a person has stopped playing. Symptoms can include memory loss, impulsive behavior, anxiety, depression, executive dysfunction, and suicidal thoughts. Symptoms often get more severe as the disease progresses and the frightening part is that there is no way to confirm or diagnose CTE until after death. 

     

The topic of CTE came into my mind while I was watching the Miami Dolphins play against the Buffalo Bills on September 12, 2024. Near the end of the game, the quarterback of the Miami Dolphins, Tua Tagovailoa, had a scary collision where he displayed an abnormal posturing position after the impact. Tua left the game diagnosed with a concussion and has been on the injured reserve ever since. This was not the first time that this had happened to Tua and many people in the media urged him to retire. Many reports say that Tua Tagovailoa does not want to quit, but the NFL and the league's chief medical officer, Allen Sills MD FACS, have the final word. Right now, there is still no clear direction to where Tua is headed.

    

The case of Tua Tagovailoa is a more extreme and clear example of repetitive head trauma that was nationally televised. It is crucial to shed light on all the NFL players and other athletes competing in high-contact sports. Many years of playing the sport, practicing, and competing at different levels, exposes repetitive head trauma, which could lead to adverse consequences for the athletes. There is still much research required for this disease, such as looking for a definitive way to diagnose CTE while a person is still alive, or looking at technology that could reduce the impact of high-contact sports. It is necessary to begin this discussion on high-contact sports and the long-term health of athletes. What are your thoughts? Should we place harsher regulations on contact sports?

Sources: 

Els, L. C. (2024, March 28). What is CTE? Understanding chronic traumatic encephalopathy. Harvard Health. https://www.health.harvard.edu/mind-and-mood/what-is-cte-understanding-chronic-traumatic-encephalopathy 

Seifert, K. (2024, October 4). NFL will not have role in Tua Tagovailoa’s potential return - ESPN. ESPN.com. https://www.espn.com/nfl/story/_/id/41607477/nfl-not-role-tua-tagovailoa-potential-return

Stern, R. A., Riley, D. O., Daneshvar, D. H., Nowinski, C. J., Cantu, R. C., & McKee, A. C. (2011). Long‐term consequences of repetitive brain trauma: chronic traumatic encephalopathy. PM&R, 3(10S2). https://doi.org/10.1016/j.pmrj.2011.08.008

Els, L

Els, L

Can Stress Actually Age You?

Stress is often considered an inevitable part of life, but what if its impact goes beyond feeling overwhelmed? Research from a review called "Stress Hormones: Unveiling the Role in Accelerated Cellular Senescence" suggests that chronic stress may accelerate aging at the cellular level. Stress hormones like cortisol play a critical role in speeding up cellular senescence, the process where cells lose the ability to divide and grow, entering a state of arrested function. While cellular senescence is a natural part of aging, prolonged exposure to stress can accelerate this process, leading to inflammation, tissue damage, and age-related diseases.

What's concerning is that senescent cells can secrete harmful substances that damage nearby healthy cells. This is primarily driven by cortisol. In short bursts, cortisol can be a good thing because it helps manage the body's fight-or-flight response. However, under chronic stress, the continuously elevated levels can be linked to an accelerated rate of cellular aging. Cortisol activates inflammatory pathways, such as the p38 MAPK and NF-κB pathways, which increase oxidative stress and DNA damage, pushing cells into senescence. Senescent cells, in turn, release pro-inflammatory molecules that contribute to senescence-associated secretory phenotype (SASP), further promoting tissue damage and dysfunction. Not only does this mechanism accelerate aging, but increases the risk of diseases like Alzheimer's, cardiovascular issues, and cancer.

A critical factor in this process is the shortening of telomeres, the protective caps at the ends of chromosomes (chromosomes are used to carry genetic information). Chronic stress speeds up telomere shortening, limiting the cell's capacity to divide and regenerate. Shortened telomeres are a known sign of aging, contributing to the overall decline of tissues and organs.

However, anti-inflammatory treatments, which help preserve telomere length, and stress-management techniques like meditation and regular exercise can help mitigate the impact of chronic stress. By actively managing stress, you can slow cellular aging and improve your long-term health. Just remember stress doesn't just affect your mood, but it impacts your entire body. So, the next time you feel overwhelmed, remember that taking care of yourself not only helps you feel better in the moment but also protects your long-term well-being. You have the power to slow down the aging process and improve your health by managing your stress.

