Can your smart watch save your life?

 

                  More and more every day I see ads with wearable technology, including rings, watches, necklaces and glasses. Many of these ads include star athletes from all sports. For example, Cristiano Ronaldo has been seen in ads for the WHOOP band. Boston Celtics star, Jaylen Brown, has also been seen promoting a neckband developed by Hapbee. Hapbee, a company that claims their neckband can elevate mood, boost productivity, and aid with sleep through magnetic waves. Additionally, companies like Apple, Fitbit, and WHOOP claim that their wearable technology can detect abnormal heart rhythms, monitor oxygen levels, and recognize critical situations in which a device can alert first responders. But how reliable are these wearable technologies?

 

            Most of these technologies are focusing on heart rhythms and oxygen levels, using these markers to determine other health metrics such as recovery and sleep. To track heart function, smartwatches use LED light technology that measures the blood volume beneath the skin. As our heart pumps with blood, the amount of LED light that is absorbed changes, allowing the device to estimate heart rate and blood volume. Although these technologies can provide some data on heart metrics, it is a common misconception that these technologies can detect a heart attack.

 

             In general, heart attacks occur when a coronary artery is blocked, cutting the oxygen supply to a certain part of heart muscle. In a hospital, a heart attack would normally be diagnosed using an ECG and blood tests to measure levels of troponin, a protein released when there is damage to heart tissues. These extensive tests are far more advanced than any capability a smartwatch may currently carry. However, while a current wearable technology cannot diagnose a heart attack it can often provide warning signs when measuring pulse and blood volume.

 

            Although, wearable technologies may not provide the same detection that a medical device may, they can still be invaluable in emergency situations. For example, in 2022 a hike in Utah suffered a severe fall while hiking in a remote area. His Apple watch detected the fall and sent his GPS coordinates to first responders, potentially saving his life.

 

            Wearable technologies have become a very common accessory and is trusted by many. Although these technologies do offer functions that allow users to monitor their heart function, potentially saving their lives, they should be used with caution. Ultimately, these technologies cannot currently become a substitute for professional medical care.

 

 

Graham, M. (2024, August 12). The big name athletes investing in Wearable Tech. Boardroom. https://boardroom.tv/the-big-name-athletes-investing-in-wearable-tech/

Lubitz, S. A., Faranesh, A. Z., Selvaggi, C., Atlas, S. J., McManus, D. D., Singer, D. E., Pagoto, S., McConnell, M. V., Pantelopoulos, A., & Foulkes, A. S. (2022). Detection of Atrial Fibrillation in a Large Population Using Wearable Devices: The Fitbit Heart Study. Circulation, 146(19), 1415–1424. https://doi-org.dml.regis.edu/10.1161/CIRCULATIONAHA.122.060291

Microplastics: Should we be worried?

    Throughout high school and college, I would spend my summers working in construction with my dad. Every day before work we would stop at a gas station and purchase 24-pack of bottled water to drink throughout the day. Without fail, we would drink the entire pack in one day. Looking back, I can’t help but wonder how many microplastic particles we must have unknowingly consumed and if it has had or could have any future consequences.  

     Studies have shown that specifically, bottled water, contains high levels of microplastics when compared to regular tap water, with an average of about 300 particles per liter. A different study estimates that the average person consumes around 50,000 microplastics a year! Microplastics are plastic particles that are 5 mm or less. However, when most people think of microplastics they think of its subgroup, nano plastics, which are particles less than 1mm in size. Now the question is, what can these tiny particles do to us?

 

    Once microplastics have entered the body they can travel throughout the body via our blood and even cross cell membranes. In a study published by the journal of Environmental Science and Pollution Research, it was found that accumulation of microplastics in the ovaries of female mice led to a decreased size in follicles and ovaries. The accumulation of microplastics was also found to cause a significant decline in the pregnancy rate and embryo production among the mice, ultimately causing a decline in fertility. Lastly, as microplastic presence increased granulosa cell apoptosis increased, further inhibiting fertility. Granulosa cells are cells of the ovaries that produce hormones and support egg development. Although the study did not include much research on male mice, it is likely that there may be similar results.