Qin T, Chen T, Ma R, Li H, Li C, Zhao J, Yuan J, Zhang Z, Ning X. Stress Hormones: Unveiling the Role in Accelerated Cellular Senescence. Aging Dis. 2024 Aug 18. doi: 10.14336/AD.2024.0262. Epub ahead of print. PMID: 39226159.

The Gut-Brain Connection: A Pathway to Resilience Against Stress

    In recent years, the connection between our gut health and mental well-being has gained significant attention. Central to this discussion is the concept of the microbiome-gut-brain axis (MGBA), which refers to the complex communication network linking our gut bacteria, the gut, and the brain. This relationship plays a crucial role in how we respond to stress and our overall mental health.

    Stress is a common experience that can lead to anxiety and depression. However, not everyone reacts the same way to stress as some individuals are more resilient than others. This resilience may be influenced by various factors, including our gut microbiota, the trillions of microorganisms living in our gut. Emerging research suggests that these gut bacteria can affect our mood and stress responses, potentially offering a pathway to strengthen our resilience to stress. The study by Bear et al. (2021), cited below, underscores the importance of understanding this relationship. It reveals that stress can alter the composition of gut bacteria, which in turn may impact our emotional state. For instance, certain beneficial bacteria, such as Lactobacillus and Bifidobacterium, have been linked to improved mood and reduced anxiety levels. Conversely, stress-induced changes in gut microbiota can lead to an increase in harmful bacteria, which may cause feelings of anxiety and depression.

    Why does this matter? Understanding the MGBA could open new avenues for treatment options. Instead of solely relying on traditional therapies, incorporating probiotics or dietary changes to promote a healthy gut microbiome might help individuals cope better with stress. This approach could be particularly beneficial for those experiencing chronic stress or those who are more susceptible to mood disorders.

Bear, T., Dalziel, J., Coad, J., Roy, N., Butts, C., & Gopal, P. (2021). The microbiome-gut-brain axis and resilience to developing anxiety or depression under stress. Microorganisms, 9(4), 723. https://doi.org/10.3390/microorganisms9040723

Don’t Rub Your Eyes!

Keratoconus, Are you in any danger? 

Keratoconus is defined by an irregular thinning and bulging out the cornea. The cornea is the first lens that bends and focuses the light when it first enters the eye. It works with the lens on the inner portion of the eye to enable us to see clearly. Thus a thinning and bulging of the cornea causes some major issues in vision of those affected. 

Is there anything it can do to you?

The cone effect can also cause an irregular astigmatism that warps the surface of the eye and is unable to be corrected. It can also cause a higher dependence on near vision as the eyes become more cone shaped. 

Treatments 

Until keratoconus is severe there are more management options for patients such as needing rigid gas permeable contacts or scleral contacts instead of soft contacts or corneal collagen cross linking. Advanced stages of keratoconus may also require corneal transplants about 20% of the time. 

Causes:

Eye rubbing, chronic contact use, exposure to UV rays, if you have many allergies are environmental factors that increase your likelihood of keratoconus. 

Genetic component: There is also a genetic inheritance factor that is not fully understood. There are several gene regions that are known to affect different ethnicities. Once a family that shows keratoconus heritability they have to look for specific genes that repeat in those who have keratoconus but aren't as common in those not diagnosed. Due to the candidate genes being so large they really have to narrow down what they are looking for genetically which can become complicated and expensive to reproduce in knockout mice for example. 

Successful genetic links:

Interleukin 1 receptor antagonist (IL1RN) and solute carrier family 4 member 11 ( SLC4A11) genes have been seen with a higher frequency in keratoconus family members than those without the diagnosis. 

There are several studies that have found changes in the mitochondrial DNA relate higher in association with keratoconus due to increased oxidative stress. This problem is especially relevant due to the corneas exposure to UV light which increases the rate of the redox reactions.

Ask not what your body and do for you but what you can do for your body!

While we can not change our genetic predisposition to keratoconus, we can be mindful about how we take care of our corneas. This means not rubbing our eyes or if you must raise corneas up or down rub the sclera to avoid damage to one of the most important parts of your eye.  

Wearing ultraviolet protective sunglasses just like you should do for your skin, your eyes need it too. Translucent UV protective layers are also available at most eye glasses and lastly eat antioxidants to reduce redox reactions in the body!

Links to the case study and more basic information about Keratoconus

https://doi.org/10.1007/s00438-016-1283-z

https://my.clevelandclinic.org/health/diseases/14415-keratoconus

Altitude matters! did you know where you grew up might affect your levels of hemoglobin?

 I was born and raised in Colombia a country in South America which is very near to the equator, I moved to Denver around seven years ago, I remember that a couple of years ago after having routine tests ran on my blood, my primary care giver saw something unusual on my results, very elevated hemoglobin levels. After careful consideration they decided to send me to Anschutz's oncology wing, after more tests and a little scare, hematologists explained to me that the elevated levels of hemoglobins in my blood where thanks to where I grew up, since the moment I moved to colorado the drastic change in altitude caused my body to adapt to the altitude and the lack of oxygen by producing higher amounts of hemoglobin in my blood.

did you know that Hemoglobin levels increase in response to higher altitudes primarily due to the body's adaptation to lower oxygen availability?. At elevated altitudes, the reduced oxygen pressure prompts the body to enhance its oxygen-carrying capacity through increased production of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. This rise in red blood cell count leads to higher hemoglobin levels, improving oxygen transport throughout the body. But this higher levels are not only seen in South American people that move to states like Colorado, Notably, populations from South America, particularly Andean highlanders (the highest mountains), exhibit a more pronounced increase in hemoglobin levels as well compared to other ethnic groups. This adaptation is influenced not only by environmental factors but also by genetic traits specific to these populations, allowing them to thrive in high-altitude conditions with greater oxygen efficiency.

Elevated hemoglobin levels, particularly in high-altitude populations , can have significant health implications. While increased hemoglobin improves oxygen transport, it may lead to chronic mountain sickness , This can strain the heart and complicate oxygen delivery to tissues. In pregnant women, improper hemoglobin monitoring can affect maternal and fetal health. Moreover, using standard reference ranges without considering altitude can result in misdiagnosis of anemia which I found interesting taking into consideration that this is what almost happened to me. All of this information further proves that understanding the variability in hemoglobin levels among different ethnic groups is crucial for accurate health assessments and effective management strategies. 

References:

Gassmann, M., Mairbäurl, H., Livshits, L., Seide, S., Hackbusch, M., Malczyk, M., Kraut, S., Gassmann, N. N., Weissmann, N., & Muckenthaler, M. U. (2019). The increase in hemoglobin concentration with altitude varies among human populations. Annals of the New York Academy of Sciences, 1450(1), 204–220. https://doi.org/10.1111/nyas.14136

Stressed even in your Dreams? Here's Why!

Have you ever been stressed about something right before going to bed and then find yourself still stressed while dreaming? Whether it's an exam, a family conflict, an upcoming sport's game, or just a really demanding homework problem, it is not uncommon to fall asleep thinking about these things and dream about it. Here's why. 

One area of study is that when one is in REM (rapid eye movement) sleep, acetylcholine is often alone when monitoring brain activity while we are in such a state. However, it has been seen that corticol levels can be as high in a sleeping state as they were in an active state. So, if one goes to bed with high levels of stress it can then translate to higher levels of stress when one is asleep, and even when one is sleeping. 

Another area or scope of study is looking considering that the brain can be in different states of sleep. REM sleep is one that is largely talked about and this is typically the state in which an individual will dream. The second state, is NREM (non-rapid eye movement) sleep. In this state the individual is entering deep sleep. So, essentially this area of study is taking into consideration that different parts of the brain can be in these two stages at the same time. This would explain how an individual is able to sleepwalk (but that's for another day!). If an individual is experiencing both of these at the same time, it could potentially lead to these two stages not necessarily being exclusive and potentially allowing the individual to experience stress while still in the dream state (REM sleep). 

Now, here are some ways you can hopefully avoid being stressed out even in your dreams:

1. Spend time relaxing and preparing yourself for bed. 

2. Practice relaxation/meditation techniques.

3. Avoid exposing yourself to the thing that is making you stressed right before going to bed. 

4. If you wake up because of the dream, don't check the clock or your phone and try to practice the meditation techniques. 

5. If you cannot go back to sleep, get out of bed and try to find something boring to do (funny right?); this will help your brain activity to decrease and essentially lull you back to sleep.

This topic is still being heavily researched and it isn't clear if there is a singular reason why an individual can experience stress even in their dreams. However, if you're someone who experiences these kinds of dreams, hopefully something here will provide some kind of answer or even some tips on how to manage your stressful dreams. 