    Microplastics have silently infiltrated almost every aspect of our daily lives, even showing up in the air we breathe. While research on the effects of microplastics is still on going, research that is available is pointing towards various ways in which microplastics can be harmful including causing inflammation, hormonal imbalances, and reproductive harm. I encourage everyone to do their part in minimizing these effects by taking preventative steps such as, using glass or metal water bottles, filtering tap water, and supporting legislation that prohibits further microplastic pollution.

Afreen, V., Hashmi, K., Nasir, R., Saleem, A., Khan, M. I., & Akhtar, M. F. (2023). Adverse health effects and mechanisms of microplastics on female reproductive system: a descriptive review. Environmental science and pollution research international, 30(31), 76283–76296. https://doi-org.dml.regis.edu/10.1007/s11356-023-27930-1

Mason SA, Welch VG, Neratko J. Synthetic Polymer Contamination in Bottled Water. Front Chem. 2018 Sep 11;6:407. doi: 10.3389/fchem.2018.00407. PMID: 30255015; PMCID: PMC6141690.

The strength of exercise

Spina bifida is a birth defect which is caused in vitro improper formation of the spinal cord and spine. This birth defect is common within the United States and leads to lifelong complications, it is reported that 7 of every 10,000 children have this condition. The limitations range from mobility to system complications such as cardiovascular complications. Due to the severe limitation and complication it is often extremely difficult to live active lifestyles. This can further cause a significant impact on their quality of life and mental wellbeing. 

The article took adult with spina bifida and did a comparison analysis based off different factions such as age, fitness level, and impairments or limitations. They found that adults who regularly exercised had a lower risk of cardiovascular disease, high cholesterol, and bone density. All of which highly impact spina bifida. 

With early intervention of physical therapy and low impact exercise many patient with Spina bifida have found a improvement in their quality of life. During my internship in physical therapy we had one patient who also had spina bifida and had previously as an infant undergone many surgeries and procedures. Standard exercises were too aggressive and dangerous for him. We chose an alternative route to more aerobic treatment with manual therapy. During my 4 month internship the improvement this patient showed was significant. He first would only use the elevator to our clinic and by the end of my time he had started using the stairs. He also informed us that with the exercise and diet he was able to manage his glucose levels better and was no longer pre-diabetic (about 16 months after start of treatment). By making treatments more accessible and catered to individual needs we were able to showcase beneficence. By catering to his needs we impacted not only his lifestyle but also learned a lot about inclusivity and catering to individual needs. Exercise may not look the same for all but by making slight adjustments the impact may be greater than one could imagine.

Crytzer, Theresa M., et al. “Physical activity, exercise, and health‐related measures of fitness in adults with spina bifida: A review of the literature.” PM&R, vol. 5, no. 12, Dec. 2013, pp. 1051–1062, https://doi.org/10.1016/j.pmrj.2013.06.010. 

Rocky Mountain High Could Cause Psychosis

    As a native of Colorado, who grew up during the legalization of marijuana, I have been fed numerous ideas about the drug. Some say that it will make you go crazy, while others claim that marijuana has no adverse side effects. After all, you can’t overdose on it, right? This smokey cloud of confusion led me to investigate the psychological effects of marijuana, and the results were mixed.

    It turns out that all the wild propaganda of the late 20^th century, depicting marijuana users as losing their minds, is not entirely false. Consistent users of marijuana are twice as likely to develop psychosis, and heavy users are 4 times as likely. The good news is that the psychosis is likely not permanent. A study with 35 patients found that after a psychotic episode, patients who did not continue to use marijuana did not relapse, whereas, patients that continued using the drug saw higher rates of relapse and worse outcomes. It is also worth noting that marijuana use has been found to increase the risk of developing schizophrenia and increase the severity of symptoms for those who already have the disease.