Resources:

https://health.clevelandclinic.org/stress-dreams-why-do-we-have-them-and-how-to-stop

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814941/

Investigating Traumatic Axonal Injuries

    Traumatic axonal injury (TAI) is a form of a traumatic brain injury where there is shearing to the white matter neurons. Damages to these neurons can lead to neurological, psychological, and or cognitive deficits, and this type of injury most commonly occurs in the corpus callosum, the midbrain, and the space between white matter neurons and gray matter neurons. The identification of TAIs is of great importance for the care of the patient and for forensic purposes. Through the use of various techniques, TAIs can be better identified and understood. 

    Typically, in trauma related injuries to the head, a CT scan is procedural in order to visualize any internal damage or abnormalities as a result of the trauma. CT scans are ideal for this as they tend to be fast scans and they are more accessible to most patients. Additionally, this type of scan can help in determining the treatment path for individuals. This can include, a more extensive laboratory work-up, or other types of imaging. When it comes to TAIs, in many cases, a hemorrhage visualization on a CT scan can point towards a TAI. However, the mechanical parameters of a CT scan present as a challenge when attempting to visualize TAIs due to their complexity. For this reason, obtaining an MRI might prove to be more effective.

    MRI scans are a good method of imaging particularly when a patient begins to decline unexpectedly. and they become more critical. Due to their mechanical sensitive, MRIs are better for detecting TAIs, and there are various MRI techniques that can better localize the damage and improve diagnosis. One of those techniques is known as fluid-attenuated inversion recovery (FLAIR). This MRI imaging technique is most effective in visualizing injuries that are near accumulations of CSF such as areas around the ventricles. This is done by decreasing the signal that is produced by CSF, and in doing so, contrast is reduced (Kates et al., 1996). Another type of MRI imaging technique is known as diffusion weighted imaging (DWI). This particular technique utilizes contrast to further examine molecular function and composition of structures (Baliyan et al., 2016). This also includes analyzing the amount of water molecules within the brain. Susceptibility Weighted Imaging (SWI) is considered the most effective imaging technique as it focuses on portions where there is a hemorrhage since they appear less dense. Other techniques such as diffusion tensor imaging, analyzing places where there is water blockage which is indicative of a TAI, tractography which recreates bundles of nerves to visualize damage, and spectroscopic MRI which looks at changes in the chemistry within the brain, are all various ways to attempt to diagnose a TAI. When it comes to TAI, imaging is useful for determining the care of the patient and the next steps. However, not all of these imaging techniques are give to patients with suspected TAIs all the time. A CT will be the first step and if there are any changes to the patient's health then an MRI will be considered. What makes diagnosing TAIs challenging is they are used to assess how severe a traumatic brain injury (TBI) might be. A patient will not be directly diagnosed with a TAI, instead, the finding of a TAI can indicate a severe TBI, yet there are different methods to measure that. 

    In addition to imaging, there are also certain tissue staining techniques that can be used to identify a TAI. The only challenge is it can only be done after someone has passed away, and typically this is done in an attempt to confirm the presence of a TAI. In a TAI, due to the damage to the axon there are problems with molecular transportation along the axon. Additionally, it also very characteristic of a TAI to have a breakage of bundles within the axon with causes the process to retract to the cell body, forming a retraction ball. There is then demyelination that occurs as the lesion worsens. This can be observed with immunohistochemical staining. Due to the trauma to the axons, there is an increase in amyloid protein precursor (APP) as this protein is involved in helping with neuronal repair. To visualize, a APP Beta immunostaining can occur. 

    Although modern imaging and tissue staining have been effective in identifying a TAI, they still are not effective in determining the mechanisms that led to a TAI. This challenge also arises as TAIs are complex, so determining their mechanisms are also hard. If however, TAIs are thought of as a risk for a more severe head injury, then a finite element (FE) model, which uses information such as brain strain and stress to predict a mechanism. It is important to note that this model will use stressors and strains related to any tension, shearing, or compression not only to at the level of the cortex but also at the axonal level. In general, there must be some deformation to the tissue and based on the damage, a percentage relating to the damage can be derived. This ultimately will be used to mathematically determine a TAI and predict a mechanism mainly by considering it as a risk. Using this technology, in combination with imaging, it allows for personalization of models where the brain geometry and mechanisms are considered, resulting useful in determining the cause of a TAI. 