    So we should go back to banning marijuana, right? The answer is not definitive, as it is worth noting that, despite the increased risk, most people who use marijuana will never develop psychosis or schizophrenia. These disorders are genetically linked, and the risk of developing these disorders from marijuana use probably lessens after adolescence. CBD from marijuana has also shown great benefits in helping chemotherapy patients manage symptoms and has been used in other medicinal products. So is that Rocky Mountain High going to give you a psychological disorder? It probably won’t, but there is definitely an increased risk.

Source

Urits, I., Gress, K., Charipova, K., Li, N., Berger, A. A., Cornett, E. M., Hasoon, J., Kassem, H.,     Kaye, A. D., & Viswanath, O. (2020). Cannabis Use and its Association with Psychological     Disorders. Psychopharmacology bulletin, 50(2), 56–67.

Count Meow-t

 Cat scratch Disease

Transmission? Vector born as in the bacteria Bartonella henselae was first expelled by a flea which infected a cat which then can infect a human by scratches bites or even liking a wound. Cats are also often asymptomatic so it is difficult to know a cat is infected prior to your infection. 

How does the disease progress? There is a large latency period of 3 to 10 days for loss of appetite, fatigue, swelling, redness of skin and pus from the natural immune response. 

Close lymph nodes near the infected area can be swollen and infected in one to three weeks. Rarely it can also cause breast masses, endocarditis, osteomyelitis, Neuroretinitis (eye pain) or hepatosplenomegaly. Another study found it caused cysts in the lung and kidneys. 

While generally the bacterial infection can be fought by the body's own natural defenses some risk factors for the more severe complications are age and immunocompromising conditions like HIV. 

Diagnosis- Metagenomic next-generation sequencing can inform a practitioner of the exact bacteria but because the latency period is so long they often have to look for unilateral lymph node enlargement and take a detailed history. They can also test the lymph for the bacteria, 

Doxycycline and azithromycin are effective medications for this bacterial infection if you are having trouble fighting the infection. 

Knowledge of this disease is essential because an insignificant scratch can cause weeks of issues all of which are hard to diagnose if one interaction with a cat if forgotten about. Children and elderly are also at risk so it's important to know their safety at rick when new animals are brought into the home as well. 

Cleveland Clinic. (NA). Cat Scratch Fever. https://my.clevelandclinic.org/health/diseases/23537-cat-scratch-fever

Klotz, S., Ianas, V., & Elliott, S. (2011, January 15). STEPHEN A. KLOTZ, MD, VOICHITA IANAS,. Cat-scratch Disease. https://www.aafp.org/pubs/afp/issues/2011/0115/p152.html

Zhou, T., Zheng, Y., Zhang, H., & Liu, Y. (2024, January 14). A case report of diagnosis of cat-scratch disease using metagenomic next-generation sequencing. Frontiers. https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1322651/full

Ketamine for Treatment Resistant Depression

When I first heard about Ketamine as a potential option for treatment resistant major depressive disorder, I was shocked. I first heard about ketamine as a an anesthetic that had psychoactive and hallucinogenic properties. I had never imagined it as being a real and viable treatment option for depression. Esketamine, a nasal spray consisting of the S enantiomer of ketamine, has been FDA approved in the treatment for treatment resistant depression. Tt is often associated with high efficacy under the careful dosage and supervision of a psychiatrist.

A ketamine trial consisting of 25 individuals affected by major depression, were given an IV injection of ketamine hydrochloride (Mandal et al., 2019). The dosage was given right below the anesthetic dose at 0.5 mg/kg. The patients baselines were recorded before the treatment, one hour after treatment, after 2 weeks, and then after 1 month of treatment. This study concluded that patients had a significant rapid improvement of depressive symptoms, after ketamine treatment.

Ketamine treatment may be a fast and a seemingly efficient treatment for depression. Depression is truly an serious and can be a lifelong disease, but hope must never be lost when fighting against it. More research still needs to be done on how Ketamine and its dissociative effects play a role in treating depression. Other drugs such as psilocybin and other psychedelics are being studied to learn about their effectiveness in treating psychiatric disorders. How do you feel about these, once illicit drugs, being used for treatment? Do you feel like the risks outweigh the benefits? This new field opens a very unknown field of consciousness, and there are many ethical concerns about the field. However, I feel like this is still a very good start to discovering our identities and the very essence of being human.