    TAIs can be complex to analyze as it can be hard to diagnose or visualize them; however, using the right imaging, their identification can help to improve patient care and treatment. In combination with mathematical models, it is also possible to determine a mechanism when it might not be clear. 

References:

Baliyan V, Das CJ, Sharma R, Gupta AK. Diffusion weighted imaging: Technique and 

    applications. World J Radiol. 2016 Sep 28; 8(9):785-798. Doi: 10.4329/wjr.v8.i9.785.

    PMID: 27721941; PMCID: PMC5039674.

Delteil, C., Manlius T., Bailly, N., Godio-Raboutet, Y., Piercecchi-Marti, M. -D.,

    Tuchtan, L. Hak, J-F., Velly, L., Simeone, P., & Thollon, L., (2024). Traumatic axonal

    injury: Clinic, forensic, and biomechanics perspectives. Legal Medicine, 70. 

    https://doi.org/https://doi.org/10.1016/j.legalmed.2024.102465.

Kates R, Atkinson D, Brant-Zawadzki M. Fluid-attenuated inversion recovery (FLAIR):

    clinical prospectus of current and future applications. Top Magn Reson Imaging. 1996

    Dec;8(6):389-96. PMID: 9402679.

Endocrine Connection to PCOS

Polycystic Ovary Syndrome (PCOS) is known as a highly prevalent disorder, characterized as the single most common endocrine-metabolic disorder in reproductive-aged women. If this is the case, why is it commonly underdiagnosed and misunderstood? PCOS is a disorder affecting the endocrine and reproductive systems. More specifically, it is a hormone imbalance in the ovaries, creating excess hormones. When this is the case, the ovaries produce incredibly high levels of androgens, commonly known as the male sex hormone. This results in a hormone imbalance. These high levels of androgens restrain the ovaries from releasing eggs and lead to irregular menstrual cycles, acne, obesity, and excessive hair growth (facial/body) in women.   

Most patients with PCOS experience oligo-anovulation, characterized by menstrual cycles longer than 35 days, which is linked to ovulatory dysfunction. It is the first reason for female infertility and often includes other etiologies. 

 

Alongside these symptoms, insulin levels increase due to the release of androgens. The majority of patients presented with PCOS have demonstrated chronic insulin resistance. This insulin resistance makes patients with PCOS more likely to have Type 2 diabetes mellitus. In addition to Type 2 diabetes mellitus, metabolic syndrome increases, leading to an increased risk for cardiovascular disease. 

 

Overall, PCOS demonstrates a reduced quality of life, showing an increased risk for anxiety, depression, and other mood disorders. PCOS disorder commonly remains underdiagnosed, and within the clinician community, it is needed to be better understood, educated, and knowledgeable. Future and current clinicians should be able to understand the pathophysiology, diagnosis, and treatment within the female reproductive age group.

 

Azziz R. (2018). Polycystic Ovary Syndrome. Obstetrics and gynecology, 132(2), 321–336. https://doi-org.dml.regis.edu/10.1097/AOG.0000000000002698

Supernumerary Kidneys

  According to Rehder et al. (2019), the term for normally 1, but can be two, additional kidneys are supernumerary kidneys (SK), with the estimated number of occurrences being 1:26,750. Most people, if they have supernumerary kidneys, only have one additional kidney, which is normally on the left side. It is hard to know, however, truly how many people have supernumerary kidneys because unless there are additional problems, people normally do not have the scans needed to reveal the additional kidneys. Some of these problems could include kidney infections or problems with the ureters. Supernumerary kidneys are much rarer than the more common duplex kidneys, with the latter being fused with the regular kidney and having the same blood supply. With the additional kidneys, the ureters, which drain the kidneys, can also have variation, with some ureters joining to the ureter of the kidney below, which is more common, or each kidney having its own ureter. Altogether, to show the rarity of this condition, Rehder et al. (2019) looked at scans of 461,500 people taken between 2000 and 2017 and found 9 with the condition. 