Mandal, S., Sinha, V., & Goyal, N. (2019). Efficacy of ketamine therapy in the treatment of depression. Indian Journal of Psychiatry, 61(5), 480. https://doi.org/10.4103/psychiatry.indianjpsychiatry_484_18

Do Violent Video Games Lead to Increased Aggression ?!

There’s been a long term debate and a lot of buzz about whether playing violent video games really makes people more aggressive. A recent study by Kühn et al. (2018) dives into this topic, and I found it pretty eye-opening.

The researchers looked at how playing a violent game, Grand Theft Auto V, compared to a non-violent game, The Sims 3, over two months affected players' behavior. They divided participants into three groups, one group played the violent game, another played the non-violent game, and the last group didn’t play any games at all. This setup was designed to see if long-term gameplay had any real impact on aggression and other psychological factors.

What’s interesting is that while some earlier studies showed that playing violent games could lead to short bursts of aggressive thoughts, this new research suggests those effects don’t stick around. The researchers found that after two months of gameplay, there were no significant changes in aggression levels among the players. This challenges the idea that violent video games automatically lead to aggressive behavior.

To measure aggression, the study used various tests, including word completion tasks. Surprisingly, most of these tests didn’t show any major differences between the groups. This makes me think that the connection between violent gaming and aggression might not be as clear-cut as we often hear. The study also pointed out that many previous studies focused on short gaming sessions, which might not reflect real-life situations. By looking at longer gameplay, the researchers found that continuous gaming didn’t lead to the expected increases in aggression or negative social interactions.

In the end, this research suggests that while violent video games are often blamed for aggressive behavior, the reality is much more complicated. It's worth considering that potential biases in past studies could have significant ethical implications. If researchers selectively report findings that support the idea that violent games lead to aggression, it can misinform the public. This could lead to unnecessary stigma against gamers. It’s crucial for future research to be transparent and comprehensive to ensure that published work is based on accurate and balanced evidence.

Kühn, S., Kugler, D. T., Schmalen, K., Weichenberger, M., Witt, C., & Gallinat, J. (2018). Does playing violent video games cause aggression? A longitudinal intervention study. Molecular Psychiatry, 24(8), 1220–1234. https://doi.org/10.1038/s41380-018-0031-7 

The Healing Power of Music

I’ve recently been diving into the fascinating world of music therapy, and I’m amazed by its potential to impact mental health. Unlike other music interventions, often led by healthcare professionals, music therapy involves a curative process between patient and therapist and allows individuals to connect with music in a way that feels personal and expressive. It’s all about exploring emotions and finding a voice through sound.

One of the coolest things I’ve learned is how music can really change our mood and behavior. For people dealing with disabilities, injuries, or mental health issues, music therapy offers a unique way to communicate feelings that might be hard to put into words. It’s like music speaks a language of its own, breaking down barriers and helping people express themselves. However, it's not just about feelings, as there are some impressive physiological benefits too. Research shows that engaging with music can improve heart rate, motor skills, and even boost our immune system. When we listen to or create music, our brains release dopamine, the “feel-good” chemical. This not only lifts our spirits but also contributes to our overall health.

Of course, it’s important to remember that not all music has a positive effect. Some studies point out that certain lyrics, especially those that are misogynistic, can lead to aggressive behavior in men toward women. This really highlights how crucial it is to choose the right music in therapy settings. Music therapy can be applied in so many different environments, from hospitals to community centers. Whether it’s in a group setting or one-on-one, the use of music can create a supportive space for healing and self-exploration.

Overall, music therapy is a powerful approach to mental health that combines emotional expression with real physiological benefits. As I continue to learn more about the connection between music and health, it’s clear that music is more than just entertainment…it’s a vital tool for enhancing our mental and physical well-being.