I am very interested in supernumerary kidneys because I was diagnosed with two additional kidneys when I was younger. What led to this diagnosis was that I would constantly have kidney infections, which were caused by a problem in one of my ureters. While my parents don’t remember much of what the doctors told them about the condition, I do have a scan of my four kidneys. Mine are currently all still functioning, which according to the article is pretty rare since only two of the people that they found with SKs had fully functional ones. As well as having two SKs, on one side I have two separate ureters, while on the other side, both kidneys are connected to the same ureter. This article highlights how SKs can have an increased morbidity rate, but it explains further that this increase is normally caused by complications from unneeded surgery due to misdiagnosis because of how rare they are. I almost experienced this, with the first set of doctors misdiagnosing and telling my mom that I had cysts on my kidneys and would die within a year. Luckily, the next doctors discovered the problem and fixed the small issue with my ureter by stretching the tube out at the connection to the kidney. 

Reference:
Rehder, P., Rehwald, R., Böhm, J. M., Grams, A. E., Loizides, A., Pedrini, M., Stühmeier, J., & Glodny, B. (2019). Supernumerary kidneys: a clinical and radiological analysis of nine cases. BMC Urology, 19(1). https://doi.org/10.1186/s12894-019-0522-0

How Fast Do You Really Wanna Be!

    It’s widely accepted that altitude training is highly effective for distance runners. Training at higher elevations allows the body to adapt to lower oxygen levels, significantly enhancing endurance and overall performance. The increase in red blood cell production and improved oxygen delivery to muscles are just a few of the numerous benefits. This strategy has been embraced by many elite athletes seeking a competitive edge.

    Recently, I came across an article that sparked a new perspective. After years of training, I had never considered the impact of sleeping at high elevations while training there as well. The article explored the concept of "training low, living high." While not many places can facilitate this, I learned that Flagstaff, with its elevation just under 7,000 feet, is nearly ideal for distance training. Coach Mike Smith from NAU mentioned that he can drive just two hours to reach about 3,000 feet above sea level, a significant drop from 7,000 feet.

    The premise is that this approach can enhance performance at sea level by increasing red blood cell mass, which allows for greater oxygen transport. Simply put, more oxygen to the muscles equals improved performance. By sleeping at higher elevations, you can stimulate red cell volume while mitigating the challenges of reduced VO2 max and training intensity at altitude (and let’s be honest running at 8,000 feet is tough!).

    This concept resonates with me, though the results can be inconclusive due to variables like diet, sleep, and mental state. I would be very interested in trying this training method if resources allowed for daily travel. As for the secrets behind East African dominance in distance running, that mystery may remain unsolved.

Cited:

Lundby, Carsten & Millet, Gregoire & Calbet, Jose & Bärtsch, Peter & Subudhi, Andrew. (2012). Does 'altitude training' increase exercise performance in elite athletes?. British journal of sports medicine. 46. 792-5. 10.1136/bjsports-2012-091231.

Is Moisturizer bad for your skin?

Truly it depends on what sort of moisturizers you use, but all moisturizers can change the barrier function of the epidermis. The epidermis is the outermost layer of skin that protects and hydrates our body. Moisturizers are made up of many things but i believe moisturizers that are rich in dimethicone and glycerine are best. My all time favorite is Lubriderm because it has repaired my dry skin like no other and leaves me feeling silky smooth. Especially when I pair it with a white gardenia oil it's quite amazing and is a natural perfume. 

Using moisturizers that are rich in dimethicone and glycerine can thicken the average epidermis by 0.019 mm and can improve the barrier function by reducing permeability and subsequent allergen penetration and sensitization. This allows skin to look younger because moisturizers support optimal enzymatic function, increases ceramide production, and facilitates ideal conditions for commensal microorganisms that repair and help maintain homeostasis of the skin and body. 

Although old age will get us all in the long run, we can reverse the effects of the cruel sun and keep our skin looking extra glowy and brand new for an extra decade by moisturizing everyday and using dimethicone and glycerine in our favor. 

GO BUY MORE LOTION AND OILS TO KEEP THAT SKIN YOUNG GUYS!!!!

Short, R. W., Chan, J. L., Choi, J. M., Egbert, B. M., Rehmus, W. E., & Kimball, A. B. (2007). Effects of moisturization on epidermal homeostasis and differentiation. Clinical and experimental dermatology, 32(1), 88–90. https://doi.org/10.1111/j.1365-2230.2006.02297.x

Jeffrey Rajkumar, Neha Chandan, Peter Lio, Vivian Shi; The Skin Barrier and Moisturization: Function, Disruption, and Mechanisms of Repair. Skin Pharmacol Physiol 13 November 2023; 36 (4): 174–185. https://doi.org/10.1159/000534136