Rebecchini, L. (2021). Music, mental health, and immunity. Brain, Behavior, & Immunity - Health, 18, 100374. https://doi.org/10.1016/j.bbih.2021.100374 

Diabetic Neuropathy 101

 Burning, stabbing, shooting pain are all common symptoms of someone with DPN or Diabetic peripheral neuropathy. Having DPN can significantly impact ones daily activities and lifestyle. DPN is a complication of diabetes which is presented in many different forms and often being referred as diabetic sciatic pain. Diabetes affects over 11% of the US population and of which over 40% develop DPN. Being that this disease is so prevalent within our society and community it is essential to understand what preventative measures or treatments are available for those within our communities. 

This study focuses on manual therapy and exercises with a focus on lower limbs of patients with DPN. Various different intervention methods were used such as aerobics or gait training all of which encompass the idea of exercises for patients with limited mobility or limited impact. Pedro scale was used to help determine the results of the study of which it was found that after 12 weeks of exercise various nerves such as the motor tibial or peroneal nerve have improved the neuropathic conduction velocity. Patients described this as lower frequency of pain and or discomfort. In this study it is important to note that along with the change in exercise patterns overall lifestyle and diet changes were also made. 

While working at my local clinic I was fortunate enough to work with a patient with DPN. This patient had been experiencing these pains for years before being diagnosed with diabetes. Multiple different medications were tried, none with much success. I found myself working with this patient once again at this summer's internship at a Physical therapy clinic. This patient had significant weight loss 250lb to under 200lb. I learned that with the weight loss and exercise treatments he had been receiving he has felt a significant decrease in the frequency of his DPN pain. He explained that when he would take a traditional exercise route of walking or weight lifting he would experience sharp pain especially after working. Via water aerobics he was able to decrease the impact on his joints and feet resulting in a decrease in pain frequency. 

This study had many confounding variables which was further highlighted with my patient in which many of these studies do not account for variables such as economic status or lifestyle. I questioned about, How these studies cater more to the main population affected while also taking into account the various lifestyles and limitations? It essential to explore more deeply into these differences in order to be able to better help various communities. 

Sharma, Jyoti, et al. “Effects of exercises and manual therapy on nerve conduction studies of lower limb in patients with diabetes and diabetic peripheral neuropathy: A systematic review.” International Journal of Diabetes in Developing Countries, vol. 44, no. 2, 23 Oct. 2023, pp. 241–264, https://doi.org/10.1007/s13410-023-01258-5.

Are We Making Vegetables Less Healthy?

    In a previous class, I designed a study to determine if glyphosate, one of the most common herbicides used, had negative effects on pollinators. The herbicide should, theoretically, be harmless, as it inhibits 5-enolpyruvylshikimate-3-phosphate synthase, an enzyme not found in animals. During my research, however, I found numerous studies that showed bees exhibited negative side effects when exposed to glyphosate. But what about humans? Everyone reading this likely has some glyphosate in their body right now. 79 million kg of glyphosate were sprayed in 2014 alone, and one study found that most people have 0.16-7.6µg/L in their urine. Should we be concerned about this? These questions led me dig into the literature on the potential harm glyphosate-based herbicides (GBH) could have on humans; the results were frightening

    Glyphosate has been shown to disrupt and/or damage numerous physiological systems, including reproductive, endocrine, and digestive functions. Exposure to GBH has been linked to higher rates of miscarriage and birth defects, and studies have shown GBH exposure inhibits estrogen production. A study on mice also found a reduction of testosterone when exposed to nontoxic levels of glyphosate. GBHs also likely have adverse effects on the liver, with one study finding liver lesions on trout exposed to GBH, and another study found that rats developed heavier livers and abnormal glycogen storage when exposed to glyphosate. Concerning its cancer-causing risks, its effects are still unclear, however, it is worth noting that the International Agency for Research on Cancer has labeled glyphosate as “probably carcinogenic.”

    These adverse effects raise the ethical question of how we ought to regulate agriculture. It’s important to remember that so much glyphosate is used because of its effectiveness, but does this out way the health risks? As someone who is not a farmer, I don’t think I’m in a position to make a definitive condemnation, but if something is “probably carcinogenic” then I would prefer if it weren’t sprayed all over my food.

Source

Peillex, C., & Pelletier, M. (2020). The impact and toxicity of glyphosate and glyphosate-based   herbicides on health and immunity. Journal of immunotoxicology, 17(1), 163–174.                       https://doi.org/10.1080/1547691X.2020.1804492

THE STRESS HORMONE OF CORTISOL RELATED TO AUTISM SPECTRUM DISORDER ( ASD)

A few months ago, I became personally aware of Autism Spectrum Disorder (ASD) in a way that completely changed my understanding of the condition. A close friend of mine has a 7-year-old son whom we always thought was just a slow talker. We never considered that he might have ASD. It wasn’t until we went through a series of tests and the doctor diagnosed him with ASD that I was left asking, "What is that?" This moment led me to do some deep research, and I quickly realized how complex and misunderstood this condition is.

ASD is a disorder caused by communication and social interaction and it can possibly lead to misinteraction of their behavior and ASD is caused by how the body process of stress and their system we can know as HPA axis.

    - HPA axis is important to regulation the body response to stress, and it is encounter in a stressful situation cause the hormone response and lead to release of cortisol and know as stress hormone. Cortisol is help to prepare the body challenge , energy and focus.

How ever people with ASD , their body response to stress and particularly regulation of cortisol can be discrup . Children with ASD often have heightened stress responses, meaning their HPA axis is more sensitive to stressors. This can cause them to experience more intense stress and anxiety, which can, in turn, lead to difficulties in coping with new or social situations. This abnormal cortisol regulation is one of the reasons why children with ASD might struggle with stress management. The presence of high or poorly regulated cortisol levels over time can also have long-term impacts on both mental and physical health. It’s a complex interaction between stress, the brain, and the body that makes ASD particularly challenging to manage,Understanding the relationship between cortisol and ASD has been eye-opening for me. By acknowledging the stress-related challenges these children face, we can better support them through strategies that address anxiety and stress.

I hope there will be more research and study is will able to better treat this disease for future outcome

References :

Corbett, B. A., & Simon, D. (2014). Adolescence, Stress and Cortisol in Autism Spectrum Disorders. OA autism, 1(1), 2.

Be Proud of Yourselves

 Well, guys, this is the end of a great semester, with a great teacher such as Dr. Campisi, I believe we all will do well in the final exam and will achieve great things in the future. We will all graduate despite any hardships we may face, and will find success in the outside world. When we are confident we can do anything, self-esteem can help us cope with stressful events and by building self-confidence we can turn dangerous chronic stress into acute stress events that have no impact on our daily lives. We are rangers, and we will perform a colonoscopy with our boots on this next exam cause we are just that awesome. Don't stress, you will not remember this exam score in the next two years when you're on your private yacht basking in success.

Best of luck to everyone

-Drew

Watch Out Pregnant Vegans!

When I was born I had Jaundice, and after numerous attempts to cure my Jaundice, it still persisted. Eventually, it was revealed that one of the supplements my mother was taking was the cause of my condition, and after she stopped taking it, my Jaundice cleared up. This story reminds me of the important effects a mother’s diet has on her child, both during pregnancy and while breastfeeding. One population of women that should especially monitor this is vegans. With veganism being increasingly popular today, I think it is worth examining how eliminating animal products from a mother’s diet can affect her child.

Contrary to my own experience, vegan mothers should likely supplement their diet during pregnancy and while breastfeeding. Specifically, vegans should optimize their diet and supplementation for vitamin D, choline, calcium, iron, protein, and omega-3 fatty acids. These nutrients are often found in animal-derived foods, and a lack of them can result in numerous complications during pregnancy. Some of the most severe complications include permanent organ malfunction due to the fetus having iron-deficient tissues, or neural abnormalities due to a lack of choline, which is linked to stem cell proliferation during development. These negative effects are the extremes, but they illustrate that vegan women must take extra nutritional precautions.

These complications aren’t to say that veganism is necessarily bad for fetal development; with proper supplementation, it may have some benefits. Vegan diets have been shown to reduce the risk of gestational diabetes, hypertension, and prevent mothers from gaining an unhealthy amount of weight during pregnancy. Some studies even suggest that children of vegan mothers have higher IQ scores, however, the evidence is not clear on this and it could be a correlation rather than a causation.

With so many new diet trends and social media gurus, medical providers and scientists must help the public cut through the nonsense and showcase the evidence. This is especially evident when pregnant women are taken into account, as poor advice could affect not only their health but also their children’s development. Veganism mothers should be advised that with careful supplementation and diet structure, they can maintain their non-animal product lifestyles and have a healthy baby.

Source

Palma, O., Jallah, J. K., Mahakalkar, M. G., & Mendhe, D. M. (2023). The Effects of                             Vegan Diet on Fetus and Maternal Health: A Review. Cureus, 15(10), e47971.                                  https://doi.org/10.7759/cureus.47971

Deliciously Deadly- Fugu

Fugu also known as pufferfish is an eastern delicacy. While portions of puffer fish can be consumed when handled by those with a fugu license, there are deadly consequences for any incorrect cuts or handling of the fish causing the leaching of the neurotoxin tetrodotoxin.

So how does tetrodotoxin (TTX) work? 

TTX competitively inhibits voltage-gated sodium channels which stops the production and dispersion of action potentials. This is a huge issue for many cells in the body, most importantly neurons and muscle cells. TTX is dose dependent meaning there is some leeway in how much a person can consume but really only one to two mg of TTX can be lethal to adults.

Symptoms- Initially just tingling and numbness around the mouth, salivation, nausea, vomiting and lethargy. Due to the total loss of function in sodium channels some more severe effects are done to the lungs. Paralysis of the lungs and diaphragm inhibit the creation of the pressure gradient which essentially stops the patient from breathing leading to death. On the same token when the heart is subjected to TTX the patient presents with bradycardia and hypotension yet total paralysis of the heart was not mentioned. The blood brain barrier also offers some protection because patients have been completely conscious while paralyzed in mild cases. 

Treatment revolves around treating the patients paralysis of the lungs. Quick ventilation intravenous fluids and vasopressors are used to eliminate TTX and some cases use cholinesterase inhibitors. 

Current TTX Research

Interestingly enough TTX has been seen as a possible analgesic (pain relief medication that does not cause loss of consciousness in patients) for cancer related pain. A meta analysis of varying studies using TTX found that it could reduce cancer-related pain without producing serious adverse events in patients.

A dose of just 30 micro grams twice a day significantly increased the

number of patients who achieved an improvement in pain intensity versus the placebo group. Additionally, 47% maintained persistent relief of cancer pain that was present during successive treatment cycles without any evidence of tolerance.

Nearly all adverse effects of TTX at this dosage were considered mild or moderate, with sensory alterations and gastrointestinal issues being the most common. No deaths were reported in treatment groups. 

As previously mentioned, the heart did not fully stop as a symptom which is due to Nav1.5 isoform, which from what I gather is a specific channel, being TTX-resistant. Nav1.5 maintains the heart's upstroke of action potential in the heart as they worded it which means no patient cardiac failure. 

This research, while intimidating given it is a neurotoxin, is a tremendous step forward because cancer pains are so complex and really debilitating for patients if it works for even a few people then its worth pursuing personally.

References

Huerta, M., De La Nava, J., Artacho-Cordón, A., & Nieto, F. (2023, May 21). Efficacy and security of tetrodotoxin in the treatment of cancer-related pain: Systematic review and meta-analysis. MDPI. https://www.mdpi.com/1660-3397/21/5/316

Kheifets, J., Rozhavsky, B., Girsh Solomonovich, Z., Marianna, R., & Soroksky, A. (2012). Severe tetrodotoxin poisoning after consumption of lagocephalus sceleratus (pufferfish, fugu) fished in Mediterranean Sea, treated with cholinesterase inhibitor. U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010039/

Mirror Neurons!

    The discovery of mirror neurons has allowed for a new way of understanding the relationship between cognition and actions. In a recent review, "Mirror neurons and their relationship with neurodegenerative disorders" by Farina et al, looked further into the mechanisms of these mirror neurons when it came to neurodegenerative diseases. 

    Traditionally, it was thought that functions such as cognition, perception, and any type of execution are separate, however, with the discovery of mirror neurons, it can be seen that actually these functions might not be separated but rather are associated using mirror neurons. It has also been shown that the motor and cognitive symptoms that come with many neurodegenerative diseases appear to be associated with each other, and so attempting to look into mirror neurons which also connect such associations, can potentially be used as a therapy for such diseases. 

    What makes mirror neurons particularly interesting is they will activate when you carry out an action but they will also activate when you see someone else carry out that same action. These type of neurons were first seen in monkeys are researches were recording from neurons in the ventral premotor area and the inferior parietal lobe. They noted that these neurons were activate when a monkey saw another monkey grabbing a cup or even during chewing motions. That neuron would also fire when the monkey was carrying that particular action themself. In another study done on monkeys, an interesting observation was made where mirror neurons might also be involved with other cognitive functions such as determining intentions as they can incorporate actions with conditions and ultimately associate them. They noted that this might be done as a form of trying to understand other behaviors and finding a way to response to those observed behaviors. 

    Mirror neurons have also been observed in humans using fMRI (functional magnetic resonance imaging) imaging and EEG (electroencephalography) recordings. In humans, mirror neurons are typically seen in the premotor cortex, primary motor cortex, and the hippocampus. The mechanisms of neuronal activation when a perceived grabbing action is observed, is also seen in humans. In fact, in some EEG recordings, it has been shown that the mirror neuron mechanism is linked to a suppression of micro rhythms that were seen when someone observed someone else carry out an action. As it was noted in monkeys, mirror neurons can be used when recognizing actions, interpretation, and also when it comes to learning motor skills. This was particularly done by having participants, who have never played the guitar before, watch a video a tutorial on how to play certain chords. The video was then paused and the participants had to play what was just shown in the video. Researchers found there to be an activation of the mirror neurons when this was done. Mirror neurons have also been shown to be involved in functions such as language and even memory since these functions come from actions themselves. 

    When it comes to mirror neurons and neurodegenerative diseases, there is slightly more information with regards to Parkinson's disease. As is known, Parkinson's disease involves the degeneration of dopamine neurons in the substantia nigra which lead to motor deficits and even changes in behaviors. When it comes of mirror neurons, their functions seem to be disrupted with the degeneration of pathways in Parkinson's disease. However, there have also been studies to show that if mirror neurons are stimulated, it can help with some functions carried out by these neurons like motor skills and cognition. When it comes to neurodegenerative diseases such as frontotemporal dementia and amyotrophic lateral sclerosis, it has been thought that mirror neurons take on mostly motor functions, and the language decline that is typical of these diseases can be explained as the mirror neurons are also decaying. With regards to Alzheimers' disease and mild cognitive impairment, there is still more research that needs to be done to investigate mirror neurons. There are some potential treatments that can target mirror neurons when it comes to neurodegenerative disease such as AOT (action observation training) which can help in motor and cognitive functions and even memory. However, this might only be a temporary solution as the diseases would still progress. 

    Overall, mirror neurons have been shown to be involved in varying functions which include those of learning, motor, and cognitive functions. Although there is still more research that needs to be done regarding some neurodegenerative disease and mirror neurons the information that is already known can point to another way of understanding higher level functions and learning motor functions. 

Reference:

Farina E,  Borgnis F,  Pozzo T.  Mirror neurons and their relationship with neurodegenerative disorders. J     Neuro Res.  2020; 98: 1070–1094. https://doi-    org.dml.regis.edu/10.1002/jnr.24